Texas Childhood Immunizations on the Rise
By Teresa McUsic
Monday November 17, 2008
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The immunization rate for Texas children has increased 19% over the past five years to reach a record high in 2007, according to statistics released by the U.S. Centers for Disease Control and Prevention.
The Texas rate was 77.3% for 2007, equal to the national percentage of children who have received all the vaccinations in the recommended immunization series. Texas now ranks 22nd in the country in children immunized, the highest ranking the state has ever reached. Ten years ago the state ranked second to last in immunized children.
In 2003, Texas Gov. Rick Perry signed an executive order directing the Texas Department of Health (now the Department of State Health Services) to implement a comprehensive plan to increase immunization rates statewide.
Pediatric nurses and school nurses in the state are playing an important role in increasing the population of immunized children, says Susan Belisle, RN, BSN, nurse consultant for the immunization branch of the Department of State Health Services.
"One of the biggest things we're pushing is the fourth DTaP (diphtheria, tetanus and pertussis) shot," Belisle says. "That's where we were falling behind. The nurses are helping to keep that push going."
The CDC survey showed immunization progress in four metropolitan areas in the state in 2007:
Houston's rate increased 4.3% from 70% to 73%.
El Paso County's rate increased 12.3% from 68.9% to 77.4%.
Bexar County's (San Antonio) rate increased 7.4% from 74.6% to 80.1%.
Dallas County was the only major metro area to see a slight decrease in immunizations from 73.3% to 71.9%.
The CDC's National Immunization Survey provides vaccination coverage estimates for children 19 through 35 months of age. The series includes four doses of DTaP, three doses of polio vaccine, one dose of measles-containing vaccine, three doses of Hib vaccine, three doses of hepatitis B vaccine, and one dose of varicella vaccine.
One program that has helped increase the immunized population in the state is the Texas Vaccine for Children Program, a federal and state program that provides free vaccines for children without insurance, with insurance that does not cover immunizations, and for children in the state's Children Health Insurance Program and on Medicaid.
"Access to the vaccines is not an issue," Belisle says.
Through the TVCP, school nurses can obtain vaccines to distribute to school children if they have a refrigerator in the nurse's office to house the vaccines. Nurses can administer the vaccines on the spot once they have received permission from the parents.
Betsey Weaver, RN, an elementary school nurse in the Bushland ISD near Amarillo says she recently received a packet describing the program sent from the City of Amarillo Department of Public Health and the Texas Department of State Health Services. For more information, go to www.ImmunizeTexas.org.
"I plan on getting signed up for this," says Weaver. "Not only would it help our children remain healthy, it would take some pressure off parents to get them to the doctor."
In August, San Antonio received a $2.65 million grant from the Department of Health and Human Services to support its immunization effort, the largest grant it has received to date. The city's Vaccines for Children program will be funded with the money, as well as a special vaccination program aimed at undocumented children.
All of the school nurses in San Antonio's public school system can offer immunization in their clinics, says Phyllis Priess, MSN, RN, director of student health services for the city's school district. Many of the nurses provide the shots, or refer children to nearby health department clinics, she says. Recently, a small grant was also given to the school district to distribute flu shots to students in three elementary schools, Priess says.
"The burden of flu to the community and the school district is great," she says. "And children are the primary way flu is spread in the community."
Most school districts in the state enforce a "No Shot, No School, No Kidding" policy. By law, Texas children must receive the recommended amount of immunizations shots before they start school, unless the parents apply for and are granted a waiver, Belisle says. This year, 39,000 waiver forms were sent to parents, and Belisle estimates that around 14,500 children have received the waiver.
"What many conscientious objectors don't realize is that they cannot go to school if there is a breakout of one of the diseases until the outbreak is over," she says. A recent outbreak of chicken pox in the state required these students to stay home until the disease was over, she says.
Another program to help keep track of immunizations of children in Texas is called ImmTrac, a statewide registry that records the shots as they are administered, Belisle says.
"ImmTrac sends a card to parents when their children need a vaccine," she says. "If a child doesn't have a medical home, it's not easy for parents to track their vaccines."
Belisle says now is the time for nurses and other healthcare professionals to make sure they are up-to-date on their own vaccines—and to get their flu shots.
"Just 42% of healthcare workers get their annual flu shot," she says. "The majority do not. We have plenty of supply this year. You don't want to have a subliminal case and pass it on to a fragile patient."
Teresa McUsic is a freelance writer.
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