February 11, 2011


The Virus of Hysteria: Paul Offit’s new book chronicles the destructive impact of the anti-vaccination movement.: a review of Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, by Paul A. Offit (Theodore Dalrymple, 1 February 2011, City Journal)

In his eloquent and bracing book, Paul Offit, an expert on child immunization, traces the intellectual—or perhaps I should say the emotional—history of the modern anti-vaccination movement and its consequences. If progress in preventive medicine has been remarkable, so in its own way has been the persistence of prescientific and even anti-scientific thought in modern society.

The author correctly draws attention to the similarities between the anti-vaccination movements in modern America and in Victorian England. The Victorians, however, had the excuse that they were facing a new and unprecedented situation, which the Americans do not. The Victorians knew nothing of bacteriology, virology, and immunology; their epidemiology was rudimentary. Moreover, smallpox vaccination was a crude procedure, sometimes genuinely dangerous; arm-to-arm vaccination, which was eventually abandoned, could spread syphilis.

Offit underestimates the range, both social and intellectual, of the Victorian anti-vaccination movement. While it might have started off as a popular agitation against Parliament’s decree of compulsory vaccination—which was in practice mainly directed at the poor—it quickly spread to the middle and upper classes. It produced an astonishing range of literature, including a mass-circulation magazine that ran for 70 years. Not all of its adherents by any means were willfully ignorant cranks (such as George Bernard Shaw). Converts to the cause included Charles Creighton, an eminent pathologist and the erudite historian of epidemics in Britain, as well as the first person to hold a chair in bacteriology in Britain, E. M. Crookshank. Vast and learned tomes were produced on the noxiousness of vaccination, and while some of the wilder claims—such as that vaccination had led to a recrudescence of leprosy in Europe—were absurd, attempts to prove vaccination’s dangers by statistical means helped spur the development of the science of epidemiology.

Still, the Victorian anti-vaccination movement discovered, and maybe even invented, a fundamental principle of modern pressure-group politics: always make lots of noise. It is noise that makes the world go round as much as money, with truth coming in a poor third; and noise is difficult to counteract. It’s true that the adventure novelist Henry Rider Haggard produced a good pro-vaccination novel, Doctor Therne, in 1898, after Parliament surrendered to pressure and repealed compulsory vaccination. But it seems that there is a quasi-law of politicking that the noise of opponents is always louder than that of proponents.

As with any medical procedure, things can go wrong with vaccination. But modern vaccine scares are generally not the consequence of genuine problems. They are the result of unproven scientific hypotheses given echo, and magnified and coarsened, by campaigners. The idea, for example, that the MMR (measles, mumps, and rubella) vaccine causes childhood autism gained currency when a British surgeon, Andrew Wakefield, claimed to have found evidence that the vaccine could damage the intestines of those to whom it was given—thus giving a portal to neurotoxic substances.

It was an error of judgment on the part of the medical journal The Lancet to have published this research in the first place. The experimental group was completely without a control group. Even odder, the principal author of the research, Wakefield, held a press conference to announce the findings even before they were published. The most likely explanation of his conduct is that he was a highly ambitious man, desperate for a scientific coup like that of Barry Marshall, who established the bacterial causation of peptic ulceration, which had escaped thousands of previous researchers. The difference, of course, was that Marshall’s research was valuable.

Nevertheless, the autism rumor soon swept the world. Many distressed parents thought they had found the explanation for the otherwise inexplicable condition of their child. Some people underwent a quasi-religious conversion, and made Wakefield’s cause their own. When it was established beyond reasonable doubt that he had feet of clay, they turned him into a martyr, someone condemned for his heresy rather than for his conduct.

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Posted by Orrin Judd at February 11, 2011 7:35 AM
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