The Panic Virus

by Seth Mnookin; Dan B. Miller

  One result of these colliding interpretations of reality was a growing sense of distrust and paranoia. In the summer of 2000, Lyn Redwood became so convinced that her phone was being tapped that she hired countersurveillance teams to examine her house. (They didn’t find anything.) In the months to come, Redwood’s fear would be reinforced through conversations with Barbara Loe Fisher, who told Redwood of the mysterious clicks and whirrs other vaccine opponents around the country heard over their phone lines. It wasn’t long, Redwood says, before national reporters grew fearful of even mentioning thimerosal in their stories. “U.S. News & World Report came out to talk to me about environmental toxins,” she says. “When they realized mercury was from vaccines, the reporter set his pen down and said, ‘I can’t do this story.’ . . . He just thought that it would be something that would be too controversial to include, and he had to clear it with his editor.” (According to Redwood, the editor did eventually sign off on the piece and her comments about vaccines made it into print.)

  The flip side of this sense of persecution was, not surprisingly, a ratcheting up of the rhetoric on both sides of the debate. In December 2003, just after the last of the four population-based thimerosal studies to be released that year was published, Mark Geier stated flatly, “This is fraud. . . . [I]t is one of the worst things ever to have happened to this United States. If a terrorist had done this, we wouldn’t attack them, we’d nuke them.” Eight months later, the head of the CDC’s immunization program told a reporter from the Los Angeles Times that only “junk scientists and charlatans” who saw a “huge pot of gold at the end of the rainbow” believed in the thimerosal-autism link.

  It didn’t take long for this acrimony to turn into something more frightening. In the days after the publication of the Institute of Medicine report in May 2004, SafeMinds released a statement that expressed disappointment that committee members would not “have to answer later for their failures.” That summer, a series of anonymous messages sent to the CDC were judged sufficiently hostile that the FBI launched an investigation. (Marie McCormick, the committee’s chairperson, also received threatening letters, which resulted in Harvard University increasing security at her office.) One e-mail, which The New York Times obtained through an open-records request, read, “I’d like to know how you people sleep straight in bed at night knowing all the lies you tell & the lives you know full well you destroy with the poisons you push & protect with your lies.” Several weeks later, the agency received an e-mail with an even more overt threat. “Forgiveness is between [the committee’s members] and God,” it read. “It is my job to arrange a meeting.”

  46 Not all of Sunstein’s writing on behavioral law and economics is so academic. In the 2008 book Nudge, Sunstein and Richard Thaler write about external changes—nudges—that can influence human behavior. One of their examples stems from efforts to get men to stop peeing on the floor: “As all women who have ever shared a toilet with a man can attest, men can be especially spacey when it comes to their, er, aim. In the privacy of a home, that may be a mere annoyance. But, in a busy airport restroom used by throngs of travelers each day, the unpleasant effects of bad aim can add up rather quickly. Enter an ingenious economist who worked for Schiphol International Airport in Amsterdam. His idea was to etch an image of a black house fly onto the bowls of the airport’s urinals, just to the left of the drain. The result: Spillage declined 80 percent. It turns out that, if you give men a target, they can’t help but aim at it.”

  47 When intergroup distrust does take hold, it becomes ever harder to undo. In a 2009 study analyzing how nonscientists view scientific claims, a team of psychologists found that at a certain point exposure to dissenting viewpoints results in “poor source credibility.” (This is also referred to as a “sinister attribution error.”) The scientists used the example of a student who arrives at college believing in a literal interpretation of the Bible and ends up “even more strongly committed to creationism after hearing evidence for evolution.”

  Part Three

  CHAPTER 17

  HOW TO TURN A LACK OF EVIDENCE INTO EVIDENCE OF HARM

  When David Kirby got the phone call that would change the course of his professional life, the forty-two-year-old’s work history was most notable for the number of times he’d switched fields: After starting out as a wire service stringer in the mid-1980s, he’d worked for former New York City mayor David Dinkins, served as the spokesman for an AIDS charity, and even started his own PR firm. It wasn’t until 1997 that he began focusing full-time on journalism, and within a year he’d become a regular contributor to one of The New York Times’s regional sections. Three years later, when he went back to being a full-time freelancer, he still hadn’t gotten the one big break that would set him apart from the hundreds of other reporters fighting to get noticed in the media capital of the world.

  Then, in November 2002, a friend in Los Angeles suggested to Kirby that he investigate the country’s rising rates of autism. It wasn’t a subject Kirby knew anything about. Over the years, he’d written some science pieces for the Times, but for the most part they were one-offs about personal health (“More Options, and Decisions, for Men with Prostate Cancer”) or topical news (“New Resistant Gonorrhea Migrating to Mainland US”). Still, Kirby was intrigued. Maybe, he thought, he could turn the idea into a feature for a well-paying women’s magazine like Redbook or Ladies’ Home Journal. He decided to make some calls.

  One of the first people Kirby reached was a hairdresser in the San Fernando Valley. The conversation was a bit much. “She was cool,” Kirby says, “but . . . she was just throwing all this stuff at me and I had no idea what she was talking about.” At one point, Kirby says, the woman told him what sounded like a half-baked story about how there was mercury in vaccines. “I literally laughed,” Kirby says. “I said, They don’t put mercury in vaccines. That’s ridiculous.” By the time he hung up the phone, Kirby figured the whole thing was one more dead end.

  A little more than a week later, Kirby had his television on in the background of his apartment when he overheard mention of thimerosal. He turned up the volume: A CNN anchor was talking about a provision that had been inserted surreptitiously into a just-passed 475-page homeland security bill. The amendment shielded Eli Lilly, the company that manufactured thimerosal, from vaccine-related lawsuits filed by families. “I was like, Oh, mercury is in vaccines,” Kirby says. “That lady wasn’t crazy.”

  Attention surrounding what became known as the Lilly rider was intense from the get-go, and not just among families who believed vaccines had injured their children. Lilly’s ties to the Republican leadership were well documented: In the 2000 election, the company had contributed $1.28 million to Republican candidates; Mitch Daniels, the director of the White House’s Office of Management and Budget, was the former president of Lilly’s North American operations; and just months earlier, President Bush had appointed Lilly CEO Sidney Taurel to the Homeland Security Advisory Council. Now the appearance that someone had called in a favor sparked bipartisan outrage. Ohio’s Dennis Kucinich, among the most liberal members of Congress, said the provision raised “fundamental questions about the integrity of our government,” while past Republican presidential candidate and future nominee John McCain likened it to “war profiteering.” Even the amendment’s author seemed embarrassed: To this day, no one has acknowledged inserting it into the bill. “It was a big whodunit,” Kirby says. “It went on for days. It was shaping up to be a big scandal in Washington.”

  In the coming weeks, Kirby approached Vanity Fair, The New Yorker, and a number of other outlets with a proposal for a story about the politics of thimerosal. No one was interested. “It was too controversial,” he says. Then, one night, Kirby was taking a shower when he had an epiphany: “A voice told me to turn the story into a book,” he says.

  Initially, Kirby’s literary agent wasn’t much more enthusiastic than the various magazine editors he’d approached had been. “He said, ‘You can’t just w
rite a straight-up nonfiction book about this and write about the science,’ ” Kirby says. “ ‘If you really want to tell the story well, you gotta go find people who this has happened to, parents of autistic kids who really believe the vaccines and the mercury did this. Tell their story. Tell it through their point of view. Write it like a novel.’ ” What the hell, Kirby figured. It was worth a shot. On Wednesday, January 8, 2003, he headed down to Washington for a rally SafeMinds had helped to organize to protest the Lilly rider.

  Even without a huge number of people in attendance—the Republicans had all but promised to void the provision, which they did less than a week later—the rally gave Kirby a firsthand perspective on the intense emotions surrounding the issue. Parents were crying; some were carrying poster-board signs illustrated with pictures of their children pasted above captions like “VACCINE INJURED” or “VICTIM OF HOMELAND SECURITY.” Despite having met each other only in recent years, many acted as if they were lifelong friends. The rally also served as a good illustration of the coalition’s growing political clout: Dan Burton and Dennis Kucinich both addressed the crowd, as did Michigan senator Debbie Stabenow and Vermont senator Patrick Leahy. By the end of the afternoon, Kirby had introduced himself to Sallie Bernard and Liz Birt and told them he was interested in writing a book about their movement.

  For the most part, they seemed receptive—but there was one problem: Lyn Redwood was working on a book of her own. In fact, she’d already put together a proposal, written a sample chapter, and even come up with a title: “Mercury Rising—The Untold Story Behind America’s Learning Disability Epidemic.” According to Redwood, when Kirby contacted her, he didn’t launch into a sales pitch but simply asked how it was going. She had to admit things didn’t look good: A number of publishers had already passed on the project. (One editor explained her reasoning in a letter: “This is such an upsetting book. . . . I wonder who would buy it.”) To make matters worse, Redwood’s agent had just started a six-month maternity leave. The more she spoke with Kirby, the more Redwood felt like the author could be an asset to her work. Soon, Redwood says, “We decided to combine forces and work on it together.” It was not a decision she would regret. “It was the best thing that could have happened,” she says. “My book would have been viewed as biased”—but Kirby would be able to present his project as an objective record of what had happened.

  For the next two years, Redwood and Kirby were in daily contact, and Kirby was given access to all the data SafeMinds had collected and all the files they’d assembled—he even got printouts of “every single e-mail they’d sent each other over the years.” (Kirby jokes that whenever he returned to New York from the Redwoods’ home in Georgia his luggage was so full of documents that it would be over the airline’s weight limit.) “He came and hung out at our house and lived down in the basement,” Redwood says. “If you could see my office, I just have boxes and boxes and files and folders and documents. Just for him to ferret through all the documents and for me to explain to him all this—it was a labor of love.”

  By the time Kirby handed in his manuscript in 2004, it looked as if the story might have outpaced all of his and Redwood’s work: The dozens of studies the Institute of Medicine committee on vaccine safety had reviewed for its recently released report had provided overwhelming evidence that there was no link between autism and vaccines—at least from a scientific perspective. Kirby’s book, however, didn’t engage scientists on their terms; instead, he invoked disputes over fringe research in order to move the discussion into the realm of public opinion, where the conversation would hinge on impressions gleamed from sound bites, pull quotes, and drive-time radio segments. His most brilliant tactical maneuver in this regard was his choice of a title: Evidence of Harm—Mercury in Vaccines and the Autism Epidemic: A Medical Controversy. It was, of course, a reference to the CDC’s 1999 statement that had been meant to reassure the public about the presence of thimerosal in vaccines: “There are no data or evidence of any harm.” The line had been problematic even then, and now Kirby made it sound anew like a frightening equivocation. In his introduction, dated less than four months after the IOM committee’s analysis was released, Kirby took full advantage of this confusion. He granted that the report “favor[ed] rejection of a causal relationship between thimerosal and autism.” Nonetheless, Kirby wrote, no one really knew for sure if thimerosal was safe:

  Meanwhile, the CDC has been unable to definitively prove or disprove the theory that thimerosal causes autism. . . . Several studies funded or conducted by the agency have been published in the past year, all of them suggesting that there is no connection between the preservative and the disease. The CDC insists that it has looked into the matter thoroughly and found “no evidence of any harm” from thimerosal in vaccines.

  Then Kirby delivered his coup de grâce:

  But no “evidence of harm” is not the same as proof of safety. No evidence of harm is not a definitive answer; and this is a story that cries out for answers.

  By daring officials to do the one thing they were incapable of—prove a negative—Kirby was making a mockery of science. And by successfully defining the terms of the debate, he rewrote a “story” that had, in fact, already provided the answers he said he so desperately hoped to find.

  Convincing people there was still a legitimate debate was only one of the hurdles Kirby faced in reaching the public. He also had to come across as a reporter and not someone advocating for one side. In the book’s opening pages, he confronted that issue head-on: He had, he acknowledged, focused on the “admittedly subjective point of view” of a community of “brave souls united in grief and hope.” Still, that did not mean that he was favoring them over the “doctors, bureaucrats, and drug company reps.” “[T]here are two sides to every good story, and this one is no exception,” he wrote. “This is not an antivaccine book. . . . Neither should this book be viewed as partisan in nature. . . . This book looks at evidence presented on both sides of the thimerosal controversy.”

  In a jury trial, two of the most crucial jobs a lawyer faces are humanizing his clients and demonizing his opponents. Like an expert litigator, Kirby accomplished both jobs while making it seem as if he was merely describing the world as it was. Redwood, he wrote, was “an attractive woman” with “almost cat-like brown eyes.” Compatriots like Sallie Bernard (a “tough businesswoman” with “upbeat emotions”), Liz Birt (a woman possessing a “fierce streak of determination and independence”), and Mark Blaxill (a man with a “remarkable aptitude for statistical analysis”) sounded just as appealing. Mark Geier was “the kind of guy you would want to have dinner with”; in Kirby’s hands, his basement full of old lab equipment was transformed into the headquarters for the “Genetic Centers of America, a private consulting firm in Silver Spring, Maryland.” Then there was the “establishment”: educators who “barked at” and “banished [children] to a small corner of the room,” pediatricians who “poked and prodded” their patients “like some pet science project,” and government scientists who “grew purple” until their “eyes bulged with annoyance.”

  Once he’s succeeded in making his clients more appealing than their opponents, the lawyer’s next task is to make his case sound plausible. The dozens of peer-reviewed studies, combined with the IOM committee’s evisceration of the Geiers’ work, had gone a long way toward undermining the mercury activists’ claims. In order to square that circle, Kirby likened the dispute to a political campaign in which an “insurgent candidate” comes under “heavy fire from an entrenched opponent . . . the vitriol demonstrates that the challenge is being taken seriously, that it poses a realistic threat to the status quo.”

  In this political battle, Kirby employed a time-honored tactic of push pollers and ward politicians: He used an ominoussounding claim—“Curiously, the first case of autism was not recorded until the early 1940s, a few years after thimerosal was introduced in vaccines”—to make his accusation sound as if it was idle speculation. In this case, Kirb
y both blurred the difference between correlation and causation and conflated the first time a disease is given a particular label with the first time it appears in a population. (It was a little like saying, “Curiously, schizophrenia was not identified as a disorder until the late 1880s, a few years after Alexander Graham Bell invented the telephone.”) He also larded his writing with conditional statements and passive constructions: Eli Lilly “reportedly earn[ed] a profit” by licensing thimerosal to other drug companies; “the American health establishment . . . understandably has an interest in proving the unpleasant [thimerosal] theory wrong.” When piled one atop another, they would have been enough to make any organization sound like a sinister cabal: The Girl Scouts of the USA reportedly uses winsome, underage children to peddle the high-fructose products it depends on for a significant portion of its income; the organization understandably has an interest in weakening child labor laws.

  Kirby’s most remarkable feat was his handling of criticism of a 2003 paper by the Geiers that had been published in the Journal of American Physicians and Surgeons and resulted in an American Academy of Pediatrics statement titled “Study Fails to Show a Connection Between Thimerosal and Autism.” The Geiers, Kirby wrote, “were made to sound like dimwits.” Clearly, the AAP “felt the same disdain” for the researchers as it did for parents. Kirby went on to accuse “unnamed editors” of the AAP’s journal, Pediatrics, of taking a “veiled swipe at their colleagues who publish the comparatively radical Journal of American Physicians and Surgeons,” a publication at which the mainstream “looks down their noses” but which, Kirby said, was peer-reviewed, which presumably gave it a certain amount of credibility. According to Kirby, the reason for this haughtiness was the AAP’s contempt for the Association of American Physicians and Surgeons, which published the journal. Many doctors, he wrote, “dismiss [the AAPS] as belonging to the bottom-feeding realm of homeopaths and chiropractors.”