This presentation examines communication related to vaccination from the perspective of the media, the public, health professionals, and information providers. Dr. David Salisbury begins by exploring what he calls "the new role" of the media in reporting on vaccination issues. He points out that vaccination affects large numbers of media consumers (readers, viewers, or listeners). What he calls "the science element" lends an "aura of mystique" to the issue of vaccination for those exposed to media reports. However, Salisbury argues that vaccine professionals are wrong to assume that the media share their views; it is crucial to recognise the media's independence. What emerges as a key communication challenge - and a key focus of strategic thinking on this issue - is the fact that what is feared is not the communicable diseases themselves but, rather, the vaccine. For example, scare tactics are sometimes used to communicate risks (perhaps unsubstantiated) associated with vaccines - both to children and to adults. Salisbury presents a media report in El Nuevo Diario suggesting that the government puts an anti-fertility agent into the tetanus toxoid (TT) vaccine. As illustrated by this example, the issue of vaccination can take on a 'political' tone: it is recommended by governments. There is a sense, too, that there is a divide between the average citizen considering vaccination, on the one hand, and the "establishment" or experts, on the other.

Salisbury then focusses on the tactics that anti-vaccine groups use to galvanise the media for their cause. He cites vague references to "Scientists..." - perhaps unqualified individuals with a mission - as a tool for establishing the credibility of "rogue views". The media exacerbates the problem by reporting findings as scientific truths, while failing to report negative findings that deny earlier false claims.

These tactics have, in Salisbury's estimation, contributed to a media environment in which the public has sometimes been "duped", or misled by false information about the safety of such vaccines as Measles, Mumps, and Rubella (MMR). As an example, Salisbury discusses the media flurry around Dr. Andrew Wakefield's claims about a link between MMR and autism. Specifically, Salisbury claims, over half of the British public wrongly believed that medical science was split about the safety of that vaccine. He indicates that, "although almost all scientific experts rejected the claim of a link between MMR and autism, 53% of those surveyed at the height of the media coverage assumed that because both sides of the debate received equal media coverage, there must be equal evidence for each. Only 23% of the population were aware that the bulk of evidence favoured supporters of the vaccine". Since media coverage can impact public behaviour, Salisbury is concerned that giving undue prominence to 'scare' stories can increase rather than reduce health risks. The Internet, he says, is a particularly worrisome source of information exchange in this context, as information is unregulated.

In light of these findings, Salisbury urges that research questioning the safety of widely used vaccines be approached with caution, both by scientists and journalists. "This is especially the case", he says, "where any decline in confidence can have serious consequences for public health". He indicates that, in the wake of the Wakefield/MMR episode described above, 48% of the public agreed that, on matters of public health, journalists should wait until other studies confirm findings before reporting alarming research.

Finally, Salisbury reviews some research that gauges the vaccination-related communication needs and preferences of UK mothers. (Twice each year, a market research company interviews 1,000 mothers of children under 3 years). The aim of this research is to provide information for strategic planning on mothers' knowledge of, attitudes toward, and experiences with immunisation. Mothers have indicated that they want information - and they want those who provide it to be clear, consistent, and open. They want full access to the facts and to further information and resources. In short, they desire an evidence-based approach, and want to be empowered to find that evidence for themselves. In light of these findings, Salisbury concludes by urging that vaccination professionals "must compete effectively and dedicate as much effort to communicating on vaccines as we do on providing them".

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