The story is amazingly silent on the message that there is controversy about vaccinating young men. The story states that the FDA approved the vaccine, but the CDC does not routinely recommend it. That begs an explanation to readers of why. In contrast, the competing WebMD story pointed out that this study just adds to the larger debate over whether there should be universal vaccination of young men.
Since Gardasil (and competitor, Cervarix) debuted a few years ago, there have been heated disagreements about the price and most helpful distribution of the vaccines and whether both sexes should receive them.
This major study, demonstrating effectiveness in young men, adds important information to complex questions of cost and prevention. But it needs to be reported in a way that provides some of the history and context for readers. HPV infection is transmitted sexually, so questions of prevention within the entire US population of men and women involve potentially vaccinating both sexes. However, both sexes are not at the same level of risk for potentially deadly cancers years later. Women bear the brunt of the health risks, but men can pass the infection to their partners and can suffer from cancerous and non-cancerous effects of the virus.This new study provides additional information for the ongoing discussion of the public health role of immunizing young men against HPV.
Yes, the story provides the retail price of the vaccine. But we would have liked mention of the deeper economic questions. Are insurers covering it for young men? Does the overall economics of paying for young men to get it makes sense for society? Cost is part of the reason that only a minority of young women have chosen to get Gardasil, even though it is both available and recommended (by many) for them.
Cost is a central issue in how these vaccines will or won’t achieve medical goals of prevention. When writing about vaccination programs, these larger system-wide costs and benefits are an important part of public discussion.
The editorial that accompanied the published study in the journal provides additional information on the cost effectiveness of HPV vaccination in boys and girls – which could have been tapped.
Neither this nor the WebMD story gets high marks on describing the potential benefits seen in the study. Although a total of seven endpoints were described in the study results, the writer chose to use the most optimistic of the lot. The 90% efficacy quoted is a far cry from the actual 60% efficacy based on an intention to treat analysis. The study results are complicated and simply picking one number of the many does not provide the reader with the correct information. THe vaccine was not shown to be 90% effective overall.
There wasn’t a single mention of potential harm to any study participants, and there wasn’t a sentence saying, "Researchers did not find any significant harm for those who received the vaccine."
In the broader social context, there was no mention of whether the vaccine might falsely lead young men to feel they are "safe" from a sexually transmitted disease, when the vaccine only covers four types of the human papillomavirus, and there are many more that are not covered.
It was good to see the story included the size of the study population and the fact that it was randomized and included three-year follow up.
Barely satisfactory because the story skated close to an edge. For example, "HPV is the leading cause of cervical cancer in women but also has been linked to penile and OTHER malignancies." What other malignancies? How common are cervical and penile cancer? It would have been better if the sentence about "most people will clear the virus naturally" had been higher in the story.
Barely satisfactory. The story notes that the research was partially funded by Merck, the manufacturer of the vaccine. It quotes only one expert not affiliated with the study, and would have been stronger if that single expert was not from the American Social Health Association, which lists advocacy for these vaccines as one of its stated positions.
The story does not explain the existing treatment (or lack of treatment) for HPV infections in young men. Although far from perfect as a preventive, the use of condoms could have been given some space in the story along with limiting the number of sexual partners or abstinence.
The story met this standard by telling us the vaccination is "approved" by the FDA, but not "recommended" by the CDC advisory board. Some readers will be a bit confused processing that seeming contradiction.
Even better would be telling us why these two "expert" bodies appear to disagree about the widespread benefits to most young men. How about saying: "While the FDA labeled the vaccine as safe, the CDC’s advisers do not recommend it for routine use." Why not? Even better would be a quote from one of those advisors about the why not, and whether this new evidence has the potential to change CDC recommendations.
The story did not provide any information about the novelty of Gardasil, one of the first vaccines of its type. It also does not mention that there is another vaccine, Cervarix, which also exists against some HPV. WebMD did a better job of this.
The story shows evidence of original reporting.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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