Immunization in the USA has been an effective measure to minimize the incidence of mumps, measles, hepatitis, diphtheria, and other dangerous infections that used to lead to epidemics associated with thousands of deaths.
However, this progress is being threatened by the current shift in public opinion as the rate of unvaccinated people reaches up to 20% in some states and communities. According to US legislation, people may be excused from vaccination due to their religious or philosophical views, and more and more people start exercising this right. The lack of resources, limited access to health care, and insufficient awareness are key factors contributing to the problem. Therefore, it is essential to launch a program that would ensure the allocation of additional resources to healthcare and educational facilities. These institutions will become the primary platforms for immunization as more people will be able to access healthcare services.
Immunization is regarded as one of the key instruments in preventing such serious infections as hepatitis, smallpox, measles, diphtheria, mumps, and many others. These infectious diseases used to result in numerous epidemics that killed thousands of people, and they still persist in some developing countries (Ventola, 2016). However, Americans are starting to neglect the necessity to vaccinate their children due to various reasons, which has already led to an adverse impact on public health. The outbreaks of Hib, pneumococcus, pertussis, and measles that have occurred regularly since the 1990s are an illustration.
Remarkably, it was declared in 2000 that the USA managed to eliminate measles, but the outbreaks of this disease in 2014 with 644 cases in almost 30 states showed that the victory was temporal (Ventola, 2016). Ventola (2016) emphasizes that between 2 and 20% of people (depending on a state) are not vaccinated or had deviated schedules, which poses considerable threats to public health. This policy brief addresses the challenges and barriers to effective immunization in the USA and includes a set of recommendations.
Approaches and Results
This study is based on a review of the recent literature on the matter with the focus on challenges and possible solutions. It is necessary to note that immunization is universal in the USA although certain populations have low access to these services (Ventola, 2016). Socioeconomic peculiarities of parents (unemployment, the status of an immigrant, living below the poverty line, and being insufficiently informed) have proved to be central to the exclusion of children from the process. Collier et al. (2014) found that 165 people were infected with Hepatitis A in ten states in 2013 after having consumed pomegranates imported from Turkey. Therefore, outbreaks of some infectious diseases can also occur due to the exposure to infected newcomers or even consumption of certain kinds of food.
Nevertheless, the most influential reason for the rising rate of children who are not vaccinated or have been vaccinated without following CDC recommendations strictly is public opinion. Dorell et al. (2014) note that parents often see vaccines as unsafe, useless, or unnecessary as they have lived in the world with no major epidemics of the diseases mentioned above. The US legislation is responsible for the increasing number of unvaccinated children as people may be excused from immunization due to medical indications (rather rare), as well as religious or philosophical views (Ventola, 2016).
As mentioned above, the low socioeconomic status of parents is associated with their children’s vaccination. Although the current rate of unvaccinated children is comparatively low, it already has negative consequences and is associated with hazards to public health.
Certain steps have been undertaken to address the issue and ensure the availability of vaccines and people’s compliance with the developed immunizations schedules. Vulnerable groups can access free vaccines through numerous programs and funds including Medicaid (Ventola, 2016). Bach and Goad (2015) claim that community pharmacy-based immunization provisions have improved the situation in many parts of the USA. It is noteworthy that such projects tend to lack funding, which can hinder the achieved positive effects. Ventola (2016) also adds that the lack of nursing professionals who could inform people and advocate for immunization contributes to the existing attitudes towards vaccines.
On balance, it is possible to state that the trends related to immunization are rather alarming as the rate of unvaccinated children is increasing. The primary reasons for such tendencies include people’s attitudes towards vaccines, population’s limited awareness of the hazards related to low immunization level, and the lack of resources to cover all groups of people. Many people choose to exercise their right to be excused from vaccination on the basis of the existing legislation. Healthcare professionals emphasize that the growing number of unvaccinated people can have adverse effects on public health as outbreaks of serious infectious diseases will inevitably become more common.
Implications and Recommendations
In order to improve the situation, it is important to address several aspects of the problem and use different channels and tools. First, education is a key to solving the problem, so the major effort should be made in this terrain. It is important to provide additional funds to healthcare facilities so that nursing professionals could provide educational services related to immunization. Community nurses should have sufficient resources to educate people and motivate them to comply with CDC guidelines. Such projects as community pharmacy-based projects should receive proper funding as well.
Apart from these efforts, educational establishments should also become a part of the program aimed at increasing immunization level. School nurses should develop interventions to promote vaccination among students and parents. Moreover, educational establishments can become another platform for immunization as students can be vaccinated at school during their studies. Parents will not have to seek an opportunity to bring their children to facilities where they will receive the services.
Therefore, it can be beneficial to launch a program facilitated by laws or regulations that would involve funding of the measures mentioned above. The program would fund and supervise the improvements in the sphere of healthcare and education, as well as community-based initiatives. Some examples of effective measure to undertake are to improve the reimbursement of nurses’ educational services or ensure the availability of resources in schools where vaccinations can take place. This new program can also provide grants to individuals who would come up with effective solutions to the problem.
The funds will be allocated to the states and communities with the highest rate of unvaccinated children. The expected outcomes include the decreased number of unvaccinated people, enhanced people’s awareness of the threats linked to inadequate immunization, and changed attitudes towards vaccines. These efforts can help in achieving a low rate (2-3%) of unvaccinated children nationwide. It is necessary to target this goal and make sure that only medical indications will be the sufficient excuse not to be vaccinated.
Bach, A. T., & Goad, J. A. (2015). The role of community pharmacy-based vaccination in the USA: Current practice and future directions. Integrated Pharmacy Research and Practice, 4, 67-77. Web.
Collier, M. G., Khudyakov, Y. E., Selvage, D., Adams-Cameron, M., Epson, E., Cronquist, A., … Xu, F. (2014). Outbreak of hepatitis A in the USA associated with frozen pomegranate arils imported from Turkey: An epidemiological case study. The Lancet Infectious Diseases, 14(10), 976-981. Web.
Dorell, C., Yankey, D., Jeyarajah, J., Stokley, S., Fisher, A., Markowitz, L., & Smith, P. J. (2014). Delay and refusal of human papillomavirus vaccine for girls, national immunization survey–teen, 2010. Clinical Pediatrics, 53(3), 261-269. Web.
Ventola, C. L. (2016). Immunization in the United States: Recommendations, barriers, and measures to improve compliance. Pharmacy and Therapeutics, 41(7), 426-436. Web.