Once upon a time, pox parties – where children were introduced to other children infected with chickenpox – were a logical way of trying to stimulate immunity to the virus in the absence of a vaccine. As epidemiologist Tara C. Smith noted on her blog Aetiology, “Chickenpox ‘parties’ were deemed a better alternative to potentially encountering the disease as an adult–when the frequency of serious complications is higher. Today, however, that just ain’t so.”
But the prevalence of “vaccineophobia” among many parents, due to all manner of concerns, has spread to the chickenpox vaccine. And now, according to the New York Post’s Page Six magazine , “A growing number of New York parents are scheduling chicken pox playdates where kids share lollipops and trade germy pajamas to spread the disease and avoid vaccinations.”
The Post asks whether this is “an ill-advised idea?” But it’s attempt at providing balance between the anti-vaccine parents’ perspective and the “mainstream” medical perspective illustrates a thorny problem for journalists: how do you report on a contentious health issue affecting children that appears to pit increasing numbers of parents against the medical community?
The problem with reporting both sides and leaving it up to the reader to decide what to make of their respective claims is that clear distinctions between testable scientific proof and non-scientific or pseudoscientific opinion can be blurred in the interests of fairness. The parents all get to say why they think vaccination is wrong; the doctors all say the parents are wrong; and the journalist steps back from the fray as if both perspectives were equally right. The problem is that they’re not equally scientific. A parent who has done research on the internet isn’t speaking the same language as someone who has been through medical school, knows how to think through statistical data, or has done years of research in a laboratory. Take the following paragraph from the Post story:
“In the last two decades, rising rates of autism have been loosely linked to vaccines and over the past few years, more and more parents have turned into anti-vaccine public crusaders. Boldfacers like Robert Kennedy Jr. and actress Jenny McCarthy (whose son, Evan, 6, was diagnosed with autism) warn against possible dangers of vaccinations, although the mainstream medical community insists there is no link to autism.”
What, to the reader who doesn’t have a background in statistics or science, does “loosely linked” mean? It suggests that there might be a link even though any correlation between rising autism rates and vaccination can’t demonstrate causation, and has, in fact, been shown to be a product of changes in the way autism has been diagnosed and reported.
Meanwhile, public statements by Jenny McCarthy suggest that she doesn’t understand basic textbook science, and that Robert Kennedy Jr.’s investigation into the suppression of data on the risks of the MMR vaccine demonstrated that he could neither report accurately or fairly nor understand basic science either.
The Post, on the other hand, says mainstream medicine “insists” that there is no link to autism. Actually, it has demonstrated that there is no link to autism through a series of rigorous studies. Again, the subtle inflection suggests that there are two bodies of commensurable knowledge in conflict and that the reporter cannot take sides in interpreting one to be superior to the other. False equivalence is even more exaggerated in the following extract:
Upstater Ingrid Johanns, 34, is the former CEO of Affinity Neighborhoods, a real estate investment company. After extensive research, she has decided not to give her ½-year-old son any vaccines. She, like a number of parents, is convinced there must be a link between vaccines and autism and has shared this belief on an NYC Craigslist forum.
“In the past, we only gave kids a few shots [for deadly diseases like mumps and measles]. Now [doctors] recommend so many. Most children’s bodies can handle that much toxicity, but for others, it does damage—possibly permanent damage,” Ingrid explains. (Although the main worry among parents like Ingrid is autism, critics have blamed vaccines for everything from ADHD to asthma.) “I would rather take the risk of my child contracting measles than autism. The fact that chicken pox has been added to the list of recommended vaccines required truly astounds me.”
Dr. Gershon assures parents that there has been no credible research linking autism to vaccinations. “But it’s very hard to prove that something doesn’t happen, so that’s why it has continued to be questioned,” she says. Although not even all doctors agree on the chicken pox vaccine, she adds that the varicella vaccine is one of the safest available. And it has a big advantage: While 30 percent of people who get pox naturally have the virus reactivated as shingles, the varicella vaccine lessens the risk of that too. Dr. Gershon says that a lot of the doubt over the vaccine comes from the time when kids were required to get just one dose—in about 15 to 20 percent of cases, the vaccine didn’t take. The Centers for Disease Control and Prevention recommends a first dose after 12 months and the second between ages 4 and 6, so “now we give two shots to everybody,” she says. “The immunity appears to persist.”
Now consider what is being said by the way the quotes have been arranged and framed. A CEO of a real estate company has done “extensive research” and determined that children can’t withstand the toxic overload from vaccines, and that it astounds her that doctors recommend children get vaccinated against chickenpox.
Here are the questions the journalist should have considered: what does it mean to tell a reader that someone, who isn’t a medical expert and appears to have no medical or scientific training, has done “extensive research?” Does this mean simply surfing the internet – and if so why should the opinion derived from that “research” be given equal or greater weight to the knowledge of doctors, research scientists, epidemiologists or biostatisticians?
To be fair, the Post then turns to Dr. Anne Gershon, professor of pediatrics at Columbia University and president of the Infectious Disease Society of America, to put the scientific case. But mainstream medicine is on the defensive – and suddenly has its authority undercut by the Post turning to a homeopath:
But Dr. Lauri Grossman, a professor at the American Medical College of Homeopathy, says the varicella vaccine can be skipped. “For eons, people have had chicken pox and survived. The immune system gets stronger by having had the virus and establishing a response to it,” she explains.”
While many people are devotees of homeopathy, it’s not exactly clear why Dr. Grossman, who treats people for physical complaints and emotional disturbances, should have a special insight on infectious diseases, other than to make the general case for alternative medicine. She doesn’t appear to have trained as an actual MD.
The bigger problem is that homeopathy has been extensively studied and found to be no better than a placebo; its claims that water has memory are undemonstrable; and we many of its practitioners have been exposed as offering really bad advice for basic health risks (A BBC investigation found many homeopaths dispensing deadly recommendations on protecting against malaria to those visiting sub-Saharan Africa). But the biggest problem with Dr. Grossman’s challenge to Dr. Gershon is that doing nothing about chickenpox will, at some point, run up against statistics. While many children can shrug off chickenpox as an unpleasant but not especially bad experience, for some, the virus will prove to be rather more traumatic. As one poster noted in a discussion about chickenpox vaccination on scienceblogs:
As for “a few pox” – the daughter of a friend of mine spent 6 weeks in a hospital with osteomyelitis due to chicken pox, 4 weeks on IV antibiotics. It wasn’t clear whether she would keep her leg (she did, luckily) – the scars were their smallest worry.
The daughter of an acquaintance had a varicella stroke.
The daugther of another friend had literally over 1000 pox *everywhere* (including in her vagina, in her throat, her ear canals, under her eyelids). She could not eat and hardly drink for 2 weeks. Granted, the scars are ugly, too, but compared to the 2 week ordeal, they are no issue.
A playmate of my son spent a week in the hospital due to seizures with chicken pox.
And of course, one child in 50,o00 who develops chickenpox will die from encephalitis (during the 1990s, and before widespread vaccination, there was an average of 145 chickenpox-related deaths in the United States each year). The Post ended with a comment from one parent – “Angie” whose child finally managed to acquire the virus through a pox party in New Jersey.
It wasn’t exactly fun watching her be so uncomfortable,” Angie says. “But I just felt hugely relieved we wouldn’t have to get the shot.” Of course, she immediately sent an e-mail to friends and family. This time, the pox party was at her place.”
One might ask how long will it be before the media run a story about a child who dies from attending a pox party; if stories about this practice prompt more parents to take the advice of other parents as being equal to that of the medical community, it will only be a matter of time.*
*One recent comment posted at the end of the article, in fact, mentions such an occurence.