Vaccines in Israel's schools: with most parents not attending vaccine administration when delivered in schools, how have parents granted permission for vaccines?
1 - From about 2002 until about 2007, the school nurse would send a notice to the parents of the upcoming vaccine day. Parents had to send the vaccine record ("pinkas chisunim") and the health declaration ("hatsharat briut") to the school to show their agreement to the vaccine.
2 - then, parents could either send the vaccine record, or the health declaration and a verbal agreement, or give a verbal agreement that included a health history that the nurse noted in the child's record.
3 - now, the health declaration is filled in by the parents on the computer and automatically enters the child's record. It includes a description of the vaccines given each year. Say the parents fill this out in August before the school year. Then, say in December, they get a notice of the upcoming vaccine. In the second grade, both the flu and tetanus-diptheria-pertussis-polio are given on the same day.
Giving two vaccines on the same day has caused confusion for many years. Many parents check off "yes" to all vaccines on the health declaration, then when it comes to vaccine time, say, "actually we refuse the flu vaccines".
The experience of school nurses in the field is this - parents view the health declaration as a general agreement to vaccines in theory, but parents still expect to declare their true intent in the few days preceding vaccine administration.
The management of the school nurses instructs the school nurses the following - if the parents filled out the health declaration and checked off agreement to vaccines, and you sent one notice to them, you vaccinate according to the health declaration.
Parents should be aware of that policy. After years of telling them this policy at parent teacher evenings and in emails, in my experience they still do not comprehend this.
"Evidence Based Practice is a process used to review, analyze, and translate the latest scientific evidence. The goal is to quickly incorporate the best available research, along with clinical experience and patient preference, into clinical practice, so nurses can make informed patient-care decisions" (Dang et al., 2022).
Evidence indicates that vaccinating according to the above policy should be questioned.
Feedback from school nurses should be paramount in implementing policy.
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