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Impact Lives

Mandated Vaccinations: Individual Choice vs. Public Health

Over 200 years ago Edward Jenner invented the first ever vaccine to combat small pox. This development eventually gave way to several other vaccinations which eventually made a significant impact on the occurrence of disease and consequently the federal government’s role in this current health practice of mandated vaccinations.

Public health laws aim to protect the health and well-being of the community but at the same time appear to disregard the rights of the individual. As schools opened their doors for yet another fun-filled academic school year, school nurses across the nation are caught in the middle of the ongoing debate over vaccinations. There are many factors to consider, the best interest of the child, the parent’s right to refuse, the local government public health laws and those policies of the school in which the school nurse serves. So, why do health care professionals, the government and academic institutions encourage and sometimes insist all citizens get vaccinated? Are these vaccinations safe and effective? Do the side effects outweigh the risks? There are so many questions and yet so little time to address them all. But I go back to the original statement that there are many factors to consider so what I want to address here in my short time is the final decision maker. But in determining the course of action on the health of children (and in some cases our own health such as with travel or occupational vaccinations), should this really be a question of ‘who” should make the decision or rather a question of “how” do we make the decision? How can we as nurses help those who need to make the final decision make a better, more informed decision? Now, as a school nurse and educator, this is a question that I am more than thrilled to answer.

As a nurse, it should not be your responsibility to provide your clients with the final decision over whether to vaccinate but to provide your clients with as many resources and support as you can to help them determine the best option for them and their family. Nursing’s role in decision making can all be traced back to our own ethical principle of advocacy. But you will find it is difficult to advocate unless you first understand the implications of societal, legislative, and occupational conflicts that exist and how it impacts your role as the educator. These are just some of the issues to consider:

  1. School Vaccination Laws.
    • Schools were enlisted to assist in disease control because of the increased risk of transmission.
    • Then there are those state regulations that require schools, more specifically school nurses (if the school has one, but don’t get me back on that soap box) to get their students to comply with the recommended vaccination schedules.
  2. Professional Organization Position.
    • School nurses are in a position to raise awareness and influence the rate of mandated and recommended vaccinations. As a community health nurse, you have a responsibility to protect not only the individual but the school community against disease. In regard to influence, this also entails educating families and staff about contraindications and side effects of vaccinations.
  3. Vaccine Safety.
    • We should all know that vaccinations are not always safe and effective; parents should be informed that their child could be injured from the vaccination or still become infected from the disease that they were vaccinated against.
    • Vaccinations also protect those who are immune-compromised and cannot be vaccinated. The herd effect is generated because the high vaccination rates reduce the risk of disease for those individuals who are not vaccinated.
  4. Exemption Laws.
    • Almost all states have provided individuals with the option to be exempt from vaccinations based on philosophical, religious or medical reasons.

Am I suggesting that we push our clients to opt to protect the masses and forgo the health of one individual? Not in the least, but I am suggesting that as a Nurse Educator you understand the basic principles of epidemiology, ethical principles, and risks to the community and or vulnerable populations. With that understanding you are better prepared to communicate effectively and educate your clients to make an informed decision about their health and how it can significantly impact not only them but those around them.

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About the Author

Dr. Jasmin Whitfield RN, MSN, MPH, DNP is an adjunct faculty member in the online MSN program at Benedictine University. Her extensive background includes progressive administrative roles in acute rehabilitation services and community health nursing. In addition, Dr. Whitfield is currently accountable for the oversight and organization of the Health Services Department at Sidwell Friends School’s D.C. campus including but not limited to health and wellness promotion and outreach and developing and managing occupational health and safety education, policies, and programming for students and employees. To learn more about Dr. Jasmin Whitfield please visit our online nursing degree faculty section.