Deadly Choices: How the Anti-Vaccine Movement Threatens Us All

by Paul A. Offit M. D.

  Imagine a herdsman as a parent choosing not to vaccinate a child. The great unsaid about vaccines is that if everyone in the world is vaccinated, it would make more sense for a parent not to vaccinate. This is true for two reasons. First: as more and more children are vaccinated it becomes less and less easy for viruses and bacteria to spread. Indeed, when enough people are vaccinated, these infections simply stop spreading. For example, when the polio vaccine was introduced in the United States in 1955, only 40 percent of the population was immunized, and, although the number of people paralyzed by polio declined, the virus continued to spread. However, after 70 percent of the population had been immunized, the virus stopped spreading and polio infections were eliminated from the United States. The same is true for measles. The only difference is that measles is much more contagious than polio, so a larger percentage of people (about 95 percent) needed to be immunized. After enough people are immunized, those who aren’t can hide in the herd, protected by those around them. Second: although vaccines are safe, they aren’t perfectly safe. All vaccines have side effects, mostly pain and tenderness at the site of injection; but some side effects, such as allergic reactions, can be quite severe. By choosing not to vaccinate, one can enjoy the benefits of hiding in the herd without risking such rare but real side effects. (This is true for all vaccine-preventable diseases save one: tetanus, which is acquired from the soil, not from another person. So, even if everyone in the world is vaccinated against tetanus except for one child, the risk to that child of acquiring tetanus is the same.)

  Hardin continued his essay by explaining how a rational choice can become an irrational one: “The rational herdsman concludes that the only sensible course for him to pursue is to add another animal to the herd. And another; and another.... But this is the conclusion reached by each and every rational herdsman sharing the commons. Therein is the tragedy. Each man is locked into a system that compels him to increase the herd without limit—in a world that is limited. Ruin is the destination toward which all men rush, each pursuing his own best interest in a society that believes in the freedom of the commons. Freedom in a commons brings ruin to all.”

  Such is the case with vaccines. As more and more people have chosen not to vaccinate, herd immunity has broken down. Now, a choice not to get a vaccine has the benefit of avoiding rare side effects, but not the benefit of herd immunity. The studies of Salmon, Feikin, Omer, and Glanz showed that the choice not to get measles or pertussis vaccine was a choice to risk infection because not enough people were getting vaccinated.

  No one has been hit harder by the loss of an immunological commons than children who can’t be vaccinated.

  On October 20, 2009, Stephanie Tatel, an elementary school reading specialist in Charlottesville, Virginia, published an article on Slate.com on her efforts to find a child-care center for her son. “Last year, while searching for child care for our 2-and-a-half-year-old son, my husband and I thought we had found the perfect arrangement,” she wrote, “an experienced home day care provider whose house was an inviting den of toddler industriousness. Under her magical hand, children drifted calmly and happily from the bubble station to the fairy garden to the bunnies and the trucks, an orchestrated preschool utopia. But when I asked, ‘Are any of the children here unvaccinated?’ the hope of my son’s perfect day care experience burnt to a little crisp. As it turned out, one child had a philosophical or religious exemption—a convenient cover-all exemption that many doctors grant, no questions asked, when a parent requests one. I still do not understand how the state can allow one to attribute his or her fear of vaccines and their unproven dangers to religion or philosophy. Ordinarily I wouldn’t question others’ parenting choices. But the problem is literally one of live or don’t live. While that parent chose not to vaccinate her child for what she likely considers well-founded reasons, she is putting other children at risk. In this instance, the child at risk was my son. He has leukemia.”

  Tatel knew that the unvaccinated child posed a risk to her son. “I realize that anti-vaccine sentiment has been around as long as the vaccines themselves,” she wrote. “But I wonder whether they have fully considered that the herd immunity, of which they are taking advantage, is designed to protect those who cannot be vaccinated. For now, we will hire an at-home sitter for [our son]. When he is ready to go off to school, we will have to face this issue again. Because we want him to have as ‘normal’ a life as possible, we’ll likely send him off in the bright yellow school bus and cross our fingers that the kid sitting next to him didn’t just attend a ‘chickenpox party’ over the weekend. Because what’s ‘just a case of chickenpox’ for that kid could be a matter of life or death for mine.”

  Like Stephanie Tatel’s son, hundreds of thousands of people in the United States cannot be vaccinated, forced to depend on those around them to be protected.

  In 1998, Hardin wrote another essay titled “Extension of ‘The Tragedy of the Commons.’” In the intervening thirty years, Hardin had witnessed increasing pollution of the air, seas, and land by “herdsmen” who had continued to “overgraze.” His summary of the situation was poignant. “Individualism is cherished because it produces freedom,” he wrote. “But the gift is conditional.”

  CHAPTER 9

  The Mean Season

  You know, you remove certain medications off shelves because they’re deemed unsafe. Why not vaccines?

  —JENNY MCCARTHY ON LARRY KING LIVE, APRIL 3, 2009

  The breakdown in herd immunity in the United States at the beginning of the twenty-first century hasn’t silenced anti-vaccine activists. Although Barbara Loe Fisher and her National Vaccine Information Center have been heard from less frequently, other groups have stepped in to take her place—specifically the Coalition for Vaccine Safety. Formed from a variety of groups that believe vaccines cause autism, this new breed of anti-vaccine activism has a dramatically different style: meaner, cruder, more strident, and less professional.

  Jenny McCarthy was born on November 1, 1972, in Chicago, Illinois. She attended St. Turibius Grade School on Chicago’s south side and Mother McAuley Liberal Arts High School. Later, she entered Southern Illinois University in Carbondale to study nursing. But her heart wasn’t in it; she wanted to be a model.

  Her success was immediate. In October 1993, McCarthy was Playboy magazine’s Playmate of the Month; in 1994, she was Playmate of the Year. Her affiliation with Playboy didn’t end there. McCarthy hosted the Playboy television show Hot Rocks, which featured uncensored music videos, and the dating show Singled Out. In 1996, she landed a bit part in the comedy The Stupids. That same year, People magazine named her one of the fifty most beautiful people in the world.

  McCarthy’s movie career wasn’t limited to The Stupids. In 1998, she had a small role in BASEketball and the following year in Diamonds , directed by John Asher, whom she married in September 1999. A few years later, on May 18, 2002, their only child, Evan, was born in Los Angeles. But all was not well. Following a chance encounter with a stranger, McCarthy knew that something was different about her son. “One night I reached over and grabbed my Archangel Oracle tarot cards and shuffled them and pulled out a card,” she wrote. “It was the same card I had picked over and over again the past few months. It was starting to drive me crazy. It said that I was to help teach the Indigo and Crystal children. [Later,] a woman approached Evan and me on the street and said, ‘Your son is a Crystal child,’ and then walked away. I remember thinking, ‘Okay, crazy lady,’ and then I stopped in my tracks. Holy shit, she just said ‘Crystal child,’ like on the tarot card.” McCarthy realized that she was an Indigo adult and Evan a Crystal child. Although Evan would soon be diagnosed with autism, McCarthy took heart in the fact that Crystal children were often mislabeled as autistic. According to Doreen Virtue, author of The Care and Feeding of Indigo Children, “Crystal Children don’t warrant a label of autism! They aren’t autistic, they’re AWE-tistic.”

  In 2005, McCarthy changed her mind. She abandoned her
tarot-card predictions and embraced the notion that her son was autistic and that vaccines were responsible. On September 18, 2007, in front of millions of viewers on Oprah, she described the moment that changed her life: “Right before my son got the MMR shot I said to the doctor, ‘I have a very bad feeling about this shot. This is the autism shot, isn’t it?’ And he said, ‘No! That is ridiculous. It is a mother’s desperate attempt to blame something on autism.’ And he swore at me. And then the nurse gave him that shot. And I remember going, ‘Oh, God, no!’ And soon thereafter I noticed a change. The soul was gone from his eyes.” By 2007, researchers had published several studies showing that MMR didn’t cause autism; McCarthy was unconvinced. “My science is Evan, and he’s at home,” she said. “That’s my science.”

  Jenny McCarthy with then husband John Asher at a party at the Playboy mansion. McCarthy has become America’s most-recognized anti-vaccine activist. (Courtesy of Kenneth Johansson/Corbis.)

  Using the fame of her Playboy and movie career, McCarthy soon became America’s most recognized anti-vaccine crusader.

  In many ways, Jenny McCarthy and Barbara Loe Fisher are similar. Both dramatize their personal stories in vivid, heart-wrenching terms. Where Fisher describes her son’s learning disabilities as brain damage, McCarthy likens certain symptoms of her son’s autism to death. When asked during an interview on CNN whether her campaign against vaccines could result in children dying from preventable infections, McCarthy said, “People are also dying from vaccination. Evan, my Evan, my son died in front of me for two minutes.” McCarthy also shares Fisher’s disdain for public health officials and pharmaceutical companies. “I think they need to wake up and stop hurting our kids,” she said. Finally, both Fisher and McCarthy continually reshape their messages to fit the style of the time. Fisher switched from a campaign against pertussis vaccine to one against all vaccines, claiming they caused chronic diseases. McCarthy, supported by environmental activists like Robert F. Kennedy, Jr., and Don and Deirdre Imus, later decided that her son’s autism wasn’t caused by MMR. It was caused by vaccine toxins—specifically, mercury, aluminum, and anti-freeze. (McCarthy later undercut her stop-injecting-toxins-into-our-bodies message by saying, “I love Botox. I absolutely love it. I get it minimally, so I can still move my face. But I really do think it’s a savior.” Made by the bacterium that causes botulism, botulinum toxin [Botox] is one of the world’s most powerful toxins.)

  Although Jenny McCarthy and Barbara Loe Fisher are alike in several ways, their differences are striking.

  Unlike Fisher, McCarthy often resorts to profanity. On April 1, 2009, Jeffrey Kluger, a veteran scientific correspondent, interviewed McCarthy for Time magazine. Kluger, who had recently written a popular book about the polio vaccine, asked, “What about the polio clusters in unvaccinated communities like the Amish in the United States? What about the 2004 outbreak that swept across Africa and Southeast Asia after a single province in northern Nigeria banned vaccines?” McCarthy replied, “I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it’s their fucking fault that the diseases are coming back. They’re making a product that’s shit. If you give us a safe vaccine, we’ll use it. It shouldn’t be polio versus autism.” Kluger also asked McCarthy about the measles vaccine. “And yet in many cases, vaccines have effectively eliminated diseases,” he said. “Measles is among the top five killers in the world of children under five years old, yet it kills virtually no one in the United States thanks to vaccines.” McCarthy replied, “If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the fucking measles.”

  Unlike Fisher, McCarthy is comfortable dispensing medical advice. In a fifteen-minute video designed for parents, she explains what causes autism and how to treat it: “Autism is a toxic overload. And one of the things I want you to write down and then put on your refrigerator are just five things: food, supplementation, detox, medicines, and positive thinking.” McCarthy starts with food, explaining that children should avoid gluten (wheat, barley, or rye) and casein (dairy products). “When you can’t break it down,” she says, “they get stoned, which accounts for their moods, their spaciness, their addiction for things. The mom says he just has to have his twelve cups of milk a day; he just has to have his mac and cheese. Well, no kidding. You know, I really liked my marijuana in college, too. When they want that milk and they want that wheat, you’re giving them a joint.”

  Although both McCarthy and Fisher openly despise pharmaceutical companies, McCarthy promotes their products. On her video describing how to treat autism, McCarthy says, “Some of our kids can’t absorb the nutrients that we give them so they have to be supplemented. Some of the multi-vitamins that I like are Super Nu-Thera® that can be found at Kirkman Laboratories. [McCarthy displays a picture of Super Nu-Thera® followed by Kirkman’s Web site.] Culturelle® you can find at any pharmacy; it’s over-the-counter. ThreeLac® is one of my favorites because it’s a probiotic that also eats yeast and pretty much recovered Evan. Also found at Kirkman. If you’re unsure about dosage, ask your pediatrician; but most of the time they don’t know anything. So I would say ask someone at Kirkman.” At the end of the video, McCarthy promotes another pharmaceutical company with the statement, “For more information about vitamins visit www.kartnerhealth.com.” According to McCarthy’s logic, then, those who promote vaccines are evil because they’re fronting for products that gross $17 billion a year; while those who promote supplements are virtuous because they’re fronting for products—almost all of which are of unproved efficacy—that gross $80 billion a year.

  Perhaps the most important difference between Jenny McCarthy and Barbara Loe Fisher is their backers. Both are heartily endorsed by personal-injury lawyers with much to gain from the Vaccine Injury Compensation Program; but McCarthy, not Fisher, is supported by a wealthy financier. On April 3, 2009, she appeared on Larry King Live. At the end of her segment, King asked, “Jenny, you have a Web site. What is it?” Although McCarthy has her own Web site, she didn’t mention it. “Generationrescue.org,” she said. “You can go there for more information.”

  Generation Rescue was started by a venture capitalist named J. B. Handley, who believes his son’s autism was caused by thimerosal in vaccines. Like McCarthy, Handley has a cure: chelation, a potentially dangerous therapy of unproved efficacy that helps rid the body of heavy metals like mercury and lead. (In 2005, a five-year-old autistic boy died during chelation in suburban Pittsburgh.) To proselytize the miracle of chelation, Handley recruited a group of parents to spread the word, calling them Rescue Angels. Generation Rescue’s mission is, in part, to “gather the information that currently exists about mercury toxicity and publicize the truth so parents can make the best decision to help their children heal.” The key word in Generation Rescue’s mission statement is publicize. On June 8, 2005, Handley’s organization took out a full-page ad in the New York Times. At the top of the page, in bold, black type, the ad declared, “MERCURY POISONING AND AUTISM: IT ISN’T JUST A COINCIDENCE.” On April 6, 2006, Handley’s organization took out another full-page ad, this time in USA Today. Written in letters two inches high, the ad angrily stated, “IF YOU CAUSED A 6,000% INCREASE IN AUTISM WOULDN’T YOU TRY TO COVER IT UP, TOO? IT’S TIME FOR THE CDC TO COME CLEAN WITH THE AMERICAN PUBLIC.” On February 25, 2009, Generation Rescue took out yet another full-page ad in USA Today. This time Handley wanted to alert the public about Bailey Banks, a boy whose parents had claimed that vaccines had caused his autism. “A LITTLE BOY SHOULDN’T HAVE TO TAKE ON AN ENTIRE INDUSTRY ALONE. IT’S TIME THE GOVERNMENT TOLD THE TRUTH ABOUT CHILDHOOD VACCINES.” Each of these ads costs as much as $180,000. Generation Rescue is an advertising arm of the anti-vaccine movement.

  Apparently McCarthy’s stance against vaccines impressed Handley. So, in 2009, “Generation Rescue” became “Jenny McCarthy’s Autism Orga
nization—Generation Rescue,” complete with pictures of and messages from McCarthy.

  Handley brought something to the anti-vaccine movement that hadn’t been seen before: personal intimidation. He didn’t just rail against journalists or professional societies or vaccine advocates; he sued them or sent them hate-filled emails or maintained Web sites to vilify them or screamed at them on national television. On CBS’s daytime program The Doctors, Handley, appearing with McCarthy, attacked the show’s host, Dr. Travis Stork. Stork was convinced by studies that had exonerated vaccines as a cause of autism; Handley wasn’t:

  STORK: In my opinion—and this is just me wanting to have an open debate about this—vaccines are really the one thing we have looked at as causing autism.

  HANDLEY: That is completely bogus! That is such a bogus statement! STORK: No, that’s ...

  HANDLEY: How many vaccines have they looked at in these studies?! How many?! What’s the answer?! I’m so sick of doctors who don’t read the studies, who don’t know the details sitting here telling parents and reassuring them that vaccines don’t cause autism. It’s irresponsible.

  Stork was angry that Handley had chosen to characterize doctors as uncaring and falsely reassuring.

  STORK: And this is the biggest problem, and the reason that doctors in this country are frustrated.

  HANDLEY: Read the science!

  STORK: All you’re doing is you’re antagonizing a medical community that wants to help these kids. OK?