“The Panic Virus: A True Story of Medicine, Science, and Fear,” by Seth Mnookin, Simon & Schuster, NY, 2011. This 429-page hardback tells the story of anti-vaxers. Diseases like measles, diphtheria, and whooping cough once thought eradicated are returning because parents decide not to vaccinate their children. These diseases can be fatal and can be especially serious in infants. The core concern is thimerosal, a mercury containing preservative, once used in some multidose vaccines. Some believe it causes autism. Studies have found no connection, but officials are unable to certify the vaccines are safe. The book was published before the arrival of Covid; safety concerns have caused some to avoid vaccination.
The book begins with an overview of vaccination technology. Smallpox was known from antiquity. That smallpox can be prevented by infecting people with mild doses goes back to Africa. In 1717, Lady Montagu, wife of the British ambassador, brought ingrafting back from the Ottoman Empire to UK. An African slave brought it to New England in 1706. Acceptance was slow. Mnookin notes that during the Revolutionary War, the British were vaccinated, but Washington’s troops were at risk. The British gave Americans contaminated blankets to spread the disease. Washington debated whether to require inoculation of his troops. Finally he decided to go ahead.
In 1796, Edward Jenner developed a vaccine based on information that milkmaids with cowpox rarely got smallpox. Cowpox inoculation proved safe and effective.
During World War II, America decided to vaccinate its troops for yellow fever. Some vaccine produced by Rockefeller Foundation was contaminated with hepatitis B. Over 300,000 soldiers were infected; sixty died.
Polio had an epidemic in 1916. When Salk vaccine became available in 1954, a major vaccination program was begun. Within two weeks, children vaccinated with vaccine from Cutter Labs in California were getting polio.
Fluoridation of drinking water to reduce tooth decay is described. Areas with natural fluoride in their water had lower tooth decay. In 1945, a comparative study found 1 ppm fluoride sufficient. By 1950, US Public Health Service recommended fluoridation of drinking water. Antifluoride activists objected.
DPT vaccine for diphtheria, pertussis (whooping cough), and tetanus was developed in 1942. At the time in Britain, over 60% of children caught whooping cough. After arrival of DPT vaccine in the 1950s, cases plummeted.
In 1976, a case of swine flu was reported at Ft. Dix in New Jersey. This could be a return of the 1918 flu that killed over 20% of those infected. President Ford decided to order mass vaccination. In 1974, Wyeth had lost a law suit claiming their vaccine had caused polio. A jury rejected their defenses and awarded $200K to the family. Half of the companies making vaccines withdrew from the market. To supply Ford’s vaccine they insisted the feds take the liability. Congress agreed, but fortunately the flu epidemic failed to develop.
A program, “Vaccine Roulette,” aired by a Washington, DC TV station in 1982 began the anti-vax movement. The program featured dubious claims by fringe researchers that “a shocking number of children were rendered a vegetable” by DPT vaccine. The story was picked up by news media and widely distributed. Concerned parents of children with developmental disordered found each other and got organized. The first was called Dissatisfied Parents Together.
A chapter describes autism. The term was first applied in 1943 in a paper by Leo Kanner, an Austrian doctor who published the first English textbook on child psychiatry. He describes children who are developmentally disabled and incapable of affective social contact. He attributed the cause to “refrigerator mothers,” whom he characterized as intellectually assertive, professionally ambitious, and emotionally restrained. Severe cases can include painful intestinal disorders. The number of autism cases is increasing. The Diagnostic and Statistical Manual of Mental Disorders from 1952 is the basis of mental diagnosis. Recent editions have broadened definitions of autism. Medicaid in some states provides funds for patients. Physicians are more liberal in their diagnoses to get patients the care they require.
In 1964, a psychologist with an autistic son published a review of what was known. That resulted in the Autism Society of America and the Autism Research Institute. Parents became politically active seeking assistance and research.
The MMR (measles, mumps, rubella) vaccine was introduced in Britain in 1988. Measles numbers were 86K cases and six deaths in 1988, and 10K cases and no deaths in 1991. In 1992, some mumps vaccine caused mild meningitis; two brands were withdrawn. Parents responded. In 1994, the number of measles cases doubled.
In the 1980s, Andrew Wakefield entered the picture. His work was on Crohn’s disease, an inflammatory bowel disease. He focused on measles as the cause. His research record was spotty, but he became a star to the public. In 1998 he published a paper that connected the MMR vaccine with Crohn’s disease and autism. He claimed MMR vaccine may be the cause of rising autism rates. The press pounced and featured the news. He was shown to have conflicting business interests. He was paid to collect data to support a lawsuit against Glaxo-SmithKline, Aventis, and Merck. He filed for a patent for the treatment of Crohn’s disease.
In the 1930s, thimerosal (from Eli Lilly) was added as a preservative after diphtheria vaccine in a large multidose vial became contaminated with staph bacteria. Twelve children died. Thimerosal is an ethyl mercury derivative. A chapter describes Minamata disease. In Japan people were poisoned by eating fish contaminated (presumably by bio accumulation) with methyl mercury from industrial discharges (probably from the mercury cells used to make chlorine and caustic soda by electrolysis of salt solutions).
In 1997, EPA began investigation of mercury in vaccines after Congress authorized a study of mercury emissions from coal fired power plants. No data were available for thimerosal but they calculated if infants were vaccinated on schedule they would receive 187.5 micrograms of mercury, more than allowed by FDA for methyl mercury. In 1999, CDC recommended removal of thimerosal from vaccines. There was no time to do the indicated studies on ethyl mercury effects in children. Lack of safety data on thimerosal had been noted in 1991, but no action was taken.
Parents of children with autism were frustrated in their efforts to find treatments. Gradually they became aware of other parents and became politically active. One organization was Defeat Autism Now. Another was Cure Autism Now. Congress held hearings on thimerosal in 2000. “Autism: A Novel Form of Mercury Poisoning” was published in 2001. It was dismissed as bad science for failure to find mercury in patients and for attributing everyman symptoms to autism.
In 1986 manufacturers discontinued DPT vaccine. Congress responded by creating the National Childhood Vaccine Injury Act. It paid injury claims funded by a surtax on vaccines. It also created the Vaccine Adverse Event Reporting System to collect data. Data were reviewed in 2000 and found no statistically significant effects of ethyl mercury. The need for more research was indicated.
The controversy intensified. BBC aired a program “Every Parent’s Choice” which presented vaccine safety as a political issue. Media picked up the story with 70% reporting that MMR vaccine was linked to autism; 11% reported its history of safety. A study of children in Denmark presented strong evidence against the hypothesis that MMR vaccination causes autism. Activists grabbed the headlines suggesting MMR is a cause when thimerosal is present. Headlines were sensational. By 2003, the autism claims were disproved. Wall Street Journal published an editorial on the politics of autism. An onslaught response followed. Reporters were threatened and secretaries were accused of aiding baby killers. The practice of denying scientific research and charging fraud for any negative results diverted resources from needed autism research.
Law firms began to advertise for autism cases for the Vaccine Court. By 2004, 4321 cases had been filed. Several cases are presented in detail. Again Andrew Wakefield was involved. CDC rejected the thimerosal-autism connection. They received threats.
In 2002, a provision was inserted in the Homeland Security bill that protected Eli Lilly who manufactured thiomersal from vaccine related lawsuits. A case is described in which Arthur Kriegsman, a New York gastroenterologist did an endoscopy on an autism patient and found autistic enterocolitis. He ordered anti-inflamatory medication and chelation therapy (used to remove metals like mercury from the system but with potentially serious side effects). Half a dozen patient stories follow.
In June, 2007, the Omnibus Autism trial began in Washington, DC. In 2009, the court decided against the plaintiff. After 28 expert witnesses, 939 pieces of medical literature, and 7700 pages of patient medical records, the court ruled the petitioners had failed to demonstrate a link showing vaccine as the cause. Not entitled to a program award.
This is a detailed study of the claim that autism is caused by MMR vaccine and especially by its thiomerosal preservative. We also learn of other vaccines such as DPT. The author finally brings us to the court decision. Those who believe autism is caused by vaccines are passionate but some work is dubious. Threats to scientists and reporters are unwarranted. Media is eager to publish medical stories to boost readership–even when the evidence is weak. And they choose inflammatory headlines that hype the impact. References. Bibliography. Index.