SRA Europe Chapter Tackles Risk Debate on Vaccines and Anti-microbial Resistance

On March 20, 2017 the second Annual Meeting of the SRA Europe Benelux chapter took place at the Netherlands National Institute for Public Health and the Environment (RIVM).

The setting could not have been more appropriate for the subject of the meeting: ‘From vaccine to anti-microbial resistance: Exploring risk-risk trade-offs.’ Debates about the use and efficacy of vaccinations make headlines regularly. Discussions, though, are primarily in the media rather than within the scientific community.

One of the most hotly contested issues in the media is the perceived fear of the repercussions of vaccines, often backed with quotes from celebrities citing negative experiences as evidence of the supposed risks of infant inoculation. The scientific community, however, agrees that the benefits outweigh the relatively low risk associated with vaccinations and that they not only save lives, but also mitigate the increasing threat of antimicrobial resistance (AMR).

While a focused debate on AMR took place later in the conference, the specific discussions on vaccinations was hugely engaging. Attendees debated how science can effectively shape wider media discussions. In particular, how can science be on the front line to frame issues such as this, rather than being defensive and fending off negative perceptions, often shaped by misinformation in the press.

Combating fake news through communication

This took the discussions seamlessly into the area of “fake news.”

The keynote speaker, retired politician and communications expert, Dr. Agnes Kant, relayed her experience in overcoming fake news and celebrity misinformation on vaccinations. A key issue she identified is that scientists often do not know how to communicate strategically and would require an entirely new set of skills in order to do so.

Dr. Kant delivered advice on how scientists should operate:

  • Be transparent yet be sure to explain and interpret, don’t just confuse with transparency or information overload.
  • When dealing with the media, insist that both positive and negative information be included, often media is not interested in anything other than the shocking bits, they follow their own rules, and are not peer reviewed.
  • Don’t influence, suggest.
  • Be short and to the point with a clear message.
  • Be honest about what you don’t know.
  • Be empathetic
  • Clearly interpret the facts
  • Be aware of audience and misinformation

The problem that scientists need to overcome, at present, is that only fake news makes the headlines. Scientists need to speak out clearly and help shape the agenda.

Antimicrobial resistance

Aleksandra Opalska, of Utrecht University, then explored the role of safety monitoring of pharmaceutical drugs, referred to as pharmacovigilance, in order to prevent anti-microbial resistance (AMR).

It is believed that steps can be taken to mitigate AMR through effective risk management in the pre-authorization phase as well as through vigilant and spontaneous reporting as the drug becomes commonly used. 

Marie-Valentine Florin, from the International Risk Governance Council (IRGC), then introduced her preliminary attempt at applying the European Union’s emerging risk framework to AMR.

Ms. Florin explained that it was important to frame the risk in order to define the boundary of the risk involved. She added that economics often kill the antibiotic dream, given it is easier to just prescribe a pill than correctly diagnose.

She went on to set out a series of steps required for adequate risk management in regards to AMR:

  • Determine what happens
  • Develop a scenario complete with narrative, do not simply anticipate an issue
  • Implement a strategy
  • Identify the potential threats, not just the vague risk of AMR.
  • Train physicians for better antibiotic prescriptions, inform the public about the cumulative risks of AMR.

Ms. Florin noted that AMR threatens the livelihood of everyone on the planet, and is plagued with uncertainty and ambiguity. Combating AMR is both a short and long-term issue and needs a crisis management system in place.

Mirko Ancillotti, from Uppsala University, then explored the attitudes and beliefs of the public towards antibiotics and AMR.

In focus groups he found the main fear among the public was the threat of losing the use of antibiotics. The prevailing perception is that antibiotics make you stronger and not weaker. A social pressure to appear healthy, take less sick days and not cancel social events, creates a misuse of antibiotics when people should be staying at home, recovering and not spreading infection to others.

Generally, AMR is a difficult risk to explain to people but one that needs to be done carefully and proactively. Additionally, when addressing the subject, it is essential to remember that benefit communication is equally as important as risk communication.

Transparency

Ragnar Löfstedt, of King’s College London, chaired a roundtable discussion on transparency. In the wake of bad press over past real, or fake, vaccination side effects, the particular question being explored was whether or not transparency rebuilds trust?

Dominic Way, also from King’s, explained that his research has indicated transparency should be invoked not defined. Lifting the veil of secrecy is important yet doesn’t help analyse which policies are helpful. We need transparency of government, not for it.

David Haerry, of the European Aids Treatment Group, shared his thoughts on transparency within the pharmaceutical sector, noting that transparency is not a quick fix. Mr. Haerry commented that finding a comprehensive answer to bad press often paralyzes communicators, allowing for a negative veil to be set before a solid response can be broadcast.

To round out the subject, Pierre Bentata, of the Troyes Business School, presented results from a social media study, conducting a word analysis of messages directed towards “big pharma.” The study found the tone was generally distrustful and were often indicative of conspiracy.

A lively debate involving all roundtable members, as well as Dr. Kant, discussed that often, transparency is used to hide information, by overloading the public with information. Transparency does, in principle, help build public trust. It also inhibits regulators, at times intentionally omitting information from documented conversations in order to avoid releasing them by transparency.

Although it was clear that transparency, at a headline level, does help in building trust, it can only do so effectively as part of a wider engagement strategy.

by Randa Kachef