“Why?” asked Thompson.
“Well, this will complicate their lives considerably,” replied Young.
Then Thompson asked Young about Larry Baraff’s study. “The UCLA study found more reactions than had ever been seen before,” she said. “The study estimates that one of every thirteen children had persistent or high-pitched crying after the shot.”
Young replied, “This may be indicative of brain damage in the recipient child.”
There were a few problems with this exchange. First: Thompson implied that Young had worked on the pertussis vaccine while at the FDA, but he hadn’t. Second: Bobby Young had no specific expertise in neurology or pediatrics and had never taken care of a patient, so he was ill-equipped to comment on the relationship between crying and brain damage. It’s not only that crying—high-pitched or otherwise—doesn’t cause permanent harm; even seizures, whether associated with fever or not, do not of themselves cause brain damage. Had Bobby Young been a clinician, he likely would have known that. Finally, and most disturbing, Young appeared to be answering questions about Larry Baraff’s study—impossible, given that Young was interviewed and had died before the study was published. This raised questions about whether Thompson had juxtaposed questions and answers. Thompson denied the allegation. “I am not going to risk my reputation by moving someone’s words around,” she said. “That speaks to my journalistic integrity.”
But Young’s interview wasn’t the only one that raised questions. Ed Mortimer, a former chairman of the AAP’s committee on infectious diseases, said that during his interview Thompson asked the same question “repeatedly in slightly different ways, apparently to develop or obtain an answer that fit with the general tone of the program.” Mortimer felt that “cutting and splicing remarks taken out of context gave a very different meaning from what I intended or what I believe.”
Gordon Stewart was another of Thompson’s experts with questionable credentials.
At the beginning of Vaccine Roulette, Thompson introduced Stewart as a member of the United Kingdom’s Committee on the Safety of Medicines. But Stewart had never been a member of that group. Stewart said, “I believe that the risk of damage from the vaccine is now greater than the risk of damage from the disease.” What Thompson didn’t say was that five years earlier, in 1977, Stewart had published an article claiming not only that the pertussis vaccine was unsafe but that it didn’t work. Like Mendelsohn, Stewart believed the decline in pertussis in the United Kingdom had nothing to do with the vaccine; it was simply a matter of improved sanitation. Given abundant evidence that the incidence of pertussis is inversely related to vaccine use, Stewart’s proclamations were at best ill-informed and at worst dangerous. Indeed, in 1977, after British health officials called for a pertussis immunization campaign, Gordon Stewart cried foul. “I accuse the committee [on the safety of medicines] of deceit,” he proclaimed. “There are no grounds for saying a major epidemic is on the way and I don’t agree with the way their figures have been collected.” During the next two years, more than a hundred thousand children were hospitalized and six hundred killed by pertussis.
Soon after Vaccine Roulette, Gordon Stewart retired. But he didn’t retire from educating the press and the public about infectious diseases. In 1981, one year before Thompson’s program, an unusual organism then called Pneumocystis carinii killed five homosexual men in Los Angeles; all of these men had severe immunological deficiencies. The CDC eventually called it Acquired Immune Deficiency Syndrome, or AIDS. At first, no one knew what caused the disease. But by 1983, a group of French researchers headed by Luc Montagnier had found the culprit: a virus later named human immunodeficiency virus (HIV). (Montagnier won a Nobel Prize for his discovery.)
Stewart didn’t buy it. He took on a medical profession that he believed had been duped into believing that HIV caused AIDS with the same ferocity as those who claimed the pertussis vaccine worked. Stewart believed AIDS was caused by the gay lifestyle, not HIV. In 1995, more than ten years after the discovery and confirmation of HIV as the cause of AIDS, Stewart wrote, “AIDS and AIDS-related complexes develop, with and without HIV, because [foreign proteins] in spermatozoa enter the rectum and bloodstream ... and elicit antibodies which are toxic to [white blood cells].” Stewart didn’t believe HIV caused immune deficiency; he believed sperm in the rectum did it. He also believed yeast infections in homosexual men did the same thing. Stewart blamed the victim, not the virus, writing: “Every time an avowedly homosexual or bisexual rock or film star dies of the disease he is elevated to martyr and hero. Yet it is an unpalatable and unpopular fact, seldom articulated, that those who die of AIDS, like the smokers who die of lung cancer and heart disease, facilitated their own death.” Stewart concluded, “We should take the sentimentality out of AIDS and recognize that the disease is, with few exceptional cases, directly caused by the behavior of the victim. If we do that, it would be better for all concerned.”
In 1995, Stewart also argued against giving azidothymidine, an anti-viral medication, to pregnant women with AIDS. His plea came at a time when AZT had already been shown to prevent transmission of HIV from pregnant women to their unborn babies. His unconscionable rants against AIDS victims, his ill-founded notions about the cause of the disease, and his strident campaign against a valuable drug made Gordon Stewart a target of ridicule.
These were the men Lea Thompson chose to educate the American public about pertussis vaccine.
During Vaccine Roulette, Lea Thompson interviewed a personal-injury lawyer named Allen McDowell. McDowell claimed that he had uncovered a conspiracy among doctors to hide the truth about pertussis vaccine. “[In] some institutions that I’ve seen in this state [Illinois],” said McDowell, “certain administrators ... have indicated that they have children there as a result of the DPT. Brain-damaged children.” And he believed that it wasn’t only doctors who covered up the fact that the damage had been caused by the vaccine; vaccine makers were in on it, too. Thompson said that attorneys had accused “the vaccine manufacturers of destroying vaccine records before they [could] be subpoenaed for a DPT lawsuit.” Then Thompson served the home run pitch—the kind of question personal-injury lawyers can only dream about. “Do you think that some children have been damaged by the DPT shot and their parents don’t even know it?” she asked, arguing that the few patients she had described were only the tip of an iceberg—an iceberg of children whose parents could ask Allen McDowell to represent them. “Absolutely,” enthused McDowell. “I don’t think the parents would be aware of [the alleged vaccine harm] and normally the pediatrician, or whoever, the GP, wouldn’t tell them.” Later, Thompson concluded, “What about the children who have already been damaged—who’s helping them? Unless they sue—and many families don’t have the money or don’t want to do that—nobody is helping them to pay the enormous costs that a brain-damaged child brings upon the family.” “A child like [Scottie] deserves to stay out of an institution,” said Marge Grant, seemingly in response to McDowell. “And, unless there’s compensation, you simply cannot do it.” If personal-injury lawyers had wanted to make an infomercial on alleged harm caused by pertussis vaccine, they couldn’t have done much better than Vaccine Roulette.
In 2007, John Stossel interviewed Allen McDowell on an ABC News program titled “Scared Stiff: Worry in America.” During the program, Stossel showed a clip of news reporter Robin Roberts and Allen McDowell during the pertussis vaccine scare. “Sudden infant death,” said Roberts. “You put your baby into the crib, you wake up the next morning, and your baby is dead.” “It’s extremely dangerous,” said McDowell. “They had the ability to make a safer vaccine.” Twenty-five years had passed since Lea Thomspon’s program. During that time, epidemiological studies had clearly shown that pertussis vaccine didn’t cause brain damage or Sudden Infant Death Syndrome, and advances in neurology and genetics had better defined the real causes of the problems. But Allen McDowell was unbowed. “The vaccine just wasn’t as safe as it could have been?” a
sked Stossel. “There’s no dispute about that,” replied McDowell. “They were making so much money off the old vaccine that they didn’t really have any incentive to improve it.” Stossel, in voice-over, said, “McDowell made money, too. The lawyer who now works out of his house won lots of lawsuits—for how much money?” “I made a good chunk of money,” said McDowell. “One hundred million?” asked Stossel. “I really can’t say,” McDowell demurred. “It’s under protective order.”
During his interview with Stossel, McDowell never mentioned his law partner, Anthony Colantoni. Between July 1990 and October 1991, Colantoni received $1.53 million in compensation checks from the Vaccine Injury Compensation Program for families of children presumably damaged by pertussis vaccine. But Colantoni gave only $124,000 to his clients, putting the remaining $1.4 million into the account of McDowell & Colantoni. His method of concealing what he’d done was simple. “When the victims or family members of the estates [of plaintiffs] would call,” said U.S. Attorney James B. Burns, “he would deny he had received the checks.” In March 1993, by consent of the Illinois Supreme Court, Anthony Colantoni was disbarred. McDowell was never implicated in his partner’s scheme.
Vaccine Roulette was arguably one of the most powerful programs ever to air on American television: thousands of parents stopped giving pertussis vaccine to their children; personal-injury lawyers pummeled pharmaceutical companies, causing many to stop making vaccines; and Congress passed a law to protect vaccine makers, while at the same time compensating those who were allegedly harmed by vaccines.
During the next fifteen years the tide turned. David Miller’s study lay in ruins at the hands of a British judge. And study after study showed that children immunized with DTP weren’t at greater risk of brain damage. As a consequence, public health agencies and medical societies throughout the world no longer considered pertussis vaccine to be a rare cause of permanent harm. Even the Vaccine Injury Compensation Program, a system designed to compensate those who felt wronged by vaccines, had removed epilepsy as a possible consequence of pertussis vaccine.
Despite this overwhelming evidence, and despite all of the harm that had been done by the false notion that pertussis vaccine was maiming America’s children, Lea Thompson was without remorse. In 1997, during a celebration in her honor held by the National Vaccine Information Center, the group once called Dissatisfied Parents Together, Thompson remembered Vaccine Roulette: “The reason it was important to me is not because it was great research, although we did a pretty good job, or that [it] was a beautifully produced piece of work. DPT [Vaccine Roulette] was important to me personally because it spawned a movement.” A movement that almost eliminated vaccines for American children, a movement that continues to cause many parents to reject vaccines in favor of the diseases they prevent, and a movement that was based on a notion that has been shown again and again to be incorrect.
In retrospect, it isn’t surprising that an anti-vaccine movement sprang up in the United States in the 1980s. The surprise is that it didn’t happen sooner.
In the early 1940s, a yellow fever vaccine was routinely given to American soldiers. Everyone got it. To make sure the vaccine virus was stable across a broad range of temperatures, manufacturers added human serum, a decision that proved disastrous. (Serum is blood without red blood cells or clotting factors.) Unbeknownst to the manufacturer, some of the blood donors had hepatitis. At the time, scientists didn’t know about the different types of hepatitis viruses or how they were spread. In March 1942, the Surgeon General’s Office noted a striking increase in the number of recruits with hepatitis; more than three hundred thousand soldiers were infected with what we now know as hepatitis B virus; sixty-two died from the disease.
In the early 1950s, Jonas Salk made a vaccine to prevent polio. Horrified that children could be fine one minute and wheelchair-bound the next, Americans gave their money to the March of Dimes, which gave it to Jonas Salk. Salk reasoned that killed poliovirus would induce a protective immune response without causing disease. Working with mice and then monkeys, Salk figured out how to make a vaccine by growing poliovirus in laboratory cells, purifying it away from the cells, and killing it with formaldehyde. In 1954, the March of Dimes tested Salk’s vaccine in a trial of almost two million children. (It was then and remains today the largest vaccine trial ever performed.) When the results of the study were announced, church bells rang across the country, factories observed moments of silence, synagogues held special prayer meetings, and parents, teachers, and students wept. “It was as if a war had ended,” one observer recalled. The euphoria didn’t last long. Two weeks later, public health officials recalled every lot of polio vaccine.
When the March of Dimes had tested Salk’s vaccine, it relied on two veteran vaccine makers: Eli Lilly and Parke-Davis. But when the vaccine was licensed for sale, three other companies joined in: Wyeth, Pitman-Moore, and Cutter Laboratories. It soon became clear that Cutter, a small pharmaceutical company in Berkeley, California, had made it badly, failing to fully inactivate the virus. As a consequence, one hundred and twenty thousand children were inadvertently injected with a vaccine that contained live, potentially deadly poliovirus: seventy thousand suffered mild polio, two hundred were severely and permanently paralyzed, and ten died. It was one of the worst biological disasters in American history. Cutter Laboratories never made another dose of polio vaccine again.
Perhaps the worst vaccine disaster in history didn’t occur in America; it occurred in Germany. In 1921, two French researchers, Albert Calmette, a physician, and Camille Guérin, a veterinarian, reasoned that a bacterium (Mycobacterium bovis) that caused tuberculosis in cows could protect people against human tuberculosis. They developed a vaccine later called BCG (Bacillus of Calmette and Guérin), a modified form of which is still used today. In 1929, however, 250 ten-day-old children in Lubeck were given a BCG vaccine that wasn’t made of BCG. It was made of pure, highly lethal human tuberculosis bacteria. Seventy-two babies died from the mistake.
The yellow fever, Cutter, and BCG vaccine disasters didn’t spur significant anti-vaccine activity. (However, the Cutter incident led to the creation of a vaccine regulatory system that prevented these kinds of tragedies from happening again.) In America, people still trusted vaccines; and they trusted those who made and recommended them. It would take fear of pertussis vaccine to turn the tide; ironic, given that the pertussis vaccine tragedy was imagined.
CHAPTER 5
Make the Angels Weep
If they can get you asking the wrong questions, they don’t have to worry about the answers.
—THOMAS PYNCHON, GRAVITY’S RAINBOW
By the late 1980s, Barbara Loe Fisher was riding high. She had written A Shot in the Dark: Why the P in the DPT Vaccination May Be Hazardous to Your Child’s Health, praised by the San Francisco Chronicle as “cautious, credible, horrifying, and outrageous all at once.” She had spurred an enormous effort by academic researchers, pharmaceutical companies, and public health officials to make a purer pertussis vaccine. She had helped craft legislation that included a monitoring system for licensed vaccines—a system that would, ten years later, detect a rare but serious side effect. And although the reason for Fisher’s activism—her belief that pertussis vaccine had caused her son’s learning disabilities—wasn’t supported by the science, she had been a catalyst to changes that clearly benefited children. She was, in short, America’s premier vaccine safety activist. The media believed her, politicians relied on her, and parents turned to her. Barbara Loe Fisher was poised to do a tremendous amount of good.
Unfortunately, during the next three decades, the opportunity was squandered—an opportunity that had been so hard won.
When Barbara Loe Fisher burst onto the scene, several vaccines had serious side effects, every year causing allergic reactions, paralysis, or death. Public health officials and doctors didn’t hide these problems. But they didn’t do anything to correct them, either. And most parents had no idea they existed.
Beginning in the early 1960s, American children were given a polio vaccine that was ingested, not injected. Albert Sabin, a well-respected virologist and Jonas Salk’s fiercest rival, invented it. Sabin’s approach was dramatically different from Salk’s; instead of killing poliovirus with a chemical, as Salk had done, he weakened it. Sabin reasoned that by taking poliovirus and growing it over and over again in nonhuman cells, the virus would become less and less capable of reproducing itself in humans. And he was right. Sabin’s vaccine, dropped onto sugar cubes and given to millions of American children, worked. By 1979, polio, a disease that had caused hundreds of thousands of children to suffer and die, was eliminated from the United States. By 1991, it was eliminated from the Western Hemisphere—a remarkable accomplishment.
But there was one problem.
When Albert Sabin weakened poliovirus in his laboratory, he found that it could no longer grow in the brains and spinal cords of experimental monkeys; so he reasoned that the vaccine virus wouldn’t grow in children, either. But Sabin hadn’t anticipated a rare occurrence: polio caused by his polio vaccine. Although this problem was extremely rare—occurring in 1 of 2.5 million doses—it was real. Every year for the next twenty years, six to eight children in the United States got polio from the oral polio vaccine. And some of these children died from the disease. The problem caused by Sabin’s vaccine was avoidable; several countries never used it, relying on Salk’s to successfully eliminate the disease.
When Barbara Loe Fisher became a vaccine safety activist, she could have taken on Albert Sabin’s polio vaccine. Pharmaceutical companies had little incentive to make an inactivated polio vaccine—one that didn’t occasionally cause paralysis—and public health officials were unwilling to spend more money on a polio vaccine in the absence of public demand. (Because it required a syringe and needle, as well as a medical professional to give the shot, Salk’s vaccine was much more expensive than Sabin’s, which could just be squirted into the mouth.) It was a perfect situation for a consumer advocate. Years later, one advocate would force the government to acknowledge the rare but invariant paralysis that came with Sabin’s polio vaccine and to change public policy. It could have been Barbara Loe Fisher. But it wasn’t.
Deadly Choices: How the Anti-Vaccine Movement Threatens Us All Page 7