Evidence Supporting Vaccine Safety and Effectiveness

Discuss how to  provide information in regards to the refusal of MMR vaccine to their child and how to communicate with parents who have concerns about vaccination.

This assignment mainly deals with the case scenario regarding immunisation. Vaccines are antigens or the weakened version of viruses that are injected in the body to fight against a particular disease (Knight-Jones, & Rushton, 2013). The feeble viruses that are contained in a vaccine look alike the original virus however, does not produce any signs of that particular disease (Atkins et al., 2013). It only stimulates the production of antibodies in the body and increase the immune system. Vaccination has become one of the best method to fight against certain germs like the small pox, Hepatitis B, measles, mumps and rubella (MMR) and so on (Grabenstein, 2013). These vaccines are given to the children on a regular basis. Due to vaccines a number of childhood disease have become rare today. Some of the risks that exists in the use of these boosters has been outweighed by the various advantages that it has. However, parents are much concerned about the little side effects that these doses have. The following paragraphs will provide a brief insight to the positive effects of vaccination along with evidences from scientific research carried out by various medical organizations and explain the strategies for communicating to the concerned parents.

Parents are raising questions on the relationship between autism and vaccines. They are concerned about the general safety and risks of using the boosters. Parents are assuming that a large number of vaccines are being used to increase the immune system and worried about the MMR vaccine in particular because it consists a preservative thimerosal. However, certain studies proves vaccine safety. I as a nurse can cite a number of examples that will prove vaccine safety. Institute of Medicine (IOM) performed almost 60 studies on vaccine safety, which showed that there is no such alarming issues regarding the safety of these boosters in addition they are associated with decreasing the vaccine-preventable diseases. Parents complain regarding the recommended vaccine schedule being crowded. Therefore, IOM surveyed the vaccine providers and researchers to gain information on the dose routine. They found that no such serious issues exists with immunizing children frequently. Furthermore, they studied around 1000 children who were born between 1993 and 1997. The effects were studied after 7 to 10 years on 42 different neuropsychological outcomes (Iqbal et al., 2013). They found that the performance of the children who were vaccinated on a regular basis performed better than the children who were less vaccinated.

Concerns Voiced by Parents

Another research was carried out in Northern California on the effects of vaccination on 77 babies born with metabolism disorders and 1540 infants with no metabolism errors (Sanders et al., 2013). Research revealed that there was no connection between vaccination and metabolism disorders. They said that on-time receipt of vaccine does not adversely affects the infant with inborn errors. Reassurance was given to the parents that vaccination and metabolism disorders has no association between them. They performed a detailed study on 715,484 children between 2 to 3 years of age to determine the effects of combined inoculation (Sherman, Anderson, Dal Pan, Gray, Gross, Hunter, & Shuren, 2016). They injected the MMRV (a combination of the MMR and Varicella vaccine) to some children and a dose of MMR along with Varicella dose separately. It was observed that the after effects of the booster like fevers and seizures were more in children who received the MMRV dose than those who received the MMR and Varicella dose separately. However, the effects were not so serious. Therefore, the researchers assured that combined doses does not affects the children largely. A number of parents argued for the negative effects of thimerosal in various vaccines. Studies performed on 109,863 infants born in U.K. from 1988 to 1997 proved there was no evidence that thimerosal in any dose caused neurodevelopmental problem in babies (Horne, Powell, Hummel, & Holyoak, 2015).

I often find that the parents are concerned more on the negative effects of vaccination. They often refuse to give the measles, mumps and rubella vaccine to their children. The main reason behind the refusal is their past experience rather than the scientific evidences. A number of parents who dosed their children with MMR have experienced deafness and measles encephalitis in their immediate family (Phadke, Bednarczyk, Salmon, & Omer, 2016). Another negative effect of MMR that the parents believed to have is autism. They refused to immunize their children forecasting the after effects of vaccination like autism. It was assumed that the long-term effects of autism were far more worse than the immediate effects of measles, mumps and rubella. It was considered that if no problem occurred after the first dose then there is a less risk of autism for their children. However, parents do not opt for the second dose. It is also believed that decisions of the parents are highly influenced by the General Practitioners. Parents refuse to vaccinate their children assessing that the general practitioners will be awarded lump sum amount of money for each patient vaccinated. The guardians often complain that they are not well informed by the doctors about the benefits or risks of the MMR vaccine. Moreover, they are worried about the thimerosal content in the vaccine. However, I would like to inform them about the risks of refusing the MMR vaccine. The unvaccinated children are more likely to face the measles disease, which might lead to an increase in the mortality rates among children. In the hospital, I have come across certain incidences where the mother refused to give MMR vaccine to her daughter. The result was that she was diagnosed with mumps at the age of five. I as a nurse would like to inform the parents about the safety of the MMR vaccine.

Strategies for Communicating with Concerned Parents

Researchers have studied the babies with gastrointestinal disorders that lasted for 24 hours after the injection (World Health Organization, 2017). They found no such serious issues regarding the illness, which might cause inflammatory bowel disease. It was even observed whether there was any association between MMR vaccine and autism. However, the data do not support this hypothesis. There are no strong evidence that shows the relationship between autistic disorders and MMR dose. Survey was made on 155 persons with inflammatory bowel disease, which showed that neither the MMR vaccine, nor the vaccination age was the reason for IBD (Ng, Bernstein, Vatn, Lakatos, Loftus, Tysk, & Colombel, 2013). Another study compared between 96 children with pervasive developmental disorder (PDD) and children who received the measles, mumps and rubella vaccine. All the epidemiologic studies failed to support the hypothesis that argued for the association of MMR injection and autistic enterocolitis.

Susan has an issue regarding vaccination. She is worried about the negative effects of the MMR vaccine. I would like to communicate to her about the negative impact on her child for not receiving the measles, mumps and rubella vaccine. She should understand the risk of the diseases.  Susan rely on her pediatrician about the information on vaccines. Therefore, I would suggest the doctor to provide scientific data and figures in response to the concerns of the parents. Media reports are yet another source of information that the Susan like to depend on (Dubé et al., 2016). I think emotional messages and personal experience stories on the benefits of vaccination should be shown on the television and I, as a nurse would like to inform her so that she is no more worried about the risks of the measles, mumps and rubella vaccine.

I would like to educate Susan about the benefits of community immunity and the rate at which the children of a community are being vaccinated. This will provide her a mental support and enthusiasm to dose her child (Tafuri, Gallone, Cappelli, Martinelli, Prato, & Germinario, 2014). I would suggest her to join an online platform to communicate with peer groups who might be also be vaccine hesitant. This would help her get rid of her concerns.   

I would request her to participate in the committee meeting that will be organized to gather information on why the parents are reluctant to vaccinate their children or do not complete their vaccination. This would help her improve the relations with the community, and me, which will directly give me the advantage to influence her decisions.

Conclusion

Conclusions:

From the above discussions, it can be concluded that immunization is one of the important aspect of child health. There might be some issues regarding the MMR, MMRV vaccine and autism. Parents believe that there is a strong relationship between the measles, mumps and rubella vaccine and autistic disorders. This is the reason behind them being reluctant to vaccinate children or not completing the vaccination course. They also believe that the dosing routine is significantly crowded. However, research, studies and surveys revealed that there is no connection between the MMR vaccine and autism. There is no association between inflammatory bowel disease, pervasive developmental disorders, autistic disorders and the negative effects of vaccination. Therefore, parents should be educated properly in this regards. Immunisation programmes, committee organisation and media publicity will be required to communicate to the concerned parents about vaccine safety

References:

Atkins, K. E., Read, A. F., Savill, N. J., Renz, K. G., Islam, A. F., Walkden?Brown, S. W., & Woolhouse, M. E. (2013). Vaccination and reduced cohort duration can drive virulence evolution: Marek’s disease virus and industrialized agriculture. Evolution: International Journal of Organic Evolution, 67(3), 851-860.

Grabenstein, J. D. (2013). What the world’s religions teach, applied to vaccines and immune globulins. Vaccine, 31(16), 2011-2023.

Horne, Z., Powell, D., Hummel, J. E., & Holyoak, K. J. (2015). Countering antivaccination attitudes. Proceedings of the National Academy of Sciences, 112(33), 10321-10324.

Iqbal, S., Barile, J. P., Thompson, W. W., & DeStefano, F. (2013). Number of antigens in early childhood vaccines and neuropsychological outcomes at age 7–10 years. Pharmacoepidemiology and drug safety, 22(12), 1263-1270.

Knight-Jones, T. J. D., & Rushton, J. (2013). The economic impacts of foot and mouth disease–What are they, how big are they and where do they occur?. Preventive veterinary medicine, 112(3-4), 161-173.

Ng, S. C., Bernstein, C. N., Vatn, M. H., Lakatos, P. L., Loftus, E. V., Tysk, C., … & Colombel, J. F. (2013). Geographical variability and environmental risk factors in inflammatory bowel disease. Gut, 62(4), 630-649.

Phadke, V. K., Bednarczyk, R. A., Salmon, D. A., & Omer, S. B. (2016). Association between vaccine refusal and vaccine-preventable diseases in the United States: a review of measles and pertussis. Jama, 315(11), 1149-1158.

Sanders, M. E., Guarner, F., Guerrant, R., Holt, P. R., Quigley, E. M., Sartor, R. B., … & Mayer, E. A. (2013). An update on the use and investigation of probiotics in health and disease. Gut, 62(5), 787-796.

Sherman, R. E., Anderson, S. A., Dal Pan, G. J., Gray, G. W., Gross, T., Hunter, N. L., … & Shuren, J. (2016). Real-world evidence—what is it and what can it tell us. N Engl J Med, 375(23), 2293-2297.

Tafuri, S., Gallone, M. S., Cappelli, M. G., Martinelli, D., Prato, R., & Germinario, C. (2014). Addressing the anti-vaccination movement and the role of HCWs. Vaccine, 32(38), 4860-4865.

World Health Organization. (2017). Measles vaccines: WHO position paper, April 2017–Recommendations. Vaccine.

Dubé, E., Vivion, M., Sauvageau, C., Gagneur, A., Gagnon, R., & Guay, M. (2016). “Nature Does Things Well, Why Should We Interfere?” Vaccine Hesitancy Among Mothers. Qualitative Health Research, 26(3), 411-425