Mississippi RN - March 2021

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Page 8 • Mississippi RN March, April, May 2021 Answering the Big Questions on COVID-19 Vaccines Juanita Graham, DNP- RN, FRSPH Although nurses strongly agree on the need to eliminate the COVID-19 virus and related suffering and death, there are much more diverse perspectives on whether the currently available vaccines should be part of the elimination plan. As a general rule, provaxxers and anti-vaxxers exist at opposite ends of the preventive health spectrum, and vaccination mandates remain a hotly debated topic. However, the accelerated speed at which COVID vaccines were created provokes skepticism among even some of the staunchest vaccine advocates. Currently, COVID-19 vaccination is ultimately a personal choice. This article seeks to objectively answer common questions on COVID-19 vaccines. What COVID-19 vaccination principles should nurses consider? The American Nurses Association cites five nursing principles regarding COVID-19 vaccination, including Access, Efficacy, Equity, Safety, and Transparency (ANA, 2021). Access recognizes the challenges of global vaccination efforts. Efficacy measures the extent to which the vaccine performs in developing immunity. Equity calls for balance in protecting essential workers and most vulnerable people groups around the world. Transparency of vaccine production and vaccination efforts is required to maintain trust among the public. Well-defined safety protocols are necessary to protect the provider and the vaccine recipients from injury or harm. What processes and protocols were followed to obtain vaccines so quickly? The US Food and Drug Administration follows stringent, three-phased protocols for vaccine development, even under such rapid-roll-out mechanisms (CDC, 2020a). Phases begin small with as few as 20 participants and gradually move up to thousands of participants. Careful monitoring of every trial participant assures a rapid halt in the process if a serious negative event occurs, and construction of a complete and accurate list of vaccine side effects. Upon completing Phase III trials, the pharmaceutical company can apply for an Emergency Use Authorization (EUA). An EUA allows the immediate use of a product or device in response to a public emergency or disaster, such as the COVID-19 pandemic (FDA, 2020). What vaccines are available? As of mid-January 2021, there are two FDA-approved EUA vaccines – one from Moderna (M), and another by Pfizer- BioNTech (PB). Both are mRNA type vaccines, meaning that they use messenger RNA to develop an immune response (CDC, 2020b). Both require two doses given nearly a month apart (PB 21 days vs. M 28 days), and administered by intramuscular injection (IAC, 2020). Both require refrigerated storage, but the PB vaccine requires ultracold storage (IAC, 2020). The M and PB report similar adverse reactions (injection site pain, swelling, redness; systemic fatigue, headache, muscle pain, joint ache, & chills) and precautions (previous severe allergic reaction to vaccines or their components; IAC, 2020). Who is eligible to be vaccinated and when? The National Academies of Science, Engineering, and Medicine (NASEM) published an interim guidance and framework for allocating vaccine based on need (NASEM, 2020). The NASEM framework divides the mass-population vaccination into four major phases, with two phase 1 subsets. Phasing protocols are controlled at the state level – usually the Governor and/or state and local public health officials. Phase 1a focuses on essential workers and healthcare providers. Phase 1b focuses on high-risk individuals, particularly the very elderly, greater than 75 years in age. Phase 1b also includes certain very high-risk groups such as those with significant chronic health conditions, including immunocompromised, diabetic, and hypertensive individuals (NASEM, 2020). Phase 2 incorporates more essential workers and people living in or with higher risk conditions (NASEM, 2020). The Phase 2 essential workers include teachers and grocery store staff, and groups such as prisoners, homeless, or those with other less critical health conditions. Phase 3 reaches farther across the masses picking up young adults, children, and more essential workers not included in Phases 1 and 2 (NASEM, 2020). Finally, Phase 4 opens the full reach of the vaccination effort to incorporate any other individuals living in the U.S., not already captured during earlier phases (NASEM, 2020). Individuals desiring earlier vaccine access may choose to join a vaccine clinical trial. Visit the National Institutes of Health website to learn more about volunteering for clinical trials (NIH, 2020). Can I stop taking safety precautions after getting a COVID-19 vaccine, or if I’ve already had COVID-19 infection? The current consensus is no. The vaccines are very new and there hasn’t been enough research and time passed to know how long vaccine-produced immunity will last. Thus, it becomes necessary to continue safety precautions until more is known about vaccine efficacy and longevity (Sparks & MCS, 2021). Similarly, if you’ve already had COVID-19, you might still consider the vaccine, because there is insufficient research to know the efficacy or longevity of natural infection-acquired immunity acquired (Sparks & MCS, 2021). Will travel ever be the same? Mass transit has been significantly impacted by COVID-19 due to reduced ability to social distance and maintain fresh air flow. Many modes of travel already require proof of disease recovery or COVID-19 testing (CDC, 2021). As the mass vaccination movement pushes forward, some travel industries are already setting requirements mandating proof of vaccination before traveling with them (Coulter, 2021; Sweet, 2020). These vaccine passports or immunity certificates may soon be required for certain entertainment venues such as Live Nation concerts and Ticketmaster (Brooks, 2020). The best travel policy will certainly be know before you go. References American Nurses Association [ANA]. (2021). Guiding principles for nurses and the COVID-19 vaccines. Available online at https://bit.ly/2KDyB8n Brooks, D. (2020). How Ticketmaster plans to check your vaccine status for concerts: Exclusive. Available online at https://bit.ly/2KFi7Nb Centers for Disease Control and Prevention [CDC]. (2020a). Ensuring the safety of vaccines in the United States. Available online at https://bit.ly/3abd8N5 Centers for Disease Control and Prevention [CDC]. (2020b). Understanding mRNA COVID-19 vaccines. Available online at https://bit.ly/3qQ0kSZ Centers for Disease Control and Prevention [CDC]. (2021). Order section 361. Available online at https://bit. ly/365VoRJ Coulter, A. (2021). Saga Cruises becomes first line to insists passengers have COVID vaccination ahead of cruise. Available online at https://www.cruisecritic. com/news/5830/ Immunization Action Coalition [IAC]. (2020). COVID-19 mRNA vaccines: What clinic personnel need to know. Available online at https://www.immunize. org/catg.d/p3210.pdf . National Academies of Sciences, Engineering, and Medicine [NASEM]. (2020). Framework for equitable allocation of COVID-19 vaccine. Washington, DC: The National Academies Press. https://doi. org/10.17226/25917. National Institutes of Health [NIH]/ (2020). Volunteer for COVID-19 clinical trials. Available online at https:// www.niaid.nih.gov/clinical-trials/covid-19-clinicaltrials . Sparks, D. & Mayo Clinic Staff [MCS]. (2021). You need the facts about COVID-19 vaccines. Available online at https://mayocl.in/3qDu1X4 Sweet, J. (2020). Will airlines require vaccine passports in 2021? Available online at https://bit.ly/39QIKHu U.S. Food and Drug Administration [FDA]. (2020). Emergency use authorization for vaccines explained. Available online at https://bit.ly/396FLvq
March, April, May 2021 Mississippi RN • Page 9 Tomekia Luckett, PhD, RN Intimate Partner Violence & the Covid-19 Pandemic Intimate partner violence (IPV) is becoming increasingly problematic within the United States and abroad. Intimate partner violence refers to physical violence, sexual violence, stalking or psychological harm by a present or former spouse or partner. Intimate partner violence can occur in heterosexuals or same-sex couples, and sex may or may not be involved in the dynamic. Individuals who experience IPV often fear speaking out about their circumstances due to fear and shame. The national domestic violence slogan is “silence hides violence.” There are also cultural and societal norms relating to “keeping silent and protecting the happenings of our house.” These cultural norms provide further barriers to individuals who are experiencing IPV from speaking out. Individuals who are in these situations could benefit greatly from a healthy outlet to share their feelings and experiences. Unfortunately, the stigmas associated with IPV prevent many from speaking out and therefore the cycle of violence continues. Sadly enough, rates of (IPV) displayed an increasing trend amid the global Coronavirus-19 (COVID-19) pandemic. To reduce the risk of COVID-19 spread and to flatten the curve, orders for shelter-in-place were initiated worldwide (Fromison et al, 2020). The orders were named “safer at home” or “shelter in place.” These orders were necessary to enhance public safety and provide possible means to reduce transmission of COVID-19. However, the reality for some patients is that the home is the least safe place for their immediate health (Fromison, et al., 2020). As individuals were mandated to shelter-inplace, this added to the amount of time for families and couples to be in close quarters together. This proximity further perpetuated the cycle of violence and led to increased incidences of IPV. Further, financial stressors and job loss secondary to the COVID-19 pandemic further increased the risk for IPV and made escape less feasible for victims (Jarneke & Flanagan, 2020). How can healthcare workers assist IPV survivors during the pandemic and beyond? One of the primary means to assist survivors of IPV is by providing resources. The provision of resources includes resources for shelter, finances, and planning for a safe escape. Nurse leaders and policy makers are further encouraged to initiate conversations centered around the management of the global pandemic and often overlooked persons to include those who are at risk for IPV. The need to provide creative and effective means to provide IPV survivors with resources across various platforms is essential to further assist during these challenging times (Jarneke & Flanagan, 2020). In the long-term, the COVID-19 pandemic may serve as a model for future planning and preparedness in the face of crisis. This planning and preparedness should include safety measures and resources for persons at risk for IPV and IPV survivors. The Mississippi Nurses’ Association is committed to providing continuing education offerings to increase knowledge and awareness of IPV. MNA instituted efforts prior to COVID-19 including adoption of a resolution to facilitate awareness of IPV within Mississippi. MNA is committed to these sustained efforts as IPV is a public health concern impacting us all in one way or another. As nurses, this is our commitment and we are dedicated to fulfilling this need. References Froimson, J. R., Bryan, D. S., Bryan, A. F., & Zakrison, T. L. (2020). COVID-19, Home Confinement, and the Fallacy of “Safest at Home.” American Journal of Public Health, 110(7), 960–961. https://doi-org.ezp. waldenulibrary.org/10.2105/AJPH.2020.305725 Jarnecke, A. M., & Flanagan, J. C. (2020). Staying Safe During COVID-19: How a Pandemic Can Escalate Risk for Intimate Partner Violence and What Can Be Done to Provide Individuals With Resources and Support. Psychological Trauma: Theory, Research, Practice & Policy, 12, S202–S204. https://doi-org. ezp.waldenulibrary.org/10.1037/tra0000688 Thank You! The Board of Directors and staff of the Mississippi Nurses’ Association offer our sincere appreciation to you, Advanced Practice Registered Nurses and Registered Nurses, who faced the challenges of Winter Storm 2021 head-on! No matter what it took, you continued to care for Mississippi’s patients, your colleagues and your communities! MNA President, Dr. Tonya Moore has a special video message for you. Click Here for MNA President, Dr. Tonya Moore Video We hope you can find time to rest, and encourage you to take care of yourselves! Thank you for your dedication! Dr. Tonya Moore’s video can be accessed at http://www.msnurses.org for those who are viewing the print copy. NursingALD.com can point you right to that perfect NURSING JOB! NursingALD.com Free to Nurses Privacy Assured Don’t just take a job... Grab a Career with a leading psychiatric and behavioral center for children and adolescents in Louisville Immediate Openings: MHS, RN, & PRN $3,000 sign-on bonus for RN’s Night Shift Position Increased shift differentials for RN’s, LPN’s and Mental Health Specialists for Evening, Night and Weekend Shifts Please contact Dalaphine Mays at 662-779-0119 or dalaphine.mays@uhsinc.com Easy to Use E-mailed Job Leads pcnursing.com Hospital/Facilities/Home Care Staffing Recruiting all RN’s New Base Pay Rates Eastern LA Mental Health System Call (225) 634-4303 for more info The largest publicly founded Mental Health System in Louisiana Leading the way in Mental Health Care! Serving Mississippi for over 30 YEARS RNs & LPNs WE NEED YOU! From the Gulf Coast to Memphis... Call 1-800-844-4298 Thank you Healthcare Workers! For working tirelessly to care for patients. For risking your own health to protect ours. For always being there when you are needed most. WE APPRECIATE YOU
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Mississippi RN - March 2021

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