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Texas lawmakers push to switch immunization registry to opt-out after COVID-19 complications



Texas – State lawmakers are looking at vaccine distribution across Texas, and where it could improve.

On Wednesday, Rep. Donna Howard (D – Austin), State Sen. Judith Zaffirini (D – Laredo) and Sen. Kel Seliger (R – Amarillo) discussed issues they have found with the state’s immunization registry during the pandemic.

“Texas is one of only four states in the entire country that has an opt-in registry,” Rep. Howard said. She and Sen. Zaffirini have been filing legislation to switch the system to opt-out for the past decade, which would automatically add patients into the system, unless they requested to be left out.

But, when the pandemic hit, the emergency declaration switched the system temporarily to opt-out, which caused problems.

“Ideally, providers should be able to upload both the consent, and the vaccine information of a text and directly from their electronic health records or EHR into ImmTrac,” Rep. Howard said, adding that the Department of State Health Services created codes that would allow EHR to report consent.

“These codes, and there are six of them to be precise, are in direct contrast with the Centers for Disease Control national standards on coding of EHR inputs. In contrast with the EHR that are being used by the 46, other states for the vast majority of providers enrolled into and track their EHR are not interoperable with ImmTrac, meaning their data cannot be seamlessly ported from the EHR to interact automatically,” Rep. Howard explained.

The representative said this has led to more work for healthcare providers, which could have been avoided if the state’s system was already opt-out.

“Providers have had to submit their hundreds of vaccines administered by hand on Excel spreadsheets, which introduces human error into the data and providers have either had to bring on temporary staff, or have their staff work overnight in order to meet the state’s daily reporting requirements,” Rep. Howard said.

“By moving to an opt out system, we finally allow providers to obtain interoperability with their EHR and clean up data issues,” Rep. Howard said.

Doctors, including Dr. Marc Boom with the Texas Hospital Association, said it’s critical to fix the issue now, as more COVID-19 variants pop up and booster shots are needed.

“If we exit a pandemic emergency declaration but are still in a year after year after year management of a coronavirus outbreak just as we deal with with flu…and don’t fix this, it’s going to be a mess,” Dr. Boom said.

Addressing privacy concerns with an opt-out system, Sen. Zaffirini said the system is not mandatory.

“Persons with an aversion to sharing this kind of information would retain the right to opt themselves or their children out of the system,” Sen. Zaffirini said.

Sen. Seliger concurred, adding that the bill doesn’t affect those who are against vaccines.

“I am avidly pro vaccine. But for those people who aren’t. I think we ought to respect that decision and make the point that for those people who are not in favor of vaccines, this bill really affects them not one bit,” Sen. Seliger said.