Ben Goldacre, Saturday 10 October 2009, The Guardian
Last month I had a debate at the Royal Institution with Lord Drayson, the Science Minister, in which he argued that I was too harsh on British science coverage, which is the best in the world. During this event our chairman (bizarrely and excellently Simon Mayo) pulled out a health front page from the Express, and asked what we thought about it. I said the article might well be accurate, but it’s also quite likely to be a work of fantasy, and as a serious matter of public health I would urge people to be extremely sceptical about health information on the front page of the Express. Lord Drayson thought this was cynical and unfair. He warmly encouraged us to trust this newspaper.
And here comes the proof in a new front page story. “Jab ‘as deadly as the cancer’” roared the giant black letters on the front page of the Sunday Express this week. “Cervical drug expert hits out as new doubts raised over death of teenager” said the subheading, although no such new doubts were raised in the article. We will now break with tradition and reproduce a whole paragraph from the Express story. I’d like you to pay attention, and perhaps build a list of its claims in your mind. This is one of those stories where every single assertion made on someone else’s behalf is false.
“THE cervical cancer vaccine may be riskier and more deadly than the cancer it is designed to prevent, a leading expert who developed the drug has warned. She also claimed the jab would do nothing to reduce the rates of cervical cancer in the UK. Speaking exclusively to the Sunday Express, Dr Diane Harper, who was involved in the clinical trials of the controversial drug Cervarix, said the jab was being “over-marketed” and parents should be properly warned about the potential side effects.”
The story seemed unlikely for three reasons. Firstly, Professor Harper is not a known member of the antivaccination community, which is vanishingly small. Secondly, it was on the front page of the Sunday Express, which is indeed cause for concern. Lastly, it was by specialist health journalist Lucy Johnston, whose previous work includes “Doctor’s MMR fears”, “Exclusive: Experts Cast Doubt On Claim For ‘Wonder’ Cancer Jabs”, “Children ‘Used As Guinea Pigs For Vaccines’”, “Dangers Of Mmr Jab ‘Covered Up’”, “Teenage Girls Sue Over Cancer Jab”, “Jab Makers Linked To Vaccine Programme”, and so many more, including a rather memorable bad science story, the front page: “Suicides ‘Linked To Phone Masts”.
So I contacted Professor Harper. For avoidance of doubt, so that there can be no question of me misrepresenting her views, unlike the Express, I will explain Professor Harper’s position on this issue in her own words. They are unambiguous.
“I did not say that Cervarix was as deadly as cervical cancer. I did not say that Cervarix could be riskier or more deadly than cervical cancer. I did not say that Cervarix was controversial, I stated that Cervarix is not a ‘controversial drug’. I did not ‘hit out’ – I was contacted by the press for facts. And this was not an exclusive interview.”
Professor Harper did not “develop Cervarix”, as the Sunday Express said, but she did work on some important trials of Gardasil, and also Cervarix. “Gardasil is not a ‘sister vaccine’ as the Express said, it is a different compound. I do not know of the side effects of Cervarix as it is not available in the US.” Furthermore she did not say that Cervarix was being over marketed. “I did say that Merck was egregiously overmarketing Gardasil in the US- but Gardasil and Cervarix are not the same vaccines.”
And here is the tragedy. In a clear example of the extent to which academics are often independently-minded about the interventions they work on, Professor Harper is a critic of Gardasil, or more specifically of how it is marketed.
Briefly, her view (which has been published a long time ago) is that we do not yet know how long the protection from these vaccines will last, and this will affect the cost-benefit decisions. She is concerned that aggressive advertising aimed directly at the public – which is not permitted in Europe, with good reason – may lead people to falsely believe they are invincible to HPV, and so neglect other precautions. Lastly, she suspects from modelling data that for the specific and restricted group of women who are punctilious about attending every single one of their cervical cancer screening appointments, vaccination may have little impact on their risk of death from cancer; but even this group will still benefit from the reduction in reproductive problems caused by treating precancerous changes in cervical cells, and from avoiding the unpleasantness of screening and treatment.
The article has now disappeared from the Express website, and Professor Harper has complained to the PCC. “I fully support the HPV vaccines,” she says. “I believe that in general they are safe in most women. I told the Express all of this.”
Her criticisms of some aspects of cervical cancer vaccination are nuanced and valuable, but they do not fit into the black and white hysteria of the British news media. It would be nice if we could have a public discussion about the relative risks and merits of different treatment options. Sadly, with this kind of ugly reporting, scientists around the world may learn that such a discussion is not currently possible in the UK media. That is the greatest tragedy.
Simon Mayo thinks the original version of this article reads as if the the front page story discussed a month ago in the debate with Lord Drayson is actually this week’s cervical vaccine scare story from the Sunday Express. I’ve added an extra sentence above to make it as clear as possible, informed the Guardian, and I hope nobody feels misled. They are of course two separate stories, and my point – which I hope is very clear and also taken – that Lord Drayson is wrong to describe the front page of the Express as a reliable source of information about health.