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NANNP Corner

Vaccine Hesitancy and Disease Resurgence

Elizabeth Welch-Carre, EdD MS APRN NNP-BC

LizzIn November 1962, actress Patricia Neal and her husband Roald Dahl lost their seven-year-old daughter Olivia to measles encephalitis. According to Dahl, Olivia seemed to be following the standard measles course. However, one night she stated she was particularly tired. She became unconscious soon thereafter and died 12 hours later (Dahl, 1986). The measles vaccine became available in 1963, and following his daughter’s tragic death, Dahl became a vocal supporter of vaccination to prevent and eliminate deadly diseases in spite of the widespread hesitancy towards the practice in Britain at the time.

Vaccine hesitancy is “the reluctance or refusal to vaccinate despite the availability of vaccines” (World Health Organization [WHO], 2019). WHO has listed vaccine hesitancy as one of the ten threats to global health in 2019. The unfortunate outcome of this hesitancy has been a resurgence in some diseases, such as measles. In 2000, measles was listed as eliminated in the U.S.; however, since January 2019, there have been 101 cases of measles across the U.S. with the primary concentration in Washington State. In 2018, there were 372 cases in the U.S.—many of these outbreaks originating from travelers coming to the U.S. However, because some individuals in the U.S. have not been vaccinated, there have been outbreaks every year since 2008 (Center for Disease Control [CDC], 2019). Currently the CDC is recommending that anyone who plans to travel outside of the U.S. should be vaccinated against measles.

As health care providers, we are in a position to educate families about the benefits of vaccinations when their children are infants. A 2006 study published in Pediatrics demonstrates that health care providers have an influence on whether parents vaccinate their children (Smith et al.). Another study published in 2008 also demonstrates that a positive and trusting relationship between a health care provider and a parent influences parental willingness to vaccinate their children (Gust, et al., 2008). In 2018, the American Academy of Pediatrics (AAP) designed a pilot study in which health care providers used their social media channels to share educational content about the benefit of vaccines. The outcome of this pilot was that half of the parents surveyed felt they had learned something new about vaccines and one-third responded that they were more likely to have their children vaccinated (AAP, 2018).

Nursing has been one of the most trusted health care professions in the U.S. for 17 years (Brenan, 2018). Because nurses are well-trusted, and families who trust their providers are more likely to vaccinate their children, Neonatal Nurse Practitioners should become active members in national efforts to encourage parents to vaccinate children. As more individuals are vaccinated, the overall health risks to individuals decreases. Additionally, healthcare costs may fall as preventable diseases are eradicated (Largeron et al, 2015).


American Academy of Pediatrics. (2018). 2018 social media toolkit. Retrieved from

Brenan, M. (Nov, 2018). Nurses outpace other professions for honesty and ethics. Retrieved from

Center for Disease Control. (2019). Measles cases and outbreaks. Retrieved from

Dahl, R. (1986). Measles: A dangerous illness. Retrieved from

Gust, D. A., Darling, N., Kennedy, A., Schwartz, B. (2008). Parents with doubts about vaccines: which vaccines and reasons why. Pediatrics. 122(4). doi: 10.1542/peds.2007-0538.

Largeron, N., Levy, P., Wasem, J., Bresse, X. (2015). Role of vaccination in the sustainability of healthcare systems. Journal of Market Access & Health Policy. doi: 10.3.3402/jmahp.v3.27043.

Smith, P. J., Kennedy, A. M., Wooten, K., Gust, D. A., Pikering, L. K. (2006). Association between health care providers’ influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics. 118(5). doi: 10.1542/peds.2006-0923

World Health Organization. (2019). Ten threats to global health in 2019. Retrieved from

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