Improve Access to Immunizations

Vaccinations are important, safe, and effective. They defend our families, our community, and our economy from infectious diseases. The COVID-19 pandemic clearly illustrates what can happen when a vaccine does not exist to ward off a deadly infectious disease.  

Research shows a supermajority of Texans – all parties, genders, and ages – support mandatory school vaccination. However, more children than ever are not getting vaccinated before entering school. Nonmedical school vaccine exemptions in Texas have tripled since 2010-11.[1] School campuses also are inconsistently enforcing the “no shots, no school” law, which states a school must exclude students from attendance if they are missing one or more required vaccinations and don’t receive them in the specified timeframe.   

As more children in Texas go unvaccinated, the risk grows for a vaccine-preventable disease outbreak, like measles. Outbreaks, as we are seeing in COVID-19, have a cost and impact on our communities and economy.  

Stay-at-home orders and interruptions in regular well-child checks due to COVID-19 prevented many parents from getting their child vaccinated this year. In the first few months of 2020, the amount of vaccine ordered and number of vaccines administered through the Texas Vaccines for Children (TVFC) program decreased in all parts of the state, some areas reporting declines in excess of 40%.[2TVFC provides vaccines for roughly half of all Texas children. 

A vaccine-preventable disease outbreak this fall will push to the brink Texas’ public health systems already straining under the COVID-19 pandemic, at tremendous cost to the state. That’s why TMA is recommending the following actions. 

TMA’s Legislative Recommendations

  • Oppose any efforts to weaken school immunization requirements.
  • Request frequent, detailed, and transparent government reporting of immunization data, including for long-term care facilities.
  • Remove obstacles to campus enforcement of school immunization requirements by ensuring students sent home for missing vaccinations do not count against average daily attendance used to fund campuses.
  • Support funding for a coordinated statewide campaign through a collaboration of physicians, the Texas Health and Human Services Commission, the Texas Department of State Health Services, and Medicaid managed care organizations to encourage families to vaccinate their children.
  • Remove consent barriers to integration of ImmTrac2 with electronic health records, while respecting the right of families and individuals to remove participation.
  • Create access to flu vaccination through the Adult Safety Net program.  

Download the Texas Public Health Coalition's legislative one pager on Improving Access to Immunizations.


[1] Annual Survey of Immunization Status, Texas Department of State Health Services Immunization Unit. 

[2] Preliminary Report – Impacts of COVID-19 on Routine Childhood Vaccination Utilization in Texas, Texas Department of State Health Services (May 2019). 

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Last Updated On

March 01, 2021

Originally Published On

December 03, 2020