By Sanne Maja Funch
Critical journalism about the HPV vaccine is a battleground with reporters and the drug company Sanofi Pasteur MSD each in their own corner of the ring. While journalists are talking about a company that controls the angles and spreads fear among the sources; the drug company believes that journalism is so unfair that girls are at risk of dying because they do not dare to be vaccinated.
“My impression was that Sanofi was indirectly the reason why these sources would not stand up. My sources told me that they were afraid of Sanofi.” Jacob Sheikh, journalist, Politikken.
Tuesday November 26th 2013 at approximately 6 am, the documentary journalist Kristian Laursen receives a disturbing message. The message is from his boss, Paul Anthony Sorensen, at the production company Eyeworks. Kristian must be in Paul’s office as soon as he arrives.
Kristian Laursen is hired to make a documentary that asks critical questions about Gardasil, the vaccine against cervical cancer offered to girls in Denmark as part of the childhood immunization program.
The documentary is already sold to the national TV station, TV 2, and the intention is that it should be transmitted in January. Kristian Laursen has worked on the project since August. In a few days recording will start.
But, that morning Paul Anthony Sorensen throws a bomb: The program is cancelled. The decision is his alone. TV 2 has already been informed. In other words, something incredible has happened: A production company pulls the product that it has already sold and invested about 100,000 DKK in. Kristian Laursen leaves his boss’s office in shock.
Why was the documentary about Gardasil killed so abruptly? There are different descriptions as of today. Paul Anthony Sorensen explains that he dropped the program because the subject was too hard to dig out within the frame that was given.
“The facts and figures, the documentary was sold on, turned out not to be 100 percent precise. It was a question of forming the complete picture with the right medical professionalism within a short deadline. We could not do that.”
On the other hand, Kristian Laursen, emphasizes that the research was spot on. But he admits that the contents was difficult. It was not made easier by the fact that journalism about the HPV vaccine has a long historical tradition of harsh criticism.
“If only I made a tiny little mistake, I knew that I would be vilified and ridiculed and dragged to the Press Council and perhaps even in court, because there are so many critical eyes in the pharmaceutical industry and public authorities. It was all we were against. It is WHO that validates this vaccine. You feel almost like you are up against the whole world,” he says of his concern for the impact the journalism could have had.
It is true that critical journalism about the HPV vaccine is a battlefield, where the parties are highly confrontational. Last year, first the Newspaper Politiken and since The Newspaper BT wrote a series of articles about the vaccine manufacturer Sanofi Pasteur MSD and the doctors and authorities that backs up Gardasil.
Today the journalists tells about an industry that monitors their research, casting doubts on the sources, scares others – and in one case sending a harassing email.
“As a journalist I have never ever experienced, that there are so many emotions in a case and so little facts,” said Heidi Pedersen, health reporter at BT.
But as a representative of the other side of the table, Mads Damkjaer is shaking his head. He is senior market access manager at Sanofi Pasteur MSD, which sells Gardasil in Denmark. He states that from his point of view, he sees some journalists who do not understand a difficult topic. But, actually he thinks most of the reporters pursuing sensation, no matter how weak the story is.
“I personally think that journalists are whining. If they see it as a journalistic obstacle, that they are made aware that they bring outright false information to the market and use sources that are very involved in things, I am extremely concerned,” he said.
Jacob Sheikh, working at Politiken writes about the HPV vaccine from February to May last year. His articles focus on how a number of doctors recommend the HPV vaccine, while working for Sanofi Pasteur MSD. A few articles are also about adverse events as for example dizziness, pain and long-term illness, as some girls claim that the vaccine has caused.
Jacob Sheikh already knows when the project starts, that he should write critically about Sanofi Pasteur MSD for a while. Therefore, his first move was to visit the company. He meets with Mads Damkjaer and has a good talk about how the pharmaceutical industry works.
The first time Jacob Sheikh ha an unusual experience is when he is working on a story about a 13-year-old girl who dropped out of school, allegedly because of adverse events. Jacob Sheikh explains that he gets a phone call from Mads Damkjaer before the article is printed. He lets the reporter know that he knows what he’s working on. So he warns about the girl Simone, that Jacob Sheikh are writing about.
“He tried to make a doubt in me about this source’s credibility and whether she could be used to illustrate anything” This warning amazes the reporter:
“I have not seen an approach like this before. I have never before seen a party source cast doubt on an experience source. Typically, a party source will stick to his own.”
‘Surveillance’ is the word that Jacob Sheikh uses when he describes the pharmaceutical company’s interest in his work. In telephone conversations Jacob Sheikh is asked to explain what the article angles are, what sources he uses, when the deadline is and why he writes as he does.
“It surprised me that they were so persuasive, and you got to be an idiot for not being able to conclude that they are so persuasive, because they in some degree want to be able to control the agenda,” he says.
Several doctors contact Jakob Sheikh while he writes about side jobs in the medical world. Jacob Sheikh’s got a point, they explain. But there are far worse examples out there. Two to three sources mention a brochure. It rests with the practitioners and informs those waiting on the benefits to be vaccinated against cervical cancer. But the booklet is hardly unbiased information. Because it is written by a doctor who has a side job at Sanofi Pasteur MSD, and is paid by the pharmaceutical company.
Politikken would like to bring this story. The problem is that nobody will put their name on the criticism. Too much cooperation is going on across the hospitals and the industry. And criticism can turn to the criticals like a boomerang, is the explanation:
“My impression was that Sanofi indirectly was the reason why these sources would not stand up. My sources told me that they were afraid of Sanofi. I saw it as a very clear self-censorship from these doctors. They did not want to start a spiral of actions that could hit them back, “says Jacob Sheikh.
BT’s Heidi Pedersen start writing about the HPV vaccine two months after Jacob Sheikh has put an end off his series of articles in the newspaper Politiken.
The first articles are published in late July 2013 and is about the vaccine’s potential adverse events. Heidi Pedersen did not contact Sanofi Pasteur MSD in her research. Her work is based on the National Board of Health News “Nyt om bivirkninger” (News about Adverse Events) and it’s the Danish National Board of Health), she contacts for an interview about the problems described.
Heidi Pedersen calls the National Board of Health’s Press Office Wednesday, July 24th in the afternoon and gets an appointment about an interview. It is a huge surprise to her, when the next morning she is called by the LEAD Agency, Communication Bureau for Sanofi Pasteur MSD. The consultant explains that she knows what Heidi Pedersen is writing on. She offers to explain out the facts.
Heidi Pedersen is stunned: “I’m used to the agencies that are sending me material. But I’ve never had them call me and say they know I’m sitting with a story about this or that. There, they try so much to control my angle.”
Heidi Pedersen asks the consultant to confirm in writing that it is from the National Board of Health, she knows about BT’s upcoming articles.
Confirmation lands in the inbox at 10:10 that morning. The email also contains some information about the HPV vaccine. The content is a refutation of the story about the vaccine’s adverse events. The consultant refers consistently to adverse events as “rumors” or “myths” and explains how the myths are originated from America’s powerful but absolutely arbitrary anti-vaccine lobby.
“It is a sobering case that illustrates the anti-vaccine lobby efficient process from Canada to the Danish parliament,” the LEAD Agency writes among other things with regard to the health minister having been questioned about the subject.
That Sunday lands BT in newspaper stands across the country with the following cover: “422.000 has been vaccinated with the HPV cancer vaccine. Doctors warn them about adverse events”
The same afternoon, Mads Damkjaers response receives in BT’s chief editor Anders-Peter Lose Landert’s inbox.
Mads Damkjaer has two main anchors. First, he believes that it is wrong when Heidi Pedersen writes that there is an increased incidence of adverse events. The disorders reported as adverse events are not increased in numbers after the vaccine was introduced. Second, the source selection is biased Mads Damkjaer states. Heidi Pedersen is among others citing the private association Vaccination Forum and the doctor Claus Werner-Jensen. But the former is part of the anti-vaccine lobby. And the last is closely related to the same association as a commentator, says the criticism.
On the bottom line is that journalists like Heidi Pedersen’s are “coverpage horny stupids,” who “read facts and figures as hell is reading the Bible,” Mads Damkjaer wrote and ends with the following reminder:
“Despite the fact that the media is under so much pressure and eventually one can feed pigs with unemployed journalists, then a disaster as Heidi Pedersen is sitting on a coveted spot as a journalist on a national newspaper, despite the fact that neither diligence, fairness, nor source criticism can be counted among her virtues.”
Heidi Pedersen describes herself as a perfectionist. She is passionate about her substance. The email is an attack on the professionalism, she carefully cherishes, and therefore it is very unpleasant. However, both the increase in adverse events and sources are presented correctly, she answers in a detailed email to Mads Damkjaer. In addition, the industry’s representative did not quite check on source criticism itself.
Heidi Pedersen forward Mads Damkjaers mail to the doctor Claus Werner-Jensen, whose credibility he doubts. But Claus Werner-Jensen refuses to be put in the same boat with the association Vaccination Forum. He picks up the phone and demands an explanation from Sanofi Pasteur MSD.
“At that time I hardly knew what Vaccination Forum was, so I thought it was to push it too far. It triggered me, I did not think it should go unchallenged” Claus Werner-Jensen said.
Heidi Pedersen writes a few articles about the HPV vaccine later this year. Mads Damkjaer follows up with a new, more subdued mail, where he again points out errors and try to affect Heidi Pedersens sources.
Also the journalist at the magazine “Journalisten” noticed the coincidence of sources across media and countries when Gardasil is criticized. Is the media source criticism good enough? Heidi Pedersen thinks several seconds before she answers:
“I think it was frustrating when the sources did not dare to step forward. I have experienced that. I could not get the doctors who actually sat with the girls in front of them to step forward and tell the National Board of Health that it was possibly the vaccine’s fault that the girls felt like this.”
In other words, according to Heidi Pedersen, she has been at pains to track new voices in the debate. But like Jacob Sheikh, she experienced that the sources are afraid. They say that criticism can connect them with doctors in special circles that are labeled as radicalized idiots. In addition, the doctors fear for their relationship with the industry. The magazine “Journalisten” has been in contact with a source in the medical environment, confirming these claims.
Sanofi Pasteur MSD is located in a streamlined building at Lyngby Station. Here Mads Damkjaer denies the journalist’s interpretation of certain conditions. He apologizes for others. But basically he maintains his criticism.
First Mads Damkjaer rejects that Sanofi Pasteur is practicing any kind of influence on doctors who are airing criticism of Gardasil, “I am not aware of a single doctor, we should have contacted and asked, for example, to re-evaluate their opinion or recommendation ” he states.
He also claims that he has never contacted the newspaper, Politiken’s Jacob Sheikh about his source Simone: “It is not correct. We have never done this. We would never call and malign an experience source, because it is something very sensitive” he says and is also surprised that Sanofi Pasteur MSD’s interest in Politiken’s articles can be mistaken for monitoring:
“It’s completely standard to ask about sources and angles, if someone calls and asks if you want to participate in a critical article.”
Other conditions call for an apology. It is the tone of the mail, Mads Damkjaer sent to Heidi Pedersen after her front flapping about the vaccine’s adveres events. Mads Damkjaer has just returned from driving on holiday in Italy when the stories are printed. The front text acts as a red rag for tired eyes.
“It was the most serious article that is hammering out: 400.000 girls at risk. I think there should be reacted very quickly and efficiently. Besides I had been sitting 22 hours behind the wheel of a car, so it explains the tone and I apologize many times. It was not okay.”
He gives the same reason to the failed prosecution of the doctor Claus Werner-Jensen.
It’s during the same holiday that LEAD Agency contacts Heidi Pedersen after she has asked the National Board of Health for an interview. Also this tip Mads Damkjaer dries the mystery of. He explains that Heidi Pedersen asked the National Board of Health a question about the vaccine’s use in Japan. The National Board of Health contacted Sanofi Pasteur MSD, which is supposed to know most about such a case. The workflow is quite common.
Mads Damkjaer sensed what was coming, and he asked his agency to contact the reporter while he was in Italy himself.
Henrik G. Jensen, department manager at the National Board of Health, confirms this process.
On the other hand, he believes that it is a problem that Sanofi Pasteur MSD utilizes the approach to influence Heidi Pedersen.
“I was annoyed that they sent my request on to their marketing department. Why on earth did they do that? It was a concrete and relevant question she asked,” Henrik G. Jensen recalls.
He also don’t believe that it is unbiased information when the LEAD Agency dismisses adverse events like rumors and myths in the material they send to Heidi Pedersen afterwards:
“Myths and rumors are not the same as adverse events and facts. You have to be fearful of your words. It is important that the communication is factual. In The National Board of Health, we have chosen a strategy that states that all information about the adverse events should be told” Henrik G. Jensen says.
By the way Mads Damkjaer sticks to his methods and his criticism. The sources are often selected from biased doctors, scientists or simply activists in the field, both in terms of Jakob Sheikh and Heidi Pedersen’s articles, he said. Moreover, there are errors in facts, especially when it comes to the extent of adverse events, and those, Sanofi Pasteur MSD needs to address.
For both sources and error jumps from medium to medium. Each time, they live a bit stronger.
“Yes, I consistently go out and correct errors to the extent that it can be done. It is a strategy because the media lives as they live. The main instrument for research is gradually Infomedia. Therefore, if the wrong information is allowed to flourish, they will become a self-explanatory truth” he said.
Your agency dismisses adverse events The National Board of Health recognizes. Is your communication not just as unsettled?
“It’s probably a polemical tightening, but the fact is that adverse events have been allowed to fill in to an extent that is not at all proportional to the adverse events.”
During the interview Mads Damkjaer recall’s a motto. Several times he says, that he “has nothing against critical journalism, it is the uncritical” that’s the problem.
And according to Mads Damkjaer the health journalism has a problem with the quality:
“I would really like to think that the biggest problem is that it is a difficult area, which is hard to understand. But I think it is because it has become okay to do research until you find the two sources that says what you want the story should sound like. This is how I see it, unfortunately.”
Mads Damkjaer estimates that Sanofi Pasteur MSD has sold 5.000 fewer doses of Gardasil than usual, because of the media buzz around the vaccine. This means that about 1.300 girls have refused to be vaccinated based on the writings. If the statistics are following the reality, 17 of these women will develop cervical cancer, and 5 will die he explains:
“Maybe I tighten it. But my tension is closer to reality than the talk about the adverse events, and that I maintain. Journalism as this ultimately risk to cost lives.”
And thus ends the story where it started. At Eyeworks and Paul Anthony Sorensen, who in the last hour pulled the plug on a documentary that was sold to, and almost featured on TV 2. The research Paul Anthony Sørensen gave free of charge to TV 2 because he actually thought there was a reason to examine the vaccine further. TV 2 does not want to disclose to the “Journalist” if they plan to go ahead with the story.
But unlike Eyeworks, TV 2 has the resources to lift the story. For it is precisely in the tension between a difficult subject and a zealous industry that journalism about medicine encounter problems:
‘Medical Histories are very complex. In fact, they require that you ally yourself with doctors and not only let journalists do the research. I was afraid that we would potentially create panic in the light of research, I did not know if it was truth. But it requires such enormous resources to meet these stories, that the industry often will draw the longest straw, “says Paul Anthony Sorensen.
Comments from a parent of a girl disabled by the HPV vaccine:
It is a completely unacceptable discussion. To judge from their own attitudes and beliefs. Where are the facts?
EMA in January prompted Sanofi Pasteur to explain the increased prevalence of POTS, meningitis and inflammation of the central nervous system after HPV vaccine.
WHERE ARE THE DATA WITH PROOF THAT THIS IS NOT THE CASE?
The “activists” referred to, are the poor souls who, like myself, followed throughout childhood immunization program. And paid the price in the form of disability. Telling one’s story is suddenly turning you in to be an activist???
0.4% of Danish women to die of cervical cancer is in sharp contrast to the official figures. In 2012 it was 1.9 per 100,000
The same official figures also say that the risk of dying from cervical cancer before 75 years of age is 0.2%
Another misrepresentation of reality from the National Board of Health and Mads Damkjaer.
Stick to the facts and tell us what the numbers really are.
How can you deny the facts that more than 1200 persons reported more than 4500 adverse events?
How can you deny the fact that Gardasil has more than 10 times higher frequency of side effects than other vaccines in Denmark?
Admit that thousands of Danish girls suffer from a disease that had its onset after their HPV vaccine. No matter, if the vaccine caused it or not – nobody wants to help them.
Is the lack of help a cover to avoid the truth coming through?