Vaccines. Photo by Carlos Reusser Monsalvez via Flickr.
Vaccines. Photo by Carlos Reusser Monsalvez via Flickr.

As legislators, lobbyists, schoolchildren, and tourists wound through the Capitol building Tuesday morning, a group of vaccine advocates from across the state, including San Antonio and as far as El Paso, gathered in a meeting room to map out their strategy.

“Today I think it’s important to show public health members the solidarity in numbers and kind of give them that visual that we have a big group of people here today, who believes this bill is extremely important and we’re asking you to take a vote on the bill as soon as you possibly can and vote it out of committee,” said Rekha Lakshmanan, director of advocacy and policy at The Immunization Partnership, to the group of about 20 people. “I’ve passed out a list of the public health committee members. Those are the members we are going to go visit today.”

Rekha Lakshmanan, director of advocacy and policy of The Immunization Partnership, addresses the group of vaccine advocates gathered at the Texas State Capitol April 18, 2017. Credit: Kathryn Sharkey for the San Antonio Report

It is the third visit to the Capitol this legislative session organized by The Immunization Partnership, a nonprofit organization based in Katy, Texas that aims to eradicate vaccine-preventable diseases by developing and coordinating community resources through public and private partnerships. The group of activists, from several organizations including The Immunization Partnership and grassroots organization Immunize Texas, came to speak to legislators in support of HB 2249, one of several bills addressing immunizations introduced into the House and Senate this session.

“We know there’s a correlation between non-medical [vaccine] exemptions and vaccine-preventable outbreaks in certain geographies and neighborhoods and schools,” Lakshmanan said. “In the past, I’d say 13 to 14 years [ago], the number of non-medical exemptions has increased 19 times. To put that in a percentage, it’s increased – on the conservative side – 1,700%.

“And if you look at it in an aggregated form, people may say, ‘Well, it’s a relatively small number.’ However, if you take one step back and look at the research that these non-medical exemptions cluster, that’s what we’re really, really concerned about.”

HB 2249, also known as the Parents’ Right to Know bill, written by Public Health Committee Vice Chairman J.D. Sheffield (R-59) aims to get more specific information about the location of clusters of children who have not been vaccinated for reasons of conscience or religious belief. Information on these non-medical exemptions would allow parents of children with compromised immune systems to make informed decisions about where to enroll their children in school.

Such children include those undergoing chemotherapy for a childhood cancer, such as leukemia, or those with autoimmune diseases who can’t be vaccinated themselves and rely on what is called herd immunity, which requires a certain percentage of people to be vaccinated to provide adequate protection against disease outbreaks.

“We’re a little bit of a victim of our own success. Because vaccines have been so effective, the diseases seem like they’ve gone away,” said Cherise Rohr-Allegrini, the San Antonio project manager for The Immunization Partnership. “You might choose not to get vaccinated and say, ‘Well, it’s just me that’s being affected,’ but it’s not just you being affected. It’s everybody around you, and that’s why we need vaccines at a community level.”

The bill calls for data, including “the number of students provisionally enrolled pending documentation of immunization, the number of students claiming an exemption for reasons of conscience, including a religious belief, the number of students claiming an exemption for a medical reason, and the number of students whose vaccinations are not current” for school districts and for each school campus in the district, to be submitted in reports from the Texas Education Agency (TEA) and the Department of State Health Services (DSHS) to the Legislature and governor. The data would be made available to the public on the DSHS website. The reports, which would not include any personally identifying data, also would include information about outbreaks of vaccine-preventable diseases in the state.

“They already have the data,” Rohr-Allegrini said. “It’s not going to require any extra money or resources to collect the data. The data’s already collected, but for public schools right now it’s only presented and reported at the district level.”

Because it is only reported at a school district level, parents of an immunocompromised student currently can’t get information about how many unvaccinated children are at their child’s school, Rohr-Allegrini said. The parents have to file an open-records request.

“We’ve seen outbreaks of pertussis in different parts of the state over the past few years. In 2013, there was a measles outbreak at a faith-based community in Fort Worth. Many of those people were unvaccinated,” Lakshmanan said. “So what we’re trying to do is identify ways to ensure our population maintains high vaccination rates, and one way of [doing] that is to have information and better understand what’s happening at a local level and, in the case of House Bill 2249, is giving transparency to parents on their child’s school health.”

In the most recent annual report on immunizations in Texas, 44,716 or 0.84% of school-age children had conscientious exemptions filed on their behalf, an increase from previous years. Texans choosing to get themselves and their children vaccinated are still in the majority at 99%. In Bexar County, there’s been a steady rise in the percentage of students whose parents have filed conscientious objections to vaccines in the past six years.

“San Antonio is actually in pretty good shape for vaccines,” Rohr-Allegrini said. “It’s not just about anti-vaccinators. It’s an access-to-care issue. Those are different issues we need to address at the city level like getting people to the clinic to get their vaccine.”

She said local representatives including State Rep. Diego Bernal (D-123) and State Sen. José Menéndez (D-26) support the immunization legislation.

The Immunization Partnership’s legislation day overlapped with Texas Meningitis Awareness Week. A meningitis vaccine proponent, Jamie Schanbaum, 28, from Austin, joined the group to visit state representatives. She contracted the illness as a freshman at the University of Texas at Austin and was hospitalized for about seven months.

“Within that time, I watched my body basically decay before me,” Schanbaum said. “Because in actuality, I got meningococcal septicemia, and septicemia means in the blood, so it went everywhere.”

Jamie Schanbaum (left) and her mother Patsy stand in front of their display for Texas Meningitis Awareness Week in the Texas State Capitol on April 18, 2017. The display features pictures from photographer Anne Geddes’ collections titled “Protecting Our Tomorrows” and “Win For Meningitis.” Credit: Kathryn Sharkey for the San Antonio Report

Schanbaum lost all of her fingers and both legs below the knee, but said she is lucky to be alive.

“One in 10 people who get meningitis will die,” Schanbaum said. “And those who survive, one in five will have long-term consequences, so that’s amputation or it can lead to blindness, deafness, mental challenges, internal organ failures, and arthritis.”

She helped press for passage in 2009 of the Jamie Schanbaum Act, amended to the Jamie Schanbaum Nicolis Williams Act in 2011, that requires all incoming college freshmen in the state of Texas to be vaccinated for bacterial meningitis.

People who oppose HB2249, most notably from the group Texans for Vaccine Choice, testified in an April 11 hearing about fears that if the bill passes, they will be easily identified and possibly bullied, harassed, shamed, or even receive death threats for not vaccinating their children.

“I’m fairly certain it will go to a House vote, and if it goes to a house vote, it will get voted ‘yes,’” Rohr-Allegrini said. “Our challenge is getting it out of committee, because there are some strong anti-vaccine activists affecting that group.”

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Kathryn Sharkey

Kathryn Sharkey is a freelance journalist based in Austin who focuses on health and science journalism. She graduated from Southern Methodist University with a bachelor's degree in journalism and has worked...