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Issues of Parental Consent on Immunization

In majority of countries legal systems, the legal age for consent is 18 years .For this
reason, a child or adolescent between the ages five and seventeen years is not eligible to provide
consent to vaccination and therefore, consent is needed from their legal guardian or parent
(WHO 2014). Mia being five years old cannot consent to vaccination and therefore, consent from
her parents or legal guardian is needed. Since Albert is the biological parent to Mia and he has
equal custody over Mia, and that she lives with Albert for every two of four weeks, then he has a
right to provide consent on her behalf.
Being a nurse immunizer in the state of Queensland, Australia, a nurse is required to
fulfil several requirements and responsibilities to be allowed to practice vaccination. (“National
Immunisation Strategy for Australia 2013 to 2018″, 2013). The person administering a vaccine
should first review vaccination history of the child; check how suitable the vaccine is and finally
acquire valid consent (WHO 2014). Today’s practices for obtaining valid consent for vaccination
are grouped into three approaches namely; an implied consent process; a written consent process
and finally a verbal consent process
Regarding review of the vaccination history of an individual, a nurse immunizer is
required to review Mia’s child record book and clinical record to establish the type of
vaccination and dose needed according to in line with the NIP, parent or legal guardians wish
(WHO 2014). The next step is to conduct a thorough clinical assessment of the vaccine, prior to
immunizing, to determine whether it is medically suitable for vaccination or that the vaccine
does not contradict to any specified vaccine (Immunisation records and data explained: A guide
for immunisation providers, 2018). The nurse immunizer has the responsibility of obatinaing
valid consent before any vaccination. Consequently, procedures before immnuisation should
incorporate pre-immunisation checklist and common reaction information
Mia’s case does not have a court order between her parents. Since no parenting orders
exist, either of the parent has a parental responsibility to decide on long-term issues and neither
of them is required to consult the other prior to making a decision (Kaye 2017). Any parent ,
Albert in this scenario, can present Mia for vaccination.
Mia’s father, Albert is required to follow a specific criteria for the consent to be valid.
The consent must be provided by an individual with legal or intellectual capacity, who is able to
understand the implications of vaccination; it should be voluntary without undue stress; a
discussion of procedures to be administered and finally; it can only be administered on
understanding benefits and risks of the vaccines, alternative options and risks associated with not
being vaccinated.
The situation in this scenario becomes complicated since Rose, Mia’s mother, objects to
vaccines. That adds conflict to the nurse immunizer, Rose and Albert. Albert will keep being
Mia’s biological parent and both he and Rose have equal custody over the child which provides
for equal rights to make a decision about vaccinations for Mia. Since Albert has finished pre-
vaccination assessment, valid consent and Mia’s indigenous heritage has been noted and that the
nursing immunizer follow all responsibilities and requirements, Mia should be vaccinated.
Finally, I would hold a discussion with Rose to be able to explain to her about the
situation and her concerns regarding the adverse effects and allergic reactions caused by vaccines
to achieve an informed understanding. Hopefully, this will help discourage any conflict that may
arise between Mia’s Parents.

When a parent strongly objects vaccinations, am healthcare provider experiences
difficulties in changing their altitudes on vaccinations. Parents such as Rose are either hesitant or
uncertain and therefore, effective communication is required (Danielsen & DFAAPA 2019).An
ineffective form of communication may cause vaccine rejection or dissatisfaction. Therefore, it is
essential that healthcare providers provide enough time to talk to hesitant parents in addressing
their concerns. Providing written materials detailing benefits and risks of vaccination may also
be helpful, to visually observe what can help Rose’s education capacity. The written resources
may also be provided to Rose in printable electronic or paper format.
Motivational interviewing principles is another approach that can be used with Rose. It
may involve questions that seek to clarify what causes a parent’s motivation and responsiveness
to change. Healthcare providers should be aware that parents are different and methods of
communication work differently on each of them. However, most of these strategies may be
incorporated with Rose, concerning assisting her make the best decision for Mia.
As a nurse immunizer or healthcare provide, I would first listen to Rose’s fears
acknowledging her concerns before talking about them. I would then begin by giving Rose the
most essential points ensuring she gets an understanding of the information I am providing her
with. Then, I would then give a clarification regarding her beliefs on vaccinations. It would be
important to discuss with Rose the risks and benefits associated with vaccines and provide
educational written materials, vaccine information statements, and reliable websites. The
approach I would take will be positive emphasizing on the lives saved through immunization
rather those that have been lost. Explaining to Rose that Mia is now attending school, and
discussing school entry state laws with rationale is also essential. I would give an explanation to
her regarding vaccine benefits on specific children and the entire society through herd immunity.

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