Vaccinations and Evidence-Based Practice, Literature Review

Vaccinationsand Evidence-Based Practice, Literature Review

Vaccinationsand Evidence-Based Practice, Literature Review

Diseasesthat can be prevented through vaccination among infants representleading causes of mortality and morbidity in the United States (U.S)despite the fact that the latter half of the 20thcentury featured successful children vaccination programs thatresulted in 95% reduction of vaccine-preventable illnesses injuveniles. However, there are still concerns about the total numberof illness cases (more than 400, 000) and death incidences (at least30, 000 children) attributed to the vaccine-preventable disease on anannual basis (Ventola,2016),hence the necessity to indulge evidence-based practice to avert thesituations. Such diseases that have caused significant disturbancesamong the children populations include measles, rubella, diphtheria,varicella, mumps, pertussis, poliomyelitis, tetanus, and invasiveHaemophilus influenza type b. Although the diseases above requireattention, the increasingly growing concerns regarding the safety ofvaccines have prompted some U.S parents to avoid taking theirchildren through immunization procedures, and that has caused aresurgence of the diseases mentioned above.

Arguably,it is not only a question of encouraging the parents to acknowledgethe significance of vaccination in controlling childhood mortalitiesand morbidity but rather reassuring them that vaccines are safe andthat is only achievable through rigorous evidence-based nursingpractice (Polit &amp Beck, 2016). Nevertheless, it is imperative toanswer questions such as: what impact do vaccines have on publichealth? What isthe most common vaccine-preventable disease among infant populationsof the U.S? What are the vaccination programs or interventions in theU.S? What risks are associated with immunization? Providingexplanation to such questions is the locus of evidence-based nursingpractice (Polit &amp Beck, 2016), and this section exploits sixsystem reviews to confront the situation and shed light on the statusof vaccination in the U.S.

Impactof Vaccines on Public Health

Evidently,communicable diseases’ incidence, prevalence, morbidity, andmortality have declined in the U.S as attributed to the existingnational vaccination strategies targeting newborns and children.Systematic review studies by Ventola (2016) indicated that about 20million illnesses and 40, 000 deaths are prevented for every U.Scohort receiving the prescribed childhood immunization nevertheless,the country saves to the tune of $70 billion. Vaccines effectivenessbases on the fact that immunized individuals enjoy resistance to theparticular disease and its asymptomatic carrier state while thoseunvaccinated persons benefit from herd immunity, i.e., reduced riskof exposure to the causative pathogens. For example, the incidence ofinvasive pneumococcal infection dropped from 99 children per 100,000(1998-1999) to 21 subjects per 100,000 (2008), and by the end of2011, the rates decreased by 90% for children below five years of agedue to vaccination programs (Ventola, 2016).

RisksAssociated with Vaccination

Someparents hesitate to subject their children to immunization due toconcerns related to vaccine side effects, the fear of autism, moraland or religious grounds, objection to the many injections, lack ofinformation, and lack of access due to cost. In the systematicreviews by Cairns et al (2012), the result of the survey of parentsof 13,000 children aged 8 to 12 months showed that the former fearedthat their infants might contract infectious diseases as much as theyalso believed vaccinations cause attention-deficit hyperactivitydisorder and autism. Besides, a study of parents of 13,000 juvenilesaged 8 to 35 months established that a majority parents could notbear the sight of their kids having more than two injections in asingle visit while some immunization programs prescribe as many aseight injections (Song, 2014). Song (2014) asserted that otherreasons for shunning immunization relate to morals of age, gender,inadequate funds, and lack of efficient communication systems.

Vaccine-PreventableDiseases in the U.S

Maglioneet al (2014) identified many vaccine-preventable diseases in the U.Sin their systematic reviews, and this included measles, rubella,diphtheria, varicella, mumps, pertussis, poliomyelitis, tetanus, andinvasive Haemophilus influenza type b. Rubella, Measles, and Mumpsare viral diseases of children characterized by complications andeven death since their immunization commenced 60 years ago, theirprevalence has fallen by 99% (Maglione et al., 2014). Pertussis is aprincipal cause of morbidity and fatality in infants younger than sixmonths, resulting in as high as 90% deaths in the U.S in the recentyears (Ventola, 2016) these, among other diseases, must be attendedto if the high death tolls are to be controlled.


Brisset al (2010) conducted systematic reviews and identified severalrecommendations related to finance, vaccine types and doses,immunization standards, and access to the programs by the parentswhose children are to be protected. Nonetheless, in order to haveadequate vaccination coverage in the United States, the data relatedto vaccine administration must be stored in immunization registersfor future reference, patients must be examined properly, and thephysicians involved must be competent. Also, immunization servicesshould be readily accessible, integrated into daily health careprovisions, and potential barriers identified and eliminated throughthe evidence-based nursing research and practice (Polit &amp Beck,2016). Furthermore, healthcare providers should limit vaccinationcosts, and introduce financing programs to make the servicesaffordable and finally, intensive research and training initiativesshould be put in place to help change the perceptions of the parentswho view vaccines as health hazards (Ventola, 2016).


Althoughsome parents partly perceive vaccination as unsafe, its importance inreducing the morbidity and mortality in the U.S is conspicuous andmore investment into the evidence-based research, the controversiesrelated to its application can be solved as have been proved in theliterature review.


Briss,P. A., Rodewald, L. E., Hinman, A. R., Shefer, A. M., Strikas, R. A.,Bernier, R. R., … &amp Task Force on Community PreventiveServices. (2010). Reviews of evidence regarding interventions toimprove vaccination coverage in children, adolescents, andadults.&nbspAmericanjournal of preventive medicine,&nbsp18(1),97-140.

Cairns,G., MacDonald, L., Angus, K., Walker, L., Cairns-Haylor, T., &ampBowdler, T. (2012).&nbspSystematicliterature review of the evidence for effective national immunisationschedule promotional communications.European Centre for Disease Prevention and Control (ECDC).

Maglione,M. A., Das, L., Raaen, L., Smith, A., Chari, R., Newberry, S., … &ampGidengil, C. (2014). Safety of vaccines used for routine immunizationof US children: a systematic review.&nbspPediatrics,&nbsp134(2),325-337.

Polit,D. F., &amp Beck, C. T. (2016).&nbspNursingresearch: Generating and assessing evidence for nursing practice.Philadelphia, PA: Wolters Kluwer.

Song,G. (2014). Understanding public perceptions of benefits and risks ofchildhood vaccinations in the United States.&nbspRiskAnalysis,&nbsp34(3),541-555.

Ventola,C. L. (2016). Immunization in the United States: Recommendations,Barriers, and Measures to Improve Compliance: Part 1: ChildhoodVaccinations.&nbspPharmacyand Therapeutics,&nbsp41(7),426.