Talk to Patients About: What’s Wrong With Vaccine Exemptions?
By Sean Price Texas Medicine May 2020

In 2003, the Texas Legislature allowed parents to opt their children out of getting mandatory public school vaccines. Since then, exemptions have jumped more than 3,000%, to 72,743 statewide, according to the Texas Department of State Health Services.

That number of exemptions threatens “herd” or “community” immunity for vaccine-preventable diseases, says Austin pediatrician Ari Brown, MD. Community immunity means people who get vaccinated protect not only themselves but also those around them because a disease has nowhere to spread.

“The more people who choose not to [vaccinate], the less protected we are,” Dr. Brown said.

Community immunity varies from disease to disease. But for measles, it breaks down if about 5% to 7% of a population is unvaccinated. Unfortunately, the unvaccinated rates at 181 Texas private schools already are greater than 5%. Austin’s Waldorf School has an unvaccinated rate of 42% – the highest in Texas.

Public schools report vaccination rates by school district, not individual school campuses. However, 23 school districts have an unvaccinated rate of more than 5%. The Loop Independent School District in the West Texas county of Gaines has the highest rate among public school districts, with 16%.

Schools and school districts with such large numbers of unvaccinated children automatically become potential disease hotspots, according to a 2018 report published by the Public Library of Science. It found that Collin, Harris, Tarrant, and Travis counties in Texas are all vulnerable to disease outbreaks because so many school children are now exempt from vaccination.

When parents are vaccine hesitant, Dr. Brown often explains to them that not getting vaccinated is a lot like not stopping at red lights while driving.

“It’s important to understand that that decision impacts not just you but other people,” she said.


Tex Med. 2020;116(5):47
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Last Updated On

July 08, 2020

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Sean Price


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Sean Price is a reporter for Texas Medicine and Texas Medicine Today. He grew up in Fort Worth and graduated from the University of Texas at Austin. He's worked as an award-winning writer and editor for a variety of national magazine, book, and website publishers in New York and Washington. He's also helped produce Texas-based marketing campaigns designed to promote public health. Sean lives in Austin and enjoys hiking, photography, and spending time with his wife and two sons.

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