The Social Trend Away from Childhood Immunization and the Reduced Critical Mass
Childhood immunization is a controversial population health issue in the United States. The preventive measure has played a critical role in the history of the country and the world in addressing the prevalence of preventable diseases, such as smallpox and measles. At the beginning of the 20th century, infectious diseases were common and led to the deaths of thousands of children and even adults. They caused a considerable cost burden to individuals, communities, and the country (Gordis, 2014). During that time, preventive and treatment strategies were few. Scientific research and medical explorations led to the development of vaccines that would help to prevent infectious diseases. Consequently, medical experts have developed and attained licensing of vaccines for more than 21 illnesses (Bärnighausen et al., 2014). Regardless of the benefits of childhood immunization in preventing infectious conditions, a social trend is common towards their avoidance amid reduced critical mass covered for illnesses such as measles.
Description of the Issue
Childhood immunization has played a critical role in the reduction of infectious diseases in the United States, such as measles and smallpox. According to Bärnighausen et al. (2014), for example, in 1900, about 21,064 cases of smallpox were reported in the country, and around 894 individuals out of the infected died. In 1920, approximately 469,924 cases of measles were recorded. Out of the reported cases, about 7,575 people died. Besides, around 147,991 cases of diphtheria led to approximately 13,170 deaths (Bärnighausen et al., 2014). The development of vaccines led to a considerable reduction in the number of cases of infectious diseases (Edwards, Hackell, Committee on Infectious Diseases, & Committee on Practice and Ambulatory Medicine, 2016). According to Bärnighausen et al. (2014), the evidence indicates a decrease in the morbidity from nine vaccine-preventable illnesses and their effects. Smallpox, poliomyelitis caused by wild-type viruses, and measles are some of the conditions that have been almost eliminated in the country (Lee & Robinson, 2016). The 20th century witnessed significant accomplishments in addressing the challenge of vaccine-preventable illnesses.
Despite the achievements made in preventing infectious diseases, a negative trend is emerging that might affect the strides made so far. Regardless of the importance of vaccines among children and adolescents, research reveals an increase in vaccine hesitancy in the United States. Many parents in the country are intentionally avoiding the vaccine because they are the critical decision-makers in their children’s lives (Kumar, Chandra, Mathur, Samdariya, & Kapoor, 2016; Ventola, 2016). Frew et al. (2016) analyzed the immunization decisions of parents with children below seven years to assess their behavioral attitudes towards immunization programs. Many parents deny their children the opportunity to undergo necessary vaccinations. Parents and the society, in general, indicate many reasons for avoiding the vaccines, such as adverse effects on the recipients, moral or religious beliefs, and resource limitations.
Ideological differences are playing a significant part in the changes in childhood immunization trend in both the United States and globally. Rabinowitz, Latella, Stern, and Jost (2016) studied the role of ideology in determining whether society supports or opposes childhood immunization. The authors investigated the pro and anti-vaccination debate in the country and concluded that political ideology influences the perception and belief of people regarding the preventive initiatives targeting infectious diseases. Some believe that vaccines are not safe for their children (Dubé, Vivion, & MacDonald, 2015). Consequently, conservatives, moderates, and liberals have divergent views regarding the issue. Most of the anti-vaccination groups have played a role in the increasing reduction in the number of people taking their children for vaccination.
Effect on Population Health
The development of vaccines has affected population health in the United States and globally. By the turn of the 20th century, many vaccine-preventable diseases had considerably reduced (Centers for Disease Control and Prevention, 2015). Many children no longer suffered the disease burden of conditions, such as smallpox and measles. The society no longer experienced the unnecessary cost of treatment of infectious ailments. Besides, the development of the immunization programs and related policies in the country resulted in a reduction in the number of deaths resulting from the conditions (van Wijhe et al., 2016). However, the current trend towards their avoidance might reverse the achievement of the government and public health if actors fail to address the problem. They might cause the society to experience increased rates of infectious diseases, including those that have been eliminated through immunization.
Health care experts in the United States have noted a rapid increase in the outbreak of vaccine-preventable diseases. The vaccine refusal phenomenon is causing a severe challenge in the country’s population health (Phadke, Bednarczyk, Salmon, & Omer, 2016). Currently, a higher risk of infection among individuals who are not vaccinated compared to those who are fully vaccinated is evident. As a result, individuals and communities are at risk of suffering from diseases that are transmitted from one person to another (Opel & Omer, 2015). Failure to vaccinate creates a considerable risk of infectious diseases in various communities in the country. Consequently, these conditions will affect the wellbeing and quality of life of populations.
Impact on Global and/or National Health Service Delivery
Some experts argue that vaccinations have made a substantial contribution to global health and improved health service delivery. It has been one of the most effective human intervention in preventing infectious diseases. Research on the impact of childhood immunization in the industrialized world since the close of the 19th century reveals a significant decline in child mortality (Greenwood, 2014). Similar results have been evident in global health. Although mixed findings in terms of the effect of vaccines in the developing world are manifest, it is clear that the progress made significant steps in reducing the impact of infectious diseases. It also led to a decline and a reduction in the burden of care in service delivery. Therefore, avoidance of immunization can bring challenges in national and global service delivery because of an increase in the rate of infectious illnesses.
The United States is experiencing a new rise in the number of cases of vaccine-preventable diseases, such as measles. Recent outbreaks of vaccine-preventable diseases in the country have been recorded, which led to critical questions regarding the role of the current hesitancy by parents to have their children vaccinated. Vaccine delay, refusal, or exemption causes a severe problem to the country’s care delivery and disease control since such conditions have already been eliminated. Most of the current cases are intentionally unvaccinated, which creates a high risk of new outbreaks and a significant challenge to health care providers (Phadke, Bednarczyk, Salmon, & Omer, 2016). The new infections also create a burden for care providers, nationally and globally.
Impact on Nurses and Nursing Practice
Nurses in the country are committed to providing quality care to their patients. They focus on public health through treatment, disease prevention, and health promotion. Therefore, any decision made by parents or society affects their work, negatively or positively. The anti-vaccination movement has a significant toll on their work. Nurses face a growing challenge of new outbreaks of infectious diseases because of the lack of compliance by parents. Although the vaccine-preventable conditions are almost extinct, new cases are emerging due to the failure of parents to vaccinate their children (Wade, 2014). The work of healthcare providers is affected in various ways, including the increase in the demand for their treatment services and the need to increase awareness among parents regarding the importance of immunization.
The United States’ nursing professionals have a unique role in promoting knowledge about the need for prevention of diseases. They are responsible for protecting un-immunized children. They should listen to and address concerns raised by parents about vaccination and dispel misconceptions. They can support a change of perceptions among parents regarding the risks associated with vaccination (Wade, 2014). Their work has increased due to the current ideological factors that have triggered failure to vaccinate children. The anti-vaccination movement has created a considerable challenge for nursing professionals due to the need to protect children and affirm the efficacy of vaccinations among serious criticisms (Dubé, Vivion, & MacDonald, 2015). They need to conduct more investigation on the benefits and drawbacks of vaccines to provide evidence-based assistance to parents.
Current Attempts to Address the Issue
The government and other policy-makers in public health and healthcare system in the United States have taken steps to improve immunization compliance. The government use sanctions for non-compliance with the mandated immunization program for children (Martin, Lowery, Brand, Gold, & Horlick, 2015; MacDonald et al., 2018). For example, the government makes it mandatory for children beginning school to have completed the immunization program. Policy-makers have also attempted to discredit or stop any anti-vaccine movement to reduce the hesitancy (Leask, 2015). Other concerted efforts include incentivizing immunization programs to improve access. Policymakers and care providers use means, such as counseling, opportunity maximization during patient visits, a combination of vaccines, and electronic records for surveillance and monitoring (Ventola, 2016). Creating awareness appears to be the most commonly used and somewhat effective means of preventing the anti-vaccine sentiments.
Recommendations to Address the Issue
Regardless of the current claims against immunization in the United States, the government and health care providers maintain that vaccinations are critical to retaining the low rate of infectious diseases. Since their benefits outweigh their effects, immunizations should be promoted and used by parents in the country. One of the recommended solutions is increasing public awareness through health education and promotion campaigns. Policymakers and program implementers should assess and analyze the factors behind vaccine hesitancy to customize their interventions. Kumar, Chandra, Mathur, Samdariya, and Kapoor (2016) propose a review of personal and societal reasons for the avoidance of immunization among parents and societies. They can use environmental factors, including community resources, policies, and the media, to implement the behavior change campaigns to improve compliance with immunization.
Another recommendation is to use the services of health care workers to collaborate with members of the community to change the ideology, such as the anti-vaccination campaigns. These professionals will be critical in creating the necessary knowledge among parents and members of the community regarding the importance of vaccinations. Besides, it is essential to train the community about the importance of vaccines and discount the negative sentiments, such as they can cause idiopathic illness. The health care professionals should use the new channels to communicate accurate information to their communities. Health care providers are always in contact with parents in “search of truth” about their children’s health (Tafuri et al., 2014). Therefore, these professionals should have updated knowledge regarding the efficacy and benefits of the vaccinations to use evidence-based facts when communicating with various patient populations.
Another major challenge in the area of childhood immunization is the support of the individual choice in the country. Therefore, another recommendation to address the issue is to create a balance between personal choice and public health, especially concerning the care of children (Lee & Robinson, 2016). The government should make it compulsory for parents to ensure that their children are vaccinated. It should impose sanctions against any parent who fails to vaccinate their children. Such measures will make it hard for parents to exercise choice to refuse or delay vaccination. The strategy is critical as a way of making the state responsible for the health and wellbeing of children.
The public health has always faced a significant challenge of contagious and infectious diseases. Many children have in the past died due to various conditions until vaccines were developed to prevent them. However, over the past few decades, many people in the developed economies have increasingly opposed vaccination among children and adolescents. A growing number of parents who choose to avoid immunization has been on the rise. As a result, cases of outbreaks of vaccine-preventable conditions such as measles have been reported. The new development is affecting population health and national and global health system because of the burden and cost of treatment. Therefore, policy-makers in government and the healthcare system should design effective strategies to overcome anti-vaccine movement, including behavior change and educational programs to create awareness on the importance of the vaccines.