Testimony by Kimberly Avila Edwards, MD
House Public Health Committee
House Bill 465 by Rep. Donna Howard
March 3, 2015
Good morning, Madame Chair and distinguished members. My name is Dr. Kimberly Avila Edwards. I am here today to speak in support of House Bill 465 by Representative Donna Howard. I am a pediatrician at Austin Regional Clinic, a member of the Texas Medical Association’s Council on Science and Public Health, and past president of the Texas Pediatric Society. I am here today on behalf of TMA, TPS, and the 30 organizations that are part of the Texas Public Health Coalition.
As a pediatrician, giving vaccines is one of the most important services I provide my patients. Ensuring children are immunized at the appropriate times to protect them from dangerous, vaccine-preventable disease is imperative. And, keeping a record of those vaccinations for school entry and public health emergencies, and to avoid duplicating immunizations is an important part of that process. Our state immunization registry, ImmTrac, is a critical component of our public health system and is necessary for keeping kids healthy. For about 15 years, Texas physicians have been working with the state health department to improve the registry for easier use and to ensure children’s vaccinations were in the registry. Most of my patients recognize the benefits of ImmTrac. The confidential, computerized registry maintains my patients’ immunization record, which can be accessed by their doctor(s), child care center, or school nurse. Having a dependable vaccination record ensures patients are appropriately immunized, especially because the recommended immunization schedule is complex and our patients may move among different physicians.
The good news is that more than 90-95 percent of Texans choose to include their records in ImmTrac. I use and depend on ImmTrac on a daily basis to keep my patients healthy. Moving to an “opt-out” system of consent means providers can advise families their vaccination information will be entered into ImmTrac unless they specifically choose not to participate. My staff and I would be required to process forms and provide documentation for only the small subset of the population who declines to consent—between 5 and 10 percent of our patients. Contrast this to the current “opt-in” system, which requires documentation of consent for almost 93 percent of those we immunize. Alleviating administrative burdens under an opt-out system would free up staff time for more appropriate patient-care activities and would ensure we more efficiently document immunizations to support the state’s public health infrastructure.
An opt-out system helps ensure our children’s immunization records stay safe as they transition into adulthood. Currently these critical records are deleted at age 18, despite the parents’ original intention of creating the immunization record. Under the current system, an adult’s childhood records will NOT be available when the adult enrolls in college or applies for a job and needs to show proof of immunizations.
To promote system efficiencies, moving to an opt-out consent process makes sense. We absolutely respect the right of Texans to keep their records out of the registry, and will gladly continue to offer that as an option. The only difference we will see by moving to an opt-out system is that we will be completing the paper work for a much smaller segment of the population, which will save time and money for patients, physicians, and our Department of State Health Services. It is time we move to a system that suits the needs of the vast majority of our population and adopt an administrative process that allows us to more effectively and efficiently direct our limited resources to patient care. We urge you to support House Bill 465. Thank you for your time.
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