When a recent study named Fort Worth as a "hotspot" for families seeking vaccine exemptions, Terri Andrews was not surprised. As president of the Immunization Collaboration of Tarrant County, she's been watching for years as anti-vaccination efforts have produced an explosion in families opting out of getting shots.
"The people who want these exemptions tend to cluster," she said. "They're people of like mind, and they're in the same social groups. So you've got clusters of kids who are not vaccinated. And then someone travels overseas and comes back, they go to church or the mall, or go to a sports tournament where you've got people from all over."
The resulting outbreaks are predictable, and that's why one of the Immunization Collaboration's two main jobs is to work with campaigns like the Texas Medical Association's Be Wise — ImmunizeSM program to counter anti-vaccine information.
"We always pop up when someone questions vaccines," she said.
The collaboration's other main task is to provide better access to vaccines. August was the group's busiest month. It hosted 23 days of events around the county to help low-income families and those with no health insurance get their back-to-school shots.
Preliminary data show that last month's events helped almost 5,000 people receive 13,000-plus doses of vaccine, Ms. Andrews says. That's about 1,000 more people than in 2017. The group also worked with partners during the spring to provide almost 6,000 vaccines to 2,861 sixth-graders and seniors at in-school events in 2018.
The collaboration's partners comprise more than 40 groups and agencies — including the Tarrant County Medical Society, Tarrant County Medical Society Alliance, Texas Medical Association Foundation, Cook Children’s hospital, the Junior League, the Tarrant County Public Health Department, the University of North Texas Health Science Center at Fort Worth College of Osteopathic Medicine and School of Public Health, area hospitals, and many individuals.
The collaboration started in 1991 to help respond to a local measles outbreak. It managed that successfully and stuck around to fill a county-wide need for more information about and better access to immunizations. There are similar collaborations in cities like Lubbock, but the one in Tarrant County is the largest and arguably the most effective in the state.
"They fill an important role in providing outreach and good support for immunizations in this county," said Jason Terk, MD, a Keller pediatrician who advises the group and sits on TMA’s Be Wise — Immunize Physician Advisory Panel. "They're certainly unburdening the health department of some of the duties they'd otherwise have to do. And I think it's great to have a grassroots organization like that that's supporting immunizations in this county."
At first, the collaboration focused on vaccinations for babies and toddlers, but Ms. Andrews says it expanded to back-to-school vaccinations for older children and adults because there is demand, and it completes the circle to protect younger children.
The vaccines are provided through the Texas Vaccines for Children program and the Adult Safety Net program, with low-cost vaccine-administration fees charged by Tarrant County Public Health in collaboration with ICTC.
The administration fee for eligible children, from infants to 18 years old, is $8 per shot. For eligible adults 19 years and older, shots are $25 each.
"Nobody's turned away," she said.
With the back-to-school vaccine rush mostly over, the collaboration is turning its attention to encouraging flu shots and debunking myths about vaccines. The same study that identified Fort Worth as a vaccination exemption hotspot also singled out Houston, Austin, and Plano as major cities with the same problem. However, Tarrant County also has to contend with the main anti-vaccination group in Texas, Texans for Vaccine Choice, which is located in Keller, just outside Fort Worth.
"The trend for the exemptions is in educated upper middle class folks who are trying to do the best for their babies," she said. "They do internet research, and the first thing they find is [anti-vaccination information]."
Ms. Andrews says using Be Wise — Immunize materials and resources is a huge help in countering that kind of misinformation and showing the need for vaccines.
"It has become the perfect partnership," she said.
To find out more about Be Wise — Immunize, contact Tammy Wishard at (512) 370-1470 or tammy.wishard[at]texmed[dot]org.
Be Wise – Immunize is a joint initiative led by TMA physicians and medical students, and the TMA Alliance. Funding for TMA’s Be Wise — ImmunizeSM is provided in 2018 by the Texas Medical Association Foundation thanks to H-E-B, TMF Health Quality Institute, Pfizer Inc., and gifts from physicians and their families.
Photo: The Immunization Collaboration of Tarrant County