On Tuesday, the U.S. Supreme Court ruled, with a vote of 6-2, that vaccine manufacturers are protected from lawsuits by parents who believe that vaccines harmed their children. One thing this assuredly means for Texas: The anti-immunization community will be out in force this session working against vaccine mandates — including a soon-to-be-filed bill expanding meningococcal vaccine requirements for college students.

Earlier this month, 20-year-old Nicolis Williams, an economics major at Texas A&M University, died after falling ill with bacterial meningitis. In Texas, students who live in college dormitories are required to be vaccinated against meningitis. Williams lived off campus — and he wasn’t vaccinated. Since his death, Williams’ parents have been pushing lawmakers to close that gap by requiring all college students be vaccinated, and lawmakers are lining up to do it. 

State Rep. Charlie Howard, R-Sugar Land, in whose district the Williams family lives, says he is drafting such a bill. Other lawmakers have already filed similar legislation. State Rep. Ron Reynolds, D-Missouri City, and Byron Cook, R-Corsicana, submitted theirs on Monday. In the upper chamber, state Sen. Wendy Davis, D-Fort Worth, says she plans to file legislation because, she says, “We feel that the law today is a little too limited.”

In 2009, the state passed House Bill 4189, known as the Jamie Schanbaum Act, requiring all students living in college dorms to be vaccinated. In 2008, during Schanbaum’s sophomore year at the University of Texas, she caught meningococcal septicemia and spent six months in the hospital where, ultimately, her lower legs and fingers had to be amputated. It sailed through the Legislature, unopposed by anti-vaccine advocates.

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“We were definitely opposed to it last session,” says Dawn Richardson, the president of Parents Requesting Open Vaccine Education, an Austin-based group opposed to mandatory vaccines and in favor of informing families and letting them decide. But the group opted to remain quiet. Now that the requirement may be extended, she says families who remained silent last time are determined to make themselves heard. This week’s Supreme Court decision has only motivated them more. “We have to fight all mandates,” Richardson says, “because we have no recourse.”

If they do put up a fight, one of the Legislature’s resident doctors, state Sen. Bob Deuell, R-Greenville, says, “They’ll fight it without a fact to stand on.”

Richardson believes that it’s those who are in favor of the mandate who are basing their position more in emotion than data — and adding to the state's financial strain in the process. “It’s a machine gun approach to try to prevent such an isolated, rare event,” she says. “We are in a budget crunch in Texas, and this vaccine is available to anyone who wants it. If a family decides not to take it, that should be their decision.”

A very small number of college-aged students — approximately 15 nationwide — die from meningitis each year. And the current meningococcal vaccine does not inoculate against all strains of the disease. And there are cases where the vaccine has failed even when it was matched to the correct strain.

But none of those make for convincing reasons not to immunize as many people as possible, says Anna Dragsbaek, executive director of the Immunization Partnership, a Houston-based advocacy group in favor of policies that boost immunization rates. While only a small number may die each year, she says, noting that is hugely important for the families who are left behind, there are hundreds of cases, many — like Schanbaum’s — with lifelong side effects. She says the state should do what it can to combat the disease, which is fast-acting, unpredictable and deadly.

The proposed legislation is based on the most recent recommendations of the Advisory Committee on Immunization Practices, a panel based at the Centers for Disease Control and Prevention and the national body that determines best practices, Dragsbaek says. It was only in January — too late to save Williams — the committee updated its recommendations to include all college-age individuals, as opposed to just those living in dormitories.

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Richardson is unmoved by the advisory committee's recommendations, noting that Texas has not always gone along with them — specifically, recommendations for vaccinating young girls against human papillomavirus (HPV), which is spread through sexual contact. 

“Those recommendations are heavily embedded in the best science available at the time,” Dragsbaek says. A mandate is necessary, she says, because it is the single most effective way to boost immunization rates. “If you have to get it for school,” she says, “rates will shoot up from 50 percent to like 95 percent.”

However the debate goes, it is sure to include some emotional testimony — both from families who have had children suffer dire consequences from the disease and from those who believe they have suffered from vaccines. “When you have that kind of situation,” Richardson says, “I really think the best policy in Texas would be to let the ultimate decision be with the family themselves.”

The law does include a provision allowing individuals with conscientious objections to vaccines to opt out. “If they choose that,” Dragsbaek says, “I would be very quick to say that they are putting themselves and everyone else around them at risk because meningitis is a contagious, deadly disease.”

Even with that exception, Richardson worries that the state’s endorsement creates a false sense of security and overlooks potential negative reactions. Dragsbaek’s position is that the benefits of the shot outweigh any risks — which, if they occur, are usually mild, and about which doctors are required to inform patients before administering the vaccine.

Both sides will have the opportunity to present their case to legislators. Howard, who still plans on filing a bill, says he’s already checked in with some policymakers on the matter. ”I’ve talked to the state’s health commissioner and the doctors in the Legislature,” he says, “and they all vouch for the vaccine.”

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