Building trust in Covid-19 vaccines through study data and clear communication

In cooperation with Christine Mertzlufft

This week saw another milestone in the crisis management of the Covid pandemic: The EMA (European Medicines Agency) approved AstraZeneca’s Corona vaccine in the EU – as the third vaccine after Biontech and Moderna. However, the Standing Committee on Vaccination at the Robert Koch Institute in Berlin recommends that only patients aged 18 to 64 years should be vaccinated with the AstraZeneca vaccine. Previously, there had been uncertainty about the vaccine’s efficacy after EMA Chairman Cook pointed out that there was a very small amount of data on older populations in the available tests. And that “very small amount of data on older populations” led to media reporting in Germany in the run-up to the approval announcement questioning the efficacy of AstraZeneca’s vaccine in patients over 65.

After the German Newspaper Handelsblatt was the first to headline that the active ingredient was “unlikely to work in seniors”, several media followed up, including the largest German daily newspaper. It is easy to imagine what impact these reports may have had on the public’s uncertainty about Corona vaccines. AstraZeneca promptly responded with a clarification: According to a spokesperson, the statement that the vaccine has very low efficacy in seniors is “completely false”. This led to further media reporting. In the main news of all German television channels, it was finally reported and speculated, how the factual situation was. Completely incredulous, we asked ourselves the question: What had happened? It is a fact that there are only few data on the older population groups – this has also been pointed out by the EMA. However, this does not mean that the vaccine is not efficacious in this age group. There is simply a lack of valid data to support this. Obviously, there had been ambiguities in the communication and/or in the reception of the results of the studies.

An article published in The Lancet stated clearly that the number of older adults participating in the AstraZeneca vaccine Phase III trial was way too few to make a final judgment on efficacy in seniors at this point. These data from the Lancet paper were obviously misinterpreted by the two tabloids that made such claims. “Around eight percent of the subjects in the AstraZeneca effectiveness study were between 56 and 69 years of age, and only three to four percent over 70 years of age”, said a spokesman for the Federal Ministry of Health. “From this, however, an efficacy of only eight percent in older people cannot be derived.” The fact is that there is only little data on the older population groups – the EMA had made this clear. However, it cannot be inferred from this that the vaccine is not efficacious in this age group – there is simply a lack of valid data to support this. The misunderstanding is actually not surprising: The language of the Lancet paper is highly complex and aimed at health research experts. Formulations, data and graphics are difficult to interpret for medical laypeople. Apparently only the data tables were read. On the other hand, a central sentence was simply overlooked, which is not in an exposed position in the paper, but is hidden in the last third of the text:

“Vaccine efficacy in older age groups could not be assessed but will be determined, if sufficient data are available, in a future analysis after more cases have accrued.”

With a clearer text structure and more understandable wording, especially in the Findings and the Study Implications, this misunderstanding could certainly have been prevented.Ambiguities that lead to uncertainty and misunderstandings – that is something that should be avoided at all costs in the PR of pharmaceutical products. On the contrary: from our daily work, we at Mertzlufft Linguistic Consulting know how important it is in communicating about pharmaceutical products to create trust, both among doctors and patients. To achieve this, one thing above all is goal-oriented: A clear communication strategy that takes study data into account in a language that is easy to understand. And this is precisely our expertise. The EU Commission agrees on this in yesterday’s press release: “Transparency and accountability are important to help build the trust of European citizens and to make sure that they can rely on the effectiveness and safety of the vaccines purchased at the EU level”.

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