Health scare stories rarely add up
If you read enough news stories about public health issues, they all start to sound the same. The headline warns us about a threat to our health. Public health officials attest that the threat is very real and advise us to be very careful, because it could happen to you or someone you love. They offer advice, such as scheduling an appointment with your doctor or getting a vaccine, if one’s available.
Reading these pieces carefully, though, reveals that the stories told by health officials often don’t quite add up.
A recent article in The Detroit News is a case in point. The headline reads: “Michigan health officials work to head off outbreak as measles cases emerge.” Readers immediately learn that Michigan’s public health officials are so dedicated that they run to their stations if there’s just one case of measles detected anywhere in the state. It “triggers an ‘aggressive, timely, and prioritized public health response.'”
That makes the current threat sound very serious. But then readers learn that health officials have identified only three cases. And they’re all unrelated. There is no evidence that measles has spread from person to person anywhere in Michigan.
Health officials use these three cases to urge people to get the measles vaccine. One says that your vaccination status is the “largest predictor” of whether you’ll get measles or not. The CDC calls measles a “vaccine-preventable disease.” The health officials say everyone should get vaccinated.
But later, readers learn that the CDC actually considers anyone born before 1957 immune to measles. Not because they’ve been vaccinated, but because they likely have natural immunity from being exposed to the disease when they were young. So, despite what these officials are saying, not everyone needs to get vaccinated apparently.
The article doesn’t say if the three people currently with cases were vaccinated or not. What we do learn is that all three — one child and two adults — had recently traveled internationally. This is the main thing the diseased have in common. No health officials warned against international travel, however.
There’s other confusing information about vaccination rates and community spread. The article alerts readers that measles is “a highly contagious disease,” and a health official says the disease will spread in “a population of under or unvaccinated individuals.” One expert is more specific: If a population has less than a 95% vaccination rate, “it’s very easy for them to start spreading it around.”
Hearing that there’s no evidence of transmission, one might assume that the communities where these cases were found have high vaccination rates. But that’s not the case. In Wayne County, where one case was identified, just 61% of kids are vaccinated, according to the article. Another case surfaced in Washtenaw Country, but the rate there is only 72%. In Detroit it’s worse: Only 51% of kids are vaccinated for measles. The article does not explain why only the vaccination rates for children are reported or why these rates are important. But if what the health officials said above is true, it makes one wonder why measles isn’t easily spreading in these areas already.
One health official implies later that vaccination actually doesn’t prevent infection. It only makes someone’s chance of contracting measles a “low concern.” To recap, health officials say that what matters most to measles spread is the vaccination rate and that outbreaks will happen in populations with less than 95% coverage. But also you can still get measles if you’re vaccinated. And it’s not currently spreading among Michigan populations with vaccine coverage significantly lower than 95%.
A few days after this story about measles appeared, a similar one warned about influenza. Sadly, a child from Michigan died. Readers learn nothing about the circumstances surrounding this death, such as the location, the age of the child, if there were other health complications, how the disease was obtained, how it was treated or if the child was vaccinated. Instead, health officials just said everyone but newborns should go get the flu vaccine. One official suggests children might want to get two. So far, only 25% of Michigan residents have followed this advice.
It seems like there must be more to these stories because much of the information is difficult to square. We shouldn’t expect health officials to explain every detail or even understand everything, but they should at least paint the whole picture. They often appear fixated on vaccination rates, for example, even when it’s obvious that the transmission puzzle is more complicated.
Health officials might respond that a simple message is most effective. And that’s true. But there is a limit. The message still needs to fully inform. Completeness shouldn’t be sacrificed for simplicity.
In the article about measles, one health official blamed Michigan’s relatively low vaccination rates on the fact that the state’s “public health system is breaking down.” That may be true, and some of the blame might fall right at the feet of public health officials themselves.
Editor’s note: This article originally was published by the Mackinac Center for Public Policy.