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Wednesday, December 7, 2011

The Panic Virus: A True Story of Medicine, Science, and Fear by Seth Mnookin


I just saw Seth Mnookin speak at a national meeting about this book, which I read in preparation for his talk. He tackles the topic of vaccine safety, focusing primarily on the alleged connection between vaccines and autism as the center of his exploration, but does cover other reasons people avoid vaccines, and then closes with the consequences of not vaccinating children--both for those who chose that route, but also for those who are innocent bystanders--like children who are too young for a particular vaccine.
Mr. Mnookin is impressed that so many well-educated Americans are so deeply skeptical of established power. Whether the target is agribusiness, Big Pharma or the government, citizens who benefit most from "the system" are concluding not only that it's broken, but also that it's out to harm us as well. He became intrigued with this paradoxical social phenomenon after attending a dinner party in 2008. At this gathering he listened to a first-time father explain that he was delaying his infant's measles-mumps-rubella (MMR) vaccine on the grounds that he felt it was unsafe. According to what system of logic, Mnookin wondered, would an otherwise sensible man with absolutely no medical authority feel vaccination was unsafe? And why were so many intelligent people who "lived in college towns like Ann Arbor and Austin" eschewing standard pediatric procedures based on gut feelings rather than hard evidence?
That and subsequent conversations led him down the path to this book, a meticulously researched investigation into the popular belief that certain vaccines can cause autism. Combining narrative talent (so you can actually enjoy and understand the facts you are presented with) with assiduous reporting he explores "a manner of thinking" that not only runs "counter to the principles of deductive reasoning," but also threatens those of us who vaccinate our kids.
It takes guts to write a book informing a group of aggrieved parents that they're wrong about the source of their child's disorder. While Mnookin is consistently respectful of the emotional pain that autism can cause, he pulls no punches. Balancing sensitivity and science, he makes a devastating case that parents who reject vaccines for fear of autism are "casualties of a war built on lies." And he has become a target of zealous parents who passionately believe he is wrong, and has damaged their world with his assertion that there is no connection.
Mnookin tells his story from an impressive number of angles, but his primary emphasis centers on the social-psychological processes underscoring the widespread misperception that vaccines cause autism. At the core of his analysis is a basic scientific truism, one that we tend to forget: It's virtually impossible to immunize millions of people without experiencing a small percentage of random adverse reactions. Put simply, some kids are always going to react badly to their "jabs." Sometimes very badly. But overall the risk is greatly outweighed by the benefit, and Mnookin includes several heartbreaking stories of people whose children died as a result of not being vaccinated.
The story is a good one, and it is well told. In his talk, Mnookin admited that there is no convincing those who adamantly believe their children were damaged by vaccines, but does have some suggestions to help battle the growing number of parents skeptical about vaccines--one good one, I thought, was to have information groups for parents prenatally where they could talk about vaccines, their concerns and address them before they are incredibly sleep deprived and have to bring their infants into the doctor's office at 2 months of age for the first round of immunizations. The book is a great contribution to public health.

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