Health and Social Care Committee
Inquiry into the measles outbreak 2013
The news media’s role in the current outbreak of measles in Swansea
Dr. Andy Williams, School of Journalism, Media and Cultural Studies, Cardiff University
1 Introduction:
1.1 The recent spate of measles cases in Swansea now looks set to become the biggest outbreakin the UK since the introduction of the MMR vaccine in 1988. The scale of the problem has led some to ask questions about the role the news media played in fostering the current public health crisis. I was able to contribute evidence based opinions about this (on BBC Radio Wales, and on Radio 4’s You and Yours) drawing on the excellent work carried out by JOMEC researchers Tammy Boyce, Justin Lewis, and Ian Hargreaves.
1.2 The evidence is clear. The UK news media have to share responsibility for what is happening in Swansea. They collectively dropped the ball over reporting the now discredited claims which linked the Measles Mumps and Rubella “triple vaccine” to autism in young children.
1.3 In the late 1990s and early 2000s, with very few exceptions, they gave far too much prominence to claims from controversial scientist Andrew Wakefield based on very thin evidence. It has since emerged that Wakefield’s research was fraudulent, but even at the beginning of the media scare it was clear from the published evidence that there was no proven link between the vaccine and autism.
1.4 Enough public health experts and officials knew, and were saying at the time, that there was nothing in these claims, but these views were given too little prominence. The news media failed to check the facts, to evaluate the evidence, and also to give enough prominence to the expert voices who knew that MMR was safe. But in some cases it was even worse: it seems that too often the press saw the prospect of reporting a controversy, a war of words between the “boffins”, as more important than passing on reliable information about public health, which was a real failing. In many cases the lure of conflict and controversy, both very common news values in reporting of science, was simply too strong for journalists.
2 What was the evidence for Wakefield’s claims at the time?
2.1 Much of the media scare coverage of MMR referred to a now retractedstudy published by Wakefield and others in the highly prestigious Lancet medical journal. Even if the study had been well conducted – which we know it was not – it was actually a “case control” study of just 12 children. It could never have justified the claim that MMR causes autism because it just didn't have enough participants. The media should have checked it out much more scrupulously, and arguably stopped reporting about it.
2.2 But again, it gets worse, Wakefield’s Lancet article actually admits it could not find evidence for a link between MMR and Autism. I am not a natural scientist, and I admit I sometimes struggle reading scientific papers, but these words from the journal article are actually very clear: “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described”. Wakefield made most of his claims about the supposed health risks of MMR in his public relations statements and interviews with journalists at sympathetic media outlets. This kind of science by press release should have been checked more against what his evidence actually showed.
2.3 Part of the reason why the news media did not report the claims more critically relates to the fact that science journalists, like their generalist counterparts, are under increasing pressures as newsroom budgets are cut, as staffing levels decrease, and as workloads rise. The steady stream of “information subsidies” provided to journalists by efficient and well-resourced PR operatives means that they are increasingly becoming processors, rather than active generators, of the news. They are more reliant on all kinds of media-facing PR than previously, and are therefore more susceptible to claims made by unscrupulous and manipulative science communicators.
3 The problem of “false balance”:
3.1 One of the main ways the news media messed up when reporting MMR was by balancing the news sources they quoted in their stories. When journalists report on politics it is common for them to quote a range of opinions from across the political spectrum, allowing readers to make up their own minds, and journalists to retain impartial.
3.2 But this can present problemswhen reporting on science. Science news should arguably be more concerned with communicating the evidence base, than simply reporting differing opinions on an issue. But on MMR, just as it often has when reporting about climate change, journalists still balanced their news stories. The weight of evidence was pretty much all on one side, MMR was (and still is) safe. But on the other side you had Andrew Wakefield, someone with no evidence, but who was shouting very loud and who was very adept at media management.
3.3 Lots of people saw those balanced news stories, and thought, “ah well, the scientists are arguing. They are not sure. They cannot make up their minds. It is not worth risking my child’s health”. And who can blame them? But there was no genuine split among the scientists, and the evidence clearly told us the vaccine was safe. In balancing stories about MMR the public were given the wrong impression by journalists.
4 Swansea and the local press:
4.1 The situation in Swansea was made worse by the fact that the local newspaper, the South Wales Evening Post, took a critical line on MMR, and gave quite a lot of prominence in its coverage to concerned local parents who (wrongly) believed their children were at risk from the jab. Swansea journalists were not alone in misinforming the public over MMR, most other UK papers and broadcasters did too. But that said the defense they have mounted recently is pretty surprising. The ex-editor at the paper claimed that they reported MMR like they did because their readers were concerned about it. He went even further, claiming that he would do it all again the same way if it happened today. This is very concerning, and displays a lack of reflection about the role his newspaper’s journalism played in creating the wrong impression about MMR.
4.2 It is true, one of the things newspapers should do is reflect public debate, but that is not all they should do. They have also got a responsibility to (as far as possible) check their facts, and check the evidence behind what they report. Otherwise they risk letting their readers down. It could be argued that generalist local journalists should not be expected to be able to read (often inaccessible and opaque) scientific papers. But part of the job journalists should do involves turning to expert sources who can guide them through difficult material and help them communicate it accurately and effectively. In this, the Post, along with many other news outlets, clearly failed.
4.3 The sceptical way news journalists reacted to the official (and correct) advice of scientists, medical professionals, and public officials is understandable to a point, however. Part of the recent historical backdrop to this story was the BSE crisis, in which the news media placed high amounts of trust in official advice about the risk of contracting CJD from BSE-infected beef only to find out later that this advice was incorrect. It could be argued that many journalists’ and editors’ distrust of official medical advice was rooted in part in the residual mistrust left over from this controversial news story.
5 Was the media actually to blame?
5.1 There is some very strong evidence that the media coverage affected uptake of the vaccine in alarming ways. Tammy Boyce’s research, outlined extensively in her book about the MMR scare Health, Risk, and News, plots uptake of the MMR vaccine against the volume of news coverage at different stages of the scare, and she found a startling correlation: as the health scare built in the UK, uptake of MMR decreased. She then plotted media coverage against MMR uptake the USA, where there was no media scare, and found that vaccination rates remained pretty stable. Some doctors in Swansea did a similar study, and found similar things in relation to the coverage of the South Wales Evening Post specifically.
5.2 Boyce also did some very strong audience research which shows just how many people were taken in by Wakefield’s claims. It strongly suggests that people did not vaccinate their children because of the media coverage. In fact, her focus group research shows that people remembered the substance of Wakefield’s scientific claims very badly. It seems that lots of us were not making decisions based on careful and rational evaluation of the evidence. But people did remember seeing reports of conflict between scientists, and they remembered repeatedly reading that some scientists were saying MMR caused autism. Her work suggests that Wakefield’s false claims were believed in part because were repeated so often in the news.
6 Current media coverage of the measles outbreak:
6.1 This time around things have been a lot better in the news media. The Wakefield research has pretty universally (and rightly) been called “discredited”, and the public health authorities have had a lot of air time and column inches. There has not been much acknowledgement of news media complicity in manufacturing this scare in the first place, but there has (again, rightly) been some soul searching.
6.2 Among the worst of the recent coverage has been the Independent’s front page coverage of a self-serving attempt from Andrew Wakefield to defend himself, to claim his innocence of any blame for the current outbreak, and to drum up some more fake controversy. This is a pity, because publicity for his groundless claims is exactly what this man wants, and that what got us in this mess in the first place.