Facilitating Middle School Students' Reasoning About Vaccines

"The results of this study may contribute to curriculum development about teaching health issues and to further research aiming to improve middle school students' reasoning about vaccines."

In recent years, the vaccine rejection movement has been rising rapidly in Turkey, as it has all around the world. A considerable number of people tend to believe in fallacies, false claims, and misleading information and reject being vaccinated. While there is a large consensus within the scientific community on a majority of controversial issues, results of scientific research are not certain. The misinformed individual's understanding of science tends to consider scientific results as certain. The use of vaccines in teaching can be an important opportunity for students to practice their skills in managing and dealing with scientific uncertainty. In the Turkish curriculum, vaccines are introduced during eighth grade. The aim of the study reported in the paper, therefore, is to explore Turkish eighth graders' reasoning about vaccination throughout a 4-week implementation of small group and plenary discussion of false claims about vaccinations.

Part of the rationale for the project is that, in order to avoid the spread of false claims and misinformation, it has been suggested targeting children and adolescents who might not have strong emotions about vaccines yet. Children's opinions may be affected by different sources, while adults' risk perception is hard to improve because of their strong emotional connection to the topic of vaccination. From this perspective, it is crucial that students are encouraged to evaluate and discuss information based on evidence.

In providing background to the project, the researchers discuss two incidents that they believe have led to the spread of the anti-vaccination movement among the public in the twentieth century: (i) the Cutter Incident, which involved Cutter Laboratories giving 120,000 doses of vaccine that actually contained active poliovirus, causing 70,000 children to have mild polio, 200 to have permanent paralysis, and 10 deaths; and (ii) the Wakefield et al. (1998) study, which established a relationship between measles, mumps, and rubella (MMR) vaccines and autism, which turned out to be a scientific fraud but led to the spread of misinformation that has continued. Also, in Turkey, some argue that, according to Islamic belief, substances such as gelatin derived from pigs found in vaccines are haram (forbidden) and therefore against religious teachings; others oppose vaccines because of the belief that vaccines are a Western conspiracy to spread infertility in order to wipe out the population of Muslim countries.

Twenty-nine eighth graders (14 females and 15 males) studying in the same class in a public middle school in Turkey participated in this study. The implementation consisted of a 5-phase procedure, including teacher presentation of false claims and related evidence texts about vaccination, small group discussions, a plenary discussion, and finally, an introduction to valid scientific content about vaccination. The teacher began the lesson by listing the false claims and concluded by presenting the scientific knowledge through critically examining each claim based on the protective function of vaccines as well as the trustworthiness of the sources of claims and evidence. Table 1 in the paper illustrates the flow of the instruction on vaccination.

The explanations of the representatives from each group during the plenary discussion were video-taped and analysed by the researchers independently to examine student decisions on each claim. Another data source of this study included student interviews in which the researchers videotaped and analysed eight interviewees' responses.

Representative students' explanations during plenary discussion revealed their lack of knowledge about vaccines. The representatives were either proponents or opponents of vaccines and did not hesitate to express their own opinions. However, they rarely provided strong evidence for the claims they supported when they were asked to. If they did not have enough knowledge about the topic and could not provide evidence for their false claims, they easily gave up their ideas, particularly in the presence of a dominant student who had the ability to convince others. This result indicates that their reasoning depends on the evaluation of their peers who have scientific knowledge about the topic as well as other sources that provide scientific knowledge.

The interviewees' responses showed that, in contrast to the plenary discussion, students seemed to be aware of false claims and conspiracy theories about vaccination. One possible interpretation of this difference can be that students learned from the discussions with peers as well as the scientific knowledge that the teacher introduced. On the other hand, this difference may also be interpreted as the representatives' responsibility to reflect on group judgment, while each one of them was free to reflect on their own thoughts during the interview. However, since three interviewees (student (S)4, S7, and S8) cited the explanations given by S1, a dominant student who had self-confidence of his knowledge about the topic), the interviewees also revealed peer influence on students' reasoning.

Thus, the findings revealed that including well-informed students in small group and plenary discussions may have a positive impact on other students' reasoning. This result indicated the benefit of encouraging students to provide evidence about vaccines during small group and plenary discussions in terms of their reasoning. The implications of this study suggest the necessity of emphasising on scientific knowledge as well as argumentation for further investigations of students' reasoning on vaccination.

In conclusion: "Further studies examining moral judgments and affective factors in an argumentative discourse environment to facilitate informed decision-making may bring new light to this issue."