HEALTH POLICY Childhood Immunizations Shannon Haskett RN BSN
HEALTH POLICY Childhood Immunizations Shannon Haskett, RN, BSN Jacksonville State University NU 540
Introduction ■ Immunizations are the most successful preventative interventions ■ Concern has been raised since the U. S has had recent epidemics of vaccinepreventable diseases ■ Low rates of childhood immunizations signal problems in health policy
Problem in Health Policy ■ Low rates of childhood immunizations due parents not being properly informed about the vaccines. ■ There is not a balance between public health policy and giving parents a choice to vaccinate.
Concerns for Vaccine Safety ■ Using adjuvants to make vaccines last longer and created stronger immune response. ■ Vaccines causing autism ■ Vaccines causing fainting or syncope ■ Vaccines causing febrile seizures (Center for Disease Control and Prevention, 2015)
Concerns for Vaccine Safety ■ Guillain-Barre Syndrome (GBS) ■ Sudden Infant Death Syndrome (SIDS) ■ Multiple vaccines and the immune system ■ Taking vaccinations while pregnant ■ Vaccine Recalls (Center for Disease Control and Prevention, 2015)
Vaccine Schedule ■ Link to access pocket size vaccination schedule: – http: //www. cdc. gov/vaccines/schedules/downloads/child/0 -18 yrs-pocketpr. pdf
Immunizations: School Requirements ■ From the time of birth, babies get approximately 28 immunization shots by the age of two. ■ School and daycare required immunizations cover for the children who were not properly immunized as infants. ■ School requirement immunization laws are state based. ■ Immunization requirements reflect the views of the Advisory Committee on Immunization Practices (ACIP). (National Conference of State Legislatures, 2015)
Immunizations: School Requirements ■ State legislature plays important role in making school requirement immunization plans. ■ Controversy surrounds the school requirements for immunizations. ■ Parents and advocates claim immunization requirements take away the person’s right to choose. ■ Parents are concerned immunizations may harm children more than benefit them. (National Conference of State Legislatures, 2015)
Immunizations: Exemptions ■ Exemption laws vary from state to state. ■ All states allow exemptions for medical reasons. ■ All states, except for Mississippi and Virginia, allow religious exemptions. ■ Some states allow for philosophical exemptions. (National Conference of State Legislatures, 2015)
Exemptions ■ State non-medical exemptions for 2015:
Immunizations: How are they funded? ■ Federal funds pay approximately 95% of all publicly funded vaccines. ■ There are two sources of federal funds: – Vaccines for Children Program (VFC) – Section 317 of the Public Health Services Act (National Conference of State Legislatures, 2015)
Vaccines for Children Program (VFC) ■ Provides free vaccines for children who are uninsured, Medicaid eligible, underinsured, Native American, or an Alaskan Native. ■ CDC gave the VFC $2. 5 billion in funds to state, local, and territorial public health agencies. (National Conference of State Legislatures, 2015)
Section 317 of the Public Health Services Act ■ Federal program administered by the CDC. ■ Provides grants to states and territories, commonwealth trusts, and several cities for vaccine purchase and programs ■ Affordable Healthcare Act reauthorizes grants. ■ States can purchase and reccomend childhood vaccines. (National Conference of State Legislatures, 2015)
State Funding ■ States rely on federal resources to purchase vaccines. ■ Universal Purchase – 7 states have policies where states or territories purchase all vaccines for all children – 2 states have policies with public providers – 5 states have universal select programs that purchase all vaccines for all children with the exception of one or more vaccines ■ Insurance Requirements – Preventative services include childhood immunizations – States vary on which immunizations are covered (National Conference of State Legislatures, 2015) (Ow
Stakeholders for Immunization Health Policy ■ Global agencies who are partners to achieve the Global Vaccine Action Plan (GVAP) for 2011 -2020: WHO, UNICEF, GAVI Alliance, Bill and Melinda Gates Foundation, U. S National Institute of Allergy and Infectious Diseases ■ What Stakeholders will lose: – Adverse reactions from the vaccine causing harm to a child – Individuals filing claim from adverse reactions ■ What Stakeholders will gain: – Prevent millions of deaths by 2020 – Gain control of vaccine-preventable diseases – Introduce new and improved vaccines (National Conference of State Legislatures, 2015) (World Health Organization, 2016)
Organizations Lobbying for Vaccines ■ National Foundation for Infectious Diseases – Non-profit organization – Encouraging and sponsoring public health education for infectious diseases ■ Allied Vaccine Group – Non-profit organization – Website that offers valid scientific information about vaccines ■ American Academy of Pediatrics – Organization for doctors specializing in pediatrics – Immunizations are a priority ■ American College Health Association – Advocacy organization – Provides advocacy, education, communications, products, and services – Promotes research and culturally competent practices (Immunize. org, 2014)
Organizations Lobbying for Vaccines ■ American College of Physicians-American Society of Internal Medicine – Provide resources and tools to support immunization efforts ■ American Nurse’s Association ■ Center for Vaccine Awareness and Research – Online vaccine education and resources – Center for Disease Control and Prevention ■ American Pharmacists Association – Provide immunization resources and training – Pharmacists must take on roles as educator, facilitator, and/or immunizer (Immunize. org, 2014)
Organizations Against Lobbying for Vaccines ■ National Vaccine Information Center – Dedicated to prevent vaccine injuries and death ■ Think Twice Global Vaccine Institute – Enables parents to make more informed vaccination choices ■ Vaccination Liberation ■ Coalition for Informed Choice – Assists people to become advocates against vaccination – Promote personal freedom of choice in all health decisions ■ My Kids, My Choice – Vaccine support group ■ Vaccine Rights (Think Twice Global Vaccine Institute, 2016)
Advantages of Lobbying For Vaccines Lobbying Against Vaccines ■ Protects entire community ■ Giving parents a choice ■ Prevents potential deadly diseases ■ Advocating against adverse reactions ■ Prevents spread of infection ■ Defends informed consent ■ Saves lives ■ Promotes public awareness about disadvantages of getting vaccinated ■ Reduces pain ■ Empowers people to get educated about vaccines ■ Saves Money
Who Holds the Power Over Immunization Health Policy? ■ State legislatures decide who gets vaccinated, when to get vaccinated, and who gets exempted from being vaccinated. ■ National Advisory Committee (NITAGS) ■ Immunization Practices Advisory Committee (IPAC) (World Health Organization, 2016)
Why They Hold the Power? ■ The state and federal legislatures holds power over immunization requirements because they ultimately are the ones responsible for making laws. ■ The national advisory committee NITAGS, holds power over immunizations because it uses evidence-based immunization policies. ■ IPAC holds power over the immunization policy because is works with the Director of the Deparment of Immunizations, Vaccines, and Biologicals (IVP). (World Health Organization, 2016)
Implementing Health Policy ■ The policy needing to be implemented for the immunization policy is having children receive the necessary vaccinations to prevent epidemics, while respecting and advocating the parent’s right to make choices for their own children.
Opening a Window for Opportunity ■ Allowing parents to be informed by the child’s physician about the immunizations, whats in them, side effects, and adverse reactions from the vaccines can help parents learn more about the risks and benefits of receiving or not receiving the vaccines. ■ After a physician informs a parent about the immunization, the parent should sign an informed consent for the child receiving the vaccination. ■ If the parent chooses not to receive the vaccine, they still must sign a form stating the reasoning why they did not choose to get their child vaccinated.
Current Status of Implementation ■ A new bill is introduce by the state representative for Oklahoma, Randy Grau, in February 8, 2016. ■ The bill was called Parental Rights Immunization Act ■ State representative Mike Ritze who is also a physician and surgeon cowrote the bill ■ The bill enforced the parent’s have a right for self decision as long as they were informed by their family physician. (Greve, 2016)
Parental Rights Immunization Act ■ Physicians are responsible for obtaining the informed consent by explaining potential risks, benefits, ingredients, and knowledge about the liability that injury or death may occur. ■ The bill will make sure parents are making informed choices on how they care for children instead of just reading things in the media. ■ The bill was passed in Oklahoma with the House of Representatives and the Health and Human Services Committee. (Greve, 2016)
Implementing Immunization Policy ■ Even though the bill previously talked about was passed and enforced in Oklahoma, other states should get involved in coming up with policies and programs similar. ■ States should still allow exemptions, but the personal choice exemptions should be backed up by informed consent from a physician.
Conclusion ■ Health policy for childhood immunizations is an important issue the United States is dealing with today. Immunization rates are decreased because of the media making accusations about vaccinations. I believe everyone has a right to their own choices they make about their own health, but should not put others at risk for their decisions. With that, parents and anyone being immunized who can make choices for theirselves should get the facts from their physician about the vaccines before making any impulsive decisions not to get vaccinated.
References ■ Center for Disease Control and Prevention. (2015, August 28). Common Vaccine Safety Concerns | Vaccine Safety | CDC. Retrieved from http: //www. cdc. gov/vaccinesafety/concerns/index. html ■ Center for Disease Control and Prevention. (2016, April 20). Birth-18 Years and Catchup Immunization Schedules for Providers | CDC. Retrieved from http: //www. cdc. gov/vaccines/schedules/hcp/child-adolescent. html ■ Greve, L. (2016, May 13). Vaccinations: Who Calls the Shots? Retrieved from http: //www. thenewamerican. com/usnews/health-care/item/23147 -vaccinations-who-calls-theshots ■ Immunize. org. (2014, February 25). Vaccine Organizations and Immunization Partners. Retrieved from http: //www. immunize. org/resources/part_us. asp ■ National Conference of State Legislatures. (2015, January 12). Immunizations Issues Policy Overview. Retrieved from www. ncsl. org/research/health/immunizations-policy-issuesoverview. aspx ■ National Conference of State Legislatures. (2015, February). States With Religious and Philosophical Exemptions from School Immunization Requirements. Retrieved from www. ncsl. org/research/health/school-immunization-exemption-state-laws. aspx ■ Think Twice Global Vaccine Institute. (2016). Think. Twice Global Vaccine Institute: Avoid Immunization Reactions. Retrieved from http: //www. thinktwice. com/support. htm ■ World Health Organization. (2016). WHO | Global Vaccine Action Plan 2011 - 2020. Retrieved from http: //www. who. int/immunization/global_vaccine_action_plan/en
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