• What should be the role of health policy at the state level?

The role of health policy at the level of the state is important to increase the number of vaccinated populations, decrease the number of non-medical vaccine exemptions (NME), lower rates of vaccine-preventable diseases (VPDs), and prevent the spread of highly infectious diseases and pandemics. To achieve a high vaccination coverage rate, state regulations are to give vaccines at a very early age such as daycare and school children; this applies to children of public and private schools. Although all states offer some kinds of exemptions including medical, religious, and philosophical exemptions, states enforce mechanisms for the regulation of school vaccination administration and exemptions (CDC – vaccination laws – publications by topic – public health law, 2022).

State laws also help to provide access to vaccination by making the vaccination within the scope of professional practice by providing selected resources for public health practitioners. Furthermore, states enforce healthcare facilities to vaccinate their healthcare workers to decrease outbreaks of vaccine-preventable diseases including Hepatitis-B, Measles, Influenza, Measles, Mumps, and Rubella (MMR), Pneumococcal disease, Pertussis, and Varicella. For the school student, either public or private, state school vaccination laws are applied to regulate and ensure identical immunization status and exemption provisions (CDC – vaccination laws – publications by topic – public health law,2022).

  • What should health policy’s role at the institutional (or provider) level be?

 Vaccination has an important effect in decreasing mortality and morbidity rates. Proper vaccination can save two to three million lives every year, due to the known fact, that healthcare personnel, including nurses, are a common cause of infection spread among patients; having identical immunization is mandatory to prevent several vaccine-preventable diseases and pandemics. The role of institutional regulation is to keep healthcare personnel immunized, as well as ensure patient education about vaccination importance. Confirming the institutional role of vaccination in protecting patients who have deficient immune responses after vaccination such as elderly and immunocompromised patients, and those who can’t get the vaccines because of host factors such as pregnant women and young infants, is very important to prevent severe nosocomial and complicated infections (Maltezou et al., 2022).

The institutional role is important in decreasing the absence of employees (Absenteeism) due to some kind of vaccine-preventable diseases such as influenza and COVID-19 infection. Furthermore, the institution’s policy and procedure for vaccination can control not only absenteeism but also presenteeism; which is defined as working while being ill. Presenteeism can put healthcare workers and patients in danger, for example, there were 35 cases of measles nosocomial outbreak in an Italian hospital, a few years ago, due to a misdiagnosed physician with measles (Maltezou et al., 2022).


The roles of the state and organization are very related and interconnected to each other, as most of the time, the healthcare organization must activate the state laws, in addition, the state should support the organization’s role by providing guidelines, regulations, and resources including financial support like what had happened during covid-19 pandemic, the state had supported employers by paying COVID-19 sick leaves for infected employees to control the spread of infection and decrease morbidity and mortality rate by proper isolation.

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