Paul D. Olivo, M.D., Ph.D.
The role of vaccines in promoting public health has recently been the subject of intense discussion (1). Despite the dramatic reduction in morbidity and mortality attributable to vaccinations, the value of vaccines is being increasingly questioned. The very success of vaccines has led to complacency in educating the public about the dangers of certain vaccine-preventable diseases. Additionally, there has been an increased emphasis on vaccine-related adverse events as well as questioning vaccine mandates especially those required for school attendance. This has led to much tension between public health strategies to address vaccine-preventable diseases and parental autonomy regarding school-required vaccine mandates.
School nurses face this issue directly as the public health experts in schools. School boards and state public health agencies set policy regarding vaccine requirements for school attendance. Parents seek to make the best decision regarding the health of their children. All parents, even those parents who are suspicious of vaccine mandates, do not want their children to be harmed by infectious diseases. School nurses are responsible for educating students and their families about infectious diseases and immunizations. An additional approach to help parents make an informed decision about vaccinations is to educate them about antibody testing which measures the level of antibodies in blood (2). Antibody testing has been shown to reveal significant levels of susceptibility to multiple vaccine-preventable diseases in various populations (3). Tests approved for children can inform the parent of the diseases for which their child demonstrates protection, and identify diseases for which their child may lack sufficient levels of antibody to a vaccine-preventable disease and are thus susceptible to a serious infection. Armed with this specific information, a parent can better appreciate that not vaccinating their child may put their child at risk. This enables the parent to feel that they can make the best decision for their child on an individual basis. Of course, there is the possibility that a parent may decide not to complete a recommended vaccine schedule or mandate because antibody levels are high, but this risk is much lower than the parents deciding not to vaccinate their child at all.
In summary, the idea of testing for antibody levels can give school nurses another valuable tool to add to their discussions with parents about the merits of vaccination. School nurses can provide information to parents as to how to access antibody testing as well as encourage parents to discuss the results with their pediatrician. Multiple versions of antibody testing are available in clinical laboratories along with a new at-home test which requires just a finger prick and is approved for children.
- Beck E, Biundo E, Devlin N, Doherty TM, Garcia-Ruiz AJ, Postma M, et al. Capturing the value of vaccination within health technology assessment and health economics: Literature review and novel conceptual framework. Vaccine. 2022;40(30):4008-16.
- Dosanjh A. Pediatric Vaccine Hesitancy and the Utilization of Antibody Measurements: A Novel Strategy with Implications for COVID 19. J Asthma Allergy. 2021;14:427-31.
- Olivo-Freites C, Miguez-Arosemena P, Olivo-Freites C, Edelman D, Leschly K, Leschly J, et al. Susceptibility to Vaccine-Preventable Infections in Asylum Seekers. N Engl J Med. 2024;391(20):1959-60.
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