Addressing the Challenges to Accessing Vaccines

Vaccinations are a part of every child's life.  Ultimately it is up to the parent's decision if their child will receive any vaccines once they are born.  With acceptable pain control along with controlling other side effects; long-term negative psychological effects can be avoided.  In order for this to happen, so that children can receive their vaccinations parents need to be educated.  The best person to educate these parents are the nurses they come across from the beginning of conception to their child's yearly checkups.  A nurse can have a great influence on parents with their own beliefs.  It is crucial that the nurses stay neutral and well educated about vaccines, so they can provide accurate information.  If children don't get vaccinated; communicable diseases can spread, causing the vulnerable populations to become sick.  In turn this increases the number of vaccinations children are now required to get.  By being proactive we could help save the future generations and inhibit the increase of more injections.  

The Importance of Pediatric Vaccinations

         From birth to six years of age; children are expected to receive a total of thirty-two injections from ten different vaccinations.  A vaccine introduces an antigen (a foreign substance that triggers an immune system response) into the body, and the vaccinated person produces antibodies that provide active immunity to a disease without having the clinical disease (London 2017).  Vaccines are meant to improve a child's health, which in turn removes that stress from the parents of having to care for them should they encounter a communicable disease.  When children are born, they are unable to develop antibodies fast enough compared to how quickly they can be exposed to diseases.  This is when passive immunity; like vaccines, is needed.  Vaccines help reduce the severity of the disease if they are exposed or it can even help prevent the disease from developing in the body.

Clinical Manifestations

There are a variety of reactions that a child could have to vaccines.  This is due to the child's immunity and how it responds to the antigen once it enters the body.  The most common reactions are localized redness and swelling, pain, arthralgia, elevated temperature, fussiness, rash, disturbed sleep, malaise, poor appetite and irritability.  When focusing on the common mild problems there is something that parents can do to help prevent or reduce these reactions. 

Prevention of Mild Problems with Antipyretic/Analgesic Medications

        Medications such as acetaminophen/Tylenol can help reduce the mild clinical manifestations related to vaccines if the parent administers the medication before or at the time the vaccination is administered.  One study suggests this practice may negatively affect the child's ability to reproduce an effective immune response to the vaccine; however, other studies say they do not negatively affect the immune response (Eden 2017).  The study that did show a decreased antibody response didn't have enough evidence to support that is was actually harmful to receive acetaminophen beforehand.  Parents can also use ibuprofen as long as the child is six months.  The American Academy of Pediatrics recommends prophylactic treatment with an antipyretic/analgesic medication only for the diphtheria, tetanus, acellular pertussis vaccination when there is a personal or family history seizures.  It is important to educate parents about how to effectively treat common vaccine-related mild common problems (Eden 2017).     

Educating the Parents

        Parents can be concerned with the side effects of these vaccinations, especially febrile seizures.  Parents may be disinclined to have their child receive the vaccination due to this.  Getting a fever post-vaccination is common, although some parents fear the potential for seizure secondary to fever, rather than the fever itself (Eden 2017).  Parents need to understand that these types of seizures only last approximately one to two minutes or less and on average they do not cause perpetual harm.  Most parents don't know that these seizures are uncommon after vaccinations.  However, giving the child an analgesic/antipyretic medication prior to the vaccination doesn't decrease the chance of them having a febrile seizure.  If it does happen the parents need to take their child to their pediatrician.  The way parents respond to the pain or anxiety of their child can directly affect the stress level of the child (Duda 2018).  The child will be able to relax more if the parents are calm.   Nurses can contribute, by making sure the parents are well educated about each vaccine and what to expect with each one.    

Do Nurses' Beliefs Impact Patient Safety?

        Parents have the right to say what their child may or may not receive for vaccinations.  Nurses can also agree or disagree with vaccinations.  However, nurses can't let their biased opinions influence a parent's decision.  If a nurse is against vaccinations and voices that to a parent, it could impact that child's future of attending a public school.  In July 2016 a law was passed that require all children enrolled in public and private schools or daycares to be vaccinated against certain vaccine-preventable diseases (Oh 2016).  Nurses and parents have several reasons for refusing to get vaccinated.  The most common reasons are fear of needles, fear of getting sick from the vaccine, and belief that the vaccine is ineffective or unnecessary (Oh 2016).  They may also feel that they are in great health; therefore, they don't need a vaccine. 

Nurses Are Trusted

Nurses are the most trusted profession, which means that they have the greatest impact on the people they come across.  They have many opportunities to influence the decisions of clients on whether or not to receive a vaccination (Oh 2016).  When vaccinations aren't administered outbreaks can happen.  For example, there was a recent outbreak of mumps and the number of cases has increased in the last decade.  The ACIP reviews these issues and has now decided that a third dose of the MMR vaccine is warranted (Zimlich 2017).  It is important for nurses to understand that education can start as early as birth.  If the client trusts their nurse, they will be more inclined to listen about vaccinations from the beginning.  Vaccinations should be encouraged from health care professionals, because they may the key to harnessing the power of the infant's own immune system (Zimlich 2017). 

Conclusion

In the end more children will be protected from communicable diseases if the parents choose to get them vaccinated.  Proper education about vaccinations will help decrease the risk of illness and hospitalization in children.  When working with children knowledge of their level of cognitive development, ability to adjust to their environment, and their stress response is important (Duda 2018).  

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