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

by Paul A. Offit M. D.

  Following the tragedy of September 11, 2001, there was a moment when we all stood still and looked at each other. No longer individuals, we were part of a whole. Personal interests were irrelevant. We were united in our grief. One.

  Then the moment was gone, dissolved in a cloud of lawsuits, finger-pointing, partisanship, and blame. But, although fleeting, it had been there. And if we can recapture it—recapture the feeling that we are all in this together, all part of a large immunological cooperative—the growing tragedy of children dying from preventable infections can be avoided. We can do this. It’s in us: the better angels of our nature.

  NOTES

  Prologue

  ix Parents choose not to vaccinate their children: G. L. Freed, S. J. Clark, A. T. Butchart, et al. “Parental Vaccine Safety Concerns in 2009,” Pediatrics 125 (2010): 1-6; P. J. Smith, S. G. Humiston, Z. Zhao, et al., “Association Between Delayed or Refused Vaccination Doses and Timely Vaccination Coverage,” abstract presented at the Pediatric Academic Society’s annual meeting, Vancouver, British Columbia, May 4, 2010.

  ix Percentage of unvaccinated children has more than doubled: S. B. Omer, W.K.Y. Pan, N. A. Halsey, et al., “Nonmedical Exemptions to School Immunization Requirements: Secular Trends and Association of State Policies with Pertussis Incidence,” Journal of the American Medical Association 296 (2006): 1757-1763.

  ix Doctors refuse to see unvaccinated children: E. A. Flanagan-Klygis, L. Sharp, and J. E. Frader, “Dismissing the Family Who Refuses Vaccines: A Study of Pediatrician Attitudes,” Archives of Pediatric and Adolescent Medicine 159 (2005): 929-934.

  Introduction

  xi Robert Bazell: NBC Nightly News, February 17, 2009.

  xi Minnesota outbreak: Centers for Disease Control and Prevention, “Invasive Haemophilus Influenzae Type B Disease in Five Young Children—Minnesota, 2008,” Morbidity and Mortality Weekly Report 58 (2008): 1-3.

  xi Parent of child with Hib: NBC Nightly News, February 17, 2009.

  xii Hib outbreaks: D. Sapatkin, “A Fatal Link in Vaccine Shortage,” Philadelphia Inquirer, April 1, 2009.

  xii Hib disease: Centers for Disease Control and Prevention, “Invasive Haemophilus Influenzae Type B Disease in Five Young Children—Minnesota, 2008,” Morbidity and Mortality Weekly Report 58 (2008): 1-3.

  xii Whooping cough before vaccine: J. Cherry, P. Brunnel, and G. Golden, “Report of the Task Force on Pertussis and Pertussis Immunization,” Pediatrics 81 (suppl.) (1988): 933-984.

  xii Whooping cough today: Centers for Disease Control and Prevention, “Preventing Tetanus, Diphtheria, and Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines,” Morbidity and Mortality Weekly Report 55 (2006): 1-42.

  xii Vashon Island: K. Rietberg, C. DeBolt, N. Heimann, et al., “School Exemption Data and Geocoding as Tools for Assessing Relationships of Pertussis Clusters to High Immunization Exemption Rates,” http://cdc.confex.com/cdc/nic2002/recordingredirect.cgi/id/1446; “Public Health Skepticism,” November 30, 2002, http://medpundit.blogspot.com/2002_11_24_medpundit_archive.html.

  xiii Whooping cough symptoms: K. M. Edwards and M. D. Decker, “Pertussis Vaccines,” in Vaccines, 5th ed., eds. S. A. Plotkin, W. A. Orenstein, and P. A. Offit (London: Elsevier/Saunders, 2008).

  xiii El Sobrante: H. K. Lee, “Whooping Cough Outbreak Closes Private School in El Sobrante,” http://sfgate.com/cgibin/article.cgi?f=/c/a/2008/05/10/BAN310JQVL. DTL; “East Bay School Opens After Whooping Cough Outbreak,” http://cbs5.com/local/whooping.cough.pertussis.2.722073.html.

  xiii Rudolf Steiner: R. Steiner, Fundamentals of Anthroposophical Medicine (Toronto: Mercury Press, 1986).

  xiii “Karmic development”: Open Waldorf.com, http://www.openwaldorf.com/health.html.

  xiii Nationwide whooping cough outbreaks: Centers for Disease Control and Prevention, “Pertussis Outbreak in an Amish Community—Kent County, Delaware, September 2004-February 2005,” Morbidity and Mortality Weekly Report 55 (2006): 817-821; Illinois Department of Public Health, “Pertussis Outbreak Prompts Public Health Warning: At Least 69 Sickened in Four Chicago-Area Counties,” http://www.idph.state.il.us/public.press04/6.18.04.htm, June 18, 2004; Centers for Disease Control and Prevention, “Use of Mass Tdap Vaccination to Control an Outbreak of Pertussis in a High School—Cook County, Illinois, September 2006- January 2007,” Morbidity and Mortality Weekly Report 57 (2008): 796- 799; Mississippi State Department of Health, “State Health Officials, CDC Studying Pertussis Outbreak in Mississippi,” http://msdh.ms.gov/msdhsite/index.cfm/23,5373,279.html, August 30, 2007; “Pertussis Outbreak Reaches 500 Cases Statewide,” Arizona Department of Health Services, http://www.asdhs.gov/news/2005-all/pout.htm; Centers for Disease Control and Prevention, “School-Associated Pertussis Outbreak—Yavapai County, Arizona, September 2002-February 2003,” Journal of the American Medical Association 291 (2004): 1952-1954; “Pertussis Outbreak Points to the Importance of Vaccination,” Oregon Department of Human Services News Release, http://www.oregon.gov/DHS/news/2008news/2008-0117.shtml; Centers for Disease Control and Prevention, “Pertussis Outbreak—Vermont, 1996,” Morbidity and Mortality Weekly Report 46 (1997): 822-826; “CDC Reported Highest Number of Whooping Cough Cases in Nearly Forty Years,” http://www.medicalnewstoday.com/articles/15220.php; Centers for Disease Control and Prevention, “Pertussis—United States, 1997-2000,” Morbidity and Mortality Weekly Report 51 (2002): 73-76.

  xiv Delaware pertussis outbreak: Centers for Disease Control and Prevention, “Pertussis Outbreak in an Amish Community—Kent County, Delaware, September 2004-February 2005,” Morbidity and Mortality Weekly Report 55 (2006): 817-821.

  xiv Ashland, Oregon: S. Robinson, A. Timmons, and L. Duncan, “School Exemptions and Disease Risk in Ashland, Oregon,” http://www.co.jackson.or.us/files/school%20exemptions%20and%20disease%20risk%20-%20final.pdf.

  xiv Indiana measles outbreak: A. A. Parker, W. Staggs, G. H. Dayan, et al., “Implications of a 2005 Measles Outbreak in Indiana for Sustained Elimination of Measles in the United States,” New England Journal of Medicine 355 (2006): 447-455; Centers for Disease Control and Prevention, “Import-Associated Measles Outbreak—Indiana, May-June 2005,” Morbidity and Mortality Weekly Report 54 (2005): 1073-1075.

  xv Measles complications: P. M. Strebel, M. J. Papania, G. H. Dayan, and N. A. Halsey, “Measles Vaccine,” in Vaccines, 5th ed., eds. S. A. Plotkin, W. A. Orenstein, and P. A. Offit (London: Elsevier/Saunders, 2008).

  xv CDC warnings: Centers for Disease Control and Prevention, “Update: Measles—United States, January-July 2008,” Morbidity and Mortality Weekly Report 57 (2008): 893-896.

  xv San Diego outbreak: Centers for Disease Control and Prevention, “Outbreak of Measles—San Diego, California, January-February 2008,” Morbidity and Mortality Weekly Report 57 (2008): 203-206; R. G. Lin II, “Rise in Measles Cases Worries Health Officials,” Los Angeles Times, May 2, 2008.

  xv California vaccination rates: R. G. Lin II, “California Schools’ Risks Rise as Vaccinations Drop,” Los Angeles Times, March 29, 2009.

  xvi Nationwide measles outbreak, 2008: Centers for Disease Control and Prevention, “Update: Measles—United States, January-July 2008,” Morbidity and Mortality Weekly Report 57 (2008): 893-896.

  xvi International measles epidemics: Centers for Disease Control and Prevention, “Measles Outbreaks in the United States: Public Health Preparedness, Control and Response in Healthcare Settings and the Community,” http://www2a.cdc.gov/HAN/ArchiveSys/ViewMstV.asp?AlertNum=00273; R. G. Lin II, “Rise in Measles Cases Worries Health Officials,” Los Angeles Times, May 2, 2008; S. van den Hof, M.A.E. Conyn-van Spaendonck, and J. E. van Steenbergen, “Measles Epidemic in the Netherlands, 1999-2000,” Journal of Infectious Diseases 186 (2002): 1483-1486.

  xvi Decline in measles immunization rates in certain communities: D. A. Salmon, M. Haber, E. J. Gangarosa, et al., “Health Consequences of Religious and Philosophical Exemptions from Immunization Laws: Individual and Societal
Risks of Measles,” Journal of the American Medical Association 281 (1999): 47-53; D. R. Feikin, D. C. Lezotte, R. F. Hamman, et al., “Individual and Community Risks of Measles and Pertussis Associated with Personal Exemptions to Immunization,” Journal of the American Medical Association 284 (2000): 3145-3150.

  xvi Mumps outbreak: Centers for Disease Control and Prevention, “Update: Mumps Outbreak—New York and New Jersey, June 2009-January 2010,” Morbidity and Mortality Weekly Report 59 (2010): 125-129.

  xvii Herd immunity: P.E.M. Fine and K. Mulholland, “Community Immunity,” in Vaccines, 5th ed., eds. S. A. Plotkin, W. A. Orenstein, and P. A. Offit (London: Elsevier/Saunders, 2008).

  xviii Tammam Aloudat and Walter Orenstein regarding polio in Africa and the United States: Quoted in “Heightened Awareness, Renewed Commitment Needed to Eradicate Polio,” Infectious Diseases in Children, June 2009.

  xviii Vaccine-preventable diseases in 1900s: S. A. Plotkin, W. A. Orenstein, and P. A. Offit, eds., Vaccines, 5th ed. (London: Elsevier/Saunders, 2008).

  1. The Birth of Fear

  1 Wiseman’s life: Frederick Wiseman, U.S. documentary filmmaker, http://museum.tv/archives/etv/W.htmlW/wisemanfred/wisemanfred.htm.

  1 Titicut Follies: Zipporah Films, Bridgewater Film Company, 1967.

  2 Reviews of Titicut Follies: Benson and Anderson, Reality Fictions, 55; V. Canby, “Titicut Follies Observes Life in Modern Bedlam,” New York Times, October 4, 1967; “Trials: Banned in Massachusetts,” Time, January 19, 1968.

  2 Theatrical poster for Titicut Follies: http://www.zipporah.com.

  2 Judge’s ruling on Titicut Follies: Benson and Anderson, Reality Fictions, xxiii.

  2 Titicut Follies ban: Ibid., xxiv.

  2 DPT: Vaccine Roulette: WRC-TV, Washington, D.C., April 19, 1982. All documentary-related quotes and graphics subsequently cited in this chapter were obtained from this source.

  6 Doctors’ response to DPT: Vaccine Roulette: E. R. González, “TV Report on DTP Galvanizes US Pediatricians,” Journal of the American Medical Association 248 (1982): 12-22.

  6 Parents’ response to DPT: Vaccine Roulette: Ibid; Hearings before the Subcommittee on Investigations and General Oversight of the Committee on Labor and Human Resources, U.S. Senate, Ninety-Seventh Congress, Second Session to Examine Adverse Drug Reactions from Immunization, Federal Efforts in Preventive Medicine, and Characteristics of Certain Diseases, May 7, 1982, Written Testimony of Vincent A. Fulginiti, M.D., Chairman, Committee on Infectious Diseases, American Academy of Pediatrics.

  6 Switchboard melting: Author interview with Alan Hinman, December 7, 2009.

  7 Kathi Williams regarding son’s reaction to DTP: First International Conference on Vaccination, National Vaccine Information Center, 1997.

  7 Jeff Schwartz regarding daughter’s reaction to DTP: Quoted in Allen, Vaccine, 252-253.

  8 Barbara Loe Fisher regarding son’s reaction to DTP: B. L. Fisher, “In the Wake of Vaccines,” Mothering, September 1, 2004.

  9 Paula Hawkins, Lea Thompson, and Dan Mica: Allen, Vaccine, 254- 255.

  10 Hawkins’s testimony: Hearings before the Subcommittee on Investigations and General Oversight of the Committee on Labor and Human Resources, U.S. Senate, Ninety-Seventh Congress, Second Session to Examine Adverse Drug Reactions from Immunization, Federal Efforts in Preventive Medicine, and Characteristics of Certain Diseases, May 7, 1982.

  10 Williams’s testimony: Ibid.

  10 AAP at Hawkins hearing: Ibid.

  11 Edward Mortimer and vaccine harm: Ibid.

  11 Thompson’s career: Lea Thompson, “Dateline NBC Correspondent,” http://www.msnbc.msn.com/id/3949442.

  12 Thompson recalls DPT: Vaccine Roulette: First International Public Conference on Vaccination, National Vaccine Information Center, 1997.

  2. This England

  14 John Wilson at Royal Society: B. Deer, “The Vanishing Victims,” Sunday Times (London), November 1, 1998.

  14 Wilson describes cases of vaccine harm: M. Kulenkampff, J. S. Schwartz-man, and J. Wilson, “Neurological Complications of Pertussis Inoculation,” Archives of Disease in Childhood 49 (1974): 46-49.

  14 Madsen paper: T. Madsen, “Vaccination Against Whooping Cough,” Journal of the American Medical Association 101 (1933): 187-188.

  14 Werne and Garrow paper: J. Werne and I. Garrow, “Fatal Anaphylactic Shock: Occurrence in Identical Twins Following Second Injection of Diphtheria Toxoid and Pertussis Antigen,” Journal of the American Medical Association 131 (1946): 730-735.

  14 Byers and Moll paper: R. K. Byers and F. C. Moll, “Encephalopathies Following Prophylactic Pertussis Vaccine,” Pediatrics 1 (1948): 437-457.

  14 Ström paper, 1960: J. Ström, “Is Universal Vaccination Against Pertussis Always Justified?” British Medical Journal 2 (1960): 1184-1186.

  14 Ström paper, 1967: J. Ström, “Further Experience of Reactions, Especially of a Cerebral Nature, in Conjunction with Triple Vaccination: A Study Based on Vaccinations in Sweden 1959-65,” British Medical Journal 4 (1967): 320-323.

  14 Wilson’s background: B. Deer, “The Vanishing Victims,” Sunday Times (London), November 1, 1998.

  15 British television program: Ibid.

  15 “Risks Concealed”: “Whooping Cough Vaccine Risks Concealed, Say Victims’ Parents,” Sunday Times (London), September 22, 1974.

  15 “Vaccine Call”: “Vaccine Call Is Attacked,” Sunday Times (London), June 26, 1977.

  15 “Should Be Abandoned”: “Whooping Cough Vaccine ‘Should Be Abandoned, ’” The Times (London), February 13, 1978.

  15 “New Campaign”: P. Healy, “New Campaign to Win State Help for the Vaccine-Damaged,” The Times (London), January 15, 1980.

  15 “Shot in the Dark”: G. Stewart, “Dangers of a Shot in the Dark,” The Times (London), September 8, 1982.

  15 “Boy’s Brain Damaged”: “Boy’s Brain Damaged in Vaccine Experiment,” Sunday Times (London), May 30, 1976.

  15 Dick paper: G. Dick, “Letter: Whooping-Cough Vaccine,” British Medical Journal 4 (1975): 161.

  15 Stewart editorial: G. Stewart, “Dangers of a Shot in the Dark,” The Times (London), September 8, 1982.

  15 David Kerridge: Quoted in “Whooping Cough Vaccine ‘Should Be Abandoned, ’” The Times (London), February 13, 1978.

  15 Health officials concerned: “Family Doctors Split over Whooping Cough Vaccine Dangers,” Sunday Times (London), March 13, 1977.

  16 Editorial describes outbreak of fear: “Whooping-Cough Vaccination,” British Medical Journal 4 (1975): 186-187.

  16 Pertussis in England in late 1970s: J. P. Baker, “The Pertussis Vaccine Controversy in Great Britain, 1974-1986,” Vaccine 21 (2003): 4003- 4010; E. R. González, “TV Report on DTP Galvanizes US Pediatricians,” Journal of the American Medical Association 248 (1982): 12-22.

  16 Salisbury on pertussis epidemic: Author interview with David Salisbury, November 30, 2009.

  16 Pertussis in Japan: E. J. Gangarosa, A. M. Galazka, C. R. Wolfe, et al., “Impact of Anti-Vaccine Movements on Pertussis Control: The Untold Story,” The Lancet 351 (1998): 356-361.

  16 Rosemary Fox: B. Deer, “The Vanishing Victims,” Sunday Times (London), November 1, 1998.

  17 Cherry regarding pertussis outbreak in England: Author interview with James Cherry, November 27, 2009.

  17 Survey of general practitioners: O. Gillie, “Family Doctors Split over Whooping Cough Vaccine Dangers,” Sunday Times (London), March 13, 1977.

  17 Pertussis deaths in the United Kingdom: J. D. Cherry, “The Epidemiology of Pertussis and Pertussis Immunization in the United Kingdom and the United States: A Comparative Study,” Current Problems in Pediatrics 14 (1984): 7-77.

  17 Pertussis deaths classified as SIDS: Author interview with James Cherry, November 27, 2009; A. Nicoll and A. Gardner, “Whooping Cough and Unrecognized Postperinatal Mortality,” Archives of Disease in Childhood 63 (1988): 41-47.

  18 Miller study: D. L. Miller, E. M. Ross, R. Alderslade, et al., “Per
tussis Immunization and Serious Acute Neurological Illness in Children,” British Medical Journal 282 (1981): 1595-1599; D. Miller, N. Madge, J. Diamond, et al., “Pertussis Immunization and Serious Acute Neurological Illness in Children,” British Medical Journal 307 (1993): 1171-1176.

  18 Lea Thompson and lawyers: DPT: Vaccine Roulette, WRC-TV, Washington, D.C., April 19, 1982.

  18 Increased number of DTP lawsuits: A. R. Hinman, “DTP Vaccine Litigation,” American Journal of Diseases in Children 140 (1986): 528-530.

  19 Tyler White: White v. Wyeth Laboratories, 40 Ohio St. 3d 390.

  19 Michelle Graham: Graham v. Wyeth Laboratories, 666 F. Supp. 1483

  19 Michelle Graham award: Allen, Vaccine, 272.

  19 Melanie Tom award: Ibid.

  19 Other DTP awards: W. A. Check, “How to Remedy Possible Harm to a Few Persons from Vaccines That Could Benefit Entire Society?” Journal of the American Medical Association 252 (1984): 2942-2946.

  19 Increase in monetary value of lawsuits: A. R. Hinman, “DTP Vaccine Litigation,” American Journal of Diseases in Children 140 (1986): 528-530.

  19 Increased cost of lawsuits: Ibid.

  19 Decreased number of companies making DTP vaccine: Letter from H. M. Meyer, director of the Bureau of Biologics to Dr. Bruce Dull of the Centers for Disease Control, December 1, 1975. This letter was generously provided by Dr. Bruce Weninger, CDC.

  19 Three companies making DTP in 1982: A. R. Hinman, “DTP Vaccine Litigation,” American Journal of Diseases in Children 140 (1986): 528-530.

  19 Wyeth drops out: Allen, Vaccine, 283.

  19 Connaught drops out: M. H. Smith, “National Childhood Vaccine Injury Compensation Act,” Pediatrics 82 (1988): 264-269.

  20 James Mason testifies: Testimony before the Subcommittee on Health and the Environment, Committee on Energy and Commerce, U.S. House of Representatives, December 19, 1984.