The Panic Virus: A True Story of Medicine, Science, and Fear | By Seth Mnookin | Simon & Schuster | 448 pages, $26.99
“A lie told often enough becomes the truth,” warned Vladimir Ilyich Lenin, who pressed this adage into service on more than one occasion. In The Panic Virus, Seth Mnookin starkly exposes the social architecture supporting one such lie: the pervasive and destructive myth that certain vaccines—those laced with a mercury-based preservative called thimerosal—are responsible for rising rates of autism in the United States.
Mnookin first offers a quick history of vaccines, beginning with “variolation,” an early approach to inoculating patients against smallpox. He moves on to the triumph of the polio vaccine—and to the disastrous “Cutter incident” of 1955, in which a tainted batch of the vaccine led to fifty-seven cases of paralysis.
Next comes the resistance to water fluoridation, wherein Mnookin pinpoints the hazy science of the opposition: “When they asserted that there is some hypothetical quantity of drinking water that would contain enough fluoride to be toxic to humans, they did so confident that nobody in the media would point out that that amount was fifty bathtubs’ worth.” The author then touches on the 1976 swine-flu fiasco and problems with the DPT vaccine, before veering off into the evolution of autism.
In the second section of his book, Mnookin turns to dismantling the causation theories that link thimerosal and autism. As he explains, this link was promulgated by such scientists as Andrew Wakefield, a physician whose 1998 Lancet paper castigated the measles, mumps, and rubella (MMR) vaccine as a possible trigger for autism. Here was the first major study to set off alarm bells—even though it was later retracted, and Wakefield himself subsequently struck off the British medical registry. What followed the initial publication was a flood of lawsuits, high-profile articles, books, televised debates, and even rumblings against a government conspiracy to protect the pharmaceutical industry.
As readers of The Panic Virus will soon grasp, the thimerosal theory has no credibility. And in any event, the preservative has long since been removed from all but a few vaccines. The FDA found no evidence that miniscule levels of thimerosal caused autism or other harms, but since the government did think it prudent to end the use of mercury and its derivatives, it was gradually phased out.
In the meantime, substantial numbers of parents hesitated to have their children vaccinated. As Mnookin explains, these holdouts put the health of others at risk, because even a small pocket of the unvaccinated may lead to an outbreak. He writes: “The notion that people should base medical decisions on what is ‘right for them’ is particularly problematic in a public health context, where individual choices cannot be cordoned off from each other.”
To drive home this point, Mnookin gives several wrenching examples of children injured or killed in this manner. Take Julieanna Metcalf, a fifteen-month-old, fully vaccinated girl, who caught Hib, or Haemophilus influenzae Type B, from her unvaccinated peers in 2008. By the time she got out of the hospital a month later, Julieanna had suffered multiple seizures and had had a buildup of fluid in the brain so dangerous that it required emergency surgery. She’d also lost all her motor skills—including the ability to swallow—and will require multiple immune globulin injections each week for the rest of her life.
Even with her weakened immune system, Julieanna might not have caught Hib if everyone around her had had their shots . The outbreak that ensnared Julieanna also resulted in the hospitalization of four other children.
In a chapter titled “A Conspiracy of Dunces,” Mnookin mercilessly dispatches an array of vaccine skeptics, including Robert F. Kennedy, Jr., who contributed articles touting the autism-thimerosal connection to Rolling Stone and Salon. He is no less sardonic about various autism advocacy groups, including the one initiated by the actor (and, as we are relentlessly reminded, former Playboy centerfold) Jenny McCarthy.
Yet Mnookin’s take-no-prisoners approach to his subject has some major drawbacks. As I’ve already suggested, he does a brilliant job amassing the evidence that thimerosal poses no danger of triggering autism in children. He launches an equally powerful assault on the intellect, motivations, and credentials of anyone who thinks otherwise.
In doing so, however, he neglects a big piece of the story: the cultural complexities and stubborn medical mythologies that bedevil both the pro-vaccine and anti-vaccine camps. As Mnookin sees it, the pro-vaccine faction consists of scientists—rational figures who are swayed only by evidence-based medicine. Members of the anti-vaccine faction (whom he also calls the “vaccine denialists”) are swayed by hysteria, ignorance, junk science and its prophets—and the news media.