Negative Effects of Vaccines and Preventive Measures Taken by Nurses to Minimize Vaccine Adverse Reactions
Afia Osei Boahen
City College of New York
English 21003: Writing For the Sciences
Ms. Conroy
October 23, 2020
ABSTRACT
The articles “BCG vaccination in patients with severe combined immunodeficiency: Complications, risks, and vaccination policies” by Beatriz E. Marciano MD, Chiung-Yu Huang PhD, Gyan Joshi PhD, Nima Rezaei MD et al., “Deaths following vaccination: What does the evidence show?” by Elaine R. Miller, Pedro L. Moro, Maria Cano et al. will examine the reasons why vaccines have negative effects on some people, some adverse reactions to some vaccines which can cause death, ways to treat those reactions, and preventive methods that nurses use to ensure that such reactions do not happen at all or are minimal and do not lead to death of patients they are administered to.
Vaccines have been used almost all over the world to prevent and cure different types of diseases over the years. Vaccines, though they prevent and cure most diseases, have complications and unintended reactions to particular patients that they are administered to. The article “BCG vaccination in patients with severe combined immunodeficiency: Complications, risks, and vaccination policies” by Beatriz E. Marciano MD, Chiung-Yu Huang PhD, Gyan Joshi PhD, Nima Rezaei MD, Beatriz Costa Carvalho MD, Zoe Allwood MD et al. published in 2014 explores the high risk of death for patients (children) with SCID (a syndrome characterized by profound T-cell deficiency) after they have been injected with BCG vaccination. The article “Deaths following vaccination: What does the evidence show?” by Elaine R. Miller, Pedro L. Moro, Maria Cano and Tom T. Shimabukuro published in 2015 illustrates that people rarely die from a vaccine, unless there is a particular vaccine used. This article lists vaccines and diseases that have the ability to cause death and how to control it. The article “The role ofnursing staff in the prevention of vaccine adverse reactions and complications” by Pawłowski Piotr, Pawłowska Paulina, Jakubowska Klaudia, Nalepa Dorota et al. published in 2018, explores the basic issues related to the subject of vaccination, with significant importance to the role of nurses in their recognition and prevention of vaccine adverse reactions. All of these articles/sources together examine some vaccines, their complications (side effects) and some precautions taken to avoid adverse reactions. Which brings about my research question, ‘What are the negative effects of vaccines and what preventive measures are taken by nurses to avoid vaccine adverse reactions?
Why some vaccines affect people negatively.
The invention of vaccines has been one of the greatest improvements in the world. Vaccines have prevented millions of deaths in the United States and billions of deaths around the world. BCG vaccine is a commonly used vaccine to treat, prevent and control tuberculosis in people around the world, especially children, “In 1993, the World Health Organization (WHO) declared the disease a global public health emergency, and in 2011, one third of the world’s population was thought to be infected with Mycobacterium tuberculosis , with almost 9 million new cases diagnosed and 1.4 million deaths attributed to this organism” (Beatriz E. Marciano MD, Chiung-Yu Huang PhD, Gyan Joshi PhD et al. 2014). BCG vaccination is suggested or indicated not to be used for patients with SCID, but due to the fact that most countries encourage the use of BCG at birth, their immune defect is not detected prior to the injection of the vaccine. An experiment/research has been made in some countries (seventeen,17 countries and 28 centers) that children suffer from SCID through sizeable systematized questionnaires analyzing the complications, therapeutics, and results regarding BCG vaccination in patients given a diagnosis of SCID. They used tables, charts and statistics to convey their studies. The complications associated with BCG vary widely in reporting countries and vaccine strain used. Two thirds of the vaccinated patients had disseminated complication and the other third had localized complication. The article “Deaths following vaccination: What does the evidence show? Lists anaphylaxis as a vaccine-strain systemic infection after administration of live vaccines to severely immunocompromised persons, intussusception after rotavirus vaccine, Guillain–Barré syndrome after inactivated influenza vaccine, fall-related injuries linked with syncope after vaccination, yellow fever vaccine connected with viscerotropic disease or connected to neurologic disease, serious complications from smallpox vaccine including eczema vaccinatum, progressive vaccinia, postvaccinal encephalitis, myocarditis, and dilated cardiomyopathy, and vaccine-associated paralytic poliomyelitis from oral poliovirus vaccine, are stated as rare cases that are known to have theoretical risk of death. The article “Deaths following vaccination: What does the evidence show? agrees with “BCG vaccination in patients with severe combined immunodeficiency: Complications, risks, and vaccination policies” article by indicating that the age of children and birth weight when the vaccine is administered to them is the reason for the high risk of dying or brings about the death of infants “BCG-associated complications, with patients vaccinated within the first month of life having a substantially higher risk, which in turn was also associated with an increased rate of death caused by vaccine-associated complications” (Beatriz E. Marciano MD, Chiung-Yu Huang PhD, Gyan Joshi PhD et al. 2014). Both articles also agree that an impaired or defective immune system contributes to complications that arise when some vaccines are administered. People that have weak immune systems are suggested not to use live vaccines, though other times it is because of age and the ability to fight the infection. “Two published case reports describe immunocompromised children who received varicella vaccine, and where vaccine strain varicella zoster virus infection contributed to their deaths [….], in the other case, a 15-month-old did not have a diagnosis of being immunocompromised, but had failure to thrive and several hospitalizations beginning at five months of age for infections and respiratory problems requiring steroid treatment” (Elaine R. Miller, Pedro L. Moro, Maria Cano et al. 2015).
Adverse Reactions and some treatments
Vaccines are extremely thoroughly tested and are part of one of the safest products in the medical field for worldwide use. Vaccines are distributed to millions of people in the United States of America. Adverse reactions are unexpected reactions to drugs that are administered. It can be life threatening or a minor side effect that is temporary. Unintended harmful effects/reactions are possible but serious adverse reactions leading to death are infrequent. Vaccine safety is now the concern of many people. According to the article “Deaths following vaccination: What does the evidence show?”, adverse events including deaths, that are temporally connected with vaccination, do take place due to high volume use of vaccines, “During the US multi-state measles outbreak of 2014–2015, unsubstantiated claims of deaths caused by measles, mumps, and rubella (MMR) vaccine began circulating on the Internet, prompting responses by public health officials to address common misinterpretations and misuses of vaccine safety surveillance data, particularly around spontaneous reports submitted to the US Vaccine Adverse Event Reporting System (VAERS)”. While the risk of anaphylaxis is not many, it can be serious and deadly, but can be treated with the appropriate medication, “The risk of anaphylaxis is less than two cases per million doses of vaccines administered to children and adolescents. While anaphylaxis is serious and can be fatal, death and other complications can be prevented with rapid treatment using effective medications including epinephrine, corticosteroids and beta-agonists” (Elaine R. Miller, Pedro L. Moro, Maria Cano and Tom T. 2015). Vaccine-associated paralytic poliomyelitis (VAPP) is a rare adverse reaction that can occur in a recipient of live oral poliovirus vaccine (OPV) or the people that they come in contact with. It can occur in people that are healthy and in people with immune system abnormalities. OPV is no longer used in the United States and has been substituted with inactivated poliovirus vaccine. Intussusception is a rare painful medical condition in a form of bowel blockage in which one part of your intestine slides inside another part. It can be fixed on its own, but might also call for medical treatment or in some cases surgery. In very rare instances, it can result in death. Serious adverse reactions and complications from smallpox vaccine can have an outcome of death in rare cases. Death has also taken place among unvaccinated persons who had accidental contact with vaccination sites of vaccine recipients. In addition, smallpox vaccination of pregnant women can cause fetal infection, which has the consequence of stillbirth or infant death. The articles “Deaths following vaccination: What does the evidence show?” and “The role ofnursing staff in the prevention of vaccine adverse reactions and complications” agree that patients should be examined to identify any issues with their immune system before being vaccinated to avoid unintended reactions.
Preventive Measures taken by Nurses
Immunization is one of the most effective treatment/way to decrease or prevent life threatening illness or diseases. Nurses are responsible for vaccinating a patient and because of this, it is their responsibility to minimize vaccine adverse reactions. The article “The role ofnursing staff in the prevention of vaccine adverse reactions and complications” conveys that medical personnel should make sure that the patient being vaccinated should be qualified to be injected. “The basic mistakes made by medical personnel at the vaccination point include improper decisions on the patient’s qualification for vaccination, violation of the fundamental principles of vaccination and lack of knowledge of individual vaccines, their properties, administration patterns as well as potential VARs, which may have serious consequences for the patient” (Pawłowski Piotr, Pawłowska Paulina, Jakubowska Klaudia et al. 2018). The doctors and nurses should have the elementary or the basic knowledge on vaccination. “Therefore, elementary knowledge on vaccination and the principles of vaccination techniques should be disseminated among nurses, doctors of all specialties, midwives and other medical professions” (Pawłowski Piotr, Pawłowska Paulina, Jakubowska Klaudia et al. 2018). Vaccination adverse reactions can be a consequence of an error in the technique of producing the vaccination itself or administration of the vaccine, the individual response of the vaccinated person’s system or the defect of the vaccine preparation. In order to prevent the occurrence of VARs effectively, the nurse should fulfill an educational function, follow aseptic and antiseptic rules. They are to store vaccine preparations in accordance with the manufacturer’s instructions, and the vaccination should be based on the choice of the propersite and route of administration of it. It is equally important to conscientiously keep records of the patient and equipmentincludedin the vaccination office. The articles “Deaths following vaccination: What does the evidence show?” by Elaine R. Miller, Pedro L. Moro, Maria Cano et al., and “The role of nursing staff in the prevention of vaccine adverse reactions and complications” agrees that to help prevent any fatal consequence, there should be screening before vaccination so that contraindications and precautions, including previously diagnosed immune system problems as well as allergy history are discovered.
The three articles “BCG vaccination in patients with severe combined immunodeficiency: Complications, risks, and vaccination policies” by Beatriz E. Marciano MD, Chiung-Yu Huang PhD, Gyan Joshi PhD et al., “Deaths following vaccination: What does the evidence show?” by Elaine R. Miller, Pedro L. Moro, Maria Cano et al., “The role ofnursing staff in the prevention of vaccine adverse reactions and complications” states that the harmful effects of vaccines occur due to reasons like weak immune system, special conditions like SCID, an error in the technique of producing a particular vaccine. The adverse reactions that are associated with some vaccines are stated not to have any serious reactions, and serious reactions to vaccines that can lead to death is rare. Even though most of the time, the reactions are minimal, nurses are required to take preventive measures so that patients do not suffer any unintended harmful reactions, no matter how minimal it is.
Bibliography
Miller, Elaine R et al. “Deaths Following Vaccination: What Does the Evidence Show?” Vaccine 33.29 (2015): 3288–3292. Web.
Piotr Pawłowski et al. “The Role of Nursing Staff in the Prevention of Vaccine Adverse Reactions and Complications.” Journal of education, health and sport 8.6 (2018): 57–68. Web.
https://zenodo.org/record/1251231#.X4KGUeaSk2w
Marciano, Beatriz E et al. “BCG Vaccination in Patients with Severe Combined Immunodeficiency: Complications, Risks, and Vaccination Policies.” Journal of allergy and clinical immunology 133.4 (2014): 1134–1141. Web.
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