Media

Dropping Science

The Toronto Star’s scandalously bad article on HPV vaccines illustrates a larger problem with Canadian newsrooms

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• 1,277 words

Detail from the Feb. 5, 2015 cover of the Toronto Star

The Toronto Star is the best investigative newspaper in Canada. In recent years, it broke Jian Ghomeshi, Rob Ford, the ORNGE scandal, and numerous other stories. To their credit, editor Michael Cooke and publisher John Cruickshank clearly take this sphere of journalism seriously, and have ploughed millions into these investigations. (Lawyers’ bills alone are enormous for stories such as these.) Without the Star, Jian Ghomeshi might still be the host of Q, Rob Ford might still be mayor of Toronto, and Chris Mazza might still be running Ontario’s air ambulance service.

So it says something that even the Star could have botched a story as badly as it did on February 5, when it splashed a gruesome banner across its front page, entitled “A wonder drug’s dark side.” The drug in question—the vaccine Gardasil—is indeed a wonder drug. By preventing human papillomavirus infections clinically associated with deadly cancers (of the cervix, most notably), the vaccine can help save hundreds of Canadian lives every year—not to mention many tens of thousands of lives around the world.

But that was not the focus of the Star’s story. Instead, reporters David Bruser and Jesse McLean zeroed in on a small group of vocal patients, family members, and activists who claim—without evidence—that Gardasil injections cause a range of severe medical problems. As noted by many prominent critics from within the medical community (including a long list of well-credentialed medical professionals, whose powerful letter to the editor was published in the Star almost a week later), the article is grossly misleading. General statements about the tested safety of the vaccine are embedded obscurely, while the horrifying tales of death and disability are splashed prominently throughout, including a huge photo spread. Any casual lay reader exposed to this article would have come away with the impression that this vaccine is dangerous.

The article is breathless and misleading—the Star letter writers argue—because the reporters who wrote it, and the anti-vaccination sources they relied upon, have no grasp of the difference between correlation and causation. It’s precisely the same error that many anti-MMR-vaccine activists make: the onset of symptoms associated with autism sometimes can coincide with standardized pediatric vaccination schedules, but that does not mean one causes the other.

As with the measles, mumps, and rubella vaccine, the HPV vaccine has been the subject of enormous epidemiological study. Almost 170 million doses have been administered worldwide. One of the largest studies of the drug’s safety was funded by national governments (Sweden and Denmark)—not drug companies. It found no increased risk of autoimmune conditions, neurological diseases or blood clots, the most commonly alleged medical harms claimed by HPV vaccine opponents.

On the other hand, who is going to focus on these sort of dry statistical studies, when you can go to the Toronto Star and get vignettes like this?

One [girl] needed a wheelchair, another a feeding tube. A 14-year-old Quebec girl, Annabelle Morin, died two weeks after receiving the second injection of the vaccine. It was 7:30 p.m. on the night of Dec. 9, 2008, when her mother, Linda, found her in the tub, her head underwater and turned to the side. The paramedics lifted Annabelle’s body on to a stretcher. “I put a blanket on her, saying, ‘She’s going to freeze,’ ” Linda recalled. “I did not know she was already dead.”

That is a heartbreaking story—so heartbreaking that it destroys the ability of most readers to rationally assess the statistically proven risk of dying from taking the HPV vaccine, which is zero.

Anti-vaccine activists will claim that such articles simply provide “balance” in a media environment otherwise dominated by journalists (like me) who rely on government bodies, respected academic studies, and public-health experts. But the media’s obligation to present balance applies only when there is a genuine controversy in the mainstream, peer-reviewed scientific literature. That is not the case here. On CBC Radio, Dr. Yoni Freedhoff called the Star story “one of the worst examples of false-balance journalism I’ve read.”

One possibility is that the Star reporters in question—Bruser and McLean—knew all this, and wrote it up anyway. If so, that would be journalistically unconscionable. Under this theory, the two reporters would have knowingly published a story whose effect would be to discourage Canadians from taking potentially life-saving medication that carries no proven risk. I would never level that charge against journalists without proof.

Instead, I prefer to assume that the pair simply don’t understand science or statistics. Nor did their assigning editor, or any of the other editors who worked on this massive front-page piece. From my experience in a newsroom, I’d estimate that at least half a dozen senior editorial staffers would have read such a legally sensitive piece before its publication.

And there is the real scandal here. None of those people had the basic scientific literacy to know that what they were putting on the front page of Canada’s biggest newspaper was misleading tripe. And we are not talking about quantum physics here—but rather the basic, high-school science-class principle of cause and effect. That’s pathetic.

The Star’s reaction to the whole affair comprises a second scandal—this one having nothing to do with scientific ignorance, but rather with ass-covering organizational-behaviour reflexes. Soon after the front-page story appeared, several medical professionals posted rebuttals on social media. Prominent among them was Dr. Jennifer Gunter—a board-certified OB/GYN, and a recognized expert in vulvovaginal disorders. (“One of my specialties is treating women with autoimmune conditions of the vulva and another is treating vulvar pain and pain with intercourse for women who have had surgery and/or radiation for cervical, vaginal, and anal cancer due to the human papilloma virus,” she recently wrote—so yeah, she’s got this one.) Earlier this week, this website reposted an essay by Gunter that put the entire Star newsroom on notice of the page-one fiasco. The paper’s response? Heather Mallick, a Star columnist who tells readers she is “trying to teach myself about statistics and science so as to find a way through the fog” slagged off Gunter as a mere “rural doctor.” Meanwhile, when health reporter Julia Belluz called Star editor Michael Cooke for comment, he dismissed her as a Gardisil shill. (Belluz’s chronology of these events, published at Vox.com, is worth reading.)

Yesterday, someone from the Star finally manned up and admitted that it was the newspaper—not some “rural doctor”—that was in the wrong. “We failed in this case,” Cruickshank told CBC Radio host Carol Off on As It Happens. “We let down. And it was in the management of the story at the top. . . . It’s especially troubling that the treatment was in that way during this period that there is an extraordinary debate over inoculations, frankly, between science and nonsense. And we have, at this newspaper, always been on the side of science.”

Well said, Mr. Cruickshank. Better late than never. (Oh, and we’re still waiting to hear directly from Mr. Cooke.)

The overarching problem, of course, is that everyone in the mainstream media says they’re “on the side of science.” But what this episode shows is that there are precious few journos who actually understand what science is.

Maybe the next hire at the Star should be someone with a degree in the health sciences. Someone with the credentials of—oh, I don’t know—Dr. Jennifer Gunter? And if they used Mallick’s salary to fund the position, you wouldn’t hear any complaints from me.

Jonathan Kay (@jonkay) is the editor-in-chief of The Walrus.


  • Barbara Kay

    Excellent summary and you took the Star on well-deserved trip to the woodshed. I think trading Heather Mallick in for a serious journalist with a background in public health (like the reporter at the CBC – Avis Favreau or something?) who covers the health beat would be a win-win for the Star and all Canadians.

    • WarOnMugs

      This is just too cute.

  • https://twitter.com/jonkay Jonathan Kay

    I should note that this comment thread is open to all readers — not just my immediate family.

    • MattGurney

      Hey guys! What’s up?

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  • yonifreedhoff

    Thanks for this. And hope you and yours enjoy The Island Cow, Cheeburger Cheeburger, The Lighthouse, Sweet Melissa’s and more. The new taco place – don’t bother.

  • slavitch

    Why doesn’t The Star team up with the Canadian Medical Association Journal, which has reporters on staff that are actual doctors?

    • jwoodgett

      Because there would have been no story to print?

      • n s

        Because the CMAJ is part of the problem. Do your history.

  • jwoodgett

    Margaret Munroe was just let go by the NatPo. She’d be a welcome addition to the Star (or Walrus) as her sense of science is impeccable.

  • slavitch

    It’s amazing how much Dunning Kruger comes into play here. The Star is too stupid about science to realise they’re being stupid about science.

  • WarOnMugs

    Back in my J School days, the venerable Peter Calamai was the Star’s science reporter. Do they even have one now? Do any newspapers of record in Canada? Botch ups like this show exactly why such journalists are needed.

  • Allison McGeer

    Although some editors at the Star seem to be listening, Kevin Donovan, the investigative editor, is not. He still thinks the story was fine

    http://canadalandshow.com/article/toronto-stars-head-investigations-stands-hpv-story

  • Keith Duhaime

    Excellent! My only criticism is it doesn’t go far enough. It’s not just reporting on health issues that gets dropped. I’m an agrologist, and far too often we are seeing the media drop the ball on agricultural issues. GMOs are a good example. Too often the non-sense of the anti-GMO movement is making the media, and far too often we are seeing reporters not checking the facts on this class of very safe, effective, and beneficial class of agricultural technologies.

    • alsodanlowe

      You’re not wrong, and I believe GMOs will provide a wealth of opportunity even for our own bodies going forward, but the anti-GMO movement is not just about the technologies themselves. It’s about the attitudes of the companies forwarding them, companies that have gone to great extents to cover up other things. Their human rights records in respect to farm labor, their political gerrymandering by criminalizing seed saving, and their roles in influencing scientific publication and government oversight to name a few.

      Companies’ own behavior hinders our ability to completely trust their technologies. I firmly believe corporate corruption – not superstition – is the obstacle to things like GMOs, stem cells, and so on. People want progress, but progress isn’t what we’re getting.

      • Michael Kuzmin

        What do you think an average Canadian thinks when you ask them about GMO food? I’m more than confident that most people will associate it with unhealthy, dangerous, junk food. And this is is entirely due to that “anti-GMO movement”.

        • alsodanlowe

          I’d argue for something slightly different: that media reframed the message of the anti-GMO movement so that it was equated to unhealthy, dangerous junk food. Whether it was propaganda or just lazy reporting, we can’t say (but both do happen). So I don’t disagree with you, but I also don’t think we should ever judge the statements of a particular ideology on the basis of another audience’s misconception about it.

          As someone who has walked the halls of the actual anti-GMO movement, yes there are a lot of people who take a very unscientific ‘from-the-gut’ approach to the issue, who write it all off as bad, but that’s not the main context of the movement. The legislative battle this last election cycle in the US wasn’t to outlaw GMOs outright, but merely to label them. It was the claim of those opposed to labeling that this would misrepresent the products as being unhealthy, dangerous junk food, etc., a conclusion that consumer advocates simply don’t come to. This claim of misrepresentation comes from the same lobby that wanted to rebrand High Fructose Corn Syrup as Corn Sugar, and that operates hundreds of subsidiary brands that are really just a dozen companies, so they think in terms of propaganda on a daily basis. And it was the same argument used against nutrition and ingredient information historically. Why all the smoke and mirrors if this is truly just about acknowledging the science?

          So it’s not just the anti-GMO movement that we should credit for those attitudes, but the behavior of media and PR departments’ own clouding of the issue.

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  • n s

    Many years ago The Star did stories on the STATIN cholesterol lowering drugs, with ‘anecdotes’ and no “proof” (as would be defined by Kay). I thank them for the lives they saved, as we now know that negative trial data on STATINS harms were withheld from Health Canada, FDA et al. We now know of the hundreds of thousands harmed by those drugs.

    We now know, they help only a minority of the population who are prescribed them. And this knowledge was there at the beginning. It’s not like some learning they’ve done as we report, but pharma has fought citizen’s rights groups tooth and nail to keep the information suppressed, and most media have been happy to go along with it for their ad revenue.

    There are many other drugs for which full trial data was edited and suppressed, many thousands upon thousand injured, for life, and doctors are not mandated to report adverse effects.

    I thank The Star. As someone life-disabled by STATINS, I know that there are thousands just like me, and when we started asking and telling our “anecdotes” we were ridiculed, dismissed, and slandered.

    Today, we are proud to say we were the instigators of a $5 million NIH study into STATIN harms, and if you know what they can do, you owe it to those who told their story, and to The Star who listened. They started the ball rolling on the expose.

    • alsodanlowe

      Good to hear some pushback in this discussion. There’s a lot of people patting themselves on the back in this thread. The problem I have is when people react to the bias in the Star and ignore the potential that research might be wrong or that other complications can occur that weren’t predicted in any preliminary studies. Or that any scientific results should ever equate to absolute surety.

      In the case of Gardasil, I think there’s been enough evidence in practice to support Merck/FDA on the safety of their vaccine, and so to present the claims such as they were in the Star is going to bother a lot of people who understand statistics and causality. But criticizing someone else’s apparently unscientific bias also has the unfortunate effect of making us ignore the biases of the position we’re supporting.

      Merck spends about 25% more on marketing as they do R&D, and are selling another medication (Nuvaring) which is causing blood clots and heart complications, and was known to have these risks in initial testing, but went to market anyway because the FDA is a revolving door agency like most other departments in the age of paid political appointments. That settlement was around $100 million, and yet they’re still aggressively advertising the product and taking the position that injuries due to the drug are coincidental and not causal. Because they sell $600 million of the stuff every year.

      Moreover, to make a statement like, “. . . the statistically proven risk of dying from taking the HPV vaccine, which is zero,” we should also clarify that a “statistically proven risk” of zero is a different thing than a risk of zero. Yes, less than .0003% of everyone who has been administered Gardasil developed thromboembolism temporally, which is not statistically significant nor necessarily causal — and we should all recognize this — but that .0003% is still some 700+ people who have had complications, and some 30+ people who have died. In educating an audience on the nature of statistics and causality in scientific research, we need to preserve a little bit of skepticism, and some respect for the process of falsification. We respect the clinical results about Gardasil (regardless of Merck’s corporate shittiness) because it was tested under the assumption that it could at any time cause complication, using testing that itself is worthwhile because at any time it can be proven wrong or improved.

      Which brings me back to my ultimate frustration. I don’t mind calling out pseudoscience, but given the state of reproducibility in medical testing (http://www.newscientist.com/article/mg21528826.000-is-medical-science-built-on-shaky-foundations.html#.VN_XL_nF-RI) it’s absolute lunacy to act like our methodology is foolproof in 2015. Thinking we’re infallible once our results are satisfactory could be just as dangerous a form of denial.

      Also, in light of what we know about propaganda (https://firstlook.org/theintercept/2014/02/24/jtrig-manipulation/), critical thinking is as important as ever.

      • MBurdock

        Who’s saying that research is infallible? Anyone? I think what people are certain about is that the epistemic basis of science is vastly better than whatever went into the Star’s article.

        • alsodanlowe

          I probably should have said ‘in this vein’ and not ‘in this thread.’ I was projecting my frustration in general and not necessarily what was going on in these comments.

          The very epistemic basis you’re talking about gets dragged through the mud by a lot of pop science audiences who read into standard models as if they’re the final word and some indication that we have achieved a complete knowledge about a topic. I once got a week ban from Facebook for spamming every single comment on a BBC article that used Social Darwinism as the explanation for why people were trying to rush a train crossing. There were literally hundreds of people who used the example of ‘cleaning out the gene pool.’ Meaning they had very little understanding about the timescale of selective pressures or the extent to which a person’s behavior actually reflects their phenotype. Yet they were willing to publicly declare, ‘Good! They should be killed because that’s how nature works!’

          I’ve spent the last few years in Microbiology, but my first undergrad was in Philosophy, and I studied History and Philosophy of Science at the graduate level (pardon me, blah blah blah I realize), so I’m probably just hypercritical about crystallizing any scientific position as if it’s dogma. It’s why we’ve made so little progress addressing climate change, because people double-down on their position, even when new data is presented.

          And heaven forbid there be contradictory data, as in the case of comets being composed of water and ice, and we still go on presenting the standard model as if nothing has changed. There are hundreds of examples like this, which is why empirical study is so worthwhile.

          I just happened to take offense to the comment about the statistically proven risk being “zero,” because I was anticipating the people who arbitrarily latch onto data to fulfill their own expectations and certainty. Yes, fringe skeptics are guilty of this way more often, but we shouldn’t radicalize our own position in response to them.

          I also have a personal bias against Merck after I went to school in the shadow of their Boston facilities, and my sister was one of the people who developed heart complications after the first time she used Nuvaring. Could be temporal, not causal, but that’s an empirical determination and should have nothing to do with my wanting Merck/FDA/etc to be trustworthy.

          • MBurdock

            I did the opposite, science and then philosophy.

            At the risk of a ridiculous generalisation, I think it is all epistemics. The two sides in this debacle are either willing to discuss them or not and if it is the latter (which I suspect it is), there is little or no point to talking.

            I had hoped that journalism would side with the method that has the better track record while acknowledging its limitation. Because of the stupid headline and big stepdown, I don’t expect to see that nuance for a while.

          • Northernvisitor

            I value your thoughts, and those of MBurdock, your respectful give and take is what is required in a debate of this sort. There is a basic misunderstanding abroad in this world about the nature of the scientific method, and how rare absolutes are in it. We would like our world to be simple and black and white, but it isn’t.

  • n s

    P.S. Thank you Kevin Donovan and team.

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  • Sarah Gilbert

    While I am beyond appreciative that this story was “found out,” it makes me very scared about all of the inflammatory stories that get through to the public as “truth.” As a society, we live in a time of riding the extremes of media reporting. I work as a Social Worker in Toronto and cancelled my Star subscription years ago because I work in the real world and the appalling manner in which life is portrayed in print is incompatible with living a happy life.

  • margo may taylor

    welcome JONATHAN KAY to the walrus.. boy, do i like your style.. i would not line my green bin with the tripe that the star wrote concerning the vaccine Gardisil and that those in the position one would have thought of knowledge had the audacity to allow the article to go to print is in all honesty disgusting when one considers that we are discussing a national newspaper … sad oh so very sad …

  • Bill McIntosh

    Missing from this discussion is recognition of the reality that while mass vaccination programs are essential to public health, inevitably a few participants in some of those programs will be injured, in some cases fatally, by the vaccines they receive. The need for a national vaccine injury compensation program has been recognized and deliberated in Canada since the early 1980’s, to no avail. See: Liability and Compensation Aspects of Immunization Injury: a Call for Reform (http://digitalcommons.osgoode.yorku.ca/cgi/viewcontent.cgi?article=2030&context=ohlj) Only two G8 countries remain without a vaccine injury compensation program: Canada and Russia. See: The Case for a Vaccine Injury Compensation Program for Canada (http://journal.cpha.ca/index.php/cjph/article/viewFile/2936/2613). Hopefully the current controversy around HPV vaccines will lead to productive policy discussion and long-overdue reform on the vaccine injury compensation issue.

  • Northernvisitor

    There seems to be a general decline in quality among the practitioners of journalism. OK, the sports journos still know a lot about sports, but the science journalists no longer have any basic grounding in science, the political ones know insufficient political science, history or geography. On and on it goes. Journalism schools seem able to turn out publicists, and perhaps TV weatherpeople, but real educated editorial comment is increasingly rare.

    • Whiskyjack

      Well said. The amount of scientific illiteracy on display in this fiasco is appalling. It is a damning observation on these journalists that they felt qualified to report on a subject when they were manifestly inadequate for the task.

  • DJ Penton

    Wrong. Anecdotal evidence IS evidence. Scientific advancement does not start with statistically sound studies. It starts with anecdotal evidence, hints and rumours, etc.

    The current debate about vaccination is mostly a caricature: sound, evidence-based science on one hand versus nutty superstition on the other. That is a flat-out mistake.

    While a large proportion of practising scientists are completely convinced that the history, philosophy and sociology of science have nothing whatever to teach them, they are mistaken. Science makes errors from time to time. Think “thalidomide”.

    And while you’re at it, read works by Kuhn, Quine, Popper, Feyerabend and a host of others who will point out that science is all too fallible. You might also note that, in general physicists are considerably less dogmatic than people who do life sciences. The natural world is pretty tricky to understand, and Merck, Pfizer and Health Canada do not have the last word on it. The day that journalists need to blessing of scientists to comment on science will be a sorry day for journalism, and for human knowledge.

    Ask yourself how it is possible to read, in the very same edition of the newspaper, admissions that SSRIs may well not work as advertised over the past few decades, admissions that the science insisting on the dangers of cholesterol may be wrong, and then – wait for it – a categorical insistence that if one questions “scientifically proven results” one is irrational or irresponsible. In the end the benefits of vaccination may outweigh the risks. (I get flu shots myself.) But the current hysteria over vaccination raises belief in science to belief in authority, not reason.

    • Brendan O’Fecalith

      Wrong. If you have read and understood Kuhn, Quine, Popper, Feyerabend et al. you will have become acquainted with the concept of conventional truth. What scientists at work do is test, over and over, discovered and agreed-upon evidence and its theoretical extensions. It is as great a misconception to believe that science is absolute as it is to believe science is ‘all too fallible.’

      Evidence-based science is the best way to successfully negotiate the material world, and accomplish real things. You can argue yourself into any belief, but only the scientific ones survive real-world correctives.

    • Michael Kuzmin

      It’s like saying all evidence suggests that humans can’t fly.. but I feel like I can fly therefore there is evidence to the contrary. While technically true, you seem to be ignoring the fact that sound scientific research overpowers any evidence suggested by non-experimental anecdotal co-occurrences. So yeah, there IS evidence to the contrary. But that evidence is garbage and suggesting otherwise is borderline (or perhaps even straight) malicious.

  • Max_Taffey

    How Heather Mallick remains gainfully employed is a puzzle for the ages.

  • CaptainJack

    The ridiculous reaction to the Star’s Gardasil story is an assault on freedom of speech and freedom of the press, and is typical of the Canadian taboo against mentioning vaccine injury. Vaccine injury is real; the fact it is rare makes it no less real. We should be able to talk about it. And healthcare practitioners are compelled to talk about it in their duty of informed consent. We have to ask ourselves why we in Canadian society were so quick to vilify the Star for what it didn’t say and so eager to ignore what it did say. Self-respecting journalists everywhere should stand up and fight for the Star story. Instead, they have positioned themselves on the wrong side of this debate. History will point to the true failures after healthcare reporting in this country is reduced to mere PSA.

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