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When speech pathologist Rebecca Hardy recalls her up-close seat to lawmaking during the 2015 state legislative session, she remembers how tough it was to find anyone interested in what she wanted: more choice for Texans when it came to getting vaccinated.
After forming Texans For Vaccine Choice the year before, she came to Austin to see if she could find lawmakers interested in policies to help parents who believe it’s their responsibility, not the government’s, to decide if and when a vaccination is administered to their child.
“We were on the scene far before COVID was even a word that anybody knew and 10 years ago, we did kind of have to sneak around the Capitol, have these conversations about vaccine mandates in the shadows,” the Keller resident now recalls. “And it was really hard to find people willing to put their names on protective pieces of legislation.”
What a difference a global pandemic makes.
Today, Hardy’s group and others in the vaccine hesitancy or anti-vaccine space have the ears of state lawmakers, especially on the heels of Texans for Vaccine Choice’s successful push back on mandatory COVID-19 vaccinations in the workplace in 2023.
While most of the vaccine bills 10 years ago were filed by Democrats to strengthen vaccine use, the opposite is now true — Republicans are filing most of the bills which aim to claw back vaccine requirements. There is even a House joint resolution proposing an amendment to the Texas Constitution that would preserve Texans’ right to refuse a vaccination.
The proposal is among more than 20 bills endorsed by Hardy’s group that have been filed, most of them before the legislative session began this month. Among them include legislation that would:
“TVC is not anti-vaccine,” Hardy said. “We’re not here to restrict anybody’s access to vaccines or to dismantle the vaccine program. So we do not take a stance on if children should get all, some or no vaccines.”
Instead, she insists, she wants laws that better support families’ right to choose what medical care they receive, including vaccines.
It’s a sentiment that is gaining more traction, particularly after President Donald Trump’s re-election and his selection of Robert F. Kennedy as his choice for U.S. Health and Human Services secretary. And it’s a somewhat counter trendline at a time studies have consistently shown that vaccines save lives and money.
A study by the U.S. Centers for Disease Control, released last summer, found the immunization of children born between 1994 and 2023 have saved the United States $540 billion by preventing illness and costly hospitalizations as well as preventing more than 1.1 million deaths.
But this move away from vaccines worries health care workers. A Texas Hospital Association’s position paper stresses concerns that vaccines have become politicized and the importance of vaccines is now overlooked because they work so well. Carrie Williams, an association spokesperson, said any decision about opting out of a vaccine should be a careful one that considers the ripple effect on others.
“Vaccine decisions impact the availability of care, hospital workforce and wait times, and the people around you,” she said. “We’re always going to be on the side of policies that help prevent epidemics.”
Focus on the vaccine exemption process
Texas requires children and students to obtain vaccines to attend schools, child care centers and college. An individual can claim they are exempt if they are in the military, they have a religious or personal belief that goes against getting immunized or if a health provider determines it is not safe to do so.
Currently, those who want to claim an exemption for their children from vaccination must request from the state Department of State Health Services that an affidavit be mailed to their home, a process that can take up to three weeks. Once it’s received, the requestor must get the affidavit notarized.
“It’s very inefficient,” Hardy said.
Her group wants the form to be downloadable. Any one of three measures filed so far could do that: House Bill 1082, House Bill 1586 or House Bill 730. She also wants providers to stop denying medical care to individuals who choose to delay or opt out of vaccinations altogether.
“If you don’t have the right in what you inject or not inject in your body, then what rights do we have?” Hardy said.
Travis McCormick, a government affairs professional, has formed the group Make Texans Healthy Again that is advocating for better affordability, access and transparency in health care. As a new dad, he said he was taken aback by medical providers’ rigid adherence to the vaccine schedule for newborns.
“I had a pediatrician who said if we didn’t get all four (vaccines) in one day we couldn’t be a client,” McCormick said.
In 2023, Gov. Greg Abbott signed Senate Bill 7, which bars private employers from mandating COVID-19 vaccinations for employees and contractors. Those employers who violate the law face a $50,000 fine and are subject to an investigation by the Texas Workforce Commission.
That same year, House Bill 44 passed, prohibiting Medicaid and Child Children’s Health Insurance Program providers from denying services to patients based on their vaccination status.
Hardy said her group lobbied hard for both bills.
“In my perspective, our movement is just beginning,” Hardy said of the 2023 victories. “We’re barely chasing the pickup.”
The appetite for vaccine exemptions growing
Data shows a consistent rise in interest in obtaining exemptions to vaccines since 2003, when then state Sen. Craig Estes offered a measure that allowed Texans to claim a conscientious exemption in addition to established exemptions based on medical and religious reasons. It’s a decision that he still stands by today, he recently told The Texas Tribune.
Since 2018, the requests to the Texas Department of State Health Services for an exemption form have doubled from 45,900 to more than 93,000 in 2024.
A spokeswoman for the agency, Lara Anton, said all requests for exemption affidavits are granted.
“There is no gatekeeping,” Anton said.
In the 2023-24 school year, more than 13,000 kindergarteners had a non-medical exemption from at least one vaccination in Texas, twice the number a decade ago. While other states had higher rates, Texas led the nation in total exemptions.
Still, most Texas children are vaccinated. More than 90% of kindergarten and 7th grade students had each of the required vaccines.
As Texans emerged from lockdowns and navigated a new vaccine for COVID-19 that became more widely available in 2021, views about shutdowns and the vaccine shifted dramatically. While Abbott moved quickly with executive orders keeping businesses and schools closed when infections spread in the United States beginning in March 2020, by November, he was resisting calls for more lockdowns.
The public’s weariness of mandates is now impacting vaccine rates, worrying public health officials and advocates who see the number of vaccine bills as problematic.
Terri Burke, who heads The Immunization Partnership, a pro-vaccine advocacy group, has the same Texas vaccine bills on her group’s watch list that Hardy does.
“I fear the vaccine issue is something they (state lawmakers) will continue to chip away at, like abortion, the border,” Burke said. “It’s like death by 1,000 cuts.”
She anticipates a hard legislative session, which runs through June 2, that will relax the exemption process as well as put more burden on health providers who could face more outbreaks if exemptions are made easier. “It’s going to be tough. It’s really going to be tough,” she said. “All we can do is block them.
Some of the legislation filed so far focus on the Vaccine Adverse Reporting System, or VAERS, a collection of self-reported post-vaccination health issues. Others mandate physicians to report o the U.S. Food and Drug Administration of health-related problems that result in death or incapacitation after a vaccine was administered.
State Sen. Charles Perry, R-Lubbock, who said he declined the COVID-19 vaccine on advice of his doctor, has filed one such bill, Senate Bill 269, because he wants to see better transparency about vaccines.
He believes the process during the race to get a COVID-19 was so fast that he and other Texans did not have enough details to evaluate potential risks for themselves.
“I hope RFK can get a more transparent system,” Perry said, referring to Kennedy if he is approved as U.S. health secretary. “We like to believe our doctors and our science” but Texans, Perry insists, want more information.
Health experts like Dr. Peter Hotez of Houston, say vaccine choice or vaccine hesitant groups exaggerate the adverse effects of vaccines and downplay the good they do in keeping deadly diseases from killing more Americans.
Hotez, one of the nation’s leading vaccine experts, is worried about any reduction in the nation’s vaccination rate, and that Texas specifically could be setting itself up for becoming the stage for the next pandemic.
Whooping cough is now returning to pre-pandemic levels. After the measles was officially eliminated in the United States in 2020, the disease has returned, occurring usually after someone has contracted it in another country. Polio, another disease thought to be eradicated, was detected in New York State wastewater in 2022.
Hotez is concerned that hesitancy and refusal of the COVID-19 vaccine is having a “spillover” effect on childhood immunizations.
“I’m worried about it unraveling our whole pediatric vaccine ecosystem,” he said.
Disclosure: Texas Hospital Association has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.