Implementation Of Mandatory Vaccination Research Articles

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There are many nursing achievements to be proud of during these difficult times, despite ongoing challenges of the COVID-19 pandemic. Staffing shortages due to sickness and self-isolation are affecting many services, and the implementation of mandatory vaccination in care settings and hospitals has brought an additional raft of issues.

Knowledge and attitudes of parents after the implementation of mandatory vaccination in kindergartens of Palermo, Italy.

Background and aim of the work:Even though vaccination is easy to access in Europe, it has been facing several outbreaks caused by vaccine preventable diseases. Trying to balance the right to health of the community with individual self-determination, in Italy was mandate vaccination for ten vaccine preventable diseases in 2017. The project “Sportello Vaccinale” provided a counseling service to parents in kindergarten of Palermo. The main objective of the study was to investigate knowledge and compliance on vaccination by children’s parents after the implementation of mandatory vaccination.Methods:A cross sectional study was conducted among parents accessing to the “Sportello Vaccinale” using a questionnaire. The questionnaire consisted of 34 items divided into three sections: socio-demographic data; knowledge and attitude on mandatory vaccination using Health Belief Model (HBM); Health Literacy (HL) level.Results:A total of 95 questionnaires were garnered in the kindergartens from respondents with a mean age of 36 (±SD=6) years. The respondents who delayed hexavalent or Measles, Mumps, Rubella and Varicella (MMRV) vaccinations were 8 (8%) and the more frequent cause was fear of adverse reaction (87%). The sample had more often high level of health literacy (37%), and 55% had higher HBM score. The factor significantly associated with higher HBM score was the age of respondents (OR= 1.14, p=0.006) after controlling for other variables.Conclusions:Consent to vaccination practice was widely represented, but the results of the study highlighted the need for parents to have more information and more time devoted to the practice of vaccination counseling. Implementing counseling activities at school or at the vaccination service, could support an aware decision process of the parents on vaccination topic.

Mandatory vaccination: a joint statement of the Ethics and Vaccination working groups of the European Academy of Paediatrics.

Vaccinating children is amongst the most cost-effective interventions for reducing children's morbidity and mortality. Parents who choose not to vaccinate their children despite having been informed about the evidence on safety and efficacy of vaccines may seriously jeopardise the health of both their own children and others. Contemporary ethical thinking about the limits of parental decision-making over their children's healthcare treatment often considers the zone of parental discretion. However, with vaccination this is slightly less direct as the benefits are not only accumulated by an individual child but also by children as a population. Forcing parents is of course not the only solution to counteracting the fear of vaccines. Health authorities should certainly fund research and deploy resources on combatting vaccine disinformation.Conclusion: It would be preferable to achieve high rates of vaccination coverage by educating both parents and physicians without adopting any legislation for mandatory vaccination. However, in countries where vaccination uptake is low and/or outbreaks of vaccine-preventable diseases occur, the implementation of mandatory vaccination will most probably save children's lives. EAP calls for action to make all scheduled childhood vaccinations a matter of fact for all European children.

The introduction of \u2018No jab, No school\u2019 policy and the refinement of measles immunisation strategies in high-income countries

BackgroundIn recent years, we witnessed a resurgence of measles even in countries where, according to WHO guidelines, elimination should have already been achieved. In high-income countries, the raise of anti-vaccination movements and parental vaccine hesitancy are posing major challenges for the achievement and maintenance of high coverage during routine programmes. Italy and France approved new regulations, respectively in 2017 and 2018, aimed at raising immunisation rates among children by introducing mandatory vaccination at school entry.MethodsWe simulated the evolution of measles immunity profiles in seven distinct countries for the period 2018–2050 and evaluated the effect of possible adjustments of immunisation strategies adopted in the past on the overall fraction and age distribution of susceptible individuals in different high-income demographic settings. The proposed model accounts for country-specific demographic components, current immunity gaps and immunisation activities in 2018. Vaccination strategies considered include the enhancement of coverage for routine programmes already in place and the introduction of a compulsory vaccination at primary school entry in countries where universal school enrolment is likely achieved.ResultsOur model shows that, under current vaccination policies, the susceptible fraction of the population would remain below measles elimination threshold only in Singapore and South Korea. In the UK, Ireland, the USA and Australia either the increase of coverage of routine programmes above 95% or the introduction of a compulsory vaccination at school entry with coverage above 40% are needed to maintain susceptible individuals below 7.5% up to 2050. Although the implementation of mandatory vaccination at school entry would be surely beneficial in Italy, strategies targeting adults would also be required to avoid future outbreaks in this country.ConclusionsCurrent vaccination policies are not sufficient to achieve and maintain measles elimination in most countries. Strategies targeting unvaccinated children before they enter primary school can remarkably enhance the fulfilment of WHO targets.

HEPATITIS B INFECTION IN EASTERN REGIONS OF BULGARIA

Background: Bulgaria is a country of moderate endemicity for hepatitis B infection with 3-7% of the general population chronically infected with the virus. Since 1991, an obligatory vaccination has been implemented for all healthy newborns. As a result, twenty years later, hepatitis B prevalence is significantly reduced but viral hepatitides still represent an important public health problem that needs to be addressed especially in some ethno-religious and regional groups. Purpose: No recent published data are available about hepatitis B circulation in Bulgaria and in its Eastern part particularly. In the current study, we analyze the epidemiological data on hepatitis B cases in easternmost Bulgarian regions and try to determine the possible risk, which the infection poses to public health in these regions. Material/Methods: We performed a retrospective analysis (2008-2014) using epidemiological data from the National surveillance system for hepatitis B notification. Results: The incidence of acute hepatitis B in all considered regions has been durably decreasing for the last seven years: while in 2014 its total value was 9,69%000, in 2014 it reached a minimal rate of 3,09%000. We found that young individuals in their 20s years (the borderline generation before and after implementation of mandatory vaccination) are most vulnerable to hepatitis B. South regions are also more affected by hepatitis B infection when compared with regions on the North. Conclusions: We reported a stable downward trend in the incidence of hepatitis B infection in all studied regions of Bulgaria. This result can be directly linked with the presence of effective vaccination program at national level.

Osijek Health Center during the 1991–1992 War in Croatia

To assess the effectiveness of health services in the city of Osijek during the 1991-1992 war in Croatia, we followed the changes in the utilization of health services, morbidity and mortality, and completion of a vaccination plan during the 2 years of the war. We used a retrospective analysis of data from the Osijek Health Center and the Osijek County Institute of Public Health. The organization of health care during the war followed the concept of integrated health care and the instructions of the Ministry of Health. Visits to primary health care physicians decreased considerably, with a concomitant increase in disease and mortality. The plan for mandatory vaccination was not completed because of the evacuation of preschool and school children. The war changed the mode of health care use, the disease and mortality structure, and the implementation of mandatory vaccination. However, timely education and preparation of the health services to the war situation resulted in an adequate provision of health care to the population.