Published: March 13, 1998

By this time next year, Texas parents can rest easier if they lose that little card that helps them keeps track of their children's vaccinations.

The state will be keeping track of that information, too.

The Texas Department of Health is writing rules to enact a 1997 law that would pool vaccine histories of Texas children into one database for health providers to use. The registry will identify areas with low immunization rates and automatically send out reminders to parents.

Supporters say the plan means a shot in the arm for Texas, where nearly 100,000 children wiggle through the system each year without getting the vaccines they need. Those numbers increase the likelihood of preventable and contagious diseases such as whooping cough, diphtheria and tetanus.

But some parents, such as Dawn Richardson of Austin, worry that the registry will violate her family's right to privacy.

"They're asking for Social Security numbers and the mother's maiden name," said Richardson, who has a 19-month-old daughter. "They're trying to give themselves license to get personal information."

The familiar struggle -- government intervention vs. individual privacy rights -- has entered new territory: children's vaccines.

Richardson has formed what she calls a "grass-roots resource group" -- PROVE, Parents Requesting Open Vaccine Education -- to oppose mandatory participation in the registry. The group, with a core of about 20 members and a mailing list of 200 supporters, informs people of vaccine-related issues.

Texas already has a two-year-old database, paid for with $2 million in state and federal money, that tracks more than 3 million children vaccinated at public clinics. The system is even prepared to tackle the computer glitches expected for the year 2000.

This latest plan, approved by the Legislature last year, expands the registry to include children vaccinated by private health providers.

Vicki Cowling, who coordinates the existing database, said some critics are going overboard because they don't understand how it works.

"The only required information is name, date of birth, sex, address, vaccines given and name of guardian." The rest of the items are optional, she said.

Cowling said that in many cases, vaccination information will go straight from the doctor's office to the insurance company for payment. The insurance company will forward the vaccination record to the Health Department, which will automatically enter it into the database.

That means parents will not be asked for consent before their children's records are in the database, although they could request that the records be removed.

Access to the registry will be limited to Health Department officials and doctors, and doctors can view only their patients' profiles.

The law also has protections making abuse of vaccine information illegal. Anyone caught soliciting new patients through the registry would face up to one year in jail and a $4,000 fine.

Tarry Meaux, a medical assistant at Rainbow Pediatrics of Austin, said the registry will be helpful in her job. Half the parents who come to her office, she said, don't know when, where or whether their children have received the proper shots.

"Parents need to keep their children's records up to date," Meaux said, "but most of them don't." Without accurate records, children often receive the same shots twice -- not necessarily harmful, Meaux said, but definitely no fun for most kids.

Confidentiality is always an issue, Meaux said, but she doubts the registry poses a real threat. "I mean, really, what are they going to do with your vaccination records?"

Richardson is concerned that children could be harmed by what the registry does not automatically include: allergic reactions on a child's vaccine profile.

That's true, said Robert Crider, director of immunization for the Health Department. The reason? Concerns about privacy.

"That would be considered confidential medical information" and subject to privacy laws, Crider said. Vaccine records are not normally considered confidential. But, Crider said, parents can add as much information as they want to their child's profile.

The database is the state's contribution to a nationwide effort to boost vaccination rates to 90 percent by the year 2000. Some say it's one step closer to a bigger goal.

"Immunization is just one piece of the puzzle," said Ellen Wild, public health adviser for All Kids Count, an Atlanta-based nonprofit group that helps pay for registries across the nation.

Wild envisions a national web of databases that would give a physician a complete, electronic profile of any patient who walks into his or her office.

That's one more reason critics don't like the vaccine registry. They fear it's just the beginning of another way for government to pry into their lives.

Richardson said she plans to continue pushing the privacy issue.

"I don't have a problem with the intent (of the registry)," she said, "as long as the parent has the ability to say, "Yes, I want to be on it' or "No, I don't want to be on it.' "