Measles: A failure to communicate

Needlessly exposing kids to measles puts them at risk of blindness and death. How did Science fail to make this clear?

(I researched and wrote this article five years ago. Recent reports show that many parents have still haven’t gotten the message – which means, Science has still failed to deliver it.)

In February, there were news reports of California families hosting “Measles Parties” to intentionally expose their children to the potentially fatal disease in order to gain immunity while avoiding the measles vaccine.

Here in Canada, a recent poll by Angus- Reid showed that nearly nine-in-ten Canadians say vaccinations are effective at preventing disease for the individual who receive the vaccine (88%) and for the community as a whole (86%); and yet, the same poll found that two-in-five Canadians (39%) agree that “the science on vaccinations isn’t quite clear.”

In attempting to understand what vaccine-doubting or even measles-promoting adults could possibly be thinking, Landmark Report spoke with Canadian virologist and post-doctoral research fellow Dr. Logan Banadyga, and Dr. Baruch Fischoff, professor of Social and Decision Sciences and Engineering and Public Policy at Carnegie Mellon University.

Neither man could fathom what such parents were thinking, but both pointed squarely at communications by the scientific community – or lack of such communications – as a major contributor to the incredible, entirely preventable situation North Americans now face.

Westerners may believe that measles and mumps are relatively benign diseases, because science has not made a concerted effort to communicate the more serious risks, Fischhoff believes.

“People view the diseases merely as an inconvenience because they don’t know of complications that can arise; the medical community knows these things, but other people generally aren’t aware… we haven’t provided them with the evidence, or communicated the risks. The risk of blindness and death, my guess is that very few people know about that,” Fischhoff points out.

“I can guarantee you that most scientists don’t think about communications at all, because they don’t trust communications people, or they don’t trust journalists,” Banadyga says. “Most scientists think it’s easier to avoid them in the first place; and then we end up in situations where people listen to Jenny McCarthy.”

Banadyga conducts research in virology in western Montana and has dedicated his life to fighting infectious disease; he is particularly concerned with children’s health.

“We know from decades of research that vaccines are one of the most effective public health measures that we have ever undertaken,” he points out.

“So rationally, vaccines are a great idea. We have the data to prove that. It’s not just a bunch of scientists or big pharma getting together and deciding that they could make money off this. We know how to improve quality of life and it improves children’s’ lives – that’s a FACT.

“When you think about these Californians who are having measles parties – people have been doing this with chicken pox for years – you think, ‘You are exposing your child to a disease to which that kid does not have to be exposed and sure, they’ll probably survive if they get measles, but they’ll still get sick, they could potentially get very sick, and they could potentially die.

“You’re exposing them to that virus for no other reason than the completely fallacious belief that you think vaccines are causing more harm than good.” Science, he believes, has not done enough to combat such emotional beliefs which often trump rational thought.

“Part of the North American challenge is that the current generation has no direct experience of diseases like measles and mumps,” he says. “Now we have the case of these parents who are considering vaccines for their children and they have no experiences of these diseases. So their decision is easier to make, because they don’t see the kinds of havoc that these diseases caused in the first place.”

Banadyga believes there has to be a concerted effort to get these messages across to parents. Currently, “the message isn’t strong enough; or it’s not being absorbed clearly enough; or perhaps not enough of an effort is being made to deliver the message.”

Fischhoff agrees that the communications effort has been found lacking: “Scientists, like everybody else, overestimate how much of what they know is common knowledge. This is called ‘the common knowledge effect.’ If you think people know something, you don’t bother repeating it. I think scientists have dropped the ball for a very understandable reason: most scientists don’t have access to the public, so everything the scientist says goes through the funnel of the media.”

“We also,” Fischhoff adds, “overestimate how well we read people’s minds.”

Both Banadyga and Fischhoff commented on the frustration and exasperation scientists and even doctors feel in attempting to communicate well-documented, factual evidence to parents who cling to irrational beliefs.

“Scientists generally communicate in situations in which they are the boss, such as the classroom. We get pretty good at communicating complicated material, but that doesn’t mean we listen to the needs of people who actually need this information.”

Banadyga stresses the importance of family doctors who will listen to parents’ fears and take the time to allay them: “I think physicians are beginning to learn that this you can’t approach this subject as a cold-hearted machine and say, ‘Vaccines are the only way to go and if you don’t vaccinate your kids, you’re stupid.’ That’s going to turn a lot of people off.”



Risk Communications Sidebar


Dr. Baruch Fischhoff, professor of Social and Decision Sciences and Engineering and Public Policy at Carnegie Mellon University is one the pioneers in the development of Risk Communications, a precise process in which testing how a message is received, understood and acted upon is a critical component in decision-making. He was instrumental in assisting the Public Health Agency of Canada in developing its Strategic Risk Communications Framework, which was released in 2006.

“Tested messages really are the ‘gold standard’ in effective communications, and I don’t know if that is being done anywhere right now,” he says. “We’ve had 40 years of Risk Communications research in support of communications and decision making. I think we know how to communicate these things in a comprehensible and respectful way; I think what’s missing is simply use of the practice…people are just shooting from the hip.”

When public health officials fail to test their messages, Fischhoff says, “they are not doing their jobs.”

“If they don’t have message-testing procedures, then they’re just digging the hole deeper…they could do $500 million dollars’ worth of damage with a $50M campaign, if they don’t test their messages.”

Unlike one-way communications processes like DAD (decide, announce, defend) or persuasion campaigns, Risk Communications includes:

  • identifying the risk information that is most critical to decisions about risk;
  • characterizing the dimensions of risk that matter most to decision makers;
  • helping people make difficult risk choices and weighing competing outcomes;
  • communicating information about the magnitude of risks (and benefits), as well as the processes that create and control them;
  • describing people’s mental models of risks, in order to identify the critical missing pieces between what they know and what they need to know;
  • evaluating the success of communications programs.

“Although it would be nice to know more about all of these things,” Fischhoff wrote in the Strategic Risk Communications Framework, “this knowledge has limited value unless it can be translated into operational terms, usable by organizations with front-line communications responsibilities.”