Wednesday, February 04, 2015

Media, Measles and Seeds of Doubt?

The media is gorging on the measles outbreak. Well it’s about time the media took measles seriously. I should be thankful after almost 15 years of bemoaning the media’s less than accurate coverage of vaccines and the thoroughly debunked link between the MMR and autism. Even in 2000 there were studies showing no link existed but the media then was not particularly interested in that empirical evidence. Certainly not persuaded. Major media outlets featured scientists, pediatricians and mothers attributing autism and a host of other ills to childhood immunizations. Of course a person can still find those voices in the media. Now thanks to measles at Disneyland it’s a hey day of mostly correct facts and figures accompanied by some finely nuanced reporting. In fact, so many good articles it’s hard to single out just a few.

And yet. I do wonder how the current coverage will be perceived. What will be the lingering effects of this media storm? Will it change the minds of parents on the line over whether to vaccinate or whether to refuse or delay some portion of the recommended vaccines? If so, how?

Many of these recent stories, even if they ultimately appear to champion vaccines or dismiss the autism-vaccine link, also feature some measure of concern, anxiety or doubt about the safety of vaccines. In other words – uncertainty where none exists in the scientific community. This is not to say that vaccines don't carry risks, they do albeit very rare ones but the evidence discrediting the autism-vaccine link is robust, the evidence is plentiful and strong. 

Both news and opinion articles still leave some room for doubt to creep in, portraying the scientific community or evidence as less certain about the link or the safety of vaccines or the risks of not vaccinating. Sometimes the distrust or fear of vaccination seeps in through the comments of parents who haven’t vaccinated. Sure they say they will vaccinate now or just did but this information comes along with their personal stories filled with reasons why they didn’t vaccinate in the first place. Of course I'm not event referring to the comments sections here. 

Sometimes the doubt comes from supposed experts.

Sometimes politicians. Even the President is not immune to uncertainty about vaccines:

"I understand that there are families that in some cases are concerned about the effect of vaccinations. The science is, you know, pretty indisputable. We've looked at this again and again. There is every reason to get vaccinated, but there aren't reasons to not," the president explained. Barack Obama, Today Show

What’s not to love here? The President advocating for childhood immunizations on national television. Well, he’s not quite right. The science is not “pretty indisputable.” The scientific research discrediting the autism-vaccine link is not “pretty indisputable.” It is not kinda sorta certain on this issue. The commander-in-chief’s comment suggests some uncertainty exists in the scientific community. The scientific evidence however is beyond a shadow of reasonable doubt. But this is progress. Back in 2008 the President called the science “inconclusive” and said “We’ve seen just a skyrocketing autism rate. Some people are suspicious that it’s connected to the vaccines” according to the Wall Street Journal.  He also obviously forgot to that there are kids and adults who can't get immunized for very good reasons like suppressed immune systems. It's just not accurate to say "there aren't reasons to not" vaccinate. I suppose he meant to say "choose not to vaccinate" but he didn't. 

Other elected officials have done the bait and switch in a more significant manner.

"All I can say is we vaccinated ours," Christie said, while touring a biomedical research facility in Cambridge, England, which makes vaccines. The New Jersey governor added that "parents need to have some measure of choice in things as well, so that's the balance that the government has to decide." New Jersey Governor Chris Christie, CNN

And this:

“I’m not arguing vaccines are a bad idea. I think they’re a good thing, but I think the parents should have some input," he added. "The state doesn’t own your children. Parents own the children and it is an issue of freedom.”

"I have heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines," he said. Rand Paul, CNBC via ABC News

True politicians and elected officials are not health professionals. Unless of course they are like Rand Paul, an ophthalmologist who should know studies have documented the safety of the American Pediatric Association’s recommended vaccination schedule. He should also know studies show spacing out or delaying vaccines carries risks.

As Frank Bruni rightly reported in his column Vaccine Lunacy, the media has contributed to the current public health crisis by “covering the news in an on-one-hand, on-the-other-hand fashion that sometimes gives nearly equal time to people citing facts and people weaving fiction.”

How true. Balance is not always the ideal. Not when the full weight of science comes down on one side.

What’s not certain - how people perceive media articles when they also contain seeds of doubt. 

It’s not clear how people react to these kinds of public health messages but recent research suggests a couple possibilities. Graham Dixon and Christopher Clark conducted a study to see how the balance of news articles influenced student’s perceptions of the vaccine-autism link. The researchers had students read actual news articles that contained either pro-link claims only, anti-link claims only or a balance of pro- and anti-claims. Students also reported how certain they thought scientists and medical professionals were about the link. Compared to those with anti-link claims, balanced news articles inspired less confidence that there is no link. In other words, balanced articles introduced uncertainty over the present science. 

Interestingly there were no significant differences between the balanced and pro-link conditions. News articles with either balanced or pro-link messages were perceived similarly, both introducing some measure of doubt that no links exists. This uncertainty stemmed in part from how divided readers judged the scientific community to be on the issue of vaccines and autism.

So understandably I wonder how coverage of doubts and fears colors perceptions of the accurate portrayal of scientific evidence. Does it introduce doubt?

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