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Child Immunization in the U.S

Child Immunization in the U.S

Immunizations are among the most important health interventions in the current times. Healthy People 2020 (2020) claims that the increased life expectancy in the 20th century is highly a result of improvements in children’s survival. However, individuals in various places fail to receive sufficient immunizations. In the U.S., some individuals get diseases that can be prevented through immunization. Children need to be immunized to prevent illnesses such as hepatitis, measles and pertussis, polio, and diphtheria, among others. Immunization is also important for older adults, adults, and adolescents. Still, this paper will mainly focus on the immunization of children in the U.S. Roughly 3 million individuals worldwide die annually from diseases that can be prevented through immunization. Approximately half of these deaths are composed of young infants and children (Macintosh et al., 2017). Various barriers to immunization are identified. Some of these include trust issues, perceptions of safety, and healthcare cost and access. Maternal child nurses have an important role in increasing the immunization rate among children by taking part in outreach programs and health promotion activities that can be used to ease the burden of families and patients in getting access to immunization.

Health Promotion of Immunization

The World Health Organization reveals that immunization can lower the rates of inequity, death, disability, and disease (Andre et al., 2021). Childhood immunization programs offer extraordinary investment returns. For instance, Healthy People 2020 (2020) reveals that for every birth cohort vaccinated with the usual immunization schedule, society saves about 33,000 lives, lessens direct healthcare costs by about $9.9 billion, and prevents 14 million disease cases, saves $33.4 billion in indirect costs. Even though there are various benefits associated with the immunization of children, various factors have prohibited some individuals from having their children immunized.

Mass media health information, particularly in the form of information campaigns that usually send a homogenous message, has been considered highly successful in effecting anticipated changes in health behavior. However, when the media presents conflicting or mixed health information to the public, individuals tend to choose and interpret information that confirms the existing positions, a tendency known as confirmation bias (Qian, Chou & Lai, 2020). For instance, media coverage on the safety of the measles-mumps-rubella vaccine and its relationship with autism has cast doubts in the minds of many parents who choose not to vaccinate their children, to their detriment. Statista (2016) reveals that 77 percent of patients who refuse immunization claim the fear of connection to autism spectrum disorder as the main reason for refusal, and this is followed by concerns regarding added ingredients in the vaccine (71%) and worries about the child suffering other complications from the vaccine (70%).

Dengvaxia, a vaccine against dengue infection, is also another controversial subject. Some individuals argue that the vaccine can augment the risk of a more severe form of dengue for individuals who have not been vaccinated (Fatima & Syed, 2018). Even though the vaccine’s efficacy has been well documented, any controversies portrayed through the media cause hesitation among parents. Hesitancy related to the doubt of vaccine efficacy is only 23 percent (Statista, 2016). This means that even though a majority of people believe in the efficacy of immunization, any media-related misconceptions or doubts published have a major impact on the beliefs and perceptions of people regarding immunization. This shows the media’s strength in influencing individuals’ perceptions about immunization. Suppose media is used to highlight the positive roles as well as the benefits of immunization. In that case, there is a higher likelihood of success in facilitating increased immunization among children and infants.

Mandatory immunization in the U.S. also brings about various ethical issues. For instance, even though mandatory immunization is justified for reducing the risk of harm to others, some individuals cite coercion of the policies since some refuse immunization based on religious, personal, philosophical, or moral reasons (MacDonald et al., 2018). Other issues related to the hesitancy of immunization include lack of insurance coverage and cost of the vaccines, but this is considered a minor reason held by about 8 percent of the parents who do not immunize their children (Statista, 2016). Macintosh et al. (2017) highlight the important role nurses can play, claiming that nurses can improve knowledge and trust regarding immunizations in local communities by working with various global and local organizations to make immunization more accessible and affordable.

Health Promotion Goals

Health literacy has favorable impacts on the acceptability of immunization and vaccination. Awareness of the controversies that surround immunization is also important. The role of nurses is to invest more in educational interventions that promote compliance of individuals and communities to the country’s immunization program and engage various stakeholders to offer support for effective implementation (Sumile et al., 2020). To increase immunization rates among children, it will be important to use such stakeholders as the media, community and social workers, and government and non-governmental organizations to help promote these efforts.

The main and long-term goal is to enhance immunization rates among children in the U.S. in one year to reduce the burden of preventable disease. This goal will be met through several short-term goals. The first short-term goal is to increase immunization literacy among parents in 1 month. Most parents cite concerns about the probable side effects and harm that can be caused by immunization on children. Immunization literacy will help eliminate parents’ misperceptions and build their trust. This can be done by engaging participants in an in-depth education about immunization, its benefits, and probable side effects whenever they visit hospitals. It is important to focus on the benefits of immunization since ASTHO (2020) reports that these positive messages are highly convincing and believable, and making use of emotional and personal messages and stories tends to be more effective as opposed to making use of scientific studies, which might fail to resonate with mothers. Literacy rates can also be enhanced through media channels such as social media, magazines, televisions, and even billboards. The media has an important role in educating the public and in swaying their opinions about immunization, hence the need to use media platforms to communicate positive messages regarding immunization. In general, this goal requires the efforts of nurses, media personnel, and community members and agencies that will be involved in educating parents about the importance of immunization.

The second goal is to increase immunization accessibility 1 month. This requires ensuring its affordability by working with different global and local organizations that can sponsor immunization and related campaigns. Generally, meeting these goals will help improve immunization rates in different communities in the U.S. to help in disease prevention and general health promotion.


Andre, F.E., Booy, H.L., Bock, H.L., Clemens, J., Datta, S.K., John, T.J., Lee, B.W., Lolekha, S., Peltota, H., Ruff, T.A., Santosham, M.,& Schmitt, H.J. (2021). Vaccination greatly reduces disease, disability, death and inequity worldwide. World Health Organization, 86(2):81-160.

Fatima, K., & Syed, N. I. (2018). Dengvaxia controversy: impact on vaccine hesitancy. Journal of global health8(2), 020312.

Healthy People 2020. (2020). Immunization and Infectious Diseases. Retrieved from

MacDonald, N. E., Harmon, S., Dube, E., Steenbeek, A., Crowcroft, N., Opel, D. J., … & Butler, R. (2018). Mandatory infant & childhood immunization: Rationales, issues and knowledge gaps. Vaccine36(39), 5811-5818.

Macintosh, J. L., Eden, L. M., Luthy, K. E., & Schouten, A. E. (2017). Global immunizations: Health promotion and disease prevention worldwide. MCN: The American Journal of Maternal/Child Nursing42(3), 139-145.

Qian, M., Chou, S. Y., & Lai, E. K. (2020). Confirmatory bias in health decisions: Evidence from the MMR-autism controversy. Journal of health economics70, 102284.

Statista. (2016). Most common reasons given to U.S. health care professionals by families for refusing vaccines or requesting alternative schedules as of 2016. Retrieved from

Sumile, E. F., Diric, J. H., Dorado, Z. M., Dumaua, K., Ecura, M. J. R., & Dumaya, J. M. (2020). Dengue Vaccine Controversy Awareness, Vaccine Health Literacy, and Vaccine Acceptability among Mothers in Select Rural Communities. Journal of Health and Caring Sciences2(2), 123-134.


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Child Immunization in the U.S

Develop a hypothetical health promotion plan, 3-4 pages in length, addressing a specific health concern for an
individual or a group living in the community that you identified from the topic list provided.
Teen Pregnancy.
LGBTQIA + Health.
Sudden Infant Death (SID).
Tobacco use (include all: vaping, e-cigarettes, hookah, chewing tobacco, and smoking) cessation.
Historically, nurses have made significant contributions to community and public health with regard to health
promotion, disease prevention, and environmental and public safety. They have also been instrumental in shaping
public health policy. Today, community and public health nurses have a key role in identifying and developing plans
of care to address local, national, and international health issues. The goal of community and public health nursing is
to optimize the health of individuals and families, taking into consideration cultural, racial, ethnic groups,
communities, and populations. Caring for a population involves identifying the factors that place the population’s
health at risk and developing specific interventions to address those factors. The community/public health nurse
uses epidemiology as a tool to customize disease prevention and health promotion strategies disseminated to a
specific population. Epidemiology is the branch of medicine that investigates causes of various diseases in a specific
population (CDC, 2012; Healthy People, n.d.).
As an advocate and educator, the community/public health nurse is instrumental in providing individuals, groups,
and aggregates with the tools that are essential for health promotion and disease prevention. There is a connection
between one’s quality of life and their health literacy. Health literacy is related to the knowledge, comprehension,
and understanding of one’s condition along with the ability to find resources that will treat, prevent, maintain, or
cure their condition. Health literacy is impacted by the individual’s learning style, reading level, and the ability
understand and retain the information being provided. The individual’s technology aptitude and proficiency in
navigating available resources is an essential component to making informed decisions and to the teaching learning
process (CDC, 2012; Healthy People, n.d.).
It is essential to develop trust and rapport with community members to accurately identify health needs and help
them adopt health promotion, health maintenance, and disease prevention strategies. Cultural, socio-economical,
and educational biases need to be taken into consideration when communicating and developing an individualized
treatment and educational plan. Social, economic, cultural, and lifestyle behaviors can have an impact on an
individual’s health and the health of a community. These behaviors may pose health risks, which may be mitigated
through lifestyle/behaviorally-based education. The environment, housing conditions, employment factors, diet,
cultural beliefs, and family/support system structure play a role in a person’s levels of risk and resulting health.
Assessment, evaluation, and inclusion of these factors provide a basis for the development of an individualized plan.
The health professional may use a genogram or sociogram in this process.
What is a genogram? A genogram, similar to a family tree, is used to gather detailed information about the quality
of relationships and interactions between family members over generations as opposed to lineage. Gender, family
relationships, emotional relationships, lifespan, and genetic predisposition to certain health conditions are
components of a genogram. A genogram, for instance, may identify a pattern of martial issues perhaps rooted in
anger or explain why a person has green eyes.
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3/30/2021 Assessment 1 Instructions: Health Promotion Plan – … 2/4
What is a sociogram? A sociogram helps the health professional to develop a greater understanding of these factors
by seeing inter-relationships, social links between people or other entities, as well as patterns to identify vulnerable
populations and the flow of information within the community.
Centers for Disease Control and Prevention. (2012). Lesson 1: Introduction to epidemiology. In Principles of
Epidemiology in Public Health Practice (3rd ed.). (n.d.).

Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course
competencies and assessment criteria:
Competency 1: Analyze health risks and health care needs among distinct populations.
Analyze a community health concern that is the focus of a health promotion plan.
Competency 2: Propose health promotion strategies to improve the health of populations.
Explain why a health concern is important for health promotion within a specific population.
Establish agreed-upon health goals in collaboration with participants.
Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve
population health.
Organize content so ideas flow logically with smooth transitions; contains few errors in
grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA

Note: Assessment 1 must be completed first before you are able to submit Assessment 4.

The first step in any effective project or clinical patient encounter is planning. This assessment provides an
opportunity for you to plan a hypothetical clinical learning experience focused on health promotion associated with
a specific community health concern. Such a plan defines the critical elements of who, what, when, where, and why
that establish the foundation for an effective clinical learning experience for the participants. Completing this
assessment will strengthen your understanding of how to plan and negotiate individual or group participation. This
assessment is the foundation for the implementation of your health promotion educational plan (Assessment 4).
You will need to satisfactorily pass Assessment 1 (Health Promotion Plan) before working on your last assessment
(Assessment 4).
To prepare for the assessment, consider various health concerns that you would like to be the focus of your plan
from the topic list provided, the populations potentially affected by that concern, and hypothetical individuals or
groups living in the community. Then, investigate your chosen concern and best practices for health improvement,
based on supporting evidence.
As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Effective Interpersonal
Communications activity. The information gained from completing this activity will help you succeed with the
assessment. Completing activities is also a way to demonstrate engagement.
For this assessment, you will propose a hypothetical health promotion plan addressing a particular health concern
affecting a fictitious individual or group living in the community. The hypothetical individual or group of your choice

3/30/2021 Assessment 1 Instructions: Health Promotion Plan – … 3/4
must be living in the community; not in a hospital, assistant living, nursing home, or other facility. You may choose
any health issues from the list provided in the instructions.
In the Assessment 4, you will simulate a face-to-face presentation of this plan to the individual or group that you
have identified.
Please choose one of the topics below:
Teen Pregnancy.
LGBTQIA + Health.
Sudden Infant Death (SID).
Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation.
In addition, you are encouraged to:
Complete the Vila Health: Effective Interpersonal Communications simulation.
Review the health promotion plan assessment and scoring guide to ensure that you understand the work you
will be asked to complete.
Review the MacLeod article, “Making SMART Goals Smarter.”
Note: Remember that you can submit all, or a portion of, your draft assessment to Smarthinking Tutoring for
feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of
the turnaround time of 24–48 hours for receiving feedback.


Health Promotion Plan
Choose a specific health concern as the focus of your hypothetical health promotion plan. Then, investigate
your chosen concern and best practices for health improvement, based on supporting evidence.
Teen Pregnancy.
LGBTQIA + Health.
Sudden Infant Death (SID).
Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation.
Describe in detail the characteristics of your chosen hypothetical individual or group for this activity.
Discuss why your chosen population is predisposed to this health concern and why they can benefit from a
health promotion educational plan.
Based on the health concern for your hypothetical individual or group, discuss what you would include in the
development of a sociogram. Take into consideration possible social, economic, cultural, genetic, and/or
lifestyle behaviors that may have an impact on health as you develop your educational plan in your first
assessment. You will take this information into consideration when you develop your educational plan in your
fourth assessment.
Identify their potential learning needs.
Identify expectations for this educational session and offer suggestions for how the individual or group needs
can be met.
Health promotion goals need to be clear, measurable, and appropriate for this activity.
Document Format and Length
Your health promotion plan should be 3–4 pages in length.
Supporting Evidence

3/30/2021 Assessment 1 Instructions: Health Promotion Plan – … 4/4
Support your health promotion plan with peer-reviewed articles, course study resources, and Healthy People 2020
resources. Cite at least three credible sources published within the past five years, using APA format.
Graded Requirements
The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each
point. Read the performance-level descriptions for each criterion to see how your work will be assessed.
Analyze the health concern that is the focus of your health promotion plan.
Consider underlying assumptions and points of uncertainty in your analysis.
Explain why a health concern is important for health promotion within a specific population.
Examine current population health data.
Consider the factors that contribute to health, health disparities, and access to services.
Explain the importance of establishing agreed-upon health goals in collaboration with hypothetical
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation,
word choice, and spelling.
Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.
Write with a specific purpose and audience in mind.
Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

Before submitting your assessment for grading, proofread it to minimize errors that could distract readers and make
it difficult for them to focus on the substance of your plan.
Portfolio Prompt: Remember to save the assessment to your ePortfolio so that you may refer to it as you complete
the final capstone course.

Use the scoring guide to understand how your assessment will be evaluated.

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