Essay on Anthrax Vaccination

Vaccination is a key component in primary health care and an undeniable human right. It is a success story known for saving millions of lives every year. A vaccine is a substance administered mostly by injection into the human body to stimulate its response against a disease. The vaccine contains weakened forms of the targeted germ that neither causes the disease nor puts the individual at risk of complications. When vaccinated, the immune system recognizes the intruding germ and produces antibodies against it (Bower et al., 2019).

1. Why scenario B?

In the case study presented, scenario B would be most appropriate to help parents make informed decisions on the vaccination process. The case study shows that at least one million of the U.S population has been exposed to the anthrax aerosol. It would be impossible to place them all in one room to explain the informed consent document. It makes sense that a group of them be brought together and provided with the information they need regarding the necessary vaccine. The general rule requires using basic terminologies so that the general population understands what is being said (Simonds & Buchwald, 2020). The first step should be to give an introduction to anthrax and the purpose of its vaccine. Anthrax is a bacterial infection with serious complications ranging from shortness of breath, massive bleeding and multiple organ damage, brain and spinal cord fluid, and even death. It is, therefore, important that a vaccine is administered to those who have been exposed.

A description of the research follows, explaining that the vaccine is obtained by injecting a killed form of anthrax into the body. In this case, if actual anthrax sets in, the body has already been trained to create antibodies. The families are then given an overview of subject participation. In this case, the exposed children are given priority due to their weaker immune systems compared to the adults. It should be made clear that they will also be given a two-month antibiotics supply after the injection. The other most important information is on the vaccine’s risks, discomforts, and potential benefits. The possible side effects of the anthrax vaccine may include tenderness and itching reactions where the shot was administered, headache, fatigue, and temporary muscle ache where the shot was given. On the other hand, the potential benefit of the anthrax vaccine is that the body will not encounter the harmful infection, maintaining its healthy state.

After all the information has been laid out, the health staff must assure families that their particulars will remain confidential. Every informed consent document requires the personal particulars of vaccination participants. At the end of the document, an authorization signed by the subject is also required to prove they consent to have their data used. An outline of how the clinic will protect the subject’s identity should be publicly available. For example, the subject’s names will be coded and not used when reporting data, the subject’s data will be safely filed and secured in a locked cabinet, and it will be destroyed after a full analysis of the data. The final part of the document is on compensation. Will or will they not receive some compensation for participating? In this case, compensation is unnecessary because the process aims to restore public health with no compromise.

2. An analysis of the fairness of the method of distribution.

According to Bower et al. (2019), vaccine equity has been a challenge of all time and a constant fail. Amidst such a crisis, it should be a time for partnership and not partisanship– exploring ways to ensure equal access and distribution of vaccines. Parents or guardians should accompany all children needing vaccination. However, some fail to turn up with their guardians probably because they have none or have been sent to go by themselves. If the public health staff decides to prioritise children accompanied by their families over those without company, it negatively affects the distribution of the vaccine calling for justice.

Justice in public health refers to fairness in how medical decisions are made and people are treated. While the general practice is health improvement for the population, treating the disadvantaged fairly should be understood. There are certain reasons that could lead the children to show up unaccompanied: poverty, social disintegration, and poor education. The case study highlights that there are only thirty local public health clinics charged with the responsibility of administering the vaccine to the larger one million exposed people. People from remote areas that are not close to any of the clinics have to spend on transport fee. The majority of the people living in these areas are poor and might not have the money to cover thethe child and guardian transport. Therefore, they decide to send the child only on little they can afford to spare.

Poor education leads to ignorance on the guardians side who assume that whether accompanied or not, the clinics will give priority to the children. The guardians forget that underage children cannot be allowed to authorize consent forms. For this reason, the unaccompanied children are put on hold as the staff try to get hold of their parents. All this time, children with their families get the vaccine. On social disintegration, traditional support systems tend to decline overtime. Traditionally, children had to remain under guardian care until they were of age. It meant that everything they did had to be supervised by their guardian. Unlike in the society today, even before children are of legal age, parents consider them adults who can do anything on their own without parental supervision. The unaccompanied children could be said to come from such families. It is not the children’s fault that they grew up in such inequalities of poor education, poverty, and social disintegration. However, these existing disadvantages beget other deprivations such as the zero priority to vaccination.

3. Protocol for vaccination of unaccompanied children

Every child is entitled to the highest standard of health treatment. Family tracing is also important for anyone that shows up in a healthcare center unaccompanied regardless of age to follow up on past medical history. Whereas anyone of age and sound mind but is unaccompanied can authorize consent documents, underage unaccompanied children cannot. It does not mean that they should be denied access to the vaccination in this case. There should be a protocol for their vaccination.

First, there should be an attempt to reach out to any known family member, which can be made possible by asking the child if they know their guardians contact. All this while, a nurse could engage the child in a conversation prompting to know why they came unaccompanied or when they last saw their guardian. It could be possible that they have a guardian but he/she failed to show up, sending the child by themselves. In such a case, if the staff gets hold of the parent, they could explain the importance of them showing up to their children’s vaccination. All goes well, the parent shows up and gets to go home with a vaccinated child. Additionally, the guardian also gains awareness on the importance of accompanying children to clinics, reducing chances of repeating the same mistake.

In the unfortunate incident that it is impossible to trace any family member, the child could be signed up for social services. Such processes might take a while to officiate delaying the child’s chances of being vaccinated. However, the child should get the vaccination still. Of importance is keeping the list of children with no traced guardian and beginning the social services process while they receive the vaccine. While at social services, the children get lucky to have foster homes, most of which are headed by well-informed parents who would not risk sending their children to clinics unaccompanied.

4. Conflicting bioethical and public health principles

Healthcare providers are confronted with ethical choices, both major and minor, prompting moral action guides on what ought to be done. In regard to ethical decisions on healthcare, there are four bioethical and public health principles, which sometimes conflict: respect for autonomy, beneficence, justice, and non-maleficence (Cambra-Badii et al., 2021).

The principle of autonomy agrees with the moral independence of the patient that they can make informed decisions without external controlling influences. The principle does not consider the age of the patient given that children should be accompanied by their parent who gives authorization in the consent forms. It goes to show conflict between the ethical principle and the clinic’s requirement that every child needing vaccination should have family with them.

The principle of beneficence ordinarily means that the clinic staff have a duty to be of benefit to the patient. It includes positive steps to remove and prevent the patient from any harm. In the case study, the primary role of the staff is to administer vaccines which is of benefit to the population. However, this role is conflicted when they have to stand in for children who came in unaccompanied as they await social services. Other duties such as tracing families of the unaccompanied conflict their vaccinating role.

The principle of justice is defined by fairness of how treatment is the vaccine is shared. There would have been conflicts if the staff neglected the unaccompanied children and attended only to those with their families. However, the protocol used to vaccinate the unaccompanied children prevent a possible conflict. The final principle of non-maleficence argues that no harm should be inflicted on the patient. There was no conflict of this principle because standard care was offered to everyone that made themselves available for the vaccination, denoting medical competence.

References

Bower, W. A., Schiffer, J., Atmar, R. L., Keitel, W. A., Friedlander, A. M., Liu, L., … & Hendricks, K. (2019). Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices, 2019.

Cambra-Badii, I., Pinar, A., & Baños, J. E. (2021). The Good Doctor and bioethical principles: a content analysis.

Simonds, V. W., & Buchwald, D. (2020). Too dense and too detailed: Evaluation of the health literacy attributes of an informed consent document. Journal of racial and ethnic health disparities.