By DAVID WILLIAMSON
UNC-CH News Services
CHAPEL HILL -- Media reports of injuries to children from vaccines designed to prevent diphtheria, pertussis, measles and other illnesses scare parents, increase costly litigation and prevent some infants from being immunized, thereby putting them in danger, according to a new study.
The University of North Carolina at Chapel Hill schools of medicine and public health and Duke University study, published in the Wednesday (Dec. 18) issue of the Journal of the American Medical Association, reaffirms physicians' strong faith in recommended childhood vaccines and scolds reporters for unintentionally distorting the facts.
Authors of the report are Dr. Gary L. Freed, associate professor of pediatrics and health policy and administration at UNC-CH; Dr. Samuel L. Katz, Wilburt C. Davison professor of pediatrics at Duke; and Sarah J. Clark, research associate at UNC-CH's Cecil G. Sheps Center for Health Services Research.
As an example of unintentional media distortion, the authors cite Heather Whitestone, who was chosen as Miss America in 1994. Her deafness has been the subject of widespread media attention. Major U.S. newspapers reported that Whitestone's deafness resulted from an adverse reaction to a routine DTP vaccination at age 18 months. Not until several days later did some papers run a correction saying her deafness was not due to a vaccination "but actually resulted from Haemophilus influenzae, type b meningitis, a disease now preventable by vaccination."
The public worries about vaccine safety in part because of erroneous news reporting of adverse events allegedly due to immunization, the study showed. Large monetary awards from courts -- despite poor or nonexistent evidence -- stimulate media coverage, more law suits and greater concern.
"Although serious and permanent reactions to vaccines do occur, recent studies and rigorous review of previous research indicate the rarity of these events," the authors said.
Scientific reports on the overwhelming safety of vaccines date back nearly 50 years and correspond with the first large-scale U.S. immunization program. But because vaccinations for pertussis, also known as whooping cough, can lead to fever in up to 50 percent of doses, high-pitched crying in 1 percent and seizures in fewer than one in 1,000 cases, people began linking vaccines with previously unexplained neurologic disorders. However, no evidence has been found that infant fever convulsions linked to the vaccine, for example, result in permanent injury.
Children receive the first doses of the primary immunization series at ages 2, 4 and 6 months, the researchers said.
"Therefore, at any time during the first 8 months of life, they are within two months of having received a vaccine. By unfortunate coincidence, this is also the same time that many neurologic diseases show their first symptoms."
Those conditions all existed before vaccines were developed and arose from mostly unexplained causes.
"Parents naturally long for an explanation as to why their child, and not another, experiences a disease or disability," the authors said. "Often, the physician has no definitive answer, leaving parents to grasp at any action or event that may have been the cause."
Suing vaccine manufacturers and health-care providers became a growth industry among lawyers in the late 1970s and early 1980s with awards regularly exceeding $1 million. In 1978 only two suits related to DTP were filed, but by 1986, more than 250 were brought annually. In 1985, lawyers sought $3.16 billion in damages -- 30 times more than the value of all DTP vaccine sold privately that year.
"The more spectacular the dollar amounts of awards became, the greater the media attention," the authors said. "The greater the media attention, the greater the number of claims filed."
Lawyers began advertising directly to parents of impaired children. As a result of the litigation, two of the last three U.S. DTP vaccine producers were driven out of business about 25 years ago.
A Washington, D.C., television station won an Emmy for a 1982 special, "DTP: Vaccine Roulette," which NBC's Today show excerpted. The American Academy of Pediatrics and other experts quickly denounced the program as unbalanced, inaccurate and dangerous, causing "extraordinary anguish and perhaps irreparable harm to the health and welfare of the nation's children." Other reporters and editors failed to question the growing yet unsubstantiated notion that vaccines were hazardous.
The incidence of vaccine-preventable diseases in this country is extraordinarily low because so many U.S. children are being immunized, the authors said. Pertussis, for example, which once killed more children in this country than all other infectious diseases combined, dropped from 265,269 cases in 1934 to fewer than 2,000 by 1976.
A 1970s pertussis epidemic in the United Kingdom, where many parents felt vaccine risks outweighed benefits, involved more than 100,000 cases and 36 deaths.
"The media have assumed the task of warning consumers of potential health risks," the authors wrote. "In light of the available scientific evidence on vaccines, the question for the media is how to report rare adverse events without perverting the perceptions of true risk...Otherwise, fear and misinformation will guide parents' decision to immunize their child.
"The media have a right, even an obligation to report ... adverse reactions to immunization, but information must be presented in a manner that accurately portrays the preponderance of evidence documenting the safety of childhood vaccines."
Childhood immunizations have become the most widely accepted, beneficial, safe and effective of all clinical preventive measures, they added.
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Note: Freed can be reached at (919) 966-5060 (w) or 932-1828 (h). Katz' number is (919) 968-0008.
Contact: David Williamson or Juliet Dickey.