Insights offer a dose of realism on vaccines
Sunday, February 18,
O ver the past two decades, the debate on vaccination has
become steadily more rancorous, which is puzzling. After
all, vaccines have wiped smallpox from the face of the
planet and reduced polio to a ghastly memory. Diseases that
once struck fear into every parent's heart --
diphtheria, tetanus, whooping cough, measles -- have become,
for most Americans, medical asterisks. But, as Arthur Allen
shows in "Vaccine: The Controversial Story of
Medicine's Greatest Lifesaver," vaccines are not
miracles: They are imperfect drugs with risks and benefits.
What's more, he argues, vaccination raises fundamental
issues about life, death, illness and the individual's
duty to society.
Misgivings about vaccines stretch back to 1721, when Cotton
Mather, a Boston minister, promoted inoculation (a primitive
forerunner to vaccination) to forestall a smallpox epidemic.
Opponents denounced Mather as a misguided crackpot who
sought to evade God's judgment through unnatural
practices. They also articulated the parental dilemma at the
heart of every shot: "I should have less distress in
burying many children by the absolute acts of God's
providence," wrote one opponent, "than in being
the means of burying one by my own act and deed."
The smallpox vaccine proved remarkably successful, so
successful it hatched a swarm of imitators. It is somewhat
unsettling to read about the haphazard development of these
early vaccines, many produced by "guts and
guesswork," and tested on soldiers or schoolchildren.
In 1942, for example, the U.S. Army, acting on intelligence
that the Axis powers might wage biological warfare, injected
millions of GIs with a vaccine against yellow fever that was
contaminated with hepatitis B. Some 100 soldiers died and
50,000 others were hospitalized. (Sadly, their sacrifice was
meaningless; the intelligence was wrong.)
In a similar vein, the polio vaccine developed by Jonas Salk
in 1952 was heralded as a triumph of American know-how. Salk
described it as "safe, and you can't get safer
than safe." Unfortunately, shoddy manufacturing and
inept federal oversight allowed contaminated shots to reach
the marketplace, crippling hundreds of children before the
vaccine was withdrawn.
As the last century wound to a close, vaccines were safer
and more effective than ever, but the political and moral
calculus surrounding them had changed. The diseases they
protected against were largely abstract. Cases of severe
reaction, though exceedingly unusual, were dramatic and easy
to demonize. And the era of trusting experts was long gone.
These trends converged in 1982, when NBC aired an expose on
the diphtheria-pertussis-tetanus (DPT) vaccine, complete
with footage of quadriplegic and brain-damaged children.
Overnight, the modern anti-vaccine movement was born.
It turns out that the whole-cell pertussis vaccine used in
the old DPT shots did indeed cause brain damage in extremely
rare instances, and that drug companies had known this for
decades but never bothered to introduce a safer alternative.
Although the pertussis vaccine has since been replaced, the
revelations inflicted tremendous damage to the public trust.
Many parents now oppose vaccination in principle and blame
shots for a horde of maladies from autism to asthma.
"Vaccine" is at least 100 pages too long, and some
chapters meander. But Allen really shines with his
perceptive analysis of the anti-vaccine movement and his
calm examination of the evidence linking vaccines and autism
(he is a skeptic). His greatest achievement is to inject a
dose of reality into a debate that has become distressingly
Allen reads from "Vaccine" at 7:30 p.m. Friday at
Powell's City of Books, 1005 W. Burnside St.
Chris Lydgate is a Portland writer.