Teaching Elementary School Students about Immunization

1. Statement of purpose, 100+ words.

As part of my Health Paper, I will be exploring a health topic related to immunization. In the first part of the paper I will first give an overview of the topic by identifying what immunization is and why this is an important health issue especially for young students in elementary school. Then I will further explain the pros and cons of immunization and discuss the reasons behind those who refuse having their children vaccinated. The Florida State’s School and Child Vaccination Laws requirements and exemptions in respect to other states will be explored and the state’s effort to increase the number of students from having immunized will also be included in this part of the essay.

In the second part of the essay, I will mention why it is important to teach about immunization to elementary school students, what contents should be covered, what methods should be used in order teach the young students effectively, and explain how to assess the students’ learnings. Then finally, I will conclude the essay with my personal stance about immunization as a general health topic and also as an educator who supports the teaching about vaccination as part of health education to all students in elementary schools.

2. Overview and rationale, 300+ words.

According to the World Health Organization (WHO), immunization is a proven process of a person becoming immune or resistant to life-threatening and infectious diseases after the administration of vaccines. (“Immunization”, 2018) The WHO also estimates that vaccination is saving between 2 to 3 million lives every year. The U.S. Department of Health and Human Services initiated Healthy People 2020 to promote public health in the nation and “life free of preventable diseases” – which can be realized to some extent with the help of vaccination – is mentioned in the first overarching goal and immunization is listed as one of the 42 topics areas that highlights vital public health concerns and specific populations. (NCHS, 2011)

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Despite the proven effectiveness in preventing the spread of epidemics and protecting young children from many diseases and the State Vaccination Laws that include vaccination requirements for children in daycare and K-12 in public and private schools and colleges/universities across the nation, it is reported that there is an increase in non-religious refusals to vaccinations partially due to medically discredited belief that vaccines may attribute to autism spectrum disorder (ASD) or Attention Deficit Disorder (ADD) and a group of researchers described this phenomenon as the “antivaccine movement in the United States”. (Olive, Hotez, Damania, & Nolan, 2018)

The same paper cited the National Immunization Survey (2015) reporting that only 72.2% of children aged 19 to 35 months were fully vaccinated as per guidelines and the number of nonmedical exemptions(NMEs) based on religious or philosophical beliefs are also expected to be on the rise. The study has found that in 12 of the 18 states that allow NMEs have been showing a gradual increase in enrolling kindergarteners with NMEs since 2009. Although the State of Florida only allows the medical exemption to vaccination and does not allow any NMEs and require immunization records (Florida Certification of Immunization, DH 680 Form) for all newly enrolling, attending, and transferring students to all Florida schools (“Immunization Guideline”, 2013), the national statistics at 70% among very young children is alarming because it is said that that at least 90% of the population should be immunized or vaccinated to prevent disease outbreaks in a community. (“School & Childcare Requirements for Immunizations”, n.d.)

The recent outbreak of measles in California in 2015, a total of 125 measles reported in U.S. residents, suspected to have sourced from two Disney theme parks although unconfirmed by the CDC report as the source infection, was first identified in an eleven years old boy, who was unvaccinated. (“Measles Outbreak- California”, 2015) Back in 2008 there was another measles outbreak where the disease was first identified in an unvaccinated 7-year-old boy living in San Diego, California. The CDC reports have identified out of the 11 additional cases: 2 were the index patient’s siblings, 5 infected children were in his school, and 4 others were those who had been in the same pediatrician’s office at the same time as the index patient. (“Outbreak of Measles”, 2008) In both cases, the index patients were unvaccinated students in elementary school evincing the importance of vaccination in young children to prevent the spread the epidemic. There are some cases where children have allergic reaction to vaccines therefore they have to be medically exempted from immunization but opting-out due to parents’ “philosophical” reasons can pose risks for other children’s lives at risk. This gives a good ratification why we need to teach about immunization to young children in elementary school and the further discussion will follow. 

3. Research studies, at least 2 references with 350+ words.

In a research article titled “Health Literacy and infectious diseases: why does it matter”, the authors have found that when people have limited and insufficient health literacy they are unlikely to adopt protective behaviors such as immunization. (Castro-Sachez, Chang, Vila-Candel, Escobedo, & Homes, 2016) Some other researchers published an article suggesting that it may be more effective to teach the importance about vaccination to students in elementary school than adults because it is harder to change beliefs that are deeply held by adulthood. (Wilson, Atkinson, & Crowcroft, 2017) The same study cited a study that found adults were showing more anti-vaccination sentiment after being exposed to a presentation about pro-vaccination information. (Wilson, Norman, Tomlinson, 2005) The first paper evinces the importance of deliberate teaching or any other effort or intervention to foster health literacy in order to change behaviors in people to receive required vaccinations. The second paper shows such effort can be tried at elementary school level. 

 Since now PE education is sought as a site of health intervention and covers more comprehensive scope than just physical activity (Gill, Roth, Rice, Prelip, & Griffin, 2018), teaching elementary school students about immunization only seems like a sensible thing to do. The National Association for Sport and Physical Education defined PE standards as what students should know and what they do to become a physically educated person while the National Health Education Standards offer a framework where knowledge and skills can be built in order to cultivate a health literacy in K-12 students. In the Executive Summary of the Shape America 2016 concluded that physical education will bring improvement in student wellness, academic outcomes, develop life skills that shape the whole person, encourage smart choices and produce a healthful lifestyle. Teaching about immunization can bring students’ awareness of immunization in other words enhance students’ health literacy and help them make smart and healthful choices of receiving necessary immunization shots. The study of immunization also integrates well with science standards where students learn about what consists of blood and how body immune system works therefor can enhance academic outcomes. (Society of Health And Physical Educators, 2016)

4.Proposed intervention theory/model, 150+ words.

I have talked about why educating elementary school students about immunization is important and how it relates to the national health standards and health education standard and now in this section I will discuss what would be the best way to deliver the health intervention. Wilson et al. (2017) suggested the use of analogies in the form of comic books, videos, and games to deliver content so that learning can be fun and different from the traditional school lesson.

Based on what I have learned from the discussion topics in the class and the textbook, I suggest using cooperative learning after reading about immunization after watching a video clip or reading comic books so that students can learn a new concept and develop communication skills at the same time. This instructional strategy is in line with John Dewey’s (1990) belief that children should take part in learning, even lead learning, and contribute to the curriculum which is different from traditional learning style of teacher-led instruction (i.e. lectures). (Flint, 2008, p.85). Cooperative learning also encompasses the process of project-based learning, where learners get together to understand a concept or skill. The whole process will encourage students to develop self-directed learning skills and help them build thinking skills that are applicable throughout their lives. (Krauss & Boss, 2013) Joint Committee on Health Education Standards (2006) has defined a health-literate individual is a critical thinker and problem solver, a responsible and productive citizen, a self-directed learner, and an effective communicator. (as cited in Meeks, Heit, & Page, 2013) The Cooperative learning strategy encourages students to become health-literate in all these four aspects, therefore I think this is the best instructional strategy that should be the core of the health instruction.

References:

• Flint, A. S. (2008). Literate lives teaching reading & writing in elementary classrooms. Hoboken (NJ): John Wiley & Sons.
• Gill, M., Roth, S. E., Rice, L. N., Prelip, M. L., & Koniak-Griffin, D. (2018). “You Only Teach PE and It Doesn’t Really Matter”: Middle School PE Teachers’ Perspectives on Intervention Efforts to Increase Physical Activity. The Journal of School Nursing, 105984051879503. https://doi.org/10.1177/1059840518795039
• Immunization. (2018, February 23). Retrieved from http://www.who.int/topics/immunization/en/
• Immunization Guidelines, Florida Schools, Childcare Facilities, and Family Daycare Homes, 2013 http://www.floridahealth.gov/programs-and-services/immunization/children-and-adolescents/_documents/school-guide.pdf
• Kraus, J., & Boss, S, (2013). Thinking through project-based learning: Guiding deeper Inquiry. Thousand Oakes, CA: Corwin.
• Meeks, L., Heit, P., & Randy M Page, D. (2012). Comprehensive School Health Education. New York, USA: McGraw-Hill Education.
• Measles Outbreak — California, December 2014–February 2015 https://www.cdc.gov/Mmwr/preview/mmwrhtml/mm6406a5.htm
• National Center for Health Statistics. (2011, October 14). Retrieved from
  https://www.cdc.gov/nchs/healthy_people/hp2020.htm
• Olive, J. K., Hotez, P. J., Damania, A., & Nolan, M. S. (2018). The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties. PLOS Medicine,15(6). https://doi.org/10.1371/journal.pmed.1002578
• Outbreak of Measles — San Diego, California, January–February 2008 https://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e222a1.htm
• School & Childcare Requirements for Immunizations :: Public Health :: Contra Costa Health Services. (n.d.). Retrieved October 4, 2018, from https://cchealth.org/immunization/school-requirements.php
• Society of Health And Physical Educators. (2016). 2016 Shape of the Nation report – SHAPE America. Retrieved from https://www.shapeamerica.org/uploads/pdfs/son/Shape-of-the-Nation-2016_web.pdf
• Wilson, K., Atkinson, K., & Crowcroft, N. (2017). Teaching children about immunization in a digital age. Human Vaccines & Immunotherapeutics,13(5), 1155–1157.