Description of the issue/concern
In the modern day, there are numerous bacteria and viruses but only a small number of them are dangerous. That small amount can be fatal to an individual, or if spread, to a group of people. Diseases such as polio and rubella infected tens of thousands of Americans in the years 1950’s and 1960’s. In the case of polio, one out of two cases resulted in permanent crippling of the infected. Communicable diseases have been reported to claim so many lives, especially of the children than adults (Ferris, Horn & Waller, 2010). Typical examples of these conditions are polio, measles, rubella, mumps, and smallpox infection. In most developing countries, families could not afford to get better healthcare for their children, therefore; some of the preventable diseases have continued to cause unnecessary deaths. Research by Bill & Melinda Gates Foundation has shown that one in every 20 children dies from vaccine-preventable diseases.
Research has shown that measles is one of the most dangerous childhood diseases and is often characterised by high fever and blotchy red rash on the body surface. Measles has also been shown to have the ability to cause severe complications including lungs infection, death and blindness. There are different interventions carried out in the world to eradicate measles, but still, measles remains the leading cause of mortality particularly in low-income countries (Maltezou et al., 2012). On the other hand, influenza is also considered as a highly contagious disease and has the potential to spread even before the emergence of the symptoms. It has been shown to cause about 150,000 hospital admissions and approximately 24,000 deaths yearly (Ferris, Horn & Waller, 2010). The patients who are hospitalized have been established to be highly vulnerable to influenza dangers since their immune system are significantly compromised by the disease that might have led to their admission or even the treatment that they might be undergoing currently. Research has shown that vaccination might be critical in the prevention of preventable diseases deaths, reduce infections of contagious illness and absenteeism at work and schools. Infectious Diseases Society of America has been sat the forefront in advocating for mandatory vaccination.
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History/Background
The Center for Disease Control and Prevention (CDC) for years has been advocating for the vaccination of the healthcare workers yearly against influenza. According to Rakita et al., (2010), there are numerous credible agencies and organisations such as Association for Professionals in Infection Control and Epidemiology and Infectious Disease Society of America that strongly support mandatory vaccination to improve the wellbeing of the population. Healthcare workforce immunisation against various communicable diseases such as influenza will help to protect the patients, their families and the valuable workforce against chronic diseases. Most hospitals and healthcare organisations have recently put into places measures and policies that make seasonal influenza vaccination mandatory for all healthcare practitioners, students and any affiliated staff.
In Canada, the vaccination policies are highly diverse, and this has been attained through conducting a public awareness and education on the massive benefits of vaccines. Ontario and New Brunswick have passed mandatory immunisation for the following major diseases: rubella, polio, measles, tetanus and mumps. On the other hand, Manitoba requires that every citizen undergoes a mandatory measles vaccination (Maltezou et al., 2012). In Alberta, every healthcare worker especially those dealing with the infants, the prenatal women or even in the postpartum setting have to be protected against preventable diseases such as rubella. There are also several private longer care facilities across Alberta that have instituted a mandatory influenza immunisation in a case of an outbreak of influenza.
In the year 2014, there were about 102 cases of measles in Disneyland reported in 14 states. The rising cases were associated with increased numbers of unvaccinated children of ages below 12 years. Vaccination is vital to ensure herd immunity against various preventable diseases. According to Rakita et al., (2010), herd immunity is simply a resistance that happens when vaccination provided to a larger proportion of a given population offers a protection measures for the rest of the individuals that have not yet developed immunity. This situation emerges in a situation where a high proportion of the larger group of persons get protected via vaccination against various bacteria or viruses hence making it hard for the illnesses to spread since there would kill few individuals who are vulnerable to be infected. When accurately applied, it can help to stop the spread of certain types of diseases within the community hence overall protecting a particular type of the larger population (Maltezou et al., 2012). Among the people who cannot be vaccinated includes the infants, people who have been diagnosed with immune system problem and those individuals who are too ill to receive the vaccine, for instance, a cancer patient.
Solution to the Problem
Immunisation is simply the introduction of a foreign substance that stimulates the immune system to respond and develop an antibody against a preventable disease. In cases of an outbreak, it is important that parents should be encouraged to decide whether they are willing for their children to be immune (Rakita et al., 2010). Mandatory vaccination has been established as one of the most efficient solutions to the prevention of vaccine-preventable diseases. Universal vaccination has been shown to be vital as far as quality health care is concerned and thus should be carried out through a routine and an intensive vaccination program within the public healthcare facilities. There is the need to have programs in place to ensure that there is vaccination of all children at a recommended age against preventable diseases such as measles, polio and mumps (Maltezou et al., 2012). Every country should strictly adopt and implement vaccine doses as outlined in the Recommended Child and Adolescent Immunisation Schedule.
Vaccination can be a strong case for the governmental health mandate. No state wishes for their children to die from any preventable disease. According to Rakita et al., (2010), it follows that if the government of a given nation has the right to mandate vaccination because it knows best, then it might slide into legitimating other less relevant mandates. The majority of the people across the world agree that all the children should receive various vaccinations; however, such an agreement must not authenticate the governmental coercion.
Immunisation has remained to be an important public health intervention across the world and hence should be adopted as an effective intervention strategy against measles, polio and rubella throughout the world. It is because it is one of the most cost-effective and successful strategies that have reduced child mortality and morbidity associated with. According to Rakita et al., (2010), mandatory immunisation would, therefore, be an effective intervention especially for most low-income countries because it will result in a cost-effectiveness ratio of mortality and further eradication of the disease. It can be argued that with the use of immunisation, eradication of measles and polio would be achieved hence allowing the developing nations to adopt the cost saving option hence reducing the mortality rates and further channelling this money into other useful use within the economy that would lead to economic growth and development.
Advantage/Disadvantage (Costs/Benefits)
Mandatory vaccination has become a major controversial issue in the contemporary world. Vaccinations have been accredited for the success in eradication of polio, measles, polio and mumps globally. With heavy manufacturing of vaccines, the entire public has become highly wary whether they are safe and this to a larger extent has led to a reduction in the vaccination coverage.
Mandatory vaccination is highly important to ensure that there is a healthy population. It should be done in an appropriate manner taking into consideration the rights of the parents and children. Public health and safety can only be attained through immunisation (Maltezou et al., 2012). Numerous communicable diseases have been eradicated through immunisation in various parts of the world. It is important that the parents should not allow the world to go back to a period where numerous preventable diseases killed children by preceding safe vaccination programs due to their religious or even philosophical reasons (Babcock et al., 2010). Some of the vaccines such as of polio are important since it can be used to produce a lifelong immunity. There are those vaccines such as for tetanus that would demand a booster injection upon exposure to make sure that the population is fully immune. Based on this, it can be said that refusing vaccination for the children or adults for reasons that are not founded other than severe medical condition is highly unfair and risk to the population that might not protect themselves.
Despite its significant benefits, mandatory vaccination has also been associated with numerous drawbacks. According to Rakita et al., (2010), mandatory vaccines have been argued to violate medical ethic of the patient's informed consent substantially. The majority of the population that undergoes vaccination are the children who do not have an informed consent as far as immunisation is concerned. Children at schools are subjected to mandatory vaccination without consulting them or seeking their approval. Most research has shown that vaccination has a potential risk to the children and most of them have not been adequately proven. It has thus raised ethical concern about immunisation. Despite the fact that the immunisation program has saved the life and improved the quality of life, it has substantially violated the rights of people as far as their informed consent is concerned (Babcock et al., 2010).
Implementation
The implementation of immunisation program is critical to ensure that it is accepted and targets the right population in the community. The following are the key steps that should be adopted:
Building Support of Leadership-
There is the need to communicate with the concerned groups about the vaccination programs. These groups of the population include the nurses, the medical directors, the clinicians and the community members. These groups will help advocate and support the program. Therefore, there is the need to have an effective communication strategy that will create awareness of the program to the target population and the entire community.
The Development of Materials and Resources-
There is the need to put measures and materials in place to ensure that the vaccination program goes on appropriately. With adequate materials and resources, the nurses will be able to reach the entire population targeted. The staffs should be informed on how to administer the vaccine, and this would thus require that they undergo intensive training.
Start vaccinating-
The nurses and all medical practitioners involved will have to be supplied with adequate tools to ensure that they run a successful immunisation program. The target population would be visited at their homes and others will be required to visit a designated place to access the vaccination. The door to door vaccination would be the most suitable approach since this will ensure that all the target population are reached and to convince parents to allow their children be vaccinated. The vaccine administration technique selected should be appropriate and less involving to ensure that there are minimal errors and wastes.
Conclusion
Measles, rubella and polio eradication through the use of the vaccine has proven the most effective and low-cost strategy especially in all the low-income countries that have for many years been struggling with accessing healthcare facilities. First and foremost, it has been well established that the use of vaccine to eradicate measles uses low cost to generate a higher effect. It is where the developed vaccination drug can be administered to a large number of people across the nation which would be high cost efficient since people only require a drop of the medication, and this will eradicate measles entirely from the face of the country. There is the need to seek the parent's consent to have their children vaccinated, and this should not entail coercing them into participating in the immunisation program. Certain religious and philosophical reasons might discourage individuals from taking part in the vaccination program; therefore, they should be allowed to opt out of the immunisation and out of government vaccination program. However, there is the need for such parents to understand that the decision to opt out from vaccination program would put their children at a higher risk.
References
Babcock, H. M., Gemeinhart, N., Jones, M., Dunagan, W. C., & Woeltje, K. F. (2010). Mandatory influenza vaccination of health care workers: translating policy to practice. Clinical infectious diseases , 50 (4), 459-464.
Ferris, D., Horn, L., & Waller, J. L. (2010). Parental acceptance of a mandatory human papillomavirus (HPV) vaccination program. The Journal of the American Board of Family Medicine , 23 (2), 220-229.
Maltezou, H. C., Gargalianos, P., Nikolaidis, P., Katerelos, P., Tedoma, N., Maltezos, E., & Lazanas, M. (2012). Attitudes towards mandatory vaccination and vaccination coverage against vaccine-preventable diseases among health-care workers in tertiary-care hospitals. Journal of Infection , 64 (3), 319-324.
Rakita, R. M., Hagar, B. A., Crome, P., & Lammert, J. K. (2010). Mandatory influenza vaccination of healthcare workers: a 5-year study. Infection Control & Hospital Epidemiology , 31 (09), 881-888.
