Shedding light on childhood vaccinationshttps://scholarworks.uvm.edu/fmclerk/1508/thumbnail.jp

Badiyan, Ramin

English

ScholarWorks @ UVM

University of VermontScholarWorks @ UVMFamily Medicine Clerkship Student Projects Larner College of Medicine2019The Truth About VaccinesRamin BadiyanFollow this and additional works at: https://scholarworks.uvm.edu/fmclerkPart of the Medical Education Commons, and the Primary Care CommonsThis Book is brought to you for free and open access by the Larner College of Medicine at ScholarWorks @ UVM. It has been accepted for inclusion inFamily Medicine Clerkship Student Projects by an authorized administrator of ScholarWorks @ UVM. For more information, please contactdonna.omalley@uvm.edu.Recommended CitationBadiyan, Ramin, "The Truth About Vaccines" (2019). Family Medicine Clerkship Student Projects. 459.https://scholarworks.uvm.edu/fmclerk/459The Truth About Pediatric Vaccinations South Burlington Ramin BadiyanRotation 7, 2019Drs. Keegan, Calkins, Luebbers, Mariani and ReiterProblem• The rate of vaccine refusal has increased nationally (Mellerson et al., 2018).• Many parents have concerns about vaccines, regardless of their ultimate decision on whether to vaccinate their children or not (Freed et al., 2009). • Children that miss one or more vaccinations are more likely to have a mother without a college degree (Smith et al., 2004). • Vaccine refusal puts both the child and the community at risk for vaccine-preventable illnesses. • There is falsified and fraudulent information on the internet and media regarding vaccinations.Consequences of Vaccine Refusal • Risk of infection is increased in non-vaccinated children (Glanz et al., 2010)• 9-fold for varicella• 35-fold for measles• 6- to 28-fold for pertussis• 57 percent of measles cases in the United States from 2000-2015 were from patients that had no history of the vaccination (Phadke et al., 2016) Community Perspective • Dr. Luebbers, a provider at the South Burlington medical clinic, states it is common for “parents to agree to some vaccines but not others”. He also notes that it is often helpful to talk about vaccination purposes, side effects, and effectiveness when parents are hesitant. Lastly he reports giving parents handouts addressing their concerns regarding vaccinations can be helpful. • Dr. Keegan, another provider at South Burlington, mentions the main vaccine that is refused at the South Burlington office is the HPV vaccine. She comments that the vaccine can often be associated with sexual activity which makes parents hesitant. However, she says when she reinforces that the HPV vaccine can prevent cervical cancer; parents are more likely to agree to getting it for the child. Intervention • Encourage providers to establish a positive dialogue with parents that creates a shared goal, explores vaccine benefits and safety, and allows parents to make an informed decision  • Identify concerns and common misconceptions amongst parents (for example - that vaccines can cause autism)• Share educational handouts and peer reviewed resourcesGraph from www.uptodate.comResults • Providers at the South Burlington medical practice agree to provide peer reviewed resources, including handouts, to parents with concerns regarding vaccinations. In addition, providers agree to engage in dialogue with parents to clarify common misconceptions such as the effectiveness of vaccines or certain possible side effects. • Surveys suggest that approximately one-third to one-half of vaccine-hesitant parents eventually vaccinate their children (Gust et al., 2008) • Health care providers can have significant influence on parental decisions regarding immunizations.Limitations • Providers have limited time with patients.• Some parents are not open to discussing vaccinations.• Past painful experiences with vaccinations can make parents hesitant to pursue further vaccinations.• Parents are influenced from information in media that is not always true.• Some parents don’t read handouts given to them. Future Projects • A office survey that addresses parents’ concern regarding vaccines. • Evaluation of parents beliefs and notions after dialogue and education with the provider. References • Freed, G. L., Clark, S. J., Butchart, A. T., Singer, D. C., & Davis, M. M. (2010). Parental Vaccine Safety Concerns in 2009. PEDIATRICS, 125(4), 654–659. https://doi.org/10.1542/peds.2009-1962• Gust, D. A., Darling, N., Kennedy, A., & Schwartz, B. (2008). Parents With Doubts About Vaccines: Which Vaccines and Reasons Why. PEDIATRICS, 122(4), 718–725. https://doi.org/10.1542/peds.2007-0538• Glanz, J. M., McClure, D. L., Magid, D. J., Daley, M. F., France, E. K., & Hambidge, S. J. (2010). Parental Refusal of Varicella Vaccination and the Associated Risk of Varicella Infection in Children. Archives of Pediatrics & Adolescent Medicine, 164(1), 66–70. https://doi.org/10.1001/archpediatrics.2009.244• Mellerson, J. L., Maxwell, C. B., Knighton, C. L., Kriss, J. L., Seither, R., & Black, C. L. (2018). Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2017–18 School Year. MMWR. Morbidity and Mortality Weekly Report, 67(40), 1115–1122. https://doi.org/10.15585/mmwr.mm6740a3• Phadke, V. K., Bednarczyk, R. A., Salmon, D. A., & Omer, S. B. (2016). Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the UnitedStates. JAMA, 315(11), 1149. https://doi.org/10.1001/jama.2016.1353• Smith, P. J., Chu, S. Y., & Barker, L. E. (2004). Children who have received no vaccines: who are they and where do they live? Pediatrics, 114(1), 187–195. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15231927Consent • Thank you for agreeing to be interviewed. This project is a requirement for the Family Medicine clerkship. It will be stored on the Dana Library Scholar Works website. Your name will be attached to your interview and you may be cited directly or indirectly in subsequent unpublished or published work. The interviewer affirms that he/she has explained the nature and purpose of this project. The interviewee affirms that he/she has consented to this interview.• Yes __X___ / No _____• If not consenting as above: please add the interviewee names here for the department of Family Medicine information only.• Name: ______________________________________________________________

The Truth About Vaccines

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The Truth About Vaccines

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