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.
In other words, he proffers a binary world in which his prosecutorial skewering of the anti-vaccine camp is contrasted to the pure, inexorable, infallible domain of “science.” He dwells on the venality, gullibility, and profiteering he encounters among parents, patients, and the news media. Yet Mnookin fails to adequately address the scientific and ethical failings of vaccine design and testing as it has been practiced for more than two centuries.
Take, for example, the author’s treatment of Onesimus, the African slave who introduced smallpox variolation to Boston (and to the U. S.) in 1721. Mnookin describes the popular and at times violent opposition to this early and effective technique. He neglects to mention that this opposition was led not by uneducated laypersons, but rather by the city’s physicians, including the eminent William Douglass, the only doctor in town to possess an actual medical degree. These pillars of the American medical establishment condemned variolation as an occult African practice, both ridiculous and “unchristian.”
Mnookin can’t completely ignore the scientific and ethical missteps that have contributed to vaccine skepticism. For the most part, though, The Panic Virus confines itself to such chilling but hoary examples as the 1955 Cutter incident or the 1976 swine-flu fiasco, in which some recipients of a vaccine for an epidemic that never materialized were felled by the Guillain-Barré virus. These twice-told tales have long since been eclipsed by more contemporary dramas, which are very much part of the current debate over whether vaccines can be trusted.
Between 1989 and 1991, for example, mostly poor black and Hispanic children in Los Angeles were given an unapproved, experimental Edmonton-Zagreb vaccine without their parents’ consent. This vaccine had been implicated in the deaths of children in Haiti and other parts of the developing world. Meanwhile, in 1998, the Department of Defense’s Anthrax Vaccination Immunization Program (AVIP) forced 2.4 million soldiers to be injected with an experimental anthrax vaccine without their consent. Many were blinded or permanently injured, and the drug’s manufacturer, Bioport, was repeatedly censured by the FDA.
One final example: in 2006, the FDA approved Gardasil, Merck’s vaccine against some strains of the human papilloma virus (HPV) that causes cancer. The manufacturer sought to corner the market quickly by having Gardasil vaccination deemed mandatory for schoolchildren as young as nine, causing an outcry in the District of Columbia, Florida, Georgia, New Mexico, Texas, and other states.
These are more recent triggers for vaccine skepticism than swine flu, and certainly more pertinent ones than Morgellon’s disease, a hotly debated disorder to which Mnookin devotes a chapter. The difference is that they hinge upon errors made by the medical establishment—so they are more or less omitted from the narrative of The Panic Virus.
Indeed, the book’s very division of the nation into two camps lacks evidence and nuance. Mnookin suggests that we have rational, disinterested, and fully credentialed scientists on one side, scientifically illiterate, crystal-peering, aura-perceiving rabble-rousers on the other—and nothing in between. Instead, there is at least one other group: those doctors, patients, and members of the media who approve of some or even most vaccines but question the timing, adulteration or ethics of others. The Panic Virus also asserts that those who cast a jaundiced eye on vaccines are likely to occupy the educated upper class, and the author discusses few if any vaccine dissenters who do not fit that mold. Yet such skeptics can be found at all socioeconomic strata of the U.S.