What is the role of registered nurses in administering immunizations to infants and children, and what is the most current immunization schedule?
The federal government has left it up to individual states’ medical licensing boards to determine who can administer immunizations for communicable diseases. Consequently, one would have to visit each state government’s website to answer a question pertaining to any particular state. In general, however, immunizations can and are routinely administered by registered nurses, who must be certified by the state (hence, the “registered” part of RNs) as well as by legally-authorized nurses’ associations that exist to ensure all members are employed by or legally authorized by licensed health care organizations to administer vaccines. The registered nurses are required to remain current on immunization protocols, which can change over time.
An example for the legal requirements pertaining to administration of immunizations in the State of New York reads as follows:
“Registered Nurses must maintain or ensure that a copy of the standing order(s) and protocol(s) authorizing them to administer immunizations is maintained.
All Registered Nurses immunizing children in accordance with non-patient specific standing orders and protocols must be employed by, or act as an agent of, the Visiting Nurses Association or an equivalent organization legally authorized to provide nursing services as determined by the New York State Education Department or by a State, county, municipal or other government agency.
An LPN [licensed nurse practitioner] can assist in administering immunizations (give the injection, assist in recordkeeping, and when appropriate, administer anaphylactic agents) as long as the RN assesses the recipient, and is responsible for the on-site direction of the LPN in administering the immunizations. It is expected that, in this setting, a ratio is maintained of no more than three LPNs to one RN.”
In addition to the above, each medical facility is responsible for maintaining records of immunizations, a good example of which is this link to a standard childhood immunization form: http://www.immunize.org/catg.d/p2022.pdf
With respect to childhood immunization schedules, the U.S. Centers for Disease Control determines the optimal schedule for children and maintains it, regularly updated as circumstances dictate, at this web address: http://www.cdc.gov/vaccines/schedules/easy-to-read/index.html. This CDC website provides the breakdown from birth through age 6 for when each of the main vaccines should be administered. The website also provides useful information on each of the diseases for which vaccines are developed and administered, including the specific vaccine used for each disease, how each disease is spread, the symptoms, and complications that often develop from each illness.