How Sane Parents Got Paranoid About Vaccines
A review of Seth Mnookin's The Panic Virus: A True Story of Medicine, Science and Fear.
When my son was a toddler, an ophthalmologist diagnosed him with a form of amblyopia (lazy eye) and recommended an eye patch to improve his overall vision. But, he added, he couldn't promise that my son would ever have normal depth perception. I felt like I'd been kicked in the gut. I threw a few search terms into Google, came upon an offbeat treatment for eye disorders called vision therapy, and soon found a local practitioner, a middle-aged Chinese-American woman with short hair and half-moon glasses whose messy office was filled with eye charts and board games and had tennis balls hanging from the ceiling and who promptly engaged my son in games and eye exercises. Immediately, I knew we were doing the right thing. But when I told the ophthalmologist about the vision therapy, he told me flatly that, at least in my son's case, it was mumbo-jumbo and not to waste my money. Although I'm a physician, the concept of vision therapy made intuitive sense. It was low-risk: Even if it didn't work, we had nothing to lose, other than co-pays and time. If you're the parent of a child with a problem and you have the means to look for answers outside of the box, this is what you do.
In his engaging, provocative, and angry new book, The Panic Virus: A True Story of Medicine, Science and Fear, Seth Mnookin traces the history of the myth that vaccines cause developmental disorders like autism. In the process, he profiles a number of mothers with autistic children who followed their gut instinct away from conventional medicine and ended up on the front lines of vaccine paranoia. In the late 1990s, Vicky Debold, a nurse in Pennsylvania, grew concerned when her young son Sam stopped trying to walk, developed severe diarrhea, and lost his curiosity about people. Devastated when a doctor told her Sam was autistic and further dismayed by local support groups where she found parents who "seemed resigned to their fates," Debold got busy. An Internet search introduced her to Andrew Wakefield, whose theories linking the MMR vaccine to intestinaldisorders and autism were gaining currency among many parents of autistic children. When she subsequently met Wakefield at a conference, she was gratified that he took her concerns seriously and suggested some next steps: an X-ray, maybe a colonoscopy, a visit with a gastroenterologist. Unlike other doctors, who had no answers, Wakefield offered hope. Even if this hope came via costly, invasive tests and even if he was scapegoating the MMR vaccine, can you really blame parents for listening?
Andrew Wakefield's name is now infamous, of course: Just last month, a British Medical Journal investigative series by journalist Brian Deer accused him of being not only wrong about MMR and autism, but a fraud to boot. Mnookin, who completed his book well before these latest BMJ revelations, is determined to convince readers of Wakefield's dangerous flakiness, and to this end he provides a few cringeworthy examples of Wakefield's character. Such as the fact that, in the name of his research, Wakefield drew blood from young children at his son's birthday party and—as though this somehow made it legit—paid them for it. Or the decidedly strange moment when Wakefield asks Mnookin about getting his new book (Callous Disregard, with a foreword by Jenny McCarthy) translated into Hebrew.
Mnookin doesn't fault parents for searching for answers through listservs and autism conferences and talking to other parents, and he's angry at sharks like Wakefield and others who take advantage of their desperation. But he has little patience for people who refuse to acknowledge scientific evidence and who, by sticking to the anti-vaccine party line, put everyone's children at risk. Nobody else will suffer if my kid's depth perception isn't quite normal, but children who don't get vaccinated can die, or can be the reason that other kids die. The book lingerson the case of Brie Romaguera, whowas just over four weeks old when she died from pertussis (whooping cough) in 2003. Too young for the DPT vaccine, she would never have caught pertussis if more of the children in her Louisiana community had been vaccinated.
Here is what baffles Mnookin most: How so many caring, well-educated, affluent parents came to buy leaky theories that vaccines cause autism. How 48 states allow parents to exempt their kids from vaccines for religious reasons, and how in 18 states all you need is a philosophical reason. How, in 2010, the journal Pediatrics reported that a staggering 25 percent of parents believed that vaccines can cause developmental disorders in healthy children. How, even after a 2002 study in the New England Journal of Medicine found no link between MMR and autism, the anti-vaccine camp grew stronger.
Perhaps it's not surprising that people are oftenmore willing to believecelebrities like Jenny McCarthy and Oprah (who gave McCarthy a platform and made"mommy instinct" ahousehold phrase) than a bunch of earnest research doctors who haven't mastered the sound bite. People also trusted Robert F. Kennedy Jr., the attorney and environmentalist, whose 2005 article "Deadly Immunity" (published simultaneously in Rolling Stone and Salon, though Salon later removed it) suggested that scientists, government agencies, and companies were conspiring to mask the dangers of thimerosal (a form of mercury sometimes used as a vaccine preservative). Mnookin is so ticked off at Kennedy that he somewhat tediously demonstrates Kennedy's selective "slicing and dicing" of statements by scientists to fit his narrative.
Vaccine paranoia may also be a consequence of print journalism's decline. Health and science reporters are supposed to not only translate scientific jargon into clear language but also comment on whether a particular study's methods are kosher. But in the last 20 years, as Mnookin notes, the number of science reporters and science sections has dropped sharply. Many journalists now treat press releases as gospel, without doing any independent reporting. And then there'sjournalist David Kirby, whose 2004 book, Evidence of Harm—Mercury in Vaccines and the Autism Epidemic: A Medical Controversy, exploredthe purported autism-MMR-thimerosal link. Bitterly sarcastic, Mnookin describes Kirby's narrative as "proud, independent-minded mothers doing battle with greedy drug companies and corrupt government agencies." Although much about the book was misleading, including its title (which as Mnookin notes was taken from a 1999 CDC statement finding no evidence of harm involving thimerosal in vaccines), the media ate it up: When Tim Russert squared Kirby off against Harvey Fineberg, the president of the venerable Institute of Medicine, Kirby's polished comments sparkled in comparison to Fineberg's bumbling attempts to respond to his absurd pronouncements without sounding condescending.
The Panic Virus is hard to put down. The chapters are short and intense; the anecdotes colorful; the explanations of scientific and medical concepts almost always crystal clear. But while Mnookin has a knack for telling a story, I don't think this book (or the BMJ series, for that matter, or infectious disease expert Paul A. Offit's new book Deadly Choices: How the Anti-Vaccine Movement Threatens Us) will be picked up by many die-hard anti-vaccine readers. Mnookin is surely preaching to the choir. And yet there may be some utility to this: He provides his readers plenty of prods with which to jab those who don't vaccinate their kids, and some of these prods are awfully sharp.
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Anna Reisman is a physician in Connecticut. You can follow her on Twitter: @annareisman.