April 21-28 is National Infant Immunization Week
Parents consider health care professionals one of the most trusted sources in answering questions and addressing concerns about their child’s health. A recent survey on parents’ attitudes, knowledge, and behaviors regarding vaccines for young children — including vaccine safety and trust — found that 82% of parents cited their child’s health care professional as one of their top 3 trusted sources of vaccine information.
“Nurses can begin talking to parents about childhood immunizations during prenatal care when asking parents about plans for their newborn’s pediatric care,” said Catherine Ruhl, MS, CNM, director of women’s health programs for AWHONN. “Messages can be reinforced during a woman’s postpartum stay when confirming plans for the baby’s follow-up care.” With so many parents relying on the advice of health care professionals about vaccines, a nurse’s recommendation plays a key role in guiding parents’ vaccination decisions.
“A nurse’s expertise, knowledge, and advice are vital in creating a safe and trusted environment for discussing childhood immunizations,” said Dr. Nancy Messonnier, CDC’s director of the National Center for Immunization and Respiratory Diseases. “How you communicate with parents during routine pediatric visits is critical for fostering parental confidence in the decision to vaccinate their children.”
The survey also found that 71% of parents were confident or very confident in the safety of routine childhood immunizations, although parents’ most common question is what side effects they should look for after vaccination. Twenty-five percent are concerned that children get too many vaccines in one doctor’s visit, and 16% of survey participants are concerned that vaccines may cause autism.
“Reinforcing vaccine safety messages can go a long way towards assuring parents that they are doing the best thing for their children,” says Patsy Stinchfield, a pediatric nurse practitioner who represents the National Association of Pediatric Nurse Practitioners. “One of the best ways you can establish trust with parents is by asking open-ended questions to help identify and address concerns they may have about vaccines. Also, restate their questions and acknowledge concerns with empathy.”
Make sure to address questions or concerns by tailoring responses to the level of detail the parent is looking for. Some parents may be prepared for a fairly high level of detail about vaccines—how they work and the diseases they prevent—while others may be overwhelmed by too much science and may respond better to a personal example of a patient you’ve seen with a vaccine-preventable disease. A strong recommendation from you as a nurse can also make parents feel comfortable with their decision to vaccinate.
For all parents, it’s important to address the risks of the diseases that vaccines prevent. It’s also imperative to acknowledge the risks associated with vaccines. Parents are seeking balanced information. Never state that vaccines are risk-free and always discuss the known side effects caused by vaccines.
If a parent chooses not to vaccinate, keep the lines of communication open and revisit their decision at a future visit. Make sure parents are aware of the risks and responsibilities they need to take on, such as informing schools and child care facilities that their child is not immunized, and being careful to stay aware of any disease outbreaks that occur in their communities. If you build a trusting relationship over time with parents, they may reconsider their vaccination decision.
To help communicate about vaccine-preventable diseases, vaccines, and vaccine safety, the Centers for Disease Control and Prevention, the American Academy of Family Physicians, and the American Academy of Pediatrics have partnered to develop Provider Resources for Vaccine Conversations with Parents. These materials include vaccine safety information, fact sheets on vaccines and vaccine-preventable diseases, and strategies for successful vaccine conversations with parents. They are free and available online.
Courtney Duggan is a digital marketing manager in the Washington, D.C. area and is a mother of 2.
Liz has over 25 years of Women’s and Children’s experience and has devoted her professional career to the care of women and children with roles as a staff nurse, nursing educator and most recently executive leadership. She has presented nationally on patient experience and mentoring new nursing leaders. In 2008, Liz was named to the Great 100 Nurses of North Carolina, and is a member of Sigma Theta Tau. In addition to her clinical work and expertise, Liz has taught at the baccalaureate and graduate levels at East Carolina University College of Nursing. She is board certified as a Nurse Executive by the American Nurses Credentialing Center.
Amy is an ABSN student at MGH Institute of Health Professions, Boston. She was a stay at home mother for 12 years, a community coordinator for a non profit kids running program and a volunteer at Dana Farber Cancer Institute in Boston before deciding to enter the nursing field. With extensive volunteer experience from a camp for blind & visually impaired adults and children, to co-president of an elementary school PTO, she enjoys working with diverse groups of all ages. Amy aims to work in labor and delivery after graduation in August 2017 but is also interested in global health and epidemiology. She has intentions to keep making a difference in the lives of those she may never meet again.
Tasha Poslaniec has been a registered nurse for 17 years. She has been working in obstetrics for over a decade and is currently a Perinatal Quality Review Nurse and Childbirth Educator.
Holly Lammer is an Obstetric Nurse, Clinical Educator and Childbirth Instructor for St. Luke’s Health System based in Boise, ID. In addition to teaching credentialed courses through AWHONN and AHA, she develops and teaches curriculum for prenatal and perinatal specialty courses offered in the St. Luke’s system. Holly is also registered with the Yoga Alliance as a 500-hr Yoga Instructor and on faculty as a Prenatal Yoga Teacher Training Instructor. She is certified in Inpatient Obstetrics and Electronic Fetal Monitoring through NCC and is in process of obtaining her Pre and Perinatal Psychology Educator through the Association for Pre and Perinatal Psychology and Health.
AWHONN Member on the Move 
Diapers by the Dozen—and More!
“First, you need to have a team that is passionate about this issue,” she explains. “Everyone has been extremely dedicated to reaching our goal. Secondly, you need a group of individuals with several skill sets to help. I have people who are excellent at acquiring donations, some with strong organizational skills, and others that can get the message out to the community. Lastly, you need to partner with the local community in order to have a successful diaper drive.”
Kimberly J. Angelini, WHNP-BC, RN is a PhD student at Boston College studying women’s health promotion. She is currently a board certified Women’s Health Nurse Practitioner and works at Dowd Medical Center Gynecology. Kim also works as a staff nurse on the in-patient transplantation unit at Massachusetts General Hospital. 
Diane L. Spatz, PhD, RN-BC, FAAN is a Professor of Perinatal Nursing & the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania School of Nursing sharing a joint appointment as a nurse researcher and director of the lactation program at the Children’s Hospital of Philadelphia (CHOP). Dr. Spatz is also the director of CHOP’s Mothers’ Milk Bank. Dr. Spatz is an active researcher, clinician, and educator who is internationally recognized for her work surrounding the use of human milk and breastfeeding particularly in vulnerable populations. Dr. Spatz has been PI or co-investigator on over 30 research grants, included several from the NIH. She has authored and co-authored over 80 peer reviewed publications. Dr. Spatz has authored or co-authored position statements for the International Lactation Consultant Association, the Association of Women’s Health Obstetric & Neonatal Nursing and the National Association of Neonatal Nurses.
Rebecca Law, MA, RN, IBCLC,ANLC,LCCE,FACCE is the manager of a the Lactation and Childbirth Education Departments at Texas Health Harris Methodist Hospital Fort Worth and has over 25 years experience in womens health. She has received a Masters degree in Health and Wellness with the focus on Human Lactation and is certified as an IBCLC and Advanced Nurse Lactation Consultant. In addition she is certified as a Lamaze Childbirth Educator and has been educating patients and staff for many years. She is part of the Baby Friendly Hospital Initiative team assisting the hospital with the designation in 2010 and is the current chair of the hospital system BFHI group. She has experience as a podium and poster presenter at several state, national and international conferences including Lamaze International, ILCA, State Breastfeeding Coalitions, and NICHQ.