NEW YORK (Reuters Health) - Scientists and the media need to do a better job helping the public know what they can realistically expect from vaccines and other medical advances, according to researchers who analyzed news coverage of the rise and fall of the rotavirus vaccine against childhood diarrhea.

The rotavirus vaccine was approved in the US in 1998 after more than a decade of research showed it could largely prevent severe cases of diarrhea caused by rotavirus. The virus is the leading cause of serious diarrheal illness in US infants, and in the developing world, babies commonly die of rotavirus infection.

However, just a year later the vaccine was withdrawn from the US market after it was tied to a rare type of bowel obstruction called intussusception, in which one part of the bowel sinks into the next like a collapsing telescope. An estimated one to two vaccinated babies per 10,000 were considered at risk of the complication.

To look into how the media covered this turn of events, researchers at the US Centers for Disease Control and Prevention in Atlanta, Georgia, analyzed news stories on the rotavirus vaccine published between 1987--when US clinical trials began--and 2001.

They found that before the intussusception risk was established, newspapers, wire services and television outlets were largely positive in their coverage and most stories did not mention the potential adverse effects of vaccination such as fever, appetite loss and irritability. And no news stories mentioned intussusception before the vaccine was suspended--even though there had been scientific reports of an association, according to Dr. M. Carolina Danovaro-Holliday and her colleagues.

After the rotavirus vaccine was linked to bowel obstruction in 1999, however, media coverage "changed abruptly to negativity," the researchers report in the March 20th issue of The Journal of the American Medical Association. Soon after, rotavirus all but disappeared from the news.

The problem with such an "early idealization-sudden condemnation" pattern in the media is that at either end, the public does not get the full picture, according to Danovaro-Holliday, now at the London School of Hygiene and Tropical Medicine in the UK.

"Maybe we--the medical community, public health and scientists--need to always provide journalists with all the facts for a vaccine or other medical intervention, the benefits and drawbacks," Danovaro-Holliday told Reuters Health. "If the public is always informed of both sides of each medical intervention, the detection of rare adverse events may be less of a surprise."

In another part of their study, the researchers looked at the public's reaction to media stories on the rotavirus vaccine by analyzing calls to the US National Immunization Hotline. They found that the increase in rotavirus stories in July 1999 was followed by an upsurge in hotline calls. And the number of rotavirus calls that month was 57% higher than for any other childhood vaccine during any month since the hotline's inception in 1997.

Danovaro-Holliday said she thinks it is a "very good thing" that parents turned to this source for vaccine information. She added that the key point seems to be that the public should have as much information about vaccines as possible "from the start, and as their kids are getting vaccinated."

Such balanced information, she and her colleagues write, could prevent "abrupt shifts" in media attention and public perception that could undermine overall vaccination efforts.

SOURCE: The Journal of the American Medical Association 2002;287:1455-

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