Discussion
Reply to two of your peers who chose two different topics. Provide your own examples of situations in which you have had to discuss immunizations/vaccines. What suggestions might you provide your peers in terms of dealing with misinformation related to this topic?
Replies to your peers must be on two separate days (minimum) and must utilize at least two scholarly references per peer post.
ARTICLE #1 LT
What is herd immunity and how can this help protect individuals who are not vaccinated? What are the rates for your state related to immunizations, and how could this affect herd immunity?
What immunizations should this patient receive today, and is there any leeway in the schedule to help alleviate some of the mom’s concerns
Herd immunity, or community immunity, protects individuals who cannot get vaccinated (CDC, 2021). Herd immunity centers on the idea that the more people with immunity (typically by receiving a vaccine), the less likely the disease will spread throughout the community. According to research, when 7 to 8 out of 10 individuals are immune to a pathogen, the community as a whole is immune (Holubar et al., 2017). It is important to remember that some diseases are more contagious than others. The desired goal is to achieve herd immunity by every eligible individual being vaccinated (Ashton, 2021)
This ensures protection from the disease for susceptible individuals with a weakened immune system or, because of age, health conditions, or other factors, who cannot receive the vaccine. Herd immunity also decreases the risk of a disease outbreak over time. In NH, minors can be exempt from required school and childcare immunizations in two ways a medical or religious exemption. In 2021, 89% of children under five years of age were up to date on recommended vaccinations in NH. The rate for children ages 5-18 increases to 93% overall (DHHS, 2022).
What immunizations should this patient receive today, and is there any leeway in the schedule to help alleviate some of the mom’s concerns?
In this case, the 6-month-old baby should receive vaccinations for their age group to remain current with CDC recommendations. The Centers for Disease Control and Prevention provides an in-depth schedule for infant, child, and adolescent immunizations. According to the Birth-18 Years Immunization Schedule, this infant is due for recommended six-month vaccinations, but a few adjustments to the schedule could be made (2022). During the 2021–2022 school year, state vaccination coverage for all required immunizations decreased from 95% to 93%, while the exemption rate remained low at 2.6% (CDC, 2022). To prevent under-vaccination and the negative outcomes of disruption in vaccination can create, close management and follow-up are essential and will ultimately protect infants and children from vaccine-preventable diseases (Holubar et al., 2017).
Supporting the mom’s autonomy while providing education on vaccine recommendations can alleviate the mom’s concerns about over-vaccination. In this case, I would use open-ended questions to gather information on the mom’s hesitance and provide information to develop a collaborative plan. In this case, the mother should be provided with the risks and benefits of the recommended vaccine schedule.
ARTICLE #2 JDV
Immunizations schedules are devised with the intention of provided the population with accurate and prolong protection from vaccination preventable diseases and infections. Then ACIP declares that” Recommendations for the use of a vaccine depend on a careful balance of benefits of vaccination, duration of protection, risks of disease, and risks of vaccination, (Roper, L. et.al., 2021). The ultimate goal is to create herd immunity through a majority of vaccinated individuals. Immunizations are created with an estimated time of protection. Immunization schedules, according to the article by Roper s evaluated periodically to assess its continued efficacy with the integration of new scientific and technological research. This calculated scheduling of immunizations adds not only to the efficacy but the safety of immunizations.
Therefore, speaking to parents about immunization requirements become an important opportunity to promote health literacy. In speaking to parents of a child during school age, it is essential to inform parents that some immunizations may be effective for a lifetime, while others need to be administered periodically, yet still others are administered yearly due to variations of strains of infection. With the consideration of efficacy through duration and potency pf protection, children are required to receive a set of vaccinations from birth to one year, and another set of vaccinations are required during school aged per the Center for Disease Control Child and Adolescent Chart. The schedules also consider the child’s environment, potential exposure, and level of a child’s ability or inability to fight an infection.
A foster care child is affected by an unstable home, and exposure to various environmental factors. Immunization with a foster child is of even most importance because they are considered a vulnerable group who are affected of low immunization rates and increased risk for illness at the age of seven, an estimated vaccination coverage for foster children is 53.1 – 65.3% compared to 76.6 – 83.4%. The vaccinations which are lacking in foster children are diphtheria, pertussis, tetanus, polio, and Haemophilus influenza type b at seven years of age. Other vaccinations disparities are noted for DTaP, IPV-Hib, Meningococcal -C and MMR, (Hermann, J. S., 2019). The protection is not only for the child but for the household in which this child resides, this is an important fact for a foster parent to realize. Building the immunity of this child is critical to their protection. A foster parent must also be informed of the legal aspects of vaccination, and state requirements in providing care to this child. Additionally, to enroll the child in school for health learning and developmental as an essential part of childhood, the child requires certain vaccinations to matriculate into a school program.
Since each state varies in vaccination requirements and legal standards for care and school system requirements, it is recommended that an APRN observes the requirement of the state and the educational program. For example, in Massachusetts according to the ACIP, the requirements for childcare and preschool children are Hib one to four doses, DTaP 4 doses, Polio 3 doses, Hepatitis B 3 doses, MMR 1 dose and Varicella 1 dose. For Kindergarten DTaP up to five doses by age 5, Polio up to 4 doses, Hepatitis B 3 doses, and MMR 2 doses by age 5, www.mass.gov. Therefore, a foster child who has not been vaccinated after age one, granted they are up to date by age one would require an additional fifth dose of DTaP is required if the fourth dose was administered on or after the 4th birthday unless there are contradictions to DTaP where a DT would be sufficient, MMR and Varicella. A fourth dose of Polio is given on or after the age of four and greater than 6 months after the last dose, otherwise a fifth dose is administered. With the non-foster child, if vaccination schedules are updated, then a lab test for Hepatitis B titers are also adequate if immunity can be established, www.mass.gov. As Roper, L. et al., stated a conversation about vaccination hesitance is important to clarify any misconceptions on vaccines, (2021). An APRN has the unique position of bridging the knowledge gap among parents and children regarding vaccines.
