Posted on May 29, 2020 at 9:00 AM
by Jamie Webb MA, MSci
‘An experimental vaccine against the coronavirus showed encouraging results in very early testing, triggering hoped-for immune responses in eight healthy, middle-aged volunteers, its maker announced Monday.’ Readers of the Associated Press’s lead paragraph on Moderna’s vaccine candidate for COVID-19 could be forgiven for getting excited.
However, the same article ends with this caveat, “The results have not been published and are only from the first of three stages of testing that vaccines and drugs normally undergo.” Rather than published data, the AP’s Moderna story is based on a public announcement from the company. But this is all it is: an announcement. The limited evidential basis for the encouraging vaccine results only becomes fully clear late in the article. Although forty-five people have been dosed in the trial, detailed antibody results are available for only eight. And although the vaccine seems safe, not enough testing has been done to know if it will remain so.
This begs the question: if these claims are provided with such a limited evidence base, then why is the AP reporting on them in the first place? Clearly, the pursuit of a coronavirus vaccine is of interest to the public; indeed it is hard to think of many topics currently more newsworthy. But that does not mean that every time a company makes a public statement they should be rewarded with an attention-grabbing headline. A media attitude of ‘if a pharmaceutical company working on COVID-19 says it, its newsworthy’ risks becoming the new ‘if the president says it (or tweets it), its newsworthy’. Just as the latter approach has flooded the public sphere with misinformation and conspiracies, the former risks incentivising bad scientific practices, rewarding bad actors, and raising public hopes prematurely, risking a loss of trust in science if those hopes are later dashed. Cautionary details relegated to the final paragraphs and corrective reporting in the days following the original story are insufficient responses to these dangers.
But journalists are not the only ones with responsibilities towards the public. Moderna could have delayed publicizing their findings until after the end of the trial, when they had concrete clinical data that had undergone review at an academic medical journal (or scholarly preprint server) to assess its accuracy, statistical significance, and consistent outcome measures. Peer review is no guarantee of scientific quality (as the much cited, and later much criticized, French hydroxychloroquine study shows), but it is a bulwark against hype and incompleteness. Instead, Moderna decided to conduct science by press release. They were ably assisted by the many publications, not just the AP, that covered their announcement.
Of course, it is reasonable for Moderna to believe in their product and its potential to help people. But Moderna no doubt watched the media coverage of Gilead’s Remdesivir, and they learned the correct lesson. It was nearly a month after Gilead announced incomplete data which offered positive early signs that Remdesivir could have some impact on shortening the hospitalization period for COVID-19 that the full research was published. In the intervening period the FDA granted Remdesivir an emergency use authorization and provided it to hospitals across the country, whilst public awareness of the treatment has skyrocketed. Meanwhile, after donating its current stockpile, Gilead is making pricing plans to sell remdesivir in the coming weeks.
The incentive structure this reveals is clear. Why wait for the publication of your full trial results when you can reap the benefits of announcing positive clinical data without the scrutiny of peer-review first?
These claims gain legitimacy when they are covered by the press, even as some journalists work hard to scrutinize them. Excellent corrective reporting carried out by STAT, which pointed out how limited the data on Remdesivir was at the time of publication, did little to dampen enthusiasm for the drug. And whilst STAT’s summary of the deficiencies of Moderna’s press release did send the company’s share price tumbling back down from its $29 billion high, the company seized the temporary jump in value as an opportunity for a public share offering which netted it more than $1.25 billion in cash, while their chief financial officer and chief medical officer dumped nearly $30 million of shares.
Pharmaceutical companies are not propagandists deliberately attempting to undermine faith in the scientific process. But they do find themselves at the center of the biggest news story of the century. Since they have shown they understand how to work the current media ecosystem to their advantage, they must be held accountable for using it responsibly as well. They know that the vast majority of drugs and vaccines that look promising in early trials are eventually shown, with larger cohort sizes, to offer no benefit. They know that halfway through a study is no time to be making claims about its results. But they also know that with the whole world desperate for good news, releasing data early can generate public pressure on regulators to make their products available irrespective of a lack of evidence.
This creates a battery of incentives for individual companies to collectively flood the public sphere with low quality evidence. That may generate initial excitement among a public not well versed in the slow progress and false starts of the clinical trial process, but may also lead to a drop in confidence in science when the early promises which were so loudly trumpeted fail to bear fruit. We cannot risk this kind of disillusionment and disappointment by publicizing results irresponsibly, particularly when public engagement and trust are so essential in fighting the spread of the virus.
The journalist’s job in this is not easy. The coronavirus is practically the only story in news right now, demanding constant content creation. Their role as gatekeepers to scientific evidence is made harder when many studies, even peer reviewed ones, are making a misjudged sacrifice of rigor for speed. But journalists need to realize that pharmaceutical companies are not above presenting their results in a misleading way to garner maximum attention. Just because they aren’t politicians doesn’t mean they can’t play you. Show you know this by making your headlines accurate: ‘Moderna: Leaks data from incomplete clinical trial’ would have been much better than the AP’s original choice of ‘Moderna: Early coronavirus vaccine results are encouraging’. Alternatively, don’t report on public statements from pharmaceutical companies at all. Report on their peer-reviewed data.
Both the media and pharmaceutical companies have a responsibility to provide the most trustworthy information on coronavirus research to the public as possible. The stakes are too high to get this wrong.