Covering vaccines: Understand the science, be thoughtful about framing
What are Reporting Resources?
By Sheila Mulrooney Eldred
In the first few years of the COVID-19 pandemic, vaccinologist Dr. Gregory Poland did more than 4,500 interviews with reporters. “What I learned,” he says, “is that most reporters are not science and health reporters. They don’t bring a sense of, ‘What is the truth of science?’ Science is never fully 100% certain; it’s not a never-changing truth. Journalists need to report science as it’s understood by experts in the area.”
During the pandemic, journalists who had never covered public health issues in-depth suddenly found themselves immersed in the complexities of vaccines: Overnight, it seemed, they learned about spike proteins, messenger RNA, the various phases of clinical trials, and emergency use authorization.
Now, pressed to cover measles outbreaks and claims by powerful vaccine skeptics like Secretary of Health and Human Services Robert F. Kennedy, Jr., journalists are once again grappling with esoteric scientific concepts and public health context.
To report on the topic accurately, responsibly, and confidently, see the following advice from a vaccinologist, a pediatrician, a health policy communication expert and a veteran health reporter.
Vaccine essentials: what you need to know
Writing about vaccines in a way that the general public can digest requires understanding and communicating some key scientific and public health concepts.
“I read so many pieces about clinical trials that never tell me what a clinical trial is,” said Dr. Matt Motta, an associate professor at the Boston University School of Public Health. “The clinical trial process is complicated, but explaining what it is is simple. Devote some space to it.”
Here’s a primer on a few of the most essential concepts:
How vaccines work
All vaccines work in the same basic way, says Poland, who is the director of research for Atria Research Institute. Here’s how he explains it: Vaccines fool the body into thinking it’s seeing a disease-causing bug. That elicits an “immune response”: Immune cells treat the vaccine as a threat—as if it were the actual pathogen about to cause disease, he says. Those immune cells produce antibodies and recruit memory cells that remember the pathogen. Instead of getting sick, your body learns to remember the pathogen so that in the future if it sees it, it remembers it and knows how to fight it off by producing antibodies.
There are different ways of doing this, which has led to the development of different types of vaccines. You can read more about that at our tip sheet here.
How clinical trials work
The bar for safety in developing vaccines is exceptionally high, Poland says, because you’re giving it to healthy people. Vaccine development typically takes years. Here’s a look at the typical timeline of a clinical trial:
Preclinical studies: In this stage, researchers are looking for the best way to target a disease-causing bug. What ways is it vulnerable? This often takes three to five years.
Phase 1: The vaccine is given to a small number of selected participants for the first time. This phase focuses on safety and dosage.
Phase 2: Researchers study how well the drug works in this phase, in hundreds of participants.
Phase 3: In this stage, researchers compare rates of infection between tens of thousands of participants divided into two groups: Those given the vaccine, and those given a placebo. They’re answering two questions: Is the vaccine safe? Is it effective?
For more details, see our fact sheet on vaccine testing.
How herd immunity works
The percentage of people who need to be vaccinated to protect an entire community is not the same for every disease. Why does it vary? Because some illnesses spread much more easily than others. A more contagious disease requires more people to be vaccinated to achieve herd immunity. Measles, for example, spreads very easily, so the threshold for herd immunity is higher than others, at 95%. For polio, which doesn’t spread as easily, the threshold is 80%, according to the World Health Organization.
Public health experts often use the metaphor of a rainstorm to explain the concept. In this comparison, raindrops represent germs, an umbrella represents the protection afforded by a vaccine, and many umbrellas opening at once represent herd immunity: Would you rather brave a rainstorm with an umbrella, they ask, or without one? People without umbrellas are still mostly protected when enough umbrellas held by others are opened over their heads.
The recent outbreaks of measles have occurred in communities where vaccination rates have dropped below the threshold for herd immunity.
“I like to say that when [measles, mumps, and rubella (MMR)] vaccination rates drop in a community, it is not a question of if, it’s a question of when measles is going to come because it is so incredibly contagious,” Dr. David Higgins, an assistant professor at the University of Colorado Anschutz Medical Campus, said in a recent SciLine media briefing.
Best practices for reporting on vaccines
Covering health like other beats can lead to false balance
Journalists who cover politics or sports are trained in the value of balancing two sides of a story. But unlike a basketball game or election, there are rarely two equivalent sides in science. Covering vaccines like there are two teams—proponents and opponents—gives readers a false sense of equivalency.
“If something is believed by an overwhelming majority of the scientific community, then it should get the overwhelming majority of coverage,” Motta says.
The value and efficacy of vaccines is an example of this. Along with clean water and sanitation, vaccines are among the factors responsible for almost doubling the average human lifespan over the last century or more, Poland said. Vaccines are safer than aspirin or Tylenol, resulting in exponentially fewer side effects. Read more about vaccine successes here.
Yet, media coverage of vaccines often gives disproportional weight to the fringe beliefs of the relatively small anti-vaccination movement.
Poland remembers a discussion he once had with former news anchor Dan Rather at a medical conference.
“He said the big switch that started to occur in ’60s and ’70s is that science and medical journalism is no longer aimed at communicating truth, but aimed at communicating all views,” Poland remembered.
So risks get blown out of proportion and conspiracy theories linger. For example, one anti-vaccination doctor made headlines when she said that the COVID-19 vaccine made people magnetic.
“When you write an article like that, I will spend hours describing why that’s B.S.,” Poland said.
Instead, journalists should report on the science as it is currently understood while emphasizing that scientific research helps us update and change our understanding of the truth as we learn more.
That’s not to say that journalists should ignore alternative points of view, Motta said.
“I don’t think we should simply accept the dominant view,” he said. “We should also ask for other views and determine whether those views are widely held.”
Journalists can do that by asking people in the field who the mainstream voices are. If fringe views are included in a story, they should be characterized as such, with a critical eye to what research they’re basing their conclusions on and how it was formulated and reviewed by peers. They can also emphasize the positives: For example, the vast majority of families who do vaccinate (and don’t experience side effects).
Much attention has been given to declining vaccination rates, said health reporter Ciara McCarthy of the Fort Worth Star-Telegram, who recently examined vaccination rates among school children. But vaccination is valued as important among the large majority of families in the U.S.
“I think it’s worth reminding readers that vaccination remains the most common choice in most communities, even as vaccination rates are declining,” she says.
Talk to those people about why they chose to vaccinate, said Dr. Nathan Chomilo, an adjunct associate professor of pediatrics at the University of Minnesota Medical School, and include cultural context.
“One message we found to be very powerful was talking about how elders in the American Indian community are more at risk, and that getting the shot for yourself protects elders,” he said.
Include a variety of sources and elevate non-scientist voices
To reach people who tend to be wary of vaccines, it’s important to interview people whom skeptics might find credible, Motta said. That means not relying only on the voices of doctors and virologists, but including social scientists and individual people who have decided to vaccinate.
“Journalists need to avoid saying that something is true simply because scientists said so,” Motta said. “There is a growing level of distrust with the scientific community, so that certainly is not an effective way to communicate science now.”
If you understand potential sources of skepticism, how to communicate productively can become more clear, he said.
For example, if you’re writing about the flu shot, talk to Republican leaders who get the vaccine. If you’re doing a story about the MMR vaccine, talk to people who regretted not vaccinating their children after measles swept through their household, such as in this recent story in The New York Times.
“The absolute best communicators [to skeptics] are like-minded skeptics,” Motta said.
If you’re writing about a study by epidemiologists, it might make sense to talk to social scientists as well, he said. For example, if a study outlines how sick people are getting from the flu or COVID-19, you could ask a social scientist for more context about why transmission might be so high. While epidemiologists document the disease burdens, social scientists would be able to explain how things like the social dynamics of vaccine refusal and poor access to high quality health care impact transmission, he said.
Watch out for unintentional viewpoint signals
If you’re writing about people choosing whether to vaccinate, frame it that way: as a piece about vaccine deliberation, not vaccine hesitancy or anti-vaxxers, Dr. Chomilo suggested. As a pediatrician, he tries to stay away from inflammatory language and approaches patients with empathy for their fear and concerns.
Also, talk to your editor and be thoughtful about what visuals might accompany the piece. Searching an image bank for “childhood vaccines” usually pulls up children looking scared or crying. It’s a far different choice than putting together “a bank of photos of folks happy to get a shot, and getting stronger,” Chomilo said. A reporter’s job, of course, is not to help convince people to get vaccinated. But journalists should be giving people accurate, research- and consensus-driven information delivered in an empathetic way.
Ready to start reporting? Check out the list of resources below to connect with trustworthy sources.
Resources
- SciLine’s expert matching service
- World Health Organization experts on global vaccination
- Press offices at local medical schools or schools of public health
- Notable researchers with expertise in vaccine communication and public trust: Matt Motta, David Higgins, Peter Hotez, Greg Poland
Academic centers
- Center for Vaccine Development and Global Health
- Vaccine Integrity Project, CIDRAP, University of Minnesota
Sheila Mulrooney Eldred is a freelance health journalist based in Minneapolis. She has written about vaccines for NPR and The New York Times, among other national and local publications.
