Katie O’Book and Gina Chu
Health Communication
Reading Summaries for October 20th, 2014
2) Vaccine- Anna Kata
Introduction:
 Vaccinations previously were known to contribute to the decline in mortality,
however there has been a prevalent increase in websites that oppose
vaccinations
 Postmodern paradigm of healthcare now exists where power is with the
patient, and not the doctor, along with the questioning of science
 Unfortunately, the anti-vaccination movement can be convincing, even
despite the lack of scientific evidence to back up claims
 Information on the web, although not scientifically supported, contributes to
the growth of the anti-vaccination movement
 It is crucial to ensure that those who are searching online are not
misinformed on vaccinations
Web 2.0
 Web 2.0 allows users to create their own information as opposed to Web 1.0
being controlled by the provider
 This has helped promote the anti-vaccination movement, as many turn to
Web 2.0 to provide their own opinions and content, whether it’s reliable or
not
 Web 2.0 encourages patients to be consistently engaged in their own
healthcare
 The postmodern medical paradigm influences patients to hold the power,
and to doubt the facts of science
 Web 2.0 also used to unite health community
1. Patient empowerment
2. Consume reviews
3. Supportive communities
 Downsides of Web 2.0
1. Unites members of marginalized groups (AIDS deniers, etc.)
2. Trap of self-referencing and influencing users that there are many
who share same negative beliefs when there are only a few
3. Relativism- no facts but looser meanings
4. For anti-vaccination, Web 2.0 says there are multiple “truths” and
worldviews that are valid, and facts from experts merely become just
an opinion
Decision making on vaccinations
 The web can provide overwhelming amounts of information, however 70%
of parents choose to use web search engines for answers, with skewed
information and opinions
The Online Anti-Vaccination community
 A 1982 documentary aired called Vaccine Roulette that persuaded many
parents to not give their children pertussis vaccines and had many personal
lawsuits with pharmaceutical companies that ended the production of
certain vaccines
 The documentary also created group of parents called Dissatisfied Together
1. Instigated by Andrew Wakefield’s press conference that MMR vaccine
was linked to autism
 The American Based National Vaccine Center in reality just produces biased
information towards certain vaccines
 Many websites like Mothering.com only spread false health information and
have large sections of false information on vaccines
 Anti-vaccination websites contain tropes that are recurring themes and
motifs
a. phrases
b. rebuttals
c. list potentially toxic vaccine ingredients but no explanation or evidence to
support
Anti-Vaccination Movement
 goes against scientific studies and scientific method
 movement always demanding more research- controlled trials comparing
vaccinated to unvaccinated children
 however, scientific studies usually prove allegations that vaccines are
harmful to be false
ex) studies failed to find connection between MMR and autism
 methods to stop anti-vaccination movement are Orac, who is the author of
the Respectful Insolence blog
 however, some anti-vaccine activists attack their opposers
a. Dr. Offit referred to as a “biostute”
Common anti-vaccine tropes
 Vaccines are toxic!
 You can’t prove vaccines are safe- arguing based on lack of evidence
 Science was wrong before- because of previous errors in science, vaccination
must also be errors and dangerous
Conclusion
 The anti-vaccination movement focuses on informed consent, health
freedom, and vaccine safety as the bulk of their arguments and hypotheses
that go against vaccinations
 Today, the internet provides endless access which allows people to put
healthcare into their own hands
 Web 2.0 doesn’t exist to inform patients, but to create fear and spread doubt
about vaccinations
 However, a PBS documentary among other media outlets/information online
has helped to fight back against the anti-vaccination movement
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In order to stop the movement, we must stop taking scientific based facts and
interpreting them into just an opinion which creates bias and misinformed
patients
4) How Politics Makes Us Stupid- Ezra Klein
 Many of our most intense and complicated political battles are simply
misunderstandings due to misinformed citizens given too little information
(The More Information Hypothesis)
 In reality: the more information partisans get, the deeper and more
convoluted disagreements become
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Yale law professor Dan Kahan tests question: why isn’t good evidence more
effective in solving political debates?
The Science Comprehension Thesis: public doesn’t know enough about
science to challenge/judge a debate
Performed various experiences to test the public knowledge and how
people’s opinions are swayed
Ex) gave subjects being studied sample bios of highly accomplished scientists
and summary of results of research
asked if scientist seemed to be “expert” on issue
people’s actual definition of expert was based on whichever credentialed
person agrees with my own opinion
we are more likely to believe information coming from someone who holds
the same opinion as us
Identity Protection Cognition- avoid dissonance and estranged
information, we subconsciously resist factual information that threatens our
own defining values and viewpoints
Politics in Washington only enhance this ideal of making identity-protection
cognition easier- democrat vs. republican
Kahan’s research tells us we can “trust our own reason”
Kahan tries to find the dynamics that lead to unproductive debates
- the point of these studies is to show how to fix the problem
- ex. HPV vaccine was series of missteps and was rushed onto the shelves
- the FDA should have considered science communication risk
- however, Kahan falls into trap of identity protection, and states that we
tend to find people he identifies with, so when they disagree they may not
seem so threatening
Conclusion
- Washington is a constant battle between two groups who have opposing
viewpoints and opinions who generate their own information to follow,
which
- Politics, however exists everywhere through the form of policy: we
experience policy through tax bills, health insurance, etc.
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To improve American politics and our nation as a whole, there must be
better structure, not better arguments and opposing opinions on
political/health issues
6) Robert Kennedy Jr.’s Belief in Autism- vaccine connection, and its political perilKeith Kloor
 Debate over mercury-containing preservative called thimerosal that was
once used in multiple vaccines for children- associated with
neurodevelopmental issues including autism
 Although thimerosal was taken out of some vaccines, why is it still in flu
vaccines?
 Federal government was aware of dangers all along!
 Both Kennedy and Hyman (physician) argue there should not be a
neurotoxin injected into children; thermisal should be taken out of flu
vaccine
 According to Center for Disease Control and Prevention, no evidence links
thimerosal with brain disorders
-parental concerns in 1990’s instigated vaccine fears
-CDC encouraged to remove thimerosal to be removed from vaccine as
precautionary measure
- this only made fear of vaccine worse, and so began Kennedy’s campaign on
the dangers of thimerosal
 2013 study by journal of Pediatrics found an increase in cases of whooping
cough in those areas heavily populated by anti-vaccine believers
 Kennedy and Hyman chose not to publish book about thimerosal- said they
were pro-vaccine
-would only publish to prod federal officials into action
 In 2011, Kennedy turned the tables by saying on air that government
scientists were involved in “massive fraud” and skewed studies to show
thimerosal was a safe ingredient
-all Kennedy did was spread more fear and conspiracy theories about
vaccines
 Kennedy received backlash on his opinions towards dangers of thimerosal
-National Vaccine Program Office sent letter saying it is complex issue but
there is no evidence thimerosal is dangerous
 Jeremy Sharp, science and public health counselor to secretary of health and
human services told Kennedy that thimerosal was taken out of pediatric
vaccines over 15 years ago, and the spike in children with autism happened
after this, meaning there is no direct link
-Hyman rebutted with: we wanted to show link between thimerosal and
neurodevelopment disorders, not just to autism
-Kennedy states that although he tried to search for the truth, the end of
every public controversy is based on personal bias which can distract from
mission of finding the truth
-Kennedy remains confident in his findings, and that the truth (that
thimerosal is linked with neurodevelopment issues) will prevail
Mismatches between “scientific” and “non-scientific” ways of knowing and their
contributions to public understanding of science
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Abstract
o This distancing between ‘scientific’ and ‘non-scientific’ cultures reflects
differences in what are considered valid and reliable approaches to
acquiring knowledge and has played a major role in recent scienceoriented controversies.
o The failure of effective communication b/w scientists and non-scientists
has hindered the progress of both effective science and effective policy.
o Throughout these public controversies, the media have played a specific
and influential role as mediator between scientist and layperson.
o Journalists play a large part in filtering and shaping scientific messages as
they are delivered to their intended audience.
o The purpose of this paper is to examine the epistemic gap between
scientific and non-scientific cultures as illustrated by the ongoing public
controversy over the measles-mumps-rubella (MMR) vaccine.
History of MMR controversy
o 1998, Andrew Wakefield and his colleagues published a study about the
investigation of the co-occurrence of bowel disease and developmental
disorder in 12 children and 8 out of the 12 were reported behavioral
symptoms disorder emerged shortly after MMR vaccination.
o Parents are delaying and foregoing the vaccination for their children
o Scientists consider media coverage of Wakefield study influenced parent’s
decisions.
The role of scientists in public understanding of science
o Deficit model -> people do not understand a particular scientific concept
and do not have sufficient information to do so.
o Scientists need to fill in the gaps in people’s knowledge and any
controversy will naturally disappear.
Scientific discourse in the MMR controversy
o The editor of Lacent describes the controversy as “system failure” which
involved media, government, and the scientific community, this quotation
underscores the implicit assumption that the science should be able to
speak for itself but cannot because the media distort the science and the
public continue to hold on to irrational fears.
The role of scientific conventions in science communication
o One reason that scientists may adhere to the deficit model is because they
are reluctant to take a more active role in shaping public understanding of
science.
o Offit and Coffin (2003) note that while scientists are the first to argue
against the purported association between MMR and autism, the language
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they use to present the scientific evidence may not be clear enough to
convince the public that MMR does not cause autism.
The role of journalists in public understanding of science
o When formal education in science ends, media become the most available
and sometimes the only source for the public to gain information about
scientific discoveries, controversies, events, and the work of scientists.
o Media consumers may depend on information presented by mass media to
form an opinion.
o This dependence, in turn, allows the media significant potential to
influence public thinking.
o Scientists’ reluctance to engage in science communication may stem in
part from their wariness of the quality of media reporting of science.
Journalist discourse in the MMR controversy
o Several studies provide evidence for the influence media may have in
shaping public understanding of the debate and public decision-making
regarding the MMR vaccine.
o Ramsay et al. (2002) conducted a study demonstrated that both perceived
safety of the MMR vaccine and actual MMR vaccination rates declined
after periods of intense media coverage but increased again once media
coverage died down.
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The rule of Journalistic conventions in science communication
o Journalists explained that their job is not to create news but report on it.
Conclusions and future directions
o Scientific and journalistic practices interact with each other, and with the
personal characteristics of lay audience members, to produce a public
discourse that is often fragmented and contradictory.
o These findings provide hope that the existing gap between scientific and
non- scientific cultures that has helped to exacerbate scientific
controversies may be bridgeable.
o The goal of public engagement efforts, then, should be to make the
scientific process more transparent to non-scientists, and “to expose to
public scrutiny the values, visions and assumptions [underlying science]
that usually lie hidden
o By doing so, scientists, policymakers, and others can open up a productive
conversation in the public square that can begin to bridge the epistemic
gap between scientific and non-scientific cultures.
I don’t want to be right
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Brendan Nyhan, a professor of political science at Dartmouth, published the
results of a study that he and a team of pediatricians and political scientists had
been working on for three years.
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They had followed a group of two thousand parents and who had at least one
child under seventeen to do a simple investigation of whether pro-vaccination
campaigns change parental attitudes toward vaccines.
The result was dramatic because even though it reduces the misperceptions about
the vaccines but it made no intention for parents to vaccinate.
One thing he learned is that not all false information goes on to become a false
belief and not all false beliefs are difficult to correct.
If information doesn’t square with someone’s prior beliefs, he discards the beliefs
if they’re weak and discards the information if the beliefs are strong.
Even when we think we’ve properly corrected a false belief, the original exposure
often continues to influence our memory and thoughts.
Nyhan decided to apply it in an unrelated context: Could recalling a time when
you felt good about yourself make you more broad-minded about highly
politicized issues, like the Iraq surge or global warming? As it turns out, it would.
On all issues, attitudes became more accurate with self-affirmation, and remained
just as inaccurate without.
Nyhan states that vaccine is not political and its not linked to ideology. And
ignoring vaccination can just make people of every political party, every religion,
just as sick.
A risky science communication environment for vaccines
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Controversy over childhood vaccinations is an example of the “science
communication problem”.
The failure of compelling scientific evidence to resolve public dispute over risks
and similar facts.
“Cultural cognition”, both to avoid dissonance and to protect their ties to others,
individuals face a strong psychic pressure to conform their perceptions of risk to
those that distinguish their group from competing ones.
CDC recommended universal vaccination of the HPV vaccine but political
dispute blocked legislative mandates in every state but one.
Experimental evidence showed that people tended to selectively credit
information relating to the vaccine's risks and benefits in patterns reflecting their
cultural predispositions (one perceived risk was that vaccination would lead to the
engagement of unsafe sex).
The media and advocacy groups routinely lament a “growing distrust of
vaccinations”.
Decades of study show that the sources of public controversy over decisionrelevant science are numerous and diverse.
The failure of democratic societies to use scientific knowledge to protect the
science communication environment from influences that prevents citizens from
recognizing that decision-relevant science contributes to their well being.