TMA Testimony by Mai Duong, MD
Senate Health and Human Services Committee
Senate Bill 329 by Sen. Kel Seliger
Testimony submitted on behalf of:
- Texas Pediatric Society
- Texas Medical Association
- Texas Academy of Family Physicians
- Texas Public Health Coalition
April 23, 2019
Good afternoon, Chair Kolkhorst and Committee Members,
My name is Dr. Mai Duong, and I am here today to speak in support of Senate Bill 329 by Senator Seliger on behalf of the Texas Pediatric Society, Texas Medical Association, and Texas Academy of Family Physicians, and the more than 30 member organizations of the Texas Public Health Coalition. I am a general pediatrician and chief of pediatrics at Austin Regional Clinic.
Despite the availability of immunization to prevent the spread of infectious disease, pockets of under-vaccinated communities can lead to outbreaks.
As you know, there has been much public debate about the issue of vaccine exemptions over the past few years – first after the significant measles outbreak at Disneyland in 2015 and now with up to 15 cases of measles in our state and 555 across the U.S. We are not here today to debate the right of anyone to obtain an exemption. Instead, physicians support SB 329 because it will increase public awareness of the state’s infectious disease trends and alert parents 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 children 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 we work to prevent are serious, and under-immunized or unimmunized individuals create a potential for outbreaks of disease.
SB 329 empowers the public with information related to outbreaks and exemptions in their communities.
We support the requirement in SB 329 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 of emerging or reemerging 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 rely only on anecdotal information from our physician colleagues to learn of infectious disease or foodborne outbreaks in our community. We believe stronger state-level reporting also will encourage more quality and timely monitoring and reporting from local areas.
SB 329 also will 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 personal-belief vaccination exemptions since the legislature first created that exemption in 2003. More than 58,000 children have been opted out of vaccinations across our state. This 20-fold 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 that limit their ability to receive vaccination.
Families whose children are immunocompromised need actionable data to protect their children from infectious disease.
Many of my patients have complex medical conditions that do not allow them to receive vaccinations. For instance, patients who are diagnosed with leukemia go through numerous surgical procedures and daily chemotherapy to save their life. But this also weakens their immune system. During the intense phases of their chemotherapy treatments, patients may have to be isolated at home to limit exposure to infections. Even simple viruses can require emergency department visits and hospital admissions for days at a time because these children’s bodies would not be strong enough to fight them off.
Even in remission, children with leukemia are on lower doses of maintenance chemotherapy. It takes months before their immune system fully recovers from the effects of the chemotherapy. Until then, these children cannot be fully vaccinated. When they enter kindergarten, it’s important for their parents to have the information available to make informed decisions on enrollment. Herd immunity is less effective when unimmunized children are clustered together, and it’s important to know if there are safer options for a child within the district. Public school should not be a dangerous place for immunocompromised children. These 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. SB 329 will allow these families to make informed decisions that will keep their children safe.
We thank Senator Seliger for his work in identifying strong public health policies to better inform the public, parents, and physicians. We urge you to support Senate Bill 329, and thank you for your time.
86th Texas Legislature Letters and Testimonies
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