Meningitis Vaccine Mandate Could Get Tweaked in 2013

With students from 35 states and 17 countries descending on the rural college for the spring semester in January -- many of them unaware of the requirement for a vaccine that was in scarce supply locally -- achieving full compliance in time would have been impossible, Dreith said recently. Rather than preventing unvaccinated students from enrolling, he let them attend classes as they awaited inoculation.

"There was great personal risk involved," he said in a phone interview from his new office at John A. Logan College in Illinois, where he is now president. "But we ultimately got the job done."

Now, after a bumpy rollout, during which many administrators felt they had too little warning of the law's sweeping requirement, even its strongest supporters may be pushing for some changes in the next legislative session. There has been debate about whether it was written too broadly, covering more students than necessary and thus making it harder to comply with.

Passed by the Legislature in 2011, the new vaccine law is named for Nicolis Williams, a 20-year-old Texas A&M University student who died after contracting meningitis, and Jamie Schanbaum, a University of Texas at Austin student who lost her fingers and lower legs at age 19. It expanded on a 2009 law that applied only to students living on campus, extending vaccine requirements to all students younger than 30.

Anna Dragsbaek, president of the Houston-based Immunization Partnership, supported the law but nevertheless thinks it could use some tweaking. "You know how things happen in the Legislature," Dragsbaek said. "Sometimes the sausage factory doesn't produce exactly the sausage you expect."

The age range of the law goes well beyond the recommendations of the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, which notes that meningitis risk is highest up to age 22 and calls for immunizations lasting into the early 20s. If immunizations were required only for students up to 22, Dragsbaek estimated, the number of affected students could be reduced by more than half.

Patsy Schanbaum, Jamie's mother and a vaccination advocate, supports such a change. "We really want to go with the guidelines of science, experts and research, and that's what we've always wanted," she said.

Mike Wintemute, a spokesman for the Texas State University System, said the application of the mandate to some schools might be worth reconsidering. It caught the system's two-year schools particularly off guard, since many of their students are older and none of them live in on-campus housing, where the risk of spreading disease is thought to be higher. "What may be a good public health requirement for one group of students may not be necessary for others," he said. He added that he would defer to health experts on what the best practices should be.

State Sen. Wendy Davis, D-Fort Worth, and the author of the 2011 measure, said she would be open to discussing changes. "The concern, of course, is that we never get into a situation where we are creating an impediment to students going to college," Davis said. "God knows it's hard enough already with tuition increases and grant decreases. Having said that, this is a very important public health issue." For now, some students may simply find a way around the provision.

Since the law took effect, it has become easier to opt out for religious or philosophical reasons. Now, instead of going through the health department, as is customary, off-campus students have been able to download an exemption form from the Texas Higher Education Coordinating Board and turn it in at their schools. Health organizations, including the Texas Medical Association, opposed the new process.

"I think it sets a dangerous precedent that other agencies can start issuing exemptions," Dragsbaek said.

Dominic Chavez, a spokesman for the coordinating board, said that in distributing exemption forms the agency had followed the law, but expected changes to the process in the future. "This has definitely been a learn-as-you-go situation," he said.

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This article originally appeared in The Texas Tribune at http://www.texastribune.org/texas-education/higher-education/meningitis-vaccine-mandate-could-get-tweaked-2013/.