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Position statement
PH NEWS C
Position Statement Immunization The goal of the National Association of Pediatric Nurse Practitioners (NAPNAP) is to maximize the quality of health care for all children. To support this goal, NAPNAP encourages immunization practices that contribute to optimum child health. Immunization in early childhood, a hallmark for preventive health care, is recognized as a proven and cost-effective public health tool in controlling certain communicable diseases. Since the 1920s when vaccines became widely available, the incidence of targeted diseases has declined dramatically. Despite exceptional progress in abating some of the life-threatening diseases of childhood, outbreaks of vaccine-preventable diseases have emerged in the United States since 1980 (Centers for Disease Control and Prevention [CDC], 1999). Immunization levels in many parts of the country remain low, with only 67% of our nation’s children fully immunized by age 2 years and levels in some areas of the country as low as 10% (CDC, 1999). Parents’ misconceptions about immunizations may lead to inadequate immunization rates. Some common misconceptions are that most vaccine-preventable diseases have been eliminated in the United States, beliefs that immunizations do not work, beliefs that immunizations are dangerous or have contraindications, and fear that multiple, simultaneous immunizations are unsafe (National Immunization Program, 1996). In addition, barriers to immunization services may prevent the health care system from delivering vaccines to children as recommended. In order to ensure children’s safety, a high level of coverage against each of the vaccine-preventable diseases must be achieved and sustained. All children need to be immunized according to the most recently published parameters of the CDC Advisory Committee on Immunization Practices and the American Academy of Pediatrics unless true contraindications exist. All children need to have access to immunizations regardless of social and economic status or type of insurance. Successful immunization rates in children depend on public awareness
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of and perception of the benefits of immunization, wide availability of vaccines, insurance reimbursement for immunizations, minimal or no cost for vaccines, and universal access to pediatric health care. There is an important relationship between the rates of immunization and the utilization of other medical services. Lower immunization rates have been identified in children who have no primary care provider or who visited multiple providers, and whose providers failed to immunize because of minor illness or did not give simultaneous immunizations (CDC, 1993). All families have the right to complete and accurate information addressing the benefits and risks of immunizations and to have all their questions answered. The information must be offered in written form by providing the Vaccine Information Sheets supplied by the CDC for each vaccine administered. Additional information should include post-care instructions. In an effort to ensure that all children receive the protection of immunizations, NAPNAP affirms to: 1. Encourage pediatric health care providers to improve accessibility and remove barriers to immunizations for children by implementing practices conducive to increased immunization compliance. These practices include “no appointment” walk-in clinics, sending reminders to caregivers, and providing fliers to families detailing available immunizations (CDC, 1993). 2. Encourage members to increase the awareness of parents/guardians, child care providers, and other professionals regarding the immunizations of children through the active support of educational programs for the public in schools, child care facilities, libraries, and other appropriate venues. 3. Increase the awareness of PNPs through educational programs and materials that provide up-to-date information on vaccines and immunization guidelines and practices.
4. Support federal and state legislation that aims to increase immunization services and ensures that immunizations are available, accessible, and affordable. 5. Actively promote the development of a national immunization registry by participation in the Computerized Immunization Information Systems being developed at local and state levels and being supported by the CDC. 6. Encourage all pediatric health care providers to conduct immunization reviews for quality assurance purposes. 7. Encourage pediatric health care providers to utilize all child health care encounters (wellness and acute) to screen and, when indicated, immunize children. 8. Promote organizational efforts to provide increased public and professional awareness of the role of the PNP in improving health services for children, including immunizations. In summary, NAPNAP acknowledges the significant advantages to all children and humanity with the development and administration of immunizations. NAPNAP recognizes these benefits and encourages PNPs to promote, protect, and support standards for ensuring that immunization services are provided to all children.
REFERENCES Centers for Disease Control and Prevention. (1999). Summary of notifiable diseases, United States, 1998. Morbidity and Mortality Weekly Report, 47(53), 1-93. Centers for Disease Control and Prevention. (1993). Standards for pediatric immunization practices. Morbidity and Mortality Weekly Report, 42(RR-5). National Immunization Program. (1996). Six common misconceptions about vaccination and how to respond to them. Atlanta: Centers for Disease Control and Prevention.
Approved: October 1991 Revised and approved by the Executive Board: March 13, 2001 Designation: Priority
Reprint requests: NAPNAP National Office, 20 Brace Rd, Suite 200, Cherry Hill, NJ 08034-2633. J Pediatr Health Care. (2002). 16, 32A. Copyright © 2002 by the National Association of Pediatric Nurse Practitioners. 0891-5245/2002/$35.00 + 0 25/8/122226 doi:10.1067/mph.2002.122226
JOURNAL OF PEDIATRIC HEALTH CARE
Position Statement Immunization The goal of the National Association of Pediatric Nurse Practitioners (NAPNAP) is to maximize the quality of health care for all children. To support this goal, NAPNAP encourages immunization practices that contribute to optimum child health. Immunization in early childhood, a hallmark for preventive health care, is recognized as a proven and cost-effective public health tool in controlling certain communicable diseases. Since the 1920s when vaccines became widely available, the incidence of targeted diseases has declined dramatically. Despite exceptional progress in abating some of the life-threatening diseases of childhood, outbreaks of vaccine-preventable diseases have emerged in the United States since 1980 (Centers for Disease Control and Prevention [CDC], 1999). Immunization levels in many parts of the country remain low, with only 67% of our nation’s children fully immunized by age 2 years and levels in some areas of the country as low as 10% (CDC, 1999). Parents’ misconceptions about immunizations may lead to inadequate immunization rates. Some common misconceptions are that most vaccine-preventable diseases have been eliminated in the United States, beliefs that immunizations do not work, beliefs that immunizations are dangerous or have contraindications, and fear that multiple, simultaneous immunizations are unsafe (National Immunization Program, 1996). In addition, barriers to immunization services may prevent the health care system from delivering vaccines to children as recommended. In order to ensure children’s safety, a high level of coverage against each of the vaccine-preventable diseases must be achieved and sustained. All children need to be immunized according to the most recently published parameters of the CDC Advisory Committee on Immunization Practices and the American Academy of Pediatrics unless true contraindications exist. All children need to have access to immunizations regardless of social and economic status or type of insurance. Successful immunization rates in children depend on public awareness
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of and perception of the benefits of immunization, wide availability of vaccines, insurance reimbursement for immunizations, minimal or no cost for vaccines, and universal access to pediatric health care. There is an important relationship between the rates of immunization and the utilization of other medical services. Lower immunization rates have been identified in children who have no primary care provider or who visited multiple providers, and whose providers failed to immunize because of minor illness or did not give simultaneous immunizations (CDC, 1993). All families have the right to complete and accurate information addressing the benefits and risks of immunizations and to have all their questions answered. The information must be offered in written form by providing the Vaccine Information Sheets supplied by the CDC for each vaccine administered. Additional information should include post-care instructions. In an effort to ensure that all children receive the protection of immunizations, NAPNAP affirms to: 1. Encourage pediatric health care providers to improve accessibility and remove barriers to immunizations for children by implementing practices conducive to increased immunization compliance. These practices include “no appointment” walk-in clinics, sending reminders to caregivers, and providing fliers to families detailing available immunizations (CDC, 1993). 2. Encourage members to increase the awareness of parents/guardians, child care providers, and other professionals regarding the immunizations of children through the active support of educational programs for the public in schools, child care facilities, libraries, and other appropriate venues. 3. Increase the awareness of PNPs through educational programs and materials that provide up-to-date information on vaccines and immunization guidelines and practices.
4. Support federal and state legislation that aims to increase immunization services and ensures that immunizations are available, accessible, and affordable. 5. Actively promote the development of a national immunization registry by participation in the Computerized Immunization Information Systems being developed at local and state levels and being supported by the CDC. 6. Encourage all pediatric health care providers to conduct immunization reviews for quality assurance purposes. 7. Encourage pediatric health care providers to utilize all child health care encounters (wellness and acute) to screen and, when indicated, immunize children. 8. Promote organizational efforts to provide increased public and professional awareness of the role of the PNP in improving health services for children, including immunizations. In summary, NAPNAP acknowledges the significant advantages to all children and humanity with the development and administration of immunizations. NAPNAP recognizes these benefits and encourages PNPs to promote, protect, and support standards for ensuring that immunization services are provided to all children.
REFERENCES Centers for Disease Control and Prevention. (1999). Summary of notifiable diseases, United States, 1998. Morbidity and Mortality Weekly Report, 47(53), 1-93. Centers for Disease Control and Prevention. (1993). Standards for pediatric immunization practices. Morbidity and Mortality Weekly Report, 42(RR-5). National Immunization Program. (1996). Six common misconceptions about vaccination and how to respond to them. Atlanta: Centers for Disease Control and Prevention.
Approved: October 1991 Revised and approved by the Executive Board: March 13, 2001 Designation: Priority
Reprint requests: NAPNAP National Office, 20 Brace Rd, Suite 200, Cherry Hill, NJ 08034-2633. J Pediatr Health Care. (2002). 16, 32A. Copyright © 2002 by the National Association of Pediatric Nurse Practitioners. 0891-5245/2002/$35.00 + 0 25/8/122226 doi:10.1067/mph.2002.122226
JOURNAL OF PEDIATRIC HEALTH CARE