Running head: ANALYSIS OF A U.S.

HEALTH CARE POLICY 1

Analysis of a U.S. Health Care Policy

Sareece S. Guerrero

Grand Canyon University: NSG-436

July 12, 2020

ANALYSIS OF A U.S. HEALTH CARE POLICY 2

Analysis of a U.S. Health Care Policy

Introduction

Health care policies must be analyzed because of the impact they have on nursing

practice and the community. As policies are analyzed, positive and negative aspects are brought

to light so revisions may be proposed that will benefit the health care system. The House Bill

2486 offers the community more opportunities for vaccination exemption and it must be changed

to ensure health and safety for the public.

Summary of a U.S. Health Care Policy

The House Bill 2486 named Immunizations; Requirements; Exemptions was proposed

January 29th, 2020 in title 36, chapter 6, article 4.1 of the Arizona Revised Statutes. It says that

anyone who is required to receive a vaccination for any purpose such as attending school may

claim exemption for themselves or their dependent if it does not meet a specified list of criteria.

The criteria includes: the vaccine must be approved by the United States Food and Drug

Administration (FDA); the vaccine must be evaluated for its long-term potential to cause cancer,

infertility, and gene mutation; the clinical trial that the FDA approves must be evaluated for one

year against a control group; the department must post the rate of injury or disease on their

website; studies must determine safety of administering with other vaccines; the risk or injury or

death of the vaccine must be less than the infection it is supposed to prevent; and the

manufacturer must be liable for design defect claims (HB 2486, 2020). The Arizona Nurses

Association’s Public Policy Committee & Bill Review Process have chosen to oppose this bill;

however, this bill is still actively in the review process (Arizona Nurses Association, 2020).
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Major Stakeholders

Everyone in the community could be affected if this bill is passed. House Representatives

that have sponsored this bill such as Frank Carroll, Walter Blackman, Shawna Bolick, John

Fillmore, Jay Lawrence, Kevin Payne, Tony Rivero, Bob Thorpe, and Ben Toma have a

significant influence on whether it is passed (HB 2468, 2020). The FDA would have to change

their vaccine product approval process and the manufacturers would carry the burden of possible

additional liabilities. The healthcare workers would immunize less people which could result in

caring for more sick patients. Healthcare workers who choose not to immunize themselves would

put their own health and the health of their patients at risk. The approval of additional vaccines in

the future could take much longer than what is necessary and delay protecting society from

illness. The development of this bill needs the cooperation of politicians, healthcare workers, and

the public to get perspectives and make the best decisions.

Positive and Negative Aspects of the Policy

The vaccination exemption policy and its criteria display both reasonable and

unreasonable stances. It appears reasonable and safe to protect the public in making sure the

FDA approves of vaccinations, but the criteria given is vague and unnecessary. There is no

specific amount of time given in the bill that makes a vaccination safe when testing for long-term

potential to cause anomalies like cancer, and it is overreaching to allow someone to be exempt if

this has not been achieved. The current vaccinations required to attend school in Arizona are Hep

B, Polio, MMR, VAR, Tdap, and Meningococcal (Arizona Department of Health Services,

2020). Each one of these vaccinations have been approved by the FDA in which extensive

clinical trials and ongoing trials are conducted to ensure safety (FDA, 2020). The FDA already

requires that manufacturers label potential risks, and they have a Vaccine Adverse Event
ANALYSIS OF A U.S. HEALTH CARE POLICY 4

Reporting System in place to further monitor effects after it is marketed (FDA, 2018). The

FDA’s existing vaccination approval process provides the United States with the safest and most

effective vaccinations to date (FDA, 2011).

Policy Impact on Nursing Practice and Effective and Equitable Care

Nursing practice is reliant on vaccinations to keep healthcare workers and the public safe

from disease. The American Nurses Association (ANA) holds a strong stance of supporting

mandatory immunizations for health care workers. The only two reasons the ANA would want to

exempt someone would be in the case of medical contraindications or religious beliefs (ANA,

2015). It is said that the advancement of immunizations has been the greatest public health

achievement in the United States (ANA, 2015). HB 2486 would move Arizona in a direction that

reduces the safety of the public by exempting more vaccination requirements. If more nurses

were to request exemptions, then there would need to be extra precautions in place to ensure that

their patients are safe from transmission of diseases. Financially, this would cause more spending

in treatment of these diseases and alternative preventative measures that are less effective. It may

also result in additional liability expenses for manufacturers.

Proposed Policy Changes

It is reasonable for FDA approval to be required for mandatory administration, although

the additional criteria in the policy for vaccination exemption should be changed. The FDA

already approves of vaccinations before allowing them to be marketed, but the policy makes it so

that vaccinations are exempted if there is no long-term evaluation for the risks of cancer,

infertility, and gene mutation. A time period must be defined in order for this point to be

considered, otherwise anything can be taken as not tested long enough. The requirement that the

rate of adverse effects be less than the rate of infection should also be changed. The rate of
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infection in the United States is low because of vaccinations, so if people stopped taking them

because the adverse effects were more prevalent, more outbreaks would occur because the

disease does not disappear (Centers for Disease Control and Prevention, 2018).

Conclusion

Health care policies such as HB 2486 must be strictly analyzed because of how much it

affects the lives of stakeholders. This health care policy as it is would do more harm than good if

implemented. Their required criteria for vaccinations must be changed or even eliminated

because they are unspecific, unnecessary, and only add barriers that would prevent the

community from receiving the immunizations they need.

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References

American Nurses Association. (2015). American Nurses Association position statement on

immunizations. Retrieved from

https://www.nursingworld.org/~49177c/globalassets/docs/ana/executivesummaryposition

statement_immunizations.pdf

Arizona Department of Health Services. (2020). Arizona guide to immunizations required for

entry. Retrieved from https://azdhs.gov/documents/preparedness/epidemiology-disease-

control/immunization/school-childcare/school-immunization-requirements.pdf

Immunizations; Requirements; Exemptions, AZ H.B. 2486, H.R., 54th Legis., 2nd Sess. (2020).

Arizona Nurses Association. (2020). 2020 Nurse’s list of bills. Retrieved from

https://www.aznurse.org/page/PPNursesList

Centers for Disease Control and Prevention. (2018). What would happen if we stopped

vaccinations? Retrieved from https://www.cdc.gov/vaccines/vac-gen/whatifstop.htm

U.S. Food and Drug Administration. (2011). Ensuring the safety of vaccines in the United States.

Retrieved from https://www.fda.gov/files/vaccines,%20blood%20&

%20biologics/published/Ensuring-the-Safety-of-Vaccines-in-the-United-States.pdf

U.S. Food and Drug Administration. (2020). Vaccines licensed for use in the United States.

Retrieved from https://www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-

licensed-use-united-states

U.S. Food and Drug Administration. (2018). Vaccine product approval process. Retrieved from

https://www.fda.gov/vaccines-blood-biologics/development-approval-process-

cber/vaccine-product-approval-process