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Deadly Choices: A Penn virologist takes on the anti-vaccine movement

Exhibit A: This year’s incoming class of the Perelman Schoolof Medicine at the University of Pennsylvania was assigned to read Deadly Choices: How the Anti-VaccineMovement Threatens Us All, by Paul A. Offit, MD. Issued by Basic Books in2011, the book came out this year in paperback. During their orientation period,Offit spoke to the students; then the students discussed the book in smallgroups.

Exhibit B: A reader of DeadlyChoices posted this review on “I find this book to be anoutrage; . . . the public needs to know the facts about vaccines and that thisauthor is one of the most uninformed, even dangerous men to the health ofAmerica.”

Sometimes there seem to be two kinds of people in the world:those who admire Offit and the work he has done in the fields of virology andimmunology, and those who call him a fraud and profiteer. There appears to beno middle ground.

Offit, the Maurice R. Hilleman Professor of Vaccinology anda professor of pediatrics at the Perelman School of Medicine at the Universityof Pennsylvania, is also chief of the Division of Infectious Diseases at theChildren’s Hospital of Philadelphia. He is a co-inventor of RotaTeq, arotavirus vaccine. In addition, he directs CHOP’s Vaccine Education Center,which is regarded by the second group of people as a purveyor of propaganda.According to the center’s site, it was launched in October 2000 “to provideaccurate, comprehensive, and up-to-date information about vaccines and thediseases they prevent to parents and health-care professionals.” It also “seeksto dispel some of the common misconceptions and misinformation surroundingvaccines. The goal is to communicate the facts about each vaccine as well ashow vaccines are made, how and why vaccines work, who recommends them, whetherthey are safe, whether they are still necessary, and when they should begiven.” Funded by CHOP, the center does not receive support from vaccinemanufacturers.

In the last few years, Offit has assumed a more forcefulrole as advocate beyond the Vaccine Education Center. He has been dismayed bywhat he sees as rampant “misconceptions and misinformation,” which are often givena free pass in the media and are increasingly spread by celebrities such asJenny McCarthy, Jim Carrey, Cindy Crawford, and Bill Maher. In 2008, Offitpublished Autism’s False Prophets: BadScience, Risky Medicine, and the Search for a Cure (Columbia UniversityPress). The second chapter recounts Dr. Andrew Wakefield’s claim in 1998 tohave discovered the cause of autism: the MMR (measles, mumps, and rubella)vaccine. (A few years earlier, Offit notes, Wakefield, a Britishgastroenterologist, had claimed that the same vaccine caused Crohn’s disease –-a claim he subsequently admitted was wrong.)

In the book’s prologue, Offit writes: “Some people whobelieve vaccines cause autism hate me because they think I’m in the pocket ofthe pharmaceutical industry, that I say vaccines are safe because I am paid to doit. . . . But the reason I say vaccines don’t cause autism is that they don’t.I say this because the false alarm about vaccines and autism continues to harma lot of children –- harm from not getting needed vaccines, harm frompotentially dangerous treatments to eliminate mercury, and harm from therapiesas absurd as testosterone ablation and electric shock. I say this because thefeared vaccine-autism link, which has now been disproved, diverts researchdollars from more promising leads. I say this because I care about childrenwith autism.” Also in the prologue, he mentions that he had his own childrenvaccinated.

In Deadly Choices,Offit continues to examine and deconstruct the “bad science” of theanti-vaccine movement. I was surprised to find that Offit includes among thedoubters Mehmet Oz, M.D., the well-known TV doctor and a graduate of Penn’smedical school. Oz’s children did not receive flu shots or swine flu shots, andhe is quoted as saying that “my wife makes most of the important decisions asmost couples have in their lives.” As Offit notes, Lisa Oz is a “reiki master,”a follower of Mikao Usui, who claims to be able to heal through his palms.Offit also notes that Jenny McCarthy, the actress and one of America’s mostrecognized anti-vaccine activists, had followed tarot cards in the past. At thesame time, Offit has recognized the circumstances that can lead parents to lookbeyond traditional medicine. As he put it in Autism’s False Prophets: “Parents of severely affected autisticchildren often face unimaginable emotional and financial stress.”

As shown by his interactions with the medical school’s Classof 2016, Offit certainly has the support of the medical establishment. In 2008,the Perelman School of Medicine honored him with its Luigi Mastroianni ClinicalInnovator Award. Last year, he was elected to the Institute of Medicine, one ofthe highest honors in biomedicine. Offit also received the 2011 David E. RogersAward from the Association of American Medical Colleges, in recognition bothfor his work with RotaTeq and for his public advocacy.

But many people beg to differ, as shown by their responsesto Deadly Choices. The paperbackedition bears praise from New Scientist,The Journal of the American MedicalAssociation, Nature, Health Affairs, and many others. At thesame time, I suspect few books reviewed by readers on show such adramatic disparity. A recent look at DeadlyChoices shows 43 five-star reviews and 22 one-star reviews, the lowestscore accepted. One of the negative responses points out that Offit “shared thepatent on the Rotavirus vaccine, RotaTeq. He makes millions every year off thevaccines he claims are safe. What does he have to loose [sic] if the‘anti-vaccine’ movement continues? A whole lot of money. Conflict of interest?”Although the paperback version of DeadlyChoices doesn’t mention Offit’s role in inventing Rotateq, it is cited inAutism’s False Prophets and thepatent he shares is listed in his CV on his web site.

Last month, the International Medical Council onVaccination, an anti-vaccine organization, posted a blog called “In Vaccines WeTrust?” The piece is by Suzanne Humphries, MD, a nephrologist who nowidentifies herself as a homeopath. She was responding to a short video by Offitthat appeared on Medscape, in which he questions vaccine exemptions. A medicalexemption is “a reasonable reason,” he says, but Offit argues that thephilosophical/personal belief or religious exemption “does not make a lot ofsense.” In response to Offit, whom she calls “Millionaire vaccine inventor andmandatory vaccine advocate,” Humphries argues, with justification, that ifparents were convinced that vaccines were safe and effective, “there would beno anti-vaccination movement.” But then she goes on assert that globalimmunization efforts and the like are “reminiscent of policies found inNational Socialist empires, Stalinist countries, or Communist China.” She alsoasserts “the hypocrisy of the vaccine faithful” and, as she writes it,“CORRUPTION.”

On the matter of “corruption,” Offit suggests in Deadly Choices that “Conspiracy theorieslie at the heart of the anti-vaccine movement, claiming that the pharmaceuticalindustry, using undue influence, causes eighty thousand practicingpediatricians and family physicians to lie about vaccine safety.”

The other rebuttal approach that Humphries takes involvesreligion. Religious principles, she writes, still stand. “God could haveinstructed Moses on how to inoculate the Israelites in the desert when thediseases came upon them.” But, she continues, “medical vaccination orinoculation of any sort was never part of God’s instruction.” Nor did “Jesus,the greatest human healer of all time,” ever heal through vaccines. In fact,according to Humphries, “the Christian scriptures, both old testament and new,make it perfectly clear that good health is solely predicated on a livingrelationship with God.”

That statement suggests that only those with such arelationship –- as prescribed in scriptures –- will have good health. That’s anastounding view for a physician to hold.

What would happen in a world without vaccines? According tothe Vaccine Education Center, before there were vaccines, parents in the UnitedStates could expect that every year, polio would paralyze 10,000 children;rubella (German measles) would cause birth defects and mental retardation in asmany as 20,000 newborns; measles would infect about 4 million children, killingabout 500; diphtheria would be one of the most common causes of death inschool-aged children; a bacterium called Haemophilusinfluenzae type b (Hib) would cause meningitis in 15,000 children, leavingmany with permanent brain damage; and pertussis (whooping cough) would killthousands of infants. That’s not a world anyone would want to return to.


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