Nursing-Immunization Provider

Running Head: NURSING-IMMUNIZATION PROVIDER
Nursing-Immunization Provider
Name of the Student:
Name of the University:
Author Note:

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Answer 1:
The provided case study is about a 5-year old child, Mia whose parents Albert and Rose are
separated. Albert is keen on administering Mia with the outstanding vaccine dosages. But
Mia’s mother, Rose is reluctant in permitting completion of the outstanding dosages of
vaccines for her daughter since she is very anxious regarding the allergic reactions as well as
the adverse effects that may come in the way post the vaccination session. The concern of
Albert is justified with respect to his aboriginal heritage in which immunization coverage can
add up to a percentage of 72%. It is also evident that Albert is concerned about the outbreak
of pertussis in his locality and he is aware that Mia is at high risk of acquiring the disease if
she is not immediately vaccinated. Albert also wants Mia to be vaccinated against the
influenza virus based on his aboriginal background Mia is prone to get infected with
influenza. There is another rationale for Albert’s request for immunization is the risk of the
new born to be exposed to the diseases that can be prevented through vaccinating and
immunizing considering the Pertussis breakout. This scenario has seemingly evoked an
ethical dilemma. It is stated in the Australian Legislation on Children’s rights that the
decision taken regarding the consent or refusal of the treatment for their child should be for
the best interest of the child (Omer, Betsch and Leask, 2019). The decision in regards to the
concerns like medical prescription, vaccination or splint of a fractured bone or similar
instances. It is to be noted that these decisions aid in promoting the physical health of the
child and exploits the best interest in their regards (Dalton-Brown, 2018). Additionally,
Australian Legislation in relation the children’s right claims that in consideration of the
separated parents, the consent of the parent bearing the custody of the child that is, the parent
with whom the child is living at present and at the time of the medical urgency is considered
for the treatment of the child (Attwell et al., 2018). It is further stated that with reference to
the case of separated parents, it is important to keep the other custodial pare informed and

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updated about the medical procedure that should be undertaken by their child in course of the
treatment procedure (Jeffery, 2015).
The case study of Mia shows similar concerns of Albert in order to get his daughter
immunized to prevent the occurrence of disease in her and this is the best fit choice for Mia
and would promote her physical health. It should also be noted that the immunization of Mia
will directly impact the safety of the new born baby. Thus, based on the legislation the
process of immunization for Mia can be proceeded with, without the consent of her mother,
Rose. This process will not violate the laws with respect to the Australian Legislation for
children’s right (Yang and Studdert, 2017).
Answer 2:
Rose is the biological mother of Mia, who is worried about the adverse effects and the
allergic reactions that might occur after the immunization. This is the reason for her to not
give consent for the vaccination of Mia. It should be noted that vaccine hesitancy can be
considered as a primary problem in the reference to Australian context (Chow et al., 2017). It
should be considered that immunising Mia against the diseases Pertussis and Influenza is
crucial with respect to the fact of her being unaffected by the diseases. Administering the
vaccinations which she had missed post 18 months ensures that she will not acquire the
preventable diseases for which she has been vaccinated. A counselling session for Rose
should be arranged and she should be educated about the urgency to get Mia vaccinated and
the rationale for the vaccination. A communication strategy would aid in imparting an
efficacious health education and ensures that the awareness regarding the total vaccination
coverage for the indigenous community (Rozbroj, Lyons and Lucke, 2019) should also be
explained to Rose. Rose should be educated about the Pertussis outbreak in the community
where Mia resides and the risk of Mia in acquiring the disease if she is not administered with

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the vaccine. Rose should be enlightened by the nurse about the positive impact of the
vaccination and the required number of doses required for Mia. The nurse should explain all
this in details and in a manner that is understandable by Rose so that effectively she can
comprehend the same. To make this simpler the nurse should exploit graphic images and
power point presentations. The nurse can use informative videos for better understanding.
Exploitation of educational tool also aids in formulating better understanding with regards to
the process of immunisation and the positive impact of the same (Possenti et al., 2019). The
nurse should avoid the use of scientific and complicated medical terminologies that might
affect the thinking of Rose and might impact her decision. The nurse should ensure an open
communication with Rose in the counselling session to understand her issues and clarify her
doubts and aid to get rid of her misunderstandings. The health care provider should address
Rose in a non-judgemental manner and not impose things on her. The nurse should spend
ample time with Rose and should not rush to conclusions and also undertake suitable
measures to reduce her concerns. The nurse should also exploit the nursing guide to enlighten
Rose about the need and advantages of vaccination and immunization. A second counselling
session should also be arranged for Rose if she is not totally convinced. Exploitation of
empowered strategies and efficacious communication can help Rose to combat her mind
block and provide consent for Mia’s vaccination. It can be concluded that it is indeed
challenging to tackle the hesitancy of the people with respect to immunization (Zhang et al.,
2019).
Answer 3:
I would ensure that Rose is educated and prepared accordingly if there is any potential AEFI,
Adverse Effect following Immunization. Not only Rose I would educate both the parents
regarding AEFI. They should immediately admit Mia to adverse events clinic if any
symptoms regarding anaphylaxis is observed. They should make the baby lie down on her

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back and they should be prepared with an anaphylactic kit (McNeil et al., 2016). Rose and
Albert should be educated about the immediate steps to be taken to manage the anaphylaxis
symptoms. They should not panic and that bleeding and vomiting are also symptoms of the
allergy and they should take the required steps. They should cover Mia with a blanket and
also loosen any tight clothes that the child is wearing. They should not offer anything to the
baby to drink. They should also act accordingly to prevent the child from choking if they are
bleeding from the mouth and they should also be alert of the cessation of breath. I would
educate the parents about the CPR technique and they should follow 100 uninterrupted
choking process for a time period of about 100 minutes and they should contact the
emergency and wait for the paramedics to arrive (Dreskin et al., 2016). They should resort to
an emergency even if the symptoms are improving in the child since literature studies state
that the post anaphylaxis symptoms can re-occur. Hence, for the safety of the child he should
be monitored for the vital signs in the hospital. I would educate Mia’s parents regarding the
administration of adrenaline while experiencing the symptoms of anaphylaxis. Parents will be
educated repeatedly and in a non-judgemental fashion not to be stressed and not to panic and
that if managed at the right time these symptoms are absolutely controllable.
I would educate the parents regarding the symptoms like respiratory distress, cardiovascular
problem, gastrointestinal distress they should immediately aid to emergency regarding AEFI.
I would educate about the importance of reporting AEFI aids in better identification and
understanding of the safety concerns in regards to vaccination. It also aids to monitor and
assess the rates of AEFI across the Australian territory. I will provide them with Queensland
TGA contact. I will educate them about the TGA website and ask them to report the event on
the National Adverse Event Following Immunization Reporting Form. I would advise the
parents that in case the child encounters discomfort at the site of vaccination then they should
be administered low dosage of paracetamol. In case of anaphylaxis event that is experienced

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by Mia her parents should consult the emergency and enquire regarding revaccination. If they
go for subsequent vaccination then they should prefer supervised vaccination. They should
also resort to a physician before getting the subsequent immunization. This act would ensure
safety of Mira and also prevent the recurrence of any adverse effect.
Answer 4:
In accordance to the World Health Organisation, anaphylaxis can be termed as a unique
allergic reaction that can manifest itself in case of multiple vaccines. It can lead to fatal
consequences if not treated effectively. This syndrome is rarely observed as a consequence of
vaccination. This situation arises due to the reaction of the immune system against the
vaccine antigen. This immune reaction can either be local or systemic which confers to the
severity of the anaphylactic response. The typical symptoms of allergic reactions may include
wheezing, swelling of the throat or mouth, breathing distress, shocks, hives and hypotension.
In reference to the Australian clinical guidelines, the treatment of anaphylaxis is done by
administration of 10micrograms/kg or 0.01 ml/kg of 1:1000 of adrenaline intra-muscularly,
into the lateral thigh. This treatment should be administered every five minutes in case the
health condition is not improving of the child. In is the duty of the nurse to ensure that the
child should not stand up or make an attempt to walk.
I would ensure that Mia is assessed in regards to the symptoms of anaphylaxis that includes
pruritis, flushing, urticarial as well as general angioedema. Based on the literature studies it is
stated the 20% of the patients does not show any skin allergies in response to anaphylaxis.
Therefore, I would pay more heed to the other symptoms of anaphylaxis that includes
elevated respiratory rate, dyspnoea, cyanosis, wheezing, stridor and vomiting (Cheng et al.,
2015). I would exploit appropriate interventions with respect to the observed confirmatory
symptoms. I would prefer to administer adrenaline during such circumstances since it is

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considered as the most appropriate intervention strategy in the management of anaphylaxis.
Adrenaline has the ability to act on several receptors at the same time. This results in
constriction of the blood vessels that serves as the rationale for exploiting adrenaline to
combat anaphylaxis. This administration aids to combat the symptoms like swelling and
increase the blood pressure. Hence, efficaciously adrenaline administration would help in
reduction of the anaphylactic symptoms.
I would have to take Mia’s airway into consideration and exploit the required interventions. If
I detect any potential obstruction of the airway, I would ensure immediate arrangement for
intubation. The process of intubation would help to clear airway obstruction and prevent
angioedema. Since I am alone, I have to analyse the cruciality of the situation and decide
wisely and accordingly. I should ensure the intubation is done with professional expertise. I
have to be extremely cautious and attentive. I would execute urine test and also keep a watch
on the vital signs of the child, in order to analyse the outcome of the applied interventions. I
would assess the symptoms of anaphylaxis in the infant if no significant change is observed
or conditions deteriorate, I should be fast enough to change the intervention strategies in
order to gain positive outcome for Mia (Dreskin et al., 2016).

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References
Attwell, K., Navin, M.C., Lopalco, P.L., Jestin, C., Reiter, S. and Omer, S.B., 2018. Recent
vaccine mandates in the United States, Europe and Australia: a comparative
study. Vaccine, 36(48), pp.7377-7384.
https://www.sciencedirect.com/science/article/pii/S0264410X18313719
Cheng, D.R., Perrett, K.P., Choo, S., Danchin, M., Buttery, J.P. and Crawford, N.W., 2015.
Pediatric anaphylactic adverse events following immunization in Victoria, Australia from
2007 to 2013. Vaccine, 33(13), pp.1602-1607.
https://www.sciencedirect.com/science/article/pii/S0264410X15001747
Chow, M.Y.K., Danchin, M., Willaby, H.W., Pemberton, S. and Leask, J., 2017. Parental
attitudes, beliefs, behaviours and concerns towards childhood vaccinations in Australia: a
national online survey. Australian family physician, 46(3), p.145.
https://search.informit.com.au/documentSummary;dn=673785317893367;res=IELHEA
Dalton-Brown, S., 2018. Damaging the Future: The Health Rights of Children and the Issue
of Short-Termism; Issues Facing Australian Bioethicists. Cambridge Quarterly of Healthcare
Ethics, 27(3), pp.440-446. https://www.cambridge.org/core/journals/cambridge-quarterly-of-
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Dreskin, S.C., Halsey, N.A., Kelso, J.M., Wood, R.A., Hummell, D.S., Edwards, K.M.,
Caubet, J.C., Engler, R.J., Gold, M.S., Ponvert, C. and Demoly, P., 2016. International
Consensus (ICON): allergic reactions to vaccines. World Allergy Organization Journal, 9(1),
p.32. https://waojournal.biomedcentral.com/articles/10.1186/s40413-016-0120-5

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Jeffery, R.H., 2015. Vaccination and the law. Australian family physician, 44(11), p.849.
https://www.racgp.org.au/afp/2015/november/vaccination-and-the-law/
McNeil, M.M., Weintraub, E.S., Duffy, J., Sukumaran, L., Jacobsen, S.J., Klein, N.P.,
Hambidge, S.J., Lee, G.M., Jackson, L.A., Irving, S.A. and King, J.P., 2016. Risk of
anaphylaxis after vaccination in children and adults. Journal of Allergy and Clinical
Immunology, 137(3), pp.868-878.
https://www.sciencedirect.com/science/article/pii/S0091674915011604
Omer, S.B., Betsch, C. and Leask, J., 2019. Mandate vaccination with care.
https://www.nature.com/articles/d41586-019-02232-0
Possenti, V., Luzi, A.M., Colucci, A. and De Mei, B., 2019. Communication and basic health
counselling skills to tackle vaccine hesitancy. Annali dell'Istituto Superiore di Sanità, 55(2),
pp.195-199. http://www.annali-iss.eu/article/view/777
Rozbroj, T., Lyons, A. and Lucke, J., 2019. Psychosocial and demographic characteristics
relating to vaccine attitudes in Australia. Patient education and counseling, 102(1), pp.172-
179. https://www.sciencedirect.com/science/article/pii/S0738399118306001
Yang, Y.T. and Studdert, D.M., 2017. Linking immunization status and eligibility for welfare
and benefits payments: the Australian “no jab, no pay” legislation. Jama, 317(8), pp.803-804.
https://jamanetwork.com/journals/jama/article-abstract/2605810
Zhang, E.J., Chughtai, A.A., Heywood, A. and MacIntyre, C.R., 2019. Influence of political
and medical leaders on parental perception of vaccination: a cross-sectional survey in
Australia. BMJ open, 9(3), p.e025866. https://bmjopen.bmj.com/content/9/3/e025866.abstract