Immunization is the process of introducing vaccines into the body. This is usually done by injection, but some are given orally, and new methods of administering vaccines are being developed. Immunization can save lives and prevent the spread of infectious diseases. Vaccines help the body make its own protection in the form of antibodies against certain diseases. Immunizations have been called one of the 20th century's most amazing and cost-effective public health accomplishments. Immunizations protect individuals, their families and co-workers and the population at large from diseases that were deadly only a century ago.

Wide scale immunizations of the work force and the general population are especially vital to those who have immune system disorders such that they cannot be vaccinated.

As guardians of public health, provinces and states in North America have a major role in determining immunization policies. Without legislation, immunization left to the individual’s choice would be hit and miss at best. If the state or province-mandated immunization program is working as it is meant to, the diseases and viruses that the immunizations protect against essentially become invisible. High vaccination rates produce low incidences of diseases, which indicates a successful immunization program.

Immunizations for Children and Adults

Health-related crises are just around the corner at any given moment. A measles outbreak or bioterrorism threats such as anthrax and smallpox heighten public awareness to the important role that immunizations play in safeguarding public health.

Immunization is something that we most associate with children, or those with compromised immune systems. When they are only a few months old, babies begin an immunization schedule aimed at ensuring they do not suffer such diseases as tetanus, diphtheria, mumps, measles, pertussis (whooping cough), meningitis, and polio. From the time that they are born, babies face up to 28 shots by age 2.

Many of these infections have a history of causing serious or life-threatening illnesses that can lead to lifelong health problems. Eliminating these diseases through immunization in developed countries has been heralded as a medical triumph. The fact is that we rarely see most of these diseases in North America now has made many people complacent, and most forget that the diseases still exist. If we stop vaccinating children, though, these diseases will return.

That being said, immunization isn’t just a concern for children. It is important that adults pay attention to immunization as well. It is a safety precaution designed to protect themselves, their families and their co-workers. Adults between twenty and sixty-five are advised to keep the tetanus, diphtheria and pertussis booster up to date. As well, it is recommended individuals in this age category receive immunization to protect against measles, mumps and rubella. Pneumococcal and Meningococcal immunizations are recommended for all individuals over the age of 19.

Adults over sixty-five are also advised to receive the pneumococcal polysaccharide vaccine and shingles immunization. Everyone over age six months is advised to have the influenza vaccine each autumn to protect themselves, their families, as well as co-workers and clients from illness. Many adults have no idea whether or not their immunizations are up to date. In addition, most have no records of immunization, or if they do, they have no idea where these records can be found.

Occupational Concerns Regarding Immunization

In many parts of North America workplace health and safety includes:

  • Immunization and tuberculin skin testing
  • Workplace response to outbreak of communicable disease

Many workplace environments put employees in situations where they are exposed to infection. Obvious examples are anyone in the healthcare profession, teachers, clergy, those in retail, and anyone who works directly with homeless individuals.

If you have a medical condition, having immunizations that are up to date may be critical. Medical conditions where immunization is especially important include autoimmune diseases like AIDS, cancer treatment patients where immunities are low, those with chronic heart, lung, kidney or liver ailments.

Healthcare workers are at a higher risk for exposure to serious, and sometimes deadly, diseases. Those who work directly with patients or handle material that could spread infection are a risk to themselves, their co-workers and their clients. It is crucial that these individuals receive the appropriate vaccines. Immunization significantly reduces the chance that you will receive or spread vaccine-preventable diseases.

The following are vaccines that are recommended to be up-to-date at all times, regardless of occupation: measles, mumps, rubella, diphtheria, whooping cough, tetanus, polio, hepatitis B, influenza, varicella (chicken pox), and meningococcal.

Immunization Legislation

Legislators have a tough job when considering issues of compulsory immunization. They must balance individual human rights with the good of the majority. The Advisory Committee on Immunization Practices (ACIP) recommends immunization schedules for children, adolescents and adults. They base their recommendations on scientific evidence and the benefits of preventing infectious diseases.

States and provinces vary in their regulations. However, although there are a variety of immunization exemption laws, all states allow exemptions for medical reasons. Most states, with the exception of Mississippi and West Virginia, grant religious exemptions. Some states, currently 20, allow individuals to claim “philosophic exemptions”. Philosophic laws allow parents to claim an exemption for their children or themselves based on their personal, moral or other beliefs.

Workers and parents cannot claim immunizations are a financial hardship—as they could in the past. The ACA requires new health plans and insurance policies to provide coverage for immunizations for workers and their families without cost for certain preventive services. These preventive services specifically include immunizations recommended by the national Advisory Committee on Immunization Practices.

The policy for immunization for adults is not nearly as clear or regulated as it is for children. Adult immunization policies differ greatly from the efforts put in place for children. Few requirements exist for adult immunizations. Moreover, very little public health infrastructure supports mass vaccination of adults. Medicare covers influenza and pneumococcal vaccines for adults age 65 or older. Adults who have access to a good medical insurance plan have immunization costs covered in full.

Adult immunization policies are not specific about what immunizations are mandatory. The Adult Immunization Schedule recommended by the Advisory Committee on Immunization Practices (ACIP) includes vaccine such as Hepatitis B, tetanus and varicella. However, these apply only to certain at-risk populations and adults in specific at-risk occupations such as healthcare. The adult immunization policy focuses mostly on influenza (flu) and pneumococcal (pneumonia) immunizations for older adults.

How Can Employers Ensure That Employees Are Immunized?

Adult immunization rates could be increased by broadening the group who can administer vaccines. Doctor and nurses presently give vaccines to adults and children. Many states have expanded certain health care providers' roles aimed at increasing the pool of health care professionals who can administer them to increase immunization rates in the adult population. Besides physician, physicians’ assistants and nurse practitioners pharmacists can now administer vaccine immunizations.

Another possible way to ensure that the work force is immunized for their safety and that of their co-workers is to put immunization and record keeping into the responsibility of healthcare professionals working within those businesses.