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Fuzzy Math Responsible for Texas "Low" Immunization Rates

February 23, 2003
by Dawn Richardson, President
Parents Requesting Open Vaccine Education

Saying that Texas has an immunization rate problem is as misleading as it is inaccurate. Unfortunately, policy and funding decisions are often based on this misperception. There is currently an epidemic of bills filed in the Texas Legislature that not only purport to fix a problem that simply does not exist, they threaten to gut important parental and medical privacy rights.

The CDC's National Immunization Survey of children 19-35 months of age is the source of the Texas vaccine coverage estimate of 74.9% resulting in Texas being ranked 43rd in immunization rates.[1]

The benchmark of the 4:3:1 series[2] used for the survey is based on the recommended vaccine schedule by the Advisory Committee on Immunization Practices (ACIP).[3] This schedule recommends one more dose each of DTP and polio vaccines than what is required by more conservative Texas law.[4]

The survey is conducted when a child is 19-35 months old, and only counts children who have received all doses in the CDC's benchmark: 4 doses of DTP vaccine, 3 doses of polio vaccine, and 1 dose of measles containing vaccine. Even though a child may be fully vaccinated according to Texas Law at the time of the survey, they are not counted by the CDC in the fully vaccinated group. It is interesting to note that any child counted as fully vaccinated by the CDC, is actually over vaccinated according to Texas Law.

While the full impact of this discrepancy is not known, it is safe to say it is quite significant based on the CDC's tracking of individual antigens for the same age category of 19-35 months: 1) 93.3±1.8 % of Texas children have received all 3 Texas age appropriate doses of the DTP vaccine. 2) Even though Texas law requires the third dose of the polio vaccine to be on or after the 4th birthday, an amazing 87.6±2.7 % of toddlers in this age group have receive 3 doses of the polio vaccine 3) 90.4±2.3 % have received 1 dose of measles containing vaccine [5]

While the numbers are even higher for Texas children enrolled in child care facilities who are fully immunized: DPT/Td 95.7%, polio 97.3%, measles 97.7% [6], the number of Texas Public School children who are fully vaccinated climb to: DPT/Td 98%, polio 99%, and measles 99%.[7]

Even the well-intentioned Comptroller's office fell for this slight of hand in immunization rate representations saying in their legislative recommendations for "HHS 5: Improve Texas' Child Immunization Rate" that "just 74.9 % of all Texas children between the ages of 19 and 35 months were vaccinated in 2001"[8] misleading legislators that 25% of Texas toddlers were completely unimmunized and spurring a flurry of misdirected legislative activity.

So why would TDH employees and medical trade associations continue to condone the propagation of such misleading representations of Texas' immunization rates? Let's face it that there are certain funding and program expansion benefits to being perceived at the bottom. A false perception of failing immunization rates makes it more likely that some legislators might find themselves less willing to respond with codified conscientious choice exemptions and medical privacy protections and more likely to institute programs and expand databases to monitor and force total immunization schedule compliance with no deference to personal or parental rights or an individual's safety.

The immunization legislation being pushed by TDH and physician trade groups this session demonstrates their myopic fixation on measuring public health in terms of high vaccination rates and low infectious-disease rates. Meanwhile, the rate of chronic disease and disability in children is at an all-time high. With children now getting as many as 44 doses of 13 different vaccines by school entry [9] -- while the brain and immune system are developing at the most rapid rate -- nobody knows whether over vaccination has contributed to the dramatic increases in asthma, allergies, learning disabilities, autism, attention-deficit disorder, diabetes and other chronic neuroimmune illnesses. The Autism rates in Texas have soared 392% in the last decade [10]. Many parents who have watched their child's health decline after vaccination believe there is a connection. While TDH officials and physician lobbyists propagate a manufactured crisis about immunization rates, more and more children are suffering from debilitating neuroimmune illnesses.

The reality is that while there are growing numbers of people concerned about the safety or effectiveness of certain vaccines, Texas's real immunization rates are high and not in crisis as some would like you to believe. While there may always be room for improvement, making the system more inflexible to prevent some parents from taking the steps they feel are necessary to protect their children from a vaccine that they believe to be harmful or unnecessary will ultimately cause the system to break down, and then everybody loses.


[1] http://www.tdh.state.tx.us/immunize/nis.htm, and http://www.cdc.gov/nip/coverage/NIS/figures/01/01-431-txt.htm
[2] 4:3:1 series corresponds to four doses of diphtheria-tetanus-pertussis vaccine, three doses of polio vaccine, and one dose of measles-containing vaccine
[3] the ACIP schedule can be viewed at http://www.cdc.gov/nip/recs/child-schedule.htm#Printable, recommends 5 doses of DTP vaccine by age 4-6 and 4 doses of Polio by age 4-6.
[4] Texas Administrative Code Title 25 Part 1 §97.63 requires 4 doses of DTP with the fourth dose on or after the 4th birthday and 3 doses of Polio with the 3rd dose on or after the 4th birthday
[5] http://www.cdc.gov/nip/coverage/NIS/01/TAB3-antigen_state.htm
[6] http://www.tdh.state.tx.us/immunize/ccare0001.htm
[7] http://www.tdh.state.tx.us/immunize/pbsc0102.htm#table3
[8] http://www.cpa.state.tx.us/etexas2003/hhs05.html, Background, paragraph 1.
[9] http://www.cdc.gov/nip/recs/child-schedule.htm#Printable and [3xHepB] + [5xDTP = 15] + [4xHib] + [4xPolio] + [2xMMR=6] + [Varicella] + [4xPCV] + [2xHepA] + [5xInfluenza] = 44 doses
[10] http://www.ideadata.org/tables25th/ar_aa3.htm and http://autismautoimmunityproject.org/shame.html

 
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