Spreading the

Word, Not the

Flu

April 11, 2018

Steven Budzinski

1

Influenza: The
Unforeseen Killer
“On average, college students who
get the flu experience up to eight or
more days of illness along with
increased rates of healthcare use,
school absenteeism, and impaired
academic performance.”3
Kyler Baughman was a 21-year-old
bodybuilder studying to be a personal trainer at his
local community college when he came home for
winter break and began showing symptoms of the
flu; he and his family thought nothing of it. Within
two days Baughman’s health took a turn for the
worse, and after two days of an off and on fever, he
went to his local emergency room. He died less than
24 hours later. An autopsy performed on Kyler
found that his body was plagued with the influenza
virus causing septic shock and multiple organ
failure. “It doesn’t seem real” said Kyler’s mother
Beverly, “I think he thought, 'I just got the flu, I'll
be alright. I'll just go rest a little bit.” Kyler, like
most other college students thought that the
influenza virus was just a mere inconvenience,
while as we all know, it has the potential to kill.1
Although University Health Services
(UHS) continues to protect some Penn State
students from the flu, Penn State consistently ranks
as one of the worst rates of vaccination in America,
with its current rate of 6% crawling to get to the 8
to 39% college vaccination rate.2 Thankfully no one
has been seriously affected, but there were over 400
reported cases of the flu just last year, with an
unknown amount of unreported cases. As you are
aware, vaccination rates are increasing at Penn State
(reported by Infectious Disease Manager and
Campus Health Liaison, Michelle Haffner) with
UHS distributing 2888 vaccines this year, a 1100
increase from last year, but UHS is still hesitant to
2
buying many more.4 Indeed, this conservative
approach to steadily buying and administering
vaccines may be fiscally beneficial for the
University (as there is less of a risk of unused
vaccines), but UHS consistently runs out of
vaccines, this year in January, and may not give out
as many vaccines as students want. And, as we are
all versed, the Center for Disease Control
recommends receiving the flu vaccinate in early
fall, right before flu season begins, but still specifies
that “[g]etting vaccinated later can still be
beneficial and vaccination should continue to be
offered throughout flu season, even into January or
later”.3
But besides the shortage of vaccines, the
current system also does a poor job at informing
students of the various benefits of vaccines. Again,
Michelle Hafner stated that UHS “orders such a low
number of vaccines because they do not expect
many students to actively seek out flu vaccines.”4
So even if the University did buy more vaccines,
there is still not a great enough need. Thus, UHS is
stuck in a stagnant system of not enough
vaccinations being supplied or demanded, leaving a
large percentage of its students unvaccinated. Yet
this problem is not exclusive to Penn State.
According to the National Foundation for Infectious
Diseases there is a widening gap between colleges
students who believe that flu vaccines are important
(70%) and those who actually get a flu vaccine
(46%).5 Despite this, some colleges have had found
success in their efforts to increase vaccination rates,
proving that UHS can benefit from change,
especially by building on its current infrastructure
and efforts.
Taken the National Foundation for Infectious Disease2

Mandatory Vaccines:
Radical but Efficient?
One radical solution proposed by Senator
Bill Cassidy of Louisiana last March is that schools
should mandate student vaccinations.6 Although he
was talking about public elementary and high
schools in his discourse, taken to a University level,
UHS could mandate that the flu vaccine be
mandatory for all students in a similar way that the
MMR vaccine is required. As the UHS policy on
the MMR vaccination stands now, if a student does
not submit either a immunization verification form
or an immunization waiver form, a registration hold
will be applied to the student’s LionPATH account
“Penn State consistently ranks as
one of the worst rates of vaccination
in America, with its current rate of
6% crawling to get to the 8 to 39%
college vaccination rate.”2
restricting any future enrollment of classes. As a
result, a large majority of campus is vaccinated for
Measles, Mumps, and Rubella, significantly
decreasing the infection rate of all three diseases.
Similarly, if the flu vaccine were mandatory, the
amount of people with the flu would decrease, and
reduce the risk of disease outbreak.
However, this option may not be
completely feasible. For one, a complete mandate
of vaccination may not completely prevent
outbreaks. Even though the MMR vaccine is
required for all Penn State students, there was a
measles outbreak in 2017, 2018, and as of this
March, 2019. Although students with the MMR
vaccine were kept protected, those who may have
opted out of the required immunizations were
susceptible, and thus an outbreak occurred. If the
flu vaccine were mandated in a similar manner, it
could be expected that a similar group of people
would opt out of the flu vaccine and thus chance an
3
influenza outbreak. According to the CDC in order
to completely remove the risk of outbreak, at least
95% of the particular population must be
vaccinated, a near impossible goal.7 One example
of this can be found in some Californian hospitals,
where although flu vaccines are mandatory (with an
option of opting out) fewer than half of the workers
get vaccinated annually.8 Of course, there were no
repercussions to opting out at the hospitals, but if
there is a significant lack of participation in a
hospital environment, how can it be expected to
work for apathetic college students?
Appealing to the Heart
of Penn State Students
Clearly, both the current system and the
ultimatum of mandatory vaccines both have their
problems, and thus I am proposing a plan focused
on both education and incentivizing vaccines. In
2017, the National Foundation for Infectious
disease found that 61% of college students were
more willing to become vaccinated if there was
either a monetary or other material incentive given
out during vaccination.2 Although this option may
appear to
Taken the National Foundation for Infectious Disease2
drain University funds, snacks and juice are already
provided in accordance to CDC protocol to those
vaccinated to alleviate any potential dizziness.9
Thus, UHS, in their normal advertising for flu
vaccines, should take the simple step to advertise
that food will be available at inoculation sessions to
draw in more college students.
The National Foundation for Infectious
Diseases also recommends that “lotteries,
giveaways, and competition are among some of the
best incentives for college students.”10 For example,
in 2008, the University of Minnesota charged the
student body with helping them break the Guinness
World Record for the highest number of
vaccinations in one day, generating an impressive
11,538 flu vaccines for only 32,000 undergraduate
students.11 Extrapolating that fact to Penn State’s
46,000 undergraduate population, along with its
historic competitive spirit, and UHS could see a
record amount of flu vaccines being administered in
the years to come. Wayne State University also
took to leveraging their university’s competitive
spirit by looking to create a competition among its
colleges to see which college could get the most flu
vaccines, and accordingly found so much success
they won the State University Flu Vaccination
Challenge for medium-sized schools.12 Should Penn
State look to also utilize its competitive spirit, I
believe it would see a vast increase in flu
vaccinations, while engaging students to become
more excited about flu vaccines.
But besides just being enthused about flu
vaccines, I also recommend that UHS look to
further educate college students on the benefits of
flu vaccines. According to a 2017 Harris Poll
conducted on 1,005 college students, some of top
reasons for not getting vaccinated include two
misconceptions: that they are healthy enough
“Lotteries, giveaways, and
competition are among some of the
best incentives for college
students”10
without it, and they do not think it will work.4
Evident by the beginning story, however, the flu’s
symptoms can span from time consuming to life
threatening, and even if college students are on
average healthier than the rest of the population,
they are still susceptible.
Regarding the other misconception that the
flu vaccines does not work, or that college students
4
worry about the risks, education must be carried out
to validate to college students that flu vaccines can
only help, not hurt. Currently I am creating an
educational PowerPoint with accompanying script
that addresses a variety of these misconceptions
while demonstrating how beneficial flu vaccines are
(you can find both in the attached).
Educational campaigns have been shown to
increase flu vaccination rates, as it deters
misunderstandings, and helps participants better
understand the risks of not getting vaccinated.13
TOP REASONS
COLLEGE
STUDENTS
DON’T GET FLU
SHOTS
And for when and where to present this
information, I recommended presenting the flu
vaccination information at the freshmen seminar
classes to ensure all undergraduate students (besides
transfers) are educated on the topic. Under the
University’s Academic Administrative Policies and
Procedures Manuel, freshmen seminars are required
to “acquiesce students [to] learning tools and
resources”; UHS could easily take advantage of this
requirement and disseminate correct information
about vaccines to clear up any misunderstandings
that students have.14 Should UHS petitioned to the
University to include this valuable information in
freshmen seminars (either by asking instructors to
directly discuss the benefits of flu vaccinations or
asking instructors to point to the UHS website for rates. And although UHS has a history of
further knowledge), I believe UHS would see an conservative vaccine purchases, UHS should look
increase in the amount of vaccinations to buy more vaccines (both injection and nasal
administered. based) to increase the availability of flu vaccines on
campus. Should UHS decide to enact any or all of
A final recommendation that I have is about these policies, I am positive that Penn State will see
the remaining 31% of college students who do not a spike in vaccinations and be well on its way to
receive flu vaccines primarily because they do not fulfilling the CDC’s Healthy People goal.
like needles. Currently there exists a nasal vaccine
that can be purchased for a similar price and from
the same retailers as normal injections.15 The CDC
also states its approval of the nasal spray to be used
in supplement to injections, and therefore, UHS
should take steps to obtain the nasal spray flu
vaccine to broaden the amount of Penn State
students that are vaccinated.

Conclusion
All in all, there is a clear need for a change
in flu vaccination policy at Penn State, as the
current movement is too inefficient at spreading the
word about the benefits of vaccine while still not
garnering enough activism within its undergraduate
population. However, the ultimatum of mandatory

“There is a clear need for a change in

flu vaccination policy at Penn State,
as the current movement is too
inefficient at spreading the word
about the benefits of vaccine while
still not garnering enough activism
within its undergraduate population”
flu vaccines would be too inefficient and costly
thus, it is advisable for UHS to build on the pre-
existing (though meek) social media infrastructure
to educate the students of the various benefits that a
vaccination can bring and to utilize the freshmen
seminar course as a medium in which to advocate
for flu vaccines. UHS should also surface the fact
that snacks and other incentives will be provided at
the clinics and seek to leverage Penn State’s
competitive spirit towards increasing flu vaccines
5

Endnotes
1
Kim, Eun Kyung. “21-Year-Old Fitness Buff's
Death from Flu a Reminder How Quickly It Can
Kill.” 21-Year-Old Fitness Buff's Death from Flu
Shows Risks, Need for Vaccination, NBC, 10 Jan.
2018, www.today.com/health/21-year-old-fitness-
buff-s-death-flu-shows-risks-t121057.
2
“National Survey on College Students &
Flu.” National Survey on College Students & Flu,
National Foundation for Infectious Diseases , May
2016, www.nfid.org/idinfo/influenza/college-
students-flu-survey.html.
3
“Frequently Asked Flu Questions 2018-2019
Influenza Season.” Centers for Disease Control and
Prevention, Centers for Disease Control and
Prevention, Jan. 2019,
www.cdc.gov/flu/about/season/flu-season-2018-
2019.htm.
4
Haffner, Michelle. “Vaccination
Information.” Vaccination Information, 21 Mar.
2019.
5
“Why Aren't College Students Getting Flu
Shots?” WHY AREN’T COLLEGE STUDENTS
GETTING FLU SHOTS?, NFID News, 6 Dec.
2017, nfid.wordpress.com/2017/12/06/why-arent-
college-students-getting-flu-shots/.
6
Kelly, Caroline. “GOP Senator Defends
Mandatory Vaccinations after Paul Says They're
Inconsistent with Liberty.” CNN, Cable News
Network, 7 Mar. 2019,
www.cnn.com/2019/03/06/politics/rand-paul-bill-
cassidy-vaccines/index.html.
7
“What Is Herd Immunity?” WHAT IS HERD
IMMUNITY?, VaccinesToday, 16 Mar. 2017,
www.vaccinestoday.eu/stories/what-is-herd-
immunity/.
8
Wiener, Jocelyn. “At Some California Hospitals,
Fewer Than Half Of Workers Get The Flu Shot.” At
Some California Hospitals, Fewer Than Half Of
Workers Get The Flu Shot, Kaiser Health News, 25
July 2018, khn.org/news/at-some-california-
hospitals-fewer-than-half-of-workers-get-the-flu-
shot/.
9
“Parents | Your Child's Vaccine Visit | CDC.” For
Parents: Vaccines for Your Children, Centers for
Disease Control and Prevention, 2016,
www.cdc.gov/vaccines/parents/visit/index.html.
10
“Addressing the Challenges of Influenza
Vaccination on US College Campuses .” A Report
by the National Foundation for Infectious Diseases,
National Foundation for Infectious Diseases, May
2016, www.nfid.org/publications/reports/college-
flu-summit-report.pdf.
11
“How Does University of Minnesota--Twin Cities
Rank Among America's Best Colleges?” University
of Minnesota--Twin Cities, U.S. News & World
Report, 2019, www.usnews.com/best-
colleges/university-of-minnesota-twin-cities-3969.
12
Wayne State University. “WSU Wins National
and State College Flu Vaccination
Challenges.” Today@Wayne, Wayne State
University, 2018,
today.wayne.edu/news/2018/01/09/wsu-wins-
national-and-state-college-flu-vaccination-
challenges-6625.
13
Mora, T, and M Trapero-Bertran. “The Influence
of Education on the Access to Childhood
Immunization: the Case of Spain.” BMC Public
Health, BioMed Central, 18 July 2018,
www.ncbi.nlm.nih.gov/pmc/articles/PMC6052631/.
14
Office of Undergraduate Education, and
Pennsylvania State University. “Academic
Administrative Policies and Procedures Manual.” L-
9: First-Year Seminars | Academic Administrative
Policies and Procedures Manual | The
Pennsylvania State University, Penn State
Undergraduate Education, 2011,
undergrad.psu.edu/aappm/L-9-first-year-
seminars.html.
15
“FluMist vs. Flu Shot: What's Best for
You.” FluMist vs. Flu Shot: What's Best for You,
LiveWell, 2019,
www.unitypoint.org/livewell/article.aspx?id=a9b8e
576-4604-473d-ba17-42fd28893419.