The Needle and the Damage Undone

panic1In The Panic Virus, his study of anti-vaccine mania, Seth Mnookin concedes that ‘[v]accine proponents, be they doctors, politicians or self styled intellectuals’ can demonstrate a ‘smug sense of superiority mixed with a condescending bewilderment at what Benjamin Gruenberg described as the hoi polloi’s insistence ‘upon the right to hold opinions (and to act according to these opinions) upon such technical questions as the efficacy of vaccination, the value of serums, or the causation of cancer.’ We’re used to sceptic titles that deconstruct alt-health and conspiracy silliness: such books sometimes have a superior cool-geek aesthetic. Mnookin’s is not one of them. What you take away from this book is his warmth, and his compassion for people who have experienced appalling suffering.

Talking to Sam Harris, UCLA paediatrics director Dr Nina L Shapiro tried to account for the drop in US vaccine rates:

I think there are several reasons why people have chosen—and I use the word ‘chosen’ specifically because I think most people now have a luxury of choice when it comes to their medical care—not to vaccinate their children. One is that they haven’t seen these illnesses. Most people with young children have never seen a case of measles; they’ve never seen mumps, rubella, polio, or whooping cough; so these illnesses are just abstractions to them.

Read Seth Mnookin’s book and they are no longer abstractions. They are real and terrifying. I’ve spared the awful details, but Mnookin doesn’t, because he needs to convince a reader living in an age of incredible health advances that these illnesses are life-altering and can lead to permanent disability, brain damage and even death. The Panic Virus is a family centred book. Mnookin discusses the frauds and quacks who lie about vaccines – Andrew Wakefield, Jenny McCarthy, Clinton nut Dan Burton (he is the congressman who at an official dinner fired a revolver into a watermelon in an attempt to demonstrate that Vince Foster’s death could not have been a suicide: that story’s from David Brock, but Mnookin speculates in a footnote that Burton may have used a pumpkin or even a cantaloupe). But his heart is with the parents and children who have to deal with the consequences of local outbreaks and a falling herd immunity.

He also writes well about autism. When I was growing up I don’t recall ever hearing the word. Now anyone who makes an awkward comment at the office or a dinner party is described as ‘autistic’ or ‘Aspergic’. As with measles and pertussis, Mnookin shows us what autism is, and the terrible isolative impact it wreaks not just on children, but parents locked into a world revolving around a child that no one understands. Because carers of autistic children struggle to find reference points with other parents – a mother tells Mnookin that she’d ask friends for advice and be told ‘I don’t know – I don’t know and that has nothing to do with my son’ – they gravitate to web forums, single issue groups and conferences: it’s there they find the only people who know what it’s like and will listen.

But when people talk and relate only with others similar to themselves, it’s easy to fall into an aggressive groupthink. Soon there was an almost militant anti vaccine movement that spread harmful disinformation on talk shows, sucked research funding away from useful work and into its junk science, and sent death threats to anyone who disagreed. And this vexatious single issue campaigning is all over the health spectrum. Mnookin doesn’t mention this in his book, but scientists researching the links between mental illness and ME have been subject to intimidation from a minority of sufferers. When Dr Max Pemberton wrote about the controversy, he was hit with scary online abuse. Pemberton writes: ‘Those who targeted me displayed an astounding degree of paranoia and obsession, twisting anything I said, or any attempts to pacify them… Others found contact details for the person who runs my website, for my partner and for several of my friends. They targeted journalists who voiced support for me… Some personal threats were made and I had to get lawyers involved… It was brought to my attention that people had been discussing, via the internet, where I lived.’ (Only in the UK would patients threaten researchers doing work that could potentially help them because these patients don’t like the implication that they have a mental health problem and not a ‘proper’ illness.)

Eventually of course Wakefield was discredited and banned from practising medicine in the UK. When Mnookin caught up with him at his clinic in Austin, he was still unrepentant, but ‘he just seemed dazed… I got the impression that he was talking more to himself than to me.’ Wakefield said he was working a book about how ‘the government is trying to cover up the fact that it introduced the MMR vaccine’. Could I have a prepublication copy, Mnookin asked? Wakefield said that was fine. ‘You might want to read it and decide whether it has a market in Israel, to see if anyone wants to find out what went wrong and why it went wrong… You may want to decide if it’s worth translating into Hebrew.’ Mnookin writes that ‘It was one of the few times in my life I have been stunned into silence.’ Later, Wakefield headlined a 9/11 truth rally in Dublin with the rather grand title of ‘The Masterplan: The Hidden Agenda for a Global Scientific Dictatorship’. Does he really believe this stuff? I almost feel sorry for Wakefield. He risked everything – his career, reputation, livelihood – on a lie, and now that the lie has fallen through, he’s trapped in the conspiracy netherworld because it’s all he has left. So I almost feel sorry for Andrew Wakefield. Almost.

I think history will judge the anti vaccine craze as a perverse byproduct of a safer world, a fad that came out of idle consumerism and bloated ease. And I am convinced that today’s modish critiques of SSRIs will go the same way.


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