An adverse reaction is an undesirable side effect that occurs after a vaccination. Vaccines are intended to produce active immunity to specific antigens. When a vaccine is refused when first offered the provider should take the opportunity to offer the vaccine again at the next visit. These discussions should be documented in the patient’s medical record, including the refusal to receive certain vaccines (i.e., informed refusal). Parents should be advised of state laws regarding entry to schools or child-care facilities, which might require that unvaccinated children be excluded from the facility during outbreaks.
Health care providers should reinforce key points about each vaccine, including safety, and emphasize risks for disease among unvaccinated children. However, an effective public health strategy is to identify common ground and discuss measures that need to be followed if the decision is to defer vaccination ( 2). The American Academy of Pediatrics (AAP) does not recommend that providers exclude from their practice patients whose parents or guardians question or refuse vaccination. Their concerns can be addressed using the VIS and offering other resource materials (e.g., vaccination information from CDC). This partial acceptance can be used to facilitate additional communication. Certain vaccines might be acceptable to a parent who is resistant to other vaccines. Effective, empathetic vaccine risk communication is essential in responding to misinformation and concerns, with health care providers recognizing that risk assessment and decision-making can be difficult and confusing. When a parent or patient initiates a discussion about a perceived vaccine adverse reaction, the health care provider should discuss the specific concerns and provide factual information, using appropriate language. Health care providers can be a pivotal source of science-based credible information by discussing with parents and patients the risks from and benefits of vaccines, which helps patients make informed decisions. Websites and other sources of vaccine information may be inaccurate or incomplete. In some circumstances, decisions about vaccination are based on inaccurate information about risk provided by the media and certain websites. Having a basic understanding of how patients and parents of patients view vaccine risk and developing effective approaches to address vaccine safety concerns are imperative for vaccination providers.Įach person understands and reacts to vaccine information on the basis of different factors, including previous experience, education, personal values, method of data presentation, perceptions of the risk for disease and perceived ability to control these risks, and risk tolerance. Some refuse certain vaccines or reject all vaccinations for personal or religious reasons. Some parents or patients question the need for or safety of vaccinations and want to discuss the risks from and benefits of certain vaccines. The act does not require that a signature be obtained however, documentation of consent might be recommended or required by certain state or local health authorities or school authorities. Translations of VISs into languages other than English are available from certain state vaccination programs and from the Immunization Action Coalition website.
Copies of VISs are available from state health authorities responsible for vaccination and from CDC. These materials, known as vaccine information statements (VISs), must be provided by all public and private vaccination providers each time a vaccine is administered. The National Childhood Vaccine Injury Act of 1986 ( 1) requires that vaccine information materials be developed for each vaccine covered by the Act (). Discussion of the benefits of and risks from vaccination is sound medical practice and is required by law. Opportunity for questions should be provided before each vaccination. Parents, guardians, legal representatives, and adolescent and adult patients should be informed about the benefits of and risks from vaccines in language that is culturally sensitive and at an appropriate educational level. Major changes to the best practice guidance include 1) more descriptive characterization of anaphylactic allergy and 2) incorporation of protocols for managing adverse reactions.
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