Dr. Paul Offit

On the weekend, Twitter was aflutter with news from the annual meeting of the Association for Health Care Journalists that vaccine researcher Dr. Paul Offit said there should be a “journalism jail” for reporters who perpetuate false controversies in medicine.

Writing for Forbes.com, Dr. David Kroll (PhD) noted that Dr. Offit’s comments came in the question period following his keynote speech at the conference in Denver.

Dr. Offit took issue with reporters and producers who quote celebrities who have no medical qualifications yet promote themselves as knowledgeable about health matters, and especially immunization, wrote Dr. Kroll. (Dr. Kroll is a pharmacologist and teacher of science and health writing at North Carolina State University, as well as contributor to Forbes.)

Dr. Offit, chief of the division of infectious diseases and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia,  noted that he is often asked to respond to claims by these self-proclaimed “experts.”

He said he’s “troubled by so-called  journalistic ‘balance’ when the contentions of only one side is supported by science,” Dr. Kroll wrote. “He called instead for ‘perspective’ in reporting.”

More heat than light
Credit: Serg Nvns

“They don’t know the data,” Dr. Offit was quoted as saying. “What I say, what others say doesn’t matter. Where is the data?”

During the question period, a fellow Forbes contributor asked if people die from not being immunized, whether journalists who write such he-said/she-said stories are party to murder. That prompted Dr. Offit to suggest they belong in “journalism jails.”

Dr. Offit later added, “You work in a hospital and you watch children die from preventable disease – it makes you passionate.”

I sympathize with Dr. Offit, as I’m sure most of his audience did. I suspect he was preaching to the choir. No good journalist will ask a recognized expert, with his or her bona fides, to rebut a Jenny McCarthy. I’ve also found it unproductive to get “both sides” of a story by interviewing genuine experts who are poles apart. Those approaches generate more heat than light.

Clinicians’ frustration withvaccine opponents as well as with journalists often betrays a lack of understanding of both vaccine opposition and journalism.

‘Vaccine opponents are not a monolithic group’

“An anti-vaccination ‘movement’ is really the creation of pro-vaccination advocates like us, who have lumped anti-vaccination sentiment into a single monolithic group which we can then rail against, ignore and vilify,” Dr. Scott Halperin told the 9th biennial Canadian Immunization Conference in Quebec City in December 2010.

Dr. Halperin — director of the Canadian Center for Vaccinology in Halifax and professor of pediatrics, microbiology and immunology at Dalhousie University — identified at least five different kinds of parents who are hesitant about having their children immunized, each of whom requires a different approach:

• the uninformed but educable;
• the misinformed but correctable;
• the well-read and open-minded;
• the convinced and content; and
• the committed and missionary, who he said he doesn’t even try to persuade “because they’re coming in to convince me of the error of my ways. I can usually tell them when I ask where their child is, and they say, ‘Well, there’s no point bringing the child to this clinic visit because my child isn’t going to get immunized.’ ” (My report of Dr. Halperin’s talk for the Medical Post is online here, but it is a password-protected site.)

How to respond to anti-vaccine sentiment depends on just who is opposing immunization (an individual, a spokesperson for an organized group or a health-care worker) and who is responding (a clinician, an academic or a public health official), he said, suggesting that doctors take advantage of office appointments with parents to:

• recognize their legitimate concerns, that there are adverse events and not to minimize them;
• provide context and understand that many people don’t view risk in the same way a medical professional does;
• refute misinformation but don’t engage in protracted arguments;
• provide a clear recommendation; and
• provide valid information, including the potential consequences of not immunizing, but recognize that whether to immunize is ultimately the parent’s decision.

Conflict is the basis of news

Physicians and public health officials also have to recognize what news is and what it isn’t. It’s conflict that makes up “news.” I don’t necessarily mean knock-down, drag-out conflict (although that too), but conflicts such as:

• human vs. microbe,
• drug vs. microbe,
• microbe vs. drug, and
• observation vs. expectation (as in government performance and new epidemiology).

So sometimes an unlikely vaccine opponent makes for a news story — although one Jenny McCarthy story would have been enough… more than enough. (But having said that, before we dump all the blame for vaccine opposition on the odious Ms. McCarthy, recall that she was a follower of the more odious Dr. Andrew Wakefield, a once-respected physician and researcher.)

The purpose of journalism is not to provide health education — although if education is a by-product of news reporting, that’s a bonus.~TM