Medicine and the media

Shire Hall Communications and the case for hepatitis B immunisation

There are two reasons why the topic was uppermost in the minds of the media that day. Firstly, SmithKline Beecham, the leading manufacturer of hepatitis B vaccine, convened a consensus panel to consider the issue last year; secondly, it paid the London public relations firm Shire Hall Communications to launch its report. The firm did a brilliant job.

The press pack, issued under embargo three days before the story broke, contained no less than 30 sides of A4 paper and three 35 mm transparencies (of virus particles, a mother smiling as her infant is immunised, and healthy toddlers playing with a train set). It was bound in a tasteful matt white art board cover with a graphic depicting the Venus de Milo's abdomen, together with the telephone number of the Children's Liver Disease Foundation.

Sending this pack out to Britain's news gathering organisations would not have been cheap, but when the prize is a policy shift that results in the taxpayer buying your product for every child born in this country, it probably constitutes a wise investment. A Shire Hall Communications spokesman declined to comment on the costs of the exercise.

View larger version (110K): [in this window] [in a new window]   Universal immunisation of infants against hepatitis B would put a smile on many faces

The press pack which supported the launch focused more on the global epidemiology of the disease than on its prevalence in Britain. It argued that the rise in foreign travel places more British people at risk; but it may also be reasonable to argue that those who can afford an airline ticket can also afford to pay for their shots before departure.

The Department of Health's current strategy is to target immunisation at individuals at high risk. This has succeeded in reducing the incidence of new cases to around 600 each year, though there are still worrying gaps in uptake of the vaccine among intravenous drug users and people who have multiple sexual partners.

Whether British taxpayers would be wise to play their part in the proposed universal immunisation programme is open to question. Dr Peter Rudd, chairman of the College of Paedia-trician's immunisation committee and a member of the consensus panel, felt that the panel had never been presented with adequate data onthe epidemiology of the disease in Britain. "There was very little input from the Public Health Laboratory Service, and I don't think we had enough information or discussion to justify changing present policy," he said. "The panel was top heavy with adult hepatologists, who see more of the disease, but are perhaps less well equipped to consider the cost-benefit analysis dispassionately. We all agree it's an important infection, but it's still an open question whether universal immunisation is the way forward."

SmithKline Beecham's consensus panel clearly succeeded in raising public awareness of a preventable infection and the need to reduce its incidence in Britain still further. If arguing against universal immunisation encourages doctors and health officials to achieve better coverage of high risk groups then the consensus panel and its backers will have performed a valuable service. And whatever the arguments in this particular instance, Shire Hall certainly provided an object lesson in how to manipulate the media machine.--DOUGLAS CARNALL, BMJ

Douglas Carnall 

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