At a cursory glance, there waswelcome unanimity in UK mediatreatment of a recent paper onmeasles, mumps, rubella (MMR)vaccine in the Archives of Disease inChildhood. This was a review byDavid Elliman of St George’sHospital and Helen Bedford of theInstitute of Child Health, London, ofall the evidence concerning allegedlinks with autism and inflammatorybowel disease. They concluded thatthere were no such links –— butpositive danger in using separatevaccines against the three differentinfections.

These findings appeared to bereflected as fairly in the Daily Mail’s“Experts back the MMR triple jab”as in The Guardian’s “Child healthexperts dismiss fears over MMRjab”. So too with the Daily Express’s“Now a scare over single jabs forkids” and The Independent’s “Children‘put at risk by single vaccines’”.

However, closer inspection ofthese and other headlines revealed asignificant divergence betweenbroadsheets and tabloids. The DailyMail, for example, positively invitedreaders to be puzzled and worried.“Parents face further confusion overchildhood vaccination today,” itsnews story began, implying problemsnot just with MMR but withimmunisation in general. After acursory summary of Elliman andBedford’s work, the reportconcluded: “The anti-MMR pressuregroup JABS rejected their findingslast night”.

The Daily Express began bytelling readers that “doctors” had“urged parents to immunise their

children and stressed that there wasno evidence to prove the safety andeffectiveness of single vaccines foreach disease”. But it then continuedwith: “The advice came as new fearsemerged in France, where doctorsclaim that aluminium, a keyingredient of many vaccines, maycause muscle damage”. The metaloccurred in diphtheria, whoopingcough, meningitis C, hepatitis andtetanus vaccines.

These and other tabloid accountsreceived far less prominence andcolumn inches than habitualimmunisation scare stories. Bycontrast, reports in the broadsheetnewspapers were prominent andcomprehensive.

Arguably the best of thebroadsheet pieces was that whichappeared in The Times. It not onlysummarised the key points of theElliman/Bedford paper, but alsopointed out that whereas there were76,000 measles cases and 16 deathsper year in Britain before theintroduction of MMR vaccine in1988, only 100 persons developed thedisease last year and there have beenno deaths since 1992.

The Times went to the heart of thecontroversy that has continued since1998 when The Lancet publishedAndrew Wakefield’s claim that thetriple vaccine may cause autism. Ithighlighted comments by ElizabethMiller of the Public HealthLaboratory Service, in a commentaryin the Archives of Disease in Childhood,regarding publication of that and asubsequent paper by Wakefield.

“There was a failure of the peerreview process to identify basic flaws

in the design and execution of thesestudies,” Miller was quoted as saying.“Unfortunately, once a paper ispublished in such a journal andwidely quoted in the media, the workachieves a respectability that carriesconsiderable weight in the publicmind. Publication in respectablemedical journals of [these] papers…isa disservice to patients and healthprofessionals alike.”

The Guardian too referred toElizabeth Miller’s commentary(ignored by the tabloids). In thiscase, the newspaper focussed on hercomparison between the MMRcontroversy and the BSE/CJD affair.The latter, she said, had “fuelledconcerns of some parents thatgovernment experts might have got ithorribly wrong, or worse still thatthere has been a cover-up.” In reality,the evidence about the safety ofMMR vaccine was “mountainous” –in contrast to the situation withBSE/CJD.

Peer review and and themethodologies used by scientists toassess evidence may appear tediousto news editors but do parents reallywant to be told that they face“further confusion”, that expertshave “dismissed fears”, that there is a“new scare” and that “top docs” sayone thing and health lobbyistsanother? Or would they appreciateinstead rather longer articlesexplaining upon what basis expert Aand expert B have based theirassertions?

To help readers in this way reallyisn’t difficult — as most of thebroadsheets demonstrated on thisoccasion.

Bernard Dixon is European Editor for theAmerican Society for Microbiology.

Magazine R807

News Focus

Pendulum swings back to MMR

Mediawatch: British tabloid and broadsheet papers reacted differentlyto evidence that the triple vaccine against measles, mumps andrubella is not linked to alleged side-effects, reports Bernard Dixon.