Vaccination

 Over the past century, immunizations have been utilized in the United States to prevent the spread of illnesses and diseases, helping to nearly eradicate many of these illnesses (Centers for Disease Control and Prevention, 2014). Currently, twenty-eight diseases are vaccine-preventable, including chicken pox, measles, diphtheria, poliomyelitis, and tetanus (Blendell & Fehr, 2012). In recent years parents have been expressing concerns to healthcare providers regarding the necessity and safety of vaccinations, and data has shown that there has been a decrease in the amount of vaccinations being administered (Blendell & Fehr, 2012). Much of the concern is due to unreliable and confusing information that is presented to parents, a majority of which can be found on the internet. With all of this misleading information from resources that may not be reliable, it is difficult for parents to sift through the information and form personal opinions on vaccination safety.

Factors Contributing to Concerns about Vaccines

There are a variety of reasons that parents are either refusing or delaying the Centers for Disease Control and Prevention’s (CDC) suggested immunization schedule. Some of the unreliable sources of information on the internet are anti-vaccination activist websites, or those that are presenting non-scientific data that has yet to be proven. Other concerns expressed by parents include worries about potential allergies to immunizations, lack of funding to pay for immunizations, concerns about possible autism after receiving certain immunizations, and a violation of religious or philosophical principles (Fernbach, 2011). An example of conflicting and confusing data includes the 1998 study released by Andrew Wakefield that claimed to find a link between the measles, mumps, and rubella (MMR) vaccine with autism. This was a very small study that has since been proven invalid (Recame, 2012). However, the rates of children receiving the MMR vaccine was dramatically affected by this study (Recame, 2012). Anti-vaccination websites inform parents that vaccinations may lead to allergies, may cause unnecessary risks to children’s immune systems, and can cause illnesses that they are intended to protect children against. Scientific data is often misconstrued and altered by anti-vaccination activists (Betsch & Sachse, 2012).

The decision to delay or refuse immunizations may unintentionally compromise the well-being and health of all children (Luthy & Orton, 2013). Due to the fact that many of the vaccine preventable diseases are no longer prevalent, many parents are unsure of the necessity to vaccinate their children against them (Smith, 2010). For example, the poliomyelitis virus was very common in the United States, causing paralysis in one percent of those infected with the virus. Of those paralyzed, five to 10 percent died because the paralysis struck the respiratory muscles. The polio vaccine was introduced in 1955, and polio is now nearly eradicated in the United States (CDC, 2013). Despite these advances, vaccine-preventable diseases are still an immense threat in the United States (Smith, 2010).

There are a number of individuals who are unable to be vaccinated due to being immunocompromised from an underlying disease process such as cancer, being too young to receive an immunization, or simply because a woman is pregnant (Cherry & Harriman, 2012). Those who are immunocompromised cannot fight infections properly due to a weakened immune system. These individuals rely on others being vaccinated in order to be protected community immunity, meaning that a large portion of the population is immune, either through a previous infection or by vaccination, thereby protecting the health of those who cannot receive an immunization (Cherry & Harriman, 2012). Recently, there have been outbreaks of both pertussis and measles in the United States. In 2010, there were more than 9,000 cases of pertussis, or whooping cough, reported in California (Cherry & Harriman, 2012). Additionally, 222 cases of measles were reported in 2011, due in a large part by people immigrating into the United States who have not been vaccinated (Cherry & Harriman, 2012). By choosing not to vaccinate, children can be exposed to diseases that could be prevent and can cause illness to those who cannot be vaccinated.

Sources of Reliable Information

         Despite all of the untrustworthy websites, there are also many reliable sources that parents can turn to in order to make an educated decision regarding immunization. In order for parents to be properly educated on immunizations, there are multiple reputable websites that are suggested to research. These include:

• The National Network for Immunization Information: www.immunizationinfo.org
• Parents of Kids with Infectious Diseases: www.pkids.org/immunizations.html
• Vaccinate Your Baby: www.vaccinateyourbaby.com
• Voices for Vaccines: www.voicesforvaccines.org
• The Centers for Disease Control and Prevention: www.cdc.gov/vaccines/
• The American Academy of Pediatrics: www.aap.org/immunization/
• Immunization Action Coalition: www.vaccineinformation.org/

In addition, speaking to a pediatrics healthcare professional is an excellent resource for parents.

Preparing Your Child for Vaccinations

 Prior to presenting to a healthcare provider for a vaccination, there are several ways that parents can prepare. This includes reading any vaccine materials, writing down appropriate questions, gathering your child’s immunization record, and preparing some of your child’s favorite toys or books for comfort measures (CDC, 2012). For an older child, it is appropriate to explain that a shot will pinch or sting. Be sure to ask your healthcare provider about any potential side effects of the vaccine (CDC, 2012). Ask your doctor if you may provide a non-aspirin pain reliever after receiving the vaccine (CDC, 2012). If your child is an adolescent, you may wish to involve your child in the decision-making process for some voluntary vaccines, such as the vaccine for human papilloma virus. Educating the adolescent on why vaccines are important provides the child with a role in his or her own care.

Conclusion

There are many reasons why parents may be opposed to vaccinating children. The take home message is that parents must conduct appropriate research from reputable resources in order to make an informed decision about immunization. Immunizations have eradicated many diseases that have caused loss of life or have altered normal functioning. The decision to not immunize your child could expose them to potentially harmful diseases in the future.

Lacey J. Toomey, BSN, RN is a registered nurse currently working at the University of Pittsburgh Medical Center in Pittsburgh, PA. I am enrolled in a Family Nurse Practitioner Master’s Degree program in Pittsburgh, Pennsylvania. It is my belief that if parents know where to find reliable information about vaccinations, then vaccine compliance will thereby increase.

References

• American Academy of Pediatrics. (2014, February 4). Immunization. Retrieved from http://www2.aap.org/immunization/
• Betsch, C., & Sachse, K. (2012). Debunking vaccination myths: Strong risk negations can increase perceived vaccination risks. Health Psychology, 32 (2), 146-155.
• Blendell, R. L., & Fehr, J. L. (2012). Discussing vaccination with concerned patients: An evidence-based resource for healthcare providers. The Journal of Perinatal and Neonatal Nursing, 26 (3), 230-241.
• Centers for Disease Control and Prevention. (2013, April 17). Polio vaccination. Retrieved from http://www.cdc.gov/vaccines/vpd-vac/polio/default.htm
• Centers for Disease Control and Prevention. (2011, May 20). Preteen and teen vaccines. Retrieved from http://www.cdc.gov/vaccines/who/teens/for-preteens-teens.html
• Centers for Disease Control and Prevention. (2012, June 1). Tips for a less stressful shot visit. Retrieved from http://www.cdc.gov/vaccines/parents/tools/tips-factsheet.html
• Centers for Disease Control and Prevention. (2014, February 7). Vaccine and immunizations. Retrieved from http://www.cdc.gov/vaccines/
• Cherry, J. D., & Harriman, K. H. (2012). Why do vaccine-preventable disease outbreaks occur in the US? Retrieved from http://www.medscape.com/viewarticle/775667_print
• Every Child by Two. (2013). Why vaccinate? Retrieved from http://www.vaccinateyour baby.com/
• Fernbach, A. (2011). Parental rights and decision making regarding vaccinations: Ethical dilemmas for the primary care provider. Journal of the American Academy of Nurse Practitioners, 23, 336-345.
• Immunization Action Coalition. (2013, February 8). Vaccine basics. Retrieved fromhttp://www.vaccineinformation.org/
• Luthy, K. E., & Orton, J. (2013). Get the facts: Making smart decisions about vaccinating your child. Retrieved from http://www.readysetgrowmag.com/index.php?page_id=269&id= 1458&topic=82&idx=82
• National Network for Immunization Information. (2014). Vaccine information. Retrieved from http://www.immunizationinfo.org
• Parents of Kids with Infectious Diseases. (2014). Immunizations. Retrieved from http://www.pkids.org/immunizations.html
• Recame, M. A. (2012). The immunization-autism myth debunked. International Journal of Childbirth Education, 27 (4), 76-78.
• Smith, M. J. (2010). Parental vaccine refusal. Contemporary Pediatrics, 27 (2), 36-47.Voices for Vaccines. (n. d.). Vaccines. Retrieved from http://www.voicesforvaccines.org/