Deadly Choices: How the Anti-Vaccine Movement Threatens Us All (13 page)

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Authors: Paul A. Offit M.D.

BOOK: Deadly Choices: How the Anti-Vaccine Movement Threatens Us All
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Although HPV vaccine was new, the strategy used to make it wasn’t. It was made with the same technology used to make the hepatitis B vaccine twenty years earlier. By 2006—when the CDC recommended it for teenage and adult women—HPV vaccine had been tested for seven years in more than thirty thousand women. Other than pain and tenderness at the site of injection, and occasional episodes of fainting, the vaccine didn’t appear to have any serious side effects. But Barbara Loe Fisher was determined to defeat the HPV vaccine, again claiming that it wasn’t necessary and that pharmaceutical companies had misrepresented data. “Merck and the FDA have not been completely honest with the people about the pre-licensure clinical trials,” said Fisher. “Merck’s pre- and post-licensure marketing strategy has positioned mass use of this vaccine by pre-teens as a morality play in order to avoid talking about the flawed science they used to get licensure.”
Two months later, Fisher turned up the volume: “In what is perhaps the most brilliant public relations and marketing strategy ever employed by a pharmaceutical company promoting the universal use of a vaccine most Americans do not need to prevent cervical cancer, Merck and Co. is in the process of pulling off one of the biggest money-making schemes in the history of medicine. The Big Pharma giant that brought us death by Vioxx has convinced the FDA, CDC, public-school officials, and gynecology professors as well as the entire European Union that every man and woman in the world must purchase and be injected with the HPV vaccine in order to survive.” Later, on her blog, she called it “the slut shot” and “the ‘cheaters’ vaccine.” (Because HPV infects 70 percent of women within five years of their first sexual encounter, one could infer that Barbara Loe Fisher doesn’t have a very high opinion of American women.)
As she had with the Hib, pneumococcal, and hepatitis B vaccines, Fisher claimed that HPV vaccine caused chronic, serious disabilities. She reported that young girls had been paralyzed and were dying from the vaccine: dying from blood clots that caused strokes and heart attacks. On CBS’s
Sunday Morning
, Fisher told Charles Osgood and millions of television viewers, “This is an intervention that carries the risk of injury or death.” CDC officials responded to the public’s growing concern, studying more than ten thousand reports to VAERS to determine if there was a pattern (as had been seen with the ill-fated first rotavirus vaccine) that suggested HPV vaccine might be causing a problem. They examined reports of paralysis and found “there has been no indication that [HPV vaccine] increases the rate of Guillain-Barré Syndrome [GBS, a rare cause of paralysis] in girls and women above the rate expected in the general population.” They also examined the medical records of twenty-seven people who had died soon after getting the vaccine, finding nothing to suggest that the vaccine had been the cause. People who had recently received HPV vaccine had died from complications of diabetes or heart failure or viral illnesses or bacterial meningitis or drug overdose or blood clots caused by birth-control pills or seizures in those already known to have epilepsy. Reports of death following HPV vaccine were consistent with deaths that were occurring in the general population before the vaccine was used. Fisher didn’t believe it. “The ‘coincidence’ defense mounted by doctors and drug-company officials every time a vaccination is followed by injury and death is as old as it is unscientific,” she blogged. “It’s amazing that they have been able to get away with it for so long.”
Perhaps Fisher’s most disingenuous comment about HPV vaccine was that it might cause cancer: “And how many [girls] will go on to develop fertility problems, cancer, or damage to their genes, all of which Merck admits in its product insert it hasn’t studied.” Fisher knew that infection with HPV could lead to cancer; so she raised the specter that the vaccine could do the same thing. But HPV causes cancer by incorporating two of its genes into cells that line the cervix. Because the HPV vaccine contains no HPV genes, only HPV proteins, it’s not possible for the vaccine to do this.
By 2009, more than thirty million doses of HPV vaccine had been given without serious consequences. Women who choose to believe Barbara Loe Fisher’s warnings and refuse the HPV vaccine are at increased risk of cervical cancer: an event that occurs twenty to twenty-five years after this very common infection.
 
Fisher’s ill-conceived notion that vaccines cause chronic diseases isn’t the only example of how she has squandered an opportunity to alert the media and parents about the real issues of vaccine safety. There were, unfortunately, many others:
• In 1995, when the chickenpox vaccine was recommended for all children, Fisher objected. “Certainly if your child has leukemia or a compromised immune system, you should have them vaccinated. But for your average kid, chickenpox is not a serious disease.” Before the vaccine, about ten thousand children were hospitalized and seventy killed by chickenpox every year. Most were previously healthy. Fisher also warned, “the chickenpox vaccine is just going to drive chickenpox into the adult population, where it can be deadly.” The chickenpox vaccine, which by 2009 had been used for fifteen years, has led to a 90 percent decrease in the disease, in both children and adults.
• Fisher also decried the concept of herd immunity. “If vaccines are as effective as they are touted to be,” she said, “then those who are vaccinated will not face any risk from those who are not.” This is clearly untrue, as illustrated by a particularly instructive measles outbreak in the Netherlands between 1999 and 2000. Researchers found that children were actually at greater risk if they were fully vaccinated and living in a relatively unvaccinated community than if they were unvaccinated and living in a highly vaccinated community. That’s because no vaccine is 100 percent effective and the greater the likelihood of exposure to a disease, the greater the risk.
• Fisher argued that diseases prevented by vaccines aren’t really that bad. “We have gotten into a mind-set where there is an abject fear of disease,” she said. “In the ‘50s, everyone had measles and mumps, and there wasn’t this drama attached.” Before the vaccine, measles caused more than a hundred thousand hospitalizations and five hundred deaths in the United States every year. Unlike Barbara Loe Fisher, who survived her encounter with measles, those who succumbed aren’t around to tell their stories.
• Fisher also argued that natural infection is better than immunization. “Experiencing infectious disease, including influenza, has been part of the human condition since man has walked the earth,” she blogged. “Why do vaccinologists insist on assuming that the human immune system is incapable of dealing with that experience? Or benefiting from it? Where is the evidence that it is good to never, ever get the flu?” Before the influenza vaccine was routinely given to children, two hundred thousand were hospitalized and a hundred killed by the virus every year. In 2009, during the H1N1 (swine flu) pandemic, more than a thousand American children died from the flu.
Perhaps Barbara Loe Fisher’s most enduring legacy can be found in the comments of Samuel Berkovic, the Melbourne neurologist who had found the real cause of seizures and mental retardation in children claimed to have been damaged by pertussis vaccine. Berkovic remembered the reaction of parents after his discovery: “Most of them were incredibly grateful because they had carried the guilt. They had taken the child to the doctor or maternal/child-health nurse and handed the kid over, and the infant got the vaccine. It was their fault. [They thought] ‘if only I’d listened to the lady down the street who said “Don’t give your kid a vaccine,” I’d have a healthy child.’ And when we tell them that that’s not right, that sadly your child had this change in the sodium channel that happened at conception and there was nothing you could do about it—that your child was destined to get this—there was an enormous sense of relief. For most, it’s relieved decades of guilt.”
By telling parents that diabetes, multiple sclerosis, asthma, allergies, seizures, mental retardation, paralysis, and autism are all caused by vaccines, Barbara Loe Fisher—whether intentionally or not—puts the burden of their children’s illnesses squarely on the shoulders of those parents. If only they hadn’t gotten their children vaccinated, none of these horrors would have happened. But now it’s too late; the only thing left is to be angry—angry at a government lost in bureaucracy, pharmaceutical companies in it for the money, and doctors who don’t care. By claiming that vaccines cause chronic diseases, Fisher contributes to this cycle of guilt, anger, and blame.
 
Barbara Loe Fisher is a lightning rod for the media. She is a powerful voice during congressional hearings. And she is the one-stop shop for parents concerned that vaccines are hurting their children. But for all the attention she garners—for all the magazine stories and radio and television interviews—studies have consistently failed to support her concern that vaccines are causing chronic diseases. At the same time that Fisher diverts the media away from real problems with vaccines, one vaccine-safety advocate, working quietly and behind the scenes, has accomplished a great deal. His name is John Salamone.
Salamone was born in upstate New York, in the town of New City. When he was nineteen years old, while studying journalism and government at the University of Maryland, he became the youngest legislative director in Congress. Later, he handled congressional affairs for the Immigration and Naturalization Service. After fifteen years with the government, Salamone moved to the private sector, heading the nonprofit National Italian-American Foundation.
In 1990, Kathy and John Salamone brought their son David to their pediatrician’s office in suburban Washington, D.C., to get his vaccines—one of which was Albert Sabin’s oral polio vaccine. Two weeks after the visit, the Salamones noticed something wrong with their son. “He couldn’t turn over,” John said. “He could only move his head back and forth.” David Salamone was completely paralyzed below the waist. Eventually he regained the use of his left leg, but his right leg withered. Doctors fitted David with a leg brace and he learned to walk with a gait that, according to John, resembled “a drunken sailor.” David’s diagnosis was elusive. “The doctors were quite perplexed,” recalled Salamone. “They couldn’t figure it out because, let’s face it, not too many doctors these days are experts in polio. They just simply diagnosed him with a neuropathy of unknown etiology.”
David wore the heavy leg brace and started physical therapy. “They noticed that he was in pain,” said Salamone, “which was unusual for his condition. And so they sent us to a rheumatologist at Georgetown [who] said, ‘Let me just try some tests here.’ For the first time, at age three, after being sick quite a bit and always on antibiotics, he was diagnosed with [a congenital immune deficiency]. [Children with severe immune deficiencies are more likely to be paralyzed by the oral polio vaccine.] So now they had figured out why he was sick all of the time with these flu-like symptoms. Then they started to put it all together, to connect the dots and figure out that he got polio from the vaccine.”
Salamone learned that a safer vaccine (Salk’s), unavailable in the United States, had been used in countries such as Sweden, Norway, and Finland and some provinces in Canada with success, completely eliminating polio. He wanted to know why health officials in the United States used Sabin’s vaccine instead of Salk’s when the former caused a rare but dangerous side effect and the latter didn’t. So, John Salamone became a vaccine-safety advocate, founding an organization called Informed Parents Against Vaccine-Associated Polio (IPAV). “At first you feel guilt,” recalled Salamone. “Because you say to yourself, ‘we brought our child to the doctor and gave him polio.’ Then we got mad, upset, when we found out that there were other options of polio vaccine out there. So we said to ourselves, ‘Why wouldn’t they be giving that to everyone? Why would you even take a chance?’ Then we found out that there were a number of kids every year who were getting polio from the vaccine and I started to identify them little by little and communicate with those families. And in the meantime I wrote to my congressman and I wrote to the White House and I wrote to anyone I could write to and really it was falling on deaf ears. It seemed that if the price was a dozen kids or so a year that got polio from the vaccine well then that was just the price of having a universal vaccine program.”
John Salamone changed polio-vaccine policy in the United States after his son, David, suffered a crippling side effect. (Courtesy of Joseph M. Valenzano, Jr.)
The turning point came in 1993, when Salamone was asked to speak before the Institute of Medicine. He remembered what happened: “The next thing you know an [Associated Press] article picked up on my story and before you knew it I was getting calls from all these newspapers. At one point I was in Italy and somebody called me up and said there’s a full page in the
Washington Post
on the front page of the health section with a picture of you and David and the whole polio story.”

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