Vaccinations and balance, again

The complainant, AnnaMaria Valastro, thought that Cross Country Checkup had stacked the deck in favor of vaccines. Again, I found that there is no “stacking” because there is no equivalence when the overwhelming evidence points to the safety and efficacy of the MMR vaccine.

COMPLAINT

You wrote to complain about the February 8 edition of CBC Radio One’s Cross Country Checkup, and an edition of The Current broadcast a day later. Both programs dealt with issues about childhood vaccination, especially the measles mumps rubella (MMR) vaccine. Overall your concern was that “CBC intentionally shaped the conversation on the benefits of the measles vaccine and therefore demonstrated a lack of journalistic integrity.”

The Cross Country Checkup episode asked the question: “Should some vaccinations, such as for measles, be mandatory?” Your concern was that the guests chosen to lead off the discussion “were advocates for the vaccination.” You added:

And while they were both professional medical doctors, they failed to take seriously, or even acknowledge, the volume of research from medical counterparts that raise legitimate concerns regarding the ill effects of vaccinations.

The best they could do was point to a discredited research paper that linked autism to the vaccine. What rang loud and clear was the dead silence regarding other papers that reached the same conclusion – that there is no link between autism and the measles vaccination.

This is because there are few papers that have looked into this issue in any substantial way. The absence of research does not make an issue defunct. The silence was thunderous.

You felt the guests were dismissive of parents who have decided not to vaccinate their children. You characterized their portrayal of these parents as arrogant, rude and mocking.

You said that you were even more offended by The Current. The episode in question involved an interview with two mothers: one whose child could not be vaccinated because of an auto-immune deficiency, and therefore at high risk if he got measles, and the other a mother who did not vaccinate her children because she believed measles is not a serious disease and because the vaccine can be harmful. You thought that Darlene Tindall, the woman who did not vaccinate her children, was unaware she would be challenged in her views and that she was “deliberately used as a punching bag by the CBC to make a point – that we all have a responsibility to protect all children by getting vaccinated.” You considered it unfair that the program host challenged the evidence she cited, but that she did not challenge the evidence used by the mother of the child who advocated vaccination to ensure the safety of all children.

In later correspondence you objected to the fact that Ms. Tindall’s evidence was not given the same weight as the science:

What I heard that day was a CBC host – AnnaMaria Tremonti, ask one of her guests why she chose not to vaccinate her children. The guest described, in general terms, her approach in making that decision. It included online research, and talking and listening to other parents whose children had experienced adverse effects to vaccines.

AnnaMaria Tremonti balked, stating that speaking and listening to the experience of others was ‘anecdotal’ and ‘untruthful’ because it wasn’t science-based.

If a modern young woman learns from the experiences of her friends, family and colleagues, this is somehow ‘anecdotal’ and ‘untruthful’. But if the same person had a hunter and gatherer cultural history, observations passed down through verbal family history would be romanticized as ‘traditional’ knowledge.

Sure, the longevity isn’t there, but the principle is the same. And all observations begin with one and then repeated. It is no less important than an observation made under a microscope.

In fact, all research begins with citizens’ observations. Whether it is commercial fisherman noticing open lesions on the fish, or playing children noticing amphibians with deformities or birders noticing a shift in migration patterns, or an isolated community noticing that the birth rate of boys is diminishing compared to girls, or bee keepers losing their hives.

In the case of both programs, you said CBC was ignorant of the science, easily found online, that supports the concerns of those against vaccination. You elaborated:

Here are some simple bits of information regarding the measles vaccine, that I have learned from my very lazy search of scientific research:

  • Women who are vaccinated have less antibodies to pass along to their children to protect them from the childhood disease.
  • Women who have had measles have greater immunity to the disease and this protection is passed on to their children.
  • It is discussed that poverty made people more susceptible to measles in the last century because they were malnourished, lending credibility to those ideas that taking good care of yourself helps the body fight back – and yes eating KALE.
  • Many of these diseases run out of steam over time such as Scarlet Fever where no vaccine is available building immunity to the disease over time and across communities.
  • That public health should focus more on protecting vulnerable populations directly rather than forcing others to risk negative impacts of vaccines. That means vaccinating vulnerable persons instead of everyone.

All information is contained in published scientific journals – all readily available to the laziest of researchers and yes even the CBC and costs NOTHING.

You are concerned that CBC “betrayed” its listeners by ignoring this evidence and not providing other points of view so that they could come to their own conclusions.

MANAGEMENT RESPONSE

Both the executive producer of The Current, Jennifer Moroz, and the senior producer of Cross Country Checkup, Charles Shanks, responded to your concerns.

Mr. Shanks pointed out that the program asked the audience to weigh in on the question of whether vaccination, especially for measles, be made mandatory:

Our intent was to discuss whether parents have a responsibility beyond keeping their own children healthy and disease-free. Do they also have a responsibility to the community to ensure that their children do not spread a dangerous infectious disease to others? It is a point worth discussing, whether parents should be allowed to shelter their own children from the very small risk of an adverse reaction to the vaccine, and thereby expose many other children to the much greater risk of contracting and being damaged by measles.

Mr. Shanks told you he agreed that both guests supported “the principle and practice of vaccination.” He explained to you why that was acceptable. He said that while CBC journalistic policy obliges producers and editors to ensure all points of view are heard, it also indicates that it be done “within proportion and context.” He pointed out that there were callers who distrust vaccinations, but that “we would not elevate a marginal view to the point that it receives equal treatment.” In this case that would have meant having a guest along with Dr. Michael Gardam, Director of Infection Prevention and Control at the University Health Network in Toronto and Physician Director of the Community and Hospital Infection Control Association Canada, who did not believe in the evidence and value of vaccination.

He added that it was beyond the scope of the program to delve into the basic scientific research when the focus was a discussion of a public policy issue. He said it was reasonable to accept the evidence as presented by experts in positions of authority and responsibility, especially since there is a large body of evidence and nearly unanimous scientific and medical opinion that immunization for measles mumps and rubella is extremely effective and extremely low risk.

Ms. Moroz addressed your concerns about the interview Anna Maria Tremonti, host of The Current, did with a mother who had chosen not to vaccinate her children. She told you that Ms. Tremonti challenged the evidence used by Darlene Tindall because the evidence she cited was inaccurate. She pointed out this exchange from the interview:

Asked by Ms Tremonti whether she would vaccinate her children if her community needed her to help protect other susceptible children, Ms Tindall responded: “I would definitely consider it. I’m not against that. I’m not against listening and reading and having a conversation and I think that’s really important. When we have a conversations like this, it’s very difficult for a person who has made a decision when everybody else you talk to has made the other decision and you’re automatically considered wrong.”

Ms Tremonti responded: “Well, it’s not that you’re automatically considered wrong. It’s again that you’re quoting things that are inaccurate... You’re entitled to opinions, but you’re not entitled to facts.”

Ms. Moroz told you that the weight of evidence, near unanimous views of the medical and scientific community, as well as existing public policy supports Ms. Tremonti’s characterization. She added:

You maintain there are ‘many’ credible sources of information that cast doubt on the safety of the measles vaccine that are ‘readily available to the laziest of researchers’ - and that we ‘chose’ to ignore in this discussion. As I have written, the medical consensus, based on a wide body of research, is that the measles vaccine is generally effective and safe. You will find plenty of fodder on the Internet suggesting otherwise, but it is our job as journalists to separate what is scientifically valid and what is not, and present the public with supported facts. That is not to say that there are no documented adverse effects to the measles vaccine. There are. And our discussion did not shy away from those - while also noting that the chances of any serious effects are extremely remote, and infinitely smaller than the chances of dying from measles.

She also addressed your concerns that Ms. Tremonti was “rude and obnoxious” to the guest. She conceded that the program host asked pointed questions and pushed her to explain the reasoning behind her decision not to vaccinate in light of the scientific evidence. She added that it is the responsibility of the host to point out inaccuracies or misinformation being presented as fact:

In the course of the conversation, Ms Tindall brought up information that was inaccurate or misleading, and Ms Tremonti corrected and clarified where needed -- as any good journalist should do. Our job certainly entails giving voice to different perspectives on an issue, as we did here, but that does not mean allowing on-air guests to freely broadcast misinformation to the public, unchallenged or uncorrected. So while you say we were ‘deliberately misleading’ listeners, I would argue that we were doing just the opposite: We wanted to ensure our audience was not mislead.”

REVIEW

This is one of many reviews I have written about complaints regarding the presentation of information surrounding the efficacy and safety of childhood vaccinations generally, and the MMR vaccine specifically. There is no violation of journalistic policy or integrity in presenting the facts endorsed by an overwhelming consensus of the medical, scientific and public policy community. I have cited the reasons before, and they remain the same. 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,” as CBC’s Journalistic Standards and Practices outlines. 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.

In your response to Ms. Moroz and Mr. Shanks you said hiding behind scientific consensus was just a way of stifling debate. There are issues that are debatable – one of them was the topic of discussion on Cross Country Checkup. And that is a public policy question on whether to make vaccination mandatory. While the invited guests talked about the importance and value of vaccination and speculated about the resistance to the data, they did not advocate one way or another for making it mandatory. The calls from members of the public eloquently presented both perspectives. And I do not agree that Dr. Gardam sounded arrogant or condescending. In response to host Rex Murphy’s questions, he tried to understand what is behind the resistance to the evidence.

To create a debate about whether the MMR vaccine is safe and effective would be to create false equivalence. First and foremost journalists have a duty to truth telling and presenting verifiable facts. The internet is filled with all kinds of information you may choose to believe. That does not oblige professional journalists to accept them as fact. In their book “The Elements of Journalism” Bill Kovach and Tom Rosenstiel say this about balance:

Balance for instance, can lead to distortion. If an overwhelming percentage of scientists, as an example, believe that global warming is a scientific fact, or that some medical treatment is clearly the safest, it is a disservice to citizens and truthfulness to create the impression that the scientific debate is equally split.

CBC Journalistic Standards and Practices reinforces the same message: its reference to balance states:

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.

Turning to your complaint about The Current. I have done a full review of that program. Its finding can be found here. Here is the most relevant portion:

The stated purpose of the interview was to understand the position and thinking of someone who made the choice not to vaccinate a child. My mandate is to judge whether there was a violation of journalistic policy, not to judge the effectiveness of the interview. I asked Ms. Tindall directly how she thought the interview went. She told me “she did not feel heard.” She also told me she prepared the interview thinking that the science behind her decision would not be the focus. On the other hand, the producer was under the impression that Ms. Tindall did want to talk about the science, and told her she would prepare the host to deal with that issue. It is unfortunate Ms. Tindall did not feel she got to say her piece as clearly as she would have liked, but in listening to the interview, her main points come across quite clearly: that she does not believe the science and that there is credible evidence to support her view the vaccine can cause serious damage, and that the medical profession and “pro-vaxxers” do not listen and employ bullying tactics against people like her. She also came across as a compassionate and caring person, when faced with the dilemma of a mother of an immune compromised child.

Ms. Tindall felt she was forced to defend, rather than explain her position. And listening to the interview, that seems a fair assessment. However, it is hard to fault or second guess a host for asking tough questions to get at what he or she sees as the truth of the important issues under discussion.

Esther Enkin
CBC Ombudsman