Published: April 25, 1998

The Texas Department of Health is rewriting the rules governing a statewide children's registry that was intended to bolster immunization but instead has caused a stir among parents and legislators concerned over confidentiality.

The registry, called ImmTrac, is designed to help boost Texas' immunization rates from 71 percent to 90 percent, the national goal, by 2000.

The system is hailed as the first step in a comprehensive system to help track areas of the state with low immunization rates and to provide reminders to parents.

But its critics regard the registry as an unwelcome governmental intrusion and fear Texas might be boosting its vaccination rates -- and the amount of federal money it gets for doing so -- at the expense of parental consent rules and privacy rights.

One Austin mother, Dawn Richardson, said she never consented to have her daughter's medical records included in any sort of database. But when she called the health department in March to check on her daughter's records, the department faxed her a form complete with her daughter's registry identification number.

"Had I not checked, I might never have known my daughter was in there,'' Richardson said. "I have never consented to have her included in any registry.''

Richardson's daughter is one of 3.3 million Texas children whose vaccination information is in a state computer. Each child's record has an ImmTrac number and, in most cases, information on the parents.

A 1995 bill sponsored by state Rep. Hugo Berlanga, D-Corpus Christi, created the statewide registry to take effect Sept. 1, 1997.

The potential benefits of a statewide tracking system, however, should not outweigh a parent's right to privacy for themselves and their children, said state Sen. Jerry Patterson, R-Houston.

-- "The government already has too much information on citizens,'' said Patterson, who with state Sen. Chris Harris, R-Arlington, co-authored a requirement for written parental consent to provisions of Berlanga's law. "This is just another database, no matter how noble its purpose.''

Although the Berlanga bill did not take effect until last year, the health department has been collecting vaccination data on Texas children since 1994. Some of that information came from Medicaid and Bureau of Vital Statistics files, and not all parents have been notified of their children's inclusion.

That fact concerns some Texas legislators, who believe the law clearly states that all parents are entitled to be informed about the registry and choose whether to participate.

"You've got to let the parents know what's occurring with their children and their children's records,'' said state Rep. Dennis Bonnen, R-Angleton. "They might not necessarily be averse to having the records in a registry, but they deserve to know.''

Yet language from the Texas Health and Safety Code dating back 20 years allows the department to get and use information -- including immunization records -- directly from the Bureau of Vital Statistics, said Monty Waters, the health department's legal counsel.

Those earlier laws allowed a tracking system. The recent one requires it.

"We certainly never intended to do anything under the table or underhandedly,'' Waters said.

Health Commissioner Reyn Archer was out of the country and unavailable for comment.

Texas, like most states, receives money from the federal government depending on the number of children immunized. According to the Comprehensive Child Immunization Act of 1993, a state can get as much as $100 per child if it immunizes up to 90 percent of its 2-year-old population.

Parents like Richardson wonder if that isn't the real reason Texas is putting so much effort into tracking which children have been vaccinated.

But more money for states that produce results makes sense, Waters said. "If you're administering more vaccine, you're going to need more vaccine,'' he said.

The health department is responsible for preventing and controlling disease in Texas. Immunizing children against illnesses like chicken pox and polio is part of that effort. In order to do that, officials say they need a complete picture of immunization rates and practices across the state -- which a registry can provide.

"There is definitely a general concern about big government here,'' said Doug McBride, a spokesman for the department. "I don't like government messing with my individual life, either, but the idea here would be to assist, not interfere.''

The new rules will be submitted at the June meeting of the Texas Board of Health, which oversees the health department.

"I'm confident the rules are going to be changed to take into account all of these concerns,'' Waters said.