Community Health: Child and Adolescent Immunization Report, HNN300

This report delves into the critical aspects of child and adolescent health, specifically addressing the significance of immunization, particularly the influenza vaccine, within the context of a community health clinical placement. The report centers on a case study involving a one-year-old infant, Beth, and her mother, Ashley, who is hesitant about the influenza vaccine due to a previous negative experience. The study explores the benefits and risks of influenza vaccination, evidence-based recommendations for infant immunization, and effective strategies for MCH nurses to engage in family-centered communication. The report emphasizes the role of nurses in providing accurate information, addressing parental concerns, and promoting informed decision-making regarding child health. It covers the importance of person-centered approaches and the use of visual aids to facilitate communication. The report concludes by reinforcing the importance of immunization in preventing influenza and improving child development.

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Introduction
The spread of Influenza is one of the most detrimental health issues and the headlines
stating “Doctors urge Australians to get a flu vaccine after virus claims 68 lives” is the highlight
of that growing concern (The Guardian, 2019). Given the low immunity of children, the infants
are more susceptible to the influenza infection than the adults, thereby making the flu vaccine an
essential part of their immunisation protocol post completion of six months of age (WHO, 2015;
Shakib et al., 2016). The healthcare of a child is important as it is the foundation of adolescent
health. Services related to health care are provided to support the development and wellbeing of
children (Flannery et al., 2017).
The medical experts along with the nurses play a significant role in recognizing the
factors which will impact the development and growth of a child (Zaman et al., 2018). This study
focuses on the case of Ashley and Beth in which immunization is the main area of focus. The
immunization assists in reducing the risk of developing adverse effects from a disease and
promotes better immunity in infants. However, in this given scenario, vaccination of one year old
infant Beth against influenza virus is denied by her mother Ashley as she is reluctant towards it.
Her hesitation is due to her unfavourable experience as she had caught flu after influenza
vaccination, during her pregnancy, thus Ashley is reluctant as she thinks Beth will catch the flu
too after vaccination.
The study will aim to present several evidences which is used by MCH nurses to deliver
the right information to Ashley and help her understand the risks and benefits of flu vaccine, so
that Ashley can make the judgement wisely. The objective of the study would also encompass
providing strategies used by MCH nurses to promote family-centred communication along with

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discussing strategies to promote immunization in infants in order to reduce the ill effects of the
influenza infection.
Benefits of influenza vaccination
Influenza virus is ubiquitously present and causes a huge health burden across the globe
(WHO, 2015). The best method to reduce the health risks caused by influenza is with vaccination
(CDNA, 2018). However, the vaccines that are being used conventionally have their effect for a
very short period of time and the influenza virus with its developed ability of antigenic drift can
overcome the effect of immunization thereby making the flu vaccine valid for a year (Chow et
al., 2017). The infection with influenza virus results in cardiovascular complications, respiratory
diseases and in even death of infants in some cases (Dempsey & Zimet, 2015).
Vaccination has proven to reduce the risk factors associated with infant's health from
seasonal influenza worldwide (WHO, 2018). Firstly, the benefits which are observed for
immunization against influenza includes reduced hospitalisation along with low chances of death
as successful vaccination has led to a reduction in the number of paediatric deaths (AuG,
Department of Health, 2018). Many researches have reported that death due to influenza was
primarily due to the absence of vaccination (WHO, 2018). Secondly, the severity of influenza
infection can be noted post flu vaccination along with a decrease in the risk of cardiac events as
the vaccination against influenza assists in preventing heart attacks (Douthit et al., 2015).
Thirdly, the influenza vaccine also protects pregnant ladies as the risk associated with respiratory
infection has been seen to decrease by 50 % in pregnant women (Savitz et al., 2015).
Risks of influenza vaccination
The risk with influenza vaccination is as low as one to two cases in million vaccinations
among infants and adolescents (NSW, 2019). Influenza vaccines might lead to development of

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side effects along with allergic reaction however, the chances of occurrence of adverse effect due
to flu vaccine is extremely rare. The side effects of the flu vaccine are generally mild and go
away on their own within a few days (AuG, Department of Health, 2018).
Common side effects from the flu shot include soreness, redness along with swelling from
the shot, fever, headache, nausea, muscle aches along with low chances of fainting (CDNA,
2018). Few studies have reported development of Guillain-Barré syndrome after administration
of Flu vaccine however the risk of acquiring Guillain-Barré syndrome post flu vaccination is less
than than 1-2 chances per one million vaccinations (NSW, 2019).
Risks associated with refusal of influenza vaccination
Ashley had the unfortunate experience of developing the flu after her influenza
vaccination during pregnancy which has made her hesitant during flu vaccination of her one year
old infant, Beth. Ashley must deliberate the vaccination as medical experts worldwide
recommend flu vaccination to infants along with pregnant women (WHO, 2015). Post influenza
vaccination, the individual has enhanced immunity against influenza virus and low risk of
acquiring the disease (CDNA, 2018). Even if the person catches the flu post vaccination, the
immunization prevents development of severe risks associated with the manifestation of
influenza infection along with reducing the chances of hospitalization (WHO, 2015).
Recommendation
Young children could be administered influenza vaccine after 6 months since birth
(WHO, 2018). As infants are immunologically inexperienced to the influenza, 2 doses of the
influenza vaccine are essential when they are being immunised for first time as this maximises
immune response to the strains of influenza in the vaccine (AuG, Department of Health, 2018).
The vaccination against additional strains like the influenza B lineage present in the vaccine

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mixture is particularly beneficial and therefore highly recommended for the children (NSW,
2019).
All influenza vaccines accessible in Australia either are split virion or are subunit
vaccines (Beyer et al., 2017). The vaccines are inactivated purified sterile influenza virus which
has been cultured in the embryonated eggs of hens (WHO, 2018). The inactivated quadrivalent
influenza vaccines or the QIV contain total four strains of influenza virus of two influenza
subtype A and two influenza subtype B lineages. Although the QIVs have been enumerated for
usage in Australia from 2014, it has gained popularity since 2016 (AuG, Department of Health,
2018). On the other hand, the trivalent influenza vaccines or the TIV has been available since
1970 which contains three influenza virus strains namely two influenza subtypes A and one
influenza subtype B (Andrews, McMenamin & Durnall, 2014). QIV is a modified version of the
TIV with additional influenza subtype B lineage (Castilla, Martínez-Baz & Martínez-Artola,
2013).
The recommendation for infants who are aged between 6 months to 3 years is
intramuscular injection of quadrivalent inactivated influenza vaccine in which each 0.25 mL of
monodose pre-filled syringe contains 7.5 μg of haemagglutinin of all the four recommended
influenza virus strains, 50 μg of formaldehyde, 125 μg of octoxinol 9 along with 0.5 μg of
ovalbumin and must be administered twice, four weeks apart (WHO, 2018).
Two strategies for promotion of effective family centred communication
Nurses need to take effective steps to promote family centred approach on the children’s
good and safe health. Influenza is a very common disease which can create a major impact on the
growth and development of an infant (Britto et al., 2017). In the case of Ashley, she is concerned
about her child Beth as she thought Beth might get affected with flu. In such a case, nurses

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should make her understand that this vaccine is not harmful to her child, and it is for her safe
health and better growth.
To make her understand nurses need to provide positive effects of influenza vaccination
which includes information like influenza vaccination can potentially reduce the mortality are of
the human being. According to the research, influenza vaccination reduces mortality rate by 29%
along with 42% reduction of viral complication including cardiac issues post administration of
the influenza vaccination (Beyer et al, 2017). Most of them developed some other kind of serious
illness like pneumonia, swine flu, etc. these are also the reason behind not given the vaccination
at a proper age an time (Blyth et al., 2016).
Person-centred approach
Person-centred therapeutic approach is a humanistic way of approach which deals with
ways through which individuals can perceive themselves, instead of external medium for the
intervention (Paciello et al., 2016). In person centred approach, the nurses can focus entirely on
the scenario at hand and provide evidences to assist Ashley make the right choice for the good
health of her child. She was unfortunately infected with influenza during her pregnancy after
taking flu vaccine (Pebody et al., 2015). Ashley might have gotten sick due to some other
respiratory viral attack or it could also be that she might have had flu like symptoms but it was
due to some other disease. It could also be that her vaccine dose did not get much time to
develop the immune protection required to fight the virus. The MCH nurses must ensure that she
has sufficient information for a clear and better perception on vaccination (Paciello et al., 2016).
Use of visual aid to present data
The communication with the parents could also be enhanced with the aid of visual
medium to present information and evidence based data to effectively convey the benefits and

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risks of vaccination (Mammen, 2016). The MCH nurses must highlight how vaccination is
recommended by WHO and healthcare professionals worldwide. The development of good
presentation will help in easing the process of communication about the influenza vaccination as
she is reluctant and has an unpleasant past experience (Hersh, Salzman & Snyderman, 2015).
The most indispensable step is to encourage Ashley by providing accurate, evidence supported
information (Ditsungnoen et al., 2016).
Conclusion
The vaccination against Influenza virus is recommended for individuals of all age groups
especially infants with the motive of preventing flu along with increasing the development
process. Even if the parents are reluctant to vaccinate their children, the MCH nurses must
communicate with them, encourage them by citing the benefits of immunization along with
providing evidence based data and information on how influenza virus reduces chances of
mortality amongst infants along with minimizing the adverse effects of the influenza infection.
Therefore, in conclusion, use of visual aid along with person centred approach would be
effective in communicating the benefits of vaccination against influenza virus with the parent of
the concerned child.

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