Question

1. Why do you believe some parents are against vaccinating their children? Explain your answer
2. Imagine you are a healthcare administrator for a 100-bed nursing home facility. How would this issue affect your facility? Explain your rationale using the reading and outside sources.

Answer 1

Why do you believe some parents are against vaccinating their children?

Vaccinations against life-threatening diseases are one of the greatest public health achievements in history. Literally millions of premature deaths have been prevented, and countless more children have been saved from disfiguring illness. While vaccinations carry unavoidable risks, the medical, social and economic benefits. However, vaccines are becoming a victim of their success--many individuals who have never witnessed diseases against which vaccines protected them are not considering the seriousness of the need of vaccination resulting in poor vaccination rates.

“Vaccine hesitancy” is a relatively new term used in research over the past few years to describe anyone who is doubtful about vaccinations or who chooses to delay or refuse immunizations even when they are readily available. Vaccines play a vital role in preventing diseases in children. So it is crucial that healthcare professionals understand the reasons that parents are hesitant or refuse to vaccinate their children.

There have been a number of studies examining the reasons why parents refuse, delay, or are hesitant to vaccinate their children

Some states allow exemption of vaccination when parents cite religious reason and special accommodations for those expressing philosophical reasons:

Reasons expressed by parents vary widely but can be classified into 4 overarching categories. These categories are religious reasons, personal beliefs or philosophical reasons, safety concerns, and a desire for more information from healthcare providers

Religious reasons:

Religious reasons tend to account for the majority of total vaccine refusal. Religious reasons are distinct from other reasons because they are generally linked to the core beliefs of the parents, and it is very difficult to persuade these individuals from views against immunization. There choices are not due to ignorance but are intentional and calculated decision taken on the basis of their religious conviction. Therefore it presents a major obstacle to health care providers who are seeking to increase immunization rates. Countries which have exemption of vaccination also have more incidence of vaccine preventable communicable diseases in children.

Personal beliefs or philosophical reasons:

Although it seems contrary to normal belief that parents try to do their best for the well being of their children and it is universally agreed that vaccination protects child from communicable diseases that is a significant cause of childhood mortality and morbidity, parents refuse or delay vaccinating their children for personal or philosophical reasons. Many parents do not see the preventable diseases as serious or life-threatening and would prefer to not put extra chemicals into their children's bodies. Some parents believe that natural immunity is better for their children than is immunity acquired through vaccinations, and if their child contracts a preventable disease, it will be beneficial for the child in the long term, as it will help make the child's immune system stronger as he grows into adulthood.

Some parents believe that the diseases for which we vaccinate are not very prevalent so their children are at minimal risk of contracting these diseases. For this reason, they also believe that the possible negative side effects of vaccine administration outweigh the benefits of the vaccines. Other parents think if their children have healthy diets and lifestyles they are at a decreased risk of contracting preventable childhood diseases.

Safety concerns:

A third, and potentially the greatest, reason parents express for refusing vaccinations for their children are concerns about the safety of vaccines. Main concerns are about safety of vaccines, doubts about both short-term adverse reactions and the possibility of long-lasting negative effects.

It is mainly based on occasional incidences of death or disabilities in children, actually not due to vaccine itself but due to inferior quality / contaminated vaccine, equipment, faulty administration or vaccine failure by media or people or acquaintances. Usually these cases are reported and highlighted by television, or other media often for TRP ratings, social media also plays a role in spreading content without testing its authenticity.

Regardless of the source these rare occurrences breed fear in the hearts and minds of parents, who overestimate the dangers associated with vaccinations. They are constantly bombarded with other peoples' opinions about vaccinations. All of this information can be overwhelming for some parents making it difficult for them to make their own well-informed decisions.

Another fear is about simultaneous administration of multiple vaccines, they think it may overload their child's immune system, and allowing all of the vaccinations to occur according to the recommended schedule will increase their risk. So some prefer missing a vaccine in between while others opt for delaying the scheduled date.

Lack of knowledge or desire for additional information:

The fourth common theme identified by multiple researchers are that parents want more information regarding vaccinations. They want to be able to make informed decisions about their child's healthcare by knowing both the benefits and risks associated with each vaccine. Many parents indicated lack of access to sufficient information, unapproachability (not easy to talk) of health care providers. Many parents desire to have more detailed information regarding the side effects and benefits associated with vaccines expressed in a factual way.

Imagine you are a healthcare administrator for a 100-bed nursing home facility. How would this issue affect your facility? Explain your rationale using the reading and outside sources.

Impact of poor vaccination on facility:

This issue of vaccination hesitancy, if not addressed properly on time will result in poor vaccination rates among children.

· As a consequence incidences of vaccine preventable communicable diseases will increase in children. As these diseases are highly contagious, there will be a large number of cases in short duration. there are chances of epidemic.

· It will increase burden on hospital, cost of treatment and hospitalization which is far greater than the negligible cost of vaccination and many of vaccines are offered free of cost too.

· Complications of some diseases will have long term impact due to disability resulting from them. For example in case of polio, hearing deficit and deafness from measles and mumps. Lost productivity resulting from convalescence and long-term disability and premature death also affects countries economy too.

Measures to address the issue:

· Healthy relationships between a practitioner and parent can go a long way toward helping patients in terms of this concern. Trust is paramount and will help put parents at ease and help them overcome unmerited fears.

Healthcare providers can play a vital role in improving vaccination rates by providing unbiased, factual information relating to vaccines as well as the discussion of these issues with the parents. Healthcare provider was one of the most important sources of information for the parents. A number of resources printed as well as electronic can be shared and explained to the parents. Parents should have the freedom to be able to ask questions without judgment. When parents do not get the information they want from their providers they seek information from other sources that can potentially mislead and misinform them, causing them to make poor choices for their children.

· Although only a handful of states allow exemptions for philosophical or personal beliefs and religious basis. Personal beliefs of parents need to be closely examined as they may present opportunities for health care practitioners to enlighten parents regarding the urgency of protecting the children through preventive measures.

· Religious basis is the most complex one and difficult to deal with. In some state’s lawmakers have placed guidelines that mandated that in order for schools to grant religious exemptions, the parents had to demonstrate their “genuine and sincere religious belief” that contradicted the use of vaccinations. These evidences of proof are likely to become more popular as an increasing number of parents attempt to use the nebulous loophole of religious freedom to bypass the societal necessity of combating preventable diseases through immunization.