‘Seeds of fear and mayhem’: Concerns media hindering vaccine rollout

Anastasia Tsirtsakis

16/04/2021 3:58:04 PM

Journalists have a responsibility to not undermine the science and contribute to issues of vaccine hesitancy, according to the RACGP President.

A person using a smartphone.
There are fears intense media scrutiny may be overstating rare associated risks and increasing vaccine hesitancy.

This article was updated at 3.45 pm on Monday 19 April to include the TGA's findings.

NSW vaccine death
NSW woman dies of blood clots after jab
Investigation into post-jab death
NSW woman dies days after receiving Covid vaccine
NSW woman ‘dead from blood clots’ after COVID-19 vaccination

No change to vaccine advice for older Australians after woman’s death ‘likely’ linked to AstraZeneca jab

These are among the headlines that surfaced last week following the death of a 48-year-old woman in New South Wales who had suffered blood clots. She received the AstraZeneca vaccine from her GP on 8 April, prior to the Australian Technical Advisory Group on Immunisation’s (ATAGI) decision that Pfizer be the preferred vaccine for patients under 50.  
An investigation by the Therapeutic Goods Administration (TGA) and NSW Health found the death was ‘likely linked’ to the vaccine
However, concerns have emerged over the media’s coverage and scrutiny of what is a very sensitive issue, and its impact on undermining public messaging amid the mass vaccination campaign.
RACGP President Dr Karen Price said the reporting around the woman’s death during the course of the investigation, when the TGA had yet to draw a conclusive link, was ‘irresponsible’.
‘It’s terrible,’ she told newsGP.
‘Firstly, it is a person’s private health information which has been splashed across the news – that’s absolutely appalling. That person’s privacy and their family’s privacy, at a time of grief, needs to be respected.
‘If [a link is] not confirmed, it has to go through a proper scientific process to establish the facts, and I would have thought that one of the journalistic imperatives is to establish the facts, not to sow seeds of fear and mayhem. In the middle of a crisis, the last thing we need is [further] anxiety.
‘Calm down and be responsible with reporting standards in a pandemic in which everyone has a responsibility to their community.’
To date, Australia has had three confirmed cases of blood clotting – thrombosis with thrombocytopenia syndrome (TSS) – out of more than 855,000 doses of AstraZeneca, putting the current risk at one per 295,000.
GP Dr Chris Moy, Vice-President of the Australian Medical Association, said many in healthcare have long feared the intense media scrutiny of the vaccines, as conclusions are being drawn and shared by people with little to no expertise.
‘The concern is that this over-analysis at the moment, without real knowledge, is essentially the media playing doctor, and it’s actually causing a material effect on vaccine confidence,’ he said.
‘[This] really shouldn’t be the role of the media.’
GPs have directly felt the effects, with patients expressing increased uncertainty and hesitancy regarding uptake of the vaccine.
Dr Price has experienced this hesitancy firsthand. She says it has made what should have been a relatively straightforward rollout ‘really complicated’.
‘I can’t think of a consultation which hasn’t been extended because of the fact that I need to talk very clearly to patients about the vaccines, and about assuring them of their safety,’ she said.
‘We know that particularly high-risk patients – we’re talking over-50s who’ve got chronic, complex medical conditions and so forth – the risk–benefit for them having AstraZeneca is clearly in their favour.
‘The risk of them contracting COVID and having a serious complication – dying from it or having the long COVID syndrome – are significant, including clots from COVID.
‘So I would ask that there is some perspective applied to this.’
A new pre-print study by Oxford University, released on 16 April, analysed the incidence of cerebral venous thrombosis (CVT) among those who contracted COVID-19 and others who were vaccinated with either AstraZeneca or an mRNA vaccine and found people have several times the risk of developing clotting from a COVID infection.

When it comes to pandemic messaging, RACGP President Dr Karen Price says the media must be mindful of the responsibility.

Many countries around the world have entered their third wave of COVID, with Brazil and India experiencing catastrophic surges and thousands of deaths every day. GPs in Australia, however, face the very different challenge of discussing risk–benefit in the context of a country where community transmission remains low.
But Dr Price says all Australians need only look to their nearest neighbours in Papua New Guinea to realise the severity of the situation and understand that the benefits of vaccination, in the majority of cases, outweigh the risks.
‘This virus is still at our borders – this is a huge issue,’ she said.
‘I saw Dr [Anthony] Fauci talk about the fact that none of us are safe in this world until every country is really free of the pandemic.
‘By putting our vaccination rollout at risk with poor reporting standards, we are then going to have an unvaccinated country and we’re not going to be able to open our borders.
‘The risk is only pertaining to the current, what I call, epidemiological environment. If that changes, we have a whole other new maths equation to work through.’

Chief Medical Officer Professor Paul Kelly says it is not a question of if, but when community transmission rates of COVID-19 will rise again in Australia.
‘We are in a very unusual situation here in Australia at the moment, with no community transmission and very few cases right throughout this year. That will not continue,’ he said.
‘We will at some point in the future, we do not know when, but we will have cases here in Australia.
‘The chances of being infected will increase, so being vaccinated is a protection not only for yourself, but also for the people you care for, if you're working for example in an aged care home or a hospital, your family, and the wider community.’
Dr Lucas de Toca, the Department of Health (DoH) First Assistant Secretary for the COVID-19 Primary Care Response, says the messaging around vaccination is a ‘delicate balance’ between institutions being transparent about any findings and not undermining confidence through a perception of risk that may not be statistically significant.
‘Trust in the institutions, the TGA and the strict regulatory processes that we have in Australia is fundamental for confidence in the entire program,’ he said during the DoH’s recent webinar for GPs involved in the rollout.
‘But I think the important bit is that we continue to be committed to being absolutely transparent as to what the findings are, and what the advice is so that people know that when we’re making regulatory decisions, when the TGA is putting out statements, it’s with all the information and never withholding anything.’
Dr Price agrees.
‘By constantly jumping on any minor change or deviation, the [media] are making it appear as if there is no plan. The plan is safety,’ she said.
‘The ability to estimate risk is a really challenging one, and to get that communication wrong and put the rollout at peril because of poor understanding of pandemic science communication, I find extraordinarily upsetting because it’s reducing confidence.
‘We need to understand very clearly what the situation is, and we need to be able to explain that very clearly to people so they can make their own decisions.
‘The science has got us to a safe place in Australia, and it will continue to get us to a safe place.’
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Dr Claire Louise Palmer   20/04/2021 6:23:53 AM

I completely agree here. The media are behaving in a very irresponsible way and there seems no way to make them accountable either.

Dr Jeanine Suzanne McMullan   20/04/2021 7:30:39 AM

If you gag doctors through AHPRA and TGA legislation on talking about the vaccine and the vaccine rollout what did you think was going to fill this vacuum?

Dr Ian   20/04/2021 8:50:16 AM

The fact is that if three hundred thousand AstraZeneca doses have been given to patients aged 18-50 then three clots means one in one hundred thousand and if less doses were given say to females between 18-50 it would be happening more often than that .
Those figures have to be analysed .
Denmark claimed one in 40,000 suffered clotting and that is too much .
There is enough mRNA vaccine to give to all under 50 health workers and that ought be the rule .
If unavailable platlet counts factor 4 platlet factor and D dimer ought be available to all AstraZeneca under 50 as part of informed consent at days 4 10 and 14 because there is treatment possible IV immunoglobulin for example .
I would advocate half dose for under 50 it worked in the trials .
The media is in negative shock mode but a lot of EU lands have said no for under 50 and the UK has said No for under 30 .
For over 60 it seems far safer we don’t know why .

Dr Andrew Carr   20/04/2021 9:35:26 AM

That is the media business model and we should accept that and work out what we can do in response. For them, the more crisis and controversy the better, and they have the attention of the public and we don’t. Misinformation is a huge public health problem and we need to address it.
Quickly discussing vaccination pros and cons in an ever changing vaccine environment, at the end of a long list of other issues during a chaotic GP appointment does not give the impression that the vaccine rollout is well coordinated.

RACGP, AMA and public health bodies also need the attention of the public. Prime time TV, YouTube channels, social media. We need to educate the public about risk perception.

Dr Bryan Connor   20/04/2021 4:42:02 PM

I agree entirely with Karen. We need herd immunity as soon as possible to get our freedoms back and that means mass uptake of the vaccine. The problem is that our medical organisations, politicians and their CMOs were happy to catastrophise about Covid-19 risks to the same group ( healthy people under 50, who aren't obese) last year, that they now want to rationally explain risk to. The fact that their risk of dying of Covid is only 10 times more than a vaccine death is lost on them because of all the hyperbole around their personal risk. Doctors know that a 1:2-300,000 risk of TTS and a 1:1000,000 risk of death is miniscule. You can't have it both ways and the media know that fear and tragedy get far better ratings than unsensationalised scientific fact. You reap what you sow.

Dr Peter JD Spafford   20/04/2021 8:05:45 PM

"the truth is out there". Attention needs to be paid to post marketing effects. Research into the safety of the vaccine is very limited due to time frames and numbers. There is no information on long term effects. Risk vs benefit is the overarching equation. There is not enough information for for doctors to give to anyone to make an "informed" decision. So do we believe Governments or facts? After all politicians are only there to win the next election.