Comprehensive Literature Review: Vaccination Studies and Findings

This report presents a comprehensive literature review of several studies related to vaccination. The review includes an analysis of articles by Fermbatch (2011), Groom et al. (2007), Miller et al. (2018), Tsai (2018), and Winter et al. (2018). Fermbatch's study focuses on ethical dilemmas faced by hea...Read More

Bibliographic Information
(APA Format, 6th ed.)
Design /
methods Sample and Setting
Level
and
Strength/
Quality
of
Evidence
(see
scale
below)
Key Findings Limitations
and Strengths
Fermbatch, A., 2011
The method
was to review
literature in
order to
explore the
reasons for
which
parents
refuse to
vaccinate
their children
and the
ethical
dilemmas
faced by the
caregivers.
Literature reviews were
searched using proper
keywords from various
databases such as
Google Scholar,
Cochrane, Pubmed.
Level – IV
Quality of
Evidence
– A (High)
Numerous
reasons are there
for which
parents oppose
to immunize
their children.
But, providing
necessary
information
regarding its
importance to
the parents can
help in building
trust which can
help to avoid
ethical
dilemmas.
No direct studies were conducted but the main
strength was lot of evidences found from the
literature review.
Groom, H., 2007 Using data
from the
National
Immunizatio
n Survey, the
immunization
coverage rate
from the year
1996 to 2004
were
compared
The NIS survey data
was collected to
compare the analysis
progress.
Level – IV
Quality of
Evidence
– C (Low).
In order to
increase the
coverage among
children,
irrespective of
income,
residential
group, race as
well as
ethnicity, equal
emphasis should
There were many limitations. The study used data
from particular two years. Because of small sample
size, there were huge exclusions. Due to small
sample size, sufficient power was not present to
detect the differences. However, the strength was
the reliability of the evidences found.

among the
children aged
from 19 to 35
months.
be placed in the
public and
private
providers.
Miller, K., 2018
The method
was to review
different
researches
and findings
to extract
strong
evidences.
No specific sample size
is there.
Level – III
(Non-
experimen
tal study).
Quality of
Evidence
– A
(High).
Importance of
HPV has been
learned from the
success of many
countries and
healthcare
providers should
commit to
provide HPV
coverage among
countries.
The potential of HPV vaccine to prevent morbidity
was not clear for the United States but evidences
from different studies and findings were enough to
reach to the conclusion.
Tsai, Y., 2018
The study
used the
Medicaid
analysis
extract data
from the year
2008 to 2012
and included
children from
the age 0-17
to experiment
the data
finding.
Apart from the
Medicaid analysis
extract data, the sample
size was 1678288.
Level –II
(Quasi
experimen
tal study)
Quality of
Evidence
– A
(High).
It was found that
higher Medicaid
reimbursement
for the vaccine
administration
was associated
with the
increased
proportion of
children who are
receiving
immunization
services.
The study had some potential limitations.
Unobserved factors could bias the estimates, and
also, the findings do not apply to the payment
structure in the Medicaid managed-care programs.
The large sample size is the strength of the study.
Winter, K., 2018 Data of
California
Pertussis
Surveillance
of specific
age groups
were
calculated for
different
The pertussis cases of
20 years age and
younger from 2010 to
2014 were the sample
data.
Level – IV
Quality of
Evidence
– A
(High).
The result
revealed that an
increase in
parental Tdap
has some impact
on the infant
pertussis.
The study was unable to control all the time-
dependent factors and also the data was incomplete
which could create bias. However, the large
amount of evidence was the main strength.

years.
Level of evidence for primary sources fits into the broad categories of study designs (listed from highest to lowest):
Level I Experimental study/randomized controlled trial (RCT) or meta-analysis of RCT
Level II Quasi-experimental study (non-randomized control studies, before and after studies, interrupted time series)
Level III Non-Experimental study, qualitative study, or meta-synthesis (cohort studies, case-controlled studies)
Level IV Opinion of nationally recognized experts based on research evidence or expert consensus panel
Level V Opinion of individual expert based on non-research evidence
Quality/Strength of Evidence:
A (High) – Consistent results, sufficient sample size, adequate controlled, and definitive conclusions; consistent recommendations based on extensive literature review that
includes thoughtful reference to scientific evidence. Very confident that the estimate of effect lies close to the true effect of this outcome.
B (Good) – Reasonably consistent results, sufficient sample size, some control, and fairly definitive conclusions, reasonably consistent recommendations based on fairly
comprehensive literature review that includes some references to scientific evidence. Moderately confident that the estimate of effect lies close to the true effect for this
outcome.
C (Low/Major flaw) – Little evidence with inconsistent results, insufficient ample size, conclusions cannot be drawn. Limited confidence that the estimate of effect lies close
to the true effect for this outcome.
I (Insufficient) – No evidence and unable to estimate an effect or have no confidence in the estimate of effect for this outcome.
(This scale can vary depending on what system is used. The scale above is based on the Agency for Healthcare Research and Quality (AHRQ) Methods Guide for Comparative Effectiveness Reviews and the John
Hopkins Nursing Evidence-Based Practice Evidence Level and Quality Guide)
Literature summary:Write a synthesis of the key findings of the papers. Discuss how the literature supports or does not support your problem
statement. If the literature does not support the problem statement, indicate what additional searches you would suggest to identify literature to
support your problem statement. (500 word max)

In the literature, the author Fermbatch was focused to find the ethical dilemmas faced by the healthcare providers from the parents while immunizing their
children. The literature provided a lot of evidences and it could establish the conclusion along with the main findings of the study. The goal of the study was
achieved as well. Therefore, it can be said that the problem statement was appropriately addressed (Fernbach, 2011). Again, the author Groom was focused to
compare the immunization coverage rate among children. However, the study has limitations and further research was required to address the gap regarding the
lack of evidence (Groom, Kolasa, Wooten, Ching & Shefer, 2007). In his article, the main target of the author Miller was to find the importance of HPV in
different countries. However, there were limitations, as potential of HPV to prevent morbidity rate in the United States was not clear. Further research to cover the
gap is essential (Miller, Dilley & Huh, 2018). In the article, the author Tsai had the target to find the payments and utilization of the immunization services among
the children who are enrolled in the fee-for-service Medicaid. The Medicaid analysis data from the year 2008 to 2012 were extracted in this regard. Also, the
sample size included children from the age 0 to 17 and the number of children included was quite large. However, the author mentioned the limitations of the study
such as bias in the estimates and gap in the payment structure. But, the strength due to large sample size helped to extract the study findings easily (Tsai, 2018).
The author Winter in his article was focused to find data about Pertussis in California. Data of California Pertussis Surveillance was considered in this regard. The
amount of evidence was high but the study had several limitations as well. The incomplete data could create bias and the time-dependent factors were also not
controlled which could produce error in the findings. Future research to address this issue should be considered (Winter, Zipprich & Harriman, 2018).

References
Fernbach, A. (2011). Parental rights and decision making regarding vaccinations: Ethical dilemmas for the primary care provider. Journal of the American
Academy of Nurse Practitioners, 23(7), 336-345.
Groom, H., Kolasa, M., Wooten, K., Ching, P., & Shefer, A. (2007). Childhood immunization coverage by provider type. Journal of Public Health Management
and Practice, 13(6), 584-589.
Miller, K., Dilley, S. E., & Huh, W. K. (2018). Lessons learned from domestic and international human papillomavirus vaccination programs: a review. American
journal of obstetrics and gynecology, 218(5), 467-473.
Tsai, Y. (2018). Payments and Utilization of Immunization Services Among Children Enrolled in Fee-for-Service Medicaid. Medical care, 56(1), 54-61.
Winter, K., Zipprich, J., & Harriman, K. (2018). Pertussis in California: A tale of 2 epidemics. The Pediatric infectious disease journal, 37(4), 324-328.