Parents Have a Right to Know

House Public Health Committee 
House Bill 2249 by Rep. J.D. Sheffield, DO 
Testimony by Lisa Pomeroy, MD 
April 11, 2017 

Testimony submitted on behalf of: 
Texas Pediatric Society 
Texas Medical Association  
Texas Public Health Coalition 


Good morning, Chairman Price and distinguished members,

My name is Dr. Lisa Pomeroy and I am here today to speak in support of House Bill 2249 by Representative J.D. Sheffield on behalf of the Texas Pediatric Society, the Texas Medical Association and the more than 30 member organizations of the Texas Public Health Coalition. I am a general pediatrician from Lubbock, but most importantly, I am the mother of a five-year-old daughter recovering from leukemia.

Despite the availability of immunization to prevent the spread of infectious disease, pockets of undervaccinated communities can lead to outbreaks

As you know there has been much public debate over the issue of vaccine exemptions over the past few years after the significant measles outbreak in Disneyland and several outbreaks of mumps in school districts across our state.  We are not here today to debate the right of anyone to obtain an exemption. Instead, physicians support HB 2249 because it will increase public awareness of the state’ infectious disease trends and alert parent’s to the infectious disease threats their children may face in the schools they choose to attend.

As a pediatrician, I am entrusted by parents to help protect their child’s health because they are often the most vulnerable to diseases and environmental threats. Providing access to immunizations for vaccine preventable diseases is a priority of every physician caring for a child. And thanks to public health and medicine working together, vaccine preventable diseases are at or near record lows. But the diseases that we work to prevent are serious and under-immunized or unimmunized individuals create a potential for outbreaks of disease.

HB 2249 empowers the public with information related to outbreaks and exemptions in their communities

We support the requirement in HB 2249 for the Department of State Health Services to complete more comprehensive epidemiological reports of disease outbreaks including the incidence of vaccine preventable diseases. We have found that other states’ health departments have been able to provide the public and health care professionals timely information on vaccine preventable outbreaks by geographic area. This is not information parents, physicians, or others can routinely access in Texas. We believe increasing the public’s awareness of preventable diseases, and also of emerging or re-emerging diseases, would be extremely valuable. While some of us fortunately reside in areas with the benefit of strong reporting from our local health department, many physicians can only rely on anecdotal information from our physician colleagues to learn of infectious disease or foodborne outbreaks in our community. We believe stronger state-level reporting will also encourage more quality and timely monitoring and reporting from local areas.

HB 2249 will also require stronger public reporting of immunization exemptions. We recognize the need for immunization exemptions for medical contraindications (as identified by the Centers for Disease Control and Prevention), but there has been a significant increase in conscientious vaccination exemptions since 2003 in our state. This increase makes it even more critical that parents and the community be readily informed of conscientious vaccination objections on their school campuses. This is especially true for parents of children with auto-immune deficiencies or diseases which limit their ability to receive vaccination.

Not only am I a pediatrician, but I am a parent of an immunocompromised child who has the right to know if my child is at risk of contracting an infectious disease

My daughter, Zoe, was diagnosed with leukemia 3 years ago when she was only 2 years old. As a toddler, she went through numerous surgical procedures and spent many scheduled days in the hospital when she was first diagnosed. The daily chemotherapy she received to save her life weakened her immune system. She was bald, weak, and unable to fight off illnesses on her own. During the most intense phases of her chemotherapy treatments, she had to be isolated at home in order to limit her exposure to infections. Even simple viruses would require ER visits and hospital admissions for days at a time because her body was not strong enough to fight them off.

Zoe’s cancer is in remission now and when she was started on lower doses of maintenance chemotherapy, she begged to go back to daycare so she could play with her friends again. My husband and I were still hesitant to expose her to a lot of children because her vaccines have been on hold since her cancer diagnosis, but as pediatricians, we also understood how important these social interactions are for her development. We met with her day care director who was able to tell us that they have a 100% vaccination rate with one medical exemption for the varicella vaccine. This was incredibly valuable information regarding the herd immunity at the campus and allowed us to make an informed decision about returning her to her daycare setting. 

Zoe recently took her last dose of chemotherapy, which is exciting, but it will be months before her immune system fully recovers from the effects of the chemotherapy. Until then, she cannot be fully vaccinated. She also just turned 5 years old and will be entering kindergarten this upcoming school year. At kindergarten registration, another mom announced that her family “doesn’t do vaccines” for personal reasons and will be turning in exemption paperwork for her child. I am worried about how many other children will be unvaccinated at my daughter’s school. Herd immunity is less effective when unimmunized children are clustered together and I do not know if I am placing my daughter at risk by sending her to that school nor do I know if there are safer options for her within the district.

Public school should not be a dangerous place to send my daughter. As a pediatrician, I also worry about many other children whom I take care of and are under vaccinated due to serious medical conditions. Their parents should have access to information regarding the vaccine rates at their children’s school campus without having to request it from every school in the district. HB 2249 will allow us, and families in similar situations, to make informed decisions that will keep our children safe.

While we have a good process for school district reporting on vaccination exemptions, this information is only available at a district level, which is of limited benefit to me when evaluating our schooling options. Parents must be able to make informed decisions so they know what they may have to do to protect their children in the event of a school-based infectious disease outbreak. These reports will give us the tools so we can be best informed, and will also enable the public health community and physicians to respond in the event of an outbreak.  

We thank Dr. Sheffield for his work in identifying strong public health policies to inform the public, parents, and physicians on how we can all be better informed. We urge you to support House Bill 2249 and thank you for your time.

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Last Updated On

April 24, 2018

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