This briefing provides an assessment of various policy options that could be used to improve childhood immunization rates in British Columbia based on a review of immunization coverage strategies utilized in other jurisdictions. The implications of implementing a mandatory immunization law for all school-aged children is analyzed and discussed, among other policy options aimed at increasing childhood immunization rates as part of a strategy to combat preventable diseases. The Province’s existing policy in this area, summarized in the Strategic Framework for Immunization in B.C., has failed to ensure immunization coverage targets for major vaccine-preventable diseases are met.
A comparative study of the influence of infused hiv and aidsAlexander Decker
This document discusses a comparative study on the influence of infused HIV/AIDS education on student awareness in rural and urban secondary schools in Kenya. The study found that students in urban schools had significantly greater knowledge of HIV/AIDS facts, more positive attitudes towards infected individuals, and exhibited higher levels of behavior change compared to rural students. It recommends revising the curriculum to provide a more multi-faceted HIV/AIDS education approach, including extracurricular activities and parent seminars.
1) Rapid population growth, especially among the poorest, poses difficulties for development and poverty reduction in the Philippines. Official data shows higher poverty incidence and lower human capital investment in larger families.
2) The poor prefer smaller families but are unable to achieve their preferences due to lack of access to family planning. Over half of pregnancies among the poor are unintended and unwanted births represent unmet need.
3) Ensuring access to modern family planning methods and information can help address both private and social costs of unintended pregnancies while respecting individual choice. Reproductive health and family planning programs offer benefits to individuals, the economy, and the environment.
This document summarizes a student paper about promoting childhood immunizations in Texas. It provides background data on recent outbreaks of vaccine-preventable diseases from sources like the CDC. Vaccination rates in Texas are outlined, with 81.5% of children receiving the full DTaP series and 92.7% receiving the MMR vaccine. The document proposes partnering with organizations like the Texas Nurses Association to educate caregivers and potentially advocate for stricter vaccination laws. The overall goal is to increase immunization rates and protect community health.
This document summarizes a student paper about promoting childhood immunizations in Texas. It provides background data on recent outbreaks of vaccine-preventable diseases from sources like the CDC. Vaccination rates in Texas are outlined, with 81.5% of children receiving the full DTaP series and 92.7% receiving the MMR vaccine. The document proposes partnering with organizations like the Texas Nurses Association to educate caregivers and advocate for stricter vaccination laws to increase immunization rates and prevent future outbreaks.
Monitoring the implications of the global financial crisis on primary schools...UN Global Pulse
Executive summary of the United Nations Educational, Scientific and Cultural Organization (UNESCO) research: “Monitoring the Implications of the Global Financial Crisis on Primary Schools, Teachers and Parents in 12 Countries,” conducted as part of UN Global Pulse’s Rapid Impact and Vulnerability Assessment Fund (RIVAF). For more information: http://www.unglobalpulse.org/projects/rapid-impact-and-vulnerability-analysis-fund-rivaf
Lucia Ferrone outlines how to measure the multi-faceted concept of child poverty. She then describes how this child poverty data can be used to influence policy. This slideshow was first presented as part of UNICEF's (Europe and Central Asia) conference on Regional Social Policy and Child Protection.
Rapid population growth is a significant obstacle to development in many poor countries. It leads to problems like environmental degradation as population and consumption levels rise, as well as economic stagnation as infrastructure and social services struggle to keep up with high birth rates. High fertility also contributes to issues like maternal mortality, youth unemployment, and political instability. While population growth alone does not cause poverty, it exacerbates development challenges. Reducing population growth through access to education and family planning is crucial for improving living standards in developing nations.
National Poll: Perceptions of Public Health Departments & Servicesde Beaumont Foundation
What do Americans think of their local health department and officials? What health services do they most value? See the results of a national poll conducted by Morning Consult on behalf of the de Beaumont Foundation.
A comparative study of the influence of infused hiv and aidsAlexander Decker
This document discusses a comparative study on the influence of infused HIV/AIDS education on student awareness in rural and urban secondary schools in Kenya. The study found that students in urban schools had significantly greater knowledge of HIV/AIDS facts, more positive attitudes towards infected individuals, and exhibited higher levels of behavior change compared to rural students. It recommends revising the curriculum to provide a more multi-faceted HIV/AIDS education approach, including extracurricular activities and parent seminars.
1) Rapid population growth, especially among the poorest, poses difficulties for development and poverty reduction in the Philippines. Official data shows higher poverty incidence and lower human capital investment in larger families.
2) The poor prefer smaller families but are unable to achieve their preferences due to lack of access to family planning. Over half of pregnancies among the poor are unintended and unwanted births represent unmet need.
3) Ensuring access to modern family planning methods and information can help address both private and social costs of unintended pregnancies while respecting individual choice. Reproductive health and family planning programs offer benefits to individuals, the economy, and the environment.
This document summarizes a student paper about promoting childhood immunizations in Texas. It provides background data on recent outbreaks of vaccine-preventable diseases from sources like the CDC. Vaccination rates in Texas are outlined, with 81.5% of children receiving the full DTaP series and 92.7% receiving the MMR vaccine. The document proposes partnering with organizations like the Texas Nurses Association to educate caregivers and potentially advocate for stricter vaccination laws. The overall goal is to increase immunization rates and protect community health.
This document summarizes a student paper about promoting childhood immunizations in Texas. It provides background data on recent outbreaks of vaccine-preventable diseases from sources like the CDC. Vaccination rates in Texas are outlined, with 81.5% of children receiving the full DTaP series and 92.7% receiving the MMR vaccine. The document proposes partnering with organizations like the Texas Nurses Association to educate caregivers and advocate for stricter vaccination laws to increase immunization rates and prevent future outbreaks.
Monitoring the implications of the global financial crisis on primary schools...UN Global Pulse
Executive summary of the United Nations Educational, Scientific and Cultural Organization (UNESCO) research: “Monitoring the Implications of the Global Financial Crisis on Primary Schools, Teachers and Parents in 12 Countries,” conducted as part of UN Global Pulse’s Rapid Impact and Vulnerability Assessment Fund (RIVAF). For more information: http://www.unglobalpulse.org/projects/rapid-impact-and-vulnerability-analysis-fund-rivaf
Lucia Ferrone outlines how to measure the multi-faceted concept of child poverty. She then describes how this child poverty data can be used to influence policy. This slideshow was first presented as part of UNICEF's (Europe and Central Asia) conference on Regional Social Policy and Child Protection.
Rapid population growth is a significant obstacle to development in many poor countries. It leads to problems like environmental degradation as population and consumption levels rise, as well as economic stagnation as infrastructure and social services struggle to keep up with high birth rates. High fertility also contributes to issues like maternal mortality, youth unemployment, and political instability. While population growth alone does not cause poverty, it exacerbates development challenges. Reducing population growth through access to education and family planning is crucial for improving living standards in developing nations.
National Poll: Perceptions of Public Health Departments & Servicesde Beaumont Foundation
What do Americans think of their local health department and officials? What health services do they most value? See the results of a national poll conducted by Morning Consult on behalf of the de Beaumont Foundation.
Haiti has the highest rates of child, neonatal, and maternal mortality in the Western Hemisphere. In 2013, Haiti's neonatal mortality rate was 25 per 1000 live births, infant mortality rate was 55 per 1000 live births, and child mortality rate for those under 5 was 73 per 1000. The maternal mortality ratio in Haiti was 380 per 100,000 live births in 2013. The authors identify poverty, preterm birth, low birth weight, lack of access to care for pneumonia and antibiotics, and complications during childbirth as key contributing factors to these high mortality rates in Haiti. They propose establishing a network of community care and a central referral hospital to improve access to evidence-based interventions and reduce mortality rates.
AIDSTAR-One Issue Paper: The Debilitating Cycle of HIV, Food Insecurity, and ...AIDSTAROne
This document aims to facilitate an understanding of the bi-directional relationship between HIV and food and nutrition security. It illuminates the causes of HIV-related food and nutrition insecurity, and points to a list of programmatic interventions and resources to consider for addressing each cause in detail. http://j.mp/U1L0iV
This research grant proposal seeks funding to evaluate the effects of a randomized microcredit lending and health education program on malaria preventative behavior in Mali. The program, run by Medicine for Mali, will offer microfinance loans and health education to villages in Mali. Some villages will receive both interventions, some only microfinance, and some only health education. The researchers hypothesize that offering both microfinance and health education will lead to higher uptake of insecticide-treated bednets compared to the other conditions. The goal is to study how microfinance and health education individually and jointly impact malaria preventative knowledge and behaviors.
UNICEF Tajikistan's work in 2010 was dominated by responding to a major polio outbreak, with 458 confirmed cases. UNICEF mobilized funds for vaccines and social mobilization and partnered with WHO to support immunization rounds. While routine immunization needs strengthening, the effective polio response demonstrated UNICEF's emergency response capacity. UNICEF also supported developing a new National Education Strategy and directly partnered with 8 districts to enhance basic social services delivery closer to communities. However, health strategy development and a girls' education strategy were delayed due to the polio outbreak response and education strategy development.
Achieving polio eradication a review of helth communication evidence and le...Dr Lendy Spires
This document reviews communication efforts around polio eradication in India and Pakistan between 2000-2007. It finds that evidence-based communication strategies, including sustained media campaigns, intensive community mobilization, interpersonal communication, and political advocacy combined contributed to reducing polio incidence. These strategies were effective by mobilizing social networks, creating political will, increasing knowledge, ensuring demand for vaccination, overcoming resistance, and reaching marginalized populations. Lessons from India and Pakistan's experiences can help improve public health communication interventions.
Alessandra Guedes took part in a webinar convened by Promundo to discuss "Preventing Intergenerational Cycles of Violence" in the context of the 64th Session of the United Nations Commission on the Status of Women. Alessandra presented work on the points of intersection of violence against women and violence against children.
The impact of the global financial crisis on reproductive and maternal health...UN Global Pulse
Executive summary of the United Nations Population Fund (UNFPA) research: “The Impact of the Global Financial Crisis on Reproductive and Maternal Health in Jordan,” conducted as part of UN Global Pulse’s Rapid Impact and Vulnerability Assessment Fund (RIVAF). For more information: http://www.unglobalpulse.org/projects/rapid-impact-and-vulnerability-analysis-fund-rivaf
Sponsored by the Public Health Communications Collaborative, this webinar features Dr. Nadine Gracia of Trust for America's Health and Dr. Joe Smyser of the Public Good Projects.
SCIP_Factors Associated with Mosquito Bed Net Use_Malaria JMelanie Lopez
- The document summarizes two cross-sectional household surveys conducted in Zambézia Province, Mozambique in 2010 and 2014 to assess mosquito bed net possession and factors associated with their use.
- The surveys found that 64.3% of households possessed at least one mosquito bed net in 2010 and 2014, with higher possession in Namacurra district (90% in 2014) compared to Alto Molócuè (77%) and Morrumbala (34%).
- Use of mosquito nets increased from 2010 to 2014 among pregnant women (58.6% to 68.4%) and children under 5 (50% to 60%), but intensified focus is still needed to improve equity
Contagious diseases have been a global issue throughout history. Various organizations monitor disease outbreaks and work to prevent epidemics. While the media can help spread awareness, their coverage of disease is sometimes exaggerated. Proper surveillance of known and unknown diseases is important for public health efforts. Vaccines have largely helped control diseases, but some choose not to vaccinate due to personal beliefs. Coordinated efforts between health and government agencies are needed to improve disease surveillance and response.
In this webinar, Dr. Brian C. Castrucci President and Chief Executive Officer of the de Beaumont Foundation, presented new polling about vaccine confidence and Dr. Ayne Amjad, Commissioner and State Health Officer for West Virginia, and Dr. Costello, Assistant Professor of Pediatrics at West Virginia University School of Medicine, presented insights from their research and successful vaccine outreach campaign to rural communities in West Virginia. Dr. Lauren Smith, Chief Health Equity and Strategy Officer for CDC Foundation, moderated the conversation and an audience Q&A with Drs. Amjad and Costello.
I hope you find this issue to be informative and helpful in your work. Please send me any information you’d like posted in upcoming issues.
The embedded links may not work in SlideShare, so please feel free to email me for a copy at DrChrisStout@gmail.com to be added to our email list.
You can join our Facebook Group and interact with over 1200 likeminded individuals at:
https://www.facebook.com/groups/CenterForGlobalInitiatives/
Any recommendations to improve this communique would be most appreciated!
And if you’d like to support the Center’s work with a tax deductible donation, that would be fantastic(!) and do a great deal: http://centerforglobalinitiatives.org/donateNow.cfm
Cheers, and thank you for your work,
Chris
The document discusses the social, economic, and environmental impacts of health risks and diseases. It examines the short-term and long-term impacts on individuals, families, communities, and countries. The short-term impacts include disruption of education, reduction in household wages, and lost productivity. The long-term impacts include reduced workforce skills and qualifications, rising costs of long-term care for disabilities and older populations, and decreased national savings and investment. Health risks disproportionately affect those with lower incomes and can contribute to divides both within and between countries.
As the UNICEF Office of Research-Innocenti, we conduct research to inform policymaking and implementation. This project brief summarizes our research activities on Child Poverty.
KAFKAS ÜNİVERSİTESİ/KAFKAS UNIVERSITY
SOCIOLOGY
Course
LECTURE NOTES AND POWER POINT PRESENTATIONS
Prof.Dr. Halit Hami ÖZ
Kars, TURKEY
hamioz@yahoo.com
Morning Consult Poll: COVID-19, Vaccine Mandates, and FDA Approvalde Beaumont Foundation
National poll of 2,500 adults, including 956 unvaccinated adults, conducted by Morning Consult Aug. 19-22 on behalf of the de Beaumont Foundation. See insights on beliefs, values, and perspectives, including what may persuade people to get vaccinated.
SFEE's Position Paper vaccines in EnglishPiecerosB
Vaccination programs are a crucial pillar of public health policy. They provide significant benefits not just for those vaccinated but for entire populations by building herd immunity. Vaccines save millions of lives worldwide each year and are highly cost effective investments that save costs in healthcare systems. Maintaining up-to-date vaccination programs that cover all age groups according to recommendations and establishing clear processes, goals, budgets and public awareness campaigns are important for optimizing vaccination programs and public health outcomes.
SOCIO-CULTURAL AND BEHAVIORAL FACTORS INFLUENCING CHILDHOOD IMMUNIZATION PR...GABRIEL JEREMIAH ORUIKOR
Abstract: Background: Immunization is one of the most cost-effective interventions with proven strategies to reach
the vulnerable populations. It is also a proven tool for controlling and eliminating life threatening infectious diseases.
It also prevents illness, disability and deaths from vaccine preventable diseases averting estimated 2-3 million deaths
each year.
Method: A descriptive survey research design was adopted, one hundred 100 nursing mothers were used for the
study. The instruments used for the study was a self-structured questionnaire. Simple random sampling technique
was used to select the sample for the study. Data collected were analysed using frequency, counts and percentage
table for demographic information.
Result: The findings of the study revealed that behaviour/attitude of healthcare workers and lack of enough
information were determinants of incomplete routine immunization, while life style, religion and belief were not
determinants of incomplete routine immunization. However, level of education, distance to health facility, life style,
religion and belief were jointly determinants of incomplete routine immunization among nursing mothers in Jericho
specialist hospital.
Conclusion: Based on the findings of the study; it is therefore recommended that State Government and
Philanthropists should assist in building more health care facilities close to the communities for easy accessibility.
Effort should be geared towards public campaign using local dialect to encourage them to complete routine
immunization. In addition, community mobilization should be strengthening especially among nursing mothers to
be fully informed about the merits of completing the routine immunization and to avert childhood morbidity and
mortality in our society.
6Health and SafetyJupiterimagesStockbyteThinkstockLe.docxalinainglis
This document discusses health and safety issues affecting children worldwide and throughout development. It covers major global health concerns like early childhood mortality and efforts to prevent it through immunizations and access to clean water. Specific safety risks for older children and adolescents discussed include homicide, suicide, and unintentional injuries which remain leading causes of death. The importance of preventative measures to reduce accidents is emphasized.
Final childhood vaccination report pdf ajZahidManiyar
This document summarizes research on the impact of COVID-19 restrictions on childhood vaccination rates globally. It finds:
- Studies showed significant disruptions to vaccination services in countries in Africa, Asia, America, and Europe due to the pandemic. Vaccination rates declined the most in places where rates were already low.
- Many countries saw substantial drops in doses administered for vaccines like diphtheria-tetanus-pertussis, BCG, measles, and polio. Declines were generally larger for older children than younger children.
- Initiatives to increase vaccination post-restrictions included drive-through clinics, mobile centers, and emphasizing the importance of vaccination during pandemics. However
Haiti has the highest rates of child, neonatal, and maternal mortality in the Western Hemisphere. In 2013, Haiti's neonatal mortality rate was 25 per 1000 live births, infant mortality rate was 55 per 1000 live births, and child mortality rate for those under 5 was 73 per 1000. The maternal mortality ratio in Haiti was 380 per 100,000 live births in 2013. The authors identify poverty, preterm birth, low birth weight, lack of access to care for pneumonia and antibiotics, and complications during childbirth as key contributing factors to these high mortality rates in Haiti. They propose establishing a network of community care and a central referral hospital to improve access to evidence-based interventions and reduce mortality rates.
AIDSTAR-One Issue Paper: The Debilitating Cycle of HIV, Food Insecurity, and ...AIDSTAROne
This document aims to facilitate an understanding of the bi-directional relationship between HIV and food and nutrition security. It illuminates the causes of HIV-related food and nutrition insecurity, and points to a list of programmatic interventions and resources to consider for addressing each cause in detail. http://j.mp/U1L0iV
This research grant proposal seeks funding to evaluate the effects of a randomized microcredit lending and health education program on malaria preventative behavior in Mali. The program, run by Medicine for Mali, will offer microfinance loans and health education to villages in Mali. Some villages will receive both interventions, some only microfinance, and some only health education. The researchers hypothesize that offering both microfinance and health education will lead to higher uptake of insecticide-treated bednets compared to the other conditions. The goal is to study how microfinance and health education individually and jointly impact malaria preventative knowledge and behaviors.
UNICEF Tajikistan's work in 2010 was dominated by responding to a major polio outbreak, with 458 confirmed cases. UNICEF mobilized funds for vaccines and social mobilization and partnered with WHO to support immunization rounds. While routine immunization needs strengthening, the effective polio response demonstrated UNICEF's emergency response capacity. UNICEF also supported developing a new National Education Strategy and directly partnered with 8 districts to enhance basic social services delivery closer to communities. However, health strategy development and a girls' education strategy were delayed due to the polio outbreak response and education strategy development.
Achieving polio eradication a review of helth communication evidence and le...Dr Lendy Spires
This document reviews communication efforts around polio eradication in India and Pakistan between 2000-2007. It finds that evidence-based communication strategies, including sustained media campaigns, intensive community mobilization, interpersonal communication, and political advocacy combined contributed to reducing polio incidence. These strategies were effective by mobilizing social networks, creating political will, increasing knowledge, ensuring demand for vaccination, overcoming resistance, and reaching marginalized populations. Lessons from India and Pakistan's experiences can help improve public health communication interventions.
Alessandra Guedes took part in a webinar convened by Promundo to discuss "Preventing Intergenerational Cycles of Violence" in the context of the 64th Session of the United Nations Commission on the Status of Women. Alessandra presented work on the points of intersection of violence against women and violence against children.
The impact of the global financial crisis on reproductive and maternal health...UN Global Pulse
Executive summary of the United Nations Population Fund (UNFPA) research: “The Impact of the Global Financial Crisis on Reproductive and Maternal Health in Jordan,” conducted as part of UN Global Pulse’s Rapid Impact and Vulnerability Assessment Fund (RIVAF). For more information: http://www.unglobalpulse.org/projects/rapid-impact-and-vulnerability-analysis-fund-rivaf
Sponsored by the Public Health Communications Collaborative, this webinar features Dr. Nadine Gracia of Trust for America's Health and Dr. Joe Smyser of the Public Good Projects.
SCIP_Factors Associated with Mosquito Bed Net Use_Malaria JMelanie Lopez
- The document summarizes two cross-sectional household surveys conducted in Zambézia Province, Mozambique in 2010 and 2014 to assess mosquito bed net possession and factors associated with their use.
- The surveys found that 64.3% of households possessed at least one mosquito bed net in 2010 and 2014, with higher possession in Namacurra district (90% in 2014) compared to Alto Molócuè (77%) and Morrumbala (34%).
- Use of mosquito nets increased from 2010 to 2014 among pregnant women (58.6% to 68.4%) and children under 5 (50% to 60%), but intensified focus is still needed to improve equity
Contagious diseases have been a global issue throughout history. Various organizations monitor disease outbreaks and work to prevent epidemics. While the media can help spread awareness, their coverage of disease is sometimes exaggerated. Proper surveillance of known and unknown diseases is important for public health efforts. Vaccines have largely helped control diseases, but some choose not to vaccinate due to personal beliefs. Coordinated efforts between health and government agencies are needed to improve disease surveillance and response.
In this webinar, Dr. Brian C. Castrucci President and Chief Executive Officer of the de Beaumont Foundation, presented new polling about vaccine confidence and Dr. Ayne Amjad, Commissioner and State Health Officer for West Virginia, and Dr. Costello, Assistant Professor of Pediatrics at West Virginia University School of Medicine, presented insights from their research and successful vaccine outreach campaign to rural communities in West Virginia. Dr. Lauren Smith, Chief Health Equity and Strategy Officer for CDC Foundation, moderated the conversation and an audience Q&A with Drs. Amjad and Costello.
I hope you find this issue to be informative and helpful in your work. Please send me any information you’d like posted in upcoming issues.
The embedded links may not work in SlideShare, so please feel free to email me for a copy at DrChrisStout@gmail.com to be added to our email list.
You can join our Facebook Group and interact with over 1200 likeminded individuals at:
https://www.facebook.com/groups/CenterForGlobalInitiatives/
Any recommendations to improve this communique would be most appreciated!
And if you’d like to support the Center’s work with a tax deductible donation, that would be fantastic(!) and do a great deal: http://centerforglobalinitiatives.org/donateNow.cfm
Cheers, and thank you for your work,
Chris
The document discusses the social, economic, and environmental impacts of health risks and diseases. It examines the short-term and long-term impacts on individuals, families, communities, and countries. The short-term impacts include disruption of education, reduction in household wages, and lost productivity. The long-term impacts include reduced workforce skills and qualifications, rising costs of long-term care for disabilities and older populations, and decreased national savings and investment. Health risks disproportionately affect those with lower incomes and can contribute to divides both within and between countries.
As the UNICEF Office of Research-Innocenti, we conduct research to inform policymaking and implementation. This project brief summarizes our research activities on Child Poverty.
KAFKAS ÜNİVERSİTESİ/KAFKAS UNIVERSITY
SOCIOLOGY
Course
LECTURE NOTES AND POWER POINT PRESENTATIONS
Prof.Dr. Halit Hami ÖZ
Kars, TURKEY
hamioz@yahoo.com
Morning Consult Poll: COVID-19, Vaccine Mandates, and FDA Approvalde Beaumont Foundation
National poll of 2,500 adults, including 956 unvaccinated adults, conducted by Morning Consult Aug. 19-22 on behalf of the de Beaumont Foundation. See insights on beliefs, values, and perspectives, including what may persuade people to get vaccinated.
SFEE's Position Paper vaccines in EnglishPiecerosB
Vaccination programs are a crucial pillar of public health policy. They provide significant benefits not just for those vaccinated but for entire populations by building herd immunity. Vaccines save millions of lives worldwide each year and are highly cost effective investments that save costs in healthcare systems. Maintaining up-to-date vaccination programs that cover all age groups according to recommendations and establishing clear processes, goals, budgets and public awareness campaigns are important for optimizing vaccination programs and public health outcomes.
SOCIO-CULTURAL AND BEHAVIORAL FACTORS INFLUENCING CHILDHOOD IMMUNIZATION PR...GABRIEL JEREMIAH ORUIKOR
Abstract: Background: Immunization is one of the most cost-effective interventions with proven strategies to reach
the vulnerable populations. It is also a proven tool for controlling and eliminating life threatening infectious diseases.
It also prevents illness, disability and deaths from vaccine preventable diseases averting estimated 2-3 million deaths
each year.
Method: A descriptive survey research design was adopted, one hundred 100 nursing mothers were used for the
study. The instruments used for the study was a self-structured questionnaire. Simple random sampling technique
was used to select the sample for the study. Data collected were analysed using frequency, counts and percentage
table for demographic information.
Result: The findings of the study revealed that behaviour/attitude of healthcare workers and lack of enough
information were determinants of incomplete routine immunization, while life style, religion and belief were not
determinants of incomplete routine immunization. However, level of education, distance to health facility, life style,
religion and belief were jointly determinants of incomplete routine immunization among nursing mothers in Jericho
specialist hospital.
Conclusion: Based on the findings of the study; it is therefore recommended that State Government and
Philanthropists should assist in building more health care facilities close to the communities for easy accessibility.
Effort should be geared towards public campaign using local dialect to encourage them to complete routine
immunization. In addition, community mobilization should be strengthening especially among nursing mothers to
be fully informed about the merits of completing the routine immunization and to avert childhood morbidity and
mortality in our society.
6Health and SafetyJupiterimagesStockbyteThinkstockLe.docxalinainglis
This document discusses health and safety issues affecting children worldwide and throughout development. It covers major global health concerns like early childhood mortality and efforts to prevent it through immunizations and access to clean water. Specific safety risks for older children and adolescents discussed include homicide, suicide, and unintentional injuries which remain leading causes of death. The importance of preventative measures to reduce accidents is emphasized.
Final childhood vaccination report pdf ajZahidManiyar
This document summarizes research on the impact of COVID-19 restrictions on childhood vaccination rates globally. It finds:
- Studies showed significant disruptions to vaccination services in countries in Africa, Asia, America, and Europe due to the pandemic. Vaccination rates declined the most in places where rates were already low.
- Many countries saw substantial drops in doses administered for vaccines like diphtheria-tetanus-pertussis, BCG, measles, and polio. Declines were generally larger for older children than younger children.
- Initiatives to increase vaccination post-restrictions included drive-through clinics, mobile centers, and emphasizing the importance of vaccination during pandemics. However
Imperial college-covid19-npi-modelling-16-03-2020Mumbaikar Le
This document summarizes the results of epidemiological modelling to assess the potential impact of non-pharmaceutical interventions (NPIs) aimed at reducing COVID-19 transmission in the UK and US. It finds that while mitigation strategies could reduce healthcare demand and deaths, hundreds of thousands may still die and healthcare systems would be overwhelmed. Suppression, including social distancing and case isolation, is the preferred option but would need to be maintained until a vaccine is available, around 18 months. Intermittent distancing may allow temporary relaxation but cases would likely rebound without continuous measures. Experience in China and South Korea shows suppression is possible short-term, but long-term feasibility and economic costs require further analysis.
Claudia Llanten, MD, MPH of CMMB describes the importance of immunization in protecting the health of children and adults and how CMMB partners with other organizations to deliver vaccines at the CCIH 2018 conference.
1. Coalition ProposalVaccination Policy for Infectious Disease P.docxmonicafrancis71118
1. Coalition Proposal
Vaccination Policy for Infectious Disease Prevention and Control
Scope of the Problem
Vaccines have done an excellent job at preventing many diseases, some of which can be deadly if not prevented. When bacteria or viruses enter the body, they immediately begin to attack and multiply, which then causes an infection. The immune system will then fight off the infection and establish antibodies, which will help recognize and fight off the same disease in the future. For this very reason, it has been important for children to be vaccinated at an early age so that they may establish those antibodies their bodies need. Vaccines act as the disease so that the body may produce antibodies, but the good thing is that it won’t cause an infection (CDC, 2017).
There are current policies that mandate vaccinations in the U.S., for example, all children are required to be up to date on their vaccines before beginning school. The problem is that there are many loopholes and exceptions to the rule, whether it’s due to religious reasons or other medical issues. Because of this, there are still many children and adults who have yet to be fully compliant with vaccine requirements
Some important statistics to note (Johns Hopkins Medicine):
· CDC estimated 2,700 new cases of hepatitis A in the U.S.
· It is estimated that in 2011, 19,000 new cases of hepatitis B and 17,000 cases of hepatitis C occurred.
· In 2012, nearly 10,000 new cases of tuberculosis were reported.
· Approximately 36,000 people per year die from influenza and pneumonia.
· 50,000 new cases of HIV infection occur annually.
· In 2012, new cases of STD’s were reported, including HPV, Chlamydia, Gonorrhea, HIV, and Syphilis.
Who is affected by this problem? Identify.
Children are mainly affected by this problem due to parents’ hesitancy for vaccinations. Although law mandates for children to be vaccinated for school enrollment, parents have the option to use exemptions to avoid having their children vaccinated. Currently, medical exemptions are allowed for medical reasons in all states, and it is estimated that one to three percent of children are excused from vaccinations because of these exemptions. Parents have continued to use reasons to avoid vaccinations, for example, the belief that the decline in vaccine-preventable diseases is due to improved health care, hygiene, and sanitation (Ventola, C. L., 2016).
Health disparities among Blacks, Hispanics, and Whites have played a huge role in terms of vaccination coverage. Studies have shown that health insurance has a direct impact on the vaccination coverage in adults, therefore, low-income families who can’t afford health insurance will most likely not get the vaccines they need. With that being said, uninsured prevalence was higher among non-Hispanic blacks (19.5%) and Hispanics (30.1%) compared with non-Hispanic whites (11.1%) (Lu, P., et al, 2015).
What has been written on the issue and policy options?
There ha.
The document discusses immunization and infectious diseases. The main goals are to increase immunization rates and reduce preventable infectious diseases. Immunization works by stimulating the body's natural defenses to recognize and attack specific bacteria or viruses. This helps prevent disease or reduce severity if exposed. While vaccines have reduced many diseases, some remain issues and new threats may emerge. Maintaining surveillance and immunization programs is important for protecting public health.
This document summarizes a study that assessed the knowledge, attitudes, and practices of mothers in Jos North, Nigeria regarding childhood immunization. The study used a questionnaire to survey 232 mothers with children aged 0-1 years old. It found that while most mothers (89.6%) had good overall knowledge of vaccines, less than 60% reported vaccinating their children on schedule and less than 3% had negative attitudes towards immunization. Factors like education level, marital status, religion, and whether the mother was vaccinated as a child influenced mothers' knowledge. Records also showed only 23.4% of children completed their vaccination schedules, revealing poor practice. The study concluded health education and promotion efforts are needed to improve mothers' knowledge
Assessment of Knowledge, Attitudes and Practices of Mothers in Jos North Rega...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Imperial college-covid19-npi-modelling-16-03-2020Wouter de Heij
- The document presents the results of epidemiological modelling to assess the potential impact of non-pharmaceutical interventions (NPIs) aimed at reducing COVID-19 transmission in the UK and US.
- Two fundamental strategies are evaluated: mitigation, which focuses on slowing spread to protect healthcare systems, and suppression, which aims to reverse epidemic growth and maintain low case numbers indefinitely until a vaccine is available.
- Modelling suggests that while mitigation may halve deaths and reduce the healthcare demand peak, hundreds of thousands could still die and healthcare systems would be overwhelmed. Suppression is the preferred option if possible, requiring a combination of social distancing, case isolation and household quarantine.
The document discusses recommendations from the National Vaccine Advisory Committee regarding adult immunization programs. It provides an overview of adult immunization levels and targets, noting that rates for influenza and pneumococcal vaccines have increased but remain below Healthy People 2010 goals. Burden of vaccine-preventable diseases in adults is significant, with estimates of tens of thousands of influenza-associated deaths annually in the US. Recommendations focus on improving coordination, evaluation, and collaboration across federal agencies to increase adult vaccination uptake.
Child mortality rates have declined globally over the past few decades due to improvements in child health programs and social conditions. However, progress has been uneven, and mortality has stalled or increased in some countries and regions. Two main types of child health programs have contributed to declines: short-term disease-specific initiatives and more general primary health care programs. Both program approaches need to evolve to complete the goal of improving child health worldwide, with a greater emphasis on household behaviors and interventions across the life cycle.
Government strategies in the covid 19 vaccination programssuserc3d5aa
The document discusses government strategies for COVID-19 vaccination programs in Palu, Indonesia. It describes the policy model applied for COVID-19 vaccination in Palu as a centralized institutional model where the central government regulates and procures vaccines while the local government implements vaccination campaigns. The local government of Palu issued 7 policies to accelerate vaccination, including establishing vaccine rangers, ambassadors, festivals, and collaborating with community leaders to provide vaccination centers and increase the number of vaccinators.
Should individual rights (e.g., parents’ right to decide whether to .docxmanningchassidy
Should individual rights (e.g., parents’ right to decide whether to vaccinate their children) be compromised to control the spread of communicable diseases for the good of society?
discussion. The childcare facility requirements/guidelines are every child must be vaccinated to attend this specific school. He was told a few schools in the community excepted exemptions for vaccinations, however not this school.
The definition of va
ccination is
to administer a injection to help the immune system develop protection from disease (Wikipedia, 2021). Vaccines contain a virus in a weakened, live, or killed state or proteins or toxins from the organism. Vaccines help prevent sickness from infectious disease by stimulating the body's adaptive immunity. When a large percentage of a population is vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them (Wikipedia, 2021). The vaccination policy in the United States is a subgroup of the U. S. health policy that deals with immunization against infectious disease.
I feel the individual rights of the parents who made a conscious decision not to vaccinate their child should not be persecuted. The parents' decision should be respected, but when the decision to not vaccinate their child may negatively affect the lives of others, the parents should be held accountable legally and financially. A population that is appropriately vaccinated against highly infectious diseases is a common good to its members' very society. Is it ethical to subject my child to the risk associated with receiving vaccines, and another parent is hesitant or refuses to have their child vaccinated? Is it right for that child to reap the benefits of herd immunity? The "herd immunity" or "community immunity" is fragile for measles. It does not take many unvaccinated individuals to approach the tipping point at which vaccine coverage levels are low, resulting in increased preventable infection levels (Hendrix et al., 2016). Many parents choose not to vaccinate their children, which is globally causing a resurgence in vaccine-preventable diseases. Parents are hesitant to vaccinate because religious beliefs are usually linked to the refusal of all vaccines or personal beliefs. Some parents believe natural immunity is better and more effective than immunity acquired from vaccinations. Safety concerns are the most significant reason parents are hesitant and refusing to vaccinate their children, especially with the known link between vaccines and autism. The desire for additional information causes hesitancy and refusal because parents feel more in-depth information about the vaccines should be accessible to review, enabling them to make better-informed decisions (Akoum, 2019).
In the United States, many safety precautions are required by law to help ensure that the vaccines we receive are reliable and safe. CO ...
Choose an organization according to the following· Current empl.docxmccormicknadine86
Choose an organization according to the following:
· Current employer
· Most recent or former employer
· Place of business that you have patronized or have been familiar with over a long period of time.
· Avoid choosing an organization that is so large that historical data would be difficult to apply. Firms in the Russell 2000® index may fit well, whereas firms in the Dow 30 Industrial index probably do not.
· The organization can be a start-up that you or a significant other may create in the future. For a start-up, focus on an entrepreneurial idea that is of substantive interest, so this project leaves you with a product you may leverage in the future.
Write a 1,000-word (maximum word count) paper in which you address the following:
· Identify the major components of the strategic management process.
· Discuss how these components work together to create value for the organization.
· Evaluate the company's mission statement, vision statement, motivation strategy, innovation strategy, and people strategy. If the organization does not have one or more of these, how does that affect the organization and its people?
· Explain the role of ethics and corporate social responsibility in strategic planning. How does this direct their strategy? How does the organization's vision and mission align with your own values and vision? If you are currently working for the organization, how does your role influence this and vice versa?
Format your paper according to APA guidelines.
Using the information below Create a 3-4 -slide PowerPoint presentation. Include speaker notes and citations for each slide, and create a slide at the end for References.
Immunization is important to infants as it prevents them from diseases which would be expensive to treat. The benefit of immunization and prevention of infectious diseases among mothers and infants cost-effective healthcare intervention and contribute significantly in reduction of mortality and morbidity in the country (Walls et al. 2018). Immunization also helps the mother to spend less on possible diseases that could affect their children. Prevention of infectious diseases is important to both the victim and other people who might be close to them, including the caregivers. In the maternal and infant population, immunization and infectious diseases continue to be a topic of debate. Averagely, immunization and prevention of infectious diseases has improved. In the United States the rate of immunization has gone up across all races, income groups and ethnicities. Similarities among the races where this special population are located narrowed down.
More so, prevention of diseases is less costly compared to the case where everyone is infected and needs medication. Despite the decreasing disparity, due to vaccination programs such as vaccination for infants, mother and infants from poor families, non-white have low immunization rates than those who were well off and white. Similarly, there are cost ba ...
This document proposes implementing school-based HPV vaccination programs to increase vaccination rates. It analyzes barriers to vaccination completion across socioecological levels and identifies interventions. The proposed intervention would educate students and parents about HPV and offer free vaccination series through schools. Applying interventions across all socioecological levels could help address multiple barriers and contribute to positive health outcomes by increasing HPV vaccination completion rates.
This document summarizes a thesis paper examining the socioeconomic impact of malaria control and eradication in Venezuela. It provides background on the malaria situation in Venezuela prior to a DDT campaign launched in 1945. Venezuela had the highest malaria mortality rate in Latin America before extensive control efforts. The campaign introduced DDT over four years between 1945-1948, varying by region. Exposure to the campaign during childhood is used to classify cohorts and analyze the impact on educational and economic outcomes like years of schooling, literacy rates, and income. Results found exposure in childhood led to better outcomes, indicating malaria negatively impacts development.
This document analyzes data from the 2014 National Immunization Survey to examine factors associated with DTaP vaccination rates in the United States. Regression models were used to analyze relationships between vaccination status and variables such as race, poverty level, WIC recipient status, number of vaccination providers, and whether the child's provider receives vaccines from state programs. The results show several significant associations, including between poverty status and vaccination rates, race and WIC status, and mother's age and WIC status. Overall vaccination rates are also presented.
This document analyzes racial disparities in flu vaccination rates in the United States using data from the 2010 National Health Interview Survey. It finds that minorities, especially Black individuals, have significantly lower flu vaccination rates than whites, likely due to barriers to healthcare access. Married individuals and those who are employed have higher vaccination rates than unmarried or unemployed individuals. The document controls for variables like age, sex, and employment status to better understand the independent effect of race and marital status on vaccination rates.
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2. 2
1. INTRODUCTION
This briefing provides an assessment of various policy options that could be used to improve
childhood immunization rates in British Columbia based on a review of immunization
coverage strategies utilized in other jurisdictions. The implications of implementing a
mandatory immunization law for all school-aged children is analyzed and discussed, among
other policy options aimed at increasing childhood immunization rates as part of a strategy
to combat preventable diseases. The Province’s existing policy in this area, summarized in
the Strategic Framework for Immunization in B.C., has failed to ensure immunization
coverage targets for major vaccine-preventable diseases are met.
2. PROBLEM
British Columbia is failing to meet provincial and national immunization targets and is
falling behind international standards in regards to coverage for vaccine-preventable diseases
(Busby & Chesterley, 2015, p.1). Provincial coverage falls short of national targets of 85-
97%, depending on disease (Winsa, 2015, para.2). While 2014-15 coverage rates in British
Columbia have not been released, the recent trend suggests that the province will not reach
its target coverage rate of 95%, set in 2007 under the Strategic Framework for Immunization
in B.C. (Ministry of Health, 2007, p.6). The B.C. Centre for Disease Control (BCCDC)
estimates that only 65% of two-year-old children in 2014 maintained up-to-date
immunizations, down from 75% in 2007 [see Figure 1] (Provincial Health, 2014, p.4).
While a high proportion of children entering kindergarten maintained up-to-date
immunizations compared to two-year old children, the numbers have remained relatively
stagnant over time (Provincial Health, 2012, p.4).
In addition, a 2013 report from
UNICEF on child well-being
placed Canada among the
worst of 29 developed
countries in terms of coverage
for measles, polio and DPT3
for children aged 12 to 23
months [see Figure 2]
(Adamson, 2013, p.14).
Notably, if we compared
British Columbia to the other
developed countries on the
list, the province would rank
28th
of 29 (p.14). The problem
therefore is clear: too few
children in British Columbia have up-to-date immunizations to protect themselves and others
from major vaccine-preventable diseases.
As Busby & Chesterley (2015) argue, “vaccination has proved a valuable tool in limiting the
incidence of infectious diseases, including measles, smallpox and whooping cough, among
others” (p.2); however, recent outbreaks of vaccine-preventable diseases in B.C., including
the 2014 measles outbreak which affected 422 people, and the 2011 mumps outbreak that
Figure 1 - Immunization Rates B.C. 1
Source: BCCDC 2014
3. 3
affected 77 people, and the noted rise in anti-vaccination sentiment among parents are cause
for concern and highlight the need for
more effective vaccination programs,
especially those aimed at children who
are most susceptible (Fraser Health, 2015,
p.vi; Busby & Chesterley, p.1).
When children are not vaccinated against
major vaccine-preventable diseases they
place themselves and others at serious
risk of infection or even death (Public
Health, 2015). Almost all of the cases in
the mumps outbreak of 2011 and the
measles outbreak of 2014 in B.C. were
associated with individuals not
immunized against the disease (Fraser
Health, 2015, p.vi).
When immunization coverage rates fall
below the 95% percent threshold
vulnerable populations in the province are
placed at an increased risk of sickness or
even death (Tolsma, 2015, p.334).
Measles for example, is one of the leading
causes of death among children globally despite widespread availability of the measles
vaccine (World Health, 2015). Vaccine coverage rates that dip below 95% percent, as they
have in B.C., significantly reduce the likelihood that vulnerable populations, namely
pregnant women, the elderly, children below the age of immunization and the
immunocompromised, will be protected through ‘herd immunity’ (p.334). As Tolsma
explains, “herd immunity occurs when a critical portion of a community is immunized
against a contagious disease….because the majority of those within the population are
immunized, those that are not, or those that cannot be immunized are protected” (p.334).
The Ministry of Health (MOH) should be concerned with finding ways to protect the health
and well-being of those who cannot protect themselves (p.334).
As Compton (2009) explains, “widespread use of vaccines can reduce pressures on the
healthcare system through averted hospitalizations and long-term disability, along with
decreased reliance on antibiotics to treat vaccine-preventable diseases” (p.4). Stagnating
immunization coverage rates among school-aged children in British Columbia should
therefore be viewed as a problem that needs to be addressed.
3. POLICY IMPLICATIONS
Immunization programs in Canada have been responsible for the elimination and control of
infectious diseases once common in this country and have saved more lives in the past 50
years than any other health intervention (Public Health, 2013, para.1). Stagnant or declining
Figure 2 – Global Immunization Rates
Source: UNICEF
Source: Adamson, 2013 (UNICEF Report)
4. 4
vaccination coverage for diseases rarely seen in Canada could result in their reappearance,
resulting in potentially serious future public health epidemics (Public Health, 2013, para.1).
While reports vary in regards to B.C.’s actual coverage rates among children for measles,
diptheriea, tetanus toxoid, pertfussis, poliovirus, hepatitis B and varicella, all major reports
indicate coverage is well under the 95% threshold, which leaves a significant portion of the
population at risk. Ultimately, the lower the vaccination coverage the greater the risk
becomes of a major public health epidemic. With that comes increased health care costs,
and if the recent UNICEF report on Canada is any indication, reputational damage in regards
to the Province’s commitment to child health and well-being (Busby & Chesterley, 2015,
p.4). The Public Health Agency of Canada (PHAC) estimates that each dollar spent on
immunization creates $16 in cost savings from “reduced visits to healthcare providers, fewer
hospitalizations and premature deaths, as well as reduced time off by parents to care for sick
children” (Busby & Chesterley, 2015, p.3). The cost of inadequate immunization coverage,
both financial and reputational, serve to act as a political impetus for the MOH to find ways
to improve coverage rates across the province.
4. RESEARCH FINDINGS
i. Jurisdictional Overview
British Columbia is not the only jurisdiction that has failed to meet immunization targets
“necessary to avert disease transmission” (Compton, 2009, p.xiv). While vaccination polices
vary considerably between national and sub-national governments the majority can be placed
in one of two broad categories: countries that promote parental choice, leaving vaccination
decisions to parents, and countries that limit parental choice, making vaccinations for certain
vaccine-preventable diseases mandatory unless a formalized exemption is obtained on
medical, religious or ideological grounds. Based on the UNICEF report, one cannot
conclude that mandatory or voluntary systems produce higher immunization coverage levels
(Adamson, 2013, p.14). Compton’s (2015) evaluation of global immunization programs
emphasizes the importance of centralized immunization registries; local coverage targets;
clear public messaging; and financial incentive programs for physicians and parents (p.xiv).
Policymakers must be aware of these best practices in making decisions about the future
direction of immunization policy in B.C.
In Canada, only Manitoba, Ontario and New Brunswick maintain mandatory vaccination
policies that apply strictly to children entering school (Walkinshaw, 2011a, para.1).
Ontario’s immunization coverage rates are the only one of the three that fare better than
British Columbia’s (Busby & Chesterley, 2015, p.6). However, even with Ontario’s
mandatory vaccination program for school-aged children, which includes penalties such as
school suspension for non-compliance, the system comes with its own set of shortfalls
(Walkinshsaw, 2011a, para.9). As Compton (2009) explains, even relatively high provincial
coverage rates mask regional disparities, as well as local program delivery (p.xiv). In
Toronto, there are certain schools with coverage rates below 50%, well below the provincial
average (Gordon, 2014, para.10). British Columbia’s voluntary system of immunization has
produced similar results. For example, only 51% of children in 2014 in the Kootney region
maintained up-to-date immunizations versus 67% provincially (BCCDC, 2014, p.6-7). For
policymakers, regional disparity should be viewed as a serious concern given, as Busby &
Chesterley (2015) explain, “immunity is a local effect” (p.3).
5. 5
ii. Political Landscape
The immunization political landscape is a controversial one that the Ministry must be aware
of in determining the most appropriate response to the immunization coverage shortfall. On
the surface, most agree that vaccination is an important component of maintaining public
health. Nationally, the PHAC has stated that they “support immunization as an effective
means to protect Canadians from infectious diseases, and encourages all Canadians to keep
their immunizations up-to-date” (Walkinshaw, 2011a, para.20). This despite the fact that
“the federal government doesn’t appear inclined to step into the fray” given immunization
administration is a provincial responsibility (para.19).
While the majority of individuals agree that vaccination programs must allow for medical
exemptions, more than 75% British Columbians would support mandatory vaccination
according to a recent (2015) poll by Insights West (Walkinshaw, 2011b, para.2; Johnson,
2015, para.1). Provincially, both the Liberals and the NDP have shied away from notions of
mandatory vaccinations despite noted concerns “about the propensity of some regions of BC
to have a low vaccination rate” (Drews, 2015; para.11; CKWN, 2015, para.4).
Policymakers must be aware that vaccination skeptics and organizations like the Vaccination
Risk Awareness Network (VRAN) will be critical of moves to limit opt-out opportunities for
parents. Policies that seek to reduce parental freedoms will likely be met with much
criticism.
iii. Parental Acceptance and Coverage
Immunizations through vaccines are one of the most effective disease prevention tools;
however, as Omer, Salmon, Orenstein, deHart & Halsey (2009) explain, “the success of an
immunization program depends on high rates of acceptance and coverage” (p.1981).
For policymakers, understanding why acceptance and coverage rates are not at a sufficient
level across all regions is an important question that must be answered to ensure policy is
appropriately tailored to address these issues. Busby and Chesterley’s (2015) evaluation of
immunization policy in Canada offers several reasons that may offer an explanation for
B.C.’s poor performance (p.6-7):
- Parental concerns over vaccine safety supported by misinformation;
- Parental complacency;
- Parental free-riders that benefit from high immunization rates without the perceived
need to have their own children vaccinated;
- Cost and access, in terms of time and resources; and
- Religious beliefs
Tailoring B.C.’s immunization strategy around these issues while respecting the diversity of
stakeholder interests will be paramount to ensure a successful outcome.
5. STAKEHOLDER ANALYSIS
As Compton (2009) asserts, “the relationship between parents – the primary gatekeepers of
childhood immunization – and the public health system’s role in providing and monitoring
immunizations, is particularly important in developing policies to empower both groups
towards responsible and informed decision-making (p.3). In the broadest sense, parents of
vaccine-eligible children and the government agencies responsible for public health can be
6. 6
viewed as the main contributors to the problem as well as the main stakeholders required to
solve it.
Children without up-to-date immunizations, to protect themselves and others from major
vaccine-preventable diseases, are a problem that largely affects vulnerable populations.
Each of the following stakeholders play an important role in solving the immunization
coverage shortfall:
i. Vulnerable populations (indirect stakeholder):
Individuals born between 1970-1992, children below the age of immunization, and the
immunocompromised are particularly at-risk of mortality, morbidity and the negative health
outcomes that can result from the spread of preventable diseases when vaccine coverage
rates fall below 95% of the population (Tolsma, 2015, p.334). Those born between 1970-
1992 are “too old to have received a second dose of measles, mumps and rubella (MMR) as
a child, but too young to have gained natural immunity through exposure to the disease in
the pre-vaccine era” (Buck & Gatehouse, 2015, para.13). Vulnerable populations can be
viewed as supporters of policy initiatives aimed at improving vaccination coverage and herd
immunity.
ii. Immunization Providers (indirect stakeholder):
Physicians and nurses play an important role as primary service providers of immunizations
in the province. As Compton (2009) explains, physicians and nurses are important
stakeholders to consider given their responsibility for “endorsing and operationalizing
immunization policy” (p.61). Their role as primary overseers of patient health provides
significant opportunities to educate parents and prompt decision-making. Changes to the
province’s immunization strategy must include consultation with physicians and nurses
because of the significant power and influence they have on parental decisions. Given the
widespread acknowledgment of the safety and benefits of early childhood vaccination, and
their role as vaccination service providers, physicians and nurses can be viewed as both
supporters and partners.
iii. Government Agencies Responsible for Public Health (direct stakeholders):
While the B.C. MOH is responsible for the development of immunization policies in the
province, Regional Health Authorities (RHA) and the B.C. First Nations Health Authority
(FNHA) provide direct immunization services and support for families through their network
of local public health units on the Ministry’s behalf (Government of BC, 2013). In addition,
the PHAC, provides
mechanisms for enhanced collaboration on issues such as vaccine safety,
surveillance, immunization registries, research, vaccine supply and immunization
program planning, and enables bridging of policy recommendations made at the
national level with immunization program development at the provincial/territorial
level (PHAC, 2013, para.6).
The PHAC, and the RHAs and their respective local health units, can be viewed as partner
stakeholders based on their involvement in the administration of immunization programs.
7. 7
iv. Parents of Vaccine-Eligible Children (indirect stakeholders):
Parents of vaccine-eligible children are key stakeholders to consider in the development of
solutions to address the inadequate rates of immunization in B.C. given parental decisions
have a direct and consequential impact on vaccination rates. This group can be viewed as
both supporters and opponents of policy initiatives aimed at improving vaccination
coverage, depending on the strategy that is pursued. Parents of vaccine-eligible children can
be broken down into four main categories:
Vaccine-Supportive Parents (VSP) – those who strongly support vaccination and
have/will ensure their children receive up-to-date immunizations. VSPs can be
viewed as supporters;
Vaccine-Hesitant Parents (VHP) - those “who might feel ill-equipped to make the
decision to vaccinate their children or are uncertain about what is best” (Busby &
Chesterley, 2015, p.10). This group also includes “unconvinced-objectors” who
“might be actively seeking more information” (p.10). Children from parents in this
group may not maintain up-to-date vaccinations or may have never received
vaccinations of any kind. Depending on the approach that is taken, VHPs can be
viewed as supporters or opponents;
Free-Rider Parents (FRP) - those “who are broadly supportive of vaccines, but who,
for reasons of time, energy or complacency, do not see that their children are fully
immunized” (Busby & Chesterley, p.10). Children from parents in this group may
not have up-to-date vaccinations or may have never received vaccinations of any
kind. FRPs can be viewed as supporters;
Vaccine-Objector Parents (VOP) – those who strongly oppose vaccination for
religious or ideological reasons (p.10). Children of these parents are least likely to
have been vaccinated (p.10). VOPs can be viewed as opponents.
As Busby and Chesterley (2015) argue, vaccine hesitant parents and free-rider parents are
the most ideal stakeholders to tailor policy interventions (p.10).
6. PUBLIC ENGAGEMENT
Given the polarizing views toward immunization, the MOH should commit to an open
public consultation to solicit feedback from the general public and targeted stakeholder
groups on the proposed policy recommendations, once developed. Doing so will help draw
out issues the government may have failed to consider; it will provide an important measure
of public support for the proposed initiatives; it will help draw attention to the problem; and
it will demonstrate that the government is committed to engaging the public in an open and
transparent manner by considering all viewpoints on the issue.
7. POLICY OPTIONS
Option 1: Prompted Informed Choice Model
While many developed nations maintain mandatory vaccination programs for children, more
than half of EU countries utilize voluntary, prompted informed choice models that have been
shown to result in high immunization coverage rates (Haverkate et al, 2012, p.2). Informed
choice has been shown to be effective in Canada as well. Immunization models, such as
those found in Newfoundland and Alberta, prompt parents to voluntarily make a decision
regarding immunization after birth (Busby & Chesterley, 2015, p.13). Nurses enter all
newborn information into a provincial registry and schedule an appointment, if the parents
agree, to discuss the risks and benefits of immunization, and to answer any questions (p.13).
8. 8
Throughout adolescence, a child’s immunizations are tracked in a provincial registry with
automatic reminders sent to parents to remind them about pending or late immunizations;
this is particularly important for Free-Rider Parents who support vaccination but fail to
ensure their child maintains up-to-date immunizations (p.13). As Busby and Chesterley
(2015) explain, the advantage of this model “is that it has one point of contact for parents
with notable expertise and specialization in delivering messages and information” (p.13).
While Alberta’s immunization rates mirror British Columbia’s for children at 2 years of age,
Alberta fares far better for children entering kindergarten, with rates of over 90%, compared
to 76% in B.C. (Walkinshaw, 2011a, para.11; BCCDC, 2012, p.4). Meanwhile,
Newfoundland’s informed consent model boasts the highest immunization rates in Canada
and is the only province that has met national targets (Busby & Chesterley, 2015, p.13).
As Jacobson-Vann & Szilagyi (2009) note, based on their study of immunization programs
in developed countries, “in virtually all settings in which patient reminder and recall
interventions were rigorously evaluated the reminder and recall systems were found to be
effective in improving immunization rates” (p.12). The lack of a centralized and integrated
immunization registry in B.C. will create an implementation challenge if this model is
pursued. However, this concern can be addressed if the province can follow through on its
commitment to develop an integrated registry (BCMOH, 2007, p.57).
While the province would incur additional costs to implement and maintain such a system--
including IT, staffing and software expenses, this could be potentially offset in the medium-
long term through health care savings achieved by an increase in immunization coverage.
PHAC estimates that $16 dollars in health care costs are saved from every $1 spent on
immunization programs (Busby & Chesterley, 2015, p.3).
Given this option preserves parental choice it is unlikely to garner any significant opposition
from Vaccine-Opposed Parents. Similarly, Vaccine-Hesitant Parents may be more inclined
to immunize their children given the single point of contact, which provides several
opportunities for dialogue and education between parents and their primary health care
provider.
Option 2: Incentive Model
A number of countries use an incentive based system to encourage parents and health care
providers to consider immunization. While the introduction of physician remuneration
provided B.C. doctors with some form of compensation for the administration of vaccines,
this “should not be confused with pay-for-performance incentives” used in jurisdictions such
as Australia (Compton, 2009, p.44). Interviews from Compton’s (2009) study revealed
existing remuneration rates for doctors in B.C., $8 per vaccination, to be insufficient at
covering the costs of administration let alone create an incentive to immunize (p.45).
Australia’s model provides performance-based remuneration for health care providers as
well as “nontaxable payments of AUS$129 for each child who meets immunization
requirements between 18 and 24 months of age, and again if the child meets requirements
between four and five years of age” (Walkinshaw, 2011b, para.7).
9. 9
The majority of jurisdictions that employ incentive based immunization systems also
maintain no-fault compensation programs for individuals injured from vaccines
(Walkinshaw, 2011b, para.16). Neither B.C. nor any other Canadian province offer this type
of compensation (p16). Policymakers should view no-fault insurance cautiously as
programs designed to compensate victims of vaccines may exasperate questions about
vaccine safety.
Implementing an incentive-based immunization model for parents and health care providers
could mobilize Free-Rider Parents to immunize their children. Tying immunizations to
financial incentives may also provide additional incentives for physicians to fully educate
parents about immunization, which could lead to more Vaccine-Hesitant Parents agreeing to
have their children immunized. Australia’s immunization coverage has increased
dramatically since the incentive program was introduced, with rates at over 90% for major
vaccine-preventable diseases (Busby & Chesterley, 2015, p.13).
Introducing an incentive-based model will come at a cost to the province. Given the
projected surpluses for the next three fiscal years, the province could likely afford to
introduce a like-model, if so desired (Government of BC, 2015). Full costing and a more
detailed proposal would need to be developed before this is pursued. Given the widespread
commitment to health care by the government and the official opposition, it is unlikely this
plan would receive significant opposition on intent alone. However, Vaccine-Supportive
Parents could view this as an unnecessary cost to government. Notwithstanding that
potential, it is unlikely that vaccine supporters would oppose this type of model.
Option 3: Compulsory, School-Age Requirements Model, with Penalties
Similar to the models used in Ontario and New Brunswick, the majority of compulsory
immunization systems require parents to provide proof of immunization upon entry into
school or request a formal exemption based on medical, religious or ideological grounds
(Carman & Kirkey, 2015, para.2). The results from these systems are mixed. In the
Canadian context, neither Ontario nor New Brunswick has significantly higher rates than
provinces that maintain voluntary systems (Busby and Chesterley, 2015, p.6). However,
European countries have fared much better; 4 of the 5 countries with the highest
immunization coverage rates utilize systems of mandatory vaccination (Haverkate et al,
2012, p.4; Adamson, 2013, p.14). Penalties in these systems range from school suspensions
for children without up-to-date immunizations or an approved exemption, as is the case in
Ontario, to requiring non-immunized students to stay home in the event of a vaccine-
preventable disease outbreak, as is the case in many European countries (Busby &
Chesterley, p.12; Carman & Kirkey, para.2)
The literature suggest that mandatory immunizations are most conducive in jurisdictions
where voluntary compliance is failing to meet immunization targets and where the social
climate is amenable to such requirements (Government of AB, p.23). In B.C., the social
climate appears to be warming and immunization targets are failing to meet provincial and
national targets. 78% of respondents from a recent Insights West poll expressed support for
mandatory vaccinations while 17% believe it should be left to the parent’s discretion.
(Johnson, 2015, para.1). In addition, the Provincial Health Officer recently supported the
call from the Canadian Medical Association (CMA) to “require parents to provide proof
10. 10
their child has received up-to-date immunizations for school entry” (Carman & Kirkey,
2015, para.1).
While the social climate in B.C. appears to be warming, dangers exist if the province moves
too aggressively with this approach, particularly given its lack of success in Canada.
Vaccine-Hesitant Parents may not respond well to stringent policies that provide a default
choice and may be swayed by the negative backlash that would likely ensue from Vaccine-
Objector Parents and organizations such as the Vaccination Risk Awareness Network
(VRAN). Groups like VRAN will continue to defend the position that “parents should be
allowed to determine whether they are willing to take the risk that their children get that
disease, get through it and develop long-term, lifelong immunity” (Walkinshaw, 2011a,
para.12-13).
8. RECOMMENDATIONS
The lack of a centralized, integrated immunization registry in British Columbia creates
challenges in identifying vulnerable populations within regions. As such, B.C. must fulfill
its long-standing commitment to introduce a fully integrated, centralized immunization
registry and ensure that it is accessible to all immunization providers. Previous
commitments made by the province to implement an integrated, centralized registry did not
include access for physicians and nurses (Compton, 2009, p.44). To establish the most
complete and accurate registry all health care providers, including physicians, nurses and
public health immunizers, must have access to the system in recognition of the various
immunization delivery models in the province. Furthermore, to maximize the success of
Recommendation 2, all health care providers should be instructed to create an immunization
record at birth, regardless of whether the parents of the child have opted to not pursue
immunization or are undecided at the time of birth. Currently, some local health units only
establish records for children who seek out immunization (p.44); which “limits the ability to
create a complete and comprehensive registry for the province” (p.44).
To help ensure all parents are aware of the benefits and risks of immunization, are made
aware of recommended immunization schedules for their children, and are provided an
opportunity to engage in dialogue with a knowledgeable health care provider, B.C. should
pursue implementation of a Prompted, Informed Choice Model based off the successful
model adopted in Newfoundland.
Recommendation 1: Introduce a fully integrated, centralized immunization registry
accessible to all immunization providers
Recommendation 2: Introduce a Prompted Informed Choice Model
11. 11
Model components that should be considered:
- registration of all children into an immunization database at birth by a health care
provider, likely a nurse or a midwife, regardless of whether the parents wish to
immunize;
- attempt to achieve written consent or refusal to schedule an immunization
appointment. Hesitant parents will not be required to state their approval or
opposition if they so choose but will be followed up with at a later date;
- require written consent be re-obtained for scheduled vaccinations in kindergarten and
grades 4, 6 and 9 to ensure consent throughout the vaccination schedule;
- ensure the provincial registry can facilitate automatic reminders for parents to ensure
vaccinations are up to date.
A full public consultation should be pursued to ensure health care providers and the public
support the above recommended changes. MOH staff will need to decide whether the above
approach can be accommodated through existing acts, regulations and guidelines or if new
ones need to be written before the province should proceed with public consultations.
12. 12
Further Research
Constable, C., Blank, N.R., & Caplan, A.L. (2014). Rising rates of vaccine exemptions:
Problems with current policy and more promising remedies. Vaccine, 32(2014),
1793-1797.
Delamonica, E., Minujin, A., & Gulaid, J. (2005). Monitoring equity in immunization
coverage. Bulletin of the World Health Organization, 83(5), 384-391.
Guttmann, A., Shulman, R., & Manuel, D. (2011). Improving accountability for children’s
health: Immunization registries and public reporting of coverage in
Canada. Paediatrics & Child Health, 16(1), 16-18.
Mah, C.L., Gutmann, A., McGeer, A., Krahn, M., & Deber, R.B. (2010). Compulsory
school-entry vaccination laws and exemptions: Who is opting out in Ontario and why
does it matter? Healthcare Policy, 5(4), 37-46.
Merilind, E., Salupere, R., Västra, K., & Kalda, R. (2015). The influence of performance-
based payment on childhood immunisation coverage. Health Policy (Amsterdam,
Netherlands),119(6), 770.
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