The portrayal of vaccination in the media has always been a controversial issue. When a new vaccination program makes the news the mainstream media often find themselves accused of ignoring the evidence in favour of scaremongering reports or the distortion of facts and yet the media commonly counter with the argument that they are acting on respectable evidence and valid scientific studies. The matter is yet to, and may never be resolved. Many people will always believe newspaper reports containing scientific reports whilst others will remain sceptical. Within the subject of vaccination in the media new reports consistently emerge, often with controversial consequences, although some become a lot larger than others. This is not to say that alternative coverage does not exist. Certainly there are many purportedly more ‘respectable’ publications that would claim to show unbiased coverage and factual or statistical evidence but these are often incompatible with the more popular reporting from mainstream news and the tabloid press. When presented with this ongoing, contradictory reportage it might be difficult for someone to make a considered opinion, particularly if they have no prior knowledge of the science of vaccination or little understanding of media machinations. Whilst the public dialogue continues between tabloid journalists, television news reporters, medical professionals, government speakers, armchair pundits and media commentators there are clearly much more important issues at stake. If the scientists and medical professionals (and the media who support them) are to be believed then the gains to be had from proper vaccination coverage (or ‘herd immunity’) throughout society are not only beneficial to individuals but are essential to public health and wellbeing. The counter arguments from the mainstream press include claims that the medicines used are insufficiently tested, are dangerous to human health and are only being pushed on the public to ensure continued profits for powerful, multinational drug companies.
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Vaccination advances have often been treated with scepticism and fear by the mainstream press. The coverage that was received by the swine flu vaccine in 2009 presented worldwide controversy, and many of the tabloid press organisations were eager to stress that the vaccine (H1N1) was not safe. Sky News pointed out the hazards associated with the vaccine with headlines such as ‘Mums to be get untested flu jab’ and ‘Mums to be in Swine Flu jab controversy’ (Moore, 2009a). The main thrust of these stories maintained that the World Health Organisation’s (WHO) strategic advisory group had recommended that ‘pregnant women should be given adjuvant-free formulations of the vaccine whenever possible’ (Moore, 2009a). Whilst this alone was not necessarily a controversial statement to report the story was coupled with the claim that, ‘even though the NHS has stocks of an alternative vaccine called Celvapan, it will not be prioritised for pregnant women’ (Moore, 2009b). This came followed by a journalistic statement of confirmation from Professor David Salisbury, Director of Immunisations at the United Kingdom’s Department of Health, who had asserted that ‘If the virus is increasing, as it has been recently and we had the supply of one vaccine ahead of the other, then we have to make a judgement that says pregnant women are at high risk and they need to be protected…and in those circumstances I would recommend whatever is available to hand to protect them.’ (Moore, 2009b). This antipathy towards the Swine Flu vaccine can be linked back to the 1976 Swine Flu epidemic, which attempts were made to vaccinate against in America. In that instance shortly after vaccination many people developed Guillain-Barre syndrome and this became linked, via the media, to the vaccine. Although there is still no evidence to support the claims that there is some kind of connection between the two, the vaccination program was halted after only 40% of the population received immunisation and the damage to the reputation of the vaccination was made. The modern epidemic of Swine Flu and the resulting media coverage/outrage of the proposed vaccination soon morphed (once many parents became convinced of the safety of the vaccine) into outrage that there would not be enough doses to go round (Iannelli, 2009).
Whilst it is no controversial statement to declare that the mainstream media (and particularly tabloid press) may have a tendency to exaggerate claims or even embellish the truth, the coverage that the MMR vaccine received in the late 1990s and turn of the century, became the subject of a huge national debate with a fall-out which still exists today. The media claims that the vaccine put children at risk of inflammatory bowel disease and more seriously, the development of autism put a lot of parents into a difficult position. To begin to understand the manner in which these media operated and to establish the value of evidence-based reporting held by such organisations it is important to examine the research upon which these claims were based alongside the severity of the diseases in question and the potential risk to public health should they not be immunised.
The MMR (Measles, Mumps and Rubella) vaccine protects children against three diseases to which they are particularly prone in infancy. Measles is a disease which thrives in dense populations and in circumstances where malnutrition is common, can achieve a fatality rate of 20%. Measles can also lead to severe complications in the host and can develop into measles encephalitis, which in turn can lead to brain damage. More commonly the host can experience convulsions and aural infections. Mumps was first effectively vaccinated against in 1967 and carries with it less potential for public health risk than measles or rubella. The disease (whilst very unpleasant) is rarely serious although it can lead to orchitis in males, which in turn can lead to sterility. Rubella (or German Measles) was first described in 1619 and although not as serious as measles is considered to be an important virus to be immunised against. Whilst rubella differs from other childhood diseases in that it rarely has any direct consequence on the health of the host it is considered a serious disease due to its effect on unborn children and can pose severe problems to the development of a foetus in utero. The ethical problem posed by this situation requires that boys be immunised as well as girls in order to ensure that ‘herd immunity’ is maintained, i.e. to decrease the chances of passing the disease to a female who has herself not been immunised (Senn, 2003).
Studies into a combined MMR vaccine began in Finland in the 1970s after common epidemics of all three viruses, leading to many deaths, cases of sterility and congenital birth defects. After many years of meticulous study into the drug’s implementation and safety what has now come to be known as the MMR vaccine, was approved in 1982 and a little afterwards, in 1988, the UK followed suit. The Finish example had shown that complications arose when the mother of a child to be immunised was in fact immune herself. The child rejects the vaccination due to the circulating antibodies which have been passed on from the mother although the protection provided by these antibodies only lasts for around a year, leaving the child susceptible at a point they are most vulnerable. It was decided that the most efficient method of immunisation was to be a course of two immunisations over the space of around five years, a strategy which the UK also adopted in 1996 (Senn, 2003).
There was little coverage of note regarding the MMR policy in the mainstream media until 1998 when a paper was published in the Lancet, a peer-reviewed medical journal. The paper, authored by Andrew Wakefield and thirteen others, presented several findings based on a study of 12 children. What was to become by far the most controversial of these claims was the implication that MMR could be a possible cause of both gastrointestinal disease and developmental regression? The popular press launched a scathing attack on the MMR vaccine, basing all of their ‘evidence’ on Wakefield’s paper and public opinion. The fear campaign projected onto the general public was relentless and coverage mostly applauded Wakefield for speaking out against this issue whilst chastising the government’s efforts to subdue his findings. In spite of numerous medical experts and scientists coming forward to discredit Wakefield’s research, tabloid and broadsheet alike ran story after story damning the vaccine. The government, led by Tony Blair, campaigned for the safety of the vaccine and issued a statement in favour of MMR. It was only under scrutiny that he refused to admit whether his own son had been given the jab, fuelling the media furore further. Even four years later the media still utilised the hype that they themselves had created surrounding the vaccine as the Times campaigned to have a trial held in public on the grounds that it was in the public interest. The case involved two mothers being taken to court by the fathers of their children because they refused to allow them the MMR vaccine. The Times did not win their battle and the case was held in private. It was widely reported that Wakefield’s research was comprehensive and indeed it was. Wakefield carried out numerous assessments on the 11 boys and one girl, aged between 3 and 10, including lumbar punctures, cerebral magnetic-resonance imaging and electroencephalography. In the years following this press coverage vaccination rates dropped dramatically, resulting in over twice the cases of measles in infants in the UK in 2006 as there was in 2003 and that same year the first death from measles in 14 years (Senn, 2003).
Whilst the media praised Wakefield and his study many experts expressed their own opinions on the research, invariably condemning the findings, and indeed the coverage, as misleading and dangerous. It was argued that the causal link which Wakefield described as potentially indicative of MMR (particularly the measles element) leading to autism in children was gained from inconclusive research that in such a small test group was meaningless. As Senn asserts:
In the period in question MMR was not at all an unusual thing for children to have been given. Wakefield’s subjects must have been born between 1987 and 1995. But according to World Health Organisation figures rates of measles immunisation for the birth cohorts from 1987 ranged from 76% to 92% so that finding 12 children with autism who have received MMR is unremarkable. To put it another way, if none of the children had received MMR this would (accepting the other weaknesses of this form of study) be an indication that MMR had a protective effect against autism. (Senn, 2003:221)
After the actual evidence and methodology behind the trials had been forced into the public eye and was sufficiently scrutinised, along with reports that Wakefield himself had been struck off over malpractice over charges of bringing his profession into disrepute, along with claims that his studies had also been affected by a conflict of interests which involved a £55,000 grant, it became difficult for the media to continue their supportive campaign for his efforts. The Telegraph, who in 2002 had described Wakefield as a ‘handsome, glossy-haired charismatic hero’ (Picardie, 2002) now called for greater scrutiny of medical practitioners. The Sun ended its ‘give us a choice’ campaign (which had called for the right to opt for multiple vaccines over the triple jab) whilst the Daily Mail disregarded all evidence and continued to publish stories which linked the MMR vaccine to autism for many years after (O’Neil, 2006).
Private Eye was one publication who had sided with Wakefield against what it purported to be a controlling and pernicious health authority which had something to hide, in its special supplement published with its regular issue. In response the British Medical Journal affirmed in a press release that:
The Eye report is dangerous in that it is likely to be read by people who are concerned about the safety of the vaccine. A doubting parent who reads this might be convinced there is a genuine problem and the absence of any proper references will prevent them from checking the many misleading statements. (Elliman, 2002)
The MMR coverage given by Private Eye was incredibly damning and made the magazine the subject of harsh criticism from many media pundits. Brendan O’Neil damned the publication in his column, stating that ‘Private Eye did perhaps more than any other publication to keep the MMR panic alive. Whether it can recover its reputation from this episode remains to be seen.’
Private Eye later apologised for the special, conceding that it was not ‘anti MMR’ and that it was ‘wrong in its coverage of MMR’. (O’Neill, 2006)
The bias in media coverage fluctuated throughout the time period in which it was delivered. From the outset the media used the Wakefield report to create a climate of fear. This strategy unfortunately became (if it were not already) indicative of the nature of the mainstream press and it was clear that their targets throughout their campaign were bewildered parents who did not know what information to believe and continued to buy newspapers in the hope of some kind of clarification, which for the most part was not forthcoming.
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There were no such scare tactics employed in New Scientist’s coverage of these events, or indeed any other stories they ran regarding vaccination, with a heavy focus in statistics, facts and procedure than conjecture (Mackenzie, 2007). This is an important distinction to regard as it is precisely the oppositional approach of the mainstream press who delivered their coverage with a complete disregard for factual or statistical evidence.
Taking all coverage into account with an appreciation for the motives that have driven each side of the MMR debate, and indeed the ongoing media coverage of vaccination on the whole, it still cannot be stated conclusively that MMR does not lead to autism as proving something is entirely safe is near to impossible. This factor, whilst testable to a certain degree is an unfortunate fact of scientific analysis. As Senn asserts (2003) ‘conclusions of safety are always tentative and hostage to being overturned by further study’ and the media is quick to exploit this fact, along with, it seems, the collective consciences of a nation, of which they know many of whom take the majority of their contemporary news from a handful of unreliable sources but would rather not take the risk when it comes to the safety of their children.