SUMMARY

It is the position of the National Association of School Nurses (NASN) that there be federal, state, and local legislation for immunization of students and their families and that schools who choose to provide immunizations to students be reimbursed for this service. In addition, the National Association of School Nurses supports the development of an immunization registry in each state. According to the American Immunization Registry Association (1999), "Immunization registries are confidential, computerized systems for maintaining information regarding children’s vaccination. Immunization registries help sustain high immunization rates and low disease levels by managing information more efficiently." Furthermore, NASN supports recognition by the health care system and the community of the school nurse’s critical position to assess immunization needs, serve in a leadership capacity to develop school immunization programs, and promote community awareness of the value of immunizations in the primary prevention of disease throughout the lifespan.

HISTORY

During the nineteenth century, there were few effective treatment and preventative measures for infectious diseases. Since 1900, however, substantial achievements have been made in the control of many vaccine-preventable diseases in the United States. Childhood vaccination against smallpox ceased in 1972 due to eradication of the virus in the hemisphere. The last wild-type poliomyelitis transmission in the United States was in 1979. Rubella is no longer considered a major health threat in the United States in large part due to more than 95% of the nation’s children being vaccinated against this disease before entering school (Medical College of Wisconsin, 2005).

The American Academy of Pediatrics offered the first immunization guidelines in the 1930s. National efforts to promote immunizations among all children began in 1955 with the appropriations of federal funds for polio vaccinations. Since then, federal, state, and local governments, as well as public and private health care providers, have collaborated in the development and maintenance of the vaccine delivery system in the United States. Five vaccines were available between 1938 and 1985. Between 1985 and 2000, the number of recommended vaccines doubled. In the next 20 years, the number of vaccines available could triple.

All states require immunizations prior to entry into school. Though the regulations are similar, they often vary between states. Specific requirements frequently change based on the availability of new vaccines.

DESCRIPTION OF ISSUE

Vaccines are responsible for the control of many infectious diseases that were once common in the country. Vaccines have reduced, and in some cases eliminated, diseases that routinely killed or disabled many infants, children, teenagers, and adults. However, the viruses and bacteria that cause vaccine-preventable disease and death still exist and can be passed on to unvaccinated people. In addition, vaccine-preventable diseases have a costly impact on Americans, resulting in lost work time for parents, doctor’s visits, hospitalizations, and premature deaths.

RATIONALE

To realize the full benefit of vaccines, individuals must recognize that vaccines enable the body’s natural defenses. Individuals should actively seek immunizations for themselves as well as those for whom they are responsible. Health care providers need to know the latest developments and recommendations regarding vaccines and their administration. To optimally prevent disease, disability, and death from preventable illnesses, the vaccine delivery system must target adolescents and adults as well as children. Professional school nurses practice in an ideal setting in which to educate families regarding the indications, contraindications, side effects, and timeliness of initial and booster doses of vaccines. As the primary health professional in schools, professional school nurses are responsible for coordinating school and public health immunization programs and have opportunities to counsel families regarding immunizations throughout the lifespan. In collaboration with local public health groups, schools can be an effective location for the delivery of vaccines to children, particularly in areas where the population is under-immunized. When this occurs, it is the position of this organization that schools seek third party reimbursement for these health services. In addition, immunization registries are important tools to facilitate immunization compliance, and they help prevent duplication of vaccinations when records have been lost or misplaced.

References

American Immunization Registry Association. (1999, July). Immunization registries [Special Edition for Public and Private Providers]. Snapshots. Retrieved April 26, 2006, from http://www.immregistries.org/pdf/Snapshots_special2003.pdf

Centers for Disease Control and Prevention (CDC). (2003). Revised standards for child and adolescent immunization practices. MMWR Morbidity and Mortality Weekly Report, 52(40), 969–970.

Centers for Disease Control and Prevention (CDC). (2006). Epidemiology and prevention of vaccine-preventable disease (9th ed.). Atlanta, GA: Author.

Grace, J. (2006). Adolescent immunization: Challenges and opportunities. Journal of School Nursing, 22(2), 87–93.

Medical College of Wisconsin. (2005). Rubella eliminated in the United States. HealthLink. Milwaukee, WI: Author. Retrieved April 23, 2006, from http://healthlink.mcw.edu/article/1031002493.html.

U. S. Department of Health and Human Services (USDHHS). (2000). Healthy people 2010: Understanding and improving health. Washington, DC: U.S. Government Printing Office.

Website Resources

www.cdc.gov/nip
www.immunizationinfo.org
www.immunize.org
www.partnersforimmunization.org
www.immregistries.org

 

Adopted: June 1978
Revised: June 1982, June 1996, and November 2001
Revised: June 2006