A Shot of Confusion: the issue of false equivalence

The complainant, Jillian Skeet, thought Marketplace’s look at homeopathic practice for child immunization was unbalanced. She was concerned the episode did not address parents’ experiences and concerns and took at face value the claims made by mainstream media. I found there is no credible, science based evidence that undermines the accepted fact that immunization for children is effective and safe.

COMPLAINT

The November 28, 2014 edition of CBC News Marketplace featured an episode entitled “Shot of Confusion.” It examined the claims made by homeopaths about the efficacy of their recommended treatments compared to conventional childhood immunization protocol. There is a lot of contradictory information available and a growing number of parents are choosing not to vaccinate their children. The program referred to the “mythology” about the danger of childhood vaccination and featured experts who dealt with some of those myths. It was this aspect of the program that disturbed you. You felt the program had “bought” the views of mainstream medicine that these were in fact myths, and that those views should have been challenged as well:

Unfortunately, the Marketplace story failed miserably to live up to CBC standards. It began with the premise that parents who are cautious or worried about vaccinations believe in ‘mythology’ and made no effort whatsoever to dispel this so-called, ‘mythology’. If it had, the show’s researchers, writers and producers would have quickly discovered that something is wrong with the mainstream story that is being sold to the public.

As the parent of a child who had internal bleeding following his MMR vaccination 11 years ago, and who then began doing her own research, I assure you that ‘mythology’ has very little to do with parental concerns.

You provided reference to several articles, many of which had to do with other kinds of vaccines, such as flu, Gardisil against the human papillomavirus (hpv) and articles about a pending lawsuit against Merck in regard to its measles mumps rubella virus (MMR).

You thought Marketplace had done a disservice to Canadians in criticizing parents for believing what the program characterized as myths, and for criticizing the alternatives offered by homeopaths. You thought this would have an impact on the health of children:

The rate of autism has gone from 1 in 10,000 about 25-30 years ago, to 1 in 76 or 78 according to the US CDC, (1 in 50 according to Forbes). Where is the panic? Where are the studies into the causes of autism? Virtually all studies focus on better diagnostics and treatment. It is absolutely untrue that it is just being diagnosed more. It is more. Two out of 7 children on my son's sports day team last June were autistic. One was climbing the chain-link fence instead of taking her turn. It is an absolute catastrophe for society and the costs are going to astronomical. The only time health officials mention autism is when they are telling us that there are no links to vaccines. This alone is reason to begin asking very tough questions. If our public health officials do not see this as a priority issue to address, what is going on?

My last point is that all the ‘studies’ that health and vaccine industry officials cite to promote vaccines have been funded by the vaccine makers - so, at the end of the day, their information is no more valid (or less so), than the real-life anecdotal information that is being shared by parents.

When you received your response from the programmers, you felt they had not really addressed your issues. You suggested a second look at vaccines, and that they were dismissive of the concerns about the “myths.”

I would like to see CBC’s Marketplace take a fresh look at the vaccine story - the new epidemic of narcolepsy amongst children, many of whom received the Swine Flu vaccine (you can follow the story in Canada - Edmonton has a sleep specialist who has already been in the news (W-5) over this, or across Europe), neurological damage and paralysis from the Gardisil vaccine documented in Japan and across Europe... The existence of mercury in flu vaccines that are being recommended locally, on an annual basis, for everyone including pregnant women and children under five, even though the Fluval insert warns that the vaccine has not been tested for safety in children, for cancer, genetic mutations, etc. Dramatic increases in chicken pox in South Korea since the introduction of widespread vaccination, whistleblower testimony from MERCK and US CDC scientists that will see MERCK in court over misrepresenting it vaccines and probably before Congress due to allegations of a cover-up of high rates of autism in African-American boys following the MMR vaccine.

MANAGEMENT RESPONSE

Marie Caloz, Executive Producer of Marketplace, responded to your concerns. She explained that the program had a fairly narrow focus, looking at homeopathic alternatives offered for child immunization. They did so because in the course of their research they discovered that some homeopaths discourage immunization, and offer other treatments:

I want to be clear too that this program is not about the effectiveness of vaccines, their use, the way they are made, or the level of risk associated with their use. That broad topic, which is largely what you wrote about, is far beyond the rather narrow focus of this program. This program specifically focused on “homeopathic immunization,” a vaccination alternative offered by some homeopathic practitioners.

She pointed out that because the program focused in on the visits of some parents wearing hidden cameras to homeopaths, it was necessary to provide balance to their viewpoint. They did so by talking to a leading proponent, Dr. Isaac Golden. She told you that many other experts were interviewed as well. She noted that they sent Dr. Golden’s research to three experts who found it lacking:

We also sent Dr. Golden’s research to be analyzed by three different experts, including a professor of infectious diseases. Those researchers found his studies on homeoprophylaxis “concerning,” and one found that the “material presented essentially no evidence” that homeopathic vaccines could “protect children from serious, often life threatening infection”.

She explained that the program was aware that parents find the decision to vaccinate a difficult one in the face of a great deal of contradictory information. She said that while there is a heated debate on media talk shows and online, there is little debate in the scientific community, where the overwhelming evidence indicates that any risks are far outweighed by the value it provides to the health and safety of children.

They [vaccinations] are considered safe, effective, and are not linked to illnesses like autism. On the question of side effects and anecdotal reports of illness, accredited experts point out that scientific evidence overwhelmingly demonstrates that the very small risks associated with vaccines are far outweighed by the benefits of immunization.

She told you she thought the program would help parents make informed choices about immunizing their children but emphasized that the program was not a “broad-based investigation of the effectiveness or the dangers you see associated with vaccines.”

REVIEW

The focus of the story, as Ms. Caloz pointed out, was around the claims of homeopaths about potential dangers of childhood immunizations, and about some of the alternatives they suggested. You are right it also looked at the wider question of parents’ fears about those dangers. It is of growing concern to health care professionals because immunization rates are dropping. CBC Journalistic policy calls for a range of perspectives. It also indicates the need to allow an individual or institution to respond to criticism or concerns raised in the course of the research. The commitment to balance is expressed this way:

We contribute to informed debate on issues that matter to Canadians by reflecting a diversity of opinion. Our content on all platforms presents a wide range of subject matter and views.

On issues of controversy, we ensure that divergent views are reflected respectfully, taking into account their relevance to the debate and how widely held these views are. We also ensure that they are represented over a reasonable period of time.

The Marketplace episode featured an interview with Isaac Golden, an Australian homeopath who is considered an expert on homeopathic immunization. He says there is good evidence that homeopathic immunization, which works on principles very different from conventional methods, is effective. The homeopaths recorded by the parents’ hidden cameras explain their views. One says: “Babies are getting too much stimulation for their immature immune systems.” Another one says “Some kids I think are sensitive and autism may be something they develop because of MMR, or not.” Another states measles is a fairly harmless disease.

The program provides opposing views. An expert on research methodology states:

I’ve reviewed the studies that Isaac Golden is presenting in his lectures, I have reviewed his graduate thesis where he presents evidence that he’s acquired, the quality of that evidence is low.

Not all journalism, especially that which is presented in programs like Marketplace with a defined mission to draw conclusions about the impact of a good or service to Canadians, is obliged to present every point of view with the same weight, or to present them at all. The commitment to balance I quoted earlier carefully says that there is a need to take into account how relevant a view is and how widely held it is. The commitment to accuracy states:

We seek out the truth in all matters of public interest. We invest our time and our skills to learn, understand and clearly explain the facts to our audience.

There is not necessarily equivalency in every point of view. Journalists use their knowledge and judgment to weigh the value of the facts or ideas that are laid before them. They are also called upon to “provide professional judgment based on knowledge and expertise.” I have written about this in the context of climate change. There comes a point where investing the same weight and attention to certain views, which are not based on the scrutiny of rigorous peer reviewed science, would be a disservice to the audience.

The program addresses and acknowledges that parents have concerns. Homeopaths on the program actually do raise them – the question of autism, the question of overwhelming immature immune systems, for example. But the fact remains medical opinion and authenticated research indicates that the risk of not immunizing is by far and away greater than immunizing. The World Health Organization, national medical associations, paediatric groups, all remain strong advocates of immunization. The Canadian Public Health Agency is unequivocal in its backing:

Over the last 50 years, immunization has saved more lives than any other health measure. Vaccination is the best way for you and your family to prevent very serious diseases.

It is important to make decisions about vaccination based on facts. You can trust the Public Health Agency of Canada to give you credible, science-based advice about vaccines. We work with national and international public health experts to ensure the safest and most effective vaccine programs for all Canadians.

That does not mean there is zero risk to individual children, and if it were mine who had an adverse reaction, I can understand the impulse to reject the notion of a greater good. Public health officials and physicians recognize that they have a challenge getting the message out. They realize that parents are motivated to do what they believe is right for their children. On a blog called Science Based Medicine, Dr. John Snyder observes:

Why are parents so afraid to vaccinate their children? First of all, every parent that comes to me with an alternate vaccine schedule is making a decision that is meant to be in the child’s best interest. These are well-intentioned parents, who want to do the right thing. One of the main issues at play here is the fact that vaccines are a preventative measure, and not a treatment for a visible, tangible disease state. This right away makes it a harder sell. That wasn’t the case when these diseases were commonplace and an ever-present specter looming over every parent’s head. Then, the thought of not vaccinating was inconceivable to most people (though not all, and that’s a different topic altogether). The infections we are trying to prevent with vaccines are now a mere abstraction for most parents. Because vaccines have been so successful at reducing the incidence of these horrific diseases, there are few parents who have ever seen or even heard of them. Add to this the rampant and ever-snowballing avalanche of vaccine myths and misinformation propagated by social circles, the mass media, social media, and the Internet, and you have the conditions for our current decline in vaccination rates.

There was no violation of CBC policy in characterizing the fears parents frequently raise about childhood immunization as “myths.” In the course of the program, there was some information given about why they were myths. They were further addressed in some detail on the website in an article entitled “Vaccines: Busting common myths.” The material you sent along with your complaint dealt with other vaccines, and for that reason Ms. Caloz was right to say they were beyond the scope of this Marketplace episode. The program focused exclusively on the series of immunizations given to babies and children. It did not address flu shots or the vaccine against HPV. The material you sent about the MMR vaccine seems to deal with questions of the efficacy results claimed by the manufacturer. It doesn’t mean it is ineffective. The issues you raise about data and clinical trials overseen by the drug companies are important ones. It might even be the subject of a future Marketplace episode, as Ms. Caloz indicated to you.

It doesn’t mean the program must agree with your contention that anecdotal evidence of parents should be given the same weight and treatment in presenting the facts of childhood immunization. To do so would create a false equivalence between ideas that have scientific weight, are public policy in Canada, and ideas that most medical practitioners and public health experts consider dangerous.

Esther Enkin
CBC Ombudsman