All about vaccines: Updates for pediatric nurse practitioners

The entire November issue of Contemporary Pediatrics is devoted to vaccines with the editorial board as lead authors for each vaccine article. All aspects of vaccinations are addressed providing opportunities for pediatric nurse practitioners (PNPs) and all pediatric providers to have candid discussions with colleagues, patients, and families about the value of vaccinations for all adolescents and young adults as well as adults who make health care decisions for children and adolescents aged younger than 18 years.

Vaccine controversy and the plight of controlling the COVID-19 pandemic

The pandemic has entangled evidenced-based public health measures designed to protect the population with strong political viewpoints and vaccine refusal that are perpetuating the pandemic. The evidence clearly shows that the unvaccinated are most at-risk for severe disease and death, with the majority of hospitalized individuals with COVID-19 symptoms identified as unvaccinated. If one hypothesized, human beings disheveled by an astoundingly powerful ever-evolving organism at pandemic proportions, controversial feelings related to vaccines and public health measures would be replaced by adherence to public health principles and a call for mass vaccination would prevail; based on today’s national data, the hypothesis would not be supported. Thus, despite scientific advances that enabled the development and production of safe and effective COVID-19 vaccines for individuals from aged 5 years and older, the pandemic remains victorious in the United States, primarily due to vaccine resistance and the social media spread for misinformation.

Vaccine articles: What lessons best inform current practices?

In this digital age of information overload, a Contemporary Pediatrics November issue with a focus on vaccines provides easy access to the most current information in one place for the busy pediatric provider. Topics include information on the history of vaccines, how to talk with vaccine hesitant individuals and families, immunization information systems, vaccine development, vaccines recommended but not required, the future of vaccinology, and the Centers for Disease Control and Prevention immunization schedules.

PNP students are often asked to highlight the most important principles or concepts learned when reading scientific information. Using this approach, I selected some important concepts from each article and highlighted the concepts in italics in each paragraph. Dr. Barakat’s article, “The History of Vaccination,” we learned that severe outbreaks of smallpox in the 1700s helped the public accept vaccinations. We also learned that once the smallpox vaccine was developed, vaccination uptake spread rapidly in England, but the United States was slower to implement vaccination recommendations. This historical information is similar to the current COVID-19 pandemic: even though the United States has led COVID-19 vaccine development, currently 62 million people in the United States, who are vaccine eligible, have not been vaccinated. Likewise, vaccine hesitancy has affected vaccine uptake by adults for themselves and now for their children. Dr. Jones interviewed Drs. Colton-Poole and Clay on the topic of vaccine hesitancy. They provide suggestions for establishing trusting relationships with parents and children to combat vaccine hesitancy and improve levels of acceptance. Vaccine hesitant and refusing individuals continue to negatively impact the progress towards conquering the COVID-19 pandemic. Efforts to combat vaccine hesitancy must persist at local, state, and national levels for the United States to reduce disease and death from COVID-19. We currently have over 700,000 deaths in the United States alone. If the unvaccinated persist in their refusals, the death toll will continue to rise…the tragic thought of reaching 1,000,000 deaths is mind boggling, and so unnecessary, as COVID-19 is now a vaccine-preventable disease.

Drs. Libby and Schuman describe the current immunization information system in their articles, “Immunization information systems: Beyond the basics.” They describe ways to improve data entry into the immunization information systems (IISs) by bar coding vaccines received into the electroni health records (EHRs) which will then interact with IISs rather than have personnel enter data both into the EHR and the IIS, as they currently do not interact with one another. Drs. Libby and Schuman further suggest COVID-19 reporting vaccine requirements to enter data into a database that monitors vaccine uptake and sends out reminders may be “the silver lining for connecting all vaccine registries into a national database, accessible from anywhere.”

Dr. Tan’s article, “Vaccines in development: What we can look forward to in preventing infectious diseases,” Drs. Schuman and Libby’s article, “The Future of Vaccinology,” and my article, “Vaccines recommended but not required: Evidence that supports a strong recommendation to parents,” provides exciting new insights into current available vaccines and vaccines of the future as well as current recommendations for vaccines that are available but not mandated for attendance at school. The future is bright with more than a dozen vaccines in development and new ways to administer the vaccines other than by injection.

The COVID-19 pandemic has reinforced resistance to vaccine uptake. Thus, all providers must collectively consider how to address latest scientific developments that have the potential to alter the course of viral and bacterial infectious diseases that lead to a much healthier future. The messaging must counter the intensely influential social media on vaccines that persuades adults and leads to parental refusal of vaccines as we have seen throughout this COVID-19 pandemic. The time to design and implement rigorous research studies to combat vaccine refusal is now.