Archive for the ‘Health’ Category


Toronto Star Fails in Vaccine Investigation

Photo Illustration (Photo Credit: Flickr/ El Alvi)

Photo Illustration (Photo Credit: Flickr/ El Alvi)

Two days after I published a post on this blog about the importance of using data to report on medicine, the Toronto Star published – what the paper called – an investigation into Gardasil, which is one of the vaccines used to prevent the human papillomavirus.


While the Star’s story included medical experts defending the vaccine, the paper relied on anecdotal reports to support a hypothesis that the drug has a “dark side” that includes undisclosed complications, including death.

As I wrote in my post on February 3, journalists have a responsibility to prevent people from being harmed by incorrect information. In this case, one can make a strong argument that the Star’s failure to adequately report its story may lead to future cancers and even deaths.

The human papillomavirus – better known as HPV – is a sexually transmitted infection responsible for a number of cancers and other complications, including genital warts. Most importantly, HPV is responsible for the vast majority of cervical cancers.

The U.S. Centers for Disease Control and Prevention (CDC) says on its website that almost all adults who are sexually active will be infected with at least one strain of HPV during their lives. Most infections will clear up on their own, but about one in 10 will persist.

There are two vaccines currently approved to protect against HPV in the U.S. Cervarix, which is manufactured by GlaxoSmithKline, and Gardasil, which is manufactured by Merck. Gardasil is the only vaccine approved for use in males, who can also get HPV and suffer from its complications.

While the CDC says the vaccines are safe and effective, the agency reports some people experience side effects ranging from pain at the injection site, headache, nausea, dizziness and fainting.

The U.S. recommends vaccination for boys and girls from ages 11 through 12 years, and teens who were not previously vaccinated. Specifically, females can get the series of three shots through age 26 and males through age 21. Gay men, bisexual men and other men who have sex with men can also receive the vaccine through age 26 years.

If people reading the Star’s story are persuaded to not be vaccinated, some may go on to develop cancers that would have been prevented by the vaccine. Additionally, some of those cancers may ultimately cause people’s deaths.

While the Star – as of right now – did not retract its story, the paper’s publisher said the publication failed in its job. Additionally, the paper’s public editor Kathy English wrote a comprehensive report on the matter on Friday.

“It’s too bad there isn’t a vaccination to prevent journalistic misstep. I suspect we’d all line up for that shot about now. The fallout here has been devastating for the newsroom,” wrote English.

English places a lot of blame on the story’s presentation, such as the accompanying headline and pictures. While those elements didn’t help, the article itself would lead a reasonable reader to assume the vaccine may cause serious complications.

Dr. Yoni Freedhoff told CBC, the Canadian Broadcasting Corporation, that he suspects the Star’s story will lead some people to not be vaccinated, and ultimately develop cancers.

“And that’s really a horrible thing for the Toronto Star to have done,” he told the CBC.

The Star already took some steps to reduce the harm its article caused, including admitting the paper failed in its responsibilities and adding several notes to the online publication. My hope is that the Star will report the story again, except with a much more critical eye.


 On a personal note: I think it’s important to say that I’m currently in the middle of receiving the HPV vaccine – as recommended by the CDC.


Andrew Seaman is the chair of the Society’s ethics committee.

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Ask for Evidence and Data When Reporting on Health

My childhood doctor vaccinated me against measles, mumps and rubella as recommended by the U.S. government. A quarter century later I sat in another doctor’s office asking if the shots still protected me against those diseases.

Photographed early in 2014 in the Philippines capital city of Manila, this baby was in a hospital with measles (rubeola).  (PHOTO CREDIT: Jim Goodson, M.P.H.)

Photographed early in 2014 in the Philippines capital city of Manila, this baby was in a hospital with measles (rubeola). (PHOTO CREDIT: Jim Goodson, M.P.H.)

In an ideal world, we wouldn’t need to ask whether effective vaccines still work as intended. Even if someone’s immune system isn’t working properly, the rest of the vaccinated population should still keep the disease at bay.

We do not live in an ideal world, however.

Measles, a once-eradicated virus, is spreading across North America. Health experts put most blame at the feet of people who refuse to vaccinate themselves and their children against diseases because of unproven fears about side effects.

While journalists aren’t to blame for these parents’ refusals, we do have a responsibility to minimize harm from incorrect information. Unfortunately, news reports continue to feature doctors and others who provide unchallenged anecdotal evidence that vaccines do more harm than good.

No substance, natural or manufactured, is free of risks. But the best available medical research shows that the vaccines recommended by the U.S. Centers for Disease Control and Prevention are extremely safe and effective.

Because the weight of evidence is so heavily stacked in favor of vaccines, people who are against vaccinations – so-called anti-vaxxers – should be challenged by journalists to provide data to support their claims.

As always, balanced reporting is important, but not all arguments carry equal weight.

One of the most popular myths is that the measles, mumps and rubella (MMR) vaccine causes autism spectrum disorders, which are a collection of developmental disabilities. This myth gained momentum when it was supported in a 1998 article in a medical journal. Since then, the 1998 paper and its author were proved incorrect time and time again.

For example, a study reported in 2002 in The New England Journal of Medicine, involving more than 500,000 Danish children from 1991 through 1998, found that 82 percent – or roughly 410,000 – received the MMR vaccine. Overall, 738 children – or less than two-tenths of one percent – were diagnosed with an autism spectrum disorder. There was no increased risk of a child being diagnosed among the children who received MMR vaccines.

There are also reports of kids having seizures and other developmental delays after a vaccination. Research shows that many of those children have Dravet syndrome, a rare genetic condition triggered by fevers and stress. Research also suggests that outcomes among kids with Dravet syndrome are similar with or without vaccinations.

People who suggest a link between vaccines and developmental conditions or severe injury should be asked to back those claims with the same quality evidence that supports vaccinations.

Especially with health issues, journalists must realize that their stories have consequences. Infectious diseases are only whispers from the past to modern U.S. parents. A 35-year-old father may choose not to vaccinate his children if a news report suggests they may be left disabled from a shot that protects against an eradicated disease.

Measles causes flu-like symptoms and a rash across the body. It’s spread through the air and is highly contagious. One measles virus infection may lead to 12 to 18 secondary infections.

About 30 percent of measles patients will have complications such as ear infections (sometimes with permanent hearing loss), diarrhea, pneumonia, brain swelling and death, the CDC warns. There’s also a risk for complications later in life.

The CDC says children should receive one dose of the MMR vaccine between 12 and 15 months of age and a second dose between ages four and six.  Most people will become immunized after the first dose; the second dose will likely protect those who didn’t respond to the first shot.

Babies younger than 12 months can’t be vaccinated against measles; they’re protected only by whatever limited immunity they may have inherited from their vaccinated mothers. Also vulnerable to measles and its complications are people with compromised immune systems, as from cancer treatment.

While a blood test confirmed that I’m still protected against measles thanks to my MMR vaccines, I continue to worry about my friends and family who are too young to be immunized or have weakened immune systems.

The Society’s Code of Ethics says journalists should seek truth and minimize harm. To me, that means we should do due diligence to make sure people have the most accurate medical information to protect themselves, their loved ones and society. As of now, the evidence says people should be immunized according to the CDC’s schedule. If others disagree, they should be required to present equally compelling evidence.


Andrew Seaman is the chair of the Society’s ethics committee.

 

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The Other Side: Rolling Stone’s Note

A screenshot of the editor's note attached to a Rolling Stone story about a 2012 gang rape at the University of Virginia. (captured 12/5/2014)

A screenshot of the editor’s note attached to a Rolling Stone story about a 2012 gang rape at the University of Virginia. (captured 12/5/2014)

The managing editor of Rolling Stone added an editor’s note earlier today to the magazine’s bombshell campus rape story that was published online November 19. The story described a 2012 gang rape of a woman called Jackie at a party in the house of a University of Virginia fraternity.

“In the face of new information, there now appear to be discrepancies in Jackie’s account, and we have come to the conclusion that our trust in her was misplaced,” writes Will Dana, the magazine’s managing editor, in the note, which does not specify the discrepancies.

Meanwhile, The Washington Post  published a story today detailing its own investigation into the events described in the original Rolling Stone report.

“Several key aspects of the account of a gang rape offered by a University of Virginia student in Rolling Stone magazine have been cast into doubt, including the date of the alleged attack and details about an alleged attacker, according to interviews and a statement from the magazine backing away from the article,” writes Post reporter T. Rees Shapiro.

Many news organizations and journalists are calling the Rolling Stone editor’s note added to the story a retraction. The magazine does not use that specific word, however. Instead it’s up to the reader to proceed with the caveat that some of the 9,000-or-so-word story may be inaccurate.

Dana emphasizes in his note that the magazine decided to honor the source’s “request not to contact the man she claimed orchestrated the attack on her nor any of the men she claimed participated in the attack for fear of retaliation against her.”

Some journalists experienced with reporting on rape are quoted as saying it may be acceptable to not reach out to the accused in some cases.

Most – if not all – sets of journalism standards emphasize the special care and compassion reporters must take when dealing with certain sources. The Society’s Code of Ethics is no different. “Journalists should use heightened sensitivity when dealing with juveniles, victims of sex crimes, and sources or subjects who are inexperienced or unable to give consent,” says the Code.

Ethics and responsible reporting are balancing acts, however. In this case, it’s easy to argue the seriousness of the crimes described in the Rolling Stone story warranted reaching out to all accused parties.

Additionally, investigations are typically not considered complete until all information within a story is thoroughly examined and substantiated. As I’ve been taught, sources and subjects should not be surprised when an investigation is published – it’s how a reporter knows all involved parties had the opportunity to have their responses included.

Perhaps the inability to reach out to the accused meant Jackie should not be included in the magazine’s story.

The Post also reports Jackie asked be left out of the Rolling Stone story altogether. The Columbia Journalism School’s Darte Center for Journalism and Trauma says journalists should respect an interviewee’s right to say no. The Center offers journalists a comprehensive sexual violence reporting tip sheet , which can be found here.

Obviously, there are exceptions to most rules in journalism. Still, Rolling Stone and its editorial team owed – and still owes – its sources, subjects and readers thorough reporting and verification of whatever information made its way to publication.

What’s especially upsetting about today’s development is that the controversy created by poor editorial management overshadows a very real problem. The Rape, Abuse and Incest National Network (RAINN) cites a December 2000 U.S. Department of Justice report that found “a college with 10,000 students could experience as many as 350 rapes per year.”

Instead of those rapes being the focus of public discussion, the conversation turns to the decisions made by a magazine. The investigation into the story is likely to only create a more traumatic experience for Jackie, too. Her friends tell the Post that “they believe something traumatic happened to her.”

Rolling Stone’s Dana took a step in the right direction on Twitter earlier today, when he wrote the “failure is on us – not on her.”

Ultimately, whatever doubt Rolling Stone has in its story is its own creation – not that of sources, subjects or readers. As a result, it’s up to the magazine to make this situation right.

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Ebola in America

Ebola virus disease is a terrifying ailment. After transmission, symptoms start two to 21 days later. The often-deadly disease usually begins with a fever and progresses to more serious symptoms, such as internal and external bleeding. Even more terrifying, the disease is caused by a virus that’s invisible to the naked eye.

As a health writer, I watched since early this year as reports of the current Ebola virus disease outbreak trickle out of West Africa. Fear and anxiety spread among Americans as it became clear that the disease would eventually reach the U.S.

While the Code of Ethics is clear that ethical journalism ensures the free exchange of information that is accurate, fair and thorough, Americans were on the receiving end of journalism during the past couple months that often failed to meet those standards.

The truth is that a person can’t develop Ebola virus disease unless they come in direct contact with an infected person’s bodily fluids, such as blood, vomit or semen. Vox offers information on Ebola virus disease here: http://bit.ly/1wYFa2w.

While many people wave off irresponsible journalism as the result of the digital world hungry for constant content, reports that lead to more questions than answers may also lead to harm.

First, there are the people with Ebola virus disease. There is a gray area whenever journalists deal with people suffering from an illness – especially a contagious disease. By releasing those patients’ names, will it affect their livelihood? Will this information put them at risk in some way? How will their family be affected by the news coverage? Simply put: do the benefits of releasing this information outweigh the harm it may cause?

Second, there is the general U.S. public, who – for the most part – only know of Ebola virus disease through the stories and images they received in years past from Africa. Journalists have the responsibility to act and provide accurate answers through thorough reporting. It’s not the job of journalists to drum up unwarranted fear or concern.

Unlike many countries in Africa, the U.S. is in a much better position to control any cases of the Ebola virus disease. While there are challenges and errors, the journalists reporting on Ebola should not consider the situations comparable.

The most recent poll from the Pew Research Center for the People and the Press found about a third of adults in the U.S. are at least “somewhat worried” that someone in their family will be exposed to the Ebola virus.

In addition to the wear and tear of general anxiety, the potential harm of unchecked rumors and fear among the general public can be seen in U.S. history books. Fear and uncertainty over the transmission of HIV in 1987 led to a ban on people infected with the virus, which causes AIDS, from entering the U.S. The ban stayed on the books until 2009, a year after then-President George W. Bush began the repeal process.

Fortunately, health officials, health experts, journalists and the general U.S. population are in a better position than they were during the beginning of the HIV/AIDS epidemic. Ebola virus disease is not new. The first outbreak occurred in 1976, according to the World Health Organization. People know how the virus spreads and how to give people infected with it the best chance at survival.

As with any topic, journalists with questions about Ebola virus disease or possible cases in communities should do what they always do – ask questions and provide accurate information.

For more information, I encourage reporters to always refer to the Code of Ethics. Additionally, the statement of principles from the Association of Health Care Journalists provides guidance to people covering health care.

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