Vaccines do no Good Unless Used

Overview of the Issue 

The vaccine is one of the greatest achievements in the medical field from a clinical perspective within the 20th century. The introduction of vaccines has enhanced the elimination of many healthcare risks that erstwhile ravaged the world. However, vaccines do not do any good to any patient or population unless and until they are administered. Administration of vaccines is mostly a nursing obligation that would be quite easy, but many patient segments are unwilling to accept vaccination. This problem is compounded by the fact that the HPV vaccine work best when a large segment of the target population is vaccinated leading to herd immunity “ For an HPV vaccination program to be successful, the majority of the population must be vaccinated” (Scott & Batty, 2016. p. 199) . Among the greatest threats to the success of vaccination is, therefore, the lack of consent and cooperation from the population. The human papillomavirus (HPV) vaccine provides a unique opportunity to the concept of vaccination. Whereas erstwhile vaccination has been limited to communicable diseases, HPV provides a unique scenario where vaccination can extenuate one of the great non-communicable disease facing women globally. This is the threat of cervical cancer “most important reason for HPV vaccination was preventing cancer” (Perkins, Zisblatt, Legler, Trucks, Hanchate & Gorin, 2015, p. 831). In Canada, nurses are determined to diminish the incidents of cervical cancer by using the HPV vaccine. The issue on focus herein is that in many cases, these nurses face a brick wall since based on several factors, many women and parents of girls decline the vaccine, thus voiding its potential benefits: providers frequently described parents choosing to defer vaccination. 

Background of the Issue 

75% of sexually active men and women will develop a minimum of one anogenital HPV infection. This is an overwhelming statistic that leaves just how HPV is a problem in Canada. Further, these HPV cases have been proven to cause 70% of anal and genital cancers as well as 90% of anogenital warts (Okoronkwo, Sieswerda, Cooper, Binette, & Todd, 2012, p. 117). This has created a definitive correlation between a communicable and a non-communicable disease, thus creating a means for the prevention of a dangerous form of cancer, through vaccination. Unfortunately, the association between HPV and sexual activity has become a major social barrier for the HPV vaccine. Just as with the HIV problem, the population would rather avoid the embarrassment of tackling health-based issues that relate to sex. This has also affected the issue of HPV vaccines for minors whose vaccination cannot be undertaken without parental consent. Every parent would want to believe that children are still innocent and not engaging in sex “in younger adolescents until the parent felt that they were closer to becoming sexually mature” (Perkins, Zisblatt, Legler, Trucks, Hanchate & Gorin, 2015, p. 833). Unfortunately, this belief also amounts to gambling with the health and life of the minor because the belief is not always based on fact. The HPV virus has been proven to work very well in preventing HPV in both male and female users (Thavarajah, Chow & Arocha, 2015, p. 266). The main problem in nursing is how to get as many sexually active people as possible to use it to lay a foundation for herd immunity that would eradicate the dangerous disease and its cancer-related consequences. 

Why It Needs Political Action 

Administration of vaccines may be a nursing obligation but the choice on whether or not to take medication is a political and economic issue. Being a democratic country that engenders the rule of law, freedom of conscience and choice is among the fundamental rights in Canada. Even when a nursing officer is sure that a patient stands the HPV vaccine, the officer has no choice in instances where the patient or the patient’s guardian declines the vaccine for a myriad of reasons and presuppositions. The nursing officer who treats a minor for a venereal infection, for example, will be aware of the great risk the minor faces for contracting HPV (Scott & Batty, 2016, p. 198). If, however, the minor’s parent declines HPV, the nurse will have to watch a young life face the risk of HPV that could have easily been mitigated. If eventually, the minor contracts the virus and has the misfortune of developing cancer, the government will spend a lot of money in treating a problem that would have been avoided. The economy will also miss out of a valuable source of labor. It is for this reason that this issue rises above the nursing profession as it requires a political intervention. 

The Stakeholders 

The principal stakeholder in this issue is the government as the sponsor of the Canadian healthcare system. Finances are a major concern in this issue as one vaccination may mean the difference between a negligible expenditure through vaccination and a massive expense through cancer treatment. The second stakeholder is the nurse who is faced with the difficult decision of convincing a patient or their loved ones to take the vaccine “Previous research has shown that spending time, discussion, and exchange of information are hallmarks of ‘shared decision making” (Smith, Stokley, Bednarczyk, Orenstein & Omer, 2016, p. 1609). Finally, there is the patient, more so the one of minority age who needs the vaccine but may not even be aware of it. 

What has been done to Date about the Issue? 

Modern solutions for the instant issue have been relegated to education and sensitization especially to the segments of the community that has been found to be most susceptible. According to Perkins, Rebecca, and Clark (2013), outreach and sensitization have a major impact on whether or not minors accept to be vaccinated (p. 1224). Most importantly, sensitization encourages those who have taken the initial dose of vaccination to come for the second and last doses without which immunity cannot be guaranteed (Smith, Stokley, Bednarczyk, Orenstein & Omer, 2016, p. 1605). This form of intervention has, however, ran into the barriers relating to the taboo nature of the subject of sex. Further, misconceptions have also played a major role in leading to many individuals declining the vaccine for themselves and their children. 

Plausible Solution 

Vaccination is necessary for the protection of the populace and the economy from the ills of HPV. Minors are the most vulnerable to the same because they lack the right to overrule their parents when it comes to vaccination (Okoronkwo, Sieswerda, Cooper, Binette, & Todd, 2012, p. 125). Choices must be limited by the impact they have on the individual, with the government having the responsibility of protecting its citizens even from themselves. It is for this reason that reckless behavior such as drug abuse and street car-races are outlawed although they are a matter of choice. The government must limit patient choice when it comes to HPV vaccination to give herd immunity a chance (Scott & Batty, 2016, p. 199).

References

Okoronkwo, C., Sieswerda, L. E., Cooper, R., Binette, D., & Todd, M. (2012). Parental consent to HPV vaccination for their daughters: The effects of knowledge and attitudes. The Canadian Journal of Human Sexuality , 21(3), 117-126. Retrieved from http://ezproxy.uwindsor.ca.ledproxy2.uwindsor.ca/login?url=https://search-proquest-com.ledproxy2.uwindsor.ca/docview/1288667166?accountid=14789 

Perkins, R. B., Zisblatt, L., Legler, A., Trucks, E., Hanchate, A., &Gorin, S. S. (2015). The effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls. Vaccine , 33(9), 1223-1229. doi:http://dx.doi.org.ledproxy2.uwindsor.ca/10.1016/j.vaccine.2014.11.021 

Perkins, Rebecca B, M.D., M.Sc., & Clark, J. A., Ph.D. (2013). Providers' perceptions of parental concerns about HPV vaccination. Journal of Health Care for the Poor and Underserved , 24(2), 828-39. Retrieved from http://ezproxy.uwindsor.ca.ledproxy2.uwindsor.ca/login?url=https://search-proquest-com.ledproxy2.uwindsor.ca/docview/1373218998?accountid=14789 

Scott, K., & Batty, M. L. (2016). HPV vaccine uptake among Canadian youth and the role of the nurse practitioner. Journal of Community Health , 41(1), 197-205. doi:http://dx.doi.org.ledproxy2.uwindsor.ca/10.1007/s10900-015-0069-2 

Smith, P. J., Stokley, S., Bednarczyk, R. A., Orenstein, W. A., & Omer, S. B. (2016). HPV vaccination coverage of teen girls: The influence of health care providers. Vaccine , 34(13), 1604-1610. doi:http://dx.doi.org.ledproxy2.uwindsor.ca/10.1016/j.vaccine.2016.01.061 

Thavarajah, N., B.Sc, Chow, E., M.B.B.S., &Arocha, J., Ph.D. (2015). Factors influencing parental decision making for the human papillomavirus (HPV) vaccine: A literature review. International Journal of Child and Adolescent Health , 8(3), 265-276. Retrieved from http://ezproxy.uwindsor.ca.ledproxy2.uwindsor.ca/login?url=https://search-proquest-com.ledproxy2.uwindsor.ca/docview/1706233100?accountid=14789