By Salinas H.C.R. No. 125
77R6488 MKS-D
HOUSE CONCURRENT RESOLUTION
1-1 WHEREAS, Hepatitis A is the most common form of hepatitis
1-2 reported in the United States and one of the most frequently
1-3 reported vaccine-preventable diseases; hepatitis A infection is
1-4 spread by person-to-person contact or by ingestion of contaminated
1-5 food or water, and the two most frequently reported sources of
1-6 infection are contact with an infected person within a household
1-7 and contact with an infected person in a day-care setting; and
1-8 WHEREAS, Hepatitis A infection typically is asymptomatic or
1-9 unrecognized in children, making them an important part of the
1-10 transmission of the disease, particularly in a household or in
1-11 other close contact situations where the presence of the hepatitis
1-12 A virus may go undetected until an adult becomes infected and
1-13 displays more severe symptoms; and
1-14 WHEREAS, Until the hepatitis A vaccine was licensed in 1995
1-15 and 1996, most preventive efforts against hepatitis A infection
1-16 were either hygienic measures or short-term immunization with
1-17 immune globulin; the hepatitis A vaccine is believed to be
1-18 long-lasting, and the goal of immunization is to protect persons
1-19 from infection, reduce the incidence of disease by preventing its
1-20 further spread, and ultimately eliminate the disease; and
1-21 WHEREAS, The Centers for Disease Control and Prevention (CDC)
1-22 and the Advisory Committee on Immunization Practices rank Texas
1-23 among the high-incidence states when comparing the number of
1-24 hepatitis A cases in Texas to the national average; routine
2-1 vaccination programs are recommended for states with high rates of
2-2 hepatitis A infection, beginning with children in the areas with
2-3 the highest rates of infection and incrementally increasing to all
2-4 children to interrupt and prevent outbreaks of the disease; and
2-5 WHEREAS, In 1999, the Texas Board of Health approved rules
2-6 that require children in 32 border counties who were born after
2-7 September 2, 1992, to receive vaccines against hepatitis A in order
2-8 to attend public or private school or child care; the rules require
2-9 two-year-old children in child care to have had one dose of the
2-10 vaccine, and children three years old and older must have two doses
2-11 given at least six months apart, with the first dose required
2-12 before they can be enrolled in school or child care; the rules
2-13 provide an exception in cases where evidence of immunity can be
2-14 provided; and
2-15 WHEREAS, Although the immunization requirements began with
2-16 the border area counties, hepatitis A cases are not confined
2-17 exclusively to those counties, and a sustained reduction in
2-18 hepatitis A rates will be successful only with widespread routine
2-19 vaccination of children; and
2-20 WHEREAS, The Texas Department of Health has identified 22
2-21 additional counties where high incidence of hepatitis A warrants
2-22 extending the hepatitis A vaccination requirements; accordingly,
2-23 the department has proposed rule changes that would apply to the
2-24 immunization of children attending school or child care in Bexar,
2-25 Comal, Dallas, Ector, Galveston, Grayson, Gregg, Guadalupe, Hale,
2-26 Harris, Hays, Johnson, Kleberg, McLennan, Midland, Nueces, Potter,
2-27 Randall, Smith, Tarrant, Tom Green, and Travis counties no later
3-1 than August 1, 2002; and
3-2 WHEREAS, The high rates of hepatitis A in these communities
3-3 indicate a need for continued commitment to immunizing Texas'
3-4 children from this disease and preventing the spread of infection
3-5 to others; without continuing efforts to control the spread of this
3-6 disease, all areas of the state are at risk; now, therefore, be it
3-7 RESOLVED, That the 77th Legislature of the State of Texas
3-8 hereby urge the Texas Board of Health to adopt rules, contingent
3-9 upon legislative appropriation of funds, that expand the hepatitis
3-10 A immunization requirements to include the 22 additional counties
3-11 the department has identified and that apply to children in the 22
3-12 new counties as they do to children in the border area counties;
3-13 and, be it further
3-14 RESOLVED, That the 77th Legislature of the State of Texas
3-15 hereby encourage the Texas Board of Health to expand the use of
3-16 hepatitis A vaccinations to other areas of the state in a manner
3-17 consistent with CDC recommendations as needed to control the
3-18 outbreak of hepatitis A in other counties; and, be it further
3-19 RESOLVED, That the secretary of state forward an official
3-20 copy of this resolution to the chair of the Texas Board of Health
3-21 and the commissioner of the Texas Department of Health.