Testimony: Committee Substitute for Senate Bill 1177
House Public Health Committee
By: Erica Swegler, MD
May 18, 2011
Chair Kolkhorst and members of the committee, it is a privilege for me to speak with you today in support of the committee substitute for Senate Bill 1177 on behalf of the Texas Medical Association (TMA), the Texas Pediatric Society, and the Texas Academy of Family Physicians (TAFP), which represent nearly 48,000 physicians and medical students in our state.
My name is Erica Swegler, MD. I am board certified in family medicine. I am in private practice, and I care for patients in Keller, Texas. I am the chair of TMA’s Committee on Infectious Diseases and an active member of TAFP. I also serve on the Texas Council on Cardiovascular Disease and Stroke.
First I want to thank you for your great support over the years for improving Texas’ ability to immunize children across Texas. It has made a difference. We believe vaccination is one of the most effective things we can do to keep our children, ourselves, and our community healthy.
Most of us think we are protected from infectious diseases by vaccinating our young children. However, as we reach adulthood, many of us don’t get vaccinated again, except for an occasional tetanus shot. We are learning much more about the waning immunity of adults, and how this puts adults at increased risk of getting sick and also spreading disease. Waning immunity could become a public health threat, especially in environments with children or other people at risk of serious illness, such as child care centers, preschools, and hospitals.
Health care workers, especially those who are not immunized against influenza and other preventable diseases, may unknowingly spread these diseases to the patients in their care. In fact, this is a significant problem — so much so that national and international organizations, as well as organized medicine including TMA, have adopted strong policies calling for physicians and other health care workers to be vaccinated routinely. This includes the American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics, Infectious Diseases Society of America, and Society for Healthcare Epidemiology of America.
Numerous published medical studies show that when health care workers are immunized, patient mortality is reduced almost by half. Additionally, evidence shows that preventing influenza reduces patient hospitalizations and death from heart, chronic lung and kidney disease, and diabetes.
As physicians, we are doing our part by promoting the importance of vaccinations to our staff, coworkers, and other health care workers. But we need your help to make sure each health care facility has strong policies in place to protect patients, health care workers, and their families.
Health care is unique. We can’t have our colleagues, coworkers, and other health care workers going into a health care facility potentially carrying an infectious deadly disease that they can transmit to others. Physicians and other health care workers have an ethical and moral obligation to protect their patients. As a physician in a small town and private practice, I can tell you that we cannot afford to have the patients who come to our office exposed to any disease. Vaccination of all health care workers is a cornerstone of the patient safety program in our office.
Some hospitals and facilities may say this legislation is too complicated to implement. We believe that anything we can do to keep patients safe and healthy deserves the time and commitment. Hospitals and other facilities may need to review the Advisory Committee on Immunization Practices recommendations and develop their own facility policy. We think the policy should state clearly which vaccinations are required and of whom, specify the action employees must take, describe when and who must use protective equipment, and also track why a worker may choose to decline.
There are very few acceptable reasons for an employee to decline a vaccination. Studies show that health care workers often decline to be vaccinated because they believe a vaccine will make them sick. This misconception likely was influenced by fraudulent studies promoted by Andrew Wakefield and others. We firmly believe that a health care worker should be able to decline only if he or she has a documented medical reason or religious belief.
Many hospitals and other facilities already have strong vaccination programs for their employees; this legislation will not have an impact on their current programs.
In closing, I want to thank Senator Nelson and Representative Zerwas for sponsoring this legislation, which will be a giant step for Texas in promoting patient safety in our health facilities. Our health professional associations have worked together on this legislation because we know that vaccinations are one of the most important parts of an infection control and prevention program. And, it is one of the most important actions we can take to keep ourselves healthy, and more importantly, to keep from making those around us sick. This legislation would allow patients and their families to trust that the facility they are going to has been diligent in immunizing its staff.