The measles outbreak and the MMR health scare

25/04/2013  -  10.43

Deborah Orpin, Senior Lecturer in English Language and Linguistics

Memories of the MMR scare of about a decade ago had all but faded until news came of an outbreak of measles in Swansea. To prevent measles epidemics in other parts of the country, Public Health England has launched a vaccination catch-up campaign. They estimate that up to a million children aged 10 to 14 are at risk of catching measles because many of them were not vaccinated as babies owing to widespread fears that the combined measles, mumps and rubella vaccine (MMR) could cause autism.

The idea that there might be a causal link between the measles vaccine and autism came from a research paper published in 1998 by a team working at the Royal Free Hospital. The paper investigated the cases of 12 children suffering from a form of autism and inflammatory bowel disease. In several of these children, the onset of the symptoms followed vaccination with MMR. The interesting thing to note is that the research paper clearly states that the study ‘did not prove an association between measles, mumps and rubella vaccine and the syndrome described’ (Wakefield et al, 1998: 641).

So how did the idea that MMR could cause autism gain currency among the public? And how did it come to wield so much influence despite the fact that numerous studies found absolutely no evidence of such a link? The answer lies partly in the way in which health stories are represented in the media. As Boyce (2007) explains, journalists need to simplify for the public what are often complex scientific arguments and to turn them into engaging stories. So the MMR issue was often represented as the story of a maverick doctor, Andrew Wakefield, battling against the medical authorities and the government. Good journalist practice also involves presenting a balanced view of an issue. Thus, in reports on MMR, a quotation from a health professional or government minister reassuring the public of the vaccine’s safety would almost always be ‘balanced’ by a quotation from an anti- MMR voice. This created the impression that the scientific community was equally divided between those who thought the vaccine was safe and those who opposed its use.

But the answer also lies in differences in the ways in which ideas about cause and effect are expressed in scientific contexts and in other domains. Scientists typically make claims in a very tentative way. Even in the now discredited paper by Wakefield et al (1998), for example, suggestions that components of the MMR vaccine may have a causal connection with autism or bowel disease are not stated in highly certain terms. They say things such as ‘Rubella virus is associated with autism’ or ‘measles virus and measles vaccines have both been implicated as risk factors for Crohn’s disease’.

When scientific claims are reproduced in non-scientific contexts, subtle shifts in meaning can take place. Evidence from a corpus of texts from an online discussion forum reveals that, on the whole, the media at the time of the MMR scare tended to express uncertainty about Wakefield’s claims, as the following example illustrates: ‘Dr Wakefield and his colleagues claimed to have found a possible link between the MMR vaccine and autism’. The word possible, here, implies that there may or may not be a link. However, in publications with an anti-MMR agenda, we often see something different. The opening line from a Daily Mail article, for example, reads: ‘The authorities still refuse to admit any link between autism and the MMR jab’. Here, the claim about a possible link is strengthened by prefacing it with the words the authorities still refuse to admit. Not only does the verb admit imply that the link is real, but the phrase still refuse implies that the authorities have known about the link for a long time and have concealed the knowledge.

When we look at the ways in which members of the public talk about the MMR-autism link, we find they too tend to express their ideas with a relatively strong degree of certainty. In the following example, a discussion forum contributor states explicitly that she believes there is a link, and she emphasises the strength of her belief by adding the word do: ‘I do believe there is a link between vaccination and autism spectrum disorder in some people’. Another forum contributor thinks that the cause-effect relationship between MMR and autism is almost certain, since she poses the question, ‘does this mean that the single vaccine may also cause autism?’ The following individual makes what is possibly the strongest claim of all: ‘MMR kills and causes autism’.

We can infer from the discourse surrounding the MMR controversy of ten years ago that the ways in which scientific claims are reformulated once they enter the wider public sphere can have far reaching implications.