Niccole Colthorp
Ashley Cruz
Christie Kleinert
Melinda Turner
Rebecca Williams
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The unvaccinated population is at risk to contract life
threatening and highly contagious diseases due to
declining routine vaccinations.
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“Childhood vaccines have the potential to prevent
42,000 early deaths and 20 million cases of disease
among Americans born in a given year, according to a
new analysis” (Gordon 2014).
 This means we can prevent disease outbreak and
exposure by vaccination. This is measurable by the
CDC and the health departments that report the
diseases each year. We can look at their data and
determine that immunizations are effective.
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"Some of the vaccine preventable diseases that still
circulate in the US include whooping cough, chicken
pox, HIB ( cause of meningitis), and influenza. These
diseases as well as the other vaccine preventable
diseases, can range from mild to severe and life
threatening. In most cases, there is no way to know
beforehand if a child will get a mild or serious case"
(CDC, 2012).
If everyone is deciding not to immunize their children
this puts the entire population at risk because now
everyone is compromised.
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The CDC recommends most vaccine series to begin
before the child is 15 months of age.
After the initial vaccines are given to a child, they will
need boosters around 4-6 years and then again at 11-12
years depending on the vaccine.
Adults who were not initially vaccinated as a child can
choose to have some vaccines later in life. They are
generally given in a series and require boosters for
optimum coverage (CDC, 2014).
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35,564 doses of vaccine administered
99% compliance in 280 schools
100% reporting compliance in 230 childcare sites
40.4% flu vaccination rate for ages 6 months-18 years;
highest in state
27.6% flu vaccination rate for ages 6 months and up;
highest in state
(Kent County Health Department, 2012)

Kent County has high compliance rates, but with the
increased number of parents opting out of
immunizations there continues to be the need to
educate the public.

In the late 90’s there was an article published in the Lancet by
Dr. Wakefield about a case study which he claimed linked the
MMR vaccine to autism. It was later found he altered much of
the data to make his case. He published his works with other
credible sources that had not actually looked into the data.
Brian Deer investigated the children used in the case study and
discovered many of them had behavioral issues documented
well before receiving the vaccine (Deer, 2011). There was
another investigation of the case study and the original article
was retracted (Eggertson, 2011). Unfortunately, the damage
was already done. The media took a hold of the article and
began blaming autism on the vaccine, which lead many
parents to avoid vaccinating their children.

Parents thought that not
immunizing their
children provided them
with “herd immunity”.
Which means they are
protected from the
disease because
everyone else is
vaccinated.

Parents refused because
of the number of
vaccines their child
received in 1 visit

Refusal because of
potential side effects,
fear, bad personal
experience, pre-existing
allergies or rashes
Many parents do not know what vaccines are covered by
insurance and where they can get them.
 Pediatrician offices
 Sometimes vaccine shortages
generally give the
can prevent willing parents from
vaccines, but if a child is
vaccinating. “Fortunately,
seen by a general
parents do not have to worry
physician they may not
carry the vaccine in the
about the cost of vaccines in the
office. The parent may
United States; free vaccines are
have a hard time
available to all uninsured and
finding a local health
underinsured children through
department or facility
they can take their child the Vaccines for Children
to as well (Chicago,
program” (Bronfin, 2008, pg 153).
1999).
Another reason for
denying vaccines is lack
of education.
 Many people believe if
you receive a vaccine,
you will develop the
disease (50, n.d.).
People allow this fear
to take over and do
not realize they are
subjecting themselves
to developing the
disease.
 “Scientific evidence has
refuted many of the
misconceptions regarding
vaccine safety; however,
parental refusal of
vaccines is increasing”
(Chatterjee & O’Keefe,
2010, pg 497). If parents
trust their healthcare
provider’s
recommendations,
vaccination rates at the
community level could
increase.

Children are at risk for developing once almost
nonexistent diseases because parents do not feel safe
vaccinating their children.
 Healthcare professionals need to listen to these fears
and explain the facts to parents, preferably before the
child is due.
 Nurses need to be educated and informed on vaccine
safety issues to effectively educate parents on the
risks and benefits of the vaccinations.
Nurses need to stay up-to-date on their
immunizations as well to help decrease the spread of
infection.

Changes would be seen rapidly if the proper education
is there. Once parents are educated and have their fears
re-assured then they can educate others about the
importance of immunizations as well.

Nurses need to reiterate the pros and cons of
immunizing your child and be sure to answer all
questions parents have.
 Anthrax, Diphtheria, Haemophilus Influenza type b (Hib),
Hepatitis A, Hepatitis B, Human Papillomavirus (HPV),
Influenza, Japanese Encephalitis, Lyme Disease, Measles,
Meningococcal, Mumps, Pertussis, Pneumococcal Disease
Polio, Rabies, Rotavirus, Rubella, Shingles, Smallpox,
Tetanus, Tuberculosis, Typhoid Fever, Chickenpox, and
Yellow Fever.
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Best practice includes:
 Primary community prevention-educate parents and
administer vaccines according to recommended
schedule.
 Secondary community prevention-Routine well-child
checks and school screenings

Disciplines that would be involved in addressing the
problem could be:
 Pediatricians in the community
 Leaders in the community
 Health department including public health nurse.
 Local church groups
 Schools
 Local television stations
 Websites with vaccine schedules
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Mass media campaign
Immunization reminder
campaign
Addressing parents
concerns about vaccines
Phone reminders for
children, teens, and
adult for flu and
pneumonia vaccines,
etc.
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A curriculum in schools
about immunizations
To help increase the
number of local children
vaccinated, communities
should offer services at
convenient times and
places and make sure
parents can access those
services.

Kent County provides immunization clinics, schedules,
travel immunizations and affordable immunizations to
those who are not insured.
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Outcomes we could track include compliance with
immunizations in a community.
 The CDC and health departments locally have an
estimate of how many people are receiving the
immunizations.
 We could also track how effective an immunization is
in an area. For example, see how many people
received the flu vaccine and compare that to how
many cases were reported in an area.
Other outcomes measure progress towards
achievement of short-term outcomes:
 Choose areas that need improvement
 Choose how to plan and implement the change
 Provide evidence to support improvements (Public
Health of Canada, 2009).


Desired outcome is “to achieve the highest possible
degree of community protection against vaccinepreventable diseases” (National Vaccine Advisory
Committee, 2003).
The local health department keeps track of the trends of
disease outbreaks so they would be involved in tracking
if there was a change in trends

Childhood immunization is pertinent in preventing
contagious, sometimes deadly, diseases. By immunizing
your child, they create antibodies to build immunity.
Children 5 or less are more at risk for potential diseases
because they do not have the immune system to fight
the infection. By immunizing your child by the age of 2
you protect your child from diseases that they can pick
up from day care or school.
50 Reasons to Not Vaccinate your ChildrenEndAllDisease.com. (n.d.). Retrieved from
http://www.endalldisease.com/50-
reasons-to-not-vaccinate-your-children
Bronfin, D. (2008). Childhood immunization controversies: What are parents asking? The Ochsner Journal, 8(3), 151156. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096324/
Centers for Disease Control and Prevention (2014). CDC - Vaccines - Adult Immunization Schedule, by Vaccine and Age Group.
Retrieved from http://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
Centers for Disease Control and Prevention. (2014, May 19). Vaccines: Vac-Gen/10 Things You Need to Know. Retrieved from
http://www.cdc.gov/vaccines/vac-gen/10-shouldknow.htm
Chatterjee, A., & O’Keefe, C. (2010). Current controversies in the USA regarding vaccine safety. Expert Reviews, 9(5), 497502. doi: 10.1586/erv.10.36
Chicago Department of Public Health (1999). Parental Barriers to Childhood Immunizations. Retrieved from
http://www.orau.gov/cdcynergy/web/IM/Content/activeinformation/resources/IM_ParentFG.pdf
County of Kent. (2014). AccessKent | Kent County, Michigan Retrieved from
https://www.accesskent.com/Health/Immunizations
Deer, B. (2011). How the case against the MMR vaccine was fixed. British Medical Journal, 342, 77-82. doi:10.1136/bmj.c5347
Eggertson, L. (2010). Lancet retracts 12-year-old article linking autism to MMR vaccines. CMAJ: Canadian Medical
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20142376)
Gordon, S. (2014). Vaccines Prevent Millions of Infections, Save Billions in Costs: CDC. Retrieved from
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Infection Control Today. (2011). What Factors Contribute to Suboptimal Childhood Immunization Rates. Retrieved from
http://www.infectioncontroltoday.com/news/2011/07/what-factors-contribute-to-suboptimal-childhoodimmunization-rates.aspx
Kent County Health Department. (2012). 2012 Annual Report. Retrieved from
http://www.accesskent.com/Health/Publications/pdfs/2012_annual_report.pdf Muecke, M. A. (1984). Community
Health Diagnosis in Nursing. Public Health Nursing, 1(1), 23-35.
National Network for Immunization Information. (2010). Demographics of Unvaccinated Children - Immunization Science.
Retrieved from http://www.immunizationinfo.org/science/demographics-unvaccinated-children
National Vaccine Advisory Committee. (2003). Standards for child and adolescent immunization practices. Official Journal of
the American Academy of Pediatrics, 112(4), 958-963. Retrieved from
http://www.immunize.nc.gov/PDFs/2014%20PDF/Standards%20for%20Child%20and%20Adolescent%20Immunizatio
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University of Pennsylvania School of Nursing. (2012, August 22). Intentionally Unvaccinated Students Putting Other Children
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