Schools Prep for Vaccine Mandate While Some Decry Overreach

Among the things 22-year old Jamie Schanbaum has now that she could not have anticipated three years ago are 2 extra inches in height when she stands, a gold medal from the USA Cycling Paralympic Road National Championships and two bills passed by the Texas Legislature in her honor. These gains came after significant losses — most noticeably both legs below the knee and most of each finger, the result of a bout with meningococcal septicemia during 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. According to the Department of State Health Services, Texas had 336 cases in 2009, 34 of them in individuals between 15 and 29 years old. Schanbaum underwent numerous surgeries during months in the hospital, where the onset of a flesh eating bacteria ultimately necessitated the amputations.

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

The outcome has also been significant for Texas, which  — after Gov. Rick Perry signed the second bill named for Schanbaum into law in May — became the first state in the country to require every college student to be vaccinated against bacterial meningitis.

Because of the Jamie Schanbaum Act of 2009, Texas law already required students living in campus dorms to be vaccinated. The new law, which will take effect at the beginning of 2012, expands that provision to apply to any new student under 30 taking on-campus classes, including those living off-campus. While the tweak sounds deceptively simple, it has colleges and universities scrambling — both to raise awareness of and to determine how to implement such a broad policy — and some observers decrying government intrusion.

The most recent bill, carried by state Sen. Wendy Davis, D-Fort Worth, was also named for Nicolis Williams, a Texas A&M University student who died in February after contracting bacterial meningitis. Because there were no dorms available when he enrolled, Williams, 20, lived off campus.

“I think it brings meaning to Nicolis’ death,” Davis said of her legislation. “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.”

Williams’ father, Greg, an administrator at Texas Southern University in Houston, who championed the bill, said of his involvement, “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.”

One of those things was an empathetic state representative in Charlie Howard, R-Sugar Land, who had buried a son himself many years before. Howard ultimately sponsored the bill in the House.

Most importantly of all, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices had just updated its recommendations for the bacterial meningitis vaccine to include all college students. It was found that the vaccination administered to preteens was wearing off, leaving young adults ages 17 through 21 particularly vulnerable to the disease — and not just those crammed into dorm rooms.

“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 program for such a rare disease.

The new recommendation passed by one vote. 

“I would like to see the whole age group immunized, because it looks like it’s an age thing and not a college thing,” said Baker, who supported Davis’ bill, though she said it is difficult to reach those who don't enroll in higher education.

Even the current extent of the laws, however, have drawn criticism. State Rep. David Simpson, R-Longview, was one of 18 House members who opposed the measure. “I’m for freedom,” he said. “I’m not for the government dictating to us what we must do with our bodies.”

Simpson said it was comparable to what he considered invasive actions of federal airport security officers, which he has been publicly challenging, and also a proposed ban on texting while driving that Perry vetoed — in Simpson’s view, correctly — for allowing government too much say in drivers’ personal lives. He noted with particular frustration a U.S. Supreme Court ruling in February that vaccine manufacturers are protected from lawsuits by parents who believe shots harmed their children.

Though Baker said potential side effects of the vaccine were not likely to exceed a sore arm, others are not convinced. Dawn Richardson, president of Parents Requesting Open Vaccine Education, opposed Davis’ bill in part because of the risks of more serious side effects, as well as a false sense of security, she believes the accompanies the inoculation. Ultimately Richardson was satisfied by the law’s requirement that universities send out information to students about the vaccine, including the fact that anyone can opt out for medical or religious reasons. “I consider that a big win,” she said.

Preparing such materials is just one of many lingering administrative considerations. The Texas Higher Education Coordinating Board, which oversees the implementation of new legislation, will 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 the issue of cost. When Davis’ bill was passed, the state did not anticipate any fiscal consequences for the state, since the money for the vaccine, which can exceed $100, would come out of the students’ pockets or be covered by insurance. But Wanda Mercer, associate vice chancellor for student affairs for the UT System, foresees complications. “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,” she said.

There is are practical concerns as well. Scott McDonald, assistant vice president for academic services at Texas A&M, said he and his colleagues have yet to determine exactly how they will prevent students from attending class if they have not been vaccinated or submitted the necessary paperwork to opt out.

As for the woman who started it all, Schanbaum plans to finish her degree at UT — and that is not all. She hopes for an invitation to compete with the American cycling team at the 2012 Paralympic Games in London. And she will continue advocating for the vaccine and promoting similar laws in other states.

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