March 10, 2011

The Injustice of Immunization Interviews

Wendy Sue Swanson, MD, MBE, FAAP
Author, Seattle Mama Doc Blog

When Dr. Wakefield interviewed on "Good Morning America" in January, an injustice occurred. It occurred inadvertently, I suspect, yet this injustice happens frequently in the world of pediatric health messaging. The stories the media covers, clearly change how we think and feel in regards to protecting and parenting our children. Their work to inform and educate, just like that of physicians and nurses, can get lost and misconstrued. ABC worked hard to inform us of the accusations against Dr. Andrew Wakefield with a 2-minute introduction by Dr. Richard Besser, a pediatrician and medical editor/correspondent. Yet, when the interview was over, we are left remembering the myth.

Dr. Wakefield interviewed with George Stephanopoulos who later labeled the interview "combative." Mr. Stephanopoulos was given a terribly difficult task. He was interviewing Wakefield on one of the most complex, emotional and loaded quandaries of the last few decades: vaccine-hesitancy and Wakefield's purport linking vaccines to autism. When Wakefield failed to deny any allegations and failed to discuss the significant research refuting his work, Mr. Stephanopoulos had to defend science. Alone. Although Stephanopoulos isn't gaining popularity (read the comments) with the anti-vaccine crowd, the 7-minute interview simply stirs the pot. I trust it had huge viewership. I worry that this is why it was done.

We need to discuss immunizations in the context in which decisions for vaccinating are made. In 2011, interviewing Wakefield alone on national TV doesn’t help. Wakefield’s myth and legacy regain power with each second he's on the news. We need to acknowledge the fear that has arrived on parents' doorsteps because of Wakefield's work. We needed a general pediatrician, a parent of immunized children, and a vaccine expert in the interview too. We need voices of reason. We need to frame issues surrounding immunizations truthfully. Although Wakefield's original study only applied to the MMR he has fueled millions of parents to distrust all vaccines. Dr. Wakefield claims that he doesn’t want others to stop immunizing against pertussis, but this point is easily lost. Stephanopoulos needed to make that point clear. In the office, when parents who are hesitant about immunizations talk about their worry, they point to Wakefield's claim.

Dr. Besser's introduction included micro-interviews (sound-bites) from Dr. Paul Offit and Seth Mnookin (book author of The Panic Virus). Neither was given the time and exposure Wakefield received. What we learned from Offit and Mnookin about immunizations could easily be forgotten by the time the interview with Wakefield was over.

Interviews, such as this one, leave parents increasingly more confused, not more informed. Although some bloggers are declaring vaccine-hesitancy dead with BMJ’s expose on Wakefield's work, we're far from seeing its end. Distrust in our physicians and nurses only increases when stories and interviews occur in this fashion. I suspect I will be helping families concerned about immunizations for the rest of my clinical career.

It can take only seconds to create a myth. It can take decades to rebuild the truth.

The editorials in The BMJ uncomfortably put Wakefield back into the spotlight. His message, although rebuked, regains momentum. Regardless of the scientific findings that vaccines have not been found to cause autism, Wakefield "won" the January interview.

Seven minutes alone in front of millions is power.

Viewership is the economy of television. If you want to get people to watch, putting Dr. Wakefield in the hot seat is a great way to start. And that’s where the injustice occurs.