167 Comments

That was the question on Campbell Live’s text poll tonight.[1]

While I battle with computer code, I’ll offer this take on the Campbell Live story and let you discuss the issue.

As part of an effort to stop a measles outbreak a fifth of the children from Oratia District School–estimated to be roughly a hundred in total–were sent home because they had not been vaccinated for measles. The coverage featured interviews of some of the kids and their parents, as well as a medical health officer, closing with an interview with Dr. Nikki Turner (GP, director of Immunisation Advisory Centre (IMAC) and lecturer).

Presenting issues involving medicine or science in a limited time frame on television is no doubt challenging. It’s unrealistic to expect perfect coverage, too. I thought that overall it was well handled, but it’s still an opportunity to look at the issues involved in presenting subjects like this.

If there is one thing I would have like to have seen done better it would be to make clear the extent to which the views of the parents interviewed are representative of the overall view of all of the parents of the roughly one hundred children that were not at school.

The presentation opens with John Campbell saying some parents’ (my emphasis). Is ‘some’ one, two or three, a handful, most? There are different views. How many hold which view?

One parent with anti-vaccine views was given a fair amount of time to put her views; I’ll give an account of what she said a little later. It is a view, fair enough. But what fraction of the parents with children at home hold a similar view? I realise it’s hard question to answer, but it would help put what was presented in perspective. I’m writing in hindsight–that convenient thing–and hindsight suggests a clue.

Near the end of the presentation Dr. Nikki Turner mentions that perhaps 2-3% of people (presumably in the general population) choose not to vaccinate because they ’don’t support the science’. This would suggest the parent with the anti-vaccine views would be in a small minority of those whose children are not at school.

The presentation is clear with those interviewed representing themselves well. For example, I thought the medical officer–Dr. Richard Hoskins–did well, offering clear, concise statements.

One parent was given opportunity to say why she did not vaccinate her children. Ms. Sherry Tosh, offered a list of vaccine misunderstandings as her reasoning. She obviously sincerely believes them. I’m not doubting that or meaning to belittle her. The bigger question for my purposes is that some measure of how representative her views were of all of the parents would have been helpful. I’m of the impression that her views are a minority view.

She said she believed that the combined MMR vaccine was ’just detrimental’, compared to the single shots, going on to say ’I can’t even as an adult fathom the thought of my body trying to combat three diseases like that at the same time myself, yet alone young babies’.

Vaccines are not diseases. In the case of live vaccines the organisms are weakened (or attenuated), as is explained on the IMAC vaccine ingredients page (PDF file). Your body doesn’t ’fight off’ a vaccine in the way it might if you caught the disease itself. Vaccines induce a small response, enough to trigger production of antibodies, enabling your body to respond more promptly in future.

Ms. Tosh went to rhetorically ask if ’‘they’ were going to tell you’ which ones contained (paraphrasing): ’formaldehyde, mercury, aluminium, aborted foetal cells within the vaccine.’

The ingredient lists for vaccines are widely available on-line, for example in the IMAC brochure I linked to earlier (PDF file). I have sympathy for people who get confused by the messages that anti-vaccine promoters put out. It’s one reason I wrote Sources of medical information for non-medics and non-scientists. These ingredients are among those commonly misrepresented by those pushing anti-vaccine stances and their uses in vaccines are widely explained elsewhere.

(I lack the time to do address each of these here, but very briefly: Alison has written about the last – aborted foetal cells are not within vaccines, but cells derived from these [with permission!] are used to culture the viruses used to make the vaccines; I wrote about ‘mercury’ in vaccines when I had just started blogging [I suspect my neophyte status shows!]; aluminium is used as adjuvant, in tiny amounts, making the vaccine more effective with less antigen; formaldehyde is naturally found in your body – Alison has a few words on this, too.)

Following the in-the-field footage, they presented Nikki Turner (from IMAC) in the studio.

The interview with her illustrated another issue with presenting this sort of material in limited time on television. John Campbell referred to the worries such as those offered by Ms. Tosh, inviting Dr. Turner to respond.

It’s hard to respond to as there are too many specific points to address in too little time. You might call it ‘the Gish Gallop problem’. It’s easy for a string of (false) claims to be listed in little time. The effect of a loaded dice in a ‘he said, she said’ framework: inaccurate statements can be made (far) faster than clarifications of them. With that in mind, I thought her response excellent.

Back to that problem of the extent to which the views of the parents interviewed were representative of the total of the parents affected. Of the roughly one hundred children not at school, how many of their parents held what views? It’s easy to emphasise one extreme view, but is that representative of what is happening? (Don’t forget that John Campbell opened with saying ’some parents’.)

I thought Nikki Turner did well to bring up that surveys indicate that 2-3% of New Zealand parents choose not to vaccinate because they ’don’t support the science’. Following this, we would expect most of the parent of the ~20% not in school did not vaccinate for other reasons.

My own impression was that many if not most parents simply didn’t get on to it, for whatever reason, but now find themselves caught out. If that’s true, does that come through to other viewers?

If this is true, would these be the bigger message?: get on it, or you might get caught out.

This also reminds me of the first of the three suggestions that Julie Leask made (see the section ‘Vaccines’): make vaccination accessible. I would like to have seen this discussed.

Finally, how did the poll fare? (Bear in mind that polls like this aren’t generally terribly reliable!)

The question again: Should children be sent home from school if they are not vaccinated?

The response (no indication as to how many responded, etc.): 65% yes  35% no

Footnotes

A video is now available on the Campbell Live website.

The IMAC website has a page on measles.


Other articles on Code for life:

Sources of medical information for non-medics and non-scientists

Preserving endangered species — of gut microbes

Fact or fallacy, a survey of immunisation statements in the print media

The worm from the deep! and other stories

Immunisation, then and now

A course for all degrees: PHIL 105, Critical Thinking