ORLANDO — Although proper vaccination is crucial for all patients with rheumatic diseases, rheumatology nurses who work with children often contend with parental concerns regarding vaccines and must know how best to approach vaccine hesitancy and debunk vaccination myths, according to a presentation at the Rheumatology Nurses Society Annual Conference.
“Vaccines are critical in maintaining patient health, as our patients, in particular, are at high risk for complications from these diseases,” Carolyn Zic, RN, BSN, CPN, a pediatric rheumatology nurse at Comer Children’s Hospital at University of Chicago Medicine, told attendees. “So why don’t parents vaccinate? There are often a whole host of reasons. Sometimes, it is simply a lack of knowledge about vaccines — or an overabundance of Google searching. But more often, parents have safety concerns about the vaccines and medications, which is fair — these are their children and they should express those concerns.”
Zic noted that additional reasons for vaccine hesitancy or refusal include the belief that vaccines are not necessary, concerns with pain associated with receiving multiple injections during a single visit, distrust of health care professionals or the government, and lingering concerns regarding the disproven vaccine and autism link.
“What can you do?” Zic said. “Listen — listen to what the parents’ real concerns are and see what you can do to help. Take this opportunity to provide parents with education and anticipatory guidance, where possible, to promote vaccine adherence. Even if you are not the one prescribing them, you can promote the vaccines, promote knowledge about vaccines and what to expect. Educate the parents about vaccines and why they are especially important to immunosuppressed patients, and explain to them why you are concerned about withholding vaccines.”
Rheumatology nurses who work with children must know how best to approach vaccine hesitancy and debunk vaccination myths, according to Zic.
However, she cautioned, try to maintain an open mind when dealing with obstinate parents. “The minute we shut them down and don’t listen to them, they lose a lot of respect for us or just won’t talk to us about vaccination,” she said.
According to Zic, the key role of the rheumatology nurse in vaccine monitoring is as keeper of information between patients and their primary care providers.
“The biggest thing that we can do, is to actually obtain the immunization information,” Zic said. “Also, it’s important to develop close ties with the patient’s primary care team; when the primary care doctor’s office is worried about administering the patient’s vaccines, take the call from them. Reassure them that, if it’s not a live vaccine, its fine to proceed. This is what I have repeatedly encouraged among my patients: ‘If your doctor’s nurse has a problem, or is concerned, tell them to call me.’”– by Robert Stott
Zic C. Immunizations in rheumatology across the lifespan. Presented at: Rheumatology Nurses Society Annual Conference; Aug. 7-10, 2019; Orlando.
Disclosure: Zic reports no relevant financial disclosures.