The leadership role undertaken by nurses in immunizing children is well-documented. They practice in multiple settings, are the largest number of health care providers and collaborate with many other professionals and groups. They are vital to the mobilization and outreach efforts of state coalitions, are frequently the first person seen by consumers in any health care setting, and have developed innovative programs for the immunization of children throughout the United States (ANA 1993). Their knowledge base, advocacy role and conceptual framework of health promotion and disease prevention provide a strong basis for their role in immunizing children.

Community health nurses in home care settings, clinics and schools can assess children for immunization status and immunize siblings at school settings. Nurses have been effective advocates linking immunization sites with other services such as Women Infants and Children (WIC) and AFDC. Nurses have an opportunity to educate providers about registries and develop the needed linkages with provider practices in states. As educators, nurses utilize students in clinic settings, teach childhood immunizations physical assessment and also work in faculty practice settings/nurse-run clinics to make certain that children in all settings receive appropriate health care.

Conclusion

As we approach a new century, health care in America will undergo major changes, revisions and challenges. The health of children must remain a major priority. Their first line of defense against disease is immunizations. We are close to reaching a major goal of assuring that all children receive timely immunizations by the time they are two years of age. We must not allow the ravages of another measles or other epidemic to take the lives of our children. The next few years will be critical in this effort. Nurses have a significant challenge ahead to maintain their leadership role in the delivery of vaccine, to educate consumers, to collaborate with others to develop innovative strategies to eliminate barriers and to develop policies that will mandate that all children be immunized by their second birthday. Anything less than a total commitment to this effort on the part of all health care providers is unacceptable.