Conscientious Exemptions in Texas

Amy Schlabach, Immunization Compliance CoordinatorImmunization BranchNovember 1, 2010

Conscientious Exemption Legislation

78th Legislature 2003 Regular Session House Bill 2292 Effective September 1, 2003

Summarizing Legislation Key Provisions of HB 2292

Allows exemption for reasons of conscience, including a religious belief

Applies to child-care facilities, elementary or secondary schools and institutions of higher education

May be excluded from school in times of emergency or epidemic

Requires affidavit Prohibits maintaining a record of names of

individuals requesting the form

Summarizing LegislationKey Provisions of HB 2292

The affidavit form: Must contain a seal or other security device to prevent

reproduction. Must contain a statement indicating the person

“understands the benefits and risks of immunizations and the benefits and risks of not being immunized.”

Must be obtained by submitting a written request to the department.

Must be signed by the person claiming the exemption or, if a minor, signed by the parent.

Must be submitted within 90 days from date notarized.

Changes to Rules

2003 Texas began allowing exemptions from immunizations based on reasons of conscience, including religious beliefs. Exemptions requested from September 2003 through April 2004,

were valid for five years. In April 2004, the former Texas Board of Health ruled exemptions

to be valid for two years. The approved rules allowed parents to fax their requests for the

affidavit form In December 2007, the Executive Commissioner of the Health &

Human Services Commission approved changes to the exemption rule allowing parents or guardians to request via the Internet that an affidavit form be mailed to them.

Conscientious Exemption

Requires written requests for affidavit, incl. facsimiles and internet

Requires full name and date of birth of child Allows request for up to five forms per child Allows exemption for one or more vaccines Affidavit form is valid for two years

Conscientious Exemption

Original requests are returned with forms Affidavit forms are pre-printed with child’s

name and date of birth Benefits and Risks of Vaccination fact

sheet is included with forms.

Sources for Conscientious Exemption Data

Number of affidavit forms requested Number of requests Number of children for whom exemptions are

requested Number of affidavit forms per child

Number of exemptions reported via school surveys & child-care audits

Yearly Comparison of the Number of Individuals Requesting Conscientious Exemptions, 2004 - 2010

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1000

2000

3000

4000

5000

6000

7000

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecMonth

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2005

2006

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2010

2009-10 Annual Report of Immunization Status: Kindergarten Conscientious Exemptions

Kindergarten Conscientious Exemptions

Vaccine Category (%)

DTP/DTaP 0.53

Hepatitis B 0.47

MMR 2 0.54

Polio 0.53

Varicella 0.58

Hepatitis A 0.53

2009-10 Annual Report of Immunization Status: 7th Grade Conscientious Exemptions

7th Grade Conscientious Exemptions

Vaccine Category (%)

Tdap 0.35

Hepatitis B 0.24

MMR 0.24

Polio 0.25

Varicella 0.35

Meningococcal 0.37

Annual Report of Immunization Status: Total Number of Conscientious Exemptions Reported, School Year 2003-2010

SchoolYear

Number of Students Enrolled with a Conscientious Exemption

Percent of Students Enrolled with a Conscientious Exemption

2003-04 2,314 0.08%

2004-05 2,722 0.09%

2005-06 6,991 0.15%

2006-07 9,606 0.21%

2007-08 10,404 0.23%

2008-09 12,633 0.28%

2009-10 19,050 0.39%

2,722

6,991

10,404

12,633

19,050

2,314

9,606

1,000

3,000

5,000

7,000

9,000

11,000

13,000

15,000

17,000

19,000

21,000

2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10

School Year

Nu

mb

er

of E

xem

ptio

ns

Annual School Report: Total Number of Conscientious Exemptions Reported, School Year 2003-2010

Questions?

Amy Schlabach Immunization Compliance Coordinator

Immunization Branch

800-252-9152512-458-7111 ext 6470

Amy.schlabach@dshs.state.tx.uswww.ImmunizeTexas.com

Vaccine Coverage Sources

Texas Immunization Branch – Coverage Levels http://www.dshs.state.tx.us/immunize/coverage/default.shtm

National Immunization Survey – Child, 19-35 months http://www.cdc.gov/vaccines/stats-surv/imz-coverage.htm#nis

National Immunization Survey – Teen http://www.cdc.gov/vaccines/stats-surv/imz-coverage.htm#nisteen

Texas County Retrospective Immunization School Survey (TCRISS) http://www.dshs.state.tx.us/immunize/coverage/tcriss.shtm

Texas School Immunization Validation Survey http://www.dshs.state.tx.us/immunize/coverage/validation.shtm

Texas Childcare Immunization Assessment http://www.dshs.state.tx.us/immunize/coverage/childcare.shtm

The Annual Survey of Immunization Status http://www.dshs.state.tx.us/immunize/coverage/schools.shtm

The Behavioral Risk Factor Surveillance System (BRFSS) http://www.dshs.state.tx.us/chs/brfss/query/brfss_form.shtm