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Global Immunizations: Health Promotion and Disease Prevention Worldwide

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Global Immunizations: Health Promotion and Disease Prevention Worldwide Brigham Young University BYU ScholarsArchive Faculty Publications 2017-5 Global Immunizations: Health Promotion and Disease Prevention Worldwide Janelle L. B. Macintosh Brigham Young University - Provo, [email protected] Lacey M. Eden Brigham Young University - Provo Karlen E. Luthy Brigham Young University - Provo Aimee E. Schouten Brigham Young University - Provo Follow this and additional works at: https://scholarsarchive.byu.edu/facpub Part of the Other Nursing Commons BYU ScholarsArchive Citation Macintosh, Janelle L. B.; Eden, Lacey M.; Luthy, Karlen E.; and Schouten, Aimee E., "Global Immunizations: Health Promotion and Disease Prevention Worldwide" (2017). Faculty Publications. 5199. https://scholarsarchive.byu.edu/facpub/5199 This Peer-Reviewed Article is brought to you for free and open access by BYU ScholarsArchive. It has been accepted for inclusion in Faculty Publications by an authorized administrator of BYU ScholarsArchive. For more information, please contact [email protected], [email protected]. Janelle L. B. Macintosh, PhD, RN, Lacey M. Eden, MS, NP-C, Karlen E. Luthy, DNP, FNP, FAAN, FAANP, and Aimee E. Schouten Abstract Background: Immunizations are one of the most important health interventions of the 20th century, yet people in many areas of the world do not receive adequate immunizations. Approximately 3 million people worldwide die every year from vaccine-preventable diseases; about half of these deaths are young children and infants. Global travel is more common; diseases that were once localized now can be found in communities around the world. Problem: Multiple barriers to immunizations have been identifi ed. Healthcare access, cost, and perceptions of safety and trust in healthcare are factors that have depressed global immunization rates. Interventions: Several global organizations have focused on addressing these barriers as part of their efforts to increase immunization 04/14/2021 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= by http://journals.lww.com/mcnjournal from Downloaded rates. The Bill and Melinda Gates Foundation, The World Health Organization, and the United Nations Children’s Emergency Fund each have a part of their organization that is concentrated on immunizations. Downloaded Clinical Implications: Maternal child nurses worldwide can assist in increasing immunization rates. Nurses can participate in outreach programs to ease the burden of patients and families in accessing immunizations. Nurses can work with local and global from organizations to make immunizations more affordable. Nurses can improve trust and knowledge about immunizations in their local http://journals.lww.com/mcnjournal communities. Nurses are a powerful infl uence in the struggle to increase immunization rates, which is a vital aspect of global health promotion and disease prevention. Key words: Barriers to immunizations; Global health; Health behavior; Immunization. by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= ImmunizationsGLOBAL Health Promotion and Disease Prevention Worldwide on 04/14/2021 BSIP SA / Alamy Stock Photo Stock Alamy / BSIP SA May/June 2017 MCN 139 Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. mmunizations are one of the most important health Misconceptions, misunderstandings, and misinformation interventions of the 20th century (Centers for Dis- have caused many to start refusing immunizations for ease Control and Prevention [CDC], 1999). In their children. Some believe that the diseases vaccines 2015, approximately 85% of children worldwide prevent are no longer a problem, at least in developed were vaccinated for tuberculosis, polio, diphthe- countries, or that vaccines do more harm than good ria, tetanus, pertussis, and measles (World Health ( Luthy, Beckstrand, & Callister, 2010; Salmon et al., IOrganization [WHO], & United Na- 2005; Wenger, McManus, Bower, & tions International Children’s Emer- Langkamp, 2011). Nurses can help gency Fund [UNICEF], 2016). Since overcome some barriers to immuni- 2010, nearly 235 million children zation such as access to healthcare, and young adults were vaccinated for cost, and perceptions of safety and meningitis A in the “meningitis belt,” trust. an area that covers 26 countries in sub-Saharan Africa (WHO Regional Photo Stock Alamy / BSIP SA Access to Healthcare Offi ce for Africa, 2016). Global im- Access to healthcare includes ability munizations are estimated to save 2.5 to make and keep appointments, million lives per year and are respon- ability to communicate with health- sible for the near eradication of polio care professionals, and availability of (CDC, 2016a; UNICEF, 2016a). Al- vaccines. Favin, Steinglass, Fields, though these statistics on global im- Banerjee, and Sawhney (2012) re- munization rates indicate signifi cant ported distance (travel conditions/ac- achievement, 3 million people still die cess), poor health staff motivation every year from vaccine-preventable and attitude (performance, knowl- diseases; approximately half of those edge, ability to communicate with deaths are young children and infants mothers), and lack of resources/logis- (WHO & UNICEF, 2016). tics (e.g., insuffi cient funding and Because worldwide travel is more stock that affect reliability, missed common, risk of spreading vaccine- opportunities to immunize and cold preventable diseases across the globe Immunizations chain [documentation of tempera- has increased. There are many rea- ture of vaccine from production to sons for world travel such as tour- save lives. delivery]) as common barriers to im- ism, visiting exchange students, munization and are found globally. adoption from foreign countries, Limited access to healthcare and life- work, and refugee assistance. Consequently, worldwide saving vaccines can be culturally grounded. For example, travel makes communicable diseases a more integrated China does not recognize migrants from North Korea as global problem. One recent example of the global legal citizens. Therefore, children of North Korean refugee migration of disease includes a measles outbreak that be- parents are deemed “stateless” in China and are not eligi- gan at Disneyland, California that spread measles to seven ble for medical care. Children born of North Korean other states in the United States, and the neighboring mothers and Chinese fathers are also not recognized as countries of Canada and Mexico in 2014. The origination legal citizens of China and are also not eligible for medical of the outbreak is unknown; however, “the measles virus care (Chung, Han, Kim, & Finkelstein, 2016). Because of type in this outbreak was identical to that recently found culturally based gender issues, a female in Israel may in the large measles outbreak in the Philippines” (CDC, encounter barriers to healthcare access (Schwartz et al., 2016b, para. 4). Worldwide immunization should be a 2013). focus of health promotion in all parts of the world. We Religious beliefs can also be a barrier to access to briefl y discuss selected barriers to immunizations, several healthcare, specifi cally immunizations. For example, organizations focused on overcoming these barriers, and trypsin is a component of oral polio vaccine and is ex- suggest ways nurses and medical professionals can imple- tracted from pork pancreas, which is prohibited in Islam. ment and be proactive agents of change. Therefore, in Islam dense regions, such as Pakistan, reli- gious beliefs are a formidable barrier to receiving the po- Barriers lio vaccine (Khan et al., 2015). Current global immunization efforts reveal several barri- ers to immunizations based on culture and geographic Cost location. Obvious diffi culties that occur in developing Barriers to immunization also include cost. Cost in both countries include isolated locations and limited access to loss of time from work or household endeavors as well as healthcare, inadequate storage of vaccines, and insuffi - payment issues continue to plague people across the world cient funding (Delamonica, 2016; Prinja, Gupta, Singh, and limit immunizations. Poorer children are often not & Kumar, 2010). However, barriers present in highly de- adequately protected by herd immunity, as they are often veloped communities are just as, if not more, alarming. underimmunized and geographically clustered (Hossein- 140 volume 42 | number 3 May/June 2017 Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. poor et al., 2016). In a study of immunizations in 51 low- with medical personnel. Favin et al. (2012) in a study income and middle-income countries, large disparities evaluating why children are not vaccinated in various based on socioeconomic status were reported in and be- parts of the world including Africa, Asia, Latin America, tween countries (Hosseinpoor et al.). Immunization rates and the Middle East reported “unpleasant experiences within countries can be as much as a 72 percentage points with healthcare services (e.g., refusal of care, post vacci- different, whereas differences between countries can be as nation abscesses, verbal abuse or public humiliation)” much as 40 percentage points. This disparity is refl ected (p. 231) as considerable barriers. worldwide. Two studies revealed monetary cost as a barrier to Trust and Perception of Safety receiving immunizations in Asia. In Japan, medical Parents have immense infl uence in the immunization of students chose to not be immunized
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