MMR: more scrutiny, pleaseBMJ 2003; 326 doi: http://dx.doi.org/10.1136/bmj.326.7401.1272 (Published 05 June 2003) Cite this as: BMJ 2003;326:1272
The media love a maverick. That's one reason why a figure such as Dr Andrew Wakefield, who challenged established thinking over the measles, mumps, and rubella (MMR) vaccine, has received so much coverage in the British press. But although some newspapers have presented Wakefield as a popular hero, fighting scientific officialdom on behalf of parents worried about autism, nearly half of the public believes that journalists should have subjected his claims to more scrutiny before reporting them.
A study of what and how people learn about science from the media discovered that 48% of the public felt that when scientists go against the grain, as Wakefield did in suggesting a link between MMR and autism, the media should wait until other studies confirm those findings before covering them. Thirty-four per cent of the survey sample of more than 1000 people thought that the media should give such scientists prominent coverage and 18% expressed no opinion.
The public's reticence might seem “odd,” particularly since MMR “does not involve issues of privacy, and since such work may already be in the public domain through publication in reputable journals,” say the researchers from Cardiff University School of Journalism. “But it speaks to the degree to which many people feel the need for expert guidance on scientific issues.”
The researchers analysed the way in which science and science related issues were reported on television news, radio news, and in the press during seven and a half months in 2002. They also used two nationwide surveys (using representative samples of more than 1000 people), carried out in April and October 2002, which tracked the public's knowledge, opinion, and understanding of science related issues reported in the media. The focus of their attention was on climate change, the MMR controversy, and cloning and genetic medical research.
Their report, Towards a Better Map: Science, the Public and the Media, published last month, found that what people knew usually corresponded with those aspects of a story that received most persistent coverage. “The details or subtleties of media coverage are, in this respect, much less important than the general themes of that coverage, in which certain ideas are repeated and associated with one another,” says the report. MMR and autism is one example of such repetition and association. “While this does mean some information is communicated effectively to most people, it can also result in widespread misunderstanding—even if the reporting itself is generally accurate.”
In the case of MMR and autism, people were also misled by the journalistic quest for balance in reporting. The researchers say, “We discovered that the coverage was unintentionally misleading in creating the impression that the evidence for the link was as substantial as the evidence against it.” This is a finding that also emerged in preliminary results released last September (BMJ 2002;325: 603). Only 30% in the April survey and 23% in the October survey were aware that the bulk of the evidence favoured supporters of the MMR vaccine.
The researchers found that Wakefield's claims—of a speculative link between the MMR vaccine and autism, “with questionable scientific data to support it”—were not “comprehensively or systematically challenged in media coverage.” Instead, the media leapt to the speculative link, and then, because the risks of non-vaccination were fairly clear, the idea of offering three single jabs gained a great deal of currency. This put government and scientists supporting MMR on the defensive, and pitched them against the notion of parental choice. “This created a serious difficulty for the scientists and health professionals, who are only able to propose dry generalisations against the more emotive and sympathetic figures of parents concerned for the welfare of their children,” says the report.
The researchers say that “while Wakefield's claims are of legitimate public interest, our report does give credence to the view that research questioning the safety of something that is widely used should be approached with caution, both by scientists publishing that research and journalists covering it.” They add, “This is especially the case if any decline in public confidence has negative consequences for public health.”
This does pose a difficulty for journalists, however, and for non-specialist reporters in particular: how to distinguish an MMR from a thalidomide. Sometimes, it seems, the public wants them to raise the alarm and sometimes it doesn't. And sometimes there is simply just no alarm for them to raise.
Towards a Better Map: Science, the Public and the Media is available at www.esrc.ac.uk/esrccontent/connect/indexpub.asp