From the Scholars Strategy Network, written by Erika Franklin Fowler, Wesleyan University, and Sarah Elizabeth Gollust, University of Minnesota School of Public Health

 

Media stories about measles outbreaks in California and Arizona have featured prominent politicians weighing in with conflicting messages. Should vaccination be required for all children with few exceptions? Are vaccines safe? Should parents have a choice — when refusing vaccines can put their own and other people’s children at grave risk? The stories are dramatic, but scholars and public officials warn that it is dangerous to turn vaccination into a political football. Other widely publicized controversies reveal that the insertion of politics into media coverage can be hard to reverse, as it may undermine public trust in doctors and public health officials.

Political controversy sticks

Our research examines two recent politically charged health controversies — the 2009 dust-up over mammography-screening guidelines and the 2006-2007 debate over whether middle schools should require girls to get vaccinated against infections by the human papillomavirus (“HPV” for short). Specifically, we found that local and national media coverage did not start with a focus on political controversy. But once news stories started to highlight partisan arguments among political leaders, political controversies became the focus of subsequent coverage.

• In media coverage of questions about mammography screening guidelines, the sheer number of articles tapered off within a week of the original stories, but the proportion of stories including political controversies increased — with six out of every ten later articles featuring such disputes.
• In media coverage of disputes over requiring vaccines for middle school girls, even after states moved on to consider less controversial approaches — like educating the public or providing insurance coverage for the vaccine — media stories continued to mention the political firestorm.

In short, once a health issue becomes a hot-button political issue in the media, the political conflict story line is likely to persist and color related coverage. Tellingly, early 2015 stories about measles vaccination controversies referred back to the 2011 political firestorm that broke out when Republican presidential contender Michele Bachmann criticized the decision of Texas Governor Rick Perry to require human papillomavirus vaccination for girls in his state.

Do publicized political controversies matter?

Does a media focus on political controversies over public health issues make any real difference? We looked into this question by pairing our findings about media coverage of the human papillomavirus vaccine debate with a nationally representative survey experiment. In that experiment, we exposed different sets of participants to various HPV vaccine media messages before asking their opinions. Some messages focused only on medical disputes, while others featured political disputes. Did people who heard media messages about political controversies over vaccines shift their views toward the relevant policies or experience changes in their level of confidence in advice from government and doctors? Established theories about political communication suggest that the inclusion of political cues in media coverage encourages people to rely on their political predispositions as they arrive at their own attitudes on the issue. When that happens, the impact on people’s understandings and opinions can be dramatic.

Our results confirmed expectations, revealing that more politicized media coverage of arguments about state rules for human papillomavirus vaccination was associated with lower support among people living in those states for rules mandating the vaccine for school-aged girls. Even more worrisome, exposure to stories about political conflict among people who had not previously encountered such stories led to reduced support for immunization programs. Participants who simply heard medical arguments about public health issues did not have distrustful reactions, but those who were newly exposed to stories about political conflicts concerning human papillomavirus vaccination became less supportive of vaccines in general — suggesting that something similar could flow from current media coverage of political arguments about measles vaccination. In addition, higher levels of media coverage of political conflict were associated with lower trust in government and doctors.

Implications for politicians and journalists

Vaccines only work to prevent dread diseases when almost everyone is vaccinated. Our research on news publicity about political disputes suggests that American society could be on a slippery slope toward distrust of public health recommendations and unwillingness to accept vaccination, with potentially concerning consequences not just for convinced hard-core opponents but for everyone. Media coverage is not problematic in itself — higher levels of coverage that did not feature political conflict were correlated with both increased support for the human papillomavirus vaccine and more support for immunization programs generally. Media reporters can heighten public understanding of the value and safety of vaccination and other public health measures — but only if they steer clear of constantly highlighting political controversies.

As more commentators bemoan the politicization of this issue, politicians like Rand Paul, Chris Christie, and others may back off controversial statements and stop turning public health matters into political footballs. This could allow citizens to move beyond thinking of vaccination as a political controversy on which people must take sides. But will journalists stop writing politically charged stories — and stop reminding audiences about political controversies over public health issues from the past? Our research makes us wonder if journalists can break the habit of spotlighting political controversy — but for the sake of public health and wellbeing, we must hope that they can.

Related research: Read more in Erika Franklin Fowler and Sarah E. Gollust, “The Content and Effect of Politicized Health Controversies,” Annals of the American Academy of Political and Social Science 658, No. 1, March 2015, 155-171.

 

Keywords: research brief, vaccines, anti-vaccination, measles, HPV