The Senate Committee on Health and Human Services met on February 24, 2010 and took up the following charge:
Charge #8 – Study the state’s ability to appropriately respond to the H1N1 influenza pandemic by examining issues related to vaccine distribution and capacity. Consider the benefit of providing the state’s independent school districts and various health authorities with standardized protocols for issues including, but not limited to, vaccine administration, absenteeism and the cancellation of school and other school-related events. Assess the state's ability to track and record H1N1 vaccinations through the ImmTrac registry, and review statutes governing ImmTrac to increase the effectiveness and efficiency of immunization information systems.
Commissioner of the Texas Department of State Health Services (DSHS), David Lakey, gave a history on the response to H1N1 and he noted the H1N1 vaccine required use of a different mechanism of delivery which had to be developed over a short time period.
Lakey noted some of the challenges were determining which high risk groups to target and the availability of vaccine supply. DSHS sent supplies to private practices and local health departments to let them decide how to get the vaccine to high risk individuals. It was also noted some vaccinations were also sent to employer’s health clinics. Another challenge was the inability to send email updates to all physicians. However, with the passage of legislation during the last session, the Texas Medical Board (TMB) has started to collect contact information on physicians and that process should be complete by December 2011. If a public health disaster is declared that contact information will be released to the DSHS.
The committee also reviewed the ImmTrac which is the state-wide immunization registry for children ages 0-18 years. DSHS is working on a comprehensive after action review which will identify several areas for improvement including potential improvements to ImmTrac. Lakey gave an overview of some of the issues they found the need for:
• Compliance with Health Level 7;
• Improving vaccination forecasting models;
• Adverse reporting systems; and
• Increase compatibility between ImmTrac and electronic health records to allow for automation of some data entry.
In regard to the last item above, ARRA funds were going to be used to work on automation with electronic health records but since the budget reductions, those ARRA funds may not be available for this project.
Dr. Donald Murphey, representing Texas Medical Association, Texas Pediatric Society, and Texas Academy of Family Physicians, stated ImmTrac helps ensure Texas has a healthy population. He further noted the system is a practical collection area for shot records saying that immunizations schedules are complex which makes the registry a great tool. He also points to a recent study which shows the state could save $1 million in expenses by switching to “opt out” registry.
However, critics of the “opt out” registry cited a lack of trust in the current system. It was also noted some individuals are sent harshly worded letters for reminder of vaccinations. A concern highlighted was if the registry would allow for tighter government control over the medicine and the inability for parents to have the ultimate decision making ability for their children. It was also pointed out by a witness that schools are not under the vaccine program protection which leaves them open for liability issues.