Deadly Choices: How the Anti-Vaccine Movement Threatens Us All (19 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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Today’s fears of vaccines are far more sophisticated than those of the past. But their biological underpinnings are about the same. It makes as much sense to say that the MMR vaccine causes autism as to say that the smallpox vaccine turns children into cows. The only difference is that today’s claims are couched in scientific jargon, so they sound better. During the Omnibus Autism Proceeding, fringe doctors and scientists claimed that thimerosal weakened the immune system, allowing measles vaccine virus to damage the intestine. Because the intestine was now leaky, brain-damaging proteins could enter the bloodstream and cause autism. These hypotheses sound perfectly feasible, except that not a single aspect of them is correct.
It isn’t hard to make even the most preposterous claim seem reasonable. If anti-vaccine activists from the nineteenth century were alive today they would no doubt provide a far more sophisticated rationale for their smallpox-turns-people-into-cows contention. For instance, they could claim that smallpox vaccine is made from the fluid of cow blisters that invariably contain cow DNA. If one injected cow DNA into children, they might argue, it is possible that in a small group of the genetically susceptible children the DNA could incorporate itself into the nucleus of some cells. Cow DNA, which contains the blueprint for making cows, could then take over the cellular machinery, causing small, but noticeable, cow-like features. Were this even remotely possible—given the number of hamburgers containing cow DNA consumed every year, and the fact that small fragments of ingested DNA probably enter the body—we would all be cows by now.
Vaccines are unnatural:
A persistent theme of those who opposed vaccination in the nineteenth century was that “parental, conjugal, and domestic rights [include] the right to be pure and unpolluted.” The best way to avoid smallpox, argued a Midland anti-vaccinator, was to keep “the blood pure, the bowels regular, and the skin clean.” Pure blood was the key. And smallpox vaccine, taken from the lymph of a cow, only made the blood impure.
A persistent theme of those who opposed vaccination in the nineteenth century was that “parental, conjugal, and domestic rights [include] the right to be pure and unpolluted.” The best way to avoid smallpox, argued a Midland anti-vaccinator, was to keep “the blood pure, the bowels regular, and the skin clean.” Pure blood was the key. And smallpox vaccine, taken from the lymph of a cow, only made the blood impure.
The sentiment that vaccines contain blood poisons was also expressed on June 4, 2008, during a “Green Our Vaccines” rally in Washington, D.C., led by celebrity anti-vaccine activists Jenny McCarthy and Jim Carrey. “The ingredients,” said McCarthy, “like the frickin’ mercury, the ether, the aluminum, the anti-freeze, need to be removed immediately, after we saw the devastating effects [they had] on our children.”
Rejection of the germ theory:
In 1796, when Edward Jenner showed that fluid taken from the blisters of cows protected against smallpox, many didn’t believe it. Their disbelief is understandable. Jenner’s observation was pure phenomenology, occurring eighty years before the discovery of germs—he had no way to explain why it worked.
In 1796, when Edward Jenner showed that fluid taken from the blisters of cows protected against smallpox, many didn’t believe it. Their disbelief is understandable. Jenner’s observation was pure phenomenology, occurring eighty years before the discovery of germs—he had no way to explain why it worked.
One of the first to successfully advance the germ theory was Robert Koch, a German physician. In 1877, Koch showed that a specific bacterium, now called
Bacillus anthracis
, caused anthrax. Then he discovered the bacteria that caused tuberculosis and cholera. By 1900, researchers had found the cause of more than twenty different infections. Koch’s observations allowed researchers to explain why Jenner’s vaccine worked: infection with cowpox virus protected against disease caused by human smallpox virus. Anti-vaccine activists refused to believe it. Their disbelief was shared by a group of practitioners who, like them, dismissed the scientific advances of the time.
Bacillus anthracis
, caused anthrax. Then he discovered the bacteria that caused tuberculosis and cholera. By 1900, researchers had found the cause of more than twenty different infections. Koch’s observations allowed researchers to explain why Jenner’s vaccine worked: infection with cowpox virus protected against disease caused by human smallpox virus. Anti-vaccine activists refused to believe it. Their disbelief was shared by a group of practitioners who, like them, dismissed the scientific advances of the time.
The medical marketplace in nineteenth-century England was broad and diverse, including disciplines that were based on scientific principles, known as allopathic medicine, and those that weren’t, known as heteropathic medicine. Heteropathic practices included hydropathy, which claimed the curative power of bathing; homeopathy, which offered medicines that were so dilute there wasn’t a single molecule of the active ingredient remaining; and mesmerism, which argued in part that diseases could be treated with magnets. Heteropaths were angry that allopaths had convinced the government to compel a medical practice they didn’t offer, seeing compulsory vaccination as allopathic medicine harnessing authority for financial gain.
Anti-vaccine activists joined forces with heteropaths to vigorously denounce the germ theory. One activist argued, “We are being frightened to death by microbes. It is germs, germs, germs everywhere. Must one give up shaking hands, kissing, eating, and drinking? With all the germs ever-present, it is a wonder that any of us are alive at all.” Another prominent anti-vaccine activist said, “This infection scare is a sham, fostered, if not got up originally by doctors as a means of raising their own importance and tightening their grasp on the throat of the [nation].” Perhaps the harshest critic of the germ theory was the president of the National Anti-Vaccination League. In 1893, he wondered whether “infection [by germs was] merely a theoretical bogey, worked to frighten laymen, and diverting attention from the real enemy of the human race: dirt.”
Surprisingly, the notion that the germ theory was ill-founded isn’t dead. It’s alive and well among chiropractors, who often distribute literature warning of the dangers of vaccines and offer a safe haven for parents frightened by them.
Chiropractic traces its roots to a mesmerist in Iowa. In 1895, Daniel D. Palmer claimed to have made a startling discovery. One of his patients, Harvey Lillard, who had been deaf for seventeen years, wasn’t responding to Palmer’s magnets. Then Palmer noticed a lump on the back of Lillard’s neck. “An examination showed a vertebra racked from its normal position,” Palmer recalled. “I reasoned that if that vertebra was replaced, the man’s hearing should be restored. With this object in view, a half-hour’s talk persuaded Mr. Lillard to allow me to replace it. I racked it into position by using the spinous process as a lever and soon the man could hear as before.” It was a miracle—a miracle that would have made infinitely more sense if the cochlear nerve, responsible for sending nerve impulses from the ear to the brain, actually passed through the neck. Nevertheless, Palmer was convinced and a new method for treating disease—chiropractic—was born. Based on Palmer’s observation, chiropractors believe that diseases are caused by an imbalance of the flow of energy from the brain, which could be cured by manipulating the spine.
At the time of Palmer’s observation, Robert Koch and others were well on their way to proving the germ theory of disease. Palmer didn’t believe it. Nor did his son Bartlett Joshua (B. J.), who became a dominant figure among his fellow chiropractors, all of whom had trained at Daniel Palmer’s school for chiropractors in Davenport. B. J. Palmer eschewed the germ theory, writing, “Chiropractors had found in every disease that is supposed to be contagious, a cause in the spine. If we had one hundred cases of smallpox, I can prove to you where, in one, you will find a subluxation [misalignment of the spine] and you will find the same condition in the other ninety-nine. I adjust one and return his functions to normal. There is no contagious disease. There is no infection.”
Because chiropractors didn’t believe the germ theory of infection, they didn’t believe in vaccination. Why bother? They could simply treat diseases like smallpox by manipulating the spine. That chiropractors rejected the germ theory at its birth isn’t surprising; that some reject it today—given the impact of vaccines and antibiotics—is.
As of 2010, about a hundred thousand chiropractors were practicing in the United States.
The lure of alternative medicine:
In nineteenth-century England, alternative medicine was attractive because it was much less invasive, much gentler, much more humane, caring. No surgeries, no harsh medicines, no grim prognoses. And the explanations for how alternative therapies worked were easy to understand. Water and magnets treated diseases.
In nineteenth-century England, alternative medicine was attractive because it was much less invasive, much gentler, much more humane, caring. No surgeries, no harsh medicines, no grim prognoses. And the explanations for how alternative therapies worked were easy to understand. Water and magnets treated diseases.
Alternative medicine is attractive today for the same reasons. A perfect example is autism: a disorder for which mainstream medicine hasn’t found a cause or cure. Practitioners of alternative medicine, on the other hand, claim both. Fringe doctors argue that autism is caused by vaccines and can be treated with hyperbaric oxygen, anti-fungal medications, and creams that rid the body of mercury. Good science gets shoved to the side, in part, because it’s hard to understand. For example, in 2009, researchers published a paper in
Nature
, one of the world’s premier scientific journals. They found that some children with autism spectrum disorder had a defect in genes that made proteins on the surface of brain cells called neural cell adhesion molecules. The specific proteins, cadherin 9 and cadherin 10, help brain cells communicate with each other. Unfortunately, conceptualizing how problems with cadherin 9 and 10 could cause autism is much more difficult than laying the blame on vaccines; even worse, it doesn’t offer immediate hope for prevention or cure. It is in such a setting that alternative medicines thrive.
Nature
, one of the world’s premier scientific journals. They found that some children with autism spectrum disorder had a defect in genes that made proteins on the surface of brain cells called neural cell adhesion molecules. The specific proteins, cadherin 9 and cadherin 10, help brain cells communicate with each other. Unfortunately, conceptualizing how problems with cadherin 9 and 10 could cause autism is much more difficult than laying the blame on vaccines; even worse, it doesn’t offer immediate hope for prevention or cure. It is in such a setting that alternative medicines thrive.
Fear of medical advances:
Although the germ theory explained
why
Jenner’s vaccine worked, a hundred years would pass before researchers figured out
how
it worked. In 1891, Elie Metchnikoff, a Russian microbiologist and pathologist, showed that certain cells in the bloodstream could kill germs. He called them white corpuscles, leukocytes, or phagocytes. Anti-vaccine activists refused to believe Metchnikoff’s discovery. Walter Hadwin, a pharmaceutical chemist and one of the anti-vaccine movement’s greatest orators, mocked Metchnikoff’s findings. On November 1, 1907, more than fifteen years after the establishment of the theory of specific immunity and thirty years after proof of the germ theory (and one year before Metchnikoff won the Nobel Prize in Medicine), Hadwin likened Metchnikoff’s immune cells to “Thames policemen [that supposedly went] rollicking round, gobbling up the disease germs and thus extinguishing the imaginary source of the disease.”
Although the germ theory explained
why
Jenner’s vaccine worked, a hundred years would pass before researchers figured out
how
it worked. In 1891, Elie Metchnikoff, a Russian microbiologist and pathologist, showed that certain cells in the bloodstream could kill germs. He called them white corpuscles, leukocytes, or phagocytes. Anti-vaccine activists refused to believe Metchnikoff’s discovery. Walter Hadwin, a pharmaceutical chemist and one of the anti-vaccine movement’s greatest orators, mocked Metchnikoff’s findings. On November 1, 1907, more than fifteen years after the establishment of the theory of specific immunity and thirty years after proof of the germ theory (and one year before Metchnikoff won the Nobel Prize in Medicine), Hadwin likened Metchnikoff’s immune cells to “Thames policemen [that supposedly went] rollicking round, gobbling up the disease germs and thus extinguishing the imaginary source of the disease.”
The inability to accept scientific advances, the desire to protect outdated, disproved theories, and the rejection of new technology weren’t unique to anti-vaccine activists. Perhaps nineteenth-century England’s best example of the fear of science occurred in 1818 with the publication of a book by a twenty-one-year-old author named Mary Shelley:
Frankenstein
. Shelley was inspired in part by the work of the Italian physicist Luigi Galvani, who showed that if he stimulated the nerve of a dead frog with an electrical current, the frog’s leg would twitch. In Shelley’s book, Dr. Victor Frankenstein uses electricity (in the form of lightning) to bring the dead back to life. But Frankenstein’s monster would eventually break free, terrorizing the community. Shelley’s message was clear. Science was powerful but dangerous.
Frankenstein
. Shelley was inspired in part by the work of the Italian physicist Luigi Galvani, who showed that if he stimulated the nerve of a dead frog with an electrical current, the frog’s leg would twitch. In Shelley’s book, Dr. Victor Frankenstein uses electricity (in the form of lightning) to bring the dead back to life. But Frankenstein’s monster would eventually break free, terrorizing the community. Shelley’s message was clear. Science was powerful but dangerous.
Today’s fears of new technology are no different. When the human papillomavirus (HPV) vaccine was first made available in the United States in June 2006, anti-vaccine activists targeted it for elimination. This was in part a response to the relatively new method used to make it: recombinant DNA technology. To make HPV vaccine, researchers took the gene responsible for the surface protein of the virus, known as the L1 protein, inserted it into a small circular piece of DNA, known as a plasmid, and put the plasmid inside yeast cells (specifically, common baker’s yeast). When the yeast cells reproduced themselves, they also made large quantities of the HPV L1 protein, as instructed by the plasmid inside them. The L1 protein, which then assembles itself into a structure that looks just like the virus, is used as a vaccine. The same process is employed by one vaccine maker to make four different L1 proteins representing four different strains of HPV. This means that the vaccine contained only four viral proteins. (In contrast, Jenner’s smallpox vaccine contained at least two hundred different viral proteins, plus the contaminating proteins in cow lymph.)
By using a technology that produced only one critical viral protein under highly sterile conditions, the science of vaccine making had advanced well beyond the days of harvesting cow blisters. Antivaccine activists, however, were unimpressed, claiming that the HPV vaccine caused strokes, blood clots, heart attacks, paralysis, seizures, and chronic fatigue syndrome. The notion that a single viral protein could do all this—when the whole natural replicating virus can’t do any of it—was illogical. And although we might dismiss anti-vaccine activists in the mid-1800s who claimed that vaccination transformed some healthy children into oxen destined to graze on all fours and go mad, the biological bases of those claims are as logical as claims against HPV vaccine today.
Vaccines are an act against God:
Anti-vaccine protesters saw vaccines not only as an act against nature but as an act against God, frequently using biblical references to make their point. “Like the mother of Moses,” proclaimed one anti-vaccine activist, “I have ‘hid’ my little one. Hers was in danger from the execution of a senseless and murderous law; mine now is; but no ark of bulrushes would avail me, and there is no Pharaoh’s daughter to interpose.” Referring to the slaughter of the newborns under King Herod, activists likened the consequences of compulsory vaccine acts to children being slaughtered by “Herodian decree.”
Anti-vaccine protesters saw vaccines not only as an act against nature but as an act against God, frequently using biblical references to make their point. “Like the mother of Moses,” proclaimed one anti-vaccine activist, “I have ‘hid’ my little one. Hers was in danger from the execution of a senseless and murderous law; mine now is; but no ark of bulrushes would avail me, and there is no Pharaoh’s daughter to interpose.” Referring to the slaughter of the newborns under King Herod, activists likened the consequences of compulsory vaccine acts to children being slaughtered by “Herodian decree.”
Activists described vaccination as a perversion of the Christian sacraments, which were supposed to secure the safety of children, not put them in harm’s way. Vaccination was “unchristian,” a type of “devil worship” that transformed a child into an “anti-Christ.” In a pamphlet titled
Jenner or Christ?
the author described vaccination as the “most outrageous blasphemy against God [and] against Nature.” Mary Hume-Rothery, a prominent anti-vaccine activist in the 1880s, argued that vaccination fulfilled the apocalyptic prophesy in Revelations 16:2 that warned, “Foul and evil sores came upon the men who bore the mark of the beast.” To Hume-Rothery, vaccination scars were the mark of the devil.
Jenner or Christ?
the author described vaccination as the “most outrageous blasphemy against God [and] against Nature.” Mary Hume-Rothery, a prominent anti-vaccine activist in the 1880s, argued that vaccination fulfilled the apocalyptic prophesy in Revelations 16:2 that warned, “Foul and evil sores came upon the men who bore the mark of the beast.” To Hume-Rothery, vaccination scars were the mark of the devil.
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