Vaccination is the best and most effective way to decrease morbidity and mortality associated with diseases that can be prevented through vaccinations among young children aged between 19-35 months (Raphael & Lopez, 2018). Immunization programs in the United States have significantly contributed to eradication of most diseases that can be prevented by administering vaccines. One of the major aims of Healthy People 2020 is to decrease health disparities which include reducing disparities in immunization levels that happen by race and ethnic affiliation. However, the disparities in immunization still exist among different ethnic/racial groups.
African American children record a low coverage level of childhood immunization. This paper presents a health promotion project addressing the low rates of African American c hildren receiving the recommended doses of DTap, polio, MMR, Hib, HepB, varicella, and PCV by age 19-35 months in my area. Included in the project is a discussion of the relevance of the topic of childhood immunization to the target population and Healthy People 2020, literature review of the problem, and a discussion of the health promotion approaches that will be implemented.
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Background
Immunization rates for African American children between the ages of 19 to 35 months remain low in my area compared to the rates of white children of the same age. Research conducted shows that attitudes of African American mothers and their concerns about vaccination impact their decisions on whether to immunize their children (Song, 2013). Statistics show that the rates for African American children between ages 19 to 35 months stood at 66 5% in 2016. African American’s mothers’ health and immunization literacy levels influence their decisions on children immunization. Therefore, health education promotion regarding immunization is imperative in this case.
The generic aim of Healthy People 2020 is to increase the rates of immunization and decrease the rates of diseases that can be prevented through immunization. One of Healthy People 2020 specific goals for children below the age of going to school is to achieve and retain effective coverage rates of childhood immunization for universally proposed vaccines. The projects aims at creating awareness on the importance of vaccination of children between ages 19-35 among African Americans with a major target on mothers because their health literacy levels are a major determinant of their immunization practices. By doing so, the project will be contributing to the achievement of the Healthy People 2020 goals for immunization and compliance of more than 90% of all children and eradication of health disparities in immunization.
Summary
Existing literature about factors affecting vaccination rates for children between the ages of 19 to 35 months and evidence based promotion activities is reviewed. Relevant and evidence based established guidelines about children vaccination plan are also reviewed. In addition, this literature review includes research that examines the influence of existing racial disparities in immunization and health care access, beliefs about vaccination, parents’ decisions about childhood immunization, and influence by immunization and health literacy.
Moran et al. (2016) conducted an information scan and studied immunization safety concerns among African American, Mexican American and non-Hispanic White Women. The aim of the study was to assess the relationship between scanned information, levels of trust in information provided by health providers and concerns regarding vaccination safety among the target group. A study sample of 761 women from Los Angeles was used. A survey was conducted through a random digit dial and information about the topic under study gathered.
Results from the study indicate that each of the ethnic groups studied had their different sources of information related to vaccination safety concerns. African American women showed high rates of concerns about child immunization and reported higher rates of non-compliance to vaccination schedules. The study concludes that information scanning is related to beliefs about the safety of immunization and this may cause parents to refuse or at times delay immunizing their children. The study suggests that knowing information sources that cause the concerns can help in development of educational practices that promote vaccination in target group.
In his review, Ventola (2016) propose recommendations; identify barriers and measures to promote compliance of childhood vaccination. According to the article, some parents fail or delay to immunize their children between the ages of 19 to 35 months or follow other vaccination plans because of a number of reasons such as religious, cultural and socioeconomic issues. The article suggests a number of interventions that can be implemented by health care providers in an effort to fight non-compliance of vaccination. The proposed interventions include improved access to vaccines, making maximum use of patient’s doctor visits by educating about the importance of childhood vaccination, giving combination vaccines among others. For community based interventions, activities that can promote compliance include education for public members, recall techniques, offering financial incentives and giving alternative places for vaccination.
The WHO (2017) training manual on vaccines safety and false contraindications to vaccinations provides a scientific and authoritative advice and information for health professionals in order to counter common misconceptions regarding vaccination. Although the final decision on whether to vaccinate children or not remains with their parents, the article suggests that health professionals are a very important influence in the decisions made by parents.
Gilkey et al. (2016) present findings from a study conducted on vaccination confidence and parental refusal/delay of early childhood vaccination. The aim of the study is to promote efforts to address hesitancy by parents towards vaccination of children between 19 to 35 months of age. The study used a sample of 9,354 parents who completed a survey on vaccination history of their 19 to 35 months old children. The findings show that 15% and 27% of the surveyed parents refused or delayed vaccinating their children respectively. From the results, the study concludes that vaccination confidence was positively correlated with conduct in early childhood immunization in different vaccines.
Health Promotion Practices
Health literacy plays a major role in parents’ decisions regarding early childhood immunization. The project will conduct vaccination promotion awareness campaigns among African American women. The awareness campaigns will include addressing of common misconceptions about vaccinations and any other concerns raised by members form the cultural group about vaccination. In addition, the vaccination promotion campaign will include information on the importance and health benefits of vaccinating children aged 19 to 35 months and the dangers associated with lack of vaccination. The target group will also receive printed material on vaccination for children to ensure that more than 90% of the targeted group is reached.
Conclusion
In conclusion, although reducing, a disparity related to vaccination among African American young children still exist in my community and in the United States in general. African American children record low levels of vaccination when compared to their white counterparts (Raphael & Lopez, 2018). Therefore, because of this health disparity in immunization among African Americans, it is important that this problem is addressed. This is the reason as to why this project will implement. By creating awareness and promoting vaccination through education, the project hopes to improve the rates of vaccination in the target group.
Reference
Gilkey, M. B., Mcree, A., Magnus, B. E., Reiter, P. L., Dempsey, A. F., & Brewer, N. T. (2016). Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines. Plos One, 11 (7). doi:10.1371/journal.pone.0159087.
Moran, M. B., Frank, L. B., Chatterjee, J. S., Murphy, S. T., & Baezconde-Garbanati, L. (2016). Information scanning and vaccine safety concerns among African American, Mexican American, and non-Hispanic White women. Patient Education and Counseling, 99 (1), 147-153. doi:10.1016/j.pec.2015.08.016
Raphael, J. L., & Lopez, M. A. (2018). Disparities in Child Health: A Review. Springer Briefs in Public Health Disparities in Child Health, 1-10. Doi: 10.1007/978-3-030-03210-4_1
Song, G. (2013). Understanding Public Perceptions of Benefits and Risks of Childhood Vaccinations in the United States. Risk Analysis, 34 (3), 541-555. doi:10.1111/risa.12114
Training manual: Vaccine safety and false contraindications to vaccination (2017). (2017, December 15). Retrieved from http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/2017/training-manual-vaccine-safety-and-false-contraindications-to vaccination-2017
Ventola, L., C. (2016). Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance. Pharmacy & Therapeutics .
