By Asu Erden
Most of us are aware of the political controversies surrounding the human papillomavirus (HPV) vaccine. Some of us even have personal anecdotes relating to this highly charged subject. “I remember my aunt calling me to ask me about the vaccine. She was worried about what it meant for her children’s health and why her son should get an immunization aimed at preventing cervical cancer,” said Dr. Heather Marshall, a postdoctoral fellow at the Yale Department of Immunology. The confusion is all too common. As scientists, we have failed Dr. Marshall’s aunt and millions like her. In fact, the HPV vaccine has been extremely poorly marketed despite its astounding efficacy. The Centers for Disease Control (CDC) estimates that the quadrivalent vaccine offered in the US has an efficacy against genital pre-cancers and warts of nearly 100% in previously unexposed women, as well as 90% against genital warts and 75% against anal cancer in men. Despite the remarkable efficacy of the vaccine, not all parents in the US want to have their sons and daughters vaccinated. The scientific achievement that a vaccine embodies is not enough. This is one of the tragedies brought about by the failure of science communication. The HPV vaccine has been marketed towards young girls. Why has it not been made clear that both women and men should get the vaccine and that the early age of vaccination is only meant to increase vaccine efficacy? Men and women can actually be immunized up until the age of 26, after which it is assumed that you have most likely been exposed to one or more of the HPV strains that the vaccine protects against. In reality, you can still get the vaccine after this age. It will just not be as efficacious.
“The contribution of science is to have enlarged beyond all former bounds the evidence we must take account of before forming our opinions” wrote British biologist Sir Peter Medawar in Pluto’s Republic. In this day and age, the Internet provides readers around the world with a spate of resources – most of which not peer-reviewed – on just about anything. Unlike newspapers and books, blogs are most often not fact-checked. Just have a look at the Natural News blog and you’ll see how harmful misinformation disguised in a professional layout can be. As Dr. Marshall notes “a hundred years ago, it took weeks or months for a piece of scientific news to reach the other end of the country or the other side of the Atlantic. Fifty years ago it took a few hours or days. Twenty years ago it became one second but that sort of news still had a very narrow audience. Today you can literally reach 100 million people within a few seconds, which is really scary.” It is scary because it comes with a duty to inform that too many scientists choose to ignore out of frustration and because of the lack of any tangible benefits to their career. Dr. Schatz, professor of Immunobiology and Molecular Biophysics and Biochemistry at Yale, deplored that the connection is very tenuous between talking to students at local high schools and increasing interest and funding for scientific research. It inevitably comes down to scientists’ intrinsic motivations to go out there and share their research with the public.
As a graduate student at Yale and as a scientist, I find these realities challenging. I am unsure as to when I first came to realize the widening mismatch between how scientists talk to the public about their research and how they should talk about it. But this is something that every budding and established scientist is aware of. Yet we are seldom taught how to translate scientific concepts back into the vernacular. Science truly has a separate language that facilitates talking about complex concepts with peers that share the same premises. It is easy to forget that this has been taught to us and does not come naturally. I discussed this with Will Khoury-Hanold, a graduate student in my lab. His involvement with the Science in the News initiative – which trains Yale graduate students to give talks to high school students about a broad range of current scientific topics – taught him a lot in this regard. He described science as requiring a greater leap than other disciplines. “Anyone can pick up a history book and read about the elements that led to the Civil War. It’s not the same with science. […] With science, it’s about translating it back to English.” This is hard to do, and we often shy away from talking to the public. But in a world where Jenny McCarthy is hired by The View and has access to a 3 million viewer platform to spread her anti-vaccine views, scientists have to speak up and as loudly as they can to provide the public with fact-checked truths. Of course entertainers can aptly serve the cause: if you have not seen this vaccine-related video by Penn & Teller I strongly encourage you to do so. Nevertheless, the duty to inform the public about these matters should fall on scientists.
Scientists are partly responsible for the failures of science communication. Clearly, we have a tendency to revel in esoteric statements about our research and about science more generally. If you take the word “theory” for instance, its scientific meaning widely differs from its colloquial understanding. For non-scientists, a theory is something that has yet to be proven. For scientists, a theory is “a well-substantiated explanation of some aspect of the natural world that can incorporate facts, laws, inferences, and tested hypotheses […] theories do not turn into facts through the accumulation of evidence. Rather, theories are the end points of science. They are understandings that develop from extensive observation, experimentation, and creative reflection,” as pointed out by the National Academy of Sciences. Our arcane vocabulary makes it seem as though understanding science were a luxury. We need to use more accessible language so that such misrepresentations of scientific truths do not happen. Is it the fault of scientists that the HPV vaccine was poorly marketed? Perhaps not directly but we should have made it clearer to journalists why the vaccine is so important and how it is significantly reducing the incidence of cervical cancer. Another infamous example is that of the alleged correlation found between the measles, mumps, and rubella (MMR) vaccine and autism. While the study published by Mr. Wakefield in 1998 has been debunked and his medical license was stripped, most people still don’t know why his results were wrong. Not only did he not comply with the clinical trial rules for his study, the putative correlation he claimed to have found was based on a confounding factor. What is that you say? That would be an example of scientific jargon but what it really means is this: the MMR vaccine usually gets administered around the age of 2, which is also the age at which most children start speaking. One of the clearer symptoms of autism is to not start speaking when you are supposed to. Thus, autism inherently gets diagnosed around the age of 2. This is what underlines the correlation Wakefield reported. The confounding factor was the age of the children. When it comes down to their kids’ health, reminding parents that “correlation is not causation” achieves little. Having the population actually exposed to that concept more generally would achieve much more.
As Dr. Marshall emphasized, “a lot of the time it can come down to the scientist. If you had asked me [about it] a couple of years ago, I might not have said this as easily.” As scientists we never get properly trained to know how to answer that phone call we might get from journalists who under the pressure of publication might perform less than optimal fact-checking. By not being as clear as possible we inadvertently provide ground for sensationalism. But this reflects a broader failure to communicate science to the public. We live in a world where it is acceptable not to know what a gene is or how evolution actually works. To remedy this, scientists need to make concepts they are familiar with more accessible and report their research aptly.
But the language of scientific discovery and science communication is not solely beneficial to the public. It can help scientists better share their research with people beyond the realm of their own department. A good talk fosters cross-fertilization between fields. Scientists have a tendency to narrowly focus on their thought-processes and dig a deeper and deeper hole to burrow themselves into. As a result, we lose the forest for the trees. Many graduate students, postdoctoral fellows, professors, and department chairs have encountered this somewhere along the line. Insufficient training in writing and in giving public speeches results in science talks that fail to convey their points across. The problem is that scientists are asked to give many talks and presentations. What happens most often is that they regurgitate PowerPoints they prepared for specialists in their field and use them to give talks to an unspecialized audience.
The challenge and art of giving a good talk is to know your audience and to aptly choose the level of detail versus abstraction that suits said audience. “We as a species – by which I mean scientists –,” added Professor Schatz “are so programmed to show the data that it takes effort not to.” That skill is not just useful when communicating science to a lay audience. It fosters collaborations and thus important breakthroughs within the field of scientific research. Professor Schatz recalled an immunology meeting organized by the Federation of American Societies for Experimental Biology he was at a few months ago. One of the speakers at that conference was Dr. Margaret Goodell who specializes in the field of stem cell research and therefore stood out as not being an immunology-related speaker. She gave such an inspiring and thought-provoking talk that immunology professors were lining up to discuss potential collaborations with her lab. This does not happen when content prevails over format. At a time when knowledge within the sciences has become so specialized, collaborations become a necessity. If as scientists we are unable to communicate our research to people outside our field – whether they are scientists or not – we prevent such collaborations from budding. It also prevents good scientists from getting grants because they are unable to write well enough about their research.
Most scientists get into their field with the hope to increase the spectrum of human knowledge about the world surrounding us, even if only by a little bit. And most of us thrive on the possibility of understanding something about nature that no one had understood previously and of sharing it with the rest of the world. But somewhere along the line, this humanistic ideal wanes or at least no longer suffices. “You make a scientific discovery and you can’t wait to share it with your peers” said Will. Why this does not necessarily translate into a desire to talk about your research to the public remains somewhat elusive. So to those scientists out there, I must ask: do you remember your personal statement for college and for graduate school? You meant it when you said that you wanted to save the world by increasing our understanding of worm neurobiology or by curing cancer. Don’t forget it!