< Shot of Fear


Friday, October 09, 2009

BOB GARFIELD: Sometimes one heartbreaking incident can threaten to unravel a government’s best efforts to educate the public. Since September of 2008, all British girls between the ages of 12 and 18 have been encouraged to get a vaccine that protects against cervical cancer. Last week, fear gripped the country following the tragic death of a 14-year-old named Natalie Morton.

FEMALE CORRESPONDENT: Friends and family have been left devastated after 14-year-old Natalie Morton died suddenly after being given the cervical cancer vaccine —

MALE CORRESPONDENT: The 14-year-old was vaccinated, along with most of her school, yesterday. Shortly after having the injection, she turned pale, stopped breathing and collapsed.

BOB GARFIELD: That same week, an autopsy revealed that a previously undiagnosed tumor had killed Natalie, but by then the damage to the vaccine’s reputation was done. Ben Goldacre is a doctor, and author of the Bad Science column in The Guardian newspaper. He says reporters have to be especially careful when it comes to a story like this, because:

BEN GOLDACRE: Health scares are a lot like toothpaste. Once they're out of the tube, they're very, very difficult to get back in.

BOB GARFIELD: Now this story blew up with Natalie’s death, but in many ways the bridge had already wired for explosives. Papers like The Daily Mail had been on a crusade against the cervical cancer vaccine, and her death seemed to prove that all of their grim predictions were coming to pass.

BEN GOLDACRE: Yeah, that’s absolutely true. And I think there’s a strong sense in the U.K. that, in particular, the right-wing use anti-vaccine scares as a kind of rod with which to beat the government’s back. There’s a very interesting piece of evidence for this. The Daily Mail, which is one of the biggest newspapers in the U.K., sells around two million copies here, has two editions, one for mainland Britain and one for Ireland. In Britain, the government had paid for the cervical cancer vaccine, so The Daily Mail had a huge campaign against it where they would talk up side effects and they would talk about how dangerous it was. In Ireland, however, the government had refused to fund the cervical cancer vaccine, and in this territory, The Daily Mail’s Irish edition was running entirely different stories. They were running a campaign against the government, demanding that the government roll the cervical cancer vaccine. And they even had a special campaign logo with The Daily Mail’s logo on it, saying “Roll out the vaccine now!” Exclamation mark! And to people who know of The Daily Mail in Britain, this is unimaginable, The Daily Mail campaigning for a vaccine. And I think that just, to me, sort of reeks of cynicism and political opportunism.

BOB GARFIELD: So, comes this girl’s death immediately after having been vaccinated. I'm a reporter. I know she’s died. I know she’s just received the cervical cancer vaccine. What exactly am I supposed to do?

BEN GOLDACRE: I agree. It’s a very, very problematic area for journalists. What you saw firstly, after this girl tragically died, was people writing stories that were extremely highly suggestive that it was the vaccine that had caused her death. They were writing stories containing things that were just factually incorrect, like saying that the vaccination program had been terminated, when it hadn't been. And then even after it was revealed that this girl had died, unfortunately, of a previous undiagnosed fatal cancer, they continued to push an anti-vaccine line. So, for example, there was a front page story in The Daily Express, then followed up in The Daily Mail, saying that an American vaccination expert called Diane Harper had said that the vaccine was more dangerous than the cancer it was supposed to protect against. And I've been in touch with Diane Harper, and she says that’s not what she thinks at all, and that’s what I'm writing about in my column this week. But it’s inevitable that “Girl died probably from cancer vaccination” is a much more significant story to the news media than, by the way, you remember that story from a couple of days ago? Well, actually, it wasn't the cancer vaccination.

BOB GARFIELD: Now, I must say fear of vaccines is on the list of public policy issues here in the United States, but it’s not quite as resonant, it seems to me, as it is in England. Why do you suppose that is?

BEN GOLDACRE: There’s something very interesting about vaccine scares. These are cultural products. They're not about evidence. If vaccine scares were about genuine scientific evidence showing that a vaccine caused a disease, then the vaccine scares would happen all around the world at exactly the same time, because information can disseminate itself around the world very rapidly these days. But what you find is that vaccine scares actually respect cultural and national boundaries. So, for example, over the course of the last 10 years in the U.K., we had this huge scare that the MMR vaccine causes autism. And this was largely unheard of outside of the U.K., although about ten years after we had it, you seemed to be having it. In France, nobody’s heard of the idea that the MMR vaccine causes autism, but they have a huge scare that the hepatitis-B vaccine causes multiple sclerosis. The most extreme example, of course, is the story of polio vaccine. The World Health Organization were on target to eradicate polio from the face of the globe, but then in Kano Province in northern Nigeria there was a sudden scare that polio vaccine caused infertility, and there was a huge campaign against it there, and the vaccination program failed as a result of that. And Kano Province is now a net exporter of polio. So, you know, vaccine scares — I think maybe the media feel that they're quite trivial issues because often the diseases that they protect against, such as measles, are no longer very big killers in the West. But when you take these vaccine scares out of their Western context and put them into a situation where it really matters, the consequence is that people die in very large numbers.

BOB GARFIELD: You've made reference to how globally there’s something about vaccines that scares people. What is that something?

BEN GOLDACRE: Vaccination is inherently at odds with modern notions in health care of the primacy of choice that we should all be able to choose our own health care interventions, because this is something which by its nature has to be taken on by almost the entire population. And I think people resent that. I think in some respects, also, it’s kind of an act of protest on which people can take a stand. When the MMR vaccine scare really kicked off in the U.K. in 2002, it was shortly after we were sort of going off to wars that were very, very unpopular, and I think, in some respects, people might have felt, well, there’s nothing I can do to stop my country bombing, but I can take a stand on vaccines. It almost becomes a kind of poetic response to unrelated problems.

BOB GARFIELD: Ben, thank you so much.

BEN GOLDACRE: Cheers, boss.

BOB GARFIELD: Ben Goldacre is a physician and columnist for The Guardian. His column can be found at Badscience.net. On Saturday, he weighs in on the cervical cancer vaccine scare.

[MUSIC UP AND UNDER] Coming up, scientists cut out the middleman by starting their own wire service, and a hockey team does pretty much the same thing by hiring its very own reporter. This is On the Media from NPR.