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MMR and the effect of the media on the public — a pharmacist’s perspective

Pharmacists, scientists and other healthcare professionals should be consulted to ensure proper reporting of health issues so that the media have a positive impact on people’s health

By Reem El-Sharkawi

Pharmacists, scientists and other healthcare professionals should be consulted to ensure proper reporting of health issues so that the media have a positive impact on people’s health

Reem El-Sharkawi pharmacist, Abertawe Bro Morgannwg University health board, Singleton hospital, Swansea

With measles cases fast approaching 1,200 in South Wales since November 2012,1 the question of the responsibility of the media has come to the fore. This outbreak is attributed to the way that the media reported Andrew Wakefield’s since discredited paper in The Lancet in 1998 in which a link was proposed between the measles, mumps and rubella vaccination and autism.2

The coverage of Wakefield’s paper led parents to question a vaccine they had never previously given much thought to because they did not have any doubts about its safety. With the furore about the paper on television, on radio and in newspapers, parents started to  question the safety of the vaccine, leading to a drop in the MMR vaccination rate in the UK from 92 per cent in 1996 to 81 per cent in 2004.3

Although the rate of vaccination uptake has increased since 2004, it still has not reached the target figure of at least 95 per cent to stop the spread of measles.4 Apart from the current outbreak of measles in south Wales, there were previous outbreaks in Sussex and Merseyside last year.

Negative impact

Health scares and controversies have not been restricted to the MMR vaccination. Media coverage, in general, and television programmes, in particular, about various drugs have resulted in an increase in reporting of adverse drug reactions, and even led some patients to stop their medicines, with serious implications.

The media reported in 1995 on the warning issued by the UK Committee on Safety of Medicines on the association of the oral contraceptive that contains gestodene or desogestrel with a higher risk of venous thromboembolism. This resulted in many women stopping taking their contraceptive pill.

There was no analysis in the media of the type of risk that the warning referred to.  This “pill scare” consequently led to an increase in the number of unintended pregnancies especially in teenagers.5

Another example is the reporting of adverse drug reactions to statins, which increased considerably after a television programme in the Netherlands in 2007. The Foundation for Pharmaceutical Statistics found that the number of patients who stopped taking statins after the programme was broadcast rose from 30,000 to 41,000 per month (ie, an increase of 35 per cent).

It should be noted that there was no evidence of patients in the Netherlands having particular concerns about statins before the programme was aired, and that after two weeks ADRs returned to the level of reporting before the airing of the programme.6

Similarly, the media coverage of the “Panorama” programme about paroxetine and its side effects in 2002 resulted in an unprecedented response, with about 65,000 telephone calls and 1,374 emails to the BBC. There was an increase in reporting of ADRs to it, as well as a decrease in its prescribing following the airing of the programme.7

Positive impact

Despite the misinterpretation of research studies, at times, with its negative impact on patients’ health decisions, the mass media may also produce a positive effect in health issues by promoting effective interventions.8

In recent weeks, the coverage of the outbreak of measles has not left the media spotlight. The current MMR media campaign on radio, television, social network sites and newspapers aims at increasing awareness of measles and its complications, and supporting health bodies to target one million children aged 10 to 16 years who have not been vaccinated or who have been partially vaccinated to get the MMR vaccine.9

The case of Jade Goody is another example of the positive role that the media can play in promoting healthcare. Goody, a reality TV star, was diagnosed with cervical cancer in 2008 and died the following year. Within that year, she increased the awareness of cervical cancer and the importance of having regular smear tests, as well as generating the option for teenage girls to receive the human papilloma virus injection. It was reported that between 2008 and 2009 there was an increase of half a million women going for smear tests.10

Conclusion

Media coverage can have positive and negative impacts. It sometimes fails to discuss the details of a research study, as it did with Wakefield’s paper. As trained scientists, pharmacists are capable of examining and evaluating scientific research. They are fully aware that you cannot draw conclusions from a study that involves few people (ie, 12 children in Wakefield’s study).

Pharmacists are used to reporting, analysing and interpreting results. They know how to communicate issues related to risk. In the “pill scare” the media reported an increase of 50 per cent in the risk of getting venous thromboembolism by taking the combined oral contraceptive. Although this sounds a lot, it refers to the relative risk, and since the absolute risk of getting venous thromboembolism in all contraceptive pills is small, the doubling of the relative risk does not mean much increase in the absolute risk.

Pharmacists are in a perfect position to provide information and advice to patients on a one-to-one basis. Moreover, they are also highly accessible, whether in community pharmacies or hospitals, and can discuss and allay any fears that patients may have about health issues. They can easily engage with the public on a larger scale and can run health campaigns such as the “Antibiotic awareness” or “Blue September” campaigns as part of their public health role.

Perhaps the media should use pharmacists, scientists and other healthcare professionals in order to ensure proper analytical reporting of health issues, and thus avoid the disastrous health consequences of the MMR controversy.
References

References


1    Mumps warning as measles outbreak cases continue to rise. 11 June 2013. Available at: http://www.wales.nhs.uk/sitesplus/888/news/27584.

2    Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet 1998;35:637–41.

3    Murch S. Separating inflammation from speculation in autism. The Lancet 2003;362:1498–9.

4    Vaccinations: how vaccines work. 2013. Available at: http://www.nhs.uk/Conditions/vaccinations/Pages/How-vaccines-work.aspx?tabname=Children%20and%20teens (accessed 14 June 2013).

5    Furedi A.,The public health implications of the 1995 “pill scare”. Human Reproduction Update 1999;5:621–6.

6    Van Hunsel F, Passier A, Van Grootheest K. Comparing patients’ and healthcare professionals’ ADR reports after media attention: the broadcast of a Dutch television programme about the benefits and risks of statins as an example. British Journal of Clinical Pharmacology 2009;67:558–64.

7    Medawar C, Herxheimer A, Bell A et al. Paroxetine, Panorama and user reporting of ADRs: consumer intelligence matters in clinical practice and post-marketing drug surveillance. The International Journal of Risk and Safety in Medicine 2002;15:161–9.

8    Grilli R, Ramsay C, Minozzi S. Mass media interventions: effects on health services utilisation. Cochrane Database of Systematic Reviews 2002: p. CD000389.

9    National MMR vaccination catch-up programme announced in response to increase in measles cases. 2013. Available at: https://www.gov.uk/government/news/national-mmr-vaccination-catch-up-programme-announced-in-response-to-increase-in-measles-cases (accessed 14 June 2013).

10    Lancucki L, Sasieni P, Patnick J et al. The impact of Jade Goody’s diagnosis and death on the NHS Cervical Screening Programme. Journal of Medical Screening 2012;19:89–93.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11122558

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