NAPNAP Position Statement on Immunizations

The National Association of Pediatric Nurse Practitioners (NAPNAP) fully supports timely and complete immunization of all infants, children, adolescents, and adults to maximize the health and wellbeing of all people. Routine childhood immunizations prevent approximately 2.5 million deaths every year (World Health Organization, 2012). Maintaining the highest immunization rates possible is essential to prevent outbreaks of vaccine preventable diseases across the nation (Centers for Disease Control and Prevention [CDC], 2013). The CDC recommends all children, adolescents, and adults should be immunized to protect children who are most vulnerable to serious illness and death (CDC, 2014). In concert with the American Academy of Pediatrics (AAP), NAPNAP strongly encourages adherence to recommended immunization schedules that are updated annually using both primary care and mandatory school entry immunization policies to ensure full protection from vaccine-preventable diseases (AAP, 2014).

NAPNAP strongly supports all pediatric nurse practitioners (PNPs) as leaders of evidence- based standards for immunization. NAPNAP encourages the PNP to participate on employer based, hospital, school, local, state and national committees that address immunization policies and practice including advocacy for vaccine funding. NAPNAP supports the prioritization of immunization education for parents, guardians and other caregivers of infants, children, and adolescents. This education must include the most current scientific evidence related to vaccine safety, risk, benefits and current resources available to ensure that parents and caregivers receive adequate information about immunizations. This includes, when necessary, relaying the risk of not immunizing their child and potential devastation that can occur when a child is infected with a vaccine-preventable disease. It is incumbent that a PNP also be aware of misinformation in the public domain and provides the correct information to the public as well as the health care community.

In an effort to ensure that all pediatric populations are protected against vaccine preventable illness and remain healthy, NAPNAP affirms that PNPs and other pediatric health care providers must:

1. Ensure access to timely immunization for all children.

2. Consider every health care encounter as a means to review immunization records and immunize as needed.

3. Engage in thoughtful discussion with parents and caregivers at each health encounter about vaccine safety and efficacy issues and to acknowledge that the ultimate goal of immunizing children in a timely and appropriate fashion is to benefit the health of each individual child (Maglione,, Das, Raaen, Smith, Chari, Newberry, Shanman, Perry, Goetz, & Gidengil, 2014).

4. Enable parents and caregivers to critically evaluate vaccine information (and misinformation).

5. Recommend that parents, caregivers, and other adults remain compliant with recommended immunizations for their age and risk group in order to protect children in their care.

6. Distribute the accurate and thorough CDC Vaccine Information Statements for each recommended vaccine to parents and caregivers at every immunization encounter (CDC, 2013).

7. Ensure adherence to immunization schedules by utilizing electronic health records, statewide vaccine registries, and recall systems.

8. Incorporate changes in immunization policies, recommendations, and practices in their practice site and community by remaining knowledgeable through educational programs, evidence-based research, and peer-reviewed journals.

9. Participate in local and state immunization information systems in order to actively promote the continued development of the national and global immunization information system.

10. Provide complete, accurate, and culturally sensitive educational programs about immunizations to the public, childcare centers, schools, and community groups, including information on benefits, safety, evidence-based quality resources, and the importance of active and timely participation in immunization programs utilizing the news, social media, the internet, and other applicable communication methods.

11. Utilize quality improvement principles to evaluate immunization practices for the purpose of improving compliance with recommended immunization practices and educating members of the health care team.

12. Advocate for vaccine funding at the state, national, and international levels.

13. Actively participate on local, state, and national committees, advisory groups, and other venues that impact public policies concerning childhood immunization practices.

14. Actively participate in federal, state, and local legislation that aims to keep childhood immunizations available, accessible, and affordable for all children regardless of social or economic status or the type of health insurance.

15. Advocate for an integrated national immunization infrastructure to ensure the supply and delivery of vaccines, maintenance of coverage rates, outbreak control, and immunization education (Martin, Lowery, Brand, Gold & Hurlick, 2014).

16. Serve as immunization experts for national, regional or local board and committee positions to ensure the safety and efficacy of childhood immunization programs.

17. Assist the families of children who have debilitating sequelae following vaccines to access the Vaccine Injury Compensation Program (VICP) to assist with their ongoing care (HRSA, 2011).

18. Report adverse vaccine reactions to the Vaccine Adverse Event Reporting System (VAERS) (CDC, 2014)

In summary, NAPNAP, an organization which empowers PNPs and their healthcare partners to enhance child and family health through practice, leadership, advocacy, education and research, recognizes the immense benefits of immunizations and encourages PNPs and other health care providers to assess immunization needs, implement immunization programs, and promote community awareness of the value of comprehensive immunization programs. It is the position of NAPNAP that federal, state, and local legislation and funding remain available for comprehensive immunization delivery, educational programs, and a national immunization registry. We must advocate for the protection of every infant, child and adolescent’s health by working toward 100% immunization rates.