It’s 2013. Enough With the “False Balance” on the MMR vaccine

It’s tempting to blame the re-emergence of measles in the United Kingdom squarely on Andrew Wakefield. After all, Wakefield’s 1998 paper in the Lancet (now retracted) attempted to link the measles, mumps, and rubella vaccine with autism. This research was later shown to be fraudulent. His actions was so heinous that he was eventually stripped of his medical license for unethical behavior, including research misconduct and undeclared conflicts of interest. But not before a long period of “false balance” in the UK media that repeatedly offered fringe, scientifically unsupported opinions that the MMR vaccine safety was in question. Why would the media do this? Controversy sells. The brave maverick physician standing up against the medical establishment – Big Pharma, even. But this was a narrative completely out of line with the facts. There has never been any serious scientific controversy about the MMR vaccine and autism – none. Carefully controlled studies, conducted after Wakefield’s initial paper, have failed to show any relationship. Yet the reporting didn’t reflect this, for years. False balance has the potential to be incredibly damaging. I’ve pointed out in the past that viewing anti-vaccine material for only five to ten minutes increased the perception of risk of vaccination, and decreased the perception of risk of omitting vaccines. It also lowers vaccination intentions. By changing perceptions of safety, the willingness to vaccination decreases. This is a common tactic of antivaccinationists – raising questions about safety and effectiveness. And it’s something the UK media continued for several years, until Wakefield was eventually investigated, discredited, and disgraced.

With Wakefield losing his medical license, the media coverage seemed to start shifting away from “false balance” into communicating a more accurate perspective – that Wakefield’s work was bogus and quite likely driven by undeclared conflicts of interest. Certainly several stories I’ve seen over the past few years have described antivaccinationists views more accurately – as fringe perspectives without scientific credibility. I was heartened fairly recently to see a significant victory in Australia, where the Orwellian “Australian Vaccination Network”, a defiantly anti-vaccine organization, has been ordered to change its name because of its position on vaccines. My hope was that the tide was turning into more cautious and accurate reporting on vaccine safety and public health.

So now that it’s been a decade of addressing fears of vaccines causing autism, has the damage been undone? Sadly, no. Last week I noticed an American poll of over 1200 voters on a variety of conspiracy topics. To the question “Do you believe there is a link between childhood vaccines and autism, or not?” 20% said “do” and 34% said “not sure”, with 46% saying “do not”. If that poll’s accurate, that’s 62 million Americans who believe there’s a link, when that link has been definitively disproved. Quite the legacy for Wakefield. Back in the UK, Wakefield’s home turf, vaccination rates plummeted and while they did start to recover, it wasn’t before before measles was declared endemic in 2008, meaning immunization rates were insufficient to control the spread of the disease. There is currently an active outbreak of measles in Wales – almost 700 cases reported so far, with that number expected to double. And frighteningly, but no unexpectedly, the United Kingdom may have its first measles death in years.

Andrew Wakefield: Concern Troll

Given the demonstrable public health harms driven by Andrew Wakefield, I was stunned to see images of yesterday’s Independent:

MMR scare doctor: this outbreak proves I was right

Cover via Martin Robbins, writing in New Statesman

Yep, it’s Wakefield quoted:

The discredited doctor who triggered the MMR scare 15 years ago has pinned the blame for the outbreak of measles in south Wales on the Government.

In an extraordinary intervention, Andrew Wakefield, who was struck off the medical register, said the “British Government is entirely culpable” for the outbreak and accused officials of “putting price before children’s health” – despite a widespread consensus that it was the panic over his flawed research that led to the surge in the disease.

It’s not until the 15th paragraph that his comments are rebutted. It’s textbook false balance. And amazingly, inside the paper, Wakefield’s statement is reproduced in full:

Photo via Margaret McCartney

Now it takes a certain chutzpah (to be polite) to manufacture fears about the MMR vaccine, continue to propagate those fears for over a decade (despite evidence showing you’re wrong), watch vaccination rates drop and measles re-emerge, and then declare victory. Yet that’s exactly what Wakefield does, in a statement that the Independent seems to have copied verbatim from the antivaccine group Age of Autism’s website:

Measles cases in the UK rose when the government withdrew the importation licence for the single measles vaccine leaving concerned parents with no choice. When I demanded to know why, if the government’s principal concern was to protect children from measles, it would prevent parents with genuine safety concerns over MMR from protecting their children, Elizabeth Miller of the Health Protection Agency responded, “…if we allowed parents the choice of single measles vaccines it would destroy our MMR programme.” The government’s concern appeared to be to protect the MMR programme over and above the protection of children.

Despite the claim of David Salisbury, head of the UK’s Immunisation Division, that MMR has, “an exemplary safety record”, two of the three brands introduced in 1988 had to be withdrawn for safety reasons – they caused meningitis.

Government officials had approved these dangerous vaccines – Pluserix and Immravax – giving them the great majority of the UK market despite knowing that they were high risk and despite having been warned explicitly of their dangers. These government officials put price before children’s health and have been seeking to cover up this shameful fact ever since.

The US government has paid out millions of dollars to children whose autism followed vaccine-induced brain damage. A recent government concession in the US Vaccine Court confirms that the parents’ claims were valid all along. In a recently published December 13, 2012 vaccine court ruling, hundreds of thousands of dollars were awarded to Ryan Mojabi, whose parents described how “MMR vaccinations”, caused a “severe and debilitating injury to his brain, diagnosed as Autism Spectrum Disorder [‘ASD’]”.

As is usual for Wakefield, he is still disingenuous and lays on the conspiracy theories thick and fast. The MMR vaccine is superior to single vaccines (for which Wakefield had coincidentally sought to patent). Pluserix and Immravax may have had higher risks compared to other MMR vaccines, but it’s not relevant to the drop in vaccination rates – Pluserix and Immravax had been off the market for six years before Wakefield published his “research”. Ryan Mojabi may indeed have suffered a rare adverse effect of a vaccine but was never diagnosed with autism.  And so on. Wakefield does his best concern troll, positioning himself as the voice of wisdom on the safety of the MMR vaccine. It’s the “I’m not anti-vaccine, I’m pro-safe vaccine” tactic so common among antivaccinationists.  He fails to note the extensive data that shows his hypothesis is demonstrably false and there are now hundreds of papers that support this conclusion.

Why would the Independent do this? Martin Robbins, writing in the New Statesmen, writes very critically about the Independent’s health writer, Jeremy Laurance:

On Twitter, the Independent’s health writer Jeremy Laurance has spent the day demanding that critics read the whole piece. “Jeeezus!”, he responded to Ben Goldacre and others at one point, “U have NOT read the story.” What Laurance fails to understand is that few people ever do read the whole story. Any competent journalist understands that people tend to grab the information at the top, and don’t always stick around until the end of the piece.

And besides, it’s not just the headline. Laurance’s article continues to put Wakefield’s point of view for a further 14 paragraphs, before giving over barely half that space to one contrary voice, addressing only a fraction of the points made. It would be a great example of the false balance inherent in ‘he-said, she-said’ reporting, except that it isn’t even balanced – Laurance provides a generous abundance of space for Wakefield to get his claims and conspiracy theories across, and appends a brief response from a real scientist at the end.

As Anthony Cox noted way back in 2007, this isn’t the first time that the Independent’s editor, Jeremy Laurance, has been criticized for its role in the MMR debacle. The Independent in particular seems to have demonstrated ignorance or indifference to the fact that it is also responsible for propagating these antivaccine fears.  As Robbins continues:

Jeremy Laurance has a history of reacting badly to the idea that health and science journalists deserve scrutiny. What he doesn’t seem to grasp is that this is not an abstract public health debate between a few angry people on Twitter – he, and journalists like him, are putting the lives of real children at risk, their clumsy reporting stoking unwarranted fears about a safe vaccine.

Just like it has done before, the Independent is supporting the dissemination of unfounded and unsubstantiated messaging about the MMR vaccine that only serve to stoke fears. It’s clear now that Wakefield’s message would not have been so widespread had the media not fueled this antivaccine fire.  For the Independent to fail to recognize this, in the midst of a measles outbreak, is quite frankly, disgraceful.