DELIGHT AND UNEASE OVER LAW ON STUDENT VACCINATIONS FOR MENINGITIS

Saturday, 13th of August 2011

DELIGHT AND UNEASE OVER LAW ON STUDENT VACCINATIONS FOR MENINGITIS

By REEVE HAMILTON

New York Times, August 11, 2011

Among the things 22-year old Jamie Schanbaum could not have anticipated three years ago was standing two inches taller, winning a national Paralympic gold medal in cycling and reveling in the Texas Legislature’s passage of two bills in her honor. Those gains, however, came after significant losses — most noticeably of both legs below the knee and much of each finger, the result of a bout with meningococcal septicemia in her sophomore year at the University of Texas.

Commonly known as bacterial meningitis, meningococcal disease is a potentially fatal bacterial infection that saddles about one-fifth of its survivors with lifelong effects. Texas had 336 cases in 2009, according to the Department of State Health Services, 34 of them in people ages 15 to 29.

Ms. Schanbaum underwent numerous operations during months in the hospital, where the onset of a flesh-eating bacteria ultimately necessitated the amputations.

“It could have been worse,” Ms. Schanbaum said. “I could have been blind. I could have been deaf. I could have had brain damage. I could have died. I wouldn’t say I feel unlucky at all. I would say I consider this significant.”

So does Texas, which — after Gov. Rick Perry signed the second bill named for Ms. Schanbaum into law in May — became the first state to require every college student to be vaccinated against bacterial meningitis. (The Jamie Schanbaum Act of 2009 already required students living in campus dorms to be vaccinated.)

The new law, which will take effect at the start of 2012, expands that provision to apply to any new student under 30 taking on-campus classes even if they live off campus. While the tweak sounds deceptively simple, it has colleges and universities scrambling to raise awareness of such a broad policy and to figure out how to put it into effect.

Some critics, like Representative David Simpson, Republican of Longview, argue that the new laws amount to government intrusion, though students can opt out for medical or religious reasons.

The most recent bill, introduced in the Senate by Wendy Davis, Democrat of Fort Worth, was also named for Nicolis Williams, a Texas A&M University student who died in February after contracting bacterial meningitis. Mr. Williams, 20, lived off campus.

“I think it brings meaning to Nicolis’s death,” Ms. Davis said of her bill. “From this day forward, we’ll never know, of course, whose life was saved as a consequence, but no doubt there will be people whose lives are saved.”

Nevertheless, Mr. Simpson and 17 other House members opposed the bill. “I’m for freedom,” he said. “I’m not for the government dictating to us what we must do with our bodies.”

Mr. Simpson said it was comparable to what he considers invasive actions by federal airport security officers, which he has publicly challenged, and to a proposed ban on texting while driving that Mr. Perry vetoed — in Mr. Simpson’s view, correctly — for allowing government too much say in the personal lives of drivers.

Mr. Simpson also noted with particular frustration a February ruling in which the Supreme Court ruled that vaccine makers are protected from lawsuits by parents who believe shots harmed their children.

Mr. Williams’s father, Greg, an administrator at Texas Southern University who championed the bill, said, “I knew at the time of his death that there was probably a bigger plan in place in than I even thought of, because too many things happened that, in my mind, were more than a coincidence.”

Among those things was an empathetic state representative, Charlie F. Howard, Republican of Sugar Land, who had also lost a son. Mr. Howard sponsored the bill in the House.

Most important, the Advisory Committee on Immunization Practices at the federal Centers for Disease Control and Prevention had just updated its recommendations for the bacterial meningitis vaccine to include all college students. The update came after it was found that the vaccination given to preteenagers was wearing off, leaving all young adults ages 17 to 21 vulnerable, not just those living in crowded dorms.

“There was more distress than I’ve ever seen during my tenure about making that recommendation solely on the basis of cost,” said Dr. Carol Baker, a professor at Baylor College of Medicine in Houston and the chairwoman of the advisory committee.

The dispute centered on whether it was worth doubling the price tag of the vaccination program for such a rare disease. The new recommendation passed by a single vote.

Though Dr. Baker said potential side effects of the vaccine were unlikely to be anything more than a sore arm, other people are not convinced.

Dawn Richardson, president of Parents Requesting Open Vaccine Education, opposed the Davis bill because of fear of more serious side effects and of what she sees as a false sense of security the inoculation brings. Ultimately, Ms. Richardson said, she was satisfied by a requirement that universities give students detailed information about the vaccine and the ability to opt out of it. “I consider that a big win,” she said.

Preparing informational materials is one of many tasks facing universities as a result of the law. The Texas Higher Education Coordinating Board, which oversees the carrying out of new legislation, plans to invite public comments to address, among other questions, what to do about continuing-education students who might be on campus for only one or two classes.

There is also the issue of cost. The bill was not expected to create any costs for the state since the vaccine, which can exceed $100 a dose, is to be paid for by students or be covered by insurance. But Wanda Mercer, associate vice chancellor for student affairs for the University of Texas System, sees complications ahead.

“The administrative record-keeping and follow-up by people that is going to be required for those students who don’t comply — and there will be students who don’t comply — is very expensive,” Ms. Mercer said.

Scott McDonald, assistant vice president for academic services at Texas A&M, said he and his colleagues had yet to determine exactly how to prevent students from attending class if they had not been vaccinated or submitted the necessary forms to opt out.

And what about the woman who started it all? Ms. Schanbaum plans to finish her degree at U.T. and hopes for an invitation to compete with the American cycling team at the 2012 Paralympic Games in London. She and her family also promise to continue advocating for the meningitis vaccine and promoting similar laws in other states.

“We have a good friend in Florida whose son died of the disease,” said Ms. Schanbaum’s mother, Patsy. “So we think we’ll go there next.”