Public Health Links, Lost in Translation

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PLOS is at SpotOn London (#solo13) again this year, taking part in workshops and panels on science communication tools, policy, and outreach. On Friday November 8, I’ll be joined by three PLOS authors and two independent science journalists for a science outreach workshop titled Public Health Links, Lost in Translation. With our moderator, science journalist Suzi Gage (@soozaphone) of the Sifting the Evidence blog on The Guardian, we will address weak links in the science communication “food chain” that contribute to falling vaccination rates, mainly in the UK, Europe, and the US.

For this session, I will be speaking as Editorial Director of PLOS ONE, the world’s largest scientific journal. But the debate around vaccination began before PLOS existed and it has gone on longer than I’ve been involved in science communication. Coming as I do from a background of ‘peddling the evidence,’ it disturbs me when I see evidence ignored in favour of quackery. But I also bring a personal perspective to this issue. As with climate change, it frustrates me that my own actions are not enough to safeguard my children against a threat to their health and safety. Although no vaccine is perfect, every time my children play with others who are intentionally un-vaccinated their risk of contracting preventable contagious diseases increases.

So it seems to me that the aim of this workshop will be to use our combined perspectives – and those of the science community members present – to discuss how we strengthen the links between evidence-based science and the public on vaccines. We aren’t the first and certainly won’t be the last meeting of scientists and science writers to take on this issue, but that doesn’t let us off the hook and excuse us for not trying.

Good and Bad News

The news on vaccines in the UK is not all bad. By summer of 2013, ninety per cent of two-year-old children had received their first dose of the MMR (measles-mumps-rubella) vaccine – the highest level for 13 years according to the Health Protection Agency. This uptake in MMR vaccinations has been a public reaction to widely-reported measles outbreaks in Europe and the UK – suggesting an appropriate public response to highly visible evidence. However, present MMR uptake is still short of the 95% rate that would establish a sufficient level for herd immunity, which would stop the spread of the disease in the community.

The Legacy of MMR

All of us continue to pay the price for the broken public trust that came from the Andrew Wakefield-MMR debacle of the mid-90s. Strong distrust concerning vaccine safety exists not only in rich and middle income countries, but also on the front lines of the Global Polio Eradication Initiative, as my colleagues at PLOS Medicine have covered in depth.

The link between this widespread distrust and falling vaccination rates are clearly established:

New vaccinations for diseases such as HPV, and new approaches to old ones, e.g. targeting different populations to avert new outbreaks of influenza or shingles, increase the challenges for public health practitioners and advocates.

A More Honest System

In many ways, I don’t blame the public for being mistrustful of scientific research – the scientific community and mainstream media make it very hard for people to know what to believe. As Editorial Director of a large journal, I see the entire spectrum of misinterpretation of data. I see original datasets being over-interpreted by authors, in order to get published in top journals. I see journalists taking these papers and adding yet another layer of spin in order to sell them to the public. I see newspaper editors pushing the most shocking articles to the front pages to ensure maximum impact. It’s little wonder that the public are mistrustful.

At PLOS ONE, we are trying to deal with these challenges by encouraging honest reporting of data. By removing the question of ‘novelty’ and ‘impact’ from our review process, we aim to get authors to state simply what they’ve discovered without feeling they have to dress it up in layers of over-interpretation. That drug you’ve discovered kills some cells in a petri dish. Great! Is it a cure for cancer? No. So don’t say it is – we’ll still publish your paper!

We are also very careful about what we release to the press, and how the message is put out. Clearly we can’t stop journalists misinterpreting our papers, but we can at least give the science we publish a decent chance of being reported correctly.

Finally, we track press and blog coverage and add it to the comments of the papers. Combined with our Article-level Metrics, which display a whole array of reactions to the paper and usage statistics, readers can see whether high activity on a paper is a result of heavy media attention, or whether it’s from interest from other researchers.

Certainly the papers most covered in the press are among those that receive the most views, so if we are to affect public attitudes on vaccines or any other highly-charged public health or science issue, we are as dependent on the excellent work of our authors as we are on our colleagues in new and old media. Panelists at this Friday’s SpotOn London 13 workshop represent this wide spectrum. With each bio below, I’ve included some of the research or science writing that will inform our discussion.

Marc Baguelin PhD (@marcbaguelin) is a mathematical modeler working in the Immunisation department at the Health Protection Agency and at the London School of Hygiene and Tropical Medicine on models of influenza transmission, immunization, and control. Marc’s research has been published in the journals Vaccine, Biostatistics, and Emerging Infectious Disease. His latest study, Assessing Optimal Target Populations for Influenza Vaccination Programmes: An Evidence Synthesis and Modelling Study, published in PLOS Medicine, resulted in a change of UK health policy with an extension of the influenza vaccination programme to 2-16 year old children.

Tammy Boyce, PhD (@tamboyce) holds an honorary lecturing post with the Centre for Infection Prevention and Management, Imperial College London, Hammersmith Hospital, London, and was a Research Fellow in Health, Risk, Science and Communication at the Cardiff School of Journalism.  Tammy’s research has been published in Nature Reviews Immunology, and the British Journal of Healthcare Management. She was one of the first to examine public reception of media coverage and the impact the style of reporting has on public opinion and vaccination decisions. From this research, Tammy published the book Health, Risk and News: The MMR Vaccine and the Media (with Peter Lang, 2007). Her latest research article in PLOS ONE examines the role of the school nurse in addressing inequities in HPV vaccine uptake in the UK.

Stephan Lewandowsky PhD (@STWorg) is a cognitive scientist in the School of Experimental Psychology, University of Bristol, UK. His research, published in Nature Climate Change, Journal of Experimental Psychology, and Cognitive Psychology, examines peoples’ memory and decision making with particular emphasis on how people respond to corrections of misinformation. His latest PLOS ONE research article, The Role of Conspiracist Ideation and Worldviews in Predicting Rejection of Science,. studies how conspiracist thinking affects public attitudes towards scientific issues; as Hilda Bastain blogged: a “strong consensus around science can be seen as evidence that ‘they’re all in cahoots’… with vaccination, say, presenting yet more facts or another study could paradoxically confirm their rejection of science.”

Beth Skwarecki (@BethSkw) is an independent science journalist specializing in public health issues who writes for AAAS Science News, and DoubleXScience and blogs on the PLOS BLOGS Network. Recent posts have covered the HPV vaccine’s “image problem” and the role of Twitter in spreading misinformation on the 2009 H1N1 pandemic.

Please add your thoughts and suggest questions for our panel by tweeting to the hashtag #solo13links. You can watch the live stream of the discussion at: http://plos.io/solo13links

Here is the entire Spot On London 2013 program, FYI. Keep in mind all sessions will be live streamed with the archives kept online thereafter for your viewing.

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