Professional Documents
Culture Documents
Immunizations
Reneé S. Smallwood
December 3, 2017
IMMUNIZATIONS 2
Abstract
This paper explores immunizations and their impact on global health. Vaccinations are available
in different countries around the world from newborns to the elderly. According to the CDC,
there are 16 vaccine preventable diseases currently including Measles, Mumps, Rubella,
Varicella, Influenza, Rotavirus, Polio, Hep A, Diphtheria, and Tetanus (DTaP). In addition to
(pertussis) and HPV (Roper, 2014). Vaccine administrations have kept communicable diseases
under control and prevented epidemics that risk fatal outcomes. As developing countries try to
improve their health care system many people are not able to get vaccines and are at a higher risk
of contracting a disease like meningitis, measles, or hepatitis. This paper will reference Frieden
Health Impact Pyramid from most significant impact to the smallest effect and later examine the
Immunizations
There are multiple vaccines available around the world that protect from infectious
pathogens and diseases. Many are designated as part of a routine childhood vaccination schedule
(Glatman-Freedman & Nichols, 2012). When given in childhood, vaccines have many benefits
with the most critical being saving a child’s life (HHS, n.d.). According to UNICEF (n.d.),
bacteria, viruses, and parasites are responsible for significant childhood diseases like tetanus,
diphtheria, TB, and pertussis. Children are known not to have the most healthy immune systems
leaving them vulnerable to infections and diseases. Children with diseases may become
extremely ill and infect those around them. Immunizations protect people and others, are safe
and effective, save time and money, and protect future generations (HHS, n.d.). A significant
portion of childhood mortalities has been found in low-income countries (Glatman-Freedman &
Nichols, 2012).
Low- income countries have a higher burden of disease that is vaccine preventable. Low-
income countries face a high burden of diseases as a result of low vaccine supplies or shortages
and poor funding (Glatman-Freedman & Nichols, 2012). As underdeveloped countries work to
improve their health care system people are dying every day from preventable diseases (HHS,
n.d). Though non-vaccinations are killing the population due to the inadequate healthcare
system, there are also many people who refuse to vaccinate because of religious beliefs, lack of
Educated parents are associated with higher childhood immunizations (WHO, 2016). A
few studies completed on the effect of education on men and women concluded higher education
allows for healthy behavior including childhood immunizations (WHO, 2016). Many parents in
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underdeveloped countries lack the knowledge to weigh out the risk and benefits of vaccines and
long-term health. In addition to education, religious belief interferes with controlling and
preventing the spread of vaccine prevented diseases as with the Muslim culture, one of the most
general populations in the world (DeSilver & Masci, 2017). “Certain religious leaders have cited
vaccines as a sin against God” (Glatman-Freedman & Nichols, 2012). The Muslim culture often
does not vaccinate because of their restriction to eat pork and their commitment to their holy
bible known as the Quran. The Quran states, “God allows us to enjoy all the good, lawful things
and forbids us to partake of those things that are harmful to our beliefs, health, well-being, or
morals” (Stacey, 2011). The intake of pork and pork containing products is considered unhealthy
and a sin if consumed by a Muslim (Stacey, 2011). Vaccines like influenza, measles, MMR,
varicella, and DTaP contain gelatin, a product made from pork (Johnson, 2013), deterring these
individuals away from the vaccine. Many religious groups “respect” their leader's opinion, but
in the end, they are putting themselves, their family and loved ones at risk by not being
immunized. Muslim have lower immunization rates because of alienation from society (WHO,
2016). Islam makes up the second largest religious group in the world with an estimated 1.6
billion as of 2010 (DeSilver & Masci, 2017). As a group often seen around the world, Muslims
impact global health as they continue to isolate and deny vaccines. Defined as, “behavior and
beliefs that are learned and shared” (Skolnik, 2016), culture plays a significant part in
immunizations worldwide.
Framework
If addressed appropriately, critical health issues could reduce the leading cause of
preventable deaths and illnesses drastically (Roper, 2014). The availability of clean water and a
rapid decline in infectious diseases has increased the life expectancy by an average of 20 years in
IMMUNIZATIONS 5
the United States and parts of Europe (Frieden, 2010). Many health impact modules have been
proposed but only focus on health infrastructure and service and delivery of clinical health
(Frieden, 2010). “Although these are critical importance, public health involves far more than
health care” (Frieden, 2010). The operation, fundamentals composition, organization of society
are often unnoticed. Current health impact frameworks fail to define the essential elements or the
The public health pyramid explores the impact of the variety of public health
interventions that provide an outline for improving health. These impacts range from
socioeconomic factors to clinical responses to recommendations that may allow more people to
get vaccinated (Frieden, 2010). Frieden’s 5 tier health impact pyramid was established to
implement interventions that discuss long-term protection, ongoing direct clinical care,
counseling and education and overall to improve health (Frieden, 2010). These 5- tiers will be
Socioeconomic factors. When vaccines and healthcare are not available, social
determinants appear to play a significant role (Belardo, 2015). The environment, safety,
education, nutritional status, religion, and socioeconomic status are a few that play a role in
health determinants about immunizations (Skolnik, 2016). Immigrant groups are currently living
outbreaks (Belardo, 2015). Many people in underdeveloped countries do not have the resources
or access to health care to pay for vaccines for themselves or their family. Household living
conditions and vaccine rates were found to be limited in low-income countries (Glatman-
Freedman & Nichols, 2012). Families with better housing are more likely to have their child(ren)
IMMUNIZATIONS 6
vaccinated. Income is a vital part of health care. Indirect cost and transportation to clinics are
bearable in households with higher income (Glatman-Freedman & Nichols, 2012). Health and
culture are often linked together, and what is often perceived as an unacceptable cultural practice
for some, it is considered an adaption to others (Skolnik, 2016). Immunizations are highly
significant in countries like the United States to prevent the spread of diseases, but on the other
hand in Africa, a child with measles is considered healthy because of the high incidences of the
disease (Skolnik, 2016). A household in Uganda, Africa is often led by the father who makes
decisions about family participation in government programs even though the mothers are
considered the primary caregivers of children (Glatman-Freedman & Nichols, 2012). The father's
choices and objections are a barrier identified in partaking in immunization programs (Glatman-
Freedman & Nichols, 2012). Compared to women in high-income countries women in low-
income countries depend on men “socially, economically, and culturally, and are at a
disadvantage…” (Glatman-Freedman & Nichols, 2012). Women’s role and power affect child
vaccines because of social support and education, and social support mold attitudes toward the
Changing the context to encourage health decisions. New laws in Germany make it
mandatory for all children to receive their immunizations before entering kindergarten (Scutti,
2017). Germany is trying to keep their children safe and prevent the spread of diseases or viruses
like measles that have seen a recent increase in outbreaks since May 2017 (Scutti, 2017). The
United States and Australia mandate immunization before starting school, but in the U.S., there
is an exception for medical, religious, and ethical beliefs (Scutti, 2017). Most insurance
companies cover vaccines. The state of Delaware offers free vaccines to children between the
ages of 0-18 years who are uninsured, have Medicaid, underinsured, and Native American or
IMMUNIZATIONS 7
Alaskan Native (DHSS, 2017). Free vaccines for all children between the ages of 0-18 and the
vulnerable like the elderly is an alternative to fighting infectious diseases and epidemics. As
previously mentioned, due to the Muslim culture belief of not intaking pork or pork containing
products, a possible organic vaccine can be researched and trialed for effectiveness. Clinical
trials are currently being done on natural alternatives for vaccines for parents against vaccines
due to their additives (Carmen, n.d.). Vaccine avoidance can lead to inadequate immunization
significant and potentially tragic consequences to the societies in which these children
live”(Belardo, 2015).
in our homes, schools, workplaces, neighborhoods, and communities” (Healthy People, 2017).
Many diseases have been reduced or eliminated that at one point killed or disabled people a few
years ago (HHS, n.d.). Because of parents against vaccines, measles and pertussis have been on
the rise in children in the U.S. (HHS, n.d.). Vaccinating on the immunization schedule is
recommended (HHS, n.d.). Vaccine boosters are available for lifelong immunity because of the
weakened immunes system memory (Vaccine Center, 2017). Titers are available to check how
much antibodies are in the blood and an individual’s immunity to the disease (Vaccine Center,
2017). Also, titers are an alternative if there is a concern about too many vaccines and if they are
useful.
Clinical Interventions. Vaccine hesitancy requires ongoing monitoring due to its global
difficulty and the rapid global problem (WHO, 2016). The World Health Organization defines
vaccine hesitancy as the,“… delay in acceptance or refusal of vaccines despite the availability of
vaccination services. Vaccine hesitancy is complex and context-specific varying across time,
IMMUNIZATIONS 8
place and vaccines. It includes factors such as complacency, convenience, and confidence”
(WHO, 2016). Survey questionnaires have been utilized to determine the risk and uncertainty
amongst those who are not vaccinated (WHO, 2016). Questionnaires will decide if the child is at
risk of contracting or spreading a highly contagious disease like meningitis. Many Latin
countries offer incentives for vaccines and well-visit checkups (Skolnik, 2016). Money can make
people agree to participate in programs like vaccine programs and the participant and society
benefits as a result.
Counseling and Education. Vaccine programs have been a success at the global level
and in public health (Miller & Sentz, 2006). Though a significant amount of effort has been
made in vaccination development and administrations throughout the world, many countries,
mainly developing countries, struggle with immunizing their children (Miller & Sentz, 2006).
Education appears to take priority in decreasing the occurrence of widespread diseases from
happening. Although the spread of some diseases like polio, measles, and mumps have declined
due to the development of vaccines, family and education of an individual also impact
immunizations. The growing anti-vaccine movement has hurt individual and population-level
health (Belardo, 2015). The decade's old measles vaccine is associated with autism leading to a
decrease in the measles vaccine (Belardo, 2015). Anti-vaccine movements have become
“weapons of mass distraction” regarding education on the risk and benefits of the vaccine
(Berlardo, 2015). No causes about the MMR vaccine and autism have yet to be confirmed, yet
parents remain concerned about the safety of vaccines (Berlardo, 2015). Adopting a plan that
figures out why parents are opposed to vaccines besides becoming autistic will assist in tackling
Immunizations are vital to overall health now and in the future. Many determinants
parents to maintain trust because vaccine safety is a concern for most parents (Roper, 2014).
Communication allows for matters to be expressed and to establish a rapport. Personal accounts
from peers or healthcare professionals could be persuasive too. Reinforcing the social norm
around vaccinations can be beneficial (Roper, 2014). If vaccines were considered a “social
programs around the world (Glatman-Freedman & Nichols, 2012). Globalization and
communication ease these effects resulting in a reduction and stopping the spread of diseases
leading to lower death rates (Glatman-Freedman & Nichols, 2012). Healthcare can assist to
hesitancy. Educating younger individuals about vaccines can alter future beliefs about vaccines
and behavior (WHO, 2016). Involving nontraditional/trusted providers like fire department
medics or pharmacist will help sustain the system (Roper, 2014). The pharmacist can be utilized
underserved communities. The nontraditional staff will be available on weekends and after hours
and prove to be a safe place for a lot of families (Roper, 2014). With full involvement of the
community, a fight can be made to decrease the burden of disease and determinates impacting
Conclusion
Immunizations have been around for decades and are administrated to protect us from
deadly diseases. Developing countries suffer from a weak and inadequate health care system
countries also prevent proper protection in these underdeveloped countries. Many anti-vaccine
groups are developing in middle and higher income countries putting children and societies at
risk. A health pyramid framework was designed by Thomas Friedan as an outline to improve
health and supply an appropriate variety of public health interventions. With this health outline,
the help of the community, and support of health care providers will get the world close to
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