Albert presents to your general practice clinic with his five-year-old daughter Mia for review of her vaccinations. Mia’s parents, separated several years ago and share custody of Mia.
Mia’s scheduled vaccinations up to 18 months of age have been administered correctly and fully according to the Australian Immunisation handbook 2018 as applicable for your state. Mia’s father identifies as having indigenous heritage. Mia has not had any subsequent vaccinations after her vaccinations given at 18 months.
Albert is concerned that there has been an ongoing pertussis outbreak in their local community, with many children not being vaccinated. You are aware that the immunisation coverage rate, for all measured age groups, within Albert’s community is approximately 72%.
Mia is due to start primary school soon. Albert requests Mia’s outstanding vaccinations to be completed, especially the pertussis vaccine, due to the recent community outbreak. He also requests Mia to be vaccinated against influenza, as he is aware that Mia has an added vulnerability due to her indigenous heritage.
An additional reason for Albert’s request is that his new partner, Talia, who is Mia’s step-mother, is due to have their first baby in six weeks’ time. Albert is anxious that the newborn may be at risk of exposure to vaccine preventable diseases, especially pertussis, if Mia remains unvaccinated. Talia has received all of her childhood vaccinations as appropriate for your state and the time that she grew up. She has not had any adult vaccinations after the age of 16 years and is now 37.
Mia’s biological mother, Rose, also comes to your practice during the consultation. Your practice has a recall system for overdue vaccinations, so you are mindful of Rose’s awareness of Mia’s overdue vaccines. Mia’s case report has documented that Rose has an objection to vaccinations due to concerns about allergic reactions and adverse events following immunisation (AEFI).
Referring to the above case scenario, and integrating the knowledge gained in Themes 1, 2 and 4 in providing immunisation service in a culturally informed and safe environment, answer the following questions:
- Can Albert consent to Mia’s vaccination without the consent of Mia’s mother? Should you go ahead and vaccinate the child after completing the pre-vaccination assessment and obtained consent from Mia’s father? Discuss and explain your decision (500 words).
- Outline how you would counsel Mia’s biological mother, Rose, who is deemed to be ‘hesitant vaccinator’ or a ‘fence-sitter’, regarding vaccinating Mia (500 words).
- Articulate how you would identify and manage anaphylaxis following an immunisation encounter (500 words).
- Explain how you would advise Rose regarding Mia’s future vaccination recommendations following AEFI (500 words).
As can be seen by Brown and Loehlin’s criticisms of Shuey’s publication, the 1970’s brought with it more research arguing for an environmental origin of the Black-White IQ gap (21, 22). In 1974, Willerman, Naylor, and Myrianthopoulos looked at children born to either a Black or White mother (23). The idea was that if the Black-White IQ gap is largely hereditary, then children with one Black and one White parent should have, on average, the same IQ, no matter which parent is Black (23). If, however, mothers were particularly important to the intellectual socialization of their children, and the socialization practices of White mothers were more favourable than those of Black mothers, then children of White mothers and Black fathers should have higher IQs than children of Black mothers and White fathers (23). It emerged that children of White mothers and Black fathers had IQs 9 points higher than children with Black mothers and White fathers, suggesting that most of the Black-White IQ gap due to environmental factors (23). Scarr and Weinberg performed a study in 1976, in which they investigated the IQ test performance of Black and interracial children adopted by White families in Minnesota (17). Over 100 families participated, with a total of 321 children four years old or older (17). Of those children, approximately half were the biological White children of adoptive parents, while the other half were the Black and interracial adopted children (17). Intellectual, personality, and attitudinal tests were administered to both the parents and the children, extensive interviews were conducted with the parents, and ratings of home environment were made (17). Based on their analyses, the authors saw that socially-classified Black children’s IQ scores varied by at least one standard deviation, or fifteen IQ points, in White environments compared with Black environments (17). They further found that interracial children scored an estimated 12 points higher than those with two Black children, but it is important to note that they attributed that difference to confounding variables such as large differences in maternal education and pre-placement history (17). Based on these results, Scarr and Weinberg ultimately concluded that “if all [B]lack children had environments such as those provided by the adoptive families in this study … their IQ scores would be 10-20 points higher than their scores are under current rearing conditions” (17). Contemporary Research>GET ANSWER