In the past few months there have been several outbreaks of mumps — a handful of cases linked to a Halloween party in Dallas and more to cheerleading contests in North Texas. As for measles, there have been fewer cases in Texas. But in 2013, there was an outbreak tied to a church northwest of Dallas.
With that in mind, some experts predict Texas could soon be at the center of a nationwide debate over highly contagious diseases and vaccinations.
“Around 100,000 kids die every year of measles; it used to be millions,” Dr. Peter Hotez says.
Hotez is dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. He says the combined vaccine that protects against measles, mumps and rubella is highly effective. Still, one shot isn’t always enough to protect against mumps, which are best known for causing a swollen jaw and puffy cheeks.
“A single immunization provides about 75 percent protection,” he says. "Two immunizations give you about 85 percent protection.”
Meaning those cheerleaders who came down with mumps in December could have already been vaccinated.
Measles 'takes off' when vaccinations decline
But what really concerns public health officials is measles. The virus is so contagious that if one person has it, 90 percent of the people close by, who aren’t immune, will also become infected. It’s the virus that surfaced at Disney theme parks and infected more than 130 Californians in 2015. The virus that can cause brain damage and death.
“Measles is something that takes off when vaccination rates start to decline and what we see now in Texas is a very ominous trend where we’ve had a dramatic rise in the number of kids whose parents are opting them out of them getting vaccinated. It’s therefore almost inevitable Texas will start experiencing measles outbreaks.”
Hotez says even though statewide levels of vaccinations remain high, at over 98 percent, what concerns public health officials are "pockets". They are growing clusters of geographic areas, like Travis County, where parents are getting conscientious, philosophical or religious exemptions from state vaccine requirements.
Parents like Jackie Schlegel.
“Two of my children go to school on a vaccine waiver, philosophical waiver,” she says. “I believe these decisions are personal and private and should stay that way.”
Schlegel, who lives outside Austin, got together with about 20 moms back in 2015 to form a group called Texans for Vaccine Choice. This was after legislation that would have eliminated those philosophical waivers was sent to the state house. Now, she says, Texans for Vaccine Choice has 10,000 members.
“I think you’ve seen this attempt to label parents as ‘crazy conspiracy theorists’ or ‘Jenny Mccarthy followers,’ which really couldn’t be farther from the truth. We have really educated families. We have doctors and attorneys, and we are definitely seeing a change in the movement.”
Schlegel says some of the group’s parents have chosen to vaccinate their kids but don’t want it to be a state requirement. All three of Schlegel’s children are vaccinated. But she says a vaccine caused her daughter’s brain injury and believes it’s connected to her autism.
Dr. Hotez says the autism-vaccine link has been been proven false.
“We have these massive studies that have been published over the last few years, which clearly show no links between any of our childhood vaccines and autism — that’s Point one," Hotez says.
"I also point out we have a lot of information about autism showing that the changes in the brain of kids with autism happen within the first and second trimester of pregnancy, well before those kids ever see a vaccine. So there’s not even any plausibility of a link.”
This issue is especially close to Hotez because he also has a daughter with autism.
Should vaccines be optional?
From 2006 to 2014, the U.S. Department of Health and Human Services reports there were 2.5 billion vaccine doses administered in the U.S. The number of vaccine-associated injuries that merited compensation was 2,000. That's about one per million. To put that in perspective, Hotez says you are four times more likely to be struck by lightning than injured by a vaccine. He doesn’t think vaccines should be optional.
“Some of the anti-vaxxers bring up civil liberties issues. They say: ‘It’s our right not to vaccinate our child.’ I say, well, it works both ways. Now you have a situation in many parts of Texas, like in Travis County, where you have a mother or a parent with a child, who is an infant here not yet eligible to receive their measles vaccine, and they have to walk around in terror going to shopping malls, going to the public library because they're worried their infant are going to be exposed to measles. What about her civil liberties?”
These are some of the arguments members of the Texas Legislature will debate this session. There are a handful of bills that would make getting vaccine exemptions more difficult.
Bills that Hotez says don’t go far enough to protect public health are the same bills mom Jackie Schlegel says go too far.
Note: In Part Two next Wednesday, KERA’s Lauren Silverman will explore vaccination legislation on the 2017 agenda, and look back at what happened to one North Texas representative who tried to get rid of philosophical vaccine exemptions.