Department of Philosophy, Oakland University, Rochester, MI.
Department of Psychology, Oakland University, Rochester, MI.
Nurs Outlook. 2020 Jan-Feb;68(1):62-72. doi: 10.1016/j.outlook.2019.06.014. Epub 2019 Jun 27.
Since 2015, Michigan has required parents who request nonmedical exemptions (NMEs) from school or daycare immunization mandates to receive education from local public health staff (usually nurses). This is unlike most other US states that have implemented mandatory immunization counseling, which require physicians to document immunization education, or which provide online instruction.
To attend to the activity and dispositions of the public health staff who provide "waiver education".
This study reports results of focus group interviews with 39 of Michigan's vaccine waiver educators (37 nurses), conducted during 2016 and 2017, and analyzed in 2018.
Four themes emerged from analysis of the transcripts of these interviews: Participants had (1) complex and nuanced observations and evaluations of parents' judgments and feelings about vaccines and vaccine education; (2) sympathetic attitudes about alternative vaccine schedules; (3) critical and supportive evaluations of institutional policies and the background political context of immunization education; and (4) consistent commitments to respect parents, affirm their values, and protect their rights.
These results show that public health nurses are sensitive to the burdens mandatory immunization education places on families, the motivations for parents' requests for nonmedical exemptions, and the values implicated by personal immunization decisions and government immunization policies. In light of the unique training, experiences, and public reputation of nurses, there is good reason for additional investigation into the roles that nurses can play in immunization education and in vaccine mandate policies, more generally.
自 2015 年以来，密歇根州要求因非医学原因请求学校或日托免疫豁免（NME）的家长接受当地公共卫生工作人员（通常为护士）的教育。这与大多数其他实施强制性免疫咨询的美国州不同，这些州要求医生记录免疫教育，或提供在线指导。
关注提供“豁免教育”的公共卫生工作人员的活动和处置情况。
本研究报告了对 2016 年至 2017 年间对 39 名密歇根州疫苗豁免教育者（37 名护士）进行的焦点小组访谈的结果，这些访谈于 2018 年进行了分析。
对这些访谈记录的分析中出现了四个主题：参与者对家长对疫苗和疫苗教育的判断和感受有（1）复杂而微妙的观察和评估；（2）对替代疫苗接种时间表的同情态度；（3）对机构政策和免疫教育背景政治环境的批判和支持评价；以及（4）始终致力于尊重家长、肯定他们的价值观和保护他们的权利。
这些结果表明，公共卫生护士对强制性免疫教育给家庭带来的负担、家长因非医学原因请求豁免的动机，以及个人免疫决策和政府免疫政策所涉及的价值观非常敏感。鉴于护士独特的培训、经验和公众声誉，有充分的理由进一步探讨护士在免疫教育和疫苗授权政策方面可以发挥的作用。
