Review — January / February 2007
Under the Skin: A History of the Vaccine Debate Goes Deep but Misses the Drama
Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver by Arthur Allen.
By Rebecca SklootAt this point, it’s safe to say, most people in the United States have not been on the receiving end of midnight vaccination raids, with doctors breaking into their homes and jabbing their families with needles. It’s been a long time since we saw entire cities flattened by disease. So long, in fact, that lessons from those days seem to have been lost on a few generations.
We’re in the midst of a confused national debate over vaccines, with some fearing immunization side effects more than the diseases they fight, and others pushing for more vaccines, at younger ages, and being baffled when parents object. Newspapers report that vaccines may or may not cause autism, autoimmune diseases, and allergies; at the same time, they warn of viral pandemics that can (and do) kill millions, and call for new vaccines to save us (from, say, AIDS, or avian flu). But when those new vaccines arrive and officials say we must give them to our children, we balk. This is nothing new: the vaccine debate has been raging for hundreds of years, because immunizations have a long and complicated history of both saving our lives and hurting us. We needed a book that laid out the history and made sense of it.
There have been at least twenty books on smallpox and polio alone. But until Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver, by the science journalist Arthur Allen, no book had so carefully and clearly catalogued the history of immunization. And, as Allen writes, “the best way to gain an understanding of why our children [are] vaccinated against particular diseases—and why some people [are] challenging these choices—[is] to delve into the history.”
We’ve seen viruses threaten to wipe out millions (and succeed). Parents have refused immunization, then found themselves with sick and dying children, while those doing the immunizing had to pay large sums for damages caused by vaccines that were not properly made or tested. And here’s something ironic: when vaccines do their job best, people doubt them most. They start thinking, Who gets whooping cough anymore? Why should I expose my children to even the slightest risk of vaccine side effects to protect them from a disease no one gets? Anyone who’s ever asked that question should read this book. So should anyone who thinks vaccine doubters are crazy. Because Allen shows that those fears come from real stories of vaccines causing everything from brain damage to tetanus to polio. But more than that, he shows why we have vaccines in the first place, and why it’s a bad idea to shun them.
Allen’s book starts in the 1700s, with smallpox and the first immunizations, and ends with the nearly 10,000 lawsuits filed in 2006 claiming vaccine damages. Along the way, he raises important ethical issues (like the role vaccines played in eugenics), and highlights the many ways children bore the burden of that history: their bodies were used to develop and test vaccines (not always ethically); they suffered the injection side effects, and got the diseases when parents refused to immunize them. Allen traces the legal history of vaccine production, from the first lawsuit for damaging side effects to a litigation free-for-all, with companies paying large sums for problems their shots didn’t cause. (Covering their losses by raising vaccination costs was easier than fighting in court.)
Much of the material devoted to smallpox and polio has been explored elsewhere. Allen’s truly original contributions come with more recent issues that haven’t been widely covered. Whooping cough, for example, lingers in the United States in part because many parents refuse to vaccinate against it. The story that feels largely missing is the new vaccine for strains of the HPV virus, which can cause cervical cancer. HPV is rapidly headed toward as much controversy as any vaccine before it. More, perhaps, since this one—like the vaccine for hepatitis B, which faced similar problems—is a sexually transmitted disease. But Allen makes up for that omission with his detailed coverage of the autism controversy.
He is one of the first authors to really delve into the science behind the do-immunizations-cause-autism debate. “No one could deny,” he writes, “that autism diagnoses had gone up during a period in which vaccine use was going up.” What caused that increase is still unknown. In 1997, a study found that the hepatitis B vaccine contained as much mercury as a can of tuna. That alone may not be toxic, but because of multiple vaccinations, by the age of six months, kids were getting “doses up to 87 times higher than FDA guidelines for the maximum consumption of mercury from fish.” Mercury is known to cause brain damage, so no one was wrong to ask what it was (and still is) doing in vaccines. Allen doesn’t deny that. But by documenting the science behind the debate, he makes a convincing case against the vaccine-autism theory.
The way Allen sees it, one reason the autism debate still exists, despite evidence against it, is “pseudo-investigative, sensationalist news reporting.” He says a “chunk of the news media” continues to hype the story, and he criticizes them sharply for this. (He might well criticize cjr. See “Drug Test,” November/December 2005.) The vaccine-autism theory was, Allen says, “the Pamela Anderson of news stories—dumb, maybe, but oh, so sexy.” Not that the media must always agree with science, but it’s irresponsible to ignore scientific evidence in favor of a sexy headline, something Allen clearly has not done.
When it comes to modern medicine, there are few topics more dramatic than vaccination. It’s a story full of politics, big-business, desperate parents, sick and dying children, conflicts of interest, national security—it even has abortion controversy, since many vaccines are created using cells from aborted fetuses. The subject should be a narrative goldmine.
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