![[The Panic Virus: The True Story Behind the Vaccine-Autism Controversy] [By: Mnookin, Seth] [January, 2012]](https://images-na.ssl-images-amazon.com/images/I/513ZGY9BqsL._AC_UL165_SR165,165_.jpg)
As most of the Amazon reviewers have noted, this book is rare gift---thoroughly documented and wonderfully written, using references to the primary literature for statistical support, yet always inserting the human element. If all you want is an account of the "vaccines cause autism" controversy from the viewpoint of a supporter of the scientific establishment, then you can stop here, buy the book, and enjoy. If you also want to understand the viewpoint of the "other side," the quick way is to (a) read the several one-star review of this book on Amazon (all are opponents of the scientific evidence for one reason or another), and (b) read positive reviews of the book online (e.g., New York Times, Salon) and their negative comment-providers. If this is not enough, there are plenty of publications by Andrew Wakefield, Jenny McCarthy and others.
My purpose in reading this was different. I come from a theoretical position in behavioral science that takes the so-called rational actor model seriously as a tool for understanding human behavior. The model assumes people have certain beliefs (called subjective priors) which they use to maximize an objective function that reflects their personal values, needs, likes, and dislikes. The model is very well ensconced in traditional economic theory, and describes human behavior extremely well, as long as we recognize a few "provisos." First, people don't literally "maximize" anything, any more than does a baseball player chasing down a fly ball or a fox chasing down a rabbit.
The theory says that if peoples preferences are consistent, we can model them "as if" they were maximizing, just as we act "as if" a thermodynamical system is maximizing entropy---it's an innocuous short-hand expression. Second, individual wants and desires are not perfectly attuned to individual well-being. People engage in all sorts of harmful practices, such as smoking cigarettes and eating unhealthy foods. Third, people are generally not selfish, but rather exhibit other-regarding preferences and prefer in many circumstances to behave morally even when this is costly in terms of forgone alternatives. Thus, the sort of rationality embodied in the rational actor model is rather thin, but it is sufficient to enable economists (and biologists who use the model in studying animal behavior and epidemiology) to get lots of things right lots of the time.
The core problem with the rational actor model is that, while it deals with risk rather well, it has absolutely no handle on genuine "uncertainty," as the famous Ellsberg Paradox so well illustrates. When a situation has a probabilistic outcome but the probabilities are clearly known, as for instance in flipping a fair coin, people behave different than in a situation in which they are not sure of the probabilities.
The standard axiomatic of rational choice cannot deal with such a situation. Of course, we may treat uncertainty by positing that we live in one of several "possible worlds," in each of which the probabilities are known. But then we must know the probabilities assigned to being in each of these worlds. If we know these probabilities, it is a simple exercise to calculate the meta-probabilities for our situation. This is absolutely nothing new. However, suppose we don't know the probabilities for each of the possible worlds. Then we must posit a universe of higher-level worlds, in each of which the probability distribution over the lower-level worlds takes some determinate form. Once again, however, we can perform simple calculations (so-called "compound lottery" calculations) to get determinate probabilities ("risks") for our world. And so on, up the ladder of meta-possible-universes.
The central fact is that people do not engage in such infinitely recursive reasoning. This is not a failure of rationality, but rather a weakness of the whole recursive possible worlds framework, which is really a device for reducing uncertainty to risk.
What do people do when there is fundamental uncertainty? This is the question that has haunted me for many years. I do not claim to have a scientifically acceptable model of human behavior under uncertainty yet, but I'm looking around, for sure (Joni Mitchell once wrote "Everybody's saying/Hell's the hippest way to go/Well, I don't think so/But I'll take a look around it though.") Here is a brief summary of where I am at, and I invite commentary.
The first reaction to fundamental uncertainty is to delay making a choice. This is basically Keynes' explanation of boom and bust investment cycles---when they don't have a clear idea what is going to happen, businesses "pull in their horns" and wait for the situation to clarify itself. However, sometimes one cannot delay without incurring huge costs. Parents of autistic children, for instance, must decide on the efficacy of the array of alternatives open to them. Doing nothing is, basically, one of these alternatives.
The second reaction is to lay out a search plan: try out several alternatives, and let your experience clarify the risks and the payoffs of each. This is fine for some things, such as what brand of wine to drink. But it will not help in situations where (a) it is very costly to try out alternatives (e.g., how many occupations do you want to experience) or (b) the choices are irreversible (e.g., how many levels of education do you want to try out? If you get too much education, there is often no way back).
The third reaction is to see what other people have done in your situation, with a heavy emphasis on the choices have been successful and the people making the choices are a lot like you. To my mind, this is perhaps the most important choice mechanism. There are several models of such behavior, but none has the generality the phenomenon deserves. Itzak Gilboa and David Schmeidler, A Theory of Case-Based Decisions (Cambridge: Cambridge University Press, 2001) is in the ball-park, but they only allow the decision-maker to range over previous personal choices. Their model should extend rather easily and insightfully to the more general case, where there is uncertainty concerning the success of others as well as the "distance" between successful others and the decision-maker.
I expect such a model would exhibit the following properties, depending on the parameters of the situation. For situations in which success is public information, there would be a Nash equilibrium with some "experimenters" who try out new ideas and "traditionalists" who stick with the known and true until the success of the experimenters is sufficiently clear. There are papers in the literature that model this phenomenon: John Conlisk, "Optimization Cost", Journal of Economic Behavior and Organization 9 (1988):213-228; Robert Boyd and Peter J. Richerson, "Group Beneficial Norms Can Spread Rapidly in a Cultural Population", Journal of Theoretical Biology 215 (2002):287-296.
Within the same category of imitation, there can be "bandwagon" effects, as modeled in Sushil Bikhchandani, David Hirshleifer and Ivo Welsh, "A Theory of Fads, Fashion, Custom, and Cultural Change as Informational Cascades", Journal of Political Economy 100 (1992):992-1026; B. Douglas Bernheim, "A Theory of Conformity," Journal of Political Economy", University of Chicago Press 102,5 (1994):841-877; Abhijit V. Banerjee, "A Simple Model of Herd Behavior", Quarterly Journal of Economics 107 (1992):797-817. In these models, difference social groups can settle on distinct decisions, and there is little tendency for groups to switch to the decision of another group because the distinct decisions increase the social distance between members of different groups, for a variety of reasons. This is stressed in a very nice paper: Joseph Henrich and Robert Boyd, "The Evolution of Conformist Transmission and the Emergence of Between-Group Differences", Evolution and Human Behavior 19 (1998):215-242. For this reason, several distinct religions can persist among spatially and social distanced groups, each holding firm to its own beliefs.
A key element in the rational actor model is that of "Bayesian updating." What this means is that with a given set of subjective priors, when new evidence comes in, there is exactly one "rational" way to transforms beliefs in light of the new information. Many beliefs, however bizarre, have little to fear from Bayesian updating, because there is virtually never new information that impacts on these beliefs. The intellectual/scientific problem is that individuals often update the credibility of the evidence in light of their beliefs rather than the other way around. For instance, when Christians discovered that the Earth was millions of years old, not the six thousand odd years portrayed in the Bible, and the humans are the product of Darwinian evolution, many revised their cosmologies and their scientific preconceptions (including the Catholic Church), while others mounted vicious attacks on the scientific community, calling them a group of atheists who were colluding with the Devil to thwart the will of God. In terms of the rational actor model, the strategy of the second group is no less Bayesian updating that that of the first.
There are also situations in which people are collectively unsure what to do, and where they must make a choice that will commit them collectively to a single decision. This is the setting for the emergence of ideological divisions and cultural politics so characteristic of the socialism/capitalism debates of the past, or the current global warming debates.
Science has no secure position of authority in dealing with natural events. For one thing, despite their pretentions to objectivity, scientists have been known to be collective incorrect. One horrible example close to home was the psychoanalytic theory of childhood autism, which for many years in the US was blamed on inadequate mothering. The pain that this stupid but virtually universally promulgated theory imposed on the parents of autistic children was incalculable. Not only were these parents forced to with the frightful problems of having an autistic child, but they were forced to live in ignominy in a society that held the parents to blame. I do not know of a comprehensive historical account of this affair, promulgated by Bruno Bettelheim, Leo Kanner, and other psychoanalysts who never bothered to check the facts.
Another more recent affair of this type is the "recovered memories" movement among professional clinical psychologists. The "expert testimony" put many innocent people behind bars, and clinical psychologists misled many patients seeking psychological relief into attributing their mental problems to childhood molestations that in fact did not take place. This is well recounted in Elizatheth Loftus and Katerine Ketcham, The Myth of Repressed Memory: False Memories and Allegations of Sexual Abuse (St. Martin's Press, 1996).
The vaccination model of the origins of autism is quite a different story. In this case there is no doubt but that the scientific community very carefully studied, and rejected, the claims of frantic parents misled by a few demagogic physicians, in the context of a network of newspapers, magazines, and TV shows eager to exploit the controversy rather than come down firmly on the side of science (which they should have in this case, because the empirical evidence was clear).
I think the autism controversy is one instance of a large category of situations in which human nature leads people to make decisions that are not in their interest. These situations all involve serious threats to our health and well-being, where traditional science and common cultural practices offer us no hope. The evil turns in life can be much better supported if we can conjure up some reason for hope and optimism, however far-fetched. This is why it has been necessary to place draconian restrictions on the ability of the public to seek health advice and purchase the medications of their choice. And because people generally realize that this is the case, even in the most democratic countries, however devoted to the free market, the local version of the Food and Drug Administration is widely supported.
In terms of the rational actor model, it is the Sour Grapes axiom that is violated. Rational choice depends on our evaluation of the probility of an event being independent from the desirability of the event. In particular, we should not think an outcome more likely just because we like the outcome more. But, when there is no hope, or all "traditional" remedies have been sought, it is part of human nature to ease our pain by elevating the probabilities of the theretofore hopeless. Thus the quack miracle cures for terminal diseases and chronic conditions.
However, where medicine provides neither cure nor an understanding of the disease, the collective action of sufferers (in this case parents of autistic children) can lead to serious social breakdown. In the autism case, the social practice of refusing to inoculate young children against infectious diseases spread far beyond the autistic community, to the point where outbreaks of deadly communicable diseases are now occurring in several countries. This natural human predilection is amplified by predatory religious and political doctrines in some countries (opposition to measles vaccination in some Muslim communities in Africa comes to mind) and to anti-scientific fads in others (Postmodernism in the United States is the major culprit here, inducing the affluent and highly educated to turn away from even proven policies, such as universal vaccination against some diseases).
Parents want absolute proof of the vaccine's non-harm, as the following, taken from an Amazon review of Mnookin's book: "It is not up to people who do not wish to vaccinate their children to prove that vaccines are unsafe or fail to provide their recipients with a healthier, longer life. It is up to the salesmen, the CDC & NIH and the pharmaceutical manufacturers to PROVE that they do." However, the fact is that vaccination is often a social benefit that has a small individual cost that, in very rare cases, can be a devastatingly large cost. Individual parents who may be perfectly willing to run such risks for themselves may be unwilling to impose such risks on their children, and it is hard to fault them for this.
My own (tentative) position on this is that we should remove from parents the onus of choice. When an inoculation is required to protect herd immunity, is should be required of all parents, without the possibility of opting out for personal or religious reasons. Much of the time, this will also benefit the individual child, but in cases where the gains are social and the expected costs are individual and very small, and where the ratio of benefit to harm is great, coercion should be vigorously defended, although in a democratic society, the defense of coercion is a very delicate affair.
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Audible sample The Panic Virus: A True Story of Medicine, Science, and Fear Hardcover – January 11, 2011
by
Seth Mnookin
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WHO DECIDES WHICH FACTS ARE TRUE?
In 1998 Andrew Wakefield, a British gastroenterologist with a history of self-promotion, published a paper with a shocking allegation: the measles-mumps-rubella vaccine might cause autism. The media seized hold of the story and, in the process, helped to launch one of the most devastating health scares ever. In the years to come Wakefield would be revealed as a profiteer in league with class-action lawyers, and he would eventually lose his medical license. Meanwhile one study after another failed to find any link between childhood vaccines and autism.
Yet the myth that vaccines somehow cause developmental disorders lives on. Despite the lack of corroborating evidence, it has been popularized by media personalities such as Oprah Winfrey and Jenny McCarthy and legitimized by journalists who claim that they are just being fair to “both sides” of an issue about which there is little debate. Meanwhile millions of dollars have been diverted from potential breakthroughs in autism research, families have spent their savings on ineffective “miracle cures,” and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. Most tragic of all is the increasing number of children dying from vaccine-preventable diseases.
In The Panic Virus Seth Mnookin draws on interviews with parents, public-health advocates, scientists, and anti-vaccine activists to tackle a fundamental question: How do we decide what the truth is? The fascinating answer helps explain everything from the persistence of conspiracy theories about 9/11 to the appeal of talk-show hosts who demand that President Obama “prove” he was born in America.
The Panic Virus is a riveting and sometimes heart-breaking medical detective story that explores the limits of rational thought. It is the ultimate cautionary tale for our time.
In 1998 Andrew Wakefield, a British gastroenterologist with a history of self-promotion, published a paper with a shocking allegation: the measles-mumps-rubella vaccine might cause autism. The media seized hold of the story and, in the process, helped to launch one of the most devastating health scares ever. In the years to come Wakefield would be revealed as a profiteer in league with class-action lawyers, and he would eventually lose his medical license. Meanwhile one study after another failed to find any link between childhood vaccines and autism.
Yet the myth that vaccines somehow cause developmental disorders lives on. Despite the lack of corroborating evidence, it has been popularized by media personalities such as Oprah Winfrey and Jenny McCarthy and legitimized by journalists who claim that they are just being fair to “both sides” of an issue about which there is little debate. Meanwhile millions of dollars have been diverted from potential breakthroughs in autism research, families have spent their savings on ineffective “miracle cures,” and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. Most tragic of all is the increasing number of children dying from vaccine-preventable diseases.
In The Panic Virus Seth Mnookin draws on interviews with parents, public-health advocates, scientists, and anti-vaccine activists to tackle a fundamental question: How do we decide what the truth is? The fascinating answer helps explain everything from the persistence of conspiracy theories about 9/11 to the appeal of talk-show hosts who demand that President Obama “prove” he was born in America.
The Panic Virus is a riveting and sometimes heart-breaking medical detective story that explores the limits of rational thought. It is the ultimate cautionary tale for our time.
- Print length448 pages
- LanguageEnglish
- PublisherSimon & Schuster
- Publication dateJanuary 11, 2011
- Dimensions6.13 x 1.4 x 9.25 inches
- ISBN-101439158649
- ISBN-13978-1439158647
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Editorial Reviews
From Bookmarks Magazine
It might be possible to view Mnookin’s book as the final nail in the coffin for the contemporary antivaccine movement, given its recent scientific and legal setbacks. But Mnookin’s own conclusions would likely deny this; as several reviewers approvingly observed, The Panic Virus is just as much about how today’s society deals with information overload as it is about how it confronts disease. Many reviews echoed Mnookin’s condemnation of the American media for allowing false antivaccine findings to flower. Yet they also praised him for avoiding heavy-handedness and unnecessary jargon, even if the book breaks little new ground in the vaccine debate. Critics strongly recommended the book to anyone interested in medicine and public health, as well as to parents who may fear that booster shot.
From Booklist
Over the last three decades, the incidence of autism spectrum disorder, better known simply as autism, has risen dramatically in the U.S., from approximately 1 in 1,000 children to 1 in 110, arousing widespread concern among parents and psychiatrists alike. A few of the many potential possible culprits scientists have targeted are faulty genes and thimerosal, a mercury-laced preservative in vaccines. Former Newsweek senior journalist Mnookin focuses his masterful investigative skills primarily on the latter, highly controversial possibility, illustrating how the current, misguided anti-vaccine movement can be blamed almost equally on panic-driven parents, sensation-hungry media, and PR-challenged health authorities. In making his case, Mnookin covers a wide swathe of medical history, from polio outbreaks to the scare tactics of fringe British researcher Andrew Wakefield, who first forged the dubious vaccine-autism link. While Mnookin dismantles this link convincingly, his argument that multivaccine cocktails have been proven safe is ultimately less persuasive. Still, he’s an able, engaging wordsmith, and this cautionary tale about misinformed medical alarmism is thoroughly compelling. --Carl Hays
Review
“With rationality and science under siege these days, Seth Mnookin has produced a riveting and important chronicle of one life-and-death realm in which passionate, panicky belief has dangerously trumped reason—and put millions of children at risk.” -- Kurt Andersen, Host, "Studio 360"
“Seth Mnookin has given us a non-fiction story worthy of Michael Crichton—an absorbing, disturbing and scrupulously researched account of a contagion of human unreason run wild. This time the hysteria was over autism; the next panic virus could be even more dangerous.” -- Jonathan Mahler, author of The Challenge and Ladies and Gentlemen, the Bronx Is Burning
“An accomplished journalist, Seth Mnookin takes an objective look at both sides of the vaccine/autism controversy and lands squarely on the side of science. With humor and wit, The Panic Virus examines the often bizarre events that led some families to become distrustful of science and erroneously conclude that vaccines might cause autism. This book will leave you scratching your head in pure amazement that this issue could get so out of hand when the science is so clear.” -- Alison Singer, President, Autism Science Foundation
“In plain language, Seth Mnookin provides an excellent narrative and evaluation that helps clarify for readers how and why vaccine controversies have arisen over the years as well as sensible ways for readers to understand the science that supports vaccine usage. Vaccines are the most effective public health measure since clean water.” -- Judith Palfrey, MD, FAAP, professor of pediatrics, Harvard Medical School and author of Child Health in America
“Seth Mnookin understood there was something more to the cruelly misled and dangerously misleading vaccines-cause-autism movement than just an unhappy group of parents with a need to blame someone. He saw the connection between this deathless conspiracy theory and the proliferating irrationality of a society that has supersized its information diet while starving its capacity to think straight. For that reason alone—not to mention the deft, often charming characterizations woven into its skillful and fascinating narrative—this is an important, powerful, and bracing book.” -- Arthur Allen, author of Vaccine and Ripe
"There have been hundreds of recent outbreaks of ailments like whooping cough and measles that we thought would be eradicated by now—and might have been, if not for the anti-vaccine obfuscation. Bravo Seth Mnookin for digging for the truth and telling eloquent stories of what happens when lies, half-truths and self-interest collide with fear." -- Laurie Garrett, Pulitzer Prize-winning writer and author of Betrayal of Trust: The Collapse of Global Public Health
"Mr. Mnookin's passionate defense of vaccination may be just what the public needs, in equal parts because of what it says and because of who is saying it. . . . Parents who want to play it safe, but are not altogether sure how, should turn with relief to this reasoned, logical and comprehensive analysis of the facts." -- Abigail Zuger, M.D. ― The New York Times
“Seth Mnookin has given us a non-fiction story worthy of Michael Crichton—an absorbing, disturbing and scrupulously researched account of a contagion of human unreason run wild. This time the hysteria was over autism; the next panic virus could be even more dangerous.” -- Jonathan Mahler, author of The Challenge and Ladies and Gentlemen, the Bronx Is Burning
“An accomplished journalist, Seth Mnookin takes an objective look at both sides of the vaccine/autism controversy and lands squarely on the side of science. With humor and wit, The Panic Virus examines the often bizarre events that led some families to become distrustful of science and erroneously conclude that vaccines might cause autism. This book will leave you scratching your head in pure amazement that this issue could get so out of hand when the science is so clear.” -- Alison Singer, President, Autism Science Foundation
“In plain language, Seth Mnookin provides an excellent narrative and evaluation that helps clarify for readers how and why vaccine controversies have arisen over the years as well as sensible ways for readers to understand the science that supports vaccine usage. Vaccines are the most effective public health measure since clean water.” -- Judith Palfrey, MD, FAAP, professor of pediatrics, Harvard Medical School and author of Child Health in America
“Seth Mnookin understood there was something more to the cruelly misled and dangerously misleading vaccines-cause-autism movement than just an unhappy group of parents with a need to blame someone. He saw the connection between this deathless conspiracy theory and the proliferating irrationality of a society that has supersized its information diet while starving its capacity to think straight. For that reason alone—not to mention the deft, often charming characterizations woven into its skillful and fascinating narrative—this is an important, powerful, and bracing book.” -- Arthur Allen, author of Vaccine and Ripe
"There have been hundreds of recent outbreaks of ailments like whooping cough and measles that we thought would be eradicated by now—and might have been, if not for the anti-vaccine obfuscation. Bravo Seth Mnookin for digging for the truth and telling eloquent stories of what happens when lies, half-truths and self-interest collide with fear." -- Laurie Garrett, Pulitzer Prize-winning writer and author of Betrayal of Trust: The Collapse of Global Public Health
"Mr. Mnookin's passionate defense of vaccination may be just what the public needs, in equal parts because of what it says and because of who is saying it. . . . Parents who want to play it safe, but are not altogether sure how, should turn with relief to this reasoned, logical and comprehensive analysis of the facts." -- Abigail Zuger, M.D. ― The New York Times
About the Author
Seth Mnookin is a contributing editor at Vanity Fair and a former senior writer for Newsweek, where he covered media, politics, and popular culture. His writing has appeared in The Washington Post, New York magazine, and many other publications. He is the author of The Panic Virus: A True Story of Medicine, Science, and Fear; Feeding the Monster: How Money, Smarts, and Nerve Took a Team to the Top and Hard News: The Scandals at The New York Times and Their Meaning for American Media. He lives in Brooklyn, New York.
Excerpt. © Reprinted by permission. All rights reserved.
INTRODUCTION
On April 22, 2006, Kelly Lacek looked around her dinner table and smiled: Dan, her husband of thirteen years, was there, along with the couple’s three children, Ashley, Stephen, and Matthew. Kelly’s parents had also come over: There was a father-daughter dance at the local church that evening, and Kelly and her dad were double-dating with Dan and Ashley. As the four of them were getting ready to leave, Kelly couldn’t resist needling her mother. “You’re stuck with the boys,” she said. “But don’t worry—we won’t be out too late.” She kissed Stephen goodbye, and then bent down to say good night to Matthew. He was three years old, and Kelly marveled at how quickly he was growing up: It seemed as if it was only moments ago that he’d been an infant, and now he was already being toilet-trained. (Dan and Kelly both agreed that it was adorable how proudly he announced that he had to go to the bathroom.)
For a brief moment, Kelly says, she wondered if Matthew was okay—he seemed a little out of sorts, and earlier that afternoon, he’d complained of a sore throat—but then she figured he’d probably just tired himself out wrestling with his older brother.
Kelly and Dan returned home that night around eight o’clock. They’d barely walked in the door when Kelly’s mother rushed over: “It’s Matthew,” she said. “He’s running a fever—and his breathing seems a little shallow.” The Laceks realized right away that something was seriously wrong. “He was just sort of hunched over,” Kelly says. “We didn’t know what to do.” Since there was no way to get in touch with Matthew’s doctor, they decided to make the ten-minute drive from their home in Monroeville, about fifteen miles east of Pittsburgh, to the Forbes Regional Campus of the Western Pennsylvania Hospital.
When the Laceks arrived at the emergency room, the attending physician told them there was nothing to worry about. In all likelihood, he said, Matthew had a case of strep throat. Worst-case scenario, it was asthma; regardless, they’d be home in no time. Two hours later, they were feeling much less assured: Matthew’s fever was still rising, and when a doctor tried to swab his throat, he began to choke. By eleven p.m. Matthew’s temperature had risen to 104 degrees and his breathing seemed to be growing shallower by the minute.
It was around that time that a doctor the Laceks hadn’t met before walked over. He was older—probably in his sixties, Kelly thought—and as soon as he saw Matthew, he began to suck nervously on his teeth. He turned to the Laceks: Had Matthew received all his shots? Actually, Kelly said, he hadn’t. Matthew had been born in March 2003, several years after rumors of a connection between autism and vaccines had begun to gain traction in suburban enclaves around the country. That May, Kelly’s chiropractor warned her about the dangers of vaccines. “He asked if we were going to get [Matthew] vaccinated and I said yes,” Kelly says. “And then he told me about mercury. He said, ‘There’s mercury in there.’ ” Kelly had already heard rumors that the combined measles-mumps-rubella (MMR) vaccine was dangerous, but this was something new. “He was really vocal about it causing autism. He said there was this big report over in Europe and blah blah blah. And I thought, Well, I’m surrounded by people who have autistic children. What if this happened to Matthew?” If Kelly was unconvinced, the chiropractor said, she should make Matthew’s pediatrician prove to her that the vaccines Matthew was scheduled to receive were one hundred percent safe.
“So that’s what I did,” Kelly says. “I asked my doctor if she could give me a label that says there’s no mercury and she said, ‘No.’ She said she wouldn’t give it to me.” It was as if, Kelly says, her pediatrician was hiding something. The doctor tried to tell Kelly that she would be putting Matthew at serious risk by not immunizing him, but, Kelly says, “I don’t think I heard anything else she might have said, quite honestly. At that point I had lost faith.”
From that day forward, Matthew didn’t receive any of his scheduled vaccinations, including one for a bacterial disease called Haemophilus influenzae type b, or Hib. Oftentimes, a Hib infection is not particularly threatening—if the germs stay in the nose and throat, it’s likely the child won’t get sick at all—but if the infection travels into the lungs or the bloodstream, it can result in hearing loss or permanent brain damage. Hib can also cause severe swelling in the throat due to a condition called epiglottitis, which, if not treated immediately, results in infected tissue slowly sealing off the victim’s windpipe until he suffocates to death. As recently as the 1970s, tens of thousands of children in America had severe Hib infections each year. Many of those suffered from bacterial meningitis, and between five hundred and one thousand died. After the Hib vaccine was put into widespread use, the disease all but disappeared in the United States: In 1980, approximately 1 in 1,000 children caught Hib; today, fewer than 1 in 100,000 do. In fact, the immunization had been so effective that out of everyone working in the Monroeville ER, the doctor who’d asked Kelly Lacek about her son’s vaccine history was the only one who had been practicing long enough to have seen an actual Hib infection in a child.
Until that night, Kelly had never given much thought to the potential repercussions of her decision not to have Matthew vaccinated. “I must have read somewhere that after he turned three, he would have been okay for many of those diseases,” she says. “I thought he was in the clear.” She was wrong. “I have never seen a doctor panic so quickly,” she says. If, as the doctor was all but certain was the case, Matthew had been infected, then everything that had been done to him in the hospital that night—the examinations, the swabs, the breathing treatments—had served only to further inflame his throat. It wasn’t until Kelly saw her son’s X-rays that she realized just how dire the situation was: It looked as if Matthew had a thumb lodged in his throat. “I started to shake,” Kelly says. “There was just a tiny bit of airway left for him to breathe.”
Within minutes, the entire emergency room was thrown into a frenzy. Kelly heard someone shout out, “Page Children’s!” Then she heard a second command: “Get Life Flight here right away.” Finally, a doctor pulled the Laceks aside and explained the situation to them. “If we don’t get Matthew on a helicopter [to the Children’s Hospital in Pittsburgh] right now, your son is probably going to die,” he said. “It could be within minutes.” While they were waiting, the doctor said, Kelly had to make sure Matthew remained calm. “I do not want you crying,” the doctor said. “I do not want you reacting to anything. If you are upset, Matthew will be upset, and that will make his throat close up more. If that happens he will suffocate.” As if in a daze, Kelly went and picked up her son. It wasn’t until she heard her teeth chattering that she realized she was shaking. She focused all her energy on trying to remain still.
While Kelly was holding Matthew, Dan Lacek was conferring with the hospital staff. It had rained earlier in the evening, and now the entire area was covered in fog, which made it too dangerous to land a helicopter. Matthew was going to have to make the trip to Pittsburgh in an ambulance—but before he could be moved, he’d have to be intubated. If that didn’t work—if there was not enough room in Matthew’s throat for a breathing tube—the doctors would try to perform a tracheotomy, which involves cutting into the windpipe in an effort to form an alternate pathway for air to get into the lungs. (The procedure is not without risk: The physicist Stephen Hawking lost his speech when the nerves that control the vocal cords were damaged during an emergency tracheotomy.) Once again, it fell to Kelly to keep her son calm. Fortunately, the tube slid down Matthew’s throat. Unless it closed up so much that the tube was forced out, they’d bought themselves a few more hours.
It was almost four in the morning when the Laceks arrived in Pittsburgh. Matthew was immediately placed in a medically induced coma. All the doctors could promise was that he’d live through the night. “They said something about not catching it quickly enough with the antibiotics,” Kelly says. “Even if he did recover, there was a good chance he would have permanent brain damage, or, best-case scenario, he would have hearing loss.”
For forty-eight hours, Dan and Kelly Lacek’s son remained in stable condition. “You’re in shock,” Kelly says. “You never let your guard down. You’re just so focused on him getting better.” Then, on Tuesday, just as they were growing more hopeful, Matthew’s blood pressure plummeted. The only thing the Laceks could think to do at that point was to ask their friends to pray for them.
When Kelly Lacek’s chiropractor told her that vaccines had been linked to autism, he was repeating the most recent of hundreds of years’ worth of fears about vaccinations. The roots of this latest alarm dated back to 1998, when a British gastroenterologist named Andrew Wakefield claimed to have discovered a new gut disorder associated with the MMR vaccine—and with autism. Wakefield based his conclusions on a case study of a dozen children who’d been brought to his clinic at the Royal Free Hospital in London. Almost immediately, Wakefield’s research methods and his interpretations, which had been published in the medical journal The Lancet, came under fire. Wakefield’s response was to appeal to the public rather than to his colleagues: The medical establishment was so determined to discredit him, he said, because he threatened their hegemony by taking parents’ concerns seriously. The media took the bait, and despite Wakefield’s lack of proof and his track record of dubious assertions and unverified lab results, they began churning out stories about how a maverick doctor was trying to protect innocent children from corrupt politicians and a rapacious pharmaceutical industry. Within months, vaccination rates across Western Europe began to fall.
Then, a year later, the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) publicly recommended the removal of a widely used mercury-based preservative called thimerosal from childhood shots. The move had been hotly debated; in the end, one of the factors that had tipped the balance was a concern that following the Wakefield brouhaha, any connection, real or rumored, between vaccines and neurodevelopmental disorders had a chance of unraveling public confidence in vaccines.
That fear proved to be well founded, in no small part because of the growing hold autism had on the public’s consciousness. In the half-century since “infantile autism” had been defined as a discrete medical condition, it had gone from being a source of shame for parents, who were blamed for their children’s conditions, to becoming a seemingly omnipresent concern, especially among those well-educated, upper-middle-class families for whom child rearing had become an all-encompassing obsession.
In spite of this increased attention, researchers in the 1990s were barely any closer to understanding autism’s origins or devising effective therapies for its treatment than their predecessors had been fifty years earlier. For parents of autistic children, this lack of reliable information resulted in feelings of hopelessness and frustration; for parents in general trying to determine the best course of action for the future, it fueled a sense that medical experts and health authorities couldn’t be counted on to look out for their families’ well-being.
Together, these reactions prepared the ground for new hypotheses to take root, regardless of how speculative or scientifically dubious they were. In the year following the CDC/AAP recommendations regarding thimerosal, a small group of parents decided that some of the symptoms of mercury poisoning seemed to match the behavior they saw in their autistic children—and they suddenly realized that their children had appeared to be fine before they’d received their vaccines. These parents began posting their observations online, sparking hundreds more parents to confirm that they’d noticed the exact same thing. With a network of nontraditional doctors and alternative health practitioners urging them on, they became more and more convinced that the common threads that ran through their stories were too odd and too widespread to be mere happenstance.
The more these newly politicized parents learned, the more outraged they became. Why were children with weak immune systems injected with vaccines just as potent as those used on children in perfect health? Why was everyone instructed to receive the same number of inoculations, regardless of their medical histories or family backgrounds? Why, for that matter, were more and more shots being added all the time? Was a chicken pox vaccine really necessary? Or one for the flu?
Just as had been the case with the MMR vaccine, there was no concrete evidence linking thimerosal to autism, and the anecdotal corroboration often seemed more impressive than it actually was. (To take but one example: Despite superficial similarities, the motor difficulties exhibited by people with mercury poisoning bear little resemblance to the repetitive movements typical of autistics.) That didn’t stop the American media from reacting much the same way their colleagues across the Atlantic had when Andrew Wakefield had published his assertions, as the emotional pull of stories featuring sick children and devoted parents outstripped anything as boring as hard data or the precautionary principle. In a matter of months, an ad hoc coalition of “Mercury Moms” transformed itself into a potent political force: Senators spoke at their rallies, public health officials tried to assuage their concerns, and federal agencies included them in discussions on how to spend tens of millions of dollars. Soon, vaccination rates began to fall in the United States as well.
By the beginning of the new millennium, Wakefield’s supporters and the proponents of the thimerosal link had joined forces to create an international cadre of vaccine skeptics whose message had an undeniable appeal: Parents trying to do nothing so much as raise their children had been taken advantage of by a society they had trusted—and now they were determined to make it right.
• • •
Over the past two decades, the instant accessibility of information has dramatically reshaped our relationship to the world of knowledge. Five hundred years after Gutenberg’s introduction of the printing press and Martin Luther’s translation of the Bible let common people bypass the priestly class, the vernacular of twenty-four-hour news channels and Internet search engines is freeing us to take on tasks that we’d long assumed were limited to those with specialized training. Why, after all, should we pay commissions to real estate brokers or stock analysts when we can find online everything we need to sell our houses or manage our investments? And why should we blindly follow doctors when we can diagnose our own ailments?
One of the first effects of this hyper-democratization of data was to unmoor information from the context required to understand it. On the Internet, facts float about freely and are recombined more according to the preferences of intuition than the rules of cognition: Mercury is toxic, toxins can cause development disorders, mercury is in vaccines; ergo, vaccines cause autism. Combined with the self-reinforcing nature of online communities and a content-starved, cash-poor journalistic culture that gravitates toward neat narratives at the expense of messy truths, this disdain for actualities has led to a world with increasingly porous boundaries between facts and beliefs, a world in which individualized notions of reality, no matter how bizarre or irrational, are repeatedly validated.
Take the “birther” movement, which contends that Barack Obama was born in Kenya and therefore is not eligible to be president. In the summer of 2009, Orly Taitz, a Russian-born dentist/lawyer/real estate agent, almost single-handedly turned her one-woman media blitz into a national preoccupation. Taitz, who believes that the Federal Emergency Management Agency is building internment camps to house anti-Obama activists and that Venezuelan president Hugo Chávez controls the software that runs American voting machines, makes for undeniably good television: She looks like a young Carol Channing, sounds like an overexcited Zsa Zsa Gabor, and has the ability to make absurd accusations with a completely straight face. By midsummer, Taitz was appearing regularly on CNN, Fox News, and MSNBC, a decision the news channels justified with the risible pretext of needing to be fair to those on “both sides” of an issue about which there was nothing up for debate—at least not in the real world. Before long, mainstream on-air personalities like Lou Dobbs were pimping the story as hard as Taitz or any of her allies were, to equally comical effect.
This type of cognitive relativism—or “truthiness,” as fictional talk show host Stephen Colbert termed it—has become the defining intellectual trend of our time. Colbert coined truthiness as a way to define former president George W. Bush’s disdain for “those who think with their head” as opposed to “those who know with their heart.” Its pervasiveness was most tragically illustrated in Iraq: By inventing a set of facts to support the overthrow of Saddam Hussein, the Bush administration changed a discussion of whether Iraq had weapons of mass destruction to whether the theoretical presence of WMDs was sufficient justification for war. In the fall of 2004, after both WMDs and easy victory were revealed as mirages, a presidential aide made an astounding admission to The New York Times Magazine. The White House, he said, didn’t waste time worrying about those “in what we call the reality-based community” who “believe that solutions emerge from your judicious study of discernible reality.” That, the aide said, “is not the way the world really works anymore. . . . When we act, we create our own reality.” Orly Taitz couldn’t have put it any better herself.
My interest in the controversies surrounding childhood inoculations began in 2008. My wife and I were newly married, and though we didn’t yet have children, we found ourselves initiates in a culture in which people obsessed over issues about which we’d previously been unaware, such as the political implications of disposable diapers and the merits of home births. Another common preoccupation, we discovered, was the fear that widespread fraud was being perpetrated by the medical establishment. These people were our peers: They gravitated toward fields like journalism or law or computer programming or public policy; they lived in college towns like Ann Arbor and Austin or sophisticated urban centers like Boston and Brooklyn; they drove Priuses and shopped at Whole Foods. They tended to be self-satisfied, found it difficult to conceive of a world in which their voices were not heard, and took pride in being intellectually curious, thoughtful, and rational.
And, we soon learned, a good number of them didn’t trust the American Medical Association (AMA) or the American Academy of Pediatrics—or at least didn’t trust them enough to adhere to their recommended immunization schedules, which included vaccinations for diphtheria, hepatitis B, Hib, influenza, measles, mumps, pertussis, pneumococcal, poliovirus, rotavirus, rubella, and tetanus, all in the first fifteen months of a child’s life. This caught us by surprise: The AAP wasn’t high on the list of organizations we thought likely to be part of a widespread conspiracy directed against the nation’s children.
That fall, we were at a dinner party when the subject of vaccines came up for what felt like the millionth time. I asked the parents at the table how they went about making decisions concerning their children’s health. Did they talk to their pediatricians? Other parents? Were they reading books? Poking around online? One friend, a forty-one-year-old first-time father, said there was so much conflicting information out there he hadn’t known what to do.1 In the end, he said, he and his wife decided to delay some shots, including the ones for the MMR vaccine, which he’d heard was particularly dangerous. “I don’t know what to say,” he told me. “It just feels like a lot for a developing immune system to deal with.”
At the time, I had no idea what the evidence supported. Still, I cringed when my friend said he’d made his decision based on what he felt rather than by trying to assess the balance of the available evidence. Anecdotes and suppositions, no matter how right they feel, don’t lead to universal truths; experiments that can be independently confirmed by impartial observers do. Intuition leads to the flat earth society and bloodletting; experiments lead to men on the moon and microsurgery.
The more I pushed my friend, the more defensive he grew. Surely, I said, there had to be something tangible, some experiment or some epidemiological survey, that informed his decision. There wasn’t; I was even more taken aback when he said he likely would have done the same thing even if he’d been presented with conclusive evidence that the MMR vaccine was safe. “Let’s say that there haven’t been any studies that have uncovered a problem,” he said. “That doesn’t mean they won’t find one someday.” He was, of course, technically correct: It is always impossible to prove a negative. That’s why gravity is still a “theory”—and why you can’t prove with absolute certainty that I won’t wake up tomorrow with the ability to fly. (As Einstein said, “No amount of experimentation can ever prove me right; a single experiment can prove me wrong.”) Finally, he offered up this rationalization: “If everyone agreed that vaccines are so safe, we wouldn’t even be having this discussion.” By that point, my wife was kicking me under the table. I let the subject drop.
But when I got home that night I couldn’t stop thinking about that conversation. The issue didn’t affect me directly: No one close to me had a personal connection with autism and I didn’t know any vaccinologists or government health officials. What nagged at me, I realized, was the pervasiveness of a manner of thinking that ran counter to the principles of deductive reasoning that have been the foundation of rational society since the Enlightenment.
I began work on this book the next day. After reading hundreds of academic papers and thousands of pages of court transcripts, I couldn’t help but agree with a federal judge who presided over an omnibus proceeding in which thousands of families with autistic children requested compensation for what they claimed were vaccine injuries: This was “not a close case.”
Once I’d arrived at the conclusion that there was no evidence supporting a link between childhood inoculations and developmental disorders, I had to confront a set of issues that get to the heart of social dynamics and human cognition: Why, despite all the evidence to the contrary, do so many people remain adamant in their belief that vaccines are responsible for harming hundreds of thousands of otherwise healthy children? Why is the media so inclined to air their views? Why are so many others so readily convinced? Why, in other words, are we willing to believe things that are, according to all available evidence, false?
In an effort to answer those questions, I interviewed scientists and doctors, healers and mystics, government appointees and elected officials. I also spoke with dozens of parents who watched helplessly as their autistic children were enveloped by worlds outsiders could not penetrate. Some of these children were in obvious physical pain, some were sullen and unresponsive, some were violent and uncontrollable, and some moved from one extreme to another. The suffering of parents who feel unable to protect their children is almost impossible to describe—and helplessness only begins to cover the range of emotions they endured. There was guilt: Despite everything they were told, it was impossible for some parents to fully rid themselves of a feeling that somehow their child’s condition was their fault. There was resentment: Many were tired of having their lives taken over by a disease about which so little is known and so little can be done. There was bitterness: How could a society that propped up foreign governments and bailed out failing banks not pay for adequate services for disabled children? And there was anger: Surely someone or something was to blame for the ways in which their lives had been upended.
But more than anything else, parents spoke of their isolation. Those split seconds of synchronicity that freckle people’s days—the half-smile a new mom gives a pregnant woman on the street, the glance shared by two strangers reading the same book on the subway—those are missing from a lot of these parents’ lives. Those with children on the more extreme end of the autism spectrum tend to feel the most alone: There are no knowing winks when a child won’t stop screaming, no “I’ve been there” grins when he defecates in public. No one thinks it’s cute when a child scratches his mother until she bleeds and strangers don’t chuckle when a ten-year-old wants to know why the woman who just got on the bus is so fat.
This sense of being cut off from the world helps to explain why tens of thousands of parents have gravitated to a close-knit community that stretches around the globe. The fact that the community’s most vocal and active members believe that vaccines cause autism and that autism can be cured by “biomedical” treatments like gluten-free diets and hormone injections is of secondary importance—what’s paramount is the sense of fellowship and support its members receive. Every spring, between fifteen hundred and two thousand of these parents travel to Chicago’s Westin O’Hare hotel for the annual conference of a grassroots organization called AutismOne, which claims to be the single largest producer of information about the disorder in the world. For those three or four days, the dynamic that shapes many of these parents’ lives is turned on its head: Here, it’s people whose lives haven’t been affected by autism who feel out of place.
In order to protect this space, AutismOne discourages outsiders from attending. In incidents over the past several years, the organization has barred journalists identified as unsympathetic, kicked out parents who were perceived as being impertinent, and asked security to remove a public health official. This gatekeeping is severe but the worry behind it—that only people with a vested interest in the organization’s survival can be trusted to take a generous view of its beliefs—is not misplaced. Even after I was granted permission to attend one of the group’s conferences, I always had the feeling that my temporary visa did not come with the right to ask about the apparent contradictions highlighted by the weekend’s proceedings.
The most obvious of these is the insistence by AutismOne’s founders that they promote a “pro-science” and not an “anti-vaccine” agenda, a claim that is hard to reconcile with the group’s mission statement: “The great majority of children suffering from autism regressed into autism after routine vaccination. . . . Autism is caused by too many vaccines given too soon.”2 If anything, the conference’s speakers have become more extreme as an ever-growing body of evidence disproves their claims: Included among the 150 presentations at the conference I attended was a four-hour-long “vaccine education” seminar, a lecture on “autism and vaccines in the US [legal system],” an environmental symposium on “the toxic assault on our children,” and a presentation on “Down syndrome, vaccinations, and genetic susceptibility to injury.” During her talk, Barbara Loe Fisher, the grande dame of the American anti-vaccine movement, explained how vaccines are a “de facto selection of the genetically vulnerable for sacrifice” and said that doctors who administer vaccines are the moral equivalent of “the doctors tried at Nuremberg.” (That parallel, she said, had been pointed out to her by Andrew Wakefield, in whose honor the 2009 conference was held.) One night, there was the premiere of a documentary called Shots in the Dark, which examined “current large-scale vaccination policies” in light of the “onset of side effects such as autism or multiple sclerosis.” This list could go on for pages.
If you assume, as I had, that human beings are fundamentally logical creatures, this obsessive preoccupation with a theory that has for all intents and purposes been disproved is hard to fathom. But when it comes to decisions around emotionally charged topics, logic often takes a back seat to what are called cognitive biases—essentially a set of unconscious mechanisms that convince us that it is our feelings about a situation and not the facts that represent the truth. One of the better known of these biases is the theory of cognitive dissonance, which was developed by the social psychologist Leon Festinger in the 1950s. In his classic book When Prophecy Fails, Festinger used the example of millennial cults in the days after the prophesied moment of reckoning as an illustration of “disconfirmed” expectations producing counterintuitive results:
Suppose an individual believes something with his whole heart; suppose further that he has a commitment to this belief, that he has taken irrevocable actions because of it; finally, suppose that he is presented with evidence, unequivocal and undeniable evidence, that his belief is wrong; what will happen? The individual will frequently emerge, not only unshaken, but even more convinced of the truth of his beliefs than ever before. Indeed, he may show a new fervor about convincing and converting other people to his view.3
In this light, another seeming paradox of the anti-vaccine movement—its extreme paranoia about ulterior motives on the part of anyone promoting vaccination combined with an almost willful blindness to the conflicts of interest of the profiteers in their midst—also makes more sense. In a speech delivered at eight in the morning of the first full day of the conference I attended, Lisa Ackerman, the head of a group called Talk About Curing Autism (TACA), ran through a long list of things parents “need” to do for their children, including testing for mineral deficiencies, installing water filtration systems, eating organic chickens, and throwing out all flame-retardant clothing, mattresses, and carpeting. “If you buy clothes and pajamas from Target and Wal-Mart, almost all of those have a flame retardant applied,” she said. “If you’re building or doing home improvement, that’s like the biggest toxic exposure you can give a child. New carpets are one of the worst things you can do. Sorry if you just did it.” Ackerman also talked about “supplementation [and] nutritional therapies,” including “vitamin B12 shots in the buttocks” and antioxidant IVs, and described a range of other alternative treatments, many of which were available from the eighty-plus vendors who’d set up shop in one of the hotel’s exhibition halls. (According to Ackerman, twenty-second treatments in one of the types of hyperbaric oxygen chamber for sale—“They’re not just for people like Michael Jackson; they’re really cool!”—had transformed her son from a “caveman” into a verbal child capable of having normal conversations.)
The following afternoon, the father-son team of Mark and David Geier stood on stage in the same lecture hall for the first of their two presentations on “New Insights into the Underlying Biochemistry of Autism.” The most recent insight of the Geiers, who’ve been stalwarts of the anti-vaccine movement for decades, involved a treatment called the “Lupron protocol,” which is based on a theory so odd it sounds like a joke: Autism, the Geiers were claiming, is the result of a pathological reaction between mercury and testosterone, and Lupron, an injectable drug used to chemically castrate sex offenders, is the cure. Before determining whether patients are candidates for their “protocol,” the Geiers order up dozens of lab tests at a cost of more than $12,000. The treatment itself, which consists of daily injections and bimonthly deep-tissue shots, can run upward of $70,000 a year. It also is excruciatingly painful. (In an article in the Chicago Tribune, an acolyte of the Geiers’ described giving a shot to one child: “His dad is a big guy like myself, [and] it took both of us to hold him down to give him the first injection. It reminded me of . . . a really wild dog or a cat.”) At the time of the 2009 conference, the Geiers had already opened eight Lupron clinics in six different states. Mark Geier, who calls Lupron a “miracle drug,” told a reporter that was just the beginning of their expansion aspirations: “We plan to open everywhere.”4
Outside the conference rooms of AutismOne and without a child suffering from the disorder, it can be hard to fathom how something as bizarre as Lupron ever gains momentum. But when you watch the transaction happening in real time it’s not hard to understand its appeal. “If someone like Mark Geier comes up to you at a conference, and he’s got twenty impressive PowerPoint slides, and he’s got a Ph.D. and a long string of letters after his name, you’re going to listen to him because you’ve been taught that someone like that is someone who knows what he’s talking about,” says Kevin Leitch, a British blogger and the parent of an autistic child. “And if this same parent reads in The Guardian or the London Times or The New York Times that a new study has been published in Science about a gene that might be associated with 15 percent of cases of autism, hooray. They look at that and think, ‘Screw that. One of them is mildly interesting and the other gives me a load of hope.’ ”
The vast majority of parents, of course, don’t bring such strong predilections to the topic of vaccines. What parents do want is to protect their children from infectious diseases while also being conscientious and informed about what is being injected into their bodies. A lot of parenting decisions come down to our gut reactions—science can’t tell us what’s an appropriate curfew for a sixteen-year-old or whether it’s better to indulge or resist a child who says he wants to quit violin lessons—and when it comes to vaccines, most of the “commonsense” arguments appear to line up on one side of the equation: Vaccines contain viruses, viruses are dangerous, infants’ immune systems aren’t fully developed, drug companies are interested only in profit, and the government can’t always be trusted. The problem, as psychologist and Nobel laureate Daniel Kahneman and his longtime research partner Amos Tversky demonstrated in a series of groundbreaking papers in the 1970s, is that in many situations regarding risk perception and data processing, “commonsense” arguments are precisely the ones that lead us astray.5 Because the risks associated with foregoing vaccines feel so hypothetical, and because the infinitesimally remote possibility that vaccines could hurt our children is so scary, and because there’s nothing in our daily experience to indicate that a little fluid administered through a needle would protect us from a threat we can’t even see, it’s very hard for parents working by intuition alone to know what’s best for their children in this situation.
This leaves us with two choices: We can either take it upon ourselves to do a systematic analysis of all the available information—which becomes ever less feasible as the world grows more complex—or we can trust experts and the media to be responsible about the information and advice they provide. When they’re not, whether it’s because they’re naive or underresourced or lazy or because they’ve become true believers themselves, the consequences can be severe indeed. A recent Hib outbreak in Minnesota resulted in the deaths of several children—including one whose parents said they do not “believe” in vaccination. In 2009, there were more than 13,000 cases of pertussis (more commonly known as whooping cough) in Australia, which is the highest number ever recorded. Among those infected was Dana McCaffery, whose parents do believe in vaccination, but who was too young to get the pertussis vaccine. She died when she was thirty-two days old. Six months later, Dana’s mother got an e-mail from a woman in Dallas, Texas, named Helen Bailey. Bailey was looking for someone who might understand her grief: Her son, Stetson, died of pertussis when he was just eleven weeks old. If anything, the situation is getting even worse: In 2010, a yearlong pertussis outbreak in California was so severe that in September some foreign governments began warning their citizens of the dangers of traveling to the region.
Then there’s measles, which is the most infectious microbe known to man and has killed more children than any other disease in history. A decade after the World Health Organization (WHO) declared the virus effectively eradicated everywhere in the Americas save for the Dominican Republic and Haiti, declining vaccination rates have led to an explosion of outbreaks around the world. In Great Britain, there’s been more than a thousandfold increase in measles cases since 2000. In the United States, there have been outbreaks in many of the country’s most populous states, including Illinois, New York, and Wisconsin. A recent outbreak in California began when a grade-schooler whose doctor supports “selective vaccination” was infected while on a family vacation in Europe. In an anonymously published article in Time magazine, that child’s mother said she “felt safe in making the choice to vaccinate selectively” because she lives in “a relatively healthy first-world country” with a well-functioning health care system. “Looking at the diseases mumps, measles and rubella in a country like the US . . . it doesn’t tend to be a problem,” she said. “Children will do fine with these diseases in a developed country that has good nutrition. And because I live in a country where the norm is vaccine, I can delay my vaccines.”
That statement could not be more false. Measles remains deadly regardless of whether you live in the United States or in Uganda. (Before the MMR vaccine was introduced, its annual death toll in the United States reached into the hundreds, and each year rubella infections resulted in more than twenty thousand infants who were born blind, deaf, or developmentally disabled.) This mother’s conviction also perfectly encapsulates one of the most vexing paradoxes about vaccines: The more effective they are, the less necessary they seem.
On the fourth morning of Matthew Lacek’s coma, a doctor told his parents that he appeared to have stabilized from the drop in his blood pressure the day before. There was a chance, the doctor said, that the antibiotics were winning the fight against the infection that had taken over Matthew’s body—but there was no way to know for sure until he woke up. For the rest of the day, Kelly and Dan sat by their son’s bedside. Late that afternoon, he began to breathe on his own—slowly at first, but then more regularly. It was getting dark outside when he blinked open his eyes. The first words out of his mouth were, “I want to go potty.”
In April 2010, about a year after we first spoke, Kelly Lacek e-mailed me a picture of Matthew and his older brother, chins in hand, posing for the camera like a pair of tough guys. “We just celebrated [Matthew’s] 7th birthday,” she wrote. “It takes everything for me not to cry each day, let alone his birthday. We are so blessed to still have him. He had strep throat 4 times since January and each time his tonsils swell up, [he gets a] high fever and my husband Dan and I are reminded of that day.” Kelly told me about her sons’ Little League games and how much the whole family loves board games and sitting around campfires. “I hope that helps, Seth,” she wrote. “Please let me know if you need anything else. . . . [It’s important] to make sure families are making the right decisions, based on fact and not by fear or misinformation.”
1 This character, and the subsequent conversation, is drawn from an amalgam of discussions I had over a period of several months. These quotes represent my best recollection; as a rule, I try to avoid taking notes during dinner parties.
2 The term “anti-vaccine” has been the subject of extremely contentious disputes. Throughout the book, I have used it to describe groups or individuals whose efforts to discredit vaccines depend on claims that are not supported by, and in many cases are directly contradicted by, the available scientific evidence. It’s worth noting that activist groups have been largely successful in pressuring the media to adopt a standard that relies on these groups’ own beliefs about what qualifies as being “anti-vaccine.” A correction that appeared in The New York Times in April 2010 is an example of this: “A picture caption on Tuesday . . . referred incorrectly to the rally in Washington in 2008 at which the actors Jenny McCarthy and Jim Carrey were shown. Participants were calling for the elimination of what they said were toxins in children’s vaccines and for a reassessment of mandatory vaccination schedules for children; it was not ‘an anti-vaccine’ rally.” (Emphasis added.)
3 One of the case studies on which Festinger based his theory focused on Dorothy Martin, a housewife and former follower of L. Ron Hubbard’s Dianetics movement. Martin claimed that inhabitants of the planet Clarion had told her that Chicago would be destroyed in a flood just after midnight, early on December 21, 1954. Festinger and his colleagues observed Martin’s followers as they quit their jobs, left their spouses, and gave away their money in preparation for their rescue by a flying saucer. By 4:45 a.m. on the morning of the 21st, Martin and her disciples had to acknowledge that Chicago was not underwater and that they had not been rescued by aliens. At that point, Martin received a new message: The apocalypse had been canceled. As Festinger wrote, “The little group, sitting all night long, had spread so much light that God had saved the world from destruction.”
4 Over the course of more than two decades, judges have ruled that Mark Geier’s expert testimony in vaccine-related lawsuits was “below the ethical standards” required of lawyers, “intellectually dishonest,” and “not reliable, or grounded in scientific methodology and procedure.” The Geiers counter such criticism by insisting that there are mainstream scientists who support their work. One person they’ve cited is a British clinical psychologist named Simon Baron-Cohen. When the Chicago Tribune asked Baron-Cohen about the Geiers’ “protocol,” he said that administering Lupron to autistic children “fills me with horror.”
5 Virtually anything having to do with technology provides a good example of how often commonsense assumptions end up being wrong. Think about how recently it would have sounded ludicrous to propose that an invisible worldwide communication network would be capable of beaming movies into a device smaller than a deck of cards, or that shooting lasers into people’s eyeballs could improve their sight. Politics is also an area in which the fantastical has a way of becoming reality: Twenty years ago, a scenario in which the Terminator was elected governor of California would have seemed possible only in a science fiction movie.
© 2011 Seth Mnookin
On April 22, 2006, Kelly Lacek looked around her dinner table and smiled: Dan, her husband of thirteen years, was there, along with the couple’s three children, Ashley, Stephen, and Matthew. Kelly’s parents had also come over: There was a father-daughter dance at the local church that evening, and Kelly and her dad were double-dating with Dan and Ashley. As the four of them were getting ready to leave, Kelly couldn’t resist needling her mother. “You’re stuck with the boys,” she said. “But don’t worry—we won’t be out too late.” She kissed Stephen goodbye, and then bent down to say good night to Matthew. He was three years old, and Kelly marveled at how quickly he was growing up: It seemed as if it was only moments ago that he’d been an infant, and now he was already being toilet-trained. (Dan and Kelly both agreed that it was adorable how proudly he announced that he had to go to the bathroom.)
For a brief moment, Kelly says, she wondered if Matthew was okay—he seemed a little out of sorts, and earlier that afternoon, he’d complained of a sore throat—but then she figured he’d probably just tired himself out wrestling with his older brother.
Kelly and Dan returned home that night around eight o’clock. They’d barely walked in the door when Kelly’s mother rushed over: “It’s Matthew,” she said. “He’s running a fever—and his breathing seems a little shallow.” The Laceks realized right away that something was seriously wrong. “He was just sort of hunched over,” Kelly says. “We didn’t know what to do.” Since there was no way to get in touch with Matthew’s doctor, they decided to make the ten-minute drive from their home in Monroeville, about fifteen miles east of Pittsburgh, to the Forbes Regional Campus of the Western Pennsylvania Hospital.
When the Laceks arrived at the emergency room, the attending physician told them there was nothing to worry about. In all likelihood, he said, Matthew had a case of strep throat. Worst-case scenario, it was asthma; regardless, they’d be home in no time. Two hours later, they were feeling much less assured: Matthew’s fever was still rising, and when a doctor tried to swab his throat, he began to choke. By eleven p.m. Matthew’s temperature had risen to 104 degrees and his breathing seemed to be growing shallower by the minute.
It was around that time that a doctor the Laceks hadn’t met before walked over. He was older—probably in his sixties, Kelly thought—and as soon as he saw Matthew, he began to suck nervously on his teeth. He turned to the Laceks: Had Matthew received all his shots? Actually, Kelly said, he hadn’t. Matthew had been born in March 2003, several years after rumors of a connection between autism and vaccines had begun to gain traction in suburban enclaves around the country. That May, Kelly’s chiropractor warned her about the dangers of vaccines. “He asked if we were going to get [Matthew] vaccinated and I said yes,” Kelly says. “And then he told me about mercury. He said, ‘There’s mercury in there.’ ” Kelly had already heard rumors that the combined measles-mumps-rubella (MMR) vaccine was dangerous, but this was something new. “He was really vocal about it causing autism. He said there was this big report over in Europe and blah blah blah. And I thought, Well, I’m surrounded by people who have autistic children. What if this happened to Matthew?” If Kelly was unconvinced, the chiropractor said, she should make Matthew’s pediatrician prove to her that the vaccines Matthew was scheduled to receive were one hundred percent safe.
“So that’s what I did,” Kelly says. “I asked my doctor if she could give me a label that says there’s no mercury and she said, ‘No.’ She said she wouldn’t give it to me.” It was as if, Kelly says, her pediatrician was hiding something. The doctor tried to tell Kelly that she would be putting Matthew at serious risk by not immunizing him, but, Kelly says, “I don’t think I heard anything else she might have said, quite honestly. At that point I had lost faith.”
From that day forward, Matthew didn’t receive any of his scheduled vaccinations, including one for a bacterial disease called Haemophilus influenzae type b, or Hib. Oftentimes, a Hib infection is not particularly threatening—if the germs stay in the nose and throat, it’s likely the child won’t get sick at all—but if the infection travels into the lungs or the bloodstream, it can result in hearing loss or permanent brain damage. Hib can also cause severe swelling in the throat due to a condition called epiglottitis, which, if not treated immediately, results in infected tissue slowly sealing off the victim’s windpipe until he suffocates to death. As recently as the 1970s, tens of thousands of children in America had severe Hib infections each year. Many of those suffered from bacterial meningitis, and between five hundred and one thousand died. After the Hib vaccine was put into widespread use, the disease all but disappeared in the United States: In 1980, approximately 1 in 1,000 children caught Hib; today, fewer than 1 in 100,000 do. In fact, the immunization had been so effective that out of everyone working in the Monroeville ER, the doctor who’d asked Kelly Lacek about her son’s vaccine history was the only one who had been practicing long enough to have seen an actual Hib infection in a child.
Until that night, Kelly had never given much thought to the potential repercussions of her decision not to have Matthew vaccinated. “I must have read somewhere that after he turned three, he would have been okay for many of those diseases,” she says. “I thought he was in the clear.” She was wrong. “I have never seen a doctor panic so quickly,” she says. If, as the doctor was all but certain was the case, Matthew had been infected, then everything that had been done to him in the hospital that night—the examinations, the swabs, the breathing treatments—had served only to further inflame his throat. It wasn’t until Kelly saw her son’s X-rays that she realized just how dire the situation was: It looked as if Matthew had a thumb lodged in his throat. “I started to shake,” Kelly says. “There was just a tiny bit of airway left for him to breathe.”
Within minutes, the entire emergency room was thrown into a frenzy. Kelly heard someone shout out, “Page Children’s!” Then she heard a second command: “Get Life Flight here right away.” Finally, a doctor pulled the Laceks aside and explained the situation to them. “If we don’t get Matthew on a helicopter [to the Children’s Hospital in Pittsburgh] right now, your son is probably going to die,” he said. “It could be within minutes.” While they were waiting, the doctor said, Kelly had to make sure Matthew remained calm. “I do not want you crying,” the doctor said. “I do not want you reacting to anything. If you are upset, Matthew will be upset, and that will make his throat close up more. If that happens he will suffocate.” As if in a daze, Kelly went and picked up her son. It wasn’t until she heard her teeth chattering that she realized she was shaking. She focused all her energy on trying to remain still.
While Kelly was holding Matthew, Dan Lacek was conferring with the hospital staff. It had rained earlier in the evening, and now the entire area was covered in fog, which made it too dangerous to land a helicopter. Matthew was going to have to make the trip to Pittsburgh in an ambulance—but before he could be moved, he’d have to be intubated. If that didn’t work—if there was not enough room in Matthew’s throat for a breathing tube—the doctors would try to perform a tracheotomy, which involves cutting into the windpipe in an effort to form an alternate pathway for air to get into the lungs. (The procedure is not without risk: The physicist Stephen Hawking lost his speech when the nerves that control the vocal cords were damaged during an emergency tracheotomy.) Once again, it fell to Kelly to keep her son calm. Fortunately, the tube slid down Matthew’s throat. Unless it closed up so much that the tube was forced out, they’d bought themselves a few more hours.
It was almost four in the morning when the Laceks arrived in Pittsburgh. Matthew was immediately placed in a medically induced coma. All the doctors could promise was that he’d live through the night. “They said something about not catching it quickly enough with the antibiotics,” Kelly says. “Even if he did recover, there was a good chance he would have permanent brain damage, or, best-case scenario, he would have hearing loss.”
For forty-eight hours, Dan and Kelly Lacek’s son remained in stable condition. “You’re in shock,” Kelly says. “You never let your guard down. You’re just so focused on him getting better.” Then, on Tuesday, just as they were growing more hopeful, Matthew’s blood pressure plummeted. The only thing the Laceks could think to do at that point was to ask their friends to pray for them.
When Kelly Lacek’s chiropractor told her that vaccines had been linked to autism, he was repeating the most recent of hundreds of years’ worth of fears about vaccinations. The roots of this latest alarm dated back to 1998, when a British gastroenterologist named Andrew Wakefield claimed to have discovered a new gut disorder associated with the MMR vaccine—and with autism. Wakefield based his conclusions on a case study of a dozen children who’d been brought to his clinic at the Royal Free Hospital in London. Almost immediately, Wakefield’s research methods and his interpretations, which had been published in the medical journal The Lancet, came under fire. Wakefield’s response was to appeal to the public rather than to his colleagues: The medical establishment was so determined to discredit him, he said, because he threatened their hegemony by taking parents’ concerns seriously. The media took the bait, and despite Wakefield’s lack of proof and his track record of dubious assertions and unverified lab results, they began churning out stories about how a maverick doctor was trying to protect innocent children from corrupt politicians and a rapacious pharmaceutical industry. Within months, vaccination rates across Western Europe began to fall.
Then, a year later, the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) publicly recommended the removal of a widely used mercury-based preservative called thimerosal from childhood shots. The move had been hotly debated; in the end, one of the factors that had tipped the balance was a concern that following the Wakefield brouhaha, any connection, real or rumored, between vaccines and neurodevelopmental disorders had a chance of unraveling public confidence in vaccines.
That fear proved to be well founded, in no small part because of the growing hold autism had on the public’s consciousness. In the half-century since “infantile autism” had been defined as a discrete medical condition, it had gone from being a source of shame for parents, who were blamed for their children’s conditions, to becoming a seemingly omnipresent concern, especially among those well-educated, upper-middle-class families for whom child rearing had become an all-encompassing obsession.
In spite of this increased attention, researchers in the 1990s were barely any closer to understanding autism’s origins or devising effective therapies for its treatment than their predecessors had been fifty years earlier. For parents of autistic children, this lack of reliable information resulted in feelings of hopelessness and frustration; for parents in general trying to determine the best course of action for the future, it fueled a sense that medical experts and health authorities couldn’t be counted on to look out for their families’ well-being.
Together, these reactions prepared the ground for new hypotheses to take root, regardless of how speculative or scientifically dubious they were. In the year following the CDC/AAP recommendations regarding thimerosal, a small group of parents decided that some of the symptoms of mercury poisoning seemed to match the behavior they saw in their autistic children—and they suddenly realized that their children had appeared to be fine before they’d received their vaccines. These parents began posting their observations online, sparking hundreds more parents to confirm that they’d noticed the exact same thing. With a network of nontraditional doctors and alternative health practitioners urging them on, they became more and more convinced that the common threads that ran through their stories were too odd and too widespread to be mere happenstance.
The more these newly politicized parents learned, the more outraged they became. Why were children with weak immune systems injected with vaccines just as potent as those used on children in perfect health? Why was everyone instructed to receive the same number of inoculations, regardless of their medical histories or family backgrounds? Why, for that matter, were more and more shots being added all the time? Was a chicken pox vaccine really necessary? Or one for the flu?
Just as had been the case with the MMR vaccine, there was no concrete evidence linking thimerosal to autism, and the anecdotal corroboration often seemed more impressive than it actually was. (To take but one example: Despite superficial similarities, the motor difficulties exhibited by people with mercury poisoning bear little resemblance to the repetitive movements typical of autistics.) That didn’t stop the American media from reacting much the same way their colleagues across the Atlantic had when Andrew Wakefield had published his assertions, as the emotional pull of stories featuring sick children and devoted parents outstripped anything as boring as hard data or the precautionary principle. In a matter of months, an ad hoc coalition of “Mercury Moms” transformed itself into a potent political force: Senators spoke at their rallies, public health officials tried to assuage their concerns, and federal agencies included them in discussions on how to spend tens of millions of dollars. Soon, vaccination rates began to fall in the United States as well.
By the beginning of the new millennium, Wakefield’s supporters and the proponents of the thimerosal link had joined forces to create an international cadre of vaccine skeptics whose message had an undeniable appeal: Parents trying to do nothing so much as raise their children had been taken advantage of by a society they had trusted—and now they were determined to make it right.
• • •
Over the past two decades, the instant accessibility of information has dramatically reshaped our relationship to the world of knowledge. Five hundred years after Gutenberg’s introduction of the printing press and Martin Luther’s translation of the Bible let common people bypass the priestly class, the vernacular of twenty-four-hour news channels and Internet search engines is freeing us to take on tasks that we’d long assumed were limited to those with specialized training. Why, after all, should we pay commissions to real estate brokers or stock analysts when we can find online everything we need to sell our houses or manage our investments? And why should we blindly follow doctors when we can diagnose our own ailments?
One of the first effects of this hyper-democratization of data was to unmoor information from the context required to understand it. On the Internet, facts float about freely and are recombined more according to the preferences of intuition than the rules of cognition: Mercury is toxic, toxins can cause development disorders, mercury is in vaccines; ergo, vaccines cause autism. Combined with the self-reinforcing nature of online communities and a content-starved, cash-poor journalistic culture that gravitates toward neat narratives at the expense of messy truths, this disdain for actualities has led to a world with increasingly porous boundaries between facts and beliefs, a world in which individualized notions of reality, no matter how bizarre or irrational, are repeatedly validated.
Take the “birther” movement, which contends that Barack Obama was born in Kenya and therefore is not eligible to be president. In the summer of 2009, Orly Taitz, a Russian-born dentist/lawyer/real estate agent, almost single-handedly turned her one-woman media blitz into a national preoccupation. Taitz, who believes that the Federal Emergency Management Agency is building internment camps to house anti-Obama activists and that Venezuelan president Hugo Chávez controls the software that runs American voting machines, makes for undeniably good television: She looks like a young Carol Channing, sounds like an overexcited Zsa Zsa Gabor, and has the ability to make absurd accusations with a completely straight face. By midsummer, Taitz was appearing regularly on CNN, Fox News, and MSNBC, a decision the news channels justified with the risible pretext of needing to be fair to those on “both sides” of an issue about which there was nothing up for debate—at least not in the real world. Before long, mainstream on-air personalities like Lou Dobbs were pimping the story as hard as Taitz or any of her allies were, to equally comical effect.
This type of cognitive relativism—or “truthiness,” as fictional talk show host Stephen Colbert termed it—has become the defining intellectual trend of our time. Colbert coined truthiness as a way to define former president George W. Bush’s disdain for “those who think with their head” as opposed to “those who know with their heart.” Its pervasiveness was most tragically illustrated in Iraq: By inventing a set of facts to support the overthrow of Saddam Hussein, the Bush administration changed a discussion of whether Iraq had weapons of mass destruction to whether the theoretical presence of WMDs was sufficient justification for war. In the fall of 2004, after both WMDs and easy victory were revealed as mirages, a presidential aide made an astounding admission to The New York Times Magazine. The White House, he said, didn’t waste time worrying about those “in what we call the reality-based community” who “believe that solutions emerge from your judicious study of discernible reality.” That, the aide said, “is not the way the world really works anymore. . . . When we act, we create our own reality.” Orly Taitz couldn’t have put it any better herself.
My interest in the controversies surrounding childhood inoculations began in 2008. My wife and I were newly married, and though we didn’t yet have children, we found ourselves initiates in a culture in which people obsessed over issues about which we’d previously been unaware, such as the political implications of disposable diapers and the merits of home births. Another common preoccupation, we discovered, was the fear that widespread fraud was being perpetrated by the medical establishment. These people were our peers: They gravitated toward fields like journalism or law or computer programming or public policy; they lived in college towns like Ann Arbor and Austin or sophisticated urban centers like Boston and Brooklyn; they drove Priuses and shopped at Whole Foods. They tended to be self-satisfied, found it difficult to conceive of a world in which their voices were not heard, and took pride in being intellectually curious, thoughtful, and rational.
And, we soon learned, a good number of them didn’t trust the American Medical Association (AMA) or the American Academy of Pediatrics—or at least didn’t trust them enough to adhere to their recommended immunization schedules, which included vaccinations for diphtheria, hepatitis B, Hib, influenza, measles, mumps, pertussis, pneumococcal, poliovirus, rotavirus, rubella, and tetanus, all in the first fifteen months of a child’s life. This caught us by surprise: The AAP wasn’t high on the list of organizations we thought likely to be part of a widespread conspiracy directed against the nation’s children.
That fall, we were at a dinner party when the subject of vaccines came up for what felt like the millionth time. I asked the parents at the table how they went about making decisions concerning their children’s health. Did they talk to their pediatricians? Other parents? Were they reading books? Poking around online? One friend, a forty-one-year-old first-time father, said there was so much conflicting information out there he hadn’t known what to do.1 In the end, he said, he and his wife decided to delay some shots, including the ones for the MMR vaccine, which he’d heard was particularly dangerous. “I don’t know what to say,” he told me. “It just feels like a lot for a developing immune system to deal with.”
At the time, I had no idea what the evidence supported. Still, I cringed when my friend said he’d made his decision based on what he felt rather than by trying to assess the balance of the available evidence. Anecdotes and suppositions, no matter how right they feel, don’t lead to universal truths; experiments that can be independently confirmed by impartial observers do. Intuition leads to the flat earth society and bloodletting; experiments lead to men on the moon and microsurgery.
The more I pushed my friend, the more defensive he grew. Surely, I said, there had to be something tangible, some experiment or some epidemiological survey, that informed his decision. There wasn’t; I was even more taken aback when he said he likely would have done the same thing even if he’d been presented with conclusive evidence that the MMR vaccine was safe. “Let’s say that there haven’t been any studies that have uncovered a problem,” he said. “That doesn’t mean they won’t find one someday.” He was, of course, technically correct: It is always impossible to prove a negative. That’s why gravity is still a “theory”—and why you can’t prove with absolute certainty that I won’t wake up tomorrow with the ability to fly. (As Einstein said, “No amount of experimentation can ever prove me right; a single experiment can prove me wrong.”) Finally, he offered up this rationalization: “If everyone agreed that vaccines are so safe, we wouldn’t even be having this discussion.” By that point, my wife was kicking me under the table. I let the subject drop.
But when I got home that night I couldn’t stop thinking about that conversation. The issue didn’t affect me directly: No one close to me had a personal connection with autism and I didn’t know any vaccinologists or government health officials. What nagged at me, I realized, was the pervasiveness of a manner of thinking that ran counter to the principles of deductive reasoning that have been the foundation of rational society since the Enlightenment.
I began work on this book the next day. After reading hundreds of academic papers and thousands of pages of court transcripts, I couldn’t help but agree with a federal judge who presided over an omnibus proceeding in which thousands of families with autistic children requested compensation for what they claimed were vaccine injuries: This was “not a close case.”
Once I’d arrived at the conclusion that there was no evidence supporting a link between childhood inoculations and developmental disorders, I had to confront a set of issues that get to the heart of social dynamics and human cognition: Why, despite all the evidence to the contrary, do so many people remain adamant in their belief that vaccines are responsible for harming hundreds of thousands of otherwise healthy children? Why is the media so inclined to air their views? Why are so many others so readily convinced? Why, in other words, are we willing to believe things that are, according to all available evidence, false?
In an effort to answer those questions, I interviewed scientists and doctors, healers and mystics, government appointees and elected officials. I also spoke with dozens of parents who watched helplessly as their autistic children were enveloped by worlds outsiders could not penetrate. Some of these children were in obvious physical pain, some were sullen and unresponsive, some were violent and uncontrollable, and some moved from one extreme to another. The suffering of parents who feel unable to protect their children is almost impossible to describe—and helplessness only begins to cover the range of emotions they endured. There was guilt: Despite everything they were told, it was impossible for some parents to fully rid themselves of a feeling that somehow their child’s condition was their fault. There was resentment: Many were tired of having their lives taken over by a disease about which so little is known and so little can be done. There was bitterness: How could a society that propped up foreign governments and bailed out failing banks not pay for adequate services for disabled children? And there was anger: Surely someone or something was to blame for the ways in which their lives had been upended.
But more than anything else, parents spoke of their isolation. Those split seconds of synchronicity that freckle people’s days—the half-smile a new mom gives a pregnant woman on the street, the glance shared by two strangers reading the same book on the subway—those are missing from a lot of these parents’ lives. Those with children on the more extreme end of the autism spectrum tend to feel the most alone: There are no knowing winks when a child won’t stop screaming, no “I’ve been there” grins when he defecates in public. No one thinks it’s cute when a child scratches his mother until she bleeds and strangers don’t chuckle when a ten-year-old wants to know why the woman who just got on the bus is so fat.
This sense of being cut off from the world helps to explain why tens of thousands of parents have gravitated to a close-knit community that stretches around the globe. The fact that the community’s most vocal and active members believe that vaccines cause autism and that autism can be cured by “biomedical” treatments like gluten-free diets and hormone injections is of secondary importance—what’s paramount is the sense of fellowship and support its members receive. Every spring, between fifteen hundred and two thousand of these parents travel to Chicago’s Westin O’Hare hotel for the annual conference of a grassroots organization called AutismOne, which claims to be the single largest producer of information about the disorder in the world. For those three or four days, the dynamic that shapes many of these parents’ lives is turned on its head: Here, it’s people whose lives haven’t been affected by autism who feel out of place.
In order to protect this space, AutismOne discourages outsiders from attending. In incidents over the past several years, the organization has barred journalists identified as unsympathetic, kicked out parents who were perceived as being impertinent, and asked security to remove a public health official. This gatekeeping is severe but the worry behind it—that only people with a vested interest in the organization’s survival can be trusted to take a generous view of its beliefs—is not misplaced. Even after I was granted permission to attend one of the group’s conferences, I always had the feeling that my temporary visa did not come with the right to ask about the apparent contradictions highlighted by the weekend’s proceedings.
The most obvious of these is the insistence by AutismOne’s founders that they promote a “pro-science” and not an “anti-vaccine” agenda, a claim that is hard to reconcile with the group’s mission statement: “The great majority of children suffering from autism regressed into autism after routine vaccination. . . . Autism is caused by too many vaccines given too soon.”2 If anything, the conference’s speakers have become more extreme as an ever-growing body of evidence disproves their claims: Included among the 150 presentations at the conference I attended was a four-hour-long “vaccine education” seminar, a lecture on “autism and vaccines in the US [legal system],” an environmental symposium on “the toxic assault on our children,” and a presentation on “Down syndrome, vaccinations, and genetic susceptibility to injury.” During her talk, Barbara Loe Fisher, the grande dame of the American anti-vaccine movement, explained how vaccines are a “de facto selection of the genetically vulnerable for sacrifice” and said that doctors who administer vaccines are the moral equivalent of “the doctors tried at Nuremberg.” (That parallel, she said, had been pointed out to her by Andrew Wakefield, in whose honor the 2009 conference was held.) One night, there was the premiere of a documentary called Shots in the Dark, which examined “current large-scale vaccination policies” in light of the “onset of side effects such as autism or multiple sclerosis.” This list could go on for pages.
If you assume, as I had, that human beings are fundamentally logical creatures, this obsessive preoccupation with a theory that has for all intents and purposes been disproved is hard to fathom. But when it comes to decisions around emotionally charged topics, logic often takes a back seat to what are called cognitive biases—essentially a set of unconscious mechanisms that convince us that it is our feelings about a situation and not the facts that represent the truth. One of the better known of these biases is the theory of cognitive dissonance, which was developed by the social psychologist Leon Festinger in the 1950s. In his classic book When Prophecy Fails, Festinger used the example of millennial cults in the days after the prophesied moment of reckoning as an illustration of “disconfirmed” expectations producing counterintuitive results:
Suppose an individual believes something with his whole heart; suppose further that he has a commitment to this belief, that he has taken irrevocable actions because of it; finally, suppose that he is presented with evidence, unequivocal and undeniable evidence, that his belief is wrong; what will happen? The individual will frequently emerge, not only unshaken, but even more convinced of the truth of his beliefs than ever before. Indeed, he may show a new fervor about convincing and converting other people to his view.3
In this light, another seeming paradox of the anti-vaccine movement—its extreme paranoia about ulterior motives on the part of anyone promoting vaccination combined with an almost willful blindness to the conflicts of interest of the profiteers in their midst—also makes more sense. In a speech delivered at eight in the morning of the first full day of the conference I attended, Lisa Ackerman, the head of a group called Talk About Curing Autism (TACA), ran through a long list of things parents “need” to do for their children, including testing for mineral deficiencies, installing water filtration systems, eating organic chickens, and throwing out all flame-retardant clothing, mattresses, and carpeting. “If you buy clothes and pajamas from Target and Wal-Mart, almost all of those have a flame retardant applied,” she said. “If you’re building or doing home improvement, that’s like the biggest toxic exposure you can give a child. New carpets are one of the worst things you can do. Sorry if you just did it.” Ackerman also talked about “supplementation [and] nutritional therapies,” including “vitamin B12 shots in the buttocks” and antioxidant IVs, and described a range of other alternative treatments, many of which were available from the eighty-plus vendors who’d set up shop in one of the hotel’s exhibition halls. (According to Ackerman, twenty-second treatments in one of the types of hyperbaric oxygen chamber for sale—“They’re not just for people like Michael Jackson; they’re really cool!”—had transformed her son from a “caveman” into a verbal child capable of having normal conversations.)
The following afternoon, the father-son team of Mark and David Geier stood on stage in the same lecture hall for the first of their two presentations on “New Insights into the Underlying Biochemistry of Autism.” The most recent insight of the Geiers, who’ve been stalwarts of the anti-vaccine movement for decades, involved a treatment called the “Lupron protocol,” which is based on a theory so odd it sounds like a joke: Autism, the Geiers were claiming, is the result of a pathological reaction between mercury and testosterone, and Lupron, an injectable drug used to chemically castrate sex offenders, is the cure. Before determining whether patients are candidates for their “protocol,” the Geiers order up dozens of lab tests at a cost of more than $12,000. The treatment itself, which consists of daily injections and bimonthly deep-tissue shots, can run upward of $70,000 a year. It also is excruciatingly painful. (In an article in the Chicago Tribune, an acolyte of the Geiers’ described giving a shot to one child: “His dad is a big guy like myself, [and] it took both of us to hold him down to give him the first injection. It reminded me of . . . a really wild dog or a cat.”) At the time of the 2009 conference, the Geiers had already opened eight Lupron clinics in six different states. Mark Geier, who calls Lupron a “miracle drug,” told a reporter that was just the beginning of their expansion aspirations: “We plan to open everywhere.”4
Outside the conference rooms of AutismOne and without a child suffering from the disorder, it can be hard to fathom how something as bizarre as Lupron ever gains momentum. But when you watch the transaction happening in real time it’s not hard to understand its appeal. “If someone like Mark Geier comes up to you at a conference, and he’s got twenty impressive PowerPoint slides, and he’s got a Ph.D. and a long string of letters after his name, you’re going to listen to him because you’ve been taught that someone like that is someone who knows what he’s talking about,” says Kevin Leitch, a British blogger and the parent of an autistic child. “And if this same parent reads in The Guardian or the London Times or The New York Times that a new study has been published in Science about a gene that might be associated with 15 percent of cases of autism, hooray. They look at that and think, ‘Screw that. One of them is mildly interesting and the other gives me a load of hope.’ ”
The vast majority of parents, of course, don’t bring such strong predilections to the topic of vaccines. What parents do want is to protect their children from infectious diseases while also being conscientious and informed about what is being injected into their bodies. A lot of parenting decisions come down to our gut reactions—science can’t tell us what’s an appropriate curfew for a sixteen-year-old or whether it’s better to indulge or resist a child who says he wants to quit violin lessons—and when it comes to vaccines, most of the “commonsense” arguments appear to line up on one side of the equation: Vaccines contain viruses, viruses are dangerous, infants’ immune systems aren’t fully developed, drug companies are interested only in profit, and the government can’t always be trusted. The problem, as psychologist and Nobel laureate Daniel Kahneman and his longtime research partner Amos Tversky demonstrated in a series of groundbreaking papers in the 1970s, is that in many situations regarding risk perception and data processing, “commonsense” arguments are precisely the ones that lead us astray.5 Because the risks associated with foregoing vaccines feel so hypothetical, and because the infinitesimally remote possibility that vaccines could hurt our children is so scary, and because there’s nothing in our daily experience to indicate that a little fluid administered through a needle would protect us from a threat we can’t even see, it’s very hard for parents working by intuition alone to know what’s best for their children in this situation.
This leaves us with two choices: We can either take it upon ourselves to do a systematic analysis of all the available information—which becomes ever less feasible as the world grows more complex—or we can trust experts and the media to be responsible about the information and advice they provide. When they’re not, whether it’s because they’re naive or underresourced or lazy or because they’ve become true believers themselves, the consequences can be severe indeed. A recent Hib outbreak in Minnesota resulted in the deaths of several children—including one whose parents said they do not “believe” in vaccination. In 2009, there were more than 13,000 cases of pertussis (more commonly known as whooping cough) in Australia, which is the highest number ever recorded. Among those infected was Dana McCaffery, whose parents do believe in vaccination, but who was too young to get the pertussis vaccine. She died when she was thirty-two days old. Six months later, Dana’s mother got an e-mail from a woman in Dallas, Texas, named Helen Bailey. Bailey was looking for someone who might understand her grief: Her son, Stetson, died of pertussis when he was just eleven weeks old. If anything, the situation is getting even worse: In 2010, a yearlong pertussis outbreak in California was so severe that in September some foreign governments began warning their citizens of the dangers of traveling to the region.
Then there’s measles, which is the most infectious microbe known to man and has killed more children than any other disease in history. A decade after the World Health Organization (WHO) declared the virus effectively eradicated everywhere in the Americas save for the Dominican Republic and Haiti, declining vaccination rates have led to an explosion of outbreaks around the world. In Great Britain, there’s been more than a thousandfold increase in measles cases since 2000. In the United States, there have been outbreaks in many of the country’s most populous states, including Illinois, New York, and Wisconsin. A recent outbreak in California began when a grade-schooler whose doctor supports “selective vaccination” was infected while on a family vacation in Europe. In an anonymously published article in Time magazine, that child’s mother said she “felt safe in making the choice to vaccinate selectively” because she lives in “a relatively healthy first-world country” with a well-functioning health care system. “Looking at the diseases mumps, measles and rubella in a country like the US . . . it doesn’t tend to be a problem,” she said. “Children will do fine with these diseases in a developed country that has good nutrition. And because I live in a country where the norm is vaccine, I can delay my vaccines.”
That statement could not be more false. Measles remains deadly regardless of whether you live in the United States or in Uganda. (Before the MMR vaccine was introduced, its annual death toll in the United States reached into the hundreds, and each year rubella infections resulted in more than twenty thousand infants who were born blind, deaf, or developmentally disabled.) This mother’s conviction also perfectly encapsulates one of the most vexing paradoxes about vaccines: The more effective they are, the less necessary they seem.
On the fourth morning of Matthew Lacek’s coma, a doctor told his parents that he appeared to have stabilized from the drop in his blood pressure the day before. There was a chance, the doctor said, that the antibiotics were winning the fight against the infection that had taken over Matthew’s body—but there was no way to know for sure until he woke up. For the rest of the day, Kelly and Dan sat by their son’s bedside. Late that afternoon, he began to breathe on his own—slowly at first, but then more regularly. It was getting dark outside when he blinked open his eyes. The first words out of his mouth were, “I want to go potty.”
In April 2010, about a year after we first spoke, Kelly Lacek e-mailed me a picture of Matthew and his older brother, chins in hand, posing for the camera like a pair of tough guys. “We just celebrated [Matthew’s] 7th birthday,” she wrote. “It takes everything for me not to cry each day, let alone his birthday. We are so blessed to still have him. He had strep throat 4 times since January and each time his tonsils swell up, [he gets a] high fever and my husband Dan and I are reminded of that day.” Kelly told me about her sons’ Little League games and how much the whole family loves board games and sitting around campfires. “I hope that helps, Seth,” she wrote. “Please let me know if you need anything else. . . . [It’s important] to make sure families are making the right decisions, based on fact and not by fear or misinformation.”
1 This character, and the subsequent conversation, is drawn from an amalgam of discussions I had over a period of several months. These quotes represent my best recollection; as a rule, I try to avoid taking notes during dinner parties.
2 The term “anti-vaccine” has been the subject of extremely contentious disputes. Throughout the book, I have used it to describe groups or individuals whose efforts to discredit vaccines depend on claims that are not supported by, and in many cases are directly contradicted by, the available scientific evidence. It’s worth noting that activist groups have been largely successful in pressuring the media to adopt a standard that relies on these groups’ own beliefs about what qualifies as being “anti-vaccine.” A correction that appeared in The New York Times in April 2010 is an example of this: “A picture caption on Tuesday . . . referred incorrectly to the rally in Washington in 2008 at which the actors Jenny McCarthy and Jim Carrey were shown. Participants were calling for the elimination of what they said were toxins in children’s vaccines and for a reassessment of mandatory vaccination schedules for children; it was not ‘an anti-vaccine’ rally.” (Emphasis added.)
3 One of the case studies on which Festinger based his theory focused on Dorothy Martin, a housewife and former follower of L. Ron Hubbard’s Dianetics movement. Martin claimed that inhabitants of the planet Clarion had told her that Chicago would be destroyed in a flood just after midnight, early on December 21, 1954. Festinger and his colleagues observed Martin’s followers as they quit their jobs, left their spouses, and gave away their money in preparation for their rescue by a flying saucer. By 4:45 a.m. on the morning of the 21st, Martin and her disciples had to acknowledge that Chicago was not underwater and that they had not been rescued by aliens. At that point, Martin received a new message: The apocalypse had been canceled. As Festinger wrote, “The little group, sitting all night long, had spread so much light that God had saved the world from destruction.”
4 Over the course of more than two decades, judges have ruled that Mark Geier’s expert testimony in vaccine-related lawsuits was “below the ethical standards” required of lawyers, “intellectually dishonest,” and “not reliable, or grounded in scientific methodology and procedure.” The Geiers counter such criticism by insisting that there are mainstream scientists who support their work. One person they’ve cited is a British clinical psychologist named Simon Baron-Cohen. When the Chicago Tribune asked Baron-Cohen about the Geiers’ “protocol,” he said that administering Lupron to autistic children “fills me with horror.”
5 Virtually anything having to do with technology provides a good example of how often commonsense assumptions end up being wrong. Think about how recently it would have sounded ludicrous to propose that an invisible worldwide communication network would be capable of beaming movies into a device smaller than a deck of cards, or that shooting lasers into people’s eyeballs could improve their sight. Politics is also an area in which the fantastical has a way of becoming reality: Twenty years ago, a scenario in which the Terminator was elected governor of California would have seemed possible only in a science fiction movie.
© 2011 Seth Mnookin
Product details
- Publisher : Simon & Schuster; First Edition (January 11, 2011)
- Language : English
- Hardcover : 448 pages
- ISBN-10 : 1439158649
- ISBN-13 : 978-1439158647
- Item Weight : 1.36 pounds
- Dimensions : 6.13 x 1.4 x 9.25 inches
- Best Sellers Rank: #829,198 in Books (See Top 100 in Books)
- #149 in Virology
- #3,029 in History & Philosophy of Science (Books)
- #20,558 in Classic Literature & Fiction
- Customer Reviews:
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Seth Mnookin is the co-director of MIT's Graduate Program of Science Writing and is the author of three books. His most recent, 2011's THE PANIC VIRUS: THE TRUE STORY BEHIND THE VACCINE-AUTISM CONTROVERSY, won the National Association of Science Writers Science in Society Book Award, was a finalist for the Los Angeles Times Book Prize, and was named one of The Wall Street Journal's Top 5 Health and Medicine books of the year. In 2006, he published the national bestseller FEEDING THE MONSTER: HOW MONEY, SMARTS AND NERVE TOOK A TEAM TO THE TOP, which chronicled the rise of the Boston Red Sox and their 2004 World Series win. Seth's first book was 2004's HARD NEWS: THE SCANDALS AT THE NEW YORK TIMES AND THEIR MEANING FOR AMERICAN MEDIA, which was a Washington Post Best Book of the Year.
Seth began his career as a rock critic for the now-defunct webzine Addicted to Noise. He's been a police reporter at The Palm Beach Post, a political reporter at Brill's Content, a music columnist at The New York Observer, and a national affairs reporter at Newsweek. Since 2005 he's been a contributing editor at Vanity Fair, where he's reported from Iraq, written about Stephen Colbert, and delved into plagiarism accusations against Dan Brown. His work has also appeared in The New Yorker, New York, The New York Times Book Review, The Washington Post Book World, Spin, Slate, Salon, and other publications. He graduated from Harvard College in 1994 with a degree in the History of Science and was a 2004 Joan Shorenstein Fellow at Harvard's Kennedy School of Government. A native of Newton, Massachusetts, he and his wife currently live in Brookline with their two children and adopted dog.
Customer reviews
4.4 out of 5 stars
4.4 out of 5
384 global ratings
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Learn more how customers reviews work on AmazonCustomers say
Customers find the book informative and well-written. They describe it as a great read for people interested in medicine. The writing is accessible to general audiences. Readers appreciate the engaging story and the author's understanding of the nuances. They also mention that vaccines prevent illness and save lives. The book helps reassure parents about the benefits of vaccines.
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46 customers mention "Research quality"46 positive0 negative
Customers find the book's scientific discussion fascinating. They appreciate the thorough coverage of the topic and the author's unabashed support for science. The book provides an excellent overview of important aspects of public medicine and is a must-read for anyone interested in public health, disability, or vaccines.
"...The model is very well ensconced in traditional economic theory, and describes human behavior extremely well, as long as we recognize a few "provisos..." Read more
"...In my opinion, this book summarizes that information as well as can be done when distilling complex science down to its most elemental truths...." Read more
"...6. The media deserves a lot of the blame. 7. Some great quotes of wisdom, "Anecdotes and suppositions, no matter how right they feel, don't..." Read more
"...also learn something from this book, as it also touches on important aspects of public medicine, like how science is communicated and understood..." Read more
44 customers mention "Readability"44 positive0 negative
Customers find the book engaging and well-written. They describe it as a fast-paced novel that provides an insightful account of the topic. Readers also mention it's a good read for those interested in medicine.
"...This is stressed in a very nice paper: Joseph Henrich and Robert Boyd, "The Evolution of Conformist Transmission and the Emergence of Between-Group..." Read more
"...A more in-depth look at autism. In summary, this is a very solid book...." Read more
"...I was not disappointed. I highly recommend the book to anyone - whichever side of the fence you may find yourself - who wants know more about this..." Read more
"...Overall, I think it was a really good book, i'm really glad that I chose this book." Read more
29 customers mention "Writing quality"24 positive5 negative
Customers find the book well-written and accessible for general audiences. They appreciate the honest writing style and the author's balanced approach that considers both sides of the issue. The book provides an informative overview of the anti-vaccine movement and how it relates to the vaccine debate.
"...have noted, this book is rare gift---thoroughly documented and wonderfully written, using references to the primary literature for statistical..." Read more
"...It's well-researched, well-written, and about as fair as can be given the heated subject...." Read more
"...The author does a very respectful job but in the end we need to use reason to help these families and not allow our emotions to derail us...." Read more
"...This is a very well-researched book. The writing should be accessible to general audiences...." Read more
22 customers mention "Story quality"22 positive0 negative
Customers find the story engaging and well-written. They appreciate the author's understanding of the nuances and characterization. The book is described as thought-provoking and gripping, with an introduction that draws readers in.
"...managed to present both sides of the argument and write a pretty engaging story while at it...." Read more
"...2. Well-written and surprisingly even handed. 3. An engaging book that will pull your heart strings while engaging your brain. 4...." Read more
"...I like how the author began the story, and then split into giving information about anti-vaccine activists movements...." Read more
"...easy to pick up at any point in the book because of its short stories styles of chapters." Read more
16 customers mention "Vaccine effectiveness"14 positive2 negative
Customers appreciate the book's coverage of vaccine effectiveness. They find it informative, addressing concerns about vaccine safety and efficacy, as well as the history of vaccines for various diseases. The book also provides an overview of the anti-vaccine movement and its impact on public health.
"...that has demonstrated as conclusively as possible that vaccines do not cause autism...." Read more
"...the parents of autistic children and parents of children who contracted and succumbed to preventable diseases, a consequence of decreasing rates of..." Read more
"...the mountains of evidence regarding the overall safety and efficacy of vaccines...." Read more
"PRO: Well-written overview that conveys the mindset of the pro-vaccine media...." Read more
7 customers mention "Emotion based"7 positive0 negative
Customers find the book's subject sensitive and empathetic. They appreciate the dichotomy between heart and brain, with many interesting cases.
"...16. Many interesting cases and dichotomy of heart vs the brain. 17. The PR movement and its impact. 18. Risk factors identified. 19...." Read more
"...this book is a great example of how to write about such a complex, emotion-laden, and politicized topic." Read more
"...I like how he spoke about how the decision was more emotion based, the logically based on facts in Science...." Read more
"Seth Mnookin has written an excellent review of an emotionally charged topic, with few omissions...." Read more
Top reviews from the United States
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- Reviewed in the United States on February 21, 2011
- Reviewed in the United States on January 20, 2011The title of my review comes from a quote in the book by Arthur Allen, who was describing what, to date, has been the penultimate courtroom showdown in the debate over vaccines and autism. As a mother, I could not agree more. Decisions related to our children's healthcare are agonizing and should be done carefully, using the best information available. In my opinion, this book summarizes that information as well as can be done when distilling complex science down to its most elemental truths. Even though to me it was pretty clear which side of the debate the author falls on, he nevertheless managed to present both sides of the argument and write a pretty engaging story while at it.
The Panic Virus focuses primarily on the debate over vaccines, thimerosal, and autism, but it doesn't end there. Mnookin doesn't gloss over mistakes that were made by the CDC and other government bodies in overseeing the safety of multiple vaccines. Even as someone who has a lot of respect for the contributions of vaccines to public health, I was taken aback by some of the points he made regarding the lack of rigorous safety studies in some areas related to vaccines.
However, he also presents the science that has demonstrated as conclusively as possible that vaccines do not cause autism. Those looking for the ultimate proof of a negative will not find it here, because it cannot be done using science, as Mnookin points out. He also covers some of the psychological reasons for why people are so willing to believe in junk science, and discusses Andrew Wakefield's chicanery in detail. Finally, he gives a voice to families whose children have been harmed by the anti-vaccination movement.
In fairness, one or two of the more esoteric points about the science are a tiny bit off the mark. But this should not distract the reader from the brick wall of scientific evidence presented regarding the lack of an association between vaccines and autism. I am surprised that this book has not gotten more media coverage given the topic. It's well-researched, well-written, and about as fair as can be given the heated subject. It's simply appalling that the science of this controversial story does not get the press that the more sensational anti-vaccinators have received. Read it with an open mind.
Top reviews from other countries
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Lourenço Faria CostaReviewed in Brazil on February 25, 20185.0 out of 5 stars Uma luz ante ao obscurantismo
Excelente e esclarecedor. O livro não se atém unicamente à polêmica sobre autismo em sua falsa relação com vacinas. É muito mais amplo e profundo, abrangendo inclusive aspectos da aquisição de informações em uma sociedade assolada pelo "conhecimento" não convencional, perpetrada em grande parte pelas mídias sociais. Imprescindível para compreender melhor (e combater) um fenômeno pernicioso - a pseudo-ciência popular que alardeia e dissemina concepções falaciosas, populistas e irresponsáveis.
- Dr. Manoj DhinagarReviewed in India on September 8, 2018
5.0 out of 5 stars For an unbiased opinion on vaccines
Very thoroughly researched work about the entirety of the vaccine-autism controversy. It does not belittle or neglect the concerns of the anti-vaxxers while mentioning the weight of scientific evidence to support vaccines and the horrors inflicted by vaccine-preventable diseases.
- EReviewed in Canada on May 10, 2015
5.0 out of 5 stars An invaluable resource to parents, children and educators alike
With The Panic Virus, journalist Seth Mnookin has provided his readers with an excellent and balanced overview of vaccination's history and role in public health, as well as the scientific method as a whole. Readers of the book will come away with a detailed understanding of what is behind the arguments of vaccination advocates and critics alike. While Mnookin's conclusions side with the advocates, he is very much fair to the rational skeptic (the irrational skeptic, however, is another matter).
Although Mnookin is not a scientist (he is now the Co-director of MIT's science writing graduate program), his book is clearly well-researched: the immunology and its history are spot on, as are his explanations of the underlying principles of science (e.g. association of two variables does not necessarily imply causation). Mnookin also goes onto explain how pseudoscience and bad journalism can directly affect and/or harm the population as a whole. This in particular proves especially relevant in today's world. With new "scientific" studies emerging nearly every day, many of which seem contradictory, a good understanding of the scientific method is key to debunking many of them. Mnookin provides that understanding to his readers with this book.
Stylistically, the book is easy to follow and one does not require a scientific background to read it. Any individual fortunate enough to read The Panic Virus will gain a greater knowledge of vaccination and its history as well as a good foundation in the scientific and public health in general.
- shopaholic housewifeReviewed in the United Kingdom on November 17, 2014
5.0 out of 5 stars Every parent of young children should read this book and then make sure others do
This is an exceptionally well written, scrupulously researched book. As a parent with a child on the autistic spectrum, like many others I worried at one point that giving him the MMR vaccine might have triggered his autism, but this book has now completely put my mind at rest. More importantly, it has made me aware of how dangerous not vaccinating children can be, not just for my kids but for everyone. I urge anyone, but especially parents with young children, with any questions about vaccines to read this book thoroughly. It completely debunks all the myths, lies, and snake-oil pseudo-science, and represents and exemplary work of research.
One person found this helpfulReport - Amazon CustomerReviewed in the United Kingdom on January 2, 2020
4.0 out of 5 stars Interesting but difficult to read
It's very interesting but a bit of a difficult read, one must be very dedicated to actually finish it reading quickly. I am reading a chapter a week, so it's going to take some time to finish. There are a lot of names used, and I struggle to follow who is who.
One person found this helpfulReport
