Danovaro-Holliday M Carolina, Wood Allison L, LeBaron Charles W
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
JAMA. 2002 Mar 20;287(11):1455-62. doi: 10.1001/jama.287.11.1455.
In August 1998, the US Food and Drug Administration licensed the first vaccine against rotavirus, the most important cause of severe childhood diarrhea. Fourteen months later, amid intense media activity, the vaccine was withdrawn after an association was found with intussusception.
To examine the character of news media stories about rotavirus vaccine before and after intussusception became an issue, to evaluate what prompted the stories, and to assess the extent to which they evoked public reaction.
We searched Lexis-Nexis and Video Monitoring Services of America databases for rotavirus vaccine stories from the first US clinical trials (January 1, 1987) until 17 months after withdrawal (March 31, 2001) and examined calls to the National Immunization Hotline during the period in which rotavirus vaccine information was captured (July 1-December 31, 1999).
Mention of vaccine benefits and adverse events, classification of stories as positive, negative, or neutral toward the vaccine, story stimuli, and public response.
We included 280 newspaper (primary subject of analysis), 49 wire service, and 257 television stories. Prior to identification of the intussusception association (January 1, 1987-July 14, 1999), 21% of 188 newspaper stories mentioned vaccine adverse events and only 2 stories were negative toward the vaccine. Ninety-nine percent of stories mentioned vaccine benefits. During the period surrounding withdrawal (July 15-December 31, 1999), 93% of 90 stories mentioned adverse events and 77% were negative toward the vaccine. Eighty-four percent mentioned vaccine benefits. The rate of stories per month was 14-fold greater than the preceding period (P<.001); temporal and geographic patterns of media and hotline activity were similar. Thereafter (January 1, 2000-March 31, 2001), only 2 stories focused on rotavirus vaccine. Scientific research or public health actions prompted 80% of stories. Wire service and television stories showed similar patterns. The increase in rotavirus stories in July 1999 was followed by an increase in calls to the National Immunization Hotline regarding rotavirus but not other topics. The number of rotavirus calls that month was 57% higher than for any other childhood vaccine for any month since the hotline began in 1997. Rotavirus calls ceased almost completely after withdrawal of the vaccine in October 1999.
In response to reports about an adverse event, news media stories about vaccines can change abruptly from positivity to negativity. Since most vaccine stories may be stimulated by research and public health actions, opportunities exist to provide the media with accurate information necessary to avoid the "early idealization-sudden condemnation" pattern seen with rotavirus vaccine.
1998年8月，美国食品药品监督管理局批准了首款针对轮状病毒的疫苗，轮状病毒是导致儿童严重腹泻的最重要病因。14个月后，在媒体的密集报道中，该疫苗在被发现与肠套叠有关联后被撤出市场。
研究在肠套叠问题出现前后，新闻媒体关于轮状病毒疫苗报道的特点，评估报道的诱因，并评估这些报道引发公众反应的程度。
我们在美国的Lexis-Nexis数据库和视频监测服务数据库中搜索了从美国首次临床试验（1987年1月1日）至疫苗撤出市场17个月后（2001年3月31日）有关轮状病毒疫苗的报道，并调查了在获取轮状病毒疫苗信息期间（1999年7月1日至12月31日）拨打国家免疫热线的情况。
提及疫苗益处和不良事件的情况、报道对疫苗的分类（正面、负面或中性）、报道的刺激因素以及公众反应。
我们纳入了280篇报纸报道（分析的主要对象）、49篇通讯社报道和257篇电视报道。在发现肠套叠关联之前（1987年1月1日至1999年7月14日），188篇报纸报道中有21%提及疫苗不良事件，只有2篇报道对疫苗持负面态度。99%的报道提到了疫苗的益处。在疫苗撤出市场前后期间（1999年7月15日至12月31日），90篇报道中有93%提及不良事件，77%对疫苗持负面态度。84%的报道提到了疫苗的益处。每月报道的数量比前一时期增加了14倍（P<0.001）；媒体和热线活动的时间和地理模式相似。此后（2000年1月1日至2001年3月31日），只有2篇报道关注轮状病毒疫苗。80%的报道是由科学研究或公共卫生行动引发的。通讯社和电视报道呈现出相似的模式。1999年7月轮状病毒报道的增加之后，拨打国家免疫热线咨询轮状病毒的电话增多，但咨询其他主题的电话未增加。当月关于轮状病毒的电话数量比自1997年热线开通以来任何一个月针对其他儿童疫苗的电话数量高出57%。1999年10月疫苗撤出市场后，关于轮状病毒的电话几乎完全停止。
针对不良事件的报道，新闻媒体关于疫苗的报道可能会突然从正面转向负面。由于大多数疫苗报道可能是由研究和公共卫生行动引发的，因此有机会向媒体提供准确信息，以避免出现轮状病毒疫苗那样的“早期理想化-突然谴责”模式。
