Most people in the United States today have had one experience or another with immunization. For most people, their first experience might have been before they could remember, as a newborn, receiving one of the many scheduled pediatric vaccinations against communicable diseases that the Centers for Disease Prevention and Control (CDC) recommend. This experience might have been with their children who had to meet certain vaccination requirements before entering school. Currently the CDC recommends that children in the United States receive 23 vaccinations against 11 communicable diseases before they reach kindergarten age (Mera et al, 2009, p 79). There have long been reasons why some parents make a conscious decision to not vaccinate their children. Sometimes, this decision is not made out of a deliberate attempt to keep their children from being immunized but stems from reasons such as lack of knowledge about vaccination recommendations or a lack of access to healthcare. Recent media reports questioning the safety of some vaccinations has led to more controversy and confusion among parents and healthcare workers alike on the issue of immunization. The nurse plays a key role in the implementation of the CDC’s vaccination program and has a responsibility to her patients in providing accurate and up to date information on vaccination issues. This paper will attempt to examine the issues surrounding current vaccination practices in the United States, specifically pediatric immunizations, and why this is a controversial and dynamic issue and specifically what role the professional nurse plays.
One of the most critical questions about vaccination is its hypothetical aftereffects. Many parent’s express concerns about the number of injection which their children have to endure. In their opinion, this can give rise to various complications such as seizures, autism or encephalopathy (Sharts-Hopko, 2009, p 83). However, according to the most recent findings, human body has the capacity to respond to an large amount of antigens and their actual number is much lower than it was several decades ago (Sharts-Hopko, 2009, p 85). To some extent, this example demonstrates some of the claims are not substantiated. In turn, this creates serious difficulties to the medical workers, who find hard to convince parents that vaccination is safe. Such attitude of parents can also be explained by the fact that the side-effects of immunization have not been thoroughly examined. In the vast majority of cases, scientists only associate vaccination with some diseases, for instance, neurologic adverse events, low birth weight of the infant or subsequent attention deficit (Francois et al 2005, p 953). However, they cannot state with certainty vaccinations actually cause these disorders. Due to this ambiguity vaccines are regarded as the main source of many health problems. Hence, continuous research is needed in order to evaluate the advantages and disadvantages of vaccination of children.
Naturally, the risks of immunization may not be denied or neglected. For example, several systemic reviews report the increased occurrence of leukemia following hepatitis B immunization (Sharts-Hopko, 2009, p 8). These two phenomena may be related to one another as cause and effect. But at present the evidence is inconclusive. Overall, this uncertainty only increases parental reluctance to participate. Therefore, the key task of nurses is to explain that vaccination is an effective method for the prevention of contagious diseases, and misgivings about them are not fully grounded. Yet, at the same time, they need to tell parents about those hypothetical dangers so that they could make an informed decision and this is one of their major moral and professional duties.
Another reason why so many parents are reluctant to immunize their children is that vaccination against some diseases, such as chicken pox is not quite necessary (Bar-Yam & Bromberg, 2000, p 41). This is one of those cases, when the consequences of infection are not so severe; they are very rarely fatal. Additionally, it is even much preferable to pass through this illness at childhood age because during adolescence or adulthood chicken pox may be much more dangerous. This examples shows that healthcare professionals must use vaccines only in those cases, when the disease is both contagious and perilous the childs health. This may minimize the risk of many health problems.
The ongoing debate about natural immunity and vaccination has not been resolved yet. Some scholars even argue that immunization does not actually bring the decline of diseases (Miller 1994, as cited in Bar-Yam & Bromberg, 2000, p 40). They explain it by the fact that socioeconomic and sanitary conditions of life have improved. Nonetheless, several attempts to reduce the rate of vaccination proved to be disastrous, for example in the UK or Japan (Bar-Yam & Bromberg, 2000, p 40). Paradoxically, the effectiveness of many vaccines leads to the belief that it is no longer necessary to immunize children. In fact, this is one of the major vaccine controversies. Judging from this discussion, one may say that medical workers should carefully assess the danger of any contagious disease in order to decide whether immunization should be compulsory or not.
Apart from that, it should be borne in mind that some parents simply cannot afford vaccination because they do not have insurance. Hence, it is very important that health care professionals develop strategies which would reduce the expenses; these people should refer to various governmental agencies which give provide free vaccinations (Fraleigh, 2009, p 38). Still, it seems that financial difficulties are not the most formidable obstacle. The underlying cause of parents unwillingness to participate in such programs is the fear of potential risks and most importantly lack of awareness. Therefore, the role of medical workers and particularly nurses becomes crucial.
One of their major tasks is to talk to parents about their concerns. They need to get a better understanding of immunization and its benefits. Unfortunately, very often its importance is significantly underestimated by the community. The patients also have a right to know about the alleged risks of such injections (Sharts-Hopko, 2009). The main objective of parent education is to dispel those myths about immunization, created by mass media. It is also essential that parents or legal guardians are informed about the options they have. The same contagious diseases can be prevented by different vaccines. Some of them may be more or less efficient and this data must be made available to parents. Perhaps, this explanatory work will make people more favorable of vaccination. Unfortunately, nowadays they have very few opportunities to learn more about these questions. So, it is surprising that they refuse to cooperate with medical workers.
Besides, nurses should also take into account that some children may have an allergy to the drugs, thus, they must ensure that this vaccine is compatible with a childs physical state. In this respect, we need to mention immunization of those children who are ill with fever or respiratory tract infections. Scholars believe that they must not receive any injection until recovery (Sharts-Hopko, 2009, p 86). However, under some circumstances parents may not even know that their child is ill especially at early stages of the disease. This is why nurses must pay close attention to such symptoms as high temperature, increased perspiration, fatigue, and others. Actually, the exact aftereffects of vaccination during illness have not been identified, but it is better to be on the safe side. Finally, it is crucial that nurses are familiar with the most recent findings in this field. There is a vast amount of scholarly works dedicated to the study of vaccines and healthcare professionals have bring their knowledge up-to-date.
On the whole, vaccination still remains of the most efficient methods of disease prevention and immunization. Despite the fact that it is often associated with severe complications, its benefits outweigh the risks. The debate about vaccination is stimulated by the newspapers and television, however, there is no conclusive evidence indicating that such form of immunization is hazardous. Therefore, nurses need to tell parents that their fears are usually not grounded. At the same time, parents should also know about the risks associated with a particular vaccine. As healthcare consumers they need to be well-informed of all these issues. As it has been noted before, nurses must be knowledgeable about the recommendations, made by different medical organizations; their practice must be evidence-based. This may enable medical workers to overcome parental reluctance and reduce the risk of complications to a minimum.
Reference List
Bar-Yam; & Bromberg, N. (2000). Political Issues: Calling the Shots; A Brief Look at the Vaccination Controversy. International Journal of Childbirth EducationVol. 15Issue 1, p39-41.
Fraleigh, J. M. (2009). Vaccination: Compliance and Controversary. RN, pp 36-40.
Francis,G., Duclos, P., Margolis, H., Lavanchy, D., Siegrist, C., Meheus, A., Lambert, P., Emiroglu, N., Badur, S. & Van Damme, P.(2005). Vaccine Safety Controversies and the Future of Vaccination Programs. The Pediatric InfectiousDisease Journal, vol. 24, issue 11, pp 953-961.
Mera, K. E. & Hackley, B. (2003). Childhood Vaccines: How Safe Are They? AJN, vol. 103, issue. 2, pp 79 – 88.
Sharts-Hopko, N. C. (2009). Issues in Pediatric Immunization. MCN. vol.34 , pp 80-88.