10 Facts About Vaccinations and the Role of Nurses
National Immunization Awareness Month (NIAM) takes place every August to amplify the importance of vaccinations for people of all ages. This year, the awareness campaign promotes relevant dialogue surrounding the COVID-19 pandemic, vaccine mandates, and the worldwide vaccination effort.
NIAM and its theme, "#ivax2protect," focus on the role and importance of vaccination in bringing people together, particularly as we enter the second year of the COVID-19 pandemic. This year, the CDC offers toolkits aiding in communicating with healthcare professionals about vaccines, along with a kit for communicating with parents and patients.
1. Vaccine development began in the 18th century.
Known as the pioneer of immunization, British physician Edward Jenner observed that people who contracted cowpox, a disease similar to smallpox, were immune from the disease once they recovered. He used that knowledge to contribute to the development of a smallpox vaccine. In Jenner's time, more than 3,500 people died of smallpox in London alone. Globally, outbreaks of the disease spanned 3,000 years, killing an average of three out of 10 people who contracted it. WHO declared smallpox eradicated in 1980.
After the development of the smallpox vaccine, others followed:
2. Nurses have long played a prominent role in delivering and advocating for vaccines.
Throughout the early 20th century, public health nurses in eastern U.S. cities made house calls and began staffing immunization clinics. These efforts saved many people from contracting diseases like polio and tuberculosis, the latter of which killed more U.S. citizens than any other illness in 1900. Nurses also saved many lives during the 1918 influenza outbreak, along with the 2009 H1N1 epidemic, by administering vaccines at public immunization clinics.
Nursing organizations also advocate for increased access to and awareness of immunization. The 317 Coalition lobbies the federal government to invoke Section 317 of the Public Health Service Act to provide more funding for immunization of uninsured Americans. In 2017, the American Nurses Association (ANA) included its signature on a letter to the U.S. President presenting evidence of vaccine safety and citing the importance of continuing immunization programs, given such events as the 2014 measles outbreak at Disneyland.
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3. Vaccines prevent disease.
Vaccines artificially activate the immune system by injecting the same germs that cause illness. Vaccines mildly infect people — individuals do not become sick but instead develop immunities that prevent them from getting sick. WHO reports that vaccines prevented 10 million deaths worldwide from 2010-2015.
Immunization success stories include an 80% drop in measles cases in the U.S. from 1980-1981. In 1994, polio was declared eradicated from the Americas, followed by Europe in 2002. As of 2017, polio remains in only three countries due to the development of a new and more effective vaccine in 2010.
Pandemics still present a serious challenge with the current coronavirus crisis and recent influenza outbreaks at the forefront. Before the flu vaccine, the 1918 flu pandemic killed an estimated 50 million people. Today, flu vaccines reduce illness by 40-60%. In 2017-2018, immunization prevented an estimated 5,700 deaths from influenza.
4. U.S. nurses have emerged from retirement to assist with vaccine distribution.
The U.S. Department of Health and Human Services has amended its rules that prohibited retired healthcare professionals from vaccinating people against COVID-19. The rule change hopes to increase vaccination administration once supplies become more widely available.
COVID-19 vaccines have proven highly effective against the virus, with more than 2.71 billion shots already administered across 180 countries — enough to fully vaccinate 17.7% of the global population. In the U.S., healthcare workers have delivered 319 million doses so far.
Nurses whose licenses have lapsed within the last five years can — and have — responded to the call for help, so long as their credentials were in good standing at the time they expired.
America experienced a national nursing shortage even before the pandemic, which has worsened as nurses retire or burn out from months of caring for COVID-19 patients. Rural areas have seen a particular dearth of nurses. By coming out of retirement to aid in the fight against the pandemic, nurses have saved countless lives.
5. A lack of vaccinations can result in outbreaks.
As we suffer through the coronavirus crisis, it remains clear that the largest outbreaks of highly contagious diseases tend to occur before pharmaceutical companies have developed vaccines. Outbreaks also return during times of low vaccine rates.
From 1989-1991, measles resurged in the U.S. primarily in areas where as little as 50% of children had been vaccinated. A total of 123 people died, 90% of whom were not vaccinated. Measles returned in 2008, with more than 90% of cases occurring in those who were not vaccinated or had unknown immunization status.
Other examples include these recent outbreaks:
In 2010, California's health department reported a 418% increase in pertussis cases compared to the previous year, with 89% in infants too young for immunization.
From 2010-2011, cholera killed 4,787 in Haiti after the earthquake due to logistical problems administering vaccinations.
In 2013, due to war and immunization disruption, Syria reported an outbreak of polio, which had not appeared in the country since 1999.
6. Nurses staff the front lines of immunization.
Nurses, especially registered nurses (RNs) and nurse practitioners (NPs), routinely deliver vaccines. They also provide patients with evidence-based information about vaccine safety, potential side effects, and the importance of immunization. In some countries, nurses administer all vaccinations.
Nurses often struggle to convince reluctant patients to become vaccinated. If people don't see others becoming sick from the disease, they don't believe it poses a danger. Nurses must often advise that remaining unvaccinated can affect both patients and their families.
Nurses often fill the gap between patients and doctors. In rural areas, a shortage of primary care providers can mean that communities look to nurses for immunization advice and administration.
School nurses also play a significant role in advising students and families about vaccine requirements. The National Association of School Nurses and other nursing organizations recommend implementing school-based vaccination programs.
7. Nurses can access vaccine safety information to stay up to date.
Nurses must stay informed about clinical practices, vaccine availability, regulations, and other topics concerning safe immunization. The Centers for Disease Control (CDC) monitors vaccine safety and offers online resources to help healthcare professionals communicate accurate information to their patients. These resources include links to websites with reports, data, and inquiry portals.
Examples of available CDC information include immunization schedules, lists of current shortages and delays, and instructions for reporting adverse effects. WHO offers international immunization information, such as programs, news briefs, publications, position papers, and statistics.
Nurses can access ANA's continuing education resources such as recommendations, guidelines, and applicable law compliance summaries; books and journal articles; resources on vaccines for specific diseases; and fact sheets. The CDC website offers webinars, training courses, conference calls, a continuing education guide, and quality improvement projects for certification renewal.
8. Not all nurses can prescribe vaccines.
The International Council of Nurses conducted a survey of nursing associations in 15 unidentified Organization for Economic Co-operation and Development (OECD) countries. The OECD includes 36 countries worldwide, including the United States. Survey results revealed that only 33% of nurses can prescribe vaccines.
All states, excluding Arkansas, Michigan, and New Mexico, permit NPs to prescribe vaccines under physician supervision. However, only 18 states allow NPs to prescribe vaccines on their own authority. RNs can prescribe under supervision only in Florida, Minnesota, Oregon, and Texas.
There are currently ongoing attempts to change regulations to allow nurses to prescribe vaccines. Countries that allow nurses to prescribe cite additional professional requirements, such as specific practice experience and prescription education, along with supervised training and mentoring.
9. Nurses need vaccines themselves.
While it is said "doctors make the worst patients," nurses sometimes neglect their own health too. Medical professionals focus entirely on other people's health every day and can forget about their own wellness amid busy schedules.
Nurses' exposure to infectious diseases makes it all the more important for them to receive regular vaccinations. It keeps them and their families healthy, along with reducing the risk to their patients of contracting viruses.
First and foremost, each nurse needs a flu shot every fall. All nurses, but particularly those who work with infants, need tetanus, diphtheria, and pertussis vaccines. Other important immunizations include hepatitis B, varicella, measles, mumps, and rubella.
To keep nurses and their patients safe from influenza, ANA strongly recommends urging family members and coworkers to become immunized; practice thorough handwashing; and use safety needles and standing orders for vaccine administration.
According to one news source, though N95 masks are no longer in shortage, there might be ongoing difficulties in gaining access to them. Previously, due to the shortage of supply, nurses, healthcare staff, and volunteers had sewn and fashioned homemade masks out of craft and hardware store materials to rectify this situation and maintain close contact with patients.
10. Nurses work tirelessly in the fight to prevent and contain diseases.
Nurses work long hours protecting patients and fighting diseases, often risking their health to help others. The current coronavirus pandemic highlights the sacrifices nurses make each day. While the race to roll out COVID-19 vaccines continues, nurses work in testing centers and treatment facilities and have helped to administer the vaccine to millions of people.
Resources for Nurses
Flu and Chronic Health Conditions Toolkit | National Foundation for Infectious Diseases
This site offers fact sheets and infographics about how the flu affects patients with underlying diseases and the importance of vaccination.
Handouts for Patients and Staff | Immunization Action Coalition
The IAC site provides hundreds of concise handouts for nurses and their patients, covering the full spectrum of immunization topics and specific vaccines.
Immunization Guide | American Nurses Association
The ANA immunization site contains information for nurses, including clinical tools, educational materials, policy and advocacy statements, and safety guidance.
Immunization Transition Toolkit | National Association of School Nurses
School nurses can access this resource, which provides information on vaccine requirements during students' transition times, such as moving from elementary school to middle school.
Vaccinations for Children and Teams | National Association of Pediatric Nurse Practitioners
This website offers guidance for pediatric nurse practitioners and provides links to vaccine recommendations and schedules, fact sheets, and frequently asked questions.
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