Communication and public health challenges in Europe.Specialised journalism, sources and media coverage in times of anti-vaccine lobby

Abstract

This doctoral thesis lays under the field of health communication, and carries the European perspective where this research field is becoming highly recognised. The media are one of the leading sources of information about medicines for the public, to the extent that media sources are today more significant than health professionals in learning about new medicines and their effects. Among all types of medicines, vaccines represent one of the greatest scientific achievements in the battle against serious infectious diseases, improving quality of life and life expectancy worldwide. However, the public is not always aware of the important role of vaccines in preventing diseases mainly because lack of information, fake news, and the anti-vaccine lobby which may impact mistrust in vaccines. During the last decade, immunization uptake has decreased in some countries and new outbreaks of vaccine-preventable diseases have been declared, which has led eleven european countries to adopt mandatory childhood vaccination. In this regard, previous research has established that the media has been considered an important tool for increasing awareness, confidence and trust about vaccines, as well as motivating the public to make important decisions about their health care. However, research on public communication of vaccines is still limited regardless the importance of this scientific field in public health. a) Therefore the objectives of this thesis are: a) Understand the field of health communication and identify research gaps in the field of public communication of medicines and vaccines. b) Examine newspaper coverage of vaccines to understand the media agenda in Spain; c) Identify journalists¿ sourcing to understand the extent of sources in newspaper coverage of vaccines; d) Analyse specific patterns among health journalists, and assesses whether these differ from those among generalists; e) Explore the visual content in the press coverage of vaccines; f) Analyse the association of media coverage about vaccines and immunization rates. This Thesis followed a quantitative and qualitative method based on a set of observational studies. First, literature and systematic reviews on the field of public communication of medicines and vaccines were conducted. Second, taking into account identified research gaps, a content analysis of vaccine related was conducted in relation to the coverage in major newspapers in Spain during the period 2012 ¿ 2017. Results revealed that previous research has mainly analysed media from USA and other English speaking countries. Our analysis in the Spanish media showed that the tone towards vaccination switched from negative to positive and neutral, showing how journalists and the media support vaccination. Sources from the government, clinician associations and companies were the most frequent. There is a need to use a more variety of sources including different perspectives in vaccine media coverage. In addition, health specialised journalists used more scientific sources, and wrote less opinion but more feature articles than generalist journalists. Visual content and imagery was frequent, especially the use of photographs under the frames `human interest¿ and `conflicts¿. Finally, a significant inverse correlation was found between childhood immunization rates and the negative tone in media coverage about vaccines. The aforementioned studies shed light on key patterns about the media coverage of vaccines and journalistic practices. The study shows how journalists have become more aware about vaccines as an important public health challenge, and reflect about the relevance of the health journalism specialization to ensure objectivity and accurate vaccine media coverage. As communication strategies and media relations should be part of any vaccination program, collaboration between health professionals with the media and communication experts is required.