FRIST: Well, you’re wrong. I’m serious.
One month later, Maher wrote an article for the Huffington Post titled “Vaccination: A Conversation Worth Having.” In it, he sounded many classic anti-vaccine themes: for example, that vaccines contain dangerous additives (“the formaldehyde, the insect repellent, the mercury”), that diseases prevented by vaccines were disappearing anyway (“polio had diminished by over 50 percent in the thirty years before the vaccine”), and that common belief is common wisdom (“sixty-five percent of the French people don’t want [the flu vaccine]. Are they all crazy too?”). Then Maher gave his readers the source of his information: “Someone who speaks eloquently about this is Barbara Loe Fisher, founder of the National Vaccine Information Center. I find her extremely credible, as I do Dr. Russell Blaylock, Dr. Jay Gordon, and many others. But I shouldn’t have even mentioned them because I don’t want to be ‘The Vaccine Guy’!! Look it up yourself and stop asking me about it. I’m already ‘The Religion Guy,’ and that’s enough work!”
Bill Maher, host of HBO’s Real Time with Bill Maher, declared that the novel H1N1 (swine flu) vaccine was for “idiots.” (Courtesy of Kabik/ Retna Ltd./Corbis.)
When Maher called himself “The Religion Guy,” he was referring to his 2008 movie, Religulous (presumably a contraction of the words religion and ridiculous). Maher took on religion, claiming that religious beliefs weren’t supported by scientific evidence. At the beginning of the movie he asked, “Why is believing something without evidence good?” Maher noted that many scientists were either atheists or agnostics. He was likening himself to them. But that’s where the similarity ended.
Maher argued that influenza vaccine was equivalent to “sticking a disease into your arm.” Following his criticism, Maher received letters from doctors explaining how the influenza vaccine was made and how it works—and why it wasn’t like “sticking a disease into your arm.” But Maher didn’t need their help. “I read Microbe Hunters when I was eight,” he wrote. (Microbe Hunters was written twenty years before the invention of the first influenza vaccine.)
Maher’s Huffington Post entry also contained several inaccuracies. He argued that polio was on the decline before the vaccine. In fact, in 1943, ten thousand Americans suffered polio; in 1948, twenty-seven thousand; and in 1952, three years before Jonas Salk’s polio vaccine, fifty-nine thousand. Maher claimed that the swine flu epidemic was overblown, again unsupported by the facts. Between April 2009, when swine flu entered the United States, and November 2009, when Maher made the claim, forty-seven million Americans had been infected, more than two hundred thousand had been hospitalized, and ten thousand had died, a thousand of whom were children. Finally, Maher wrote that pregnant women didn’t need the influenza vaccine—his most dangerous advice. Indeed, pregnant women were seven times more likely to have been hospitalized with swine flu than women of the same age who weren’t pregnant.
Maher argued that if most French citizens didn’t believe that a swine flu vaccine was necessary, then it must not be necessary. Ironically, in Religulous, he didn’t extend the same courtesy to those who believe in God. “So, even if a billion people believe something,” he said, “it can still be ridiculous.”
Finally, when Maher wanted to educate himself about vaccines he called on Barbara Loe Fisher (a media-relations expert), Russell Blaylock (a neurosurgeon), and Jay Gordon (an anti-vaccine pediatrician). Not one of his advisors is an expert in immunology, virology, bacteriology, epidemiology, or toxicology. And not one has ever published a single study on the science of vaccines. Whereas Maher argued that science refuted much of what was stated in biblical teachings, he abandoned science when talking about vaccines.
Jenny McCarthy, Jim Carrey, and Bill Maher have used their celebrity to misinform the public about vaccines, putting children at unnecessary risk. Unfortunately, the phenomenon isn’t new. In the 1950s, when epidemiological studies clearly showed that cigarette smoking caused lung cancer, Edward R. Murrow (a broadcast journalist for CBS News) and Arthur Godfrey (a radio and television personality) used their celebrity to argue that the science was contradictory. Both Murrow and Godfrey died of lung cancer.
Although Barbara Loe Fisher doesn’t have a medical or scientific background—and has been unable to provide a biological underpinning for her contention that vaccines cause chronic diseases—the media have viewed her as a credible source of information. She has spoken before congressional subcommittees, served on an FDA vaccine advisory panel, and appeared on well-respected news programs such as ABC’s World News Tonight. Jenny McCarthy, Jim Carrey, J. B. Handley, and Bill Maher, on the other hand, are seen as less reliable, less informed, and less credible by the media. Their voices are heard on anti-vaccine blogs and entertainment television, not at congressional hearings or federal advisory committees. Considered great entertainment, if not somewhat cartoonish, these new antivaccine activists have been relatively marginalized. And things would have stayed that way had not two people stepped forward from an unexpected place—two people no one predicted would have ended up on the other side.
Dr. Bernadine Healy was the director of the National Institutes of Health—the single most respected research organization in the United States—during President George H. W. Bush’s administration. Although most people have never heard of her, they have certainly heard of NIH. And every time Healy speaks out against vaccines, the appellation “former director of NIH” follows. On May 12, 2008, Sharyl Attkisson interviewed Healy on CBS Evening News. Calm, mature, and seemingly well reasoned, Healy did much to discredit those with whom she had previously worked. “This is the time when we do have the opportunity to understand whether or not there are susceptible children [to autism],” she began, “perhaps genetically, perhaps they have a metabolic issue, mitochondrial disorder, immunologic issue, that makes them more susceptible to vaccines. And I think we have the tools today that we didn’t have ten years ago, that we didn’t have twenty years ago, to try and tease that out.” Healy was right that the past decade had witnessed an explosion in techniques likely to reveal the cause or causes of autism. But she was wrong in claiming they hadn’t been used. Quite the opposite. During the past decade, several investigators, using the sophisticated techniques mentioned by Healy, have found several genetic defects in children with autism. Others have found structural differences in the brains of autistic children—differences likely to occur in the womb, not following vaccines.
In her interview with Sharyl Attkisson, Healy continued her attack against vaccines, arguing that children might be susceptible “to a component of vaccines, like mercury. I think the government or certain public health officials in the government have been too quick to dismiss the concerns of these families without studying the population that got sick. We should never shy away from science.” Healy’s rant against public health officials ignored several facts. For one thing, at the time of the CBS Evening News interview, the preservative that contained mercury (thimerosal) had been removed from all vaccines given to young infants. For another, far from being unwilling to study whether parents’ concerns about mercury were real, public health officials and academic investigators had performed many studies to determine whether mercury in vaccines caused autism or other problems. It didn’t. And those studies cost tens of millions of dollars to perform.
Healy concluded her interview by ignoring recent history: “I do not believe that if we identify a particular risk factor that the public would lose faith in vaccines. I think people understand a polio epidemic. I think they understand a measles epidemic. I think they understand congenital rubella. I think they understand diphtheria. Nobody’s going to turn their backs on vaccines. I don’t believe the truth ever scares people.” But some people have turned their backs on vaccines. They’ve turned their backs on MMR vaccine to the point of measles and mumps epidemics. And they’ve turned their back on Hib vaccine at the cost of their children’s lives. The problem isn’t that public health officials haven’t performed stu
dies or tried to educate the press and public. The problem is that certain people in the media, such as Sharyl Attkisson, Oprah Winfrey, and Larry King, have dismissed these studies, choosing instead to scare the public, presumably to enhance the entertainment value of their shows.
Bernadine Healy’s appearances on CBS Evening News, her articles in U.S. News and World Report (where she is an editor), and her statements in newspapers and magazines have had an effect. But Healy’s impact pales in comparison to that of a pediatrician from southern California—a pediatrician who has written a book about vaccines that has influenced a nation.
CHAPTER 10
Dr. Bob
He will look attractive and he will be nice and helpful and he will get a job where he influences a great God-fearing nation and he will never do an evil thing. He will just bit-by-little-bit lower standards where they are important.
—AARON ALTMAN, BROADCAST NEWS
Robert Sears is the son of William and Martha Sears. Together, William, a Harvard-trained pediatrician, and Martha, a registered nurse and lactation consultant, have authored more than forty books on pregnancy, birthing, attachment, breastfeeding, nutrition, sleeping, and discipline—all part of The Sears Parenting Library. Their advice once dominated parenting magazines and the airwaves, the couple having appeared on 20/20, Donahue, Good Morning America, Oprah, CBS This Morning, CNN, The Today Show, and Dateline NBC. Three of their eight children are also doctors, including Jim, who co-hosts the television program The Doctors, and Robert, a pediatrician practicing in southern California.
In October 2007, Robert Sears also published a book. He called it The Vaccine Book: Making the Right Decision for Your Child. Sears’s goal was clear. He wanted to provide what he believed was a gentler, safer way to vaccinate children—a middle ground for parents who wanted to protect their children but were frightened by so many shots. Sears has excellent credentials; he received his medical degree from Georgetown University and his pediatric training from the Children’s Hospital of Los Angeles. Like his father, who prefers to be called Dr. Bill, Robert Sears prefers Dr. Bob. At the end of his book, Sears offers a revised schedule he believes is safer than that recommended by the CDC and AAP. He calls it “Dr. Bob’s Alternative Vaccine Schedule.” For parents looking for a way to delay, withhold, separate, or space out vaccines, Dr. Bob’s schedule is the way to go; many parents bring it to their doctor’s office and say, “This is the one I want.” Sears’s book is so popular, so influential, and so widely quoted that it deserves a closer look.
Many parents are concerned that children are getting too many vaccines too early. (Courtesy of David Gould/Getty Images.)
“[The alternative schedule] gives live-virus vaccines one at a time so that a baby’s immune system can deal with each disease separately,” writes Sears. By implying that an infant’s immune system is easily overwhelmed, Sears appeals to a common fear. When Jenny McCarthy and Jim Carrey led their “Green Our Vaccines” rally in front of the Capitol, parents marched to the rhythmic chant “Too many too soon! Too many too soon!” And it’s understandable. No reasonable parent can watch a child receive as many as five shots at one time and not worry it’s too much. But the fear should be allayed by the science.
Although the number of vaccines given to young children today is more than at any time in history, the immunological challenge from vaccines is lower. A hundred years ago, young children received one vaccine: smallpox. Today, they receive fourteen. But it’s not the number of vaccines that counts; it’s the number of immunological components contained in vaccines. Smallpox, the largest virus that infects mammals, contains two hundred viral proteins, all of which induce an immune response. Today’s fourteen vaccines are made using viral proteins, bacterial proteins, and the complex sugars (polysaccharides) that coat bacteria. Each of these components, like viral proteins in the smallpox vaccine, evokes an immune response. The total number of immunological components in today’s fourteen vaccines is about a hundred and sixty, fewer than the two hundred components in the only vaccine given more than a hundred years ago.
Further, Sears fails to consider that vaccines do not significantly increase the immunological challenge that babies encounter and manage every day. In the womb, the unborn child is in a sterile environment. But while passing through the birth canal, the child immediately confronts millions of bacteria. And that’s not the end of it; the food that babies eat isn’t sterile, nor is the dust they inhale. By the time babies are just a few days old, trillions of bacteria live on the lining of their intestines, nose, throat, and skin. Indeed, people have more bacteria living on the surface of their bodies (a hundred trillion) than they have cells in their bodies (ten trillion). And each bacterium contains between two thousand and six thousand immunological components. Some of these bacteria have the capacity to invade the body and cause harm. To prevent this from happening, every day babies make large quantities of different kinds of antibodies—some of these antibodies pour into the bloodstream (immunoglobulin G), others travel to mucosal surfaces (secretory immunoglobulin A).
Bacteria aren’t the only problem. Babies also encounter a variety of viruses that aren’t prevented by vaccines—for example, rhinoviruses (which cause the common cold), parainfluenza virus, respiratory syncytial virus, adenovirus, norovirus, astrovirus, echovirus, coxsackie virus, human metapneumovirus, parechovirus, parvovirus, and enterovirus. And, unlike vaccine viruses, which reproduce poorly or not at all, these natural viruses reproduce thousands of times, causing an intense immune response. Arguably, a single infection with a common cold virus poses a much greater immunological challenge than all current vaccines combined. And common viruses occur commonly; healthy children experience as many as six to eight viral infections every year during their first few years of life.
When Sears advised giving live viral vaccines separately, he implied that children have a limited capacity to respond to vaccines. So, how many can they respond to? Do the fourteen vaccines young children receive exceed their immunological capacity? The most thoughtful answer to this question comes from two immunologists at the University of California at San Diego: Mel Cohn and Rod Langman, who study the component of the immune system most capable of protecting against infection: antibodies. Antibodies are made by cells in the body called B cells. Each B cell makes antibodies against only one immunological unit called an epitope. Given the number of B cells in the bloodstream, the average number of epitopes contained in a vaccine, and the rapidity with which a sufficient quantity of antibodies could be made, babies could theoretically respond to about a hundred thousand vaccines at one time.
The model isn’t perfect. It assumes that the immune response is static, which it isn’t. Every minute new B cells generated in the bone marrow pour into the bloodstream. So, it would be fair to say that at any single point in time a child could theoretically respond to a hundred thousand vaccines. Given that babies are constantly confronted with trillions of bacteria and that each bacterium contains thousands of epitopes, the notion that children could respond to a hundred thousand different vaccines shouldn’t be surprising. In a sense, babies are doing that every day. The challenge from vaccines is dwarfed by this natural onslaught.
In 2010, in response to the growing fear of so many vaccines given so early, researchers at the University of Louisville performed a study of more than a thousand children. They found that children who were vaccinated completely and on time were not more likely to suffer neurological problems than children whose parents had chosen to delay vaccination.
Sears advises, “It’s probably okay to give the combination MMR booster at age five, when a child’s immune system is more mature.” Because the MMR vaccine is recommended for children between twelve and fifteen months of age, Sears implies that a baby’s immune system isn’t mature enough to respond to vaccines. To the contrary, vaccines given in the first year of life induce an excellent immune response. Probably the most dramatic example is the hepatitis B vaccine. Babies born to mothers w
ith hepatitis B virus are not only at high risk of infection, they’re also at high risk of chronic liver damage (cirrhosis) and liver cancer. The greatest risk comes at the time of delivery. When passing through the bloody birth canal of an infected mother, babies come in contact with an amazing amount of hepatitis B virus; each milliliter (about one-fifth of a teaspoon) of blood contains about a billion infectious viruses—and birth exposes babies to a lot of blood. So it’s no wonder that almost all unimmunized children of infected mothers get infected. But despite the fact that the hepatitis B vaccine is given after exposure, almost all babies are protected. It is rather remarkable that following passage through a birth canal containing literally billions of hepatitis B viruses, a one-day-old baby can mount a protective immune response to a vaccine that contains only twenty micrograms (millionths of a gram) of one highly purified viral protein.
Sears doesn’t discourage parents who want to delay vaccines. Under the heading “Delaying Vaccines Until Six Months of Age,” he writes, “This choice is one that some parents make, usually for the same reasons as those who wait until two years. They just don’t feel as comfortable leaving their child unvaccinated as long. If you’ve chosen to delay shots, whether it’s for six months, one year, or more, you should be aware that your child would not need the entire vaccine series when you do eventually start.” Sears implies that a choice to delay vaccines is reasonable. Unfortunately, he fails to describe the importance of preventing diseases like Hib, pneumococcus, and pertussis, all of which typically appear in the first year of life and all of which can exact a terrible toll. Most mothers have antibodies directed against all three of these bacteria and, while pregnant, pass them to their babies through the placenta. But antibodies from the mother fade, leaving the child vulnerable. Vaccines against Hib, pneumococcus, and pertussis are given at two, four, and six months of age so that when the mother’s antibodies wear off, children will have acquired their own protective immunity. Also, young infants, because they have narrower windpipes, are much more likely to die from pertussis than older infants. By stating that a choice to delay vaccines is acceptable, Sears fails to explain why vaccines are given when they’re given.
Deadly Choices: How the Anti-Vaccine Movement Threatens Us All Page 19