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Deadly Choices: How the Anti-Vaccine Movement Threatens Us All
In 2010, California suffered the largest and deadliest outbreak of pertussis, also known as ?whooping cough,” in more than fifty years. This tragedy was avoidable. An effective vaccine has been available since the 1940s. In recent years other diseases, like measles and mumps, have also made a comeback. The reason for these epidemics can be traced to a group whose vocal proponents insist, despite evidence to the contrary, that vaccines are poison. As a consequence, parents and caretakers are rejecting vaccines for themselves and their families.
In Deadly Choices, infectious-disease expert Paul Offit takes a look behind the curtain of the anti-vaccine movement. What he finds is a reminder of the power of scientific knowledge, and the harm we risk if we ignore it.
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a compelling history of vaccines and anti-vaccine movements,
The focus of Deadly Choices is on the history of the introduction of new vaccines and the anti-vaccine movements that tend to follow. Offit is a prominent virologist and he doesn’t hide his scorn for some in the anti-vaccine movement. His book is unlikely to change the minds of anyone who is firmly within that movement, but I’m not sure what would. The book is a must read for anyone interested in a detailed, well-written, and thoroughly sourced discussion of the scientific basis of vaccines, the real and imagined risks of vaccination, and the consequences of the choices we make about vaccines.
The politics of the vaccine debate are powerful, and they often overshadow the substance. It’s remarkable how many people managed to read and write “reviews” of this book within 2 days of its release on December 28. A few even managed to review the book before it was released! Given that few of these reviews mention anything about the book’s contents, I suspect many of the reviewers, both positive and negative, have not read it.
I actually have read the book. Given that I had written about the vaccine/autism debate in the past (from the perspective of trying to understand the sorts of evidence people use when drawing causal conclusions), I requested and received a review copy of the book from the publisher 6 weeks before its publication.
Not surprisingly, the book thoroughly documents some of the unfounded claims that the anti-vaccine movement has made and explains the biological reasons why some of the perceived risks of vaccines either are not a risk or physiologically CAN’T be a risk. For example, many of the “green our vaccines” campaigns are based on the concern that there are nasty chemicals in vaccines, which is true. As Offit notes, though, it’s not the substance that’s the problem, it’s the dose. Even water is toxic when taken in a large enough dose (on occasion, college students die during frat hazings when required to drink too much water at once). Most of the substances that scare people away from vaccines (e.g., aluminum and formaldehyde) are in our bodies and blood stream all the time. Our foods contain them, and the quantities in vaccines are relatively negligible. Similarly, babies are exposed to countless bacteria and viruses, so the fact that children get a seemingly large number of vaccines does not mean that those vaccines tax the immune system at all (Offit also notes that it’s not the number of vaccines, but the number of elements within those vaccines that require an immune response).
The book is not one-sided. The first chapters discuss all of the well-documented cases of actual vaccine injury and the real side effects of vaccines (e.g., the live polio vaccine could cause polio, although most vaccines don’t use live viruses). The book uses these tragic cases to document how the CDC and regulatory agencies now catch really rare side effects that didn’t show up in the large-scale testing necessary for approval (side effects that are 1 in a million sometimes don’t show up in testing with 50,000 people). Vaccines undergo more rigorous testing than other drugs, and the mechanisms in place to detect rare side effects work far more effectively than they do for other drugs. In order to introduce a new vaccine into the recommended schedule, testing must show that it doesn’t interact in any way with the remainder of the schedule.
Offit also discusses some of the things that vaccine safety advocates could do (but haven’t done) to help make vaccines safer. For example, people who have egg allergies cannot get vaccines that are made using chicken eggs (e.g., flu vaccine). There might well be alternative ways to make such vaccines, but the pharmaceutical industry has no financial or government-initiated incentives to develop those alternatives. Vaccine safety advocates could push them to do so.
Offit makes the case that anti-vaccine movements raise fears of vaccines that are inconsistent with the science. In so doing, he draws parallels between current anti-vaccine claims and those made over a century ago after the introduction of the smallpox vaccine. Many of the fears of that vaccine are laughable by today’s standards (e.g., that children would develop cow-like facial features because the vaccine was initially taken from cows infected by cowpox). But Offit argues, fairly convincingly, that the logic and nature of current anti-vaccine scares are largely the same as those raised over a century ago and in each subsequent anti-vaccine movement. He also shows that most of the anti-vaccine proponents as well as self-identified vaccine safety advocates (including Dr. Bob) lack any relevant background in virology, epidemiology, or statistics, and that they typically lack the training to evaluate the actual risks of vaccines.
The most compelling chapter is the last one, in which Offit describes what happens when someone…
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|Comment by D. Simons — December 9, 2012 @ 5:27 am
Outstanding well researched book,
This book reviews the history of the anti-vaccine movement and with research, facts, and scientific data shows the danger of that this poses to society. A small number of zealots with no background in science, no data, and only anecdotal evidence, which is of course of no value, can do a lot of damage. One only has to read the negative comments in these reviews to see the tactics…attack the messenger and avoid dealing with the facts. One in fact only found it necessary to read the title, not the book. That pretty much says it all. The fact that the author has done scientific research with drug companies doesn’t mean what he says is wrong, only that one should look for other support for his conclusions, and there is plenty of that. The notes and documentation section of this book take up almost 40 pages, something that those with just their own personal stories never seem to need. Anyone who has a child or contemplates having one in the future should read this book if they are having doubts, which may have a very positive effect on their child’s health and maybe save their life.
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|Comment by folkie — December 9, 2012 @ 5:46 am
a must read for those on BOTH sides of the argument,
I spied this book at our local library and knew I had to read it. I am no stranger to the controversy regarding vaccination, as it is a frequently discussed topic in the homeschooling community. Our small group is split fairly evenly between those who never miss a recommended immunization and those who would never consider any type of immunization. Fortunately, amongst our group the disagreement is amicable. (One of the things I love about homeschool- independence is valued!)
I will freely admit that I am in the pro-vaccine court. I know that side effects- even death- are possible, but in weighing the potential damage from a vaccine and potential damage from disease….well, immunization seems the lesser of evils. I expect that those who choose differently go through the same painstaking inner dialogue, they just end up in a different place. I’m okay with that.
This book is also solidly pro-vaccine, but I think it does a pretty decent job of presenting the pros AND cons of the situation. There have been situations where vaccines were contaminated. There have been situations where vaccines were just a bad idea (live polio virus). And, there have been situations where disease has swept through unvaccinated communities at an alarming rate. Offit covers all this and more, without the intense fear mongering often found in this type of manuscript. A person so inclined could skip the commentary and just read the studies presented.
He does seem to be a bit harsh when speaking about those in the anti-vaccine movement. I can certainly grasp that he thinks they are making a mistake without the thinly veiled references to their moral character. He might garner more respect from that camp if he offered it up himself!
My verdict: Read it! This book does a very good job of presenting the science behind vaccines and how it has changed over the years. Regardless of what side of the argument you choose, Deadly Choices can provide you with the facts to bolster your opinion. Although I feel it is an important enough societal issue to warrant everyone reading this book, it is a MUST read for parents.
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|Comment by Word Nerd — December 9, 2012 @ 6:08 am