building vaccine confidence | An initiative to strengthen public trust in vaccines | #BuildingVaxConfidence

University of Houston

To empower nursing students to share credible COVID-19 vaccine information and respond to misinformation, this project focused on increasing knowledge using CDC toolkits; developing culturally relevant responses to misinformation via role-playing and simulations; and applying learning by developing materials to provide factual COVID-19 vaccine information. The students shared this information at campus forums and community events. To prepare nursing students to have effective COVID-19 vaccine conversations with other healthcare providers, staff, patients, and families, organizers used case scenarios and role-playing to enhance communication skills and address ethical dilemmas. They promoted effective conversations by using simulation-based learning to actively engage students in real-world situations.

Curriculum Resources

  • The UH College of Nursing developed a Vaccine Confidence curriculum to be integrated into the 2nd Degree BSN Spring 2022 course, NURS 3230 – Nursing Professional Role I. The curriculum was divided into three sessions:
    • Session 1: Build Knowledge and Identify Misinformation - The goal for this session was to increase students’ knowledge of COVID-19 and to identify misinformation, disinformation and other concerns related to vaccine hesitancy. Strategies included reviewing websites and developing materials, such as posters and flyers to be shared within UH and with community partners.
    • Session 2: Develop Communication Skills - The goal for this session was to empower students to have effective COVID-19 vaccine conversations. Strategies included the use of role play. 
    • Session 3: Simulation: The goal for this session was to provide opportunity for students to practice communication skills that are culturally appropriate and address misinformation, disinformation, and vaccine hesitancy using simulation.

Learning Opportunities

  • Build Knowledge and Identify Misinformation: This session aimed to (a) increase knowledge using CDC COVID-19 and Vaccine BasicsFDA Vaccine Facts, and CDC State of Vaccine Confidence Insights Reports; (b) identify misinformation and develop culturally relevant responses via team work; and (c) apply learning by developing materials (e.g. poster, flyers) to provide credible COVID-19 vaccine information to be shared via health fairs, social media, and community partnerships.
    • During this 3-hour session, triad cooperative learning teams of 2nd Degree BSN nursing students were provided with resources from the CDC. Using these resources, cooperative teams learned about vaccine hesitancy and were able to identify misinformation/disinformation related to COVID-19 and other vaccines. 
    • Teams applied their learning by developing posters, flyers, and brochures that provide credible COVID-19 vaccine information and address misinformation about vaccines to be shared in multiple forums.
    • Spanish versions of some posters were produced in order to meet target population needs.
    • Student products were displayed at various locations within each campus. Products were also displayed at the campuses TV monitors.
    • Through several partnerships, products were displayed and distributed at several community locations such as the UH College of Nursing Health Clinic for the working poor and homeless in Midtown Houston, a nurse-managed Pediatric Clinic, Casa El Buen Samaritano Health Clinic, and Fort Bend’s Department of Health and Human Services’ health clinics and the 50 elementary schools they serve in Ft. Bend Independent School District.
    • Flyers
  • Develop Communication Skills
    • During this 3-hour session, students learned to increase communication skills about COVID-19 vaccination and address ethical dilemmas by discussion of case scenarios and role-play.
    • Triad cooperative teams were divided into groups. Each group was assigned to address one piece of misinformation. The group identified words and/or phrases that could be used to address the concern, using culturally relevant responses. Using this strategy, each group member became an expert in one piece of information. Students were provided with web links that addressed concerns and how to address misinformation or vaccine hesitancy. Groups were reassembled into their original cooperative learning triad team. Each team member then shared information within their team. Students practiced together using role-play until the team was confident in all three areas of misinformation/disinformation.
  • Simulation with Standardized Client
    • During this day-long simulation activity, students applied communication skills to promote effective conversations on COVID-19 confidence. Simulation-based learning was used to actively engage nursing students in real world situations.
    • Cooperative learning teams of nursing students participated in a 20-minute simulation with a standardized client. The goal was to provide opportunity for students to increase confidence in communicating effectively as they addressed misinformation, disinformation, and vaccine hesitancy with a standardized client. Teams worked together to address their client’s concerns. Students also provided resources as requested by the client. Two faculty members assessed communication skills, using the Health Communication Assessment Tool (HCAT) for Vaccine Confidence.

Social Media Strategies

Download Social Media Strategies Handout


The UH College of Nursing’s development, implementation, and evaluation of curricular activities was successful. Factors contributing to the success of the project’s goals were flexibility and teamwork. Faculty and students were flexible regarding the timing of the activities as content was revised within the course selected for this initiative. The use of a cooperative learning framework and team structure contributed to the team’s success as each team member became an expert related to one type of misinformation/disinformation. Group members shared their expertise within their own team to be effective in addressing other types of misinformation/disinformation. In addition, the dedication of UH College of Nursing’s partners contributed to a successful outreach initiative by disseminating flyers/brochures/products within their organizations. The use of previous partnerships such as Ft. Bend Health and Human Services paved the way for the grant’s success.

School at a Glance

Map of Texas with a star over Houston

  • Location: Houston, Texas
  • School Type: Public University
  • Partners:
    • UH Student Health Clinic
    • UH College of Nursing Health Clinic
    • UH Wellness and Benefits Fair
    • Nurse Managed Pediatric Clinic
    • Casa El Buen Samaritano
    • Wharton County Junior College
    • Fort Bend Department of Health and Human Services
  • Faculty Contact: Dr. Lenora McWilliams

photo of project participants