Impact on health care organization
The development of vaccines is considered as one of the major scientific achievements in medicine. The prevalence, incidence, mortality, and morbidity of vaccine-preventable diseases have radically decreased since vaccination became accessible at the end of the 18th century. Ever since the discovery, the widespread use of vaccines has proven to be effective that some diseases were eventually declared eradicated from the U.S., including measles (2000) and rubella (2014) (Ventola, 2016). Despite such eradication announcements, Americans are once again being infected and even succumbing to preventable diseases thought to be history. The re-emergence of the preventable diseases is majorly linked to Anti-vaxxers (Omer et al., 2009). In spite of being documented as one of the effective healthcare measures, many people tend to view vaccination as unsafe and needless. The preceding vaccine confidence is flagging with some healthcare organization classifying it as a vaccine disaster of public trust. The United States has recently witnessed a momentous upsurge in the number of vaccine-preventable diseases such as mumps, whooping cough, and measles. For example, there has been a recent incident of measles outbreak uncovered in Disneyland visits. Vaccine non-compliance has been unfolding even as the benefits of vaccination remain undisputed. This paper aims to discuss the effects and risks of vaccine non-compliance as a preventive measure to infectious diseases on healthcare organizations, strategies for addressing the issue in a healthcare setting, and the role of healthcare managers in addressing the issue.
The trend of vaccine noncompliance has greatly impacted healthcare organizations. According to Sugerman et al. (2010) vaccine non-compliance costs the public health sector approximately $10,000 per case. Many hospitals continue to lose resources which remain underutilized when people remain hesitant for vaccination. With the increasing complexity of management of patients with infectious illnesses which are vaccine preventable, careful management of the very limited resources available to promote optimal outcomes is very difficult especially for public hospitals. According to CDC (2013), the development and testing of a single vaccine extend for more than a decade on average and costs millions of dollars. Non-compliance is, therefore, making these healthcare organizations incur a lot of losses. Also, the infected individuals require medical coverage which is also very costly to individuals and public health organizations which could otherwise be preventable using the implemented vaccines.
Risks
A major risk of vaccine non-compliance on any healthcare organization is the complexity of controlling an outbreak. The existence of Anti-vaxxers movements in U.S. and occurrences of non-medical exclusions in the country to vaccination legislations has accelerated the risks of not only acquiring but spreading preventable infections in children and adults. Retroactive group research on national surveillance shows that the comparative risks of being infected with measles were 95% higher among non-vaccinated children whose caregivers cited a non-medical exemption in comparison to immunized children (Brenzel et al., 2006). Parental non-compliance has been linked with epidemics of invasive varicella, measles, Haemophilus influenza type B disease, and pneumococcal disease (Omer et al., 2009) which are extensively challenging to control particularly if it is widely spread over a vast population. This lead to the loss of many lives which could have been easily prevented by vaccination as well hindering the performance and productivity of healthcare organizations. In 2008, approximately 44,000 incidences of invasive pneumococcal illnesses were reported which led to the death of more than 4,500 Americans (Omer et al., 2009). In 2009, HPV infections were responsible for the majority of cervical cancers; noncompliance led to equally severe and dangerous diseases even though a vaccine can prevent them. Similarly, non-compliance has also been linked to exacerbating health inequalities in healthcare organizations. This is because when an outbreak occurs, it is more likely for parents with higher socioeconomic status to make extra visits needed under the alternative schedules than those who have a lower socio-economic status.
Addressing the issue
Amplified attempts are necessary to enhance and uphold public trust in the vaccine to prevent infectious diseases. The key is for every healthcare organization involved to develop a meticulous vaccine safety structure that takes the merits of scientific methods and advanced technologies accompanied by operative communication techniques to discourse immunization fears (Sugerman et al., 2010). Organizations need to develop and rigorously evaluate evidence-based interventions to minimize if not eradicate vaccine hesitancy. Predominantly beneficial would be tools to support health providers in efficiently collaborating with people having concerns using vaccines (Salmon et al., 2008). Additionally, vaccine training programs along with guidance from authoritative organizations such as ACIP and AAP can be implemented to assist providers in overcoming their doubts concerning the effectiveness and safety of monotonous childhood vaccination.
Additionally, improving vaccination accessibility can also be used to address the issue in healthcare settings. This can be done by offering alternative venues for immunization, allowing walk-in visits, and providing availability during extended hours. Such services and programs have been shown to provide high-quality care, reach new patients and contain costs. The utility of this approach is evidenced by the success of retail pharmacy-based immunization programs. Influenza vaccines are the most commonly administered vaccine in pharmacies, but other vaccines are also available in such locations.
Further, preventive diseases can be eradicated by putting up counseling programs within the organization to influence patient’s acceptance and motivation regarding immunization (Omer et al., 2009). The counseling approaches should be individualizing the message concerning vaccine for each patient. Patients should be encouraged to accept the immunizations they need and be advised of infection risks. Any concerns about vaccine efficacy and safety should be discussed, and any misconceptions should be respectfully corrected using facts to address myths. It is the role of healthcare managers and providers to participate in such operations plan exercise actively.
Vaccine noncompliance can be reduced by implementing, maintaining, and recording patient vaccine administrations (Ventola, 2016). Healthcare providers should establish methods that deliver precise, timely information. Data systems that can be utilized include Contact Data Base for Health Professionals, Immunization Record Information System, integrated Public Health Information System, and Vaccine Ordering and Inventory.
This method provides a principle for reporting compliance standard for vaccine-preventable diseases that will prompt providers to determine their patient’s immunization needs and recommend appropriate vaccinations. One successful strategy for reducing vaccine noncompliance involved the use of EMR reminders identifying vaccination opportunities that were directed at primary care and emergency department physicians. EMRs also enable the long-term storage of medical records and provide an efficient method for the maintenance and retrieval of immunization records.
Role of the health care manager
Healthcare providers play a vital role in influencing the immunization compliance especially in parents to carb preventive diseases. They are referenced by most parents, including those whose children are unvaccinated, as the most regular information sources concerning vaccination. Healthcare managers are tasked with the responsibility of managing the delivery of vaccine-preventable disease programs and monitoring their performance (Ventola, 2016). They offer reliable and lucid leadership connected to organizing vaccine non-compliance crisis response. They are required to set tranquil and a confident tone, participate in scheduling and exercising epidemic plans by collaborating with other care providers outside their organizational jurisdiction. They are also obligated to motivate subordinate care providers in comprehending and managing the issues using incident command systems. Most importantly, they need to monitor their subordinates to make sure that accurate information is disseminated to the public.
Similarly, healthcare managers can act as advocates against national policies that exempt a portion of the population from being vaccinated. They can also develop operational, organizational strategies and measures associated with the control of vaccine-preventable diseases and outbreak control (Salmon, 2008). Example of such policies and procedures include using patient notification. In ambulatory care settings, successful strategies to increase adult vaccine compliance have included patient recall/reminder letters or text messages. Patients can also be contacted about needed vaccinations by form or individualized letter mailings, by telephone, or with inserts included with prescriptions. Adhesive reminder labels with messages such as, “You may need the flu or pneumonia vaccine, ask your pharmacist or doctor,” can also be affixed to prescription containers. For inpatients or institutionalized patients, one-on-one conversations can also be an effective means of notifying patients about needed vaccines.