CNA341 Assessment: Vaccine Hesitancy Factors in Healthcare Essay

This essay delves into the critical issue of vaccine hesitancy, a growing concern in healthcare. It begins by defining immunization and its importance in preventing infectious diseases, highlighting its effectiveness and the significant impact on child well-being. The essay addresses the rise of vaccine hesitancy, exploring parental concerns, misconceptions, and the refusal or delay of vaccinations. It emphasizes the role of registered nurses in addressing this issue by utilizing the EBM triad (best external evidence, individual clinical expertise, and patient values) to understand and counteract vaccine hesitancy. The essay discusses effective communication strategies, the use of clear language, and the promotion of immunization as evidence-based practices. It presents a clinical research question on the factors contributing to parental vaccine hesitancy and potential solutions, along with the justification for using a qualitative research methodology. Furthermore, it outlines the sources of information, including databases like Scopus, PubMed, and others, and the keywords used to find relevant articles. The essay concludes by listing four articles that are relevant to the research question, providing a foundation for understanding the complexities of vaccine hesitancy and strategies to mitigate it. The assignment is aimed at identifying a topic that requires an evidence-based approach, and justifies its importance to nursing or healthcare practice.

CLINICAL RESEARCH QUESTION 1
Clinical Research Question

CLINICAL RESEARCH QUESTION 2
Clinical Research Question
Immunization refers to the process where a person is vaccinated to be protected from
infectious diseases. Children are commonly vaccinated against infectious diseases such as
influenza, polio, tetanus and whooping cough, measles, and mumps. These diseases are very
dangerous as they can cause disability such as polio and tetanus. Immunization works by
triggering the immune system of the body to protect the person against such deadly diseases.
According to (Kaufman et al., 2018), vaccination is a proven disease prevention strategy for
managing deadly infectious disorders. The vaccination approach is estimated to prevent 2 to 3
million deaths from deadly infectious disorders every year. It remains as one of the most
effective health approaches with demonstrative systems that is easily accessible to all people
even the most vulnerable group in the society. The current immunization strategies have clearly
targets groups mostly children under the age of ten years.
Immunizations have had a significant effect on the well-being of children around the
world. Besides, 99% ability of vaccination in prevention of infectious diseases has been regarded
as one of significant achievements in health sector in the last 50 decades (Nowak et al., 2015).
Nonetheless, over the previous decade, acknowledgement of its important in prevention of
infectious diseases has been scrutinized by several people. An increasing number of individuals
have been requesting an alternative option of vaccination, whereas others have been postponing
vaccination schedules. Besides, many parents have failed to believe in vaccination for fear of
their children’s safety. Some believe that vaccine causes pain to their children; others believe
that vaccines will make their children become sick or develop autism among many other
concerns (Kaufman et al., 2018).

CLINICAL RESEARCH QUESTION 3
The refusal of many parents to vaccinate their children has become a clinical issue that
needs to be addressed. The refusing or delaying of acknowledgement of immunization in spite of
its importance is referred to as vaccine hesitancy. It has become a complex issue in clinical
setting as many parents remain adamant to participate or take their children for vaccination.
The EBM triad constitutes three main components for decision making in health care.
The three components of EBM triad include best external evidence, individual clinical expertise
and patient values and expectations. The use of these three elements of EBM triad, a registered
nurse will be able to understand the issue of parent’s hesitancy to vaccine. Besides, the element
of evidenced-based practice will be critical for a registered nurse to find effective strategies and
best practices that can reduce the rate of parent refusal to vaccination. The EBP triad will help a
registered nurse to be able to clearly identify the patient health issue based on the assessment
carried out, be able to research the literature for applicable research, evaluate the research and
choose the best interventions for quality outcome.
According to (Nowak et al., 2015), communicating effectively about the vaccines to
parents is one of the key best practices for registered nurses for a quality outcome. The registered
nurses have the responsibility to commit themselves to maintain high vaccination rates. The best
practice, in this case, is effectively answering all parents’ questions regarding the vaccine,
providing educational materials, and ensuring that families make and keep vaccine appointments
as required. When it comes to vaccines, most parents consider health care specialists who are
able to provide trustworthy information on vaccines. This applies to all parents, even those who
are vaccine-hesitant as it is evidenced by (Williams, 2014). In many cases, parents have negative
attitudes toward the vaccine. This is because they often receive erroneous information and hear
emotional narrative accounts about the adverse effects of the vaccine. This becomes a challenge

CLINICAL RESEARCH QUESTION 4
for health caregivers to correct their misperceptions about vaccines. Therefore, registered nurses
have a critical role in helping parents choose effective vaccines for their children by providing
educative information about the merits and demerits of various kinds of vaccines. One on one
conversation, the use of billboards, posters, and radio ads have been evidenced as some of the
best ways of providing education to parents who are hesitant to vaccines.
The other good practice for registered nurses is to use simple, clear language while
presenting evidence of risks of illness and vaccine benefits in an accurate way. Many parents
believe that their children are at lower risk for infection disorders because of their good health
and their privileged socioeconomic status. As a registered nurse, one should be aware of the
language to use. Besides, one should use clear and understandable vocabulary that can describe
the risks of illness and the vaccines available. It is often helpful to identify how certain illnesses
can have a serious complication.
Participating in the promotion of immunization strategy is another evidence-based
practice that a registered nurse can practice in order to solve the issue of parent hesitancy (Sadaf
et al., 2013). Nurses can promote immunization meeting the community groups and provide
advice and guidance on vaccination. This can be evidenced from(Sadaf et al., 2013), which
indicates that as a result of nurses participation in immunization promotion, the rate at which
parents attended their children to the influenza vaccine increased from 25 percent to 48 percent.
As a result, the rate of influenza virus infection reduced from 19 percent to 9 percent. The
findings indicate the participation of nurses in the promotion of immunization is one of the best
practices in reducing parent’s hesitancy to vaccination.

CLINICAL RESEARCH QUESTION 5
The research question that I am going to use is “What are the factors that contribute to
parental vaccine hesitancy, and what can we do about it? The question is highly identical to my
topic. The type of research methodology that can be utilized to answer the above clinical
research question that I have formulated is a qualitative method (Williams, 2014). This is
because the qualitative methodology is the best research strategy that can be used to answer my
clinical question. The approach aims to seek a depth understanding of social phenomena. It is an
approach that points out why by giving a significant message about issues linked to beliefs,
emotions, and behaviours of certain phenomena. In this case, the qualitative methodology will be
able to provide extensive information on why parents fail to allow their children to attend
vaccines and their beliefs about the vaccine. With the identified information, I will be able to
understand the factors that are linked to parental hesitance to immunization and what strategies
or best practices can be laid out to avoid the hesitancy.
There are different sources of information that I will use to obtain the best reliable
evidence that can answer my research question correctly. Some of the sources that I will use will
include Scopus, Google Scholar, and PubMed. Other sources will include the Cochrane Library,
CINAHL and Joanna Brings. Such sources have the best evidenced-based nursing practice
information that can effectively answer clinical questions.
In my approach towards findings, the best suitable evidenced based articles. I will list
some of the keywords. I will be able to use the keyword, Boolean, truncations, and wildcards
words which will direct me to the best available articles based on my research question.
The table below provides a guide on my listed keywords together with their Boolean, truncation,
and wildcards words.

CLINICAL RESEARCH QUESTION 6
Keyword Search term/s
for Boolean
‘or”
Truncation/s Wildcards
a. Vaccine Exemption Human papillomavirus Measles
b. Vaccine refusal Vaccine hesitant
parents
Vaccine beliefs, vaccine
attitude, Vaccine
knowledge and Vaccine
behaviours
Rubella
vaccine
c. Vaccine hesitancy Vaccination
decisions
Vaccination preventive
diseases
VHPs
After carrying out my search with Boolean phrase words such as hesitant parents, vaccine
hesitancy, and vaccine refusal, I was able to find many articles, some irrelevant others relevant.
The next step of action was to involve limiting the number of articles that I found. This was
critical as it improved the quality of relevance of the articles that I found in my search. Besides,
the action will be significant as it will ensure I get the best research articles that strongly answer
and support my clinical question. The action of limiting these articles constitutes the application
of limiters to the search which will work by ensuring the most pertinent articles are found. Some
of the limiters that I used include applying results by published date or time and apply the
evidence-based practice.
In regards to the listed strategy, I found the following four articles that can answer my
clinical question.

CLINICAL RESEARCH QUESTION 7
1. Kaufman, J., Ryan, R., Walsh, L., Horey, D., Leask, J., Robinson, P. and Hill, S.,
2018. Face‐to‐face interventions for informing or educating parents about early
childhood vaccination. Cochrane Database of Systematic Reviews, (5).
2. Nowak, G.J., Sheedy, K., Bursey, K., Smith, T.M. and Basket, M., 2015. Promoting
influenza vaccination: insights from a qualitative meta-analysis of 14 years of
influenza-related communications research by US Centers for Disease Control and
Prevention (CDC). Vaccine, 33(24), pp.2741-2756.

CLINICAL RESEARCH QUESTION 8
3. Sadaf, A., Richards, J.L., Glanz, J., Salmon, D.A. and Omer, S.B., 2013. A
systematic review of interventions for reducing parental vaccine refusal and vaccine
hesitancy. Vaccine, 31(40), pp.4293-4304.
4. Williams, S.E., 2014. What are the factors that contribute to parental vaccine-
hesitancy and what can we do about it?. Human vaccines &
immunotherapeutics, 10(9), pp.2584-2596.

CLINICAL RESEARCH QUESTION 9
References
Kaufman, J., Ryan, R., Walsh, L., Horey, D., Leask, J., Robinson, P. and Hill, S., 2018. Face‐to‐
face interventions for informing or educating parents about early childhood
vaccination. Cochrane Database of Systematic Reviews, (5).
Nowak, G.J., Sheedy, K., Bursey, K., Smith, T.M. and Basket, M., 2015. Promoting influenza
vaccination: insights from a qualitative meta-analysis of 14 years of influenza-related
communications research by US Centers for Disease Control and Prevention
(CDC). Vaccine, 33(24), pp.2741-2756.
Sadaf, A., Richards, J.L., Glanz, J., Salmon, D.A. and Omer, S.B., 2013. A systematic review of
interventions for reducing parental vaccine refusal and vaccine hesitancy. Vaccine, 31(40),
pp.4293-4304.
Williams, S.E., 2014. What are the factors that contribute to parental vaccine-hesitancy and what
can we do about it?. Human vaccines & immunotherapeutics, 10(9), pp.2584-2596.