THE RIGHT TO KNOW For some children, refraining from vaccinations is a choice their parents make. For others, it’s a necessity. That’s a distinction that Rep. J.D. Sheffi eld, DO (R-Gatesville), says many people don’t make when looking at the issue of im- munizations and reporting data on exemptions. “There are kids in our public schoolrooms today who
have [an] immunocompromised state or chronic conditions that make it harder for them to fi ght off infections and/or recover from infections,” Dr. Sheffi eld said in January, just before the beginning of this year’s session. “That’s some- thing most people have not thought of unless that’s one of their children, or they know a child [in] that condition.” DSHS culls its annual immunization report from a sur-
vey the department currently mails to about 1,240 inde- pendent school districts and 890 private schools. The re- port displays district-wide immunization coverage levels for students entering kindergarten and for seventh-grad- ers. Those annual reports, and coverage maps displaying district-level immunization data, are available at www
.dshs.texas.gov/immunize/coverage/schools. Dr. Terk says parents of children who are vulnerable to
disease have an interest in knowing which schools would pose the greatest risk. “If your child is going to a school where 8 percent of
the students have signed personal-belief exemptions, that would potentially raise a greater concern than if you were going to a school where 2 percent had signed personal- belief exemptions,” he said. At press time, a bill had not been fi led representing an-
other try at campus-level vaccine reporting, but TMA was working with Representative Sheffi eld and Sen. Kel Seli- ger (R-Amarillo) to fi le and support such a measure. Two years ago, Representative Sheffi eld and others gave it a try, backing House Bill 2474 to mandate the availability of each campus’ required annual immunization report on the DSHS website. Upon request, under the bill, a student’s parent or guardian could have obtained from the school:
•
Immunization rates at the campus disaggregated by type of vaccine;
• De-identifi ed exemption information; • The number of students provisionally enrolled pending immunization documentation;
• The number of students claiming reasons-of-con- science exemptions;
• The number of students claiming exemptions for a medical reason; and
• The number of students whose vaccinations aren’t current.
The bill ultimately passed 98-40 in the House but
stalled after referral to the Senate Committee on Health and Human Services.
EXEMPTIONS ON THE RISE
Although the state’s Annual Report of Immunization Status shows an overwhelming majority of Texas school students in kindergarten through grade 12 are completely vaccinated, it also shows the number of nonmedical exemptions is on the rise, now numbering nearly 45,000 exemptions. The Texas Department of State Health Services compiles the numbers from an annual survey of independent school districts and accredited private schools.
Year
2012–13 2013–14 2014–15 2015–16
Nonmedical Exemptions
32,616 38,197 40,997 44,716
Percentage of Students in Survey
0.64 0.75 0.79 0.84
“You had to have people with an open mind to under-
stand it,” Representative Sheffi eld said. “And for some people who are on the opposite side on this issue, any- thing that could’ve been seen as promoting vaccines is something they’ll be against. There [were] some incorrect assumptions and knowledge about this bill.” Comments on the House fl oor during debate over HB
2474 revealed the thinking driving lawmakers who op- posed more localized exemption reporting. For example, Rep. Bill Zedler (R-Arlington) invoked “peer pressure” as a motivation for the bill and referenced a potential bully- ing “witch hunt” resulting from nonmedical exemptions. “The State of Texas will not force you to get a vaccine,
but you know what? Peer pressure will,” Representative Zedler said on the House fl oor. “The fact of the matter is, if your child is bullied into this, then guess what? That is a way to get people to get vaccinated beyond their real desires. So the fact of the matter is … now don’t get me wrong, when these people came before our committee, yes, they came to us with a guise that this was going to give information to parents. We now know the truth, right here.”
March 2017 TEXAS MEDICINE 27
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