Category: Vaccination

Literature Review

An article by Stewart (2008) sets a good background for the topic by discussing the school-entry HPV vaccine in the context of public policy and legislation. The author uses the methodology of policy synthesis and legal analysis to describe the implications of establishing the HPV vaccine as a school-entry requirement for policy and practice. The article argues that the HPV vaccine is effective and using school-entry requirements is a proven method of increasing coverage rates, as well as a direct implementation of national health recommendations. Since HPV is not communicable in school settings and parental concerns were present, jurisdictions requiring the vaccine permitted opt-out rights, and it is up to policymakers to determine whether schools should be used for the health services delivery.

The study by Hansen, Okoloko, Ogunbajo, North, and Niccolai (2017) focuses on the acceptability and attitudes towards school-based health centers (SHBCs) for administering HPV vaccinations. The authors used the methodology of qualitative interviews and structured surveys with both parents and students. The results found that participants favorably viewed using SHBCs for vaccines, with 59.5% for middle schools and 80.5% for high schools. Nevertheless, the parents voiced concerns that may serve as barriers to using the school resources including worry about health services outside a health facility and fragmentation of medical records as well as a generally negative perception of SHBC’s. The authors believe this can be addressed through education and the improvement of coordinated care.

A study by Goggin et al. (2018) is an international example of utilizing school-based vaccinations in Quebec, Canada. The study is meant to determine the prevalence of HPV infections five years after introducing a public-school HPV vaccination. The researchers recruited a sample of more than 2000 women aged 17-29 from post-secondary institutions. Their risk factors and vaccination status were assessed by a computer program and a biological sample was taken to test for the presence of STIs include HPV infections. The authors found that vaccination rates were at 83.5% in ages 17-19 and only 19.1% in older women.

The general prevalence of HPV was 34.9% in sexually active women of all ages. The study concludes that HPV prevalence is rare in women who have had the vaccine, while practically nonexistent if the first vaccine was administered before sexual debut.

The article by Pierre-Victor et al. (2017) focuses on the specific mandated school-entry HPV vaccine policy in Virginia for 13-17-year-old females. The researchers used data from the National Immunization Survey-Teen including a sample of 3,203 females, with statistical analysis conducted to compare VA with other neighboring states without mandated school-entry vaccines. It was found that the Virginia policy had no significant effect on HPV vaccination coverage among adolescent females. Neither did it impact the commonality of physician recommendations which was the most effective factor in association with increased vaccination not just in Virginia but in neighboring states.

A study by Thompson, Livingston, Daley, & Zimet (2018) focuses on examining a similar mandated school-entry requirement initiative in Rhode Island, which included both sexes. Data was also used from the National Immunization Survey-Teen database which estimated gender-specific effects and using a difference-in-difference design to examine state policy. The results found an 11% increase in vaccination rates among boys, but no significant differences among girls in Rhode Island compared to other states. The researchers conclude that although school-mandated vaccines remain controversial and with mixed results, they can potentially narrow the gap to vaccine delivery and improve the strategy of increasing vaccine uptake for both genders.

Finally, Niccolai and Hansen (2015) conducted a synthesis of literature regarding various practice and community-based interventions, including school programs on HPV vaccine coverage. The methodology consisted of searching medical databases with keywords and identifying studies with adolescents and HPV vaccinations. The studies included reminder and recall, physician-focused interventions, school interventions, and social marketing. Conducted with various populations and geographical areas, the majority found significant increases in vaccination uptake, with only one showing minor improvement and one with mixed results. This is an indication that varied approaches to HPV vaccinations can be effective for diverse populations.

Strengths and Limitations of Literatures

As a whole, the body of literature demonstrates some of the initial efforts in health policy research for HPV vaccine mandates or programs. The studies are able to examine varying perspectives on the issue as well as outline the epidemiological aspects of the disease. The discussion around policy implementation, such as the primary reasoning behind it, comparisons to other programs, and public health justifications for it are competently presented.

The limitations of the literature can be attributed mostly to methodology. since all of the studies indicated reliance on self-reporting of vaccination of status which may be biased. Analysis of the issue is also rather limited or short-term, that may be insufficient to see results of interventions in the long-term as public health policy, especially as controversial as school-initiated vaccinations, take time to come into effect and become accepted by the public. Few of the studies present potential recommendations or policy alternatives.

It is currently not clear, particularly what can increase the HPV vaccine intake considering that school-mandated vaccinations only had minor impacts, particularly in jurisdictions where the policy was implemented. It is unclear the extent to which the schools and government agencies are able to correctly present this vaccination with triggering parental concerns due to the sensitive sexual-related nature of HPV.

Further research can also focus on identifying reasons for such strong public dissent against this particular vaccine, leading to suboptimal rates in the United States when generally the population adheres to standards on all other vaccinations. There are also potential ethical and legal challenges regarding mandated HPV vaccination, particularly to children at such as young age. Further research is necessary into the ethics of the issue as the vaccine may have an impact on the sexual behavior of teens as well as the common mandate to only vaccinate girls rather than both genders.

Policy and Practice Implications

The overall body of literature’s impact on policy suggests that while school-mandated HPV vaccinations can slightly increase rates, the negative perceptions of school-based health centers and initiatives, as well as parental concerns regarding the vaccination call to pursue other policy and practical avenues. Research suggests that community-based initiatives and physician-recommended vaccinations have a positive influence on the uptake of HPV vaccinations, including “catch-up” individuals seeking the immunization at a later age.

Therefore, in terms of policy, the school-mandated vaccinations have received tremendous backlash in both Virginia and Rhode Island, with the former demonstrating little impact on its low vaccination rates, while the latter has relatively high coverage. More time is potentially necessary to study states such as Rhode Island and countries internationally (Australia) that have had success with mandated HPV vaccinations.

However, the government should utilize a mixed method of approaching the issue along with school mandates. Police should focus on universal vaccine coverage to increase uptake through physician recommendations that at least two of the studies noted as effective. This would help to remove barriers to access to healthcare for vulnerable and low-income populations that are unable to receive the vaccine easily. Health equity is a critical concept in terms of mass vaccinations, and it is vital that all populations have access regardless of their socio-economic status.

It may viable to allow health professionals such as school nurses or pharmacists to administer the vaccine to anyone at a recommended age and with parental permission. Finally, the policy should focus on improved awareness and education, which is largely responsible for the success of programs in Rhode Island, as well as other countries which were discussed in the literature, even if community initiatives were used to administer the vaccine.

Literature indicates that there are a rather broad unfamiliarity and lack of understanding of HPV, particularly in the context of young children. This leads to underutilization of the vaccine, even by populations to whom it is readily available. Therefore, policy focus should be directed towards social marketing and education in combination with programs to implement HPV vaccination initiatives in healthcare settings where there is greater trust from the public and parents unlike attitudes towards educational institutions.

It is important to consider diversity as part of the policy approach. A study by Lai et al. (2018) shows that racial and ethnic minorities, especially those who are immigrants in the United States have significantly lower awareness and knowledge of the HPV vaccine, and those that do, heard it through personal networks rather than reliable health resources. In the context of health equity, it may be viable for community-focused policies to improve access and culturally competent delivery of HPV information through official healthcare system sources, and potentially increase voluntary participation in providing the vaccine to their children.

This creates numerous policy and health opportunities to develop community-based programs towards HPV education and vaccination availability. As noted by several studies, the sociopolitical climate is a consideration as well when designing policy, and in most states, including Virginia, it is not currently present for widespread support of the school-mandated policy. Nevertheless, the importance of HPV vaccinations should be advocated and directed towards funding programs at local levels that would cooperate with healthcare providers and community health organizations as the most direct method of bringing awareness and providing the vaccine. In turn, this will have an extensive impact on public health as the burden of the disease and its potential risk factors will be reduced.

Conclusions

A wide variety of literature exists on school-based interventions for HPV vaccinations, with interventions ranging from school health centers to a mandatory requirement for entry into the public education system. The practice of using schools as a mechanism for HPV vaccine coverage or awareness is common, both in the United States and internationally. However, there have been mixed results regarding the uptake of HPV vaccinations as well as various policy and social challenges to both implementing school-based programs or achieving successful results.

References

Centers for Disease Control and Prevention. (2017). HPV fact sheet. Web.

Goggin, P., Sauvageau, C., Gilca, V., Defay, F., Lambert, G., Mathieu-C., S., … Coutlée, F. (2017). Low prevalence of vaccine-type HPV infections in young women following the implementation of a school-based and catch-up vaccination in Quebec, Canada. Human Vaccines & Immunotherapeutics, 14(1), 118–123. Web.

Hansen, C. E., Okoloko, E., Ogunbajo, A., North, A., & Niccolai, L. M. (2017). Acceptability of school-based health centers for Human Papillomavirus Vaccination visits: A mixed-methods study. Journal of School Health, 87(9), 705-714. Web.

Lai, D., Bodson, J., Davis, F. A., Lee, D., Tavake-Pasi, F., Napia, E., … Kepka, D. (2016). Diverse families’ experiences with HPV vaccine information sources: A community-based participatory approach. Journal of Community Health, 42(2), 400-412. Web.

Niccolai, L. M., & Hansen, C. E. (2015). Practice- and community-based interventions to increase Human Papillomavirus vaccine coverage. JAMA Pediatrics, 169(7), 686-692. Web.

Pierre-Victor, D., Page, T. F., Trepka, M. J., Stephens, D. P., Li, T., & Madhivanan, P. (2017). Impact of Virginia’s school-entry vaccine mandate on Human Papillomavirus vaccination among 13–17-Year-old females. Journal of Women’s Health, 26(3), 266-275. Web.

Stewart, A. (2008). Childhood vaccine and school entry laws: The case of HPV vaccine. Public Health Reports, 123(6), 801-803. Web.

Thompson, E. L., Livingston, M. D., Daley, E. M., & Zimet, G. D. (2018). Human Papillomavirus vaccine initiation for adolescents following Rhode Island’s school-entry requirement, 2010–2016. American Journal of Public Health, 108(10), e1–e3. Web.

Recently, the global community has witnessed a spread of the anti-vaccination movement the followers of which refuse to immunize their children upon birth, citing allergic reactions. Some groups go as far as denying the progress of public health brought on by vaccines. Although studies questioning the immunization benefits exist, the majority of the scientific community agrees on the safety of most existing treatments. Termed “anti-vax”, the movement has been recognized by the World Health Organization as a danger to global health (“Ten Health Issues”).

The first vaccine hesitation wave of the 1990s triggered numerous worldwide epidemics of measles, a contagious infectious viral disease. Fortunately, the condition is vaccine-preventable, as over 80% of the lethal outcomes have been eradicated since the first outbreak in the 1980s (GBD 2015 Mortality Collaborators 1482). Because of its easily spreadable nature, measles has been a public health concern and required mandatory immunization in many countries since then.

The disease affects 91% of all unvaccinated people, sometimes resulting in serious complications, including but not limited to pneumonia, diarrhea, seizures, and even blindness (Atkinson et al. 210, 216). Since 2017, the death toll for measles-affected populations has been rising due to the mass-following of the anti-vaccination movement and presents a serious threat to global health (“Measles Cases Spike Globally”). Since anti-vaccination is a complex problem, it requires an ecological framework approach to solve it.

Focusing on the US as the sample population, one can rely on the interaction of the model’s components (personal, interpersonal, organizational, community, policy) to achieve the desired result (Balcazar et al. para. 9). Firstly, “pro-vaccination” activists need to ensure full comprehension of the problem and its solution. That is, they need to know both sides of the story, analyzing which side lies closer to the truth, and focusing on that as their message.

Next, activists need to use their network to pass their knowledge. For instance, they could share recent findings of vaccination-related research, such as the life-long stabilization of health systems of a treated person as well as the effectiveness of the method overall (Wilder-Smith et al. 138). Spreading truthful information would encourage others to reconsider their views, perpetuating the correct stance across the person’s network.

Furthermore, as the problem moves onto the organizational level, it affects individuals otherwise not reached in intrapersonal interactions. Organizations can educate the population about the vitality of immunization. Apart from hosting information sessions and seminars, they can partner with institutions and offer free vaccinations. Similarly, such organizations can tackle the community level, spreading their message until the understanding becomes collective. Then, the network effect is likely to take place through the individual members of the group, and information to expand onto adjacent communities or neighborhoods.

The last is the policy level, which might be the most effective way of addressing the anti-vaccination upheaval. Some countries already have a policy of mandatory immunizations required to enter any educational institution or corporation. As most public and private educational institutions already require a vaccination record, the government needs to address home-schooled or self-employed populations. While it is hard to reach families that refrain from public or private schools, unvaccinated individuals will likely encounter some individual-institution interaction eventually. Since most people in the US rely on health insurance, it is logical to make vaccination a qualifier for purchase. Similarly, any affiliation with defined communities like gyms should encourage the record of immunization to ensure the safety of its members.

Thus, the above analysis addressed the issue of anti-vaccination and its possible outcome such as the measles outbreaks, in the US and worldwide. Vaccine hesitancy is a dangerous problem that sometimes carries heavy, and even lethal consequences, and can become a national emergency. Therefore, it is vital to address the issue on multiple levels to reverse or stop the movement, ensuring greater security of public health.

Works Cited

Atkinson, William, et al., editors. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12^th ed., Public Health Foundation, 2015.

Balcázar, Hector, et al. “An Ecological Model Using Promotores De Salud To Prevent Cardiovascular Disease on the US-Mexico Border: The HEART Project.” Preventative Chronic Disease, vol. 9, 2012, p. E35.

GBD 2015 Mortality and Causes of Death Collaborators. “Global, Regional, and National Life Expectancy, All-Cause Mortality, and Cause-Specific Mortality for 249 Causes of Death, 1980-2015: A Systematic Analysis for the Global Burden of Disease Study 2015.” Lancet (London, England), vol. 388, no. 10053, 2016 pp. 1459-1544.

“Measles Cases Spike Globally Due to Gaps in Vaccination Coverage.” World Health Organization. 2018. Web.

“Ten Threats to Global Health In 2019.” World Health Organization. Web.

Wilder-Smith, Annelies., et al. “The Public Health Value of Vaccines beyond Efficacy: Methods, Measures and Outcomes.” BMC Medicine, vol. 15, no. 1, 2017, p. 138.

Introduction

The invention and evolution of vaccination as a method for fostering long-term protection against certain pathogens has had an immense positive effect on public health. Throughout the 20th century, vaccines allowed reducing the global incidence of some deadly diseases, including smallpox and congenital rubella syndrome, by at least 99% (Orenstein & Ahmed, 2017). By providing protection against many life-threatening viruses and bacteria and preventing serious morbidity, vaccination not only assists in promoting individual and community well-being but also serves as the most cost-effective method for the elimination of many infectious diseases.

Regardless of vaccines’ multiple positive impacts, the contemporary anti-vaccination movement is gathering momentum. It is valid to say that the rising negative attitude to artificial immunization is largely due to the misunderstanding of the mechanisms through which vaccines act, their interactions with the immune system, and potential vaccine-related risks to individuals’ health. Considering this, the present paper will aim to explore the concept of vaccination and explain how it stimulates responses at different levels of the immune system. Additionally, different types of vaccines will be reviewed along with the most recent developments in the field of immunization.

Overview

Although the science of vaccination commenced advancing merely by the end of the 18th century, evidence shows that first attempts to create vaccines were made in antiquity. It is known that the process of variolation was practiced in ancient China: people tried to induce immunity by intranasally inhaling small pieces of scabs collected from smallpox lesions of infected persons (Davies, Schmidt & Sheikh 2012). In the 18th century, Lady Mary Montagu introduced and promoted variolation in Western Europe and Britain after observing how this procedure was successfully implemented in Turkey (Davies, Schmidt & Sheikh 2012).

However, a significant milestone in the field of vaccinology was marked by Edward Jenner’s discovery. The scientist found out that a related but less dangerous pathogen, such as cowpox, could be utilized to prevent a more deadly infection, such as smallpox (Davies, Schmidt & Sheikh 2012). After his finding, a large number of other experiments were conducted by using a plethora of disparate bacteria and virus species including those causing cholera and tuberculosis (Davies, Schmidt & Sheikh 2012).

All of the carried-out experiments invariably revealed that a weakened pathogen could induce an immune response without actually causing disease. This observation is fundamental to the understanding of how vaccines work, and it will be further explained through an overview of different components and actions of the immune system.

Components and Functions of the Immune System

Overall, the human immune system has two large subsystems: the innate system and the adaptive system. These subsystems are in a constant process of interaction, and vaccines usually aim to stimulate responses in both of them (Clem 2011). Nevertheless, it is valid to say that the core target of vaccines is the adaptive system. Unlike the innate system that is responsible for general, first-line defense of the organism, the adaptive system protects against specific infections and, after one or a few sequential exposures to pathogens, develops memory necessary to respond to them more quickly and effectively (Clem 2011). This capability of the adaptive system for learning and memorizing its previous experiences is the main reason why after vaccination people become immune to different viruses and bacteria for a substantial time or even obtain lifelong immunity.

The scope of each immune subsystem’s response is defined by its basic components and functions. For example, protective elements of the innate system are anatomic barriers (skin, mucous membranes, and so forth), physiological barriers (body temperature, interferons, lysozymes, and so forth), inflammatory response, complement pathways (triggered by IgM/IgG antibodies, properdin, and lectin), pattern recognition receptors, mononuclear phagocytes, and granulocytic cells (Clem 2011). Neither of these protective measures can recognize specific pathogenic agents.

However, pattern recognition receptors serve to detect lipoproteins found in bacterial capsules, double-stranded DNA found in viruses, and many other general, pathogen-related molecular patterns (Clem 2011). In a way, this generalized recognition function serves as a restrictive measure, without which the innate immunity would attack host cells and disrupt the work of other body systems (Clem 2011). However, even without the ability to discern various kinds of toxins and pathogens precisely, the actions of defense mechanisms included in the innate immune system are often enough to remove pathogenic agents from the organism. The adaptive system usually gets involved when an infection is particularly aggressive and persistent.

The abovementioned evidence indicates that immune responses to pathogens, in general, and vaccines, in particular, always start at the innate system level with the activation of the pathogen recognition receptors. The further response depends on the type of pathogen detected by these receptors. However, they are all linked to the production of proinflammatory cytokines and chemokines, as well as the stimulation of antigen-presenting cells, such as phagocytes (Kang & Compans 2009). These antigens play an essential role in the initiation of the adaptive system and the further development of immune memory.

The adaptive system consists of two arms: the humoral immunity, also known as the antibody-mediated immunity, comprised of B-cells, and the cell-mediated immunity comprised of T-cells (Clem 2011). The first arm provides defense against the extracellular pathogens, whereas the second arm protects against intracellular pathogens (Clem 2011).

Most of the modern vaccines target the humoral immunity and aim to stimulate the production of antibodies by B-cells, which are considered to hold the main responsibility for the development of long-term immune memory (Kang & Compans 2009). However, although B-cells can be activated without the involvement of T-cells, it is suggested that “activation of B-cells with T-helper cell activation results in a much better immune response and more effective memory” (Clem 2011, p. 75). So far, some types of vaccines have been more efficient in triggering both T and B cell activation simultaneously than others.

Conventional Types of Vaccines

The majority of vaccines that are commonly used nowadays can be categorized as either live attenuated vaccines or non-living, non-replicating vaccines. The first type refers to vaccines that contain weakened forms of real pathogenic organisms (Titball & Atkins 2012). Considering that pathogens included in those vaccines are similar to the original, they tend to result in strong immune responses that usually do not differ from reactions to natural infections.

Following the injection of a live attenuated vaccine, the pattern recognition receptors of the innate immune system become activated, which leads to a consequent release of the pathogen-associated signals, as well as dendritic cells, macrophages, and other agents involved in the cellular immune response (Kang & Compans 2009). In this way, the innate system triggers the initiation of both arms of the adaptive immune system.

The route of live vaccine administration does not seem to define the intensity of the adaptive immune memory stimulation. In either case, live vaccines widely disseminate throughout the organism and pass all stages of natural infection development (Kang & Compans 2009). For example, when a vaccine is administered orally or through the nose, pathogens replicate in the mucosal lining, which induces a multi-site activation of antigen-presenting cells and impacts a larger number of lymph nodes where naïve B-cells are contained (Kang & Compans 2009; Clem 2011).

These naïve B-cells then commence interacting with antigens during the process of somatic hypermutation of B-cells, leading to a further maturation of the latter and their transformation into plasma cells or memory cells that start to produce specific antibodies (IgM, IgD, IgA, or IgE) needed to eradicate a certain pathogen (Clem 2011). At the phase of B-cell maturation, dendritic cells also become involved in the differentiation of CD4 (T-helper) cells, which serve to strengthen the memory capacity of the adaptive system (Kang & Compans 2009). Overall, the described process demonstrates that live attenuated vaccines substantially impact both subsystems of the immune system.

As for inactive or non-replicating vaccines, their ability to induce innate immune response is rather limited. Non-living vaccines contain pathogens that are killed by using chemicals, heat, and other laboratory-based methods (Clem 2011). Thus, compared to live vaccines, the non-replicating ones are more stable, associated with fewer risks for immunocompromised individuals, have a longer shelf life, and do not require strictly controlled storage conditions for the preservation of their potency (Clem 2011; Titball & Atkins 2012).

Regardless of these advantages, inactive vaccines usually stimulate innate immune responses only at the site of injection because the process of replication (natural infection development) is not possible in killed pathogens (Kang & Compans 2009). Moreover, unlike the case with the live attenuated vaccines, the route of administration seems to play a big role in defining the intensity of protective immune responses to non-living vaccines. For example, intradermal immunization against rabies and influenza are empirically proved to be more effective compared to other routes of injection of vaccines against these viruses (Kang & Compans 2009).

Nevertheless, even when the best site and route of administration are considered, non-living vaccines usually fail to target the cell-mediated immunity and initiate a T-cell response (although it is reported that irradiated non-living vaccines can potentially attain a high degree of T-cell activity) (Kang & Compans 2009; Clem 2011). Thus, non-replicating vaccines do not foster long-term immune protection and require additional shots over time.

New Types of Vaccines in Development

With a greater understanding of various DNA mechanisms and advanced awareness of how vaccination impacts the immune system, new types of vaccines have emerged. Two of them are naked DNA vaccines and recombinant vector vaccines. The former type implies that purified DNA of certain antigens or, in other words, DNA that is not molecularly protected and developed as a result of releasing genetic information into the environment, would be used to activate immune responses (Rouse et al. 2012).

According to Clem (2011), after the injection of a naked DNA vaccine, the body cells would consume the introduced DNA and consequently commence generating the required antigen, which would eventually result in the desired immune response. This type of new vaccines can potentially foster strong, long-term immune protection by affecting both arms of the adaptive system (Clem 2011). Besides, naked DNA vaccines will also likely be cheap to produce, yet at the present developmental stage, they are characterized by low therapeutic efficacy since naked DNA tends to degrade rapidly (Clem 2011; Hobernik & Bros 2018). The improvement of the transfection process during the vaccine design is thus the primary goal of researchers involved in the development of this type of vaccines nowadays.

The recombinant vector vaccines are also still being investigated by scientists. This type of vaccines will utilize DNAs of live viruses and bacteria and transfer them into host cells (Clem 2011). It means that their effects would be similar to those produced by conventional live attenuated vaccines and would induce immune responses that typically occur in natural infections. Evaluating recombinant vector vaccines in the context of virus/bacteria replication, they seem to be associated with a significant safety risk.

As validly noted by Bull, Nuismer, and Antia (2019), “vaccine revertants that delete or inactivate the transgene may evolve to dominate the vaccine virus population both during the process of manufacture of the vaccine as well as during the course of host infection” (p. 1). It means that besides addressing the issues of therapeutic efficiency, researchers will need to find a way to reduce the risk of viral replication when designing recombinant vector vaccines.

Conclusion

The analysis revealed that vaccination is indeed an efficient method for the prevention of infectious diseases and the protection of public health. Live attenuated vaccines are particularly effective in this regard. By mimicking natural infections and stimulating pathogen recognition receptors in the innate system along with B-cell and T-cell activities in the adaptive system, they promote the development of long-term immune memory that protects hosts from initial infections. While the injection of these vaccines may be detrimental to immunocompromised individuals, it may be expected that further developments in the field of vaccinology will eventually help to resolve this issue.

Reference List

Bull, JJ, Nuismer, S & Antia, R 2019, ‘Recombinant vector vaccines and within-host evolution’, PLoS Computational Biology, vol. 15, no. 7, pp. 1-20.

Clem AS 2011, ‘Fundamentals of vaccine immunology’, Journal of Global Infectious Diseases, vol. 3, no. 1, pp. 73-78.

Davies, DH, Schmidt, CS & Sheikh, NA 2012, ‘Concept and scope of modern vaccines’, in WJW Morrow, NA Sheikh, CS Schmidt & DH Davies (eds), Vaccinology: principles and practice, Blackwell Publishing, Chichester, UK, pp. 3-14.

Hobernik, D & Bros, M 2018, ‘DNA vaccines-how far from clinical use?’, International Journal of Molecular Sciences, vol. 19, no. 3605, pp. 1-28.

Kang, SM & Compans, RW 2009, ‘Host responses from innate to adaptive immunity after vaccination: molecular and cellular events’, Molecules and Cells, vol. 27, no. 1, pp. 5-14.

Orenstein, WA & Ahmed, R 2017, ‘Simply put: vaccination saves lives’, Proceedings of the National Academy of Sciences of the United States of America, vol. 114, no. 16, pp. 4031-4033.

Rouse, BT, Nair, S, Rouse, RJD, Yu, Z, Kuklin, N, Karem, K & Manickan, E 2012, ‘DNA vaccines and immunity to herpes simplex virus’, in H Koprowski & DB Weiner, DNA vaccination/genetic vaccination, Springer, Berlin, Germany, pp. 69-78.

Titball, RW & Atkins, HS 2012, ‘Attenuated bacterial vaccines’, in WJW Morrow, NA Sheikh, CS Schmidt & DH Davies (eds), Vaccinology: principles and practice, Blackwell Publishing, Chichester, UK, pp. 181-195.

The United States of America spent about $ 3.5 trillion on healthcare, which is about 18% of the country’s gross domestic product (GDP), according to a report by Shaw et al. (2018). The increasing cost of health care for the federal government is partly attributed to the increasing incidences of diseases that can be immunized. The government, through the Center for Disease Control and Prevention (CDC) and various other agencies, has been keen on managing conditions such as measles, diphtheria, mumps, poliomyelitis, and rubella among other conditions through immunization (McKee & Bohannon, 2016).

However, studies have shown that the number of people who are not immunizing their children because of religious or personal beliefs is on the rise. When conducting research, Weithorn and Reiss (2018) argue that it is always critical to identify what is at stake. In this case, what is at stake is the increasing cases of communicable diseases that can be managed through immunization. States should have strict vaccination laws to have herd immunity and lower the government’s expenses on healthcare. The following research questions were used to guide this study:

• Why should states have stricter vaccination laws?
• What measures should the government put in place to ensure that all children get vaccinated at the right time?

Discussion

Immunization has become one of the most effective ways of managing conditions such as polio, measles, and mumps among many other such communicable diseases. The government has made these immunization services affordable and accessible to all the residents of the United States irrespective of their financial capacity or legal status in the country (Feemster, 2017). It is unfortunate that some people often consider it unnecessary to immunize their children despite obvious benefits. Some have taken advantage of the existing laws to avoid getting their child immunized, as Reich (2019) observes.

Current State of Immunization Laws

The federal government has allowed individual states to develop laws and regulations that govern immunization against various communicable diseases in the country (Bednarczyk, King, Lahijani, & Omer, 2019). It is necessary to look at exemptions permitted to childcare and school immunization requirements in each state in the country. Figure 1 below shows the classification of countries and immunization exemptions that they have. It is evident that some states such as Texas, Ohio, Oklahoma, Arizona, Michigan, Utah, and Wisconsin among others have medical, religious, and personal belief exemptions.

In these states, an individual cannot be compelled to have their children immunized, although the practice is encouraged; in Florida, Illinois, Indiana, Kansas, Nevada, and Washington, DC among others, medical and religious exemptions from immunization are granted. In California, Louisiana, Minnesota, and Oregon, exemptions are permitted based on medical grounds or personal belief. Only West Virginia and Mississippi have exemption from immunization only on medical grounds. Figure 1 below shows the classification of these states and exemptions that they allow from immunization.

Cases of Outbreak of Communicable Diseases in the United States

In this study, the researcher considered it prudent to conduct a simple comparative analysis. It was necessary to compare the prevalence of communicable diseases which can be immunized, such as measles, with exemption laws discussed above. It was established that Mississippi and West Virginia have the strictest laws on immunization, allowing it only on medical grounds. As shown in figure 2 below, the two states recorded zero cases of measles in 2015 (Weithorn & Reiss, 2018).

States like Minnesota. Ohio and Wisconsin with some forms of regulation registered less than 5 cases of measles in the same year. States such as Florida, New York, Nevada, and Arizona registered between 5 and 9 cases of measles in 2015. Washington and Illinois had 10-19 cases of measles reported. California had the highest incidence of measles outbreak reported, at more than 20 cases.

A comparative analysis shows that states with more relaxed laws, especially those that allow individuals to make personal decisions on whether they should have their children vaccinated registered the highest incidences of measles outbreak. On the other hand, states that had strict laws on vaccination had no outbreak at all within the year of the study (Feemster, 2017). The findings show a correlation between vaccination laws and outbreak of communicable diseases. It is evident that the only way of compelling people to immunize their children is to have laws that forbid parents and guardians from avoiding vaccination. Such strict laws will help increase the rate at which children get immunized at the right time, which in turn will lower incidences of such communicable diseases.

Conclusion and Recommendations

The study shows that a section of the American community avoids vaccinating their children because of religious and personal beliefs. The problem is that when these children become ill, they take them to public hospitals for medication. It means that they end up burdening the government with increased expenditure on healthcare because of their poor decisions. The increasing incidences of measles and other communicable diseases that can be immunized is an indication that many Americans no longer value or trust immunization as a way of managing these conditions. The following recommendation can help in promoting immunization as a way of managing these diseases:

The government should criminalize the act of a parent or a guardian failing to immunize a child at the right time. Some medical experts and human rights activists have argued that one should be allowed to make the decision of whether to immunize their children. However, such arguments are inadequate because they fail to take into consideration the fact that such conditions are communicable. If there is an outbreak, the condition will affect the community and the government at large. Given that the problem can escalate to become a major communal problem, the decision should not be left in the hands of individuals.

References

Bednarczyk, R. A., King, A. R., Lahijani, R., & Omer, S. B. (2019). Current landscape of nonmedical vaccination exemptions in the United States: Impact of policy changes. Journal Expert Review of Vaccines, 18(2), 175-190.

Feemster, K. A. (2017). Vaccines: What everyone needs to know. New York, NY: Oxford University Press.

Hotez, P. J., & Caplan, A. L. (2018). Vaccines did not cause Rachel’s autism: My journey as a vaccine scientist, pediatrician, and autism dad. Baltimore, MD: Johns Hopkins University Press.

McKee, C., & Bohannon, K. (2016). Exploring the reasons behind parental refusal of vaccines. The Journal of Pediatric Pharmacology and Therapeutics, 21(2), 104-109.

Reich, J. (2019). Why parents refuse to vaccinate their children, in their own words. Advisory Board, 5, 1-2.

Shaw, J., Mader, E. M., Bennett, B. E., Vernyi-Kellogg, O. K., Yang, T. Y., & Morley, C. P. (2018). Immunization mandates, vaccination coverage, and exemption rates in the United States. Open Forum Infectious Diseases, 5(6), 1-9.

Weithorn, L. A., & Reiss, D. R. (2018). Legal approaches to promoting parental compliance with childhood immunization recommendations. Journal of Human Vaccines & Immunotherapeutics, 14(7), 1610-1617.

Introduction

Rabies, a fatal infectious disease, is a terrible and feared threat to society health, which is present on all continents except for Antarctica. Africa and Asia continue to report the highest records from rabies reaching thousands of human fatalities annually. In many regions, the disease is considered as under-reported, so its impact on human health is admittedly starkly negative. There are several ways of dealing with rabies, the bait drop strategies being the most effective ones. However, although preventing many humans and animals from the disease, current strategies still have not helped to wipe out the infection spread completely. An alternative way of dealing with the problem has to be devised since the disease is far from being eradicated.

Danger of Rabies

Rabies has an almost 100% fatality rate infecting all mammals, and wildlife is the main reservoir for the disease. Previously, the control of disease in wild animals “relied upon population reduction of rabies reservoir species” with people trapping or hunting animals that pose a risk to humans (Mähl et al., 2014, p. 1). However, these measures were unproductive, so the idea of immunization via oral vaccine baits emerged. Nowadays, it is an effective way of decreasing the amount of rabies-infected species but it is still not enough to prevent all the people from getting the disease.

One of the most important tasks for society is to control the spread of diseases, and rabies is among those that are targeted the most. Communities hold regular public clinics so that cats, dogs, rabbits, and other domestic animals can be vaccinated and encourage homeowners to ensure that their property does not attract wild animals with food. Another way of controlling rabies is public education, which helps people be aware of the threat and implications of getting infected. The primary target audience is pet owners and children since both are the most in touch with animals that may transmit the disease. Moreover, to make sure that there is no threat to them, people have to report if they witness wild animals acting strangely or during the unnatural time of day (for example, nocturnal bats and raccoons out and about during the day).

Recommendations

If a rabid animal attacks a person, The World Health Organization recommends post-exposure prophylaxis, and both humans and animals that are at risk are advised to use a pre-exposure or prophylactic scheme. The first rabies vaccine was “based on crude preparations of animal neuronal tissues that were poorly immunogenic and needed several doses to induce immunity,” but it was later replaced with safer cell-culture-derived vaccines (Fooks et al., 2014, p.6). An important thing to remember is that if the vaccination is initiated in time, it can almost certainly prevent a fatality.

Approaches to Control Rabies

There are several approaches to control rabies, and DNA vaccination technology is a promising way to prevent such diseases. “The commercial development of DNA vaccines against certain pathogens that use veterinary species as their specific host is completely feasible” (Shah et al., 2014, p. 888). Today, efforts must be concentrated on human’s immunity improvement which can be achieved by “searching for appropriate adjuvants, the optimal administration or potent delivery system” (Shah et al., 2014, p. 888). The other alternative option to the bait drop is strategic trapping of wild animals and releasing them upon vaccination. The strategy can be used with most of the animals, but skunks should be the main priority because they are the most reluctant to the bait drop.

Conclusion

Summing up, rabies is a dangerous viral disease which is mostly spread in wildlife and constitutes a significant threat to the health of humans and other species. Scientists have developed several strategies of controlling rabies, and the bait drop is among the most successful ones. However, to reach a higher level of protection, alternative approaches such as trapping and releasing wild animals, educational programs, and DNA vaccination, have to be implemented.

References

Fooks, A. R., Banyard, A. C., Horton, D. L., Johnson, N., McElhinney, L. M., & Jackson, A. C. (2014). Current status of rabies and prospects for elimination. The Lancet, 384(9951), 1389–1399.

Mähl, P., Cliquet, F., Guiot, A.-L., Niin, E., Fournials, E., Saint-Jean, N., Gueguen, S. (2014). Twenty year experience of the oral rabies vaccine SAG2 in wildlife: A global review. Veterinary Research, 45(1).

Shah, M. A. A., Khan, S. U., Ali, Z., Yang, H., Liu, K., & Mao, L. (2014). Applications of Nanoparticles for DNA based rabies vaccine. Journal of Nanoscience and Nanotechnology, 14(1), 881–891.

Background

One of the most notable aspects of today’s living in the West, is the fact that, even though the level of educational attainment among people continues to increase rather exponentially, a considerable number of citizens nevertheless cannot help remaining perceptually arrogant – especially when their attitudes to the various healthcare practices/policies are being concerned. The validity of this statement can be illustrated, in regards to the fact that, as practice indicates, a good half of practicing Christians in the U.S. opposes the policy of vaccination.

Nevertheless, there is a good reason to believe that their stance is not being of a strictly theological (rational) nature – rather it reflects these people’s deep-seated unconscious anxieties. In its turn, this presupposes the legitimacy of the psychological intervention, as the method of helping the concerned individuals to grow more positive about the policy in question.

Interest in Experiment

Many of my religious friends and relatives happened to hold highly negative attitudes towards the very idea of vaccination, as such that in their view is being inconsistent with the ‘word of God’. Nevertheless, even though I used to apply a great effort, while trying to educate them about the fact that this simply could not be the case (Bible was written before the concept of vaccination came into being), this did not seem to have any effect on them, whatsoever. In its turn, this prompted me to consider the possibility that the reason, as to why this was the case, had to do with my failure to rely on the discursively appropriate mediums of channeling information, within the context of how I went about popularizing the practice of vaccination.

Hypothesis

As it was pointed out earlier, many religious individuals do tend to rationalize their negative attitude towards vaccination. However, such their tendency can be well hypothesized as the extrapolation of these people’s unconscious fear of ‘pollution’. That is, those who oppose vaccination happened to be psychologically uncomfortable with the idea of a vaccine being injected into their bodies, which in turn causes them to believe that vaccination poses a great threat to their health.

What it means is that, while promoting the policy of vaccination among religiously minded individuals, one should be much better off deploying the emotionally-charged approach to doing it – such as exposing them to the appropriately designed poster, which would encourage these individuals to associate the practice in question with the notion of healthiness.

Social Experiment

Four selected participants (the members of the Baptist Church) will be presented with the vaccination-promoting poster and asked to reflect upon what kind of effect did it have on their perception of the concerned policy.

Predicted Outcomes

It is predicted that the participants’ exposure to the poster will cause them to experience the sensation of a cognitive dissonance (as the consequence of this poster’s motifs being utterly inconsistent with the concerned individuals’ ‘rational’ outlook on the practice of vaccination). Moreover, there should be a number of the behavioral indications (exhibited by the participants) that this indeed was the case.

Purpose

To test the validity of the hypothesis that people’s acceptance of vaccination extrapolates their largely unconscious fear of a foreign substance being injected into their bodies. The experiment will also seek to confirm/disconfirm the validity of the idea that the factor of a ‘peer pressure’ affects the participants’ perception of the practice in question.

Methodology

The experiment’s methodology is concerned with exposing the selected participants to the vaccination-promoting poster, observing their emotional reactions to what it being presented to them and interpreting what may account for the induced reactions’ discursive significance.

Measurement

The researchers will measure the intensity of the participants’ emotional responses to the applied external stimuli (poster).

Data collection

The instruments for collecting the empirical data will be pulse monitors and questionnaires, distributed among the participants, in order to allow the latter to articulate their rational reaction to the poster’s themes and motifs.

Limitation

The fact that the proposed methodology to collecting data presupposes that the would-be received interpretative insights are going to be highly subjective.

Improvement

The proposed experiment could be improved by the mean of increasing the extent of its cross-sectional integrity (the more there participants, the better).

Possible flaws

Among the possible flaws will be considered with the possibility for the would-be deployed equipment to malfunction, and the fact that the proposed research-methodology presupposes that the participants will be in the position to misrepresent what happened to be their true emotional responses to the poster.

Introduction

Vaccination of children is a standard health precaution recommended by the Centers for Disease Control (CDC) as a method to prevent outbreaks of deadly illnesses. My personal position states that vaccination should be required as a scientifically-based medical procedure that protects personal and social health. Currently, no federal laws in the US require vaccination. However, most educational institutions and programs establish guidelines on their own (ProCon, 2017). The following premises are used to justify that vaccination of children should not be mandatory.

Main body

Vaccinations can result in severe and possibly fatal side-effects, such as an allergic reaction. This position is helpful in understanding the fear that parents may have of vaccinating their children. It is interesting since there is a provided scientific basis for the choice to abstain. If I believed this view, I would notice a significant amount of studies noting that vaccination may unpredictably result in anaphylaxis, mental illnesses, or the death of a child.

Since such premises appeal directly to fear, it is easy to gain supporters from parents who are either reluctant or attempting to find a reason for a tragedy that already occurred. This idea is exemplified in reality by government health organizations reporting that vaccines may cause a variety of health problems for practically every type of immunization. Although, serious issues are rare and carefully monitored, a minuscule percentage of children experiences severe infections, brain reaction, or death (U.S. Department of Health and Human Services, 2017). The fact that this information is official and not based on inaccurate perceptions worries many parents.

Several religious congregations maintain that mandatory vaccination infringes constitutionally protected rights to religious freedom. As vaccines are opposed by the religious dogma of specific groups, any requirement to obtain them essentially forces members to violate spiritual beliefs. This perspective is interesting as it helps to establish a philosophical or religious basis for people opposing vaccination.

Since many groups hold the spiritual law in high regard, any action to violate it can jeopardize the salvation or holiness of a person in that specific religion. A follower of this belief may take notice and choose to protest numerous policies that require vaccination for children in order to participate in public education. This idea becomes a reality when examining the U.S. Constitution which mandates that persons be given the right to religious freedom and practices.

The First Amendment has often been used as the basis for allowing a religious exemption clause. However, a continuous abuse of the exemption and the recent case law has resulted in states severely limiting or eliminating this procedure. Since there are no federal laws or Supreme Court decisions on the matter, proponents are citing a violation of Constitutional rights (Greendyk, 2016). The argument essentially centers around government intervention.

The final argument states that the government has no authority to interfere in personal medical choices, including those that parents choose to make for their children. This view represents a more political side to the argument as proponents feel that individual freedoms are violated when the state can control citizens in making decisions about their physical health. A follower of this belief may be more aware of various personal freedoms that the government chooses to violate through policy as this can set a precedent for abuse of power by the state.

This becomes a reality when governments choose to implement other restrictions based on the defense of protecting public health. Even there is a substantial benefit to vaccination of children; the government should rely on public trust and education rather than forced coercion (Olson, 2013).

Conclusion

It is evident that this side of the argument seeks to justify avoiding vaccination of children as a method of protection from harmful substances and government intervention in personal freedoms. The premises are based on ideology and interpretation of religious beliefs. When analyzing the issue, it is difficult to consider the logic of such arguments as they are inherently fallacious. However, the freedom of choice and religious beliefs that supporters of this position choose to preserve should be respected.

References

Greendyk, H. (2016). Mandatory vaccination: First amendment considerations. Web.

Olson, M. (2013). Should the government mandate vaccinations? Web.

ProCon. (2017). Should any vaccines be required for children? Web.

U.S. Department of Health and Human Services. (2017). Possible side-effects from vaccines. Web.

It is vital that newborn is observed by pediatrician and receive the proper treatment during the first months of life because the body’s physiological systems are susceptible to any deteriorative factors. One of the most common practices is vaccination for various diseases, such as influenza, hepatitis A and B, rotavirus, and pneumococcal, to name a few. The current paper discusses the vaccination strategy for Haemophilus influenzae type b (Hib). Before the vaccine had been produced, Hib was the most common cause of meningitis in children in developed countries (Butler & Myers, 2018; Scott Ricci & Kyle, 2009). Vaccination for Hib is well-established, and it is worth taking the vaccine in order to prevent the threatening processes in the body.

Hib has been of huge concern for pediatricians because it may lead to significant pathophysiological consequences. Hib affects the upper respiratory tract and may cause meningitis, pneumonia, and bacteremia (Butler & Myers, 2018). The transmission usually happens through respiratory droplets and/or direct contact. The pathogen of Hib is a gram-negative Haemophilus influenzae, which inhibits nasopharynx (Butler & Myers, 2018). Polyribosyl ribitol phosphate (PRP) provides Hib with an effective mechanism for the immunity attack, and that is why Hib had been especially dangerous before the vaccine was invented (Butler & Myers, 2018). Except for the major manifestation of the disease, the patients often show a “fever or hypothermia (especially in neonates), emesis, altered mental status, and/or irritability” (Butler & Myers, 2018, p.121). Moreover, neurologic complications may result in such sequelae as seizures, language and developmental delay, and behavioral abnormalities (Butler & Myers, 2018). Therefore, Hib has numerous dangerous complications and may cause serious consequences.

For some individuals, Hib presents a greater threat then for others. First, children under the age of two are more likely to develop bacterial meningitis, not to mention all the other conditions (Butler & Myers, 2018). However, underimmunized and unimmunized children of any age should also be under constant observation for the Hib symptoms. Second, people with splenic dysfunctions or those who went through splenectomy are also at high risk (Butler & Myers, 2018). Third, older people (beyond 59 years) are also considered as a risk group (Butler & Myers, 2018). Moreover, there are some data on the higher likeliness of being infected for Native Americans, Alaskans, and indigenous Canadians (Butler & Myers, 2018). Thus, the risk depends on age, vaccination history, splenic functionality, and, probably, genetic factors.

The vaccination schedule has been firmly established and successfully implemented by the Centers for Disease Control and Prevention (CDC). It was accepted as a compulsory measure against Hib in many countries (Butler & Myers, 2018; Scott Ricci & Kyle, 2009). Depending on the medication, the vaccination may take from two to four steps. Such preparations as Hi-bTITER (HbOC) and ActHib (PRP-T) require three doses, while only two times is sufficient for RedvaxHIB and Comvax (PRP-OMP) (Scott Ricci & Kyle, 2009). Typically, the first dose is given at the age of two months and repeats after four-eight weeks (Butler & Myers, 2018). After two/three doses, one additional booster dose may be applied, and after that, the vaccination is considered to be completed (Scott Ricci & Kyle, 2009). If the vaccination cannot be started at two months, it can be initiated later with the same intervals, although the number of doses decreases with age. The vaccination has rational only before five years of age, and after that is used only in a rare case for groups at risk.

Hib vaccination does not have specific contradictions or precautions. According to Scott Ricci and Kyle (2009), the reasons for refusing may be an anaphylactic reaction to a prior dose or any components of the vaccine. Moreover, moderate to severe acute illness is a reasonable factor for postponing the vaccination, while minor illness should not cause deteriorative reactions to the vaccine (Scott Ricci & Kyle, 2009). Thus, the Hib vaccination should follow the general guidelines for this kind of measure.

The topic of immunization is significant for children’s upbringers because they are responsible for their child’s health. That is why parents or other representatives should be aware that many diseases are especially dangerous at an early age and that vaccination is the most effective way to protect the young organism. It is a known fact that the anti-vaccination movement caused many families to refuse vaccination (Scherer et al., 2016). Although some families have reasons for the hesitancy, many people were misinformed with unreliable information. That is why the medical community has to find ways to provide parents with the latest findings in the immunization measures.

Furthermore, doctors and parents should be aware of the possible side effects of vaccination. The Hib vaccine may cause some mild swelling or pain in the area of injection, and the patients may also develop a fever or irritability (Klein et al., 2017). However, these symptoms normally disappear within two days. There are rare cases of neurological reactions such as seizures and affective states, or a dangerously high fever (Klein et al., 2017). If the symptoms get aversive, the parents should immediately see the child’s pediatrician and inform the Vaccine Adverse Event Reporting System (VAERS). VAERS is an organization that supervise vaccines’ work without causing threat to people’s life (Scherer et al., 2016). It is an open database, and any parent may check beforehand if there were any adverse cases reported on the planned vaccination. Any vaccination may lead to side effects, but they are minimized during the preparation production, and the doctors carefully consider individual reactions to the vaccine so that to prevent any unpleasant consequences.

From a medical point of view, people’s health is the most significant concern. Declining vaccination is deteriorative as it causes a threat to life. This opinion is subjective in terms of its exclusively medical position and does not take into account the psychological, sociological, or political aspects of life. However, medical workers must make people realize what the function of vaccination is and let them decide how they want to treat their life.

To conclude, the Hib vaccination has been carefully established and it effectively prevents dangerous infections such as bacterial meningitis and otitis. Children before the age of two are the most vulnerable for these effects, although people underimmunized and unimmunized individuals, as well as people with the impairment of splenic functioning, should also take measures for Hib prevention. That is why they must receive the treatment at the proper time. Numerous vaccines have been produced so far, and they can be chosen depending on the individual conditions. However, parents and doctors should be aware of the possibility of aversive effects, although the vaccine rarely causes serious consequences. It is crucial to keep in mind that the Hib vaccine has prevented the most common cause of meningitis in infants. Therefore, Hib vaccination is necessary for providing a healthy human life.

References

Butler, D. F., & Myers, A. L. (2018). Changing epidemiology of haemophilus influenzae in children. Infectious Disease Clinics of North America, 32(1), 119–128.

Klein, N. P., Abu-Elyazeed, R., Cornish, M., Leonardi, M. L., Weiner, L. B., Silas, P. E., Grogg, S. E., Varman, M., Frenck, R.W., Cheuvart, B., Baine, Y., Miller, J. M., Leyssen, M., Mesaros, N., Roy-Ghanta, S. (2017). Lot-to-lot consistency, safety and immunogenicity of 3 lots of Haemophilus influenzae type b conjugate vaccine: Results from a phase III randomized, multicenter study in infants. Vaccine, 35(28), 3564–3574.

Scherer, L. D., Shaffer, V. A., Patel, N., & Zikmund-Fisher, B. J. (2016). Can the vaccine adverse event reporting system be used to increase vaccine acceptance and trust? Vaccine, 34(21), 2424–2429.

Scott Ricci, S., & Kyle, T. (2009). Maternity and pediatric nursing. Philadelphia, PA: Lippincott Williams & Wilkins.

Abstract

The aim of this paper is to analyze the risk of pneumonia during the season of flu among people of 65 years and older who have influenza vaccination compared to those who do not. The role of the nurse in the process of diagnosis and treatment of the patient is described in this study. The research is based on the latest reviews and scientific articles considering the effectiveness and the safety of the vaccine and the causes of pneumonia for older patients. The result of the analysis shows that vaccination significantly lowers the risk of pneumonia and other complications of influenza among older adults. The role of the nurse is also considered to be educational because two-third of patients refuse to make vaccines.

The efficiency and the safety of the influenza vaccination still raise questions and doubts. However, the World Health Organization advances the hypothesis that seasonal influenza vaccination is essential for older adults (World Health Organization, 2015). Some researchers propose the idea that the vaccine might not be so efficient as it is supposed to be. What is more, they pay attention to the lack of experiments and scientific monitoring (Trucchi, Paganino, Orsi, De Florentiis, & Ansaldi, 2015). The problem also consists of the impossibility of excluding the chronic diseases which are common among aged people.

Nurses play a significant role in the treatment of the flu. The first reason for it is that this disease is not considered a serious one, that is why not so much attention is paid to its therapy. Nevertheless, nursing is essential to keep the situation under control and to be able to react immediately in the case of complications (Letley, 2018). Such illnesses as pneumonia are developing rapidly and require competent actions before the intense therapy. Nurses can prevent the complication of the flu by operating correctly and efficiently.

The Specificity of Influenza

Influenza is an acute respiratory infection that is spread all over the world. It is a seasonal disease that is most active in the period from the late autumn up to spring. It has typical symptoms such as fever, sore throat, and cough (Wilhelm, 2018). Adults aged 65 and older are in the group of high risk. The reason for it might be that 35% of the aged people are not protected from the flu with the vaccine (Wilhelm, 2018). The majority of hospitalizations caused by seasonal flu are related to the older patients.

For most people, the flu is a mild illness that supposes some home treatment and, in rare cases, hospitalization for several days. None the less, there are humans that risk to have serious complications caused by influenza. Among them are babies and children up to five years, pregnant women, and people with chronic diseases like problems with the heart or asthma and elder humans (Wilhelm, 2018). About 80% of the deaths from the seasonal flu are related to older people (Wilhelm, 2018). The main reason for it is that the classic symptoms of the flu do not usually appear after the are of 65 (Trucchi et al.,2015). That is why the diagnostics and the treatment are provided too late when the situation becomes critical.

The Role of the Vaccine

The concerns about the effectiveness of the vaccine are not unfounded. The main question that researches face is its safety for the elderly (Trucchi et al.,2015). Their immunizations rates are poor, which means that the effectiveness of the vaccination becomes lower because the body does not react to the new antibodies (Wilhelm, 2018). The problem is also in the methodology of gathering essential information. Most of the ways of analysis consist of studying retrospective researchers (Trucchi et al.,2015). It makes the probability of the mistake higher because the conclusions could not be verified in real time with the patients.

Nowadays, there are many studies that concentrate on the problem of age-related immunosenescence. Several new vaccines have been approved by the specialized governmental departments. Among them is “Fluad”, which was made specifically for older adults. This vaccine passed all clinical trials during the 2016-2017 years and is used in the USA and Europe. The scientists from National Foundation of Infectious Disease claim that at the time of the clinical tests the adjuvant influenza vaccine performed better than the standard vaccine for all three flu strains (A/H1N1, A/H3N2, and B) (Schaffner, Gravenstein, Hopkins, & Jernigan, 2016). Nevertheless, the test period is too short to provide the final result.

It is important to mention that the problem is not only in the effectiveness of the vaccine but also in the level of trust and knowledge among the elderly. One-third of them in the USA do not want to have a vaccination (Wilhelm, 2018). Informational support is essential for the solution of the issue. Family nurses are among the most reliable persons for older people, that is why they also should be aware of all the latest developments. Nurses should be ready to explain in details why the vaccine is important and how it can help to overcome the illness.

The vaccination does not guarantee the impossibility of getting flu during its season. However, it lowers the risk of having complications like pneumonia. The research held in 2018 showed that among adults who were hospitalized because of influenza, the patients with a vaccine were 59% less transferred to the ICU than the others (“People 65 Years and Older & Influenza,” 2019). Therefore, the importance of the vaccine is not only in preventing the illness but also in making the risk of pneumonia and death much lower in case of illness.

The Risk of Pneumonia

Pneumonia is one of the most common complications of influenza. Scientists advance the hypothesis that vaccination plays a significant role for adults. They compared the level of deaths with different causes and the risk of hospitalization of patients with pneumonia. Their conclusion was that there are remarkable reductions in the risk for vaccinated people of 50% for general mortality and around 30% for pneumonia hospitalization the risk (Trucchi et al.,2015). It is a proof of the necessity of being vaccinated not only by older people but by all adults.

Pneumonia is the most dangerous for people of the age of 75 or older, who have problems with lunges or asthma. The patients with this disease needed hospitalization with mechanical ventilation much more often (18% vs. 5%) than other patients (Wilhelm, 2018). It is important to mention that there is a special pneumococcal vaccine that is made for people of the age 65 and older. It fights with pneumonia-related diseases like bloodstream infections and meningitis (“What are the benefits of flu vaccination?”, 2019). It is possible to get it with the influenza vaccine.

The last researches show that the influenza vaccine lowers the risk of pneumonia and other respiratory diseases during the flu period among people of 65 years and older. The vaccination helps not only to reduce the risk of complications but also prevents influenza itself. The difference in the level of hospitalized patients with flu who require intensive care unit and mechanical ventilation and who have been vaccinated illustrates the effectiveness of the cure. Nurses play a significant role not only in the process of diagnostics and treatment of the patient but also in informing people about the necessity of the vaccine for their own health and well-being.

References

Letley, L. (2018). Flu immunization in England: helping nurses to protect patients. Nursing Times, 114, 9-18.

People 65 Years and older & Influenza. (2019). Web.

Schaffner, W., Gravenstein, S., Hopkins, R., & Jernigan, D. (2016). Reinvigorating influenza prevention in US adults aged 65 years and older. Infectious Diseases in Clinical Practice, 24(6), 303-309.

Trucchi, C., Paganino, C., Orsi, A., De Florentiis, D., & Ansaldi, F. (2015). Influenza vaccination in the elderly: why are the overall benefits still hotly debated? Journal of Preventive Medicine and Hygiene, 56(1), E37-E43.

What are the benefits of flu vaccination?(2019). Web.

Wilhelm, M. (2018). Influenza in older patients: A call to action and recent updates for vaccinations. The American Journal of Managed Care, 24(2), S15-S24.

World Health Organization. (2015). Vaccine effectiveness estimates for seasonal influenza vaccines.Web.

Annually, it is estimated that at least one billion influenza cases (flu) are experienced annually. According to the provided statistical records, 10% of the total cases usually succumb to the disease and its related complications (Black et al., 2018). The highly affected group by the disease are the health care workers. These health care professionals are attacked by the flue in their lines of duty. Therefore, providing vaccine is the number one approach to treat the condition. In most cases, the influenza immunization is effective and capable of preventing health care workers from the flu attack. This research paper aims at explaining why the personnel need to receive the flu vaccine. The provided results will be based on several theories, principles, and evidence to support the position.

The Nature of the Illness

Influenza is a viral respiratory disease, which can be easily spread to other people through the droplets when they sneeze, talk, or cough. These substances may land on the next person’s nose or mouth. Healthy people may depict the virus’s symptoms soon after 5-7 days of contracting the illness (Black et al., 2018). It means they can pass the infection to others when they are still asymptomatic. These unique characteristics make the ailment one of the most complex conditions.

Theories, Evidence, and Ethical Principles

According to the social theory, health care workers are vastly sociable with patients and co-workers. As a result, they are highly susceptible to contracting the influenza virus from infected patients (Black et al., 2018). In the circumstances when these professionals contract the infection, they can easily spread the disease. Consequently, health care workers are most likely to be hospitalized and, sometimes, die. According to the most recent statistical results presented, the number of infected health care workers has continued to receive immunization against the disease. The graph provided below is a typical indication on how the stability of the vaccinated health care workers has been achieved against the number of influenza infection over the past four years. The graph proves that by being vaccinated, health care professionals will manage to protect themselves, patients, and family members.

Ethically, health care workers are expected to treat every sick member of society. While subscribing to the idea of vaccination, they must ensure that patient’s well-being becomes the priority. Immunization forms the hallmark of protecting patients against any attack and spread of the virus. In fact, it is the only option which can help reduce the number of flu-related illnesses and deaths, which have been experienced over the past years. Finally, the health care workers will be setting a good example to the entire society on protecting the sanctity of life.

Based on the presented facts, it is evidently clear that the health care workers’ vaccination against the influenza virus is a noble idea. The vaccination method will manage to protect the health care personnel against the attack and the spread of the disease. Consequently, it will be a powerful mechanism of safeguarding the patients against any possibility of contracting the infection. Therefore, through the Ministry of Health, the federal government should sensitize health care professionals and provide them with the best treatment opportunities. The application of the above recommendations will reduce the unprecedented level of spread and death caused by such diseases.

Reference

Black, C. L., Yue, X., Ball, S. W., Fink, R. V., de Perio, M. A., Laney, A. S., Williams, W. W., Graitcer, S. B., Fiebelkom, A. P., & Devlin, R. (2018). Influenza vaccination coverage among health care personnel—the United States, 2017–18 influenza season. Morbidity and Mortality Weekly Report, 67(38), 1050-1054. Web.