Importance of ImmunizationsCorie SpadaroNovember 15, 2019Southern New Hampshire UniversityImportance of ImmunizationsThe health and safety of the public is very important and taking the proper precautions is necessary in order to prevent outbreaks of communicable diseases and to control and contain the diseases from spreading to whole entire population. In the United States, approximately 42,000 adults and 300 children die each year from vaccine-preventable diseases and the CDC estimates 21 million hospitalizations and 732,000 deaths have been avoided among children born in the last 20 years as a result of vaccines (Regal, 2017). Keeping that in mind over the past 60 years the State of Evergreen has had a comprehensive immunization legislation that has had two exemptions one for religious beliefs and the other for medical safety reasons. However, the State of Evergreen has proposed a new legislation that removes the religious belief exemptions to mandatory vaccination requirements in order for children to attend public schools. This new proposed legislation was put in to place because over the past ten years there have been outbreaks of whooping cough, measles, and the flu in the State of Evergreen. The state of Evergreens Tourism Bureau discovered that these outbreaks negatively affected the economy of the state because tourism was negatively impacted. With the state’s economy decreasing, the State of Evergreen must consider the legal and economic ramifications that they will come across if they change the current legislation and remove religious beliefs. Key Organizational Stakeholders The main organizational stakeholders include children, parents, nurses, school administrators, health care providers, public health departments, the government, religious congregations, the Tourism Bureau, the business community, and elected representatives from Cedar and Fir County. Each of these stakeholders all hold different beliefs on whether or not the state should remove the religion mandate from the current legislation. The nurses and school administrators do not support the religious exemption because they are worried about the public backlash as well as the funding and staff power that would enforce the more restrictive immunization requirements. The health care providers and public health departments do not support the religious exemption because it would cost them more money. The health care providers already find that it is too expensive to purchase and maintain a supply of vaccines in their office, so they choose not to administer the vaccines and instead send patients to public health departments. The public health departments do not get paid for the administration of the vaccine for patients that have commercial health plans because they cannot bill the insurance companies. The Tourism Bureau and the business community support the religious exemption because they have lost money due to the outbreaks over the past ten years. The elected officials from Cedar and Fir counties oppose the bill and have proposed a new bill that would add a third exemption that would allow parents to exempt their children from getting a vaccination if they have a personal objection to the vaccine. The religious leaders oppose the bill because they hold strong religious beliefs and ideologies against vaccinations. Other stakeholders that would be affected by the legislation would be the vaccine manufactures whose production would increase or decrease depending on the outcome of the legislation, The Center for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the National Vaccine Advisory Committee (NVAC). All three organizations would help the state of Evergreen decide whether or not changing the mandate would be a good idea because they work together to ensure stakeholders are educated and engaged in public matters relating to vaccinations. The state of Evergreen should work with all three organizations but should try seeking more help from the NVAC because they specialize in recommendations. The National Vaccine Advisory Committee was established in 1987 and recommends ways to achieve optional prevention of human infection diseases through vaccine development and provides direction to prevent adverse reactions to vaccines (HHS Office of the Secretary, 2018). Having regular meetings with all of the stakeholders involved in the State of Evergreens new immunization legislation will allow all parties to properly understand their respective opinions on different issues and the actions they may take in any given situation which will allow all parties to have an informed discussion about the most effective way in which they might collaborate (Würz & Lopalco, 2012)Stakeholders RoleThe key stakeholders played a role in shaping the health policy and law issue on the immunization in the State of Evergreen. Cedar, Fir, and Pine counties experienced large outbreaks of whooping cough, measles, and bad flu seasons over the past ten years which are mainly due to individuals not getting vaccinated because of their religious beliefs and medical and safety reasons. Because of this, the State of Evergreen’s Legislation is proposing removing the exemption of the firmly held religious beliefs. Both Cedar and Fir, oppose the immunization and have proposed a new bill that would allow parents not to vaccinate their children if they have a “personal objection” to the vaccines. Since the State of Evergreen wants to remove the religious mandate from the legislation, they must keep in mind how it will affect different stakeholders and the role they will play. Many parents, religious leaders, and elected representative will voice their concerns about the removal of the religious mandate. These individuals will not be very happy and will speak negatively about the new legislation. They may even come up with public education campaigns and hold community meetings that voice their concerns to everyone in the State of Evergreen. Although everyone is entitled to their own opinions and beliefs, The State of Evergreen must protect and preserve the health of its people. The State of Evergreen thinks that the best way to do this is to eradicate the religious belief mandate because it is causing to many outbreaks in the community. In the 1944 Prince v. Massachusetts case, the Supreme Court ruled that “the right to practice religion freely does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death (Novella, 2015). Legal Risk and Malpractice Issues Since so many stakeholders would be affected by the implementation or lack of change to the legislation there would be a lot of legal risks and malpractice issues. Inextricably linked to such vital and occasionally competing interests as free exercise of religion, parental rights, public health, bodily autonomy and compulsory education, religious claims for exemptions to state-compelled vaccinations demonstrate the difficult challenge of balancing competing claims (McFall, 2008). If the State of Evergreen decided against the legislation and added the other exemption of “personal objection” to the legislation it could lead to the business community getting very angry and causing an uproar. If another outbreak occurred because of unvaccinated children, the business community may be able to sue the state for damages and loss of income since they have statistics and proof of financial loss from the Tourism Bureau. If the exemption is removed, despite the Supreme court ruling in Prince v. Massachusetts, religious leaders and religious parents, can sue the state claiming that the law violates their religious rights under the first amendment (McFall, 2008). Another potential legal issue that may arise, is if a person that wasn’t vaccinated catches a preventable disease and cause others to catch the disease, a civil lawsuit for negligence is possible (Reiss & Naprawa, 2014). Criminal law can be used to punish non-vaccinating individuals in the context of a death from preventable disease – the unvaccinated child, or someone she infects (Reiss & Naprawa, 2014). Medical malpractice can occur if a child was injured by a healthcare provider that administered an incorrect dose or incorrect vaccine as well as a provider that cause a child to get a dangerous infection by not practicing quality of care guidelines (Levin & Perconti, 2015).Potential Value Conflicts Among Key StakeholdersIn the State of Evergreen there are numerous value conflicts among the key stakeholders. Every stakeholder has their own values, beliefs, and opinions when it comes to the new proposed legislation to remove the firmly held religious beliefs and whether a new exemption of personal objection should be added. The State of Evergreen is responsible for doing what’s best for all members of the community and will need to review the pros and cons of each legislation before deciding whether to oppose or reject the new legislations. The decisions that are made by the State of Evergreen officials may not appease all people, but they must do what is best for the public health of the whole community. The potential value conflicts among key stakeholders include an individual’s freedom to decide whether to receive a vaccination or the right to refuse a vaccination (Reiss & Naprawa, 2014). Another conflict is the parents right to make decisions for their children even if the provider disagrees with the decision and the child’s right to manage their own health (Reiss & Naprawa, 2014). Other conflicts include the freedom of religion and thought among individuals, the communities right to protect public health and prevent outbreaks from occurring; and the rights of others to be free from preventable diseases (Reiss & Naprawa, 2014). Conflicts between stakeholders may also occur between the legislators and the religious leaders about the exemption of the religious beliefs, healthcare providers and those who want to keep the exemption since its their job to protect and care for all patients, parents and their own religious beliefs because what they believe may not be what’s best for the overall health of the population, and the business owners and legislators since their finances may decrease due to the lack of tourism.