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Texans For Vaccine Choice

The anti-vaxxers had another good legislative session

Sure would be nice if we could put a stop to this.

It was mid-April, more than halfway through the legislative session, and Texans for Vaccine Choice was finally getting the fight it had been spoiling for. On April 11, a bill to require schools to report the number of unvaccinated kids had been heatedly debated in a House committee. Doctors, public health experts, parents and others had testified in favor of House Bill 2249, calling it a transparency measure that would simply provide information about vaccination rates at individual schools. The matter was pressing, they said, because more and more parents were opting their kids out of vaccinations using a “reasons of conscience” exemption created by the Legislature in 2003. Without action, recent high-profile outbreaks of mumps and measles in Texas would only grow worse.

But Texans for Vaccine Choice has a radically different frame. While the pro-vaccination crowd appeals to legislators on the basis of science and public health, the anti-vaxxers have their own funhouse mirror version. Vaccines contain toxic chemicals, they say. They cause autism. They overwhelm the immune system. But more than that, the activists, many of them mothers, framed their position as one of parental choice and personal freedom — a message that commands attention at the Texas Legislature.

“The responsibility for my son does not fall on the state or any other family,” said one woman at the committee hearing. “And I would never rely on the herd to keep my son safe.”

Two days later, Texans for Vaccine Choice held a “Freedom Fight” rally on the South Steps of the Capitol. The event featured two prominent members of the far-right House Freedom Caucus, Jonathan Stickland and Bill Zedler, close allies of the anti-vaccination activists.

“Someone asked me the other day, ‘Why do you associate with those crazy vaccine people?’” said Stickland. “I said, ‘Because I am one’.”

Stickland went on to lay out a case for “choice.”

“Where there is risk, there must be choice,” he said. “It’s not government’s job to try to influence our behavior. … The state of Texas doesn’t own our kids. They should be looking for ways to protect parents because we know what’s best for our kids.”

[…]

In the final days of the 85th legislative session, it looked like the pro- and anti-vaccine lobbies were going to have to make do with a draw. But at the 11th hour, a discussion over a bill authored by Representative Gene Wu, D-Houston, requiring Child Protective Services to give new children in its custody medical exams, suddenly turned into a feverish argument about vaccines.

Urged on by Texans for Vaccine Choice, Zedler proposed a surprise amendment that would exclude vaccinations from those checkups. Vaccines, he insisted, “do not qualify as emergency care.” He was joined by several Republican members of the Freedom Caucus, with Representative Tony Tinderholt, R-Arlington, arguing that it was an “issue of liberty.”

A plea from Representative Sarah Davis, R-West University Place, a cancer survivor, failed to move the majority of Republicans. Davis proposed a measure that would at least require foster children to be vaccinated against cervical cancer. Her proposal was defeated in a 74-64 vote. Zedler’s amendment, meanwhile, was adopted 74-58.

Though Wu’s bill died in the Senate, a similar version of Zedler’s amendment found its way onto another child welfare bill and was signed into law by Governor Abbott.

Texans for Vaccine Choice considered the session a win. In early June, the group held a victory party that featured a fajita buffet and “chips fried in a dedicated gluten free frier.“) Photos on the group’s Facebook page show Tinderholt posing with an American flag hat while Zedler opted for a crown.

Pro-vaccine lobbyist Jason Sabo is anxious that mainstream Republicans, who might ordinarily have voted against potentially harmful anti-vaccination legislation, now see it as a primary issue.

“Only the extreme of the extreme show up to vote in the primaries: the anti-vaxxers, the pro-gun people, and the anti-annexation guys. Get four or five of these groups together and you have a bloc. And it’s really smart,” Sabo told the Observer. “So next session we have a choice: We either do the same thing and get the same results, or we come back with a different strategy.”

See here for some background. Rep. Wu’s bill was HB39, and the record vote on the Zedler amendment is here. You will note that only Republicans voted for the Zedler amendment. All Democrats, and a half dozen or so Republicans voted against it. If this isn’t a partisan issue by now, it’s pretty close. I think the “different strategy” that is needed here is to recognize that this is a campaign issue, for both March and November, and to treat it as such. Follow the model of the Texas Parent PAC, recruit and support some pro-vaccination Republicans in strong-R districts, and support Democratic candidates in competitive districts, for which there ought to be more than usual this cycle. Bill Zedler won with 57% of the vote in 2016, Stickland with 55.6%; Tinderholt didn’t have a Dem challenger in 2016, but won with 56% in 2014. None of these districts are unassailable, and maybe – just maybe – making vaccinations an issue might swing a few votes away from these guys, none of whom have anything but hardcore Republican brand loyalty to recommend them. Perhaps there’s a better strategy to stem these losses in the future, but if so I don’t know what it is. I can’t guarantee that pro-vaccination forces will be successful if they try to win a few elections, but I can guarantee they’ll have a much better time of it in the 2019 legislative session if they do.

Making vaccination information public

I support this.

While most parents in Texas vaccinate their children, the number of parents opting out of immunizations for non-medical reasons is on the rise. Since Texas changed its laws to allow parents to opt out citing a conscientious objection, the number of unvaccinated children has shot up more than 1,700 percent in 13 years, to 45,000 from 2,300. In response, parents and health advocates are backing an effort to increase public reporting on how many students who have skipped vaccines attend each school.

Currently, that data is housed at the state level and available via an open-records request. County and school district-level data also is available online.

House Bill 2249 would require the Texas Department of State Health Services to publish school-by-school data that would indicate the total number of students who forgo vaccinations, including those who opt out by choice, such as a religious objection. No names or identifying information would be listed.

Advocates for publishing the data say the information would offer parents insight into their child’s school and help them weigh whether to switch, particularly for parents of medically fragile children like Riki Graves’ daughter, Juliana. Now 3, she received a new heart at 18 days old, and doctors say she will need to attend a school where least 95 percent of the students are immunized.

“My job as a transplant mom is to protect that organ,” said Graves as she drove from her home in Sugar Land to Austin where she plans to testify before the House Public Health Committee on Tuesday. “We have the data … there’s no reason not to publish it.”

Opponents say there are plenty of reasons, including children’s medical privacy.

“If this is truly about keeping children safe, we have to have that honest conversation about keeping all people safe. It puts a target on the backs of children whose parents have chosen to opt out for various different reasons,” said Jackie Schlegel, a mother of three and executive director of Texans for Vaccine Choice, a grass-roots parent group that has ballooned in recent years as the movement against vaccinating children has gained traction. The group is planning a rally at the Capitol on Thursday, dubbed the “freedom fight.”

“At schools where you do have a high number of opt-out, we are creating a witch hunt against families, and that’s just unacceptable,” Schlegel said.

We clearly have a different definition of “unacceptable”. I think knowing that a given school has a high rate of unvaccinated children is something any parent would want to know. HB 2249 has four co-authors, two of whom )JD Sheffield and John Zerwas) are medical doctors, which ought to tell you something. As the story notes, an identical bill passed the House in 2015 but never got a hearing in the Senate. Let’s hope this year’s version meets a better fate. The Trib has more.

Still talking vaccines and measles

Because it keeps needing to be talked about.

Earlier this month, Dr. Peter J. Hotez, a pediatrician at Baylor College of Medicine and director of the Texas Children’s Hospital Center for Vaccine Development, detailed a disturbing prediction for 2017 in an op-ed for the New York Times: the country could be facing a measles outbreak, and the Lone Star State could among the earliest casualties. “Texas, where I live and work,” Hotez wrote, “may be the first state to once again experience serious measles outbreaks.”

[…]

The spread of measles—one of the most contagious and deadliest diseases—could be stopped by the Eighty-fifth Texas Legislature, where there are currently pending bills that take aim at correcting the anti-vaccination trend. In December, State Representative Donna Howard, a Democrat representing Austin, filed a bill that would require parents and students who choose not to be vaccinated to indicate that they will “opt-out,” as opposed to the current system in which people must “opt-in” in order to be vaccinated. The bill would also require education for parents and students before they choose to opt-out. A similar bill filed by Representative Sarah Davis, a Republican from Houston, would require parents to complete an online educational course to inform them about the dangers of opting out of vaccination.

But anti-vaxxers make up a strong political bloc, and they’ve successfully thwarted pro-vaccination efforts in the Lege before. In 2015, state Representative Jason Villalba of Dallas tried to pass a law that would have entirely removed the exemption protection for parents who claimed to have a “conscientious objection” to vaccinations. His proposal was promptly torn to pieces by a few thousand members of a Facebook group for Texas anti-vaxxers, which formed a PAC, Texans for Vaccine Choice, that ultimately killed Villalba’s bill.  “These people, they literally said it to my face—they hate me,” Villalba told the Texas Tribune in April 2016, after his bill flopped. “This is a group that is very dedicated, very organized; this issue is very important to them.” Even after the bill failed, the PAC kept on Villalba. Jackie Schlegel, the PAC’s creator, told KUT in January that PAC members “knocked on nearly 10,000 doors for his challenger.” Villalba narrowly avoided defeat. Villalba told KUT that he supports Representative Davis’s bill, but it seems unlikely he’ll try to revive his own. “I’m not interested in a suicide mission on this issue,” Villalba told the Tribune last April.

Texas remains one of only seventeen states that allow parents to exempt their children from receiving vaccinations due to philosophical objections. None of the currently pending bills in the Lege would change that. Still, the Texans for Vaccine Choice PAC has already started to push back against the pro-vaccine billse. The anti-vax crowd is active on social media, and let Davis know that they were upset about her bill. In several exchanges with these folks on Twitter in late January, Davis shot down claims that vaccines cause autism by calling such assertions “alternative facts.

See here and here for some background, then go read Rep. Davis’ Twitter battle with the anti-vaxxers. I’ve never been a big fan of hers, but my respect for her is higher than ever after seeing that. Despite the fact that the anti-vaxxers have a friend in the White House, I do believe we can get one or both of Rep. Davis and Rep. Howard’s bills passed. The anti-vaxxers are as we know an organized and vocal minority, but in the end they are still a minority. We do have them outnumbered, and we need to remember that. If you’ve gotten yourself in the habit of calling your legislators about this and that these days, please add these two bills to your list of things you ask them to support.

Trump and the anti-vaxxers

In case you needed another reason to dislike Donald Trump.

President Trump’s embrace of discredited theories linking vaccines to autism has energized the anti-vaccine movement. Once fringe, the movement is becoming more popular, raising doubts about basic childhood health care among politically and geographically diverse groups.

Public health experts warn that this growing movement is threatening one of the most successful medical innovations of modern times. Globally, vaccines prevent the deaths of about 2.5 million children every year, but deadly diseases such as measles and whooping cough still circulate in populations where enough people are unvaccinated.

Here in San Antonio, 80 miles southwest of the state capital, Texans for Vaccine Choice convened a happy hour to encourage attendees to get more involved politically. The event was among dozens of outreach events the group has hosted across the state. The relatively new group has boosted its profile, aided by a savvy social-media strategy, and now leads a contentious fight over vaccines that is gearing up in the current legislative session.

The battle comes at a time when increasing numbers of Texas parents are choosing not to immunize their children because of “personal beliefs.” Measles was eliminated in the United States more than 15 years ago, but the highly contagious disease has made a return in recent years, including in Texas, in part because of parents refusing to vaccinate their children. A 2013 outbreak in Texas infected 21 people, many of them unvaccinated children.

The modern anti-vaccine movement is based on a fraud. A study published almost 20 years ago purported to show a link between childhood vaccines and autism. The data was later found to be falsified, and the study was retracted.

[…]

Peter Hotez, director of the Texas Children’s Hospital Center for Vaccine Development, predicts that 2017 could be the year the anti-vaccination movement gains ascendancy in the United States. Texas could lead the way, he said, because some public schools are dangerously close to the threshold at which measles outbreaks can be expected. A third of students at some private schools are unvaccinated.

“We’re losing the battle,” Hotez said.

Although the anti-vaccine movement has been strong in other states, including California, Oregon, Washington and Colorado, experts say the effort in Texas is among the most organized and politically active.

“It’s a great example of an issue that has a targeted, small minority but an intense minority who are willing to mobilize and engage in direct action,” said Mark Jones, a political science professor at Rice University in Houston.

We’ve discussed this plenty of times before, and as you know I agree with Mark Jones. There’s no reasoning with these people. There’s only organizing, and making it so that being anti-vaccination – and let’s be clear, that’s what allowing broad parental-choice exemptions for vaccinating children is – is a disqualifier for public office. Either we vote these enablers out, or we suffer the consequences.

The coming measles outbreak

I hope we’re wrong about this.

Peter Hotez used to worry mostly about vaccines for children in far-away places. An infectious diseases researcher at Baylor College of Medicine in Houston, Texas, Hotez is developing shots against diseases in poorer countries such as hookworm and schistosomiasis.

But now, Hotez is anxious about children much closer to home. The number of schoolchildren not vaccinated against childhood diseases in Texas is growing rapidly, which means that the state may see its first measles outbreaks in the winter or spring of 2018, Hotez predicted in a recent article in PLOS Medicine. Disgraced antivaccine physician Andrew Wakefield has set up shop in the Texan capital, Austin, and a political action committee (PAC) is putting pressure on legislators facing a slew of vaccine-related bills.

“Texas is now the center of the antivaxxer movement,” Hotez says. “There is a big fight coming,” adds Anna Dragsbaek of The Immunization Partnership, a nonprofit organization in Houston that advocates for vaccinations.

Texas still has one of the highest vaccination rates for childhood diseases overall, 97.4%, according to the U.S. Centers for Disease Control and Prevention. But the number of children not vaccinated because of their parents’ “personal beliefs”—as opposed to medical reasons—has risen from 2300 in 2003, when such exemptions were introduced, to more than 44,000 so far this year, according to numbers prepared by The Immunization Partnership based on Texas Department of State Health Services data. The actual number may be much higher because an estimated 300,000 Texan children are schooled at home, says Susan Wootton, an infectious disease pediatrician at the University of Texas in Houston; though the law requires these kids to be immunized too, parents don’t need to submit proof of vaccination.

Measles is an extremely contagious pathogen and often the first one to spread when vaccination rates dip below about 95%. The risk of outbreaks is even greater because unvaccinated children aren’t randomly distributed. In Gaines county in western Texas, for instance, the exemption rate is already 4.8%, and at one school in Austin, it’s 40%. “I would describe Texas as sitting on a ticking time bomb,” Wootton says.

[…]

Meanwhile, a PAC named Texans for Vaccine Choice has sprung up after state Representative Jason Villalba, a Republican lawyer from Dallas, proposed scrapping nonmedical exemptions last year. (The Texas House of Representatives voted down the bill.) “While they do not have a whole lot of money, they have a lot of people that they can deploy to interfere in primary campaigns,” Dragsbaek says. “They made Villalba’s primary campaign very, very difficult.” Rebecca Hardy, director of state policies at Texans for Vaccine Choice, says the group is not trying to convince parents that vaccines are dangerous, but fighting for their right not to immunize their children. (It’s also helping them apply for exemptions.)

Though almost all U.S. states allow religious exemptions from vaccination, only 18 permit exemptions based on personal beliefs; with 27 million residents, Texas is the most populous one. Another hotbed of resistance to vaccines, California, stopped allowing “philosophical exemptions”—which covered religious and personal beliefs—this year, after a measles outbreak that sickened more than a hundred people. The change in legislation led some Californians opposing vaccines to move to Texas, Hotez says.

The Texas legislature is now pondering several bills that would help shore up vaccination. One would make it compulsory for parents to complete an online course before refusing vaccination; another would require them to discuss their decision with a doctor. The bill with the best chances may be one that would allow parents to know the immunization rates at their child’s school. “This does not infringe on anyone’s right to have an exemption, it simply allows parents who need to protect their children to have adequate information to do so,” Dragsbaek says. But Hardy says her PAC is opposed to even this bill: “If it’s truly about a parent’s right to know the health status of a campus, then why are we not proposing bills that would give the rates of HIV-positive kids on campus, or hepatitis B-positive kids?” she asks.

The problem, as I’ve noted before, is that the anti-vax forces are vocal and organized, which gives them a disproportionate amount of influence in the Lege. If you’re still mad about the November election (and you should be!) and you’re looking to Do Something to make our state a better place, organizing in favor of pro-vaccination candidates and officeholders, in all levels of government, would be a good way to channel that energy. Note this does not have to be strictly partisan – Rep. Villalba, who drew the wrath of the anti-vaxxers in 2015, is a Republican. But until there’s a countervailing force against the likes of Texans for Vaccine Choice, they’re going to gain all the ground. You can’t fight something with nothing, and the pro-vaccine forces have nothing right now.

Anti-vaxxers gain ground in Texas

There’s a lesson in here that we need to learn.

On a Friday night little over a year ago, a Texas mother of three was attending a school dance when she got a text message that stopped her cold.

A state lawmaker from Dallas had filed legislation taking aim at a provision in state law that allows parents to opt their children out of school immunization requirements.

“I looked at that text and I just kind of was like, ‘Oh no he didn’t,’” said Jackie Schlegel-Polvado, who lives near Bastrop. “This is Texas. We believe in parental rights in Texas. Like, that is just a fundamental belief that most Texans have that parents make decisions for their children, not the state.”

It was an issue that directly affected Schlegel-Polvado and her family. Since 2007, she has been one of a small but growing number of parents in Texas who obtain “conscientious exemptions” from state vaccine requirements.

What was several worried parents exchanging text messages over the next few days turned into a Facebook group that within two weeks had more than 1,300 members, and then, ultimately, a political action committee.

Texans For Vaccine Choice’s mission, according to Schlegel-Polvado, is to guard parents’ rights to opt out of vaccine requirements — whether that means targeting legislators who seek to close non-medical exemptions or pushing for policies that otherwise protect parents who choose not to vaccinate, like preventing physicians from excluding them from their practices.

In this year’s primary elections, that meant going after state Rep. Jason Villalba, the Dallas Republican who filed the bill.

“The animus that was leveled against me for that was very surprising to me,” said Villalba, who ultimately won his race. “These people, they literally said it to my face — they hate me. That was troubling. Because I get it, they care about their children — but I care about my children too, and the children of the community.”

[…]

State law requires that children at all public and private schools have 10 different immunizations, including for tetanus, measles and pertussis, the bacterial disease known as whooping cough. Generally, children must receive those vaccines by the time they are in kindergarten, though they receive others, like for hepatitis B, in later grades.

If parents wish to opt out of school immunization requirements, they must file a what’s known as a “conscientious exemption” form with their child’s school at the start of the year. All but two states — West Virginia and Mississippi — grant exemptions from school immunization requirements on religious grounds. Texas is among 18 that also waive requirements because of personal beliefs, according to the National Conference of State Legislatures.

Under Villalba’s initial measure, Texas would have only allowed students to receive exemptions for medical reasons, such as an allergic reaction or in instances where a weakened immune system could cause health complications.

Pediatricians — many of whom have watched with dismay as the number of parents choosing not to vaccinate their children has climbed — widely support the elimination of non-medical exemptions to immunization requirements.

[…]

During the 2015 legislative session, Villalba said he quickly became acquainted with the passion of the anti-vaccine movement’s supporters, many of whom believe the undue influence of pharmaceutical companies has led to an overabundance of immunization requirements that come at the expense of children’s health.

“This is a group that is very dedicated, very organized; this issue is very important to them,” he said.

[…]

For now, the new organization’s strength appears to lie in its mobilizing abilities. A February campaign finance report showed just over $1,000 in contributions. And while its members made their presence felt in Villalba’s race, he still managed to win with 55 percent of the vote.

But Villalba said that without the engagement of the group, he would have expected his margin of victory to be larger.

It also may have accomplished a broader goal. The lawmaker said that for the 2017 legislative session, he does not plan to re-file his bill narrowing exemptions to the state’s vaccine requirements.

“I’m not interested in a suicide mission on this issue,” he said. “I sense — and this is unfortunate — the only way a bill like this gets any traction is an even worse large-scale outbreak, between now and session. Short of that I just don’t think there is going to be the appetite to do this bill.”

See here for some background. The lesson here is that intensity matters. A group of people that care passionately about a single issue and organizes around it can often get what they want in our political system, even if they’re a distinct minority. These anti-vaxxers are but one example; I’m sure you can think of many others. The number of unvaccinated children in Texas schools is still fairly small, less than one percent of the total, but it’s grown by more than ten times since 2004. This kind of idiocy is the reason why measles has made a big comeback in the US and around the world after being declared eradicated. I can’t blame Rep. Villalba, who was left hanging by Greg Abbott, for not wanting to deal with this crap next session. If the rest of us want someone else to pick up the ball on this, we’re going to need to make at least as much noise about it as these dangerous fanatics have done. Complaining about them is easy. Doing something about it is hard. It’s up to us.