A new study by Texas medical researchers published in the Journal of Adolescent Health (JaAH) investigates the association between print media coverage and reporting of adverse events reports attributed to the human papilloma virus vaccine Gardasil (HPV4) and the meningitis vaccine Menactra (MNQ) among United States adolescents.
The study entitled “The Role of Media and the Internet on Vaccine Adverse Event Reporting: A Case Study of Human Papillomavirus Vaccination” co-authored by Jan M. Eberth and Kimberly N. Kline of University of Texas at San Antonio; Department of Epidemiology and Biostatistics, University of South Carolina, David A. Moskowitz of New York Medical College, Jane R. Montealegre of the University of Texas School of Public Health and the Dan L. Duncan Cancer Center at Baylor College of Medicine in Houston, and Michael E. Scheurer of the Baylor College of Medicine Department of Pediatrics, finds a correlation between the volume of adverse events being reported for the HPV vaccine Gardasil and an increase in the intensity of media coverage of the vaccine, while the meningitis vaccine Menactra, recommended for essentially the same demographic as Gardasil, and which has similar risks of severe side effects (1.0 percent vs. .8 percent), has not received a great deal of media coverage and has been associated with much lower incidence of adverse events attributed to the product reported to the to the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).
The co-authors note in the study abstract that compared with the MNQ vaccine, HPV4 got more coverage in the print media and Internet search activity, which corresponded with the frequency of Vaccine Adverse Event Reporting System (VAERS) reports. In February 2007, they observed a spike in print media for HPV4, and although media coverage waned, Internet search activity remained stable and correlated to a rise in HPV4-associated VAERS reports.
An example would be the spike in adverse event reporting for Gardasil nine months after the vaccine was approved by the FDA in June 2006, following Texas Governor Rick Perry’s issuance of an executive order making Texas the first state to require all girls older than age 11 entering the sixth grade to receive the HPV vaccine beginning in September 2008, The order also allowed parents dissenting for philosophical or religious reasons to opt their children out of receiving the shot via a conscientious objection affidavit form “in order to protect the right of parents to be the final authority on their children’s health care.” Gov. Perry’s order was later overturned in 2007 by the Texas legislature and Texas Senate, and the associated controversy received intensive national media coverage and Internet commentary.
Consequently, the researchers conclude that an abundance of media coverage and Internet search activity in particular catalyzed increased public interest in human papillomavirus vaccination in the months after the Food and Drug Administration approved Gardasil was strongly related to an increase in human papillomavirus vaccine-associated adverse events being reported to the VAERS. They note that public health officials who have long recognized the importance of proactive engagement with news media, and advocate that they must now consider strategies for meaningful participation in Internet discussions as well.
Part of the reason for the disparity in media and Internet search interest between the HPV4 and MNQ vaccines is that HPV4 is cultural-values controversial and MNQ much less so. A 2010 study published by the Journal of Health Communication, entitled “Passport to promiscuity or lifesaver: press coverage of HPV vaccination and risky sexual behavior” (2010 Mar;15(2):205-17. doi: 10.1080/10810730903528066), determined that: “A significant minority of parents are concerned about adolescents engaging in risky sexual behavior following human papillomavirus (HPV) vaccination.”
The article’s co-authors, Alice Forster, Jane Wardle, Judith Stephenson, and Jo Waller of the Cancer Research UK Health Behaviour Research Centre at University College, London, UK, examined the content of 92 articles published between 2003 and 2008 in British national newspapers addressing the issue of adolescents engaging in risky sexual behavior following HPV vaccination. Their analysis highlighted three main types of discussion: news stories proposing that adolescents will engage in risky sexual behavior following HPV vaccination, counterarguments insisting that adolescents will not engage in risky sexual behavior after HPV vaccination, and parents’ views of the issue of risky sexual behavior. Their results indicated that while newspapers provide parents with broadly positive descriptive norms about vaccination; the issue that adolescents will engage in risky sexual behaviors following HPV vaccination gets regularly discussed in media coverage, and has the potential to increase parents’ concerns about vaccination.
Medical Xpress’s Milly Dawson cites the JaAH study’s corresponding author Dr. Jan Eberth, an assistant professor of epidemiology at the University of South Carolina Arnold School of Public Health, observing that “Vaccines are being met with increased skepticism and criticism in society.”
The remedy would seem to be getting more objective and substantive information out to both print/broadcast media and the Internet that goes beyond sound bites and controversy, that can help the public make informed decisions weighing the benefits and risks of vaccination.
For more on the Texas Gardasil controversy see:
Journal of Adolescent Health
Journal of Health Communication
Center for Media and Democracy SourceWatch
University of South Carolina