Thursday, 26 June 2014

A bad case of measles

Priya Kurian & Debashish Munshi

There’s been a major outbreak of measles in the city we live in. Scores of children are in hospital; hundreds are in quarantine; at least two large high schools have been closed for brief periods; and several school sports teams have been asked to stay away from playing fields.

The rapid spread of the infectious disease that attacks the respiratory and immune systems has predictably re-ignited the debate on immunization of children. Nearly all the children affected are those who were not immunized at all and some who had only a single dose of the required two doses of the triple vaccine to prevent measles, mumps, and rubella (MMR). That the Waikato region of New Zealand has been affected is no surprise either as this region has the lowest immunization rates in the entire country, according to the Ministry of Health.

Resistance to immunization in some pockets of the population is fairly common in various parts of the world and has to do with differing public understandings of the science of immunization. The media often has a major role to play in how public understanding is shaped and framed.

An article in a recent issue of PUS looks at the media coverage of measles vaccination in the UK and China and shows how the approaches in the two countries are so different. The study by Jie Ren of the University of Science and Technology of China and Hans Peters, Joachim Allgaier, and Yin-Yueh Lo of the Research Center Julich of Germany shows that “the government-supported ‘mainstream position’ dominates the Chinese coverage while the British media frequently refer to criticism and controversy.”

As the authors point out, there is a dilemma “between the media functions of informing the media audience about relational risk behaviour, and providing an arena for public deliberation about risk”. The challenge is to balance two important needs – one to ensure the health outcomes for the community and the other to provide the space for people to make an informed choice about the options they have.

And yet, as Stacy Mintzer Herlihy comments in her blog, the problem with thinking about vaccinations as a matter of personal choice is that “that people are not just making a choice for themselves when they choose whether or not to vaccinate They are also choosing for other people as well. A significant subset of the population cannot get many vaccines. This includes small babies who do not produce an adequate immune response as well as those undergoing treatment for diseases such as cancer that may compromise their immune systems.”

Measles vaccinations became controversial after the publication of a research paper co-authored by Andrew Wakefield in a reputed medical journal in 1998 that suggested a link between the MMR vaccine and colitis and autism spectrum disorders. Although the mass media gave wide coverage to the findings of this paper, subsequent studies have refuted and discredited the claims of the paper, with Wakefield being struck off as a doctor in 2010. The paper itself was withdrawn by the journal a few years ago but the controversy lingers on.