As a parent or guardian, we strive to provide the best life possible for our children, family, and grandchildren when they come along. Everything that could possibly be done is done in preparation for a child’s safety. The best car seats, best schools, best neighborhoods possible, but when it comes to immunizing children and protecting them from communicable diseases, many parents are opposed to this kind of protection. Immunizing has been proven over time to be the most effective safe way of preventing the spread of infectious diseases that could lead to morbidity and mortality if left untreated. The Office of Public Health (OPH), has many goals related to the health and welfare of the public. One important one is to promote the health of the public by preventing death and illness through vaccinations. The purpose of this paper is to explain the reason for Louisiana Vaccination Policy RS:17 and why this policy is so important to the well-being of all Louisiana residents.
The Louisiana Vaccination policy RS 17:170 was developed to mandate immunizations to improve the health of Louisiana. All children entering any school, including kindergartens, colleges, vocational schools, day care centers for the first time, and any other form related to a school beginning with the 2009-2010 school year and would be in effect moving forward (Legis, 2016). Louisiana Legislature fully supports the philosophy of immunization for all children in schools and childcare facilities in Louisiana. For this reason, members of the Legislature office and health care providers worked together to develop a vaccination policy that mandates vaccinations for all school-aged children, including childcare operations in the state of Louisiana. The vaccination policy is not limited to children in public schools, it is also the policy for students attending private schools as well. In addition, the vaccine policy also covers children registering for sixth grade or middle school for the first time (NVIC, 2017). This policy is in place to ensure all children entering school have been vaccinated. It is the responsibility of the parent or guardian to ensure their children has the required vaccination or show proof of such immunization to satisfactory levels to be permitted to attend school.
The Office of Public Health has made immunization of every child in Louisiana a high priority. Immunizations when used appropriately can make serious diseases disappear for individuals and protect communities (LABP, 2012). Vaccines are highly efficient and are low in cost, but not every child has access to or has not received the immunizations they need to protect themselves and others around them from contracting a deadly disease. Receiving vaccination is one of the best ways to prevent the spread of diseases as well as help put an end to it. Another reason to continuing vaccinated is so diseases that were once known to man would not come back. This is the rationale for the policy; to prevent the spread of communicable diseases by ensuring everyone is vaccinated.
The Louisiana Vaccination Policy RS 17:170 is important to my role at work. This policy intertwines with the program I oversee at the hospital, which is my reasoning for my policy choice. For the past 12 years I have worked with the federally funded, Vaccine for Children (VFC) program and for the past year I have been the program coordinator. Through this program, over a 1000 doses of vaccines are administered each month, in six pediatrics clinics throughout the facility. The vaccine program has been very successful and helped saved the hospital I work at over $1.2 million dollars in 2016. Without this program, the hospital would not be able to vaccinate the same number of children each year. They would have to find additional funding for the needed vaccines. Funding is always hard to find and who is to say kids wouldn’t be turned away if there was no additional funding.
The vaccine program provides vaccines to children who might not be vaccinated because they cannot afford it, in hopes of reaching the target audience. This is a federally funded program that provides vaccines to children who meet the requirements, but is governed by a state policy. Any child 18 years of age and under who are eligible to receive Medicaid, uninsured, underinsured, or are American Indian or an Alaska Native qualifies for the program. Vaccines are provided free of charge, but there is a chance office visit fee might be charged. Mandating immunizations is complicated and making it policy could create access problems. For this reason, the VFC program was created to provide vaccines to children and prevent the spread of disease. This policy and program together, are critical to the health and well-being of the population. In addition, it helps ensure that all children have a better chance of getting their recommended vaccinations on schedule.
All laws requiring vaccinations are and have always been at the state or local level. The Louisiana vaccination policy does however, derive from a policy that was developed at the national level. State level policies are adapted from the national policy to suit the needs of the population. Vaccination has greatly reduced the burden of infectious diseases and only clean water, also considered to be a basic human right, performs better (Andre et al., 2008). Vaccine have become the most efficient way of preventing the spread of deadly illnesses. Mandating vaccines at the school levels ensures most of the children entering schools have received the appropriate vaccine on a set schedule to further ensure the effectiveness of the vaccine. Without the vaccine mandate for children attending school, with the exceptions to the policy, majority of the children 18 and under would not receive them.
Without the law mandating vaccines, there would probably be an epidemic outbreak of diseases that have already been eradicated as well as those that are still current. However, the mandate has faced much opposition from parents and guardians. Mandating vaccines takes away the right to make their own decision about what is best for their children. Parents feel their rights have been ignored, by this mandate. However, the success of this program relies greatly on the participation of the stakeholders. The stakeholders being the parents of the children who receive vaccines, the physicians, public health professionals as well as those who help ensure the safety of the vaccines have the most to lose if the mandate is not followed.
The vaccination policy breaks down the required vaccines by groups according to age. Vaccine requirements have been included to ensure everyone is on the same schedule. Children kindergarten through the 12th grade is required to follow the state law, with the exceptions if a dose is missed or the vaccine is given off earlier than scheduled. To aid in the mandate of every child being vaccinated before entering school, the Vaccine for Children (VFC) program was created to provide vaccine at no cost to children who would otherwise not receive the required vaccines. The Immunization Program administers the Vaccines for Children Program through the office of public health. Vaccines are purchased at a discount by the CDC and given to hospitals, public health facilities and health departments. The CDC works closely with public health agencies as well as some private groups to monitor immunization use, mainly distribution and safety.
With the program being a federally funded entitlement program, public, purchased vaccine is available at no charge to enrolled public and private health care providers for eligible children (DHH, 2017). Inflation has hit the vaccine market hard. In 1985, I cost about $45 dollars to completely provide the recommended vaccines to a child up their 19 birthdays. Today, it cost over $2000 to provide the same vaccines, which is why we need to be diligent is accounting for each dose as well as being sure of the eligibility status of the person receiving the vaccine. A dose we drop, spill, or misplace is one less vaccine available to someone who needs it. In addition, to a dose missing, many kids could go without vaccinations if the program fails to accomplish the goals (direct quote from my paper).
Federal funds pay for most of all vaccines publicly funded. The VFC program provides vaccines to children up to age 18 are eligible for the program if they qualify for Medicaid, are uninsured, or are of American Indian or Native Alaskan descent as defines by the Indian Health Services Act. Children who are underinsured are eligible to receive vaccines only if they are seen by a health center that is federally qualified, a rural health clinic, public health office, the health unit, or if state funds are available (DHH, 2017). The main goal of the vaccine program is to vaccinate as many kids who qualify for the program in the most effective and in the most efficient way possible, but the success of the program relies on everyone involved to do what is right.
There are however other exceptions to the vaccination policy. As parents feel having their child vaccination caused harmful side effects, they were concerned with the mandate. In addition to parents feeling the mandate violated their rights they decided not to vaccinate. Due to parental beliefs about vaccination, exceptions to the rule was added to the policy as to not infringe on the rights of others. It is the personal beliefs of parents that officials feel have put other people, children, teachers, and their families at risk of contracting a disease that could have been prevented. It has been determined that vaccination is the best way to prevent the spread of communicable disease, but every policy has set exemptions.
State legislatures have their own set of laws that are unique to the needs of the state. Most states have a religious exemption for people who have religious beliefs against immunizations. “Parents just want to do everything possible to ensure their children stay healthy and are protected from disease, but when parents do not understand the purpose of vaccinating and what resources are available they fear the unknown”. (T. McHenry, personal communication, April 24, 2017). According to Tangja, “her children may not like to get shots, but they would be getting them anyway.
The Louisiana policy has exemptions based on religion and personal beliefs. However, the existing statute in Louisiana does not explicitly recognize religion as a reason for claiming an exemption, however, as a practical matter, the non-medical exemption may encompass religious beliefs (NCSL, 2016). Louisiana also recognizes philosophical reasons as an exemption to the policy. A letter from the parent, guardian, or health care provider is needed to claim an exemption. Although Louisiana has religious and philosophical exemptions, an additional clause was written into the law that an overturn parental exemption in the event of a possible outbreak. Louisiana schools are mandated to have certain vaccines be administered before a child can be admitted into school. Louisiana law along with the other 49 U. S. states mandates that all children are required to have vaccinations against diphtheria, tetanus, and pertussis, polio and measles and rubella, which are found in the DTaP, IPV, and MMR vaccine, (ProCon, 2016).
This mandate has negatively impacted many parents from the targeted audience, causing parents to opt of following the law. However, there are certain exemptions allowed that addresses the needs of the law and the population without creating too much of a negative impact on the target population. All states permit medical exemptions for individuals who are immunocompromised, have allergic reactions to vaccine constituents, have moderate or severe illness, or other medical contraindications to vaccination (Salmon, D. 2002). Louisiana policy also recognizes philosophical beliefs as an exemption to the vaccination policy.
The exemptions to the Louisiana policy are just a few of the barriers that nay prevent a student from receiving the mandated vaccination. There is a growing evidence regarding the impact of the association of non-medical exemption rates with increased disease incidence (Wang et al, AJPH). The policy could consider strengthening the application process, how often vaccination records must be updated and improved enforcement (CDC, 2015). In many instances, a lack of understanding of the intent of the policy as well the purpose of the vaccine itself. Not understanding the safety concerns behind the reason for the vaccine is why many children are not vaccinated. The media has raised safety concerns, which is why continued vaccine education is so important. Parents fear the unknown, and want to be able to make to best informed decision possible, but don’t always understand what is needed and why.
The safety of vaccines draws a lot of attention, more so than the effectiveness and the goal they were intended to accomplish and for years vaccinations have been the topic of objection, whether it was it was the effectiveness, safety, or a parent personal or religious reasons. Autism has been a been factor in parents not vaccinated their children. However, the concern is still present, but autism in no longer the primary reason parents are not vaccinating their children. A study from the American Academy of Pediatrics (AAP) shows that parents feel there is no longer a need to vaccinate the children due to record low of preventable disease. However, these diseases only have record lows due to continued vaccination laws across the country. In a study completed between 2004-2008, 68% of reported measles cases was due to residents who claimed a personal belief exception and chose not to get vaccinated. (NCBI, 2010). While speaking to McHenry, about vaccinated her children, she mentioned that she herself was asked by one of her children as to why they still needed to receive certain vaccines. She told them it was because even though some disease doesn’t exist anymore we continue to vaccinate against them in hopes of preventing them from developing again.
Vaccines are among the greatest achievement in medicine and public health (NCBI, 2016). There are several factors that can contribute to children being noncompliant to the vaccine policy, some of which are out of their control. Health systems logistical errors is a barrier that influences vaccine administration. Another barrier is vaccine shortages due to the lack of manufacturing capacity, but that is a relatively common factor Vaccine shortages, is another barrier to the policy and although it does not happen often and shortage of vaccinations can create mass panic, especially if there is a disease outbreak. Logistical problems are another barrier that creates problems for vaccine administration.
Sustaining high vaccine coverage levels in children and adolescents, increasing coverage rates in adults, and incorporating new vaccines into the routinely recommended immunization schedule requires vigilance and adequate resources (ASTHO, 2014). While the law is the law, it does recognize the concerns parents have against vaccines. Vaccines have been proven safe to use, but to not take away parental rights parents can opt out of vaccinating their children. However, along with that comes strict rules if an outbreak were to occur. There is not much the law can do about the medical and the religious exemptions, but it is the philosophical reasons that can be questioned. There should be stricter methods when enforcing a vaccine violation. In addition, stricter exemption rules should be added. In addition to stricter rules, health care providers should make better use of educational problems as to ensure they are up to date on current vaccines, as well as having a better understanding to ensure the parent knows as much as possible about a vaccine to make the best decision possible.
Vaccines are important to our health, the health of our children, and their children to come. They have been heralded as one of the 20th century's most cost-effective public health achievements. Immunizations protect both individuals and the larger population, especially those people who have immune system disorders and cannot be vaccinated (NCSL, 2015). Vaccines do not just protect us know, but they help to protect the children of the future. Immunizations protect both individuals and the larger population, especially those people who have immune system disorders and cannot be vaccinated (NCSL, 2015). There is still a great need to immunize everyone from diseases, although parents sometimes question why the need is so great if many if the disease no longer. I for one believe this policy is for the greater good of the population. I stand behind it 100% and have chosen to have my child vaccinated as the schedule just. She is eight and has not missed one of the recommended doses. After speaking to several people, it seems that they are all for vaccinated their kids I would say however, that is we have a mandate to vaccine children, there should be something in place for adults. The influenza vaccine should be mandating, if not more than that.
Without this policy mandating immunization, the world as we know it could revert to the days when the so many of the population were paralyzed or died from not getting the vaccines that today, could save a life. Vaccinations are one of the best ways to put an end to the serious effects of certain diseases (CDC, 2017). Having the vaccines needed to prevent and outbreak and the parents working together with health care providers is what is needed to continue providing a safe environment for us to live in. It is a joint effort from all, involved to ensure everyone gets vaccinated on schedule. The life of so many people depends on our compliance with the Vaccination policy. Without this policy, many children would not receive the necessary vaccines that keep us well and prevent further spread of disease