Healthy Populations Paramita Pal Roy MN505M4 Purdue University Global Professor Jimmy Reyes Topics Introduction What is immunity The effects of immunization Trends of vaccination Myths about vaccination Pediatric schedule of immunization Legal, ethical and cultural issues of vaccination Conclusion Introduction Scientists made a significant contribution when they developed immunization, which helped eradicate many deadly diseases and prevent many health disparities. The Centers for Disease Control and Prevention (CDC) recommend children be vaccinated on a regular basis throughout their childhood to provide immunity before they are exposed to potentially life-threatening diseases (CDC, 2019). Vaccines have been shown to be both safe and effective in preventing outbreaks of deadly diseases. As advanced nurse practitioners, it is our responsibility to raise vaccination awareness. Healthcare providers must educate our patients about the importance of vaccination and address any concerns they may have. What is immunity? Immunity is the body's ability to defend itself against pathogens such as bacteria and viruses. There are two types of immunity: active and passive (CDC, 2021). Active immunity is obtained through either natural disease exposure or vaccine-induced immunity (CDC, 2021). Natural immunity is acquired from exposure to the disease organism through infection with the actual disease (CDC, 2021). Receiving antibodies against the disease provides passive immunity (CDC, 2021). •Vaccine-induced immunity is obtained by injecting a dead or weakened form of the disease organism (CDC, 2021). Herd immunity In a herd immunity large portion of the population is immune to a disease through vaccination or natural immunity (APIC, n.d.). Immunocompromised people are less likely to contract the disease in a herd community because they are close to others who are not carriers of the disease (APIC, n.d.). Achieving herd immunity requires a high level of vaccination coverage or natural immunity within a population (APIC, n.d.). If too many people remain unvaccinated or have not been previously infected with the disease, outbreaks can still occur (APIC, n.d.). Therefore, it is crucial for individuals to get vaccinated and for public health officials to promote vaccination campaigns in order to protect the entire community from infectious diseases (APIC, n.d.). The effects of immunization Vaccines play an important role in keeping people healthy throughout their lives by increasing immunity and protecting them from serious diseases Services (HHS, 2022). Vaccinating a community creates a herd community in which enough people are immunized against a specific disease, preventing its spread and making the entire community less likely to contract it (HHS, 2022). Vaccination, sanitation, and access to clean water are all factors that have improved health outcomes across the globe(Rodrigues & Plotkin, 2020). It is estimated that vaccines have prevented 6 million deaths from vaccine-preventable diseases annually (Rodrigues & Plotkin, 2020). Worldwide vaccination has helped eradicate diseases like polio and smallpox (Rodrigues & Plotkin, 2020). Vaccination contributes to economic growth by saving money on medical tests, procedures, and treatments, as well as allowing patients and parents to take less time off work (Rodrigues & Plotkin, 2020). Trends of vaccination The CDC advises routine vaccination during the first 24 months of life against 14 diseases (Hill et al., 2023). CDC recommends following vaccines be completed by the age of 24 month :Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella (MMR) ,Hemophilus influenzae type b (Hib),Hepatitis B (Hep B) ,Chickenpox (Varicella), (Pneumococcal conjugate vaccine (PCV),Combined 7-vaccine series (Hill et al., 2023). In comparison to children born in 2016-2017, coverage for most recommended vaccines increased among children born in 2018-2019 (Hill et al., 2023). Children living in rural areas or below the federal poverty line experienced a 4- to 5-percentage-point decline in vaccination coverage during the COVID pandemic (Hill et al., 2023). Children with private insurance had higher coverage than children with other insurance or no insurance (Hill et al., 2023). The study found no overall decrease in vaccination coverage among all children due to the COVID-19 pandemic. Routine immunization reduced the incidence of all targeted diseases, with reductions ranging from 17% (influenza) to 100% (polio). In the 2019 United States population of 328 million people, these reductions equate to more than 24 million cases of vaccinepreventable disease avoided (Talbird et al., 2022). For all children and adolescents 6 months of age and older who do not have any contraindications, the American Academy of Pediatrics suggests the COVID-19 vaccination(AAP, 2019). Across the total of US children 6 months to 17 years, approximately 56%, 40.5 million children, have not received a first dose of the COVID-19 vaccine(AAP, 2019). Myths about vaccines Vaccines cause autism and sudden infant death syndrome (SIDS)- The 1998 study that raised concerns about a possible link between measles-mumps-rubella (MMR) vaccine and autism was retracted by the journal that published it because it was significantly flawed by bad science (AAAAI, n.d.).There is no evidence to link vaccines as the cause of autism or SIDS (AAAAI, n.d.). A child can get the disease from a vaccine-Most vaccines are inactivated (killed), making disease transmission impossible. Certain vaccines contain live organisms and receiving them can result in a mild case of the disease (AAAAI, n.d.). Vaccines contain many harmful ingredients-Vaccines contain ingredients that make the product safe to use. Thimerosal, a mercury-containing compound, and formaldehyde, another vaccine ingredient thought to be harmful, contain ingredients at even lower doses than we are naturally exposed to in our environment (AAAAI, n.d.). Vaccine-preventable diseases are just part of childhood. It is better to have the disease than become immune through vaccines-Vaccines stimulate the immune system to produce an immune response to natural infection, but they do not cause the disease or put the immunized person at risk of its potential complications (AAAAI, n.d.). Pediatric vaccine schedule Figure 1:A picture of immunization schedule adopted from https://www.cdc.gov/vaccines /schedules/hcp/imz/childadolescent.html Legal, ethical and cultural issues of vaccination Ethical issue Individual freedom and decision-making vs. protecting the entire at-risk population (Ulmer & Liu, 2002). The ethical issues surrounding vaccination in wealthier countries tend to focus on the rights of individuals versus the government or society, whereas poorer countries lack access to basic health necessities such as adequate nutrition, clean water, medicines, or vaccines (Ulmer & Liu, 2002). Vaccines are made for profit; without economic support no company will not be able to manufacture and do research for new vaccines(Ulmer & Liu, 2002). Legal, ethical and cultural issues of vaccination Issues about laws for vaccination Public Health Law Program (PHLP)- For children to attend school in all states, they must be immunized against several communicable diseases (Barraza et al., 2017). The 2014-2015 measles outbreak sparked policy debates about vaccine requirements and exemptions, which only required vaccination exemption for medical reasons.(Barraza et al., 2017). Healthcare Worker Vaccination-Laws require healthcare facilities to assess the vaccination status of healthcare workers, offer vaccination to healthcare workers, require healthcare workers to be vaccinated, have a valid medical or religious exemption, or make another declination statement (Barraza et al., 2017). Pharmacist Vaccination Authority Laws- States have restrictions on the types of vaccines pharmacists can administer, as well as age restrictions for prescribing vaccines (Barraza et al., 2017). Cultural issue Some religions and belief systems advocate contrasting views on vaccination. Religious opposition to vaccines is typically motivated by ethical concerns about using human tissue cells to create vaccines, as well as beliefs that the body is sacred, should not be exposed to certain chemicals, blood, or tissues from animals, and should be healed by God or natural means (History of Vaccines, n.d.). Conclusion Vaccines are a life-saving tool for saving the world's population. Convincing the entire population to get vaccinated presents several challenges. Fear of side effects, religious beliefs, and misinformation are the most common reasons for not getting vaccinated. However, it is important to note that most vaccine side effects are mild and temporary, and the benefits far outweigh any potential risks. Vaccinations have been critical in the eradication of diseases. Individuals who get vaccinated not only protect themselves, but also contribute to herd immunity, which protects those who are unable to get vaccinated due to medical reasons. Vaccinations are therefore critical in maintaining public health and preventing the spread of infectious diseases. Individuals must educate themselves on the benefits of vaccinations. References American Academy of Allergy Asthma & Immunology(AAAAI). (n.d.).Vaccines: The myths and the facts. https://www.aaaai.org/Tools-for-the-Public/Conditions-Library/Allergies/vaccine-myth-fact American Academy of Pediatrics (AAP) (n.d.).Children and covid-19 vaccination trends. https://www.aap.org/en/pages/2019novel- coronavirus-covid-19-infections/children-and-covid-19-vaccination-trends/ Amin, A.N.E., Parra, M.T., Kim-Farley, R. Jonathan E. Fielding Ethical Issues Concerning Vaccination Requirements (2012). Public Health Rev 34, 14 https://doi.org/10.1007/BF03391666 Association for Professionals in Infection Control and Epidemiology (APIC). (n.d.). Herd immunity. https://apic.org/monthly_alerts/herd-immunity/ References Barraza, L., Schmit, C., & Hoss, A. (2017). The latest in vaccine policies: Selected issues in school vaccinations, healthcare worker vaccinations, and pharmacist vaccination authority laws. The Journal of law, medicine & ethics :A Journal of the American Society of Law, Medicine & Ethics, 45(1_suppl), 16–19. https://doi.org/10.1177/1073110517703307 Centers for Disease Control and Prevention (CDC).(2019). Why it’s important to vaccinate your children. https://www.cdc.gov/vaccines/parents/why-vaccinate/index.html Centers for Disease Control and Prevention. (2021). Types of immunity to a disease. https://www.cdc.gov/vaccines/vacgen/immunity-types.htm Centers for Disease Control and Prevention. (2022a). FastStats Immunization. https://www.cdc.gov/nchs/fastats/immunize.htm Centers for Disease Control and Prevention (CDC). (2023). Birth-18 years immunization schedule – healthcare providers. https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html References Hill, H. A., Chen, M., Elam-Evans, L. D., Yankey, D., & Singleton, J. A. (2023). Vaccination coverage by age 24 months among children born during 2018–2019 — National Immunization Survey–Child, United States, 2019–2021. MMWR. Morbidity and Mortality Weekly Report, 72(2), 33–38. https://doi.org/10.15585/mmwr.mm7202a3 History of Vaccines. (n.d.). Cultural perspectives on vaccination. https://historyofvaccines.org/vaccines-101/ethicalissues-and-vaccines/cultural-perspectives-vaccination Ulmer, J., Liu, M. (2002). Ethical issues for vaccines and immunization. Nat Rev Immunol 2, 291–296 https://doi.org/10.1038/nri780 Rodrigues, C. M. C., & Plotkin, S. A. (2020). Impact of Vaccines; Health, Economic and Social Perspectives. Frontiers in Microbiology, 11, 1526. https://doi.org/10.3389/fmicb.2020.01526 References Talbird, S. E., Carrico, J., La, E. M., Carias, C., Marshall, G. S., Roberts, C. S., Chen, Y.-T., & Nyaku, M. K. (2022). Impact of routine childhood immunization in reducing vaccine-preventable diseases in the United States. Pediatrics, 150(3). https://doi.org/10.1542/peds.2021-056013 . U.S. Department of Health and Human Services (HHS)(2022). Vaccines protect your community. https://www.hhs.gov/immunization/basics/work/protection/index.html
