For the sake of public health, the press must avoid sensationalizing stories about adverse reactions to COVID-19 vaccines
Proper context can prevent readers from overestimating the odds of allergic reactions
It’s been an exciting and hopeful past couple of weeks in the world of COVID-19 vaccine news. On December 11, the Food and Drug Administration issued an emergency use authorization for a two-part novel coronavirus vaccine produced by Pfizer-BioNTech, and over half a million doses were administered in that first week. On December 18, the FDA issued emergency authorization for a second vaccine produced by Moderna.
This good news isn’t without a few bumps in the road. Shipments of Pfizer’s vaccine have been delayed and piled up in warehouses as the company awaits instructions on where to send them, and states have been told to expect to receive fewer doses than had originally been planned.
There have also been a few stories about people who have had allergic reactions after receiving the vaccine. When stripped from context, these stories can come off as unnecessarily alarming.
The public has a right to know about problems with the vaccine rollout, and journalists have a responsibility to take extra care to not induce unwarranted panic.
Last Wednesday, The New York Times published an article about two health care workers in Alaska who had a negative reaction to Pfizer’s vaccine. The story itself is a straightforward report and includes some helpful context for readers. One of the two workers experienced puffy eyes, lightheadedness, and a scratchy throat, but was treated and released within an hour. The other worker’s story was more serious and included a short stay in the hospital’s intensive care unit.
Importantly, the Times noted that the hospital had administered 144 doses and added that both workers still supported the vaccine and didn’t want their reactions to impact others’ abilities to get it.
Where the Times may have erred, however, is how it presented the story to the public. People subscribed to the newspaper’s push notifications received an alert as soon as the article was published. “A health worker in Alaska had a serious allergic reaction after getting Pfizer’s vaccine,” it read. “It’s unclear if the case has broader safety implications."
Though the actual article puts the story in proper context, not everyone would click through to read it. Other outlets also focused on the adverse reactions out of that Alaska hospital. Politico, CBS, and CNN all covered the same story, running headlines that while not perfect, didn’t offer additional speculation about the overall safety of the vaccine, and the articles' text gave further context.
CNN’s article included quotes from two people at the FDA and made clear that these sorts of reactions are rare, but do sometimes happen during the early phases of a vaccine rollout.
The text of the CBS News article included important and reassuring details about the worker who had the more serious of the two reactions. The hospital’s emergency room director clarified that the woman’s reaction was not life-threatening, and added, “During the whole time, she was still enthusiastic that she got the vaccine and the benefits that it would give her in the future.”
The text of Politico’s article did offer a helpful note about adverse reactions during Pfizer’s trial:
Pfizer's late-stage clinical trial, which enrolled nearly 44,000 people, reported roughly the same number of adverse events in those who received the vaccine — 0.6 percent — compared to 0.5 percent in those who got a placebo. There were no cases of anaphylaxis, but the trial excluded anyone with a history of severe allergic reactions.
On the other hand, a headline by New York Daily News about negative reactions to the vaccine better contextualized the issue simply by adding the total number of shots that had been given at that point.
Six cases out of 272,000 shots amounts to just 0.0022% of people who had severe allergic reactions.
While mainstream outlets may have published headlines that are inadvertently alarming, right-wing media organizations lean heavily into the chaos.
On Saturday, the Drudge Report linked to a series of alarming-sounding headlines -- many of which had perfectly reasonable explanations.
Yes, the FDA is investigating allergic reactions to the vaccine, because that’s what it does. In the second story, the hospital referenced temporarily paused its vaccine rollout following a negative reaction while it checked to make sure it didn’t receive a bad batch. Yes, a nurse did faint after receiving the vaccine, but it had nothing to do with the vaccine itself.
Steering clear of sensational headlines could save lives. Seriously.
Public confidence in a vaccine’s safety helps determine just how effective it will be for the entire population. The more people get vaccinated, the sooner we can reach actual herd immunity. The term “herd immunity” has been thrown around by politicians a lot lately to refer to a strategy of letting the virus run rampant across the population in the hopes that those who survive the virus will have developed immunity to it, protecting the few who were lucky enough not to catch it. Public health experts have repeatedly warned against such a strategy.
Herd immunity should be achieved through vaccinations, not infections. While it’s not yet clear what percentage of the population would need to be vaccinated before we reach something resembling herd immunity from the disease in a reasonable timeframe, it’s likely pretty high.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently said during an interview with NPR that he estimated that between 75 and 85% of the population would have to get vaccinated in order to achieve a blanket herd immunity. This is one of the reasons why public influence campaigns will play an important part in the vaccine rollout. Elvis Presley famously received the polio vaccine during a TV appearance on The Ed Sullivan Show as a way to reassure the public of its importance and safety.
In November, Gallup polled Americans about whether they would be willing to take an FDA-approved COVID-19 vaccine, with 63% of them answering yes. While this is down slightly from 66% in July, it’s a marked improvement from the 50% who said they would in September.
Pew Research asked a similar question, finding in November that 60% of Americans would either “definitely” (29%) or “probably” (31%) get the vaccine if it were made available to them immediately. Additional survey findings include substantial racial disparities (while 63% of white Americans would either definitely or probably get the vaccine, just 42% of Black Americans answered the same).
Lives will be saved or lost based on how willing the public is to get vaccinated, making it that much more important for the press to think carefully about how it presents information about vaccination complications. Headlines, push notifications, and social media posts present challenges due to the extremely limited available space for clarifications. Even so, as the New York Daily News article demonstrates, it is possible to get relevant information where it needs to be.
Availability bias may lead people to believe vaccine complications are more common than they actually are.
In an interview with CNN’s Oliver Darcy, CNN medical analyst Dr. Jonathan Reiner explained his unease with how the Times used push notifications to alert people to that story:
This is akin to having a breaking news alert if a person admits to voting twice. ... An isolated instance doesn't equal widespread voting fraud and isolated adverse events shouldn't erode confidence in these vaccines. Multiple anecdotes do not equal data. We actually have solid safety data for the Pfizer vaccine from the phase 3 efficacy trial and the vaccine appears safe in the group in which it was studied.
We all deal with various cognitive biases in our day-to-day lives, but there’s one that stands out as being particularly influenced by media coverage: the availability heuristic. Also known as availability bias, the availability heuristic is the idea that people overestimate the frequency of things that are easy to recall and underestimate the frequency of things that are more difficult to recall.
For instance, after watching a news report or a documentary about shark attacks, you may subconsciously rank such attacks as being far more common than they actually are. The same can occur when it comes to plane crashes or people winning the lottery. As it’s not news when someone has an uneventful day at the beach without a shark attack, when the corner store sells a losing lottery ticket, or when a plane arrives safely at its destination, our minds may naturally exclude those non-news events when trying to estimate just how dangerous a beach trip or a plane ride may be or how frequently people win the lottery.
Our mistaken beliefs about how common those events are may influence our actions. If you’re exposed to a slew of stories with alarming headlines about the safety of the COVID-19 vaccines, you may overestimate how common the negative reactions are and adjust your actions accordingly by deciding against getting vaccinated.
One way news organizations can avoid playing into availability bias is to focus stories on broader trends as opposed to individual instances.
Part of what makes the New York Daily News headline referenced earlier such a great example of how to cover this story is that it repeats the message included in the headline, in context, right away.
Health officials are closely monitoring six people who experienced severe side effects from Pfizer’s coronavirus vaccine in the U.S., where more than a quarter million shots have been given so far.
The six cases of anaphylaxis, an acute and potentially life-threatening allergic reaction, were reported in patients under the age of 65 in different parts of the country last week, the U.S. Centers for Disease Control and Prevention confirmed Saturday.
All cases happened within the observation window and were immediately treated, according to the agency. The CDC has asked vaccine providers to monitor most patients for at least 15 minutes and those with a history of allergic reactions for 30 minutes.
Some adverse reactions were expected as authorities begin an unprecedented vaccination program that seeks to inoculate hundreds of millions of people nationwide. As of Saturday morning, at least 272,000 doses of Pfizer’s vaccine had been administered throughout the country, according to the CDC.
The story is itself framed around what adverse reactions mean, whether they were expected, and what sort of safety precautions are being taken. Rather than hitting readers with stories about the specifics of statistically rare reactions individuals had, it paints a broader picture, fulfilling the need to be transparent without being sensational. As more stories of individual reactions to COVID-19 vaccines roll out, journalists and audiences alike should always link them back to a broader picture.