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Texas legislature continues to weaken vaccine requirements, putting Texans at risk

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The majority of Texans support vaccines. Vaccines stop the spread of disease and save lives. But a vocal minority is actively working on weakening or dismantling vaccine requirements, according to a journal article published in Vaccine: X from Rice University’s Baker Institute for Public Policy and The Immunization Partnership.

Since Louis Pasteur’s successful experiments inoculating against anthrax and rabies in the late 19th century, researchers have found ways to successfully combat numerous dangerous, sometimes lethal, illnesses with vaccinations.

There’s been a 95% decrease in vaccine-preventable disease in the last 50 years. The development of vaccinations is considered one of the greatest public health achievements of the 20th century.

Polio, now eradicated in the United States thanks to widespread vaccine use, paralyzed more than 15,000 people annually in the early 1950s. It reached its peak in 1952, with 20,000 cases, leaving large hospital wards filled with patients on respirators. But In 2022, the first case of polio in New York since 1990 had been detected. According to the New York State Department of Health (NYSDOH) and the Center for Disease Control and Prevention (CDC), the polio virus was not only found in an unvaccinated adult in Rockland County but was also found in several wastewater samples from communities near the adult's residence.

The gains in public health because of widespread immunizations are being threatened by the rise and spread of disinformation about vaccinations. Vaccine hesitancy is considered one of the top health challenges of this decade.

Texas is an ideal case study for understanding how politics impact vaccine bills.

A research team reviewed witness statements from hearings during the 2021 Texas legislative session related to vaccine requirements and information transparency to understand vaccine detractor arguments used to influence policymakers. The authors found five major themes surrounding opposition to vaccines, vaccine requirements or COVID-19 vaccines. Medical freedom as well as vaccine safety and effectiveness were the top concerns of the testimonies, followed by discrimination, informed consent and mistrust of science and scientists.

The data shows that there are myths or misinterpretations of data being perpetuated related to vaccines. For instance, one witness believed that mRNA vaccines were manipulating “the instruction sets that determine how my cells operate.”

To combat this, the authors argue that vaccine advocates and policymakers should work to address the concerns of the vaccine hesitant.

Physicians and health care professionals who support vaccines should consider attending public hearings to refute false claims and misinformation in real time. One of the goals of the anti-vaccine movement is to marginalize discussions about the benefits of vaccinations, explained Kirstin Matthews, fellow in science and technology policy at the Baker Institute. Even when anti-vaccine legislation is presented but does not pass, the rhetoric used influences public distrust, she said.

From 2009-2019, Texas legislators filed 104 vaccine-related bills with 21 bills enacted. The majority of the bills enacted were pro-vaccine, with bipartisan support. These laws passed despite phone and email campaigns and vocal opposition during legislative hearings. These laws increased education and awareness about immunization, expanded access to data, and supported a stronger immunization infrastructure.

Texas lawmakers, however, have not been unaffected by anti-science and anti-vaccination rhetoric and activism. In 2003, a last-minute amendment to an omnibus bill, HB 2292, opened the door to non-medical vaccine exemptions. The passage of that amendment created a broad loophole allowing parents to opt out of school-required vaccines for their children regardless of the reason (outside of medical reasons). In the years since, Texas has experienced year-over-year increases in school vaccine exemption rates. During the 2021-2022 school year, more than 85,000 school-age children in Texas were opted out of school-required vaccines.

Since then, nonmedical vaccine exemptions have continued tohit record levels among Texas schoolchildren even as state lawmakers are preparing to weaken immunization requirements further.

During the 2022-23 school year, 3.24% of Texas kindergartners received an exemption “for reasons of conscience,” which includes religious beliefs, from at least one immunization required to attend school, according todata from the Texas Department of State Health Services. That's almost double the rate from 10 years ago, data shows. Texas is one of 41 states that saw an increase in school vaccine exemptions, which reached a record 3% nationally, according to the Centers for Disease Control and Prevention.

Meanwhile, dozens of bills filed during the 2023 legislative session sought to restrict education and access to vaccines or make the exemption process easier, according to The Immunization Partnership, a Texas nonprofit that advocates for evidence-based vaccine policies. For example, House Bill 44, which was signed into law and took effect in September, threatens to withhold Medicaid funding for physicians who don't offer vaccine exemptions for patients.

The developments are another sign of the post-pandemic momentum behind anti-vaccine messaging, experts say, and threaten to expose Texans to preventable diseases. Childhood vaccinations prevent an estimated 4 million deaths yearly, according to the CDC.

This week The Immunization Partnership is hosting a two-day public health summit in San Antonio which will tackle many issues about Texas’ public health including how to battle disinformation about vaccines.

The Immunization Partnership (TIP), a statewide nonprofit that works to improve the rate of routine immunizations in Texas, is hosting a public health summit called The Intersection, on June 6-7, in San Antonio, to address some of the biggest challenges in Texas.

The event comes at a time when the health landscape is challenged statewide:
The board of Texas’ third-largest school district approved removing core parts of its science curriculum from textbooks, eliminating whole chapters about immunizations, earth science and biology.


Terri Burke is the executive director of The Immunization Partnership.

Rekha Lakshmanan is the chief policy strategist at The Immunization Partnership.

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*This interview will be recorded on Wednesday June 5, 2024.

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David Martin Davies can be reached at dmdavies@tpr.org and on Twitter at @DavidMartinDavi