In­side the vac­cine-autism scare

The Washington Post Sunday - - OUTLOOK - BY SAN­DRA G. BOOD­MAN San­dra G. Bood­man, a for­mer staff writer for The Washington Post, writes about health and medicine.

Afew years ago, while re­port­ing a story on at­ten­tion deficit dis­or­der, I asked an af­flu­ent young mother why she was spend­ing thou­sands of dol­lars on a du­bi­ous ther­apy, rather than on treat­ment proven to be ef­fec­tive. “I did my re­search on the In­ter­net,” she replied, cit­ing a hand­ful of pseu­do­sci­en­tific Web sites that ad­vo­cated the “nat­u­ral” ap­proach she fa­vored and that warned against im­mu­niz­ing her preschool­ers against child­hood dis­eases be­cause the shots con­tained toxic in­gre­di­ents.

I thought of her while read­ing “ The Panic Virus,” jour­nal­ist Seth Mnookin’s dis­turb­ing and well-told chron­i­cle of the child­hood vac­cine wars in the United States and Eng­land. While Mnookin traces the his­tory of vac­cines, be­gin­ning with the one for small­pox, his fo­cus is on the spe­cious but re­mark­ably per­sis­tent myth that the cur­rent ros­ter of shots chil­dren re­ceive to pre­vent dis­eases such as measles, whoop­ing cough and hep­ati­tis B can cause autism or other se­ri­ous prob­lems— and that this “fact” is well-known to govern­ment of­fi­cials, pe­di­a­tri­cians and vac­cine man­u­fac­tur­ers, who have con­spired to cover it up.

A con­tribut­ing edi­tor for Van­ity Fair, Mnookin be­came in­ter­ested in the sub­ject in 2008 shortly af­ter get­ting mar­ried and be­com­ing part of a com­mu­nity of young pro­fes­sion­als who drove Priuses, shopped at Whole Foods and de­cided against vac­ci­nat­ing their chil­dren, which they con­sid­ered to be a health-con­scious choice. Some didn’t trust the med­i­cal es­tab­lish­ment, while oth­ers were swayed by me­dia re­ports about the pos­si­ble dangers of vac­cines or thought that the num­ber of shots given to chil­dren is ex­ces­sive.

Iron­i­cally, im­mu­niza­tions have be­come vic­tims of their own suc­cess, erad­i­cat­ing from pub­lic me­mory the dev­as­tat­ing af­ter­maths of once-com­mon pe­di­atric ill­nesses: deaf­ness caused by mumps, blind­ness af­ter measles and paral­y­sis brought on by po­lio. Mnookin doc­u­ments how these vac­cines, a cor­ner­stone of mod­ern pub­lic health, have be­come tar­gets of fear and mis­in­for­ma­tion. He draws on in­ter­views with anti-vac­cine ac­tivists and pub­lic health of­fi­cials, sci­en­tific lit­er­a­ture, me­dia ac­counts, and re­search into the psy­chol­ogy of risk. His view of the me­dia’s role is un­spar­ing; he shows how rat­ings-hun­gry news and en­ter­tain­ment shows kept the de­bate alive, even as ev­i­dence for the safety and ef­fec­tive­ness of the shots be­came over­whelm­ing.

Op­po­si­tion to child­hood vac­cines sim­mered mostly on the fringes un­til 1998, when London gas­troen­terol­o­gist An­drew Wake­field co-au­thored a study in the Bri­tish med­i­cal jour­nal Lancet link­ing autism to the measles, mumps and rubella (MMR) shot. Al­though his re­search was im­me­di­ately chal­lenged, it was not un­til last year that the study was re­tracted and Wake­field stripped of his med­i­cal li­cense. Two weeks ago the Bri­tish Med­i­cal Jour­nal pub­lished an in­ves­tiga­tive ar­ti­cle on the study, as well as an ed­i­to­rial call­ing it “an elab­o­rate fraud” based on fal­si­fied data. The in­flu­en­tial jour­nal re­ported that cru­cial de­tails in the case his­to­ries of the dozen chil­dren in­cluded in Wake­field’s re­port had been al­tered or were mis­rep­re­sented.

In the years af­ter Wake­field’s study, the anti-vac­cine ar­gu­ment gained sig­nif­i­cant trac­tion, es­pe­cially on the In­ter­net, which has be­come an im­por­tant source of health in­for­ma­tion for many peo­ple. As a con­se­quence, im­mu­niza­tion rates on both sides of the At­lantic dropped; out­breaks of measles, per­tus­sis and mumps in­creased; and some chil­dren died of vac­cine-pre­ventable dis­eases. Even though study af­ter study failed to find a link be­tween the in­gre­di­ents in vac­cines and autism, health of­fi­cials in the United States and Eng­land seemed un­able to ef­fec­tively re­fute anti-im­mu­niza­tion ar­gu­ments, for rea­sons that re­main puz­zling.

Mnookin’s con­tention that the con­tro­versy would not have achieved stay­ing power with­out un­crit­i­cal or at times bla­tantly ir­re­spon­si­ble re­port­ing by nu­mer­ous me­dia out­lets — in­clud­ing NBC, the Huff­in­g­ton Post, Rolling Stone and The Washington Post — is per­sua­sive. Too of­ten, he writes, jour­nal­ists dis­play “a will­ing­ness to par­rot quack claims un­der the guise of re­port­ing on cit­i­zen con­cerns.” Much of the cov­er­age failed to ad­e­quately ex­plain the fun­da­men­tal but es­sen­tial dif­fer­ence be­tween cor­re­la­tion and cau­sa­tion. Sim­ply be­cause a child re­ceived a vac­cine and soon af­ter be­gan show­ing signs of autism does not mean the shot caused the dis­or­der, only that the two events are linked tem­po­rally. Nor can sci­en­tists ever say cat­e­gor­i­cally that vac­cines do not cause autism; it is im­pos­si­ble to prove a neg­a­tive.

Tele­vi­sion talk shows also pro­vided a plat­form for vac­cine op­po­nents to make their case, largely un­chal­lenged. Dur­ing an ap­pear­ance on “Oprah,” ac­tress Jenny McCarthy blamed the MMR shot for her son’s autism, proudly telling the au­di­ence, “ The Uni­ver­sity of Google is where I go tmy de­gree.”

This book ef­fec­tively doc­u­ments the iso­la­tion and anguish of par­ents rais­ing an autis­tic child, and it’s hard not to feel that these fam­i­lies are vic­tims of a bat­tle that has squan­dered sig­nif­i­cant re­sources. A for­mer leader who has bro­ken with one prom­i­nent autism group over its anti-vac­cine stance said it best: “At some point, you have to say, ‘ This ques­tion has been asked and an­swered and it’s time to move on.’ ”

By Seth Mnookin Simon & Schus­ter. 429 pp. $26.99

THE PANIC VIRUS A True Story of Medicine, Sci­ence, and Fear

EDA AKALTUN FOR THE WASHINGTON POST

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