Although death from measles is somewhat rare among adults, the illness is still a leading cause of vaccine-preventable infant mortality globally.

Measles outbreaks are also on the rise in the United States, where 1,182 cases have been confirmed in 30 states this year. That is the greatest number of cases reported in the U.S. since the disease was declared eliminated in 2000, according to the Centers for Disease Control and Prevention (CDC).

Dire need for vaccine education

Despite these statistics, public opinion about the importance of vaccines has decreased throughout the past decade.

One survey revealed a 10% decline from 2008 to 2018 in the percentage of people who believed vaccination is very important to the health of society, according to data from Research! America and the American Society of Microbiology.

While these numbers may seem daunting for vaccination advocates, polls from the CDC are showing healthcare providers are the most influential factor in changing a vaccine-hesitant parent’s mind to immunize his or her child.

“There is a tremendous amount of fake information about vaccines on social media and other websites, and it’s important for nurses to stay up to date about the safety and efficacy of any vaccine they are giving,” said Carol Hayes, CNM, MN, MPH, FACNM, immunization adviser to the American College of Nurse-Midwives and an adjunct professor at Georgia State University’s School of Nursing in Atlanta.

One of the most common misconceptions about vaccines is their link to developmental delays, and Hayes explains to parents and patients that there have been numerous studies disproving this link in his vaccine education. Another common concern is the flu shot can cause the illness.

“I help people understand that this is impossible,” said Hayes, who is also a representative on the CDC’s Advisory Committee on Immunization Practices (ACIP). “The immune system may take 10 to 20 days to respond to the vaccine and produce antibodies. In that time frame, someone may get the flu, but the vaccine did not cause the flu.”

As a nurse-midwife, Hayes is versed in vaccine protocols for pregnant women. She recommends these patients receive the flu shot because pregnant women who contract the flu are at higher risk of developing complications such as pneumonia, and a fever during pregnancy can increase the risk that the child will suffer from developmental delays.

In 2012, ACIP also voted to recommend that pregnant women receive a dose of the Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis) vaccine during the third trimester of each pregnancy.

The vaccine will allow the mother to develop antibodies to pertussis during the pregnancy and pass this immunity to her baby, which is critical because infants are not eligible to receive the pertussis vaccination until they are 2 months old.

Vaccine education protects adults too

Hepatitis A outbreaks also have started increasing in the U.S. in the last several years, with nearly 24,000 cases reported since 2016. Of those cases, 60% have resulted in hospitalizations, and Kentucky, Ohio, West Virginia and Florida are the states with the most cases.

The highly contagious liver infection is spread by fecal-oral transmission, which is different than how Hepatitis B or C are spread.

“It used to be that Hepatitis A occurred in young children and was mild, but now more severe outbreaks are happening among adults who live in overcrowded, unsanitary conditions,” said Christine Finley, APRN, MPH, immunization program manager for the Vermont Department of Health.

The Hepatitis A vaccine is recommended for children at the age of 1 and for travelers to countries where the disease is common, people who are homeless, recreational drug users and several other high-risk groups.

The HPV vaccine is another immunization Finley has started recommending for children who are 11 or 12 years old because the vaccine is most effective at younger ages. While most parents understand that it’s protective against cervical cancer, fewer are aware it can prevent oropharyngeal (mouth and throat) cancer in men.

Although the anti-vaccination movement has centered around immunizations for children, Chad Rittle, DNP, MPH, RN, FAAOHN, associate professor of nursing at Chatham University in Pennsylvania, is focused on increasing awareness and vaccine education about the importance of protecting adults from preventable diseases.

“Many adults think they do not need vaccines,” he said. “But there’s a significant knowledge deficit among this population about their need for vaccines.”

Rittle encourages nurses to take advantage of opportunities to educate patients about the value of immunizations.

“An objection is a request for more information,” he said. “Nurses need to be vaccine champions in their communities and recommend that patients get what they need during an appointment rather than delaying.”

ACIP recommends that people 65 and older receive the pneumococcal conjugate vaccine and the pneumococcal polysaccharide vaccine to protect themselves from pneumonia, sinus infections, ear infections and meningitis.

Nurses also can educate patients who are 50 and older about the shingles vaccine, Shingrix. Studies have shown more than 99% of Americans 40 and older have had chickenpox, the same virus that causes shingles.

The virus remains dormant for years and can reactivate and cause shingles whenever the immune system is weakened. Rittle, who is the American Nurses Association’s liaison on the ACIP, said there is a shortage of Shingrix, and nurses should learn where patients can receive the vaccine in their communities so they can make referrals.

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