Vaccine-exempt law expands

As Texas joins 18 other states in allowing philosophical objections to vaccination, public health searches for a balance between community and autonomy.

By Susan J. Landers, AMNews staff. July 28, 2003.

Washington -- A new Texas law that broadens the state's school vaccine exemption categories has caused alarms to sound among state physicians with reverberations reaching physicians nationwide.

Last month Texas became the 19th state to allow parents to seek exemptions from state vaccination requirements for school entry for philosophic rather than religious or medical reasons. Although it is likely to remain in place for the time being, the new law was being challenged at press time.

Still, it's the latest round in an ongoing debate that sometimes pits parental fears against long-held public health objectives. The upshot is that primary care and family physicians who treat young patients are likely to hear more and more questions from parents.

Michael Foulds, MD, a San Antonio pediatrician and president of the Texas Pediatric Society, is concerned that the law could result in more exemptions, pockets of unimmunized children and outbreaks of diseases long thought vanquished.

"Whooping cough, which used to kill a lot of infants, is uncommon in this country. But we are seeing it start to crop up in communities when immunization rates start to drop," he said.

That the Texas law is one among many similar state laws troubles Lou Cooper, MD, immediate past president of the American Academy of Pediatrics. Dr. Cooper believes there has been an increase nationally in the number of parents seeking exemptions for their children. "It tends to be pocketed in some communities more than others, and it is probably putting some communities at significant risk."