H1N1新型流感的議題建構過程─以疫苗不良事件為例

The Agenda Building Process of Pandemic Influenza H1N1 in Taiwan-A Case of Vaccine Adverse Event

陳清芳(Ching-Fang Chen)

指導教授 ： 丁志音

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2010年)

https://doi.org/10.6342/NTU.2010.00933

摘要

H1N1新型流感病毒在2009年4月首度現蹤並爆發人類疫情，大約兩個月後，H1N1大流行流感散佈到全球。
世界衛生組織(WHO)建議各國採取的防疫對策中，包括儲備H1N1新型流感疫苗在內。在台灣，政府衛生主管機關採購1500萬劑疫苗，當年11月展開接種作業。
重大傳染病通常吸引媒體大幅報導，本研究取得2009年11月1日至2010年2月24日衛生署疾病管制局新聞稿64篇，以及同期間中國時報、自由時報、聯合報、蘋果日報等4家報紙相關報導1184則，比較疾管局新聞稿與報紙報導的內容一致程度，藉由議題建構的文獻回顧及資料分析結果，探索媒體與消息來源的互動，以及議題生命週期變動。
結果顯示，4家報紙報導疾管局的H1N1新型流感疫情說明與疫苗接種事宜時，傾向中性與正面，較為採信疾管局的說法。但是，4家報紙在報導疫苗疑似不良事件時，對疾管局的態度是明顯唱反調。
疾管局在公開說明H1N1新型流感疫情與疫苗接種事宜時，是媒體可以信賴的消息來源；疾管局具有官方地位，亦握有近用媒介的優勢，在事件中對記者扮演流行病學家的角色。可是，在攸關疫苗風險爭議性突發事件，報紙和疾管局的關係為之改變。
疾管局處理疫苗不良事件時，報紙處於對抗立場，尤其台中劉小弟在接種首劑疫苗後死亡事件，記者近身報導事件當事人，引用其他消息來源的說法，對疾管局提出質疑，不良事件超越其他議題，成為報紙報導的焦點。
建議疾管局在進行疫苗政策的效益與風險溝通時，應提供民眾易於認知的訊息，注意兒童與孕婦等敏感對象的溝通技巧；在新聞發佈時，應預先管理不良反應的媒體議題，以減少類似事件對政府公信力的傷害。

關鍵字

HIN1 ； 大流行流感 ； 疫苗 ； 不良事件 ； 議題建構

並列摘要

One of the World Health Organization's advices to nations in response to the pandemic was stockpiling H1N1 vaccines.
In Taiwan, heath authorities placed orders for 15 million doses of the vaccine, which were distributed to inoculate in November.
Usually, severe infectious diseases grab the headlines. This study tries to tell how consistent the press reports could be with the press releases issued by the authorities on H1N1 events by comparing 64 press releases issued by Center for Disease Control (CDC) between November 1, 2009 and February 24, 2010 with 1,184 news pieces about H1N1 surfaced in the meantime on Taiwan’s four major newspapers—China Times, Liberty Times, United Daily News and Apple Daily.
With literature reviews for agenda building process and analysis the contents of data, this study also attempts to explore the interaction between information sources and reporters as well as the media agenda transition in the life cycle.
The comparisons show that the newspapers tended the neutral and positive attitude toward CDC. The reporters leaned towards adopting CDC’s statements on how vaccination work and flu control were going on. But when it came to suspected adverse events which claimed lives, the newspapers turned to adopt hostile statements against CDC.
CDC, when spelling out vaccination and pandemic control work to the general public, was a reliable information source for news media because of its empowered authority. CDC also owned dominant access to media coverage and played an epidemiologist role for reporters in the whole events. But in the unexpected events that were linked to the risk of the vaccine, the relationships between CDC and news media was diverse.
The news media are opposed to CDC on how this institute handled vaccine adverse events. Especially there happened a focal event which a boy died after the first injection, reporters usually exclusively took the words from people at the heart of the disputed cases and questioned CDC with biased standpoint. The news pieces mentioned about other agenda were outnumbered by those about adverse events.
In dealing with the risk and benefit communication about vaccination policy, CDC may provide the general public comprehensible information. Sensitive cases such as kids, expectant women need extra communication skills. CDC’s press releases should in advance manage the agenda in order to minimize the damage that the adverse events may cause to the public trustworthiness of the government.

並列關鍵字

H1N1 ； pandemic influenza ； vaccine ； adverse event ； agenda building

參考文獻

李秉穎. (2008). 流感疫苗的誤解與安全議題. 台灣醫界, 51(10).

蕭惠心, 孫蕙芝, & 嚴哲傑. (2005). 醫療院所工作人員流感疫苗接種後不良反應評估問卷分析. 疫情報導, 21.

蔡美瑛. (1995). 議題設定理論之發展─從領域遷徏、理論延展到理論整合. 新聞學研究, 50, 97-124.

羅文輝. (1995). 新聞記者選擇消息來源的偏向. 新聞學研究, 第50集.

鄭瑞城. (1991). 從消息來源途徑詮釋近用媒介權：台灣的驗證. 新聞學研究, 第45集.