Vaccines for Children and Adolescents: Lessons and Activities
Stories of heroes and villains captivate children from an early age. The protectors of those universes teach kids about serving others and fighting their own enemies.
Yet, in the flash and bang of fairytale stories and superhero films, a modern marvel in our own world often goes relatively unnoticed. Vaccines are unsung heroes, the masterworks of public health experts and researchers over centuries and across backgrounds.
“It’s one of the 10 greatest public health achievements, and yet we’re not teaching kids anything about it,” said Georges C. Benjamin, MD, executive director of the American Public Health Association.
Instead of being celebrated, vaccines have become controversial, fueled by misinformation online — and, in 2020, concern is growing about how fast a coronavirus vaccine is being developed. The global coronavirus pandemic has only stoked people’s fears. An Associated Press survey indicates that only half of Americans would get a COVID-19 vaccine if available.
Linda Morse, RN, believes vaccine hesitancy and vaccine resistance today can be explained in part by adults’ own educational experiences.
“We don’t do a terrific job in this country with health education,” said Morse, past president of the American School Health Association. “If we look at the parents of today, chances are they didn’t have the basics of health education when they were in school.”
Still, an effective and widely distributed vaccine is likely the only way the COVID-19 pandemic will end — and vaccine hesitancy more broadly is one of the World Health Organization’s top 10 threats to global health.
Part of helping our children grow up well means giving them an accurate understanding of vaccines and the tools to make healthy decisions as adults.
“Parents are the first teachers, and educators are the second in terms of making sure they get good advice,” said Benjamin.
Below, MPH@Baylor explores how adults can start conversations about vaccines with children and adolescents with advice and activities for each age group.
How to Talk About Vaccines With Children and Adolescents
Before starting conversations about vaccines and epidemiology with children and adolescents, adults should make sure they have a solid understanding of how immunizations work. As previously mentioned, many parents and educators may not have had sufficient health education themselves.
“The playing ground there is not level,” said Morse. “I think it’s one reason why there are so many misconceptions and myths out there about things like vaccines.”
A healthcare provider or public health professional can be a great resource, or visit these sites to learn more:
- 14 Diseases You Almost Forgot About (Thanks to Vaccines): The Centers for Disease Control and Prevention (CDC)
- Common Questions About Immunizations: KidsHealth
- Immunize for Good: Colorado Children’s Immunization Coalition
- Learn About Vaccines With Interactive Guide: CDC
- Myths and Facts About Vaccines for Children: Consumer Reports
- Vaccines.gov: U.S. Department of Health & Human Services
Early Elementary (Ages 3 to 6)
For children in early elementary school, the emphasis should be on disease prevention and introducing the concept of germs, not disease specifics. Stick to the basics, and avoid discussing any controversies about vaccines.
“You’re trying to establish behaviors in young children that will prevent them from getting or spreading any other kind of disease,” said Linda Morse.
Germs can get in our bodies and make us feel sick.
For very young children, Georges Benjamin suggests using simple language to explain germs, the collective term for the bacteria, fungi, viruses, and protozoa that can cause disease. Try starting with: “These are little bugs that get into our bodies and make us sick.”
Referring to a recent sickness could help illustrate the concept. You might say: “Do you remember when you had a cold? Your nose was running, and you had a sore throat. You had a virus in your body that made you feel sick.”
Healthcare providers can help keep germs from making us sick.
Explain to children that the medications that providers give us can help us feel better and stay healthy. The medication specifics may not matter to younger ones. However, the mode of delivery probably will.
“Kids are always going to ask why can’t [they] swallow it versus a shot?” said Benjamin. “However, medicines are prepared so they’ll be most effective.”
Remind children that some medicines work best as a shot — even if they pinch a bit.
Create a story around the immune system.
“For the youngest children, [give] concrete answers, possibly pictures, and relatable stories,” said Dina Borzekowski, research professor and interim director of The Global Health Initiative. Instead of describing germs and antibodies in abstract language, try telling a story. For example: “When you get a shot, your body creates an antibody army. If your body encounters a virus, the antibodies will be ready to fight back and win over the disease.”
We can take actions each day to keep us from getting sick.
Though everyone feels sick sometimes, we are not powerless against germs. You can empower children by teaching and modeling healthy, preventive habits. As highlighted by the coronavirus pandemic, these include thorough hand-washing, sneezing into a tissue or sleeve instead of hands, and throwing used tissues away immediately. Healthy eating, being physically active, and getting enough sleep can help prevent chronic disease.
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Later Elementary (Ages 7 to 10)
Older children are ready for more complexity. “With this group you can show more steps not only in how antibodies work but also how scientists create and test vaccines,” said Borzekowski.
They will appreciate the logical processes involved, she added. Some may find the history of vaccines interesting; educators and parents can share or read aloud stories of specific scientists and diseases.
There are different kinds of germs that need different medications.
As children get older, help them understand the differences between different kinds of germs. Any time they get sick, receive a diagnosis, and fill a prescription, use the opportunity. For example, bacterial infections can be treated with antibiotics while some viruses can only be addressed by treating the symptoms. Share the KidsHealth page on germs, and encourage children to ask their providers clarifying questions at appointments rather than relying on parents to ask all the questions.
Vaccines are helpful, not harmful.
Children may hear claims that vaccines actually cause diseases. While a vaccine does contain the same germs (or parts of the germs) that cause the disease, the dose cannot make you sick, according to the Centers for Disease Control and Prevention’s “Vaccines: The Basics” page. Immunize for Good’s “How Vaccines Work” video helps explain how vaccines are made to be safe and effective.
Communicable and noncommunicable diseases are different.
Make sure children understand the difference between diseases they can catch and those they cannot. A disease like COVID-19 can be spread between people, which is why public health officials have encouraged physical distancing. Others, such as asthma or diabetes, are noncommunicable.
“These are health conditions that people have through no fault of their own, and you can’t give that to somebody,” said Morse. Making the distinction can help children make healthy, preventive decisions when appropriate and better support any friends and family with chronic conditions.
Vaccines have a diverse history.
Creator of the smallpox vaccine Edward Jenner is commonly cited in textbooks, but Borzekowski encourages educators not to stop there. Be sure to include women and people of color when sharing how vaccines are made. Start with Drs. Pearl Kendrick and Grace Eldering, who developed the pertussis (whooping cough) vaccine, and Dr. Hunein Maassab, who developed the FluMist vaccine. Ask students to consider the obstacles to vaccine production these individuals may have faced that others did not.
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Middle School (Ages 11 to 13)
Children in middle school can appreciate more abstract issues, including the economics and politics of vaccines, said Borzekowski. Pointing them to online materials with visuals can be helpful at this age, too. As a starting point, try the CDC’s Solve the Outbreak App and the TED-Ed talk, “How Fast Can a Vaccine Be Made?”
Vaccines have already helped you.
Children on the standard immunization schedule get booster shots in middle school. One way to start a conversation about vaccines is to point out how those early immunizations have already been protecting them. Morse suggests saying: “You don’t know it because you were a baby, but you received important vaccines to prevent some very specific conditions that could interfere with your health and development.”
Some people are hesitant about or resistant to vaccines.
By this time, children may be aware of the people who are part of a vaccine resistance movement, also called anti-vaxxers. If these questions come up, explain that the movement is founded on fraudulent research and preys upon people’s fears for their children’s safety and their own. Emphasize that vaccines are safe to receive and effective at preventing many harmful conditions. Suggest bringing questions to the family healthcare provider at their next visit.
The health system has not treated everyone fairly.
Racism and inequities in healthcare can be difficult topics. However, discussing them from a young age is important to creating a more inclusive, equitable system. According to the World Health Organization, a health inequity is a difference in health status because of the conditions in which people are born, grow up, and live. Convey to children that, although we can trust our providers to take care of us, we also need to recognize and fight against unfairness, especially in developing and distributing vaccines.
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High School (Ages 14 to 18)
High school is “the last time you have young people as a captive audience,” said Morse. The crucial messages to communicate to teenagers are that they are not invincible and that their actions now will affect the choices they have in the future.
“That’s really hard because taking control of your health, including vaccines, is seen as something that older people should do but [that is] not really relevant to adolescents,” said Morse.
Taking care of our health is part of being a responsible adult.
After high school, adolescents will eventually begin managing their own health and care. Helping them learn to navigate this process early can be an extremely useful skill. Identify together the various tasks that young adults will assume responsibility for, including scheduling regular health visits, reviewing insurance plans, and, importantly, keeping up to date on immunizations.
Getting a vaccine can be a public service.
Many students are familiar with the concept of service learning. In conversation, help them make the connection between immunization and serving the community. “You’re doing good for yourself, but you’re also doing good for others,” said Morse.
Supporting the community during a public health crisis is time well spent.
Empower adolescents with opportunities to help during difficult times, said Borzekowski. Disease outbreaks and other emergencies can be overwhelming, but finding concrete ways to support neighbors can be grounding. Try doing outdoor chores for neighbors, scheduling regular phone calls with older relatives, or helping younger siblings make thank you cards for essential workers.
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Activities for Exploring Epidemiology and How Vaccines Work for Kids
Activity 1
Tracking the COVID-19 Vaccine Race
Age Group: Elementary, Middle, or High School
With the coronavirus pandemic, children and adolescents have the opportunity to see vaccines being made in real time. Together, review the phases of vaccine development and track the progress of the leading candidates. The COVID-19 Vaccine Tracker can be a useful place to start.
Have kids follow along with MPH@Baylor’s “The Amazing Race” Tracking Template. (To use it, print out all four pages and tape them together; when the pages are properly aligned, there should be a gold star at the center.) Or, kids can create their own on a poster or whiteboard.
For each vaccine, have kids research:
- Which lab is working on the vaccine?
- Where is the lab located?
- What phase is the vaccine in?
- What is the next step, and what are the challenges?
Activity 2
How Comfortable Are You With Risk?
Age Group: Elementary, Middle, or High School
Much of life during the coronavirus pandemic involves evaluating risk. For example, if our school reopens, should our family attend or choose a remote option? If a vaccine is available, could it change your decision? People experiencing vaccine hesitancy often cite fears about the (disproven) risks of getting a vaccine.
Helping children of all ages explore their attitudes about harm, protection, and risk can build their self-knowledge and enable them to make healthy, wise decisions as adults. Borzekowski suggests asking children: Are they pessimists or optimists? How do they feel about unknowns? Compared to friends, are they more cautious or more willing to take risks?
Older children and adolescents are ready for more complex questions. For a COVID-19 vaccine, what are acceptable side effects? What side effects are unacceptable? Are they sensation-seekers, people who enjoy intense experiences and are willing to take risks to pursue them? Why or why not? Try searching for sensation-seeking scales online.
Activity 3
Pretend Play at the Provider’s Office
Age Group: Elementary School
Morse suggests inviting children to bring a comforting stuffed animal to their healthcare visits. The provider can walk the animal through what to expect in getting a shot — in effect, helping the child feel more comfortable. “The child and their best friend, so to speak, are going to go through the same thing,” said Morse.
For example: “Mr. Bear, you’re going to get a shot today. It may hurt a little but will help keep you from getting sick later.”
Kids can participate by pretending to administer the vaccine and putting a Band-Aid on the animal’s arm.
Activity 4
Developing Media Literacy
Age Group: Middle or High School
Adolescents have more than seven hours of daily screen time, not counting school or homework, according to Common Sense Media’s recent report on children and media use. The internet is a main source of news and entertainment, but it is also rife with misinformation, especially about vaccines. Teaching adolescents to discern credible and noncredible sources is essential, as explored in MPH@Baylor’s article, “How to Teach Teenagers Health Literacy in the Age of Online Influencers.”
Have students list the platforms, apps, and sites they use regularly to consume media. For each, ask them to consider who funds the source and who decides which content is published.
Benjamin encourages kids to think critically about the information they consume: “One of the things I try to do is verify those sources with my own knowledge of the world. Not just medicine, but of the world, and I ask myself, ‘Does that make sense?’”
Claims that do not make sense are likely untrue. “But validate it, because there are paradoxes — things that sound like they may not make sense, but it turns out they do,” adds Benjamin.
This activity is also an opportunity to think about what makes a source historically accurate and representative. Whose story is being told, and who is telling the story? Why is this important to consider?
Activity 5
Probing the Tuskegee Study
Age Group: High School
Black Americans have been hardest hit by the coronavirus pandemic. According to analysis of data from the Centers for Disease Control and Prevention, Black people have been three times more likely than white neighbors to become infected, and they are nearly two times as likely to die from the coronavirus.
However, a recent poll indicates that Black adults are less likely than white and Hispanic adults to get a coronavirus vaccine, despite facing higher risks. Many people attribute this hesitancy to the inequities and mistreatment of Black Americans in the U.S. health system — historically, and horrifically, exemplified by the Tuskegee Study, which took place from 1932 to 1972.
For this activity, have learners research and discuss the study. Who developed the study, and what were their motivations? What protections are in place today to prevent such misconduct, and how might they fall short?
“The way to start is by acknowledging the errors of the past and talking about the protections that have been put in place and the importance of including people of all ethnicities, ages, and genders in these clinical trials,” said Benjamin.
Prompt students to reflect more broadly on racism and inequity in the U.S. health system, both in the past and present. Benjamin added: “It’s also important to recognize that those trials were in the context of broader racism. You know, you don’t do that to people that you think are either human or equal, and so racism still exists in our systems, but we have to acknowledge that as well.”
Citation for this content: The MPH online program from Baylor University’s Robbins College of Health and Human Sciences