Zika and the vaccine hunt: An analysis of UK online news reporting in 2016

zika virus reporting

Introduction

In May 2015, health workers in Brazil began reporting an outbreak of the mosquito-borne Zika virus (Alexander, 2016). A state of emergency was declared at the end of November 2015 by the Brazilian state of Pernambuco in an effort to speed up an official response to the outbreak which, by this time, had spread to several countries in South America, Central America and the Caribbean (BBC, 2015). What was of most concern to public health officials was not the relatively mild and short lived symptoms of Zika—skin rash, fever, conjunctivitis, joint pain, headaches—that, according to the World Health Organisation (WHO), has yet to cause a single fatality amongst those infected (WHO, 2016a). More disturbing was a potential causal link between the virus and an increase in cases of congenital microcephaly, and the neurological disorder Guillain-Barré Syndrome (GBS), in regions where the virus was active.

There is currently only ecological evidence of an association between the outbreak of Zika and observed cases of microcephaly and GBS, and—although strongly suspected—a causative association hasn’t yet been proven (ECDPC, 2015). And yet, online news reports containing alarming images of birth defects, specifically babies born with the tell-tale malformed head caused by microcephaly, quickly went viral across the internet and have been prominent in online Zika reporting ever since (see: Cancian, 2015; Margolis, 2015; Levine, 2016).

As of May 4th 2016, 55 countries and territories reported continuing mosquito-borne transmission of Zika (WHO 2016b). The lack of an existing vaccine to prevent the spread to vulnerable at-risk groups, such as pregnant women, and the potential for sexual transmission spreading the virus globally, despite mosquito survivability, prompted the WHO to declare a “Public Health Emergency of International Concern” in February 2016 (WHO, 2016c). This sparked multiple scientific efforts to synthesise and distribute a Zika vaccine to effected areas—a response comparable to that during the Ebola outbreak in 2014.

In the UK in 2016, online media attention intensified following four confirmed cases amongst British citizens (Hodgekiss, 2016). With some reports claiming up to 4 million people could become infected (Gallagher, 2016), the scientific hunt for a vaccine seemingly became more pressing and relevant, and predictive timelines for delivery featured prominently in some online UK headlines (Kirby, 2016). Online UK news outlets began to speculate broadly on the potential risk posed to the British public, the feasibility of a vaccine, how long it would take to reach us, who was doing what research where, and how well was the hunt going.

Shareable online news content via Facebook, Twitter and other online social media and apps, is increasingly the way people in the West access news (American Press Institute, 2014; Greenberg, 2015). Therefore such media has the potential to influence how people conceptualise the health risks, risk of infection, and uncertainty surrounding issues such as the Zika vaccine (Wakefield et al., 2003; Prasad, 2013). News stories in general are often constructed to take one perspective or another, to define which issues are viewed as important (Menashe and Siegel, 1998). These frames influence what is included or excluded from stories and can contextualise, even misrepresent the scientific evidence, as was demonstrated during the measles, mumps and rubella vaccine (MMR) controversy (Hargreaves et al., 2003).

This report contains an analysis of UK online news coverage of the Zika vaccine issue from 01 January 2016—the month prior to the first confirmed cases of sexually transmitted Zika and the WHO declaring a public health emergency—to 30 April 2016 when global scientific efforts to find a vaccine had reached early stages of animal testing. Using quantitative analysis and coding methods, this report will offer an overview of the tone and framing of Zika vaccine reporting in the UK and how it evolved over the early stages of 2016. This report offers a general assessment as to whether UK online news outlets have been responsible in communicating risk and scientific uncertainty to the UK public, and whether the public have been offered an appropriate picture of the issue. The overall aim of this report is to gauge how the issue has been framed for public consumption and the effects this might have on the UK public’s perception of science within this context.


Method

Article Selection

The study aimed to analyse articles from online UK news outlets. It was therefore appropriate to use an advanced google search criteria as google is the most popular search engine globally with an estimated 1.1*109 unique monthly visitors (eBizMBA, 2016) and thus a likely source of searchable, shareable news content for UK publics. The search criteria demanded that articles originated from the UK, contained the words “Zika” and “vaccine”, were categorized by google as “news”, and fell within the date range: 01 January—30 April 2016.

Furthermore, articles were scrutinized by the researcher to establish whether they met all 6 of the following inclusion criteria:

  1. Content is free to access and not behind a paywall.
  2. Content has a shareable URL.
  3. Parent news outlet has a social media presence, i.e. a Facebook and/or Twitter page.
  4. Zika virus or vaccine was the primary topic of more than 50% of the article.
  5. Article is published in the Home, News, Health, Science, or Travel section of the website.
  6. Somewhere within, the article explicitly states that currently no Zika vaccine exists.

A sample of 50 articles in total were selected to be analysed by the lone researcher. To achieve a broad distribution of articles over the 4 month timeframe, it was initially intended that ~12 articles be selected from each month. However, a dearth of suitable articles were found in the month of March—the month following the WHO’s declaration of a public health emergency—so only 10 articles were selected to reflect the lower frequency of Zika vaccine reporting. Similarly, to reflect the abundance of Zika vaccine reporting in January, when the scientific response hadn’t yet gained momentum, 16 articles were selected. 12 articles were then included from both February and April. The selection was appropriate in ascertaining overall themes of reporting in the 4 month period. The first N number of articles that qualified were used, reading from the top of the google results page downwards. It was appropriate to include the most accessible online articles over those more difficult to locate, as these are the articles most visible to publics and more likely to be shared widely.

Coding

To develop a coding framework, a random selection of 10 articles were read through to identify the key discourses around the Zika vaccine issue. These discourses became thematic categories in an initial coding framework. Using the principles of grounded theory (Glaser and Strauss, 1967), a further batch of 5 articles were read and coded until no new categories emerged from the articles.

The coding framework (Appendix A) recorded the month the article was published online and the word count, including image annotations and boxes. The full-texts of the articles were then interrogated by the researcher with reference to 38 thematic categories. Included were the tone of headlines and use of primary imagery, as they not only anchor the article, and might be the only part of the content that online users are exposed to whilst scrolling through a feed, but often encapsulate what the author, or editor, define as the most relevant tone, trajectory, or aspect of the article (Andrew, 2007; Bleich et al., 2015).

After considering headlines, imagery, and adherence to the 38 thematic coding categories, articles were rated as “alarming”, “hopeful or reassuring”, or “neutral”. Alarming articles

were judged overall to have framed the issue in such a way as to potentially stoke fear or anxiety in the reader—such as including frightening risk assessments or anecdotes— without offering a balance in objective content. These articles tended to include pessimistic timeframes for vaccine delivery, and vague quotes from unspecified sources.

Hopeful or reassuring articles were judged to have reflected scientific and/or political efforts to mitigate the outbreak in a positive light, perhaps offering reassuring anecdotes, or focussing on specific scientific efforts that might soon result in a Zika vaccine. Neutral articles tended to be passive and objective in tone, conveying raw facts and reporting rather than opinion or emotive content.

Analysis

Articles were analysed for manifest content. Manifest content refers to what is explicitly stated and draws on the objective and replicable qualities of quantitative methods (Altheide, 2002). In order to systematically quantify the manifest content, every article was read line by line and coded by hand to indicate whether or not each of the 38 thematic categories in the coding framework was present. Only then was a final overall categorization of the article appropriate.

Data was entered into an Excel datasheet corresponding to the month the article was published to enable analysis of monthly themes in reporting. Then the data was added to an overall datasheet to enable a broader analysis of the 4 month period (see: Apendix B).

All percentages recorded in the results have an uncertainty of ±0.5% to enable the recording of the nearest whole number. All articles were coded once and by the same researcher, so results are prone to some subjectivity in the reading.


Results

Overall Trends in Reporting

Figure 1 shows the overall classification of the 50 articles. 20% (n=10) of articles were found to have an overall alarming tone/frame regarding the issue of Zika vaccination. Equally, 20% (n=10) articles were found to have an overall reassuring tone. The majority of articles, 60% (n=30) were found to be framed in an overall factual and neutral manner, with a focus

on delivering information from public health bodies such as the WHO, or scientific institutions working on a Zika vaccine.

Image_001
Figure 1. Total overall tone classification
Image_002
Figure 2. Distribution of tone over 4 month period

Figure 2 shows the percentage distribution of tone over the 4 month period. At all points, neutral frames dominate. The second highest frequency of alarming reports, 25% (n=4), occur in January at a time when Public Health England announced the first cases of British citizens being infected with the Zika virus (Christie, 2016). This was prior to the WHO’s declaration of a public health emergency and the galvanisation of global scientific efforts to discover a vaccine. An air of mystery still pervaded Zika reporting, and pessimistic vaccine delivery timeframes peaked during this period, 50% (n=8) of articles warning of vague but lengthy potential timeframes of “several years” (Prigg and Ryan, 2016). Images of infant birth defects caused by microcephaly also peaked during January, featuring in 63% (n=10) of articles, whilst only half (n=5) of all January’s articles communicated any scientific uncertainty regarding Zika’s causative role. Meanwhile, just one article (Sky UK, 2016) contained positive spin enough to classify as reassuring, employing a political frame to report an agreement of collaborative international efforts than might soon result in a vaccine.

The WHO declared a public health emergency regarding Zika in February, and this marked the beginning of major scientific collaborations to find a vaccine. Rather than focus on the potentially alarming WHO declaration, February saw the peak frequency of overtly positive reporting, 42% (n=5) of reports being classified as reassuring—a 27% increase from January. 42% (n=5) of reports were found to have employed a scientific frame, with a concentration on reporting specific scientific efforts to develop a vaccine—the greatest frequency of science specific reporting alongside April. Meanwhile, alarming reports fell to their lowest frequency—8% (n=1), a fall of 16%. There was also a 50% fall in the frequency of pessimism in the reporting of vaccine delivery timeframes from January. However, there was no rise in optimistic timeframe reporting, 60% (n=7) of articles speculating no timeframe at all.

March saw a dip in appropriate sources for inclusion, suggesting a diminishing interest in the Zika vaccine issue following the initial hype. Not enough time had elapsed for scientific efforts to result any significant new developments in the hunt for a vaccine. The number of alarming reports remained consistent with the previous month at 10% (n=1), and the frequency of reassuring reports dipped to 30% (n=3), the majority of articles, 60% (n=6), tending again towards neutrality. However, there was a sharp peak in optimistic speculation of timeframes for vaccine delivery, 50% (n=5) reporting experts, such as the director of the US National Institute of Allergy and Infectious Diseases, proclaiming that Zika vaccine could be ready for human trials as early as the end of 2016 (Gander, 2016).

As the weather warmed in April, and focus shifted towards summer, a greater frequency in Zika vaccine reporting was again observed, perhaps in response to a potential increase in travel to Brazil for the upcoming Olympic Games. As in January, there was a greater frequency of alarming articles compared to reassuring ones—30% (n=4) versus 8% (n=1) respectively. There was a maximum in both the frequency of articles containing alarming risk assessments—50% (n=6)—and alarming anecdotes—42% (n=5)—which contrasted starkly with reporting in previous months. However, the majority of articles were again classified overall as neutral, and remained consistent in frequency with the previous months. Whilst the general tone had shifted towards anecdotal stories focussing on the risk to travellers and at-risk groups, articles remained fairly balanced in their content.

Image_003
Figure 3. Total overall tone of headlines
Image_004
Figure 4. Distribution of headline tone over 4 month period

Figure 3 shows that 32% (n=16) of headlines were classified as pessimistic despite the observance that only 20% (n=10) articles were classified alarming overall. This suggests that sometimes the tone of headline did not match the overall framed content of the article. Figure 4 shows that whilst the peaks and troughs in headline tone over time appear fairly consistent with the peaks and troughs in overall tone, there is enough deviation to again suggest a sometime mismatch between the tone of the headline and the content of article. Note again the tendency towards emotive headlines, particularly pessimistic ones, rather

than factual neutrality. As discussed in the methods section of this report, this is significant as many people don’t read beyond the headline and so the headline itself can have as significant as impact, if not more, in shaping public perception as the full-text content.

Other Consistent Trends in Reporting

Figure 5 shows how UK publics were informed of the probable vaccine delivery timeframe. Note that the tone doesn’t reflect the numerical length of the timeframe posited, but rather the spin or perspective with which the issue was framed. For example, a 3 year timeframe to go from no vaccine to distributed vaccine is a fair feat of science. This might be reflected in reporting, or the same timeframe might be framed pessimistically as a long time to wait given the potentially alarming consequences of microcephaly and DBS. As figure 5 shows, 41% (n=14) of the time, when an article offered any timeframe at all, the article framed the prospective timeframe in a pessimistic manner as opposed to 29% (n=10) optimistic framing, and 24% (n=8) neutral. This framing weighted many articles towards an alarming classification.

Image_005
Figure 5. Overall reporting of potential vaccine delivery timeframe

96% (n=48) of all articles linked the Zika virus causally to microcephaly and DBS, whilst only 40% (n=20) of all articles communicated any level of scientific uncertainty regarding this link. Furthermore, 54% (n=27) of all articles included potentially alarming imagery of birth defects, such as malformed infant skulls, thus potentially reinforcing the link. Only 36% (n=18) of articles included any obvious science imagery—excluding pictures of mosquitos—such as laboratory pictures, technicians in white coats, pipettes and test-tubes etc. These images had no obvious value other than to present a stereotypical image of science in order to reinforce references to science within the text.

Many articles attempted to report issues pertinent to public health: 74% (n=37) articles contained direct quotes from expert scientists; 80% (n=40) reported transmission modes of Zika; and 68% (n=34) presented specific at-risk groups. However, only 46% (n=23) contained any actionable health and safety advice such as transmission prevention or travel advice; 44% (n=22) outlined symptoms; and only 48% (n=24) contained information on the number and location of countries effected.

There was no significant difference between average word-count of articles from month to month. The mean average overall was 698 words, but length varied considerably with a standard deviation of 510 words.


Conclusion

Overall 80% of articles were either neutral or reassuring, not stirring unnecessary alarm in the manner of some reporting during the BSE crisis of the 90s (Miller, 1999). Initial tendencies towards alarmist tones at the start of 2016 were likely stoked by the early, protean nature of the outbreak and recent memory of the similar West Nile, Avian Influenza and Ebola vaccine issues (see: Roche and Muskavitch, 2003; Mira et al., 2015; ). Nevertheless, the tendency of UK online reporting towards neutrality and fact delivery, over sensationalism, suggests a level of responsible reporting prevailed, as evidenced by the widespread inclusion of WHO quotes, direct quotes from expert scientists, and reporting of at-risk groups. UK reporting might be commended also for not tending towards alarmism following the WHO’s declaration of a public health emergency, but rather offering an increase in reassuring frames—focussing on specific scientific efforts to ameliorate the outbreak, and manifesting the minimal threat to UK citizens.

However, UK online reporting struggled to communicate scientific uncertainty regarding causal links between the virus, microcephaly and/or DBS, risking misinterpretation of the science amongst publics that might lead to misinformation regarding risk (Einsiedel and Thorne, 1999). Coupled with the incongruent tendency towards pessimistic headlines, and profligate use of alarming imagery, UK outlets risk framing the issue in an alarming manner despite the full-text gist of their articles (Ecker et al., 2104). Risk communication was generally presented with low precision in a more qualitative fashion rather than quantitative, therefore was likely of limited usefulness to readers and insufficient to help publics make informed decisions regarding prevention strategies (Ramsay et al., 2002). Greater accuracy in reporting is desirable to inform public choices. In addition, the tendency to report potential vaccine delivery timeframes in a pessimistic manner suggests a misunderstanding of the scientific process and might imbue publics with unreasonable expectations concerning the reactiveness of scientific bodies. This in turn might lead to a negative view of science as a whole.

Holistically, however, the framing of science was positive throughout the period. Quotes from researchers and public health officials weren’t manipulated to fit any narrative, and at times of uncertainty—such as the WHO’s aforementioned declaration—it was scientists that reporters largely turned to for expert reassurance regarding matters of risk and

probable timeframes for vaccine delivery. This speaks of a level of trust in UK science not evidenced in previous public health crises (see: Speers and Lewis, 2004)—perhaps a positive side-effect of international science collaborations in tackling other recent outbreaks.


References

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Appendix A: Coding Framework

  1. Dominant Frames Employed

    1. Alarming
    2. Hopeful or reassuring
    3. Neutral
    4. Scientific Issue
    5. Political Issue
    6. Public health
  2. Headlines and Imagery

    1. Pessimistic
    2. Optimistic
    3. Neutral
    4. Imagery of birth defects
    5. Imagery of scientists/Science in progress.
  3. Vaccine

    1. Pessimistic timeframe for delivery
    2. Optimistic timeframe for delivery
    3. No timeframe mentioned
    4. Attributes blame for pessimistic timeframe
    5. Attributes kudos for optimistic timeframe
    6. Possible side-effects/risk factors of vaccine
    7. Comparison made to other vaccine research or issues
    8. Comments on vaccine distribution
  4. Science Reporting

    1. Mentions specific scientific effort
    2. Details how vaccine might work
    3. Details science of development
    4. Communicates scientific uncertainty
    5. Quotes scientist(s) or science institution
    6. Quotes World Health Organisation
  5. Zika Virus Risk

    1. States number of UK cases
    2. States number of Brazilian cases
    3. States number of worldwide cases
    4. States number of countries effected
    5. Gives transmission modes
    6. Outlines at-risk-groups
    7. Links zika to microcephaly
    8. Offers actionable health and safety advice
    9. Includes alarming anecdotes
    10. Includes reassuring anecdotes
    11. Specifies symptoms
    12. Contains alarming risk statements or predictions
    13. Contains reassuring risk statements or predictions

Appendix B: Final Coding Results

1. DOMINANT

FRAMES

JAN

FEB

MAR

APR

TOTAL

1.1. ALARMIST

N=4

N=1

N=1

N=4

N=10 (20%)

    1. REASSURING

    2. NEUTRAL

N=1

N=11

N=5

N=6

N=3

N=6

N=1

N=7

N=10 (20%)

N=30 (60%)

1.4. SCI PRESNT

N=3

N=5

N=4

N=5

N=17 (34%)

1.5. POL PRESNT

N=2

N=1

N=0

N=2

N=5 (10%)

1.6. PUB HEALTH

N=5

N=3

N=4

N=3

N=15 (30%)

2. HEADLINES & IMAGERY

JAN

FEB

MAR

APR

TOTAL

2.1. PESS HDLNE

N=7

N=3

N=1

N=5

N=15 (32%)

2.2. OPT HDLNE

N=2

N=3

N=2

N=1

N=8 (16%)

2.3. NEUTRL

HDLNE

N=7

N=6

N=7

N=6

N=26 (52%)

2.4. IMGE BIRTH

DEFECTS

N=10

N=8

N=4

N=5

N=27 (54%)

2.5. IMGE SCI

N=7

N=8

N=1

N=2

N=18 (36%)

3. VACCINE SPECIFIC

JAN

FEB

MAR

APR

TOTAL

3.1. PESS

TMFRME

N=8

N=3

N=2

N=1

N=14 (28%)

3.2. OPT

TMFRME

N=1

N=2

N=5

N=2

N=10 (20%)

3.3. NO TMFRME

GIVEN

N=3

N=7

N=2

N=6

N=18 (36%)

3.4. BLAMES

FOR PESS

N=2

N=1

N=0

N=0

N=3 (6%)

3.5. KUDOS FOR

OPT

N=0

N=1

N=5

N=2

N=8 (16%)

3.6. POSS RISK

FACTORS

N=0

N=1

N=0

N=0

N=1 (2%)

3.7. COMPRSN

TO OTHERS

N=8

N=4

N=8

N=8

N=28 (56%)

3.8. VACCN

DISTRBTN

N=1

N=3

N=2

N=2

N=8 (16%)

4. SCIENCE REPORTING

JAN

FEB

MAR

APR

TOTAL

4.1. SPEC SCI

EFFORT

N=8

N=6

N=7

N=7

N=28 (56%)

4.2. HOW IT

MIGHT WRK

N=1

N=3

N=3

N=5

N=12 (24%)

4.3. SCI OF

DEVELOP

N=3

N=6

N=5

N=6

N=20 (40%)

4.4. UNCERT’TY

N=5

N=3

N=6

N=6

N=20 (40%)

4.5. SCI QUOTE

N=10

N=8

N=7

N=12

N=37 (74%)

4.6. WHO QUOTE

N=8

N=6

N=8

N=5

N=27 (54%)

5. ZIKA VIRUS RISK

JAN

FEB

MAR

APR

TOTAL

5.1. #UK CASES

N=6

N=0

N=0

N=1

N=7 (14%)

5.2. #BRAZIL “

N=7

N=5

N=4

N=4

N=20 (40%)

5.3. #WORLD “

N=8

N=3

N=3

N=3

N=17 (34%)

5.4. #COUNTRIES

EFFECTED

N=12

N=5

N=3

N=4

N=24 (48%)

5.5. TRANSMIT

MODES

N=14

N=5

N=10

N=11

N=40 (80%)

5.6. AT RISK

N=13

N=5

N=8

N=8

N=34 (68%)

5.7. LINKS TO

MCEPH

N=15

N=12

N=9

N=12

N=48 (96%)

5.8. ACTIONABLE

H+SFTY ADV

N=10

N=2

N=5

N=6

N=23 (46%)

5.9. ALARM

ANNECDOTE

N=1

N=2

N=1

N=5

N=9 (18%)

5.10. REASSURE

ANNECDOTE

N=0

N=3

N=0

N=1

N=4 (8%)

5.11. SYMPTOMS

N=9

N=1

N=5

N=7

N=22 (44%)

5.12. ALARMING

RISK STMNT

N=6

N=3

N=3

N=6

N=18 (36%)

5.13. REASSURE

RISK STMNT

N=8

N=3

N=0

N=1

N=12 (24%)

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