Texas headwinds: The danger of anti-vaccination policies

In “Texas and its Measles Epidemics,” published in Public Library of Science Medicine (PLOS), I sounded an alarm about the real possibility that Texas will soon experience measles outbreaks. My rationale was straightforward: the measles virus is highly transmissible between humans, and once vaccination rates go below a certain threshold, we typically see epidemics of measles occurring.

This situation explains why terrible measles outbreaks affected California, Minnesota and several European countries in 2017. We are now at the point where measles epidemics can occur anytime in pockets of Texas where vaccination coverage has precipitously fallen, such as areas in and around Austin and Denton.

So far my PLOS piece, as well as a follow up one published in The New York Times, “How the Anti-vaxxers are Winning,” have not stimulated much activity. In fact, things may have just gotten worse. The policy director of The Immunization Partnership based in Texas recently reported how several bills that could prevent future measles outbreaks were defeated in the recent legislative session.

We’re now up to almost 50,000 children attending Texas public schools not receiving their regular immunization due to non-medical or “philosophical belief” exemptions from vaccines, and if we take into account children who are home-schooled that number might be much higher.

For me, the almost complete lack of action to an imminent public health threat to the children of Texas is instructive. It says that the anti-vaccine lobby in Texas  has become very powerful and effective in Austin. Especially irksome are the phony reasons about vaccine choice being a civil liberties issue for parents, when in fact we have now stripped away civil liberties from thousands of parents in the Austin area and elsewhere in Texas who fear taking their infants (not yet old enough to get vaccinated) out in public due to potential measles exposures.

It also tells me that no one seems particularly worried about measles despite the fact that it remains one of the great killers of children globally and landed dozens of California and Minnesota children in the hospital.

History tells us that if this trend continues, Texas will soon experience terrible measles outbreaks. As a pediatrician, vaccine scientist, and parent of an adult daughter with autism, I have written extensively about the overwhelming evidence showing that vaccines do not cause autism. Therefore, we face an extraordinary situation in which thousands of Texas children are being placed in harm’s way because of misinformation that has no scientific or rational basis.

I am now of the opinion that measles outbreaks are inevitable and will be required to close Texas non-medical exemptions. This is what it took to make changes in California in the months following their measles outbreaks. I had hoped that in Texas we could learn from California’s mistakes and not be destined to repeat them.

-By Dr. Peter Hotez, director of the Texas Children’s Hospital Center for Vaccine Development and Dean of the National School of Tropical Medicine at Baylor College of Medicine