PEDIATRICS Vol. 122 No. 4 October 2008, pp. 871-872 (doi:10.1542/peds.2008-2275)
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COMMENTARY |
New Book About Vaccine Safety
Division of Infectious Diseases, Vaccine Education Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Today, more than ever before, parents are concerned about the safety of vaccines. Fear of vaccines has been fueled by information provided on television programs, in newspaper and magazine articles, and on the Internet. Much of this information is based on opinions that are unsupported by scientific evidence. As a result, some parents are choosing to withhold, separate, or space out vaccines. The consequences of delaying vaccines have been predictable; recent outbreaks of diseases such as pertussis and measles have centered on communities where parents have chosen not to vaccinate their children.1,2 Doctors, scientists, and public health officials, alarmed by the trend, have tried to counter the flood of misinformation, but their voices have often been drowned out by the journalistic drumbeat of balance, representing both sides of a controversy even when only one side is supported by scientific evidence.
With the book Do Vaccines Cause That?! A Guide for Evaluating Vaccine Safety Concerns, Martin Myers and Diego Pineda step into the fray.3 Myers is the director of public health policy and education at the Sealy Center for Vaccine Development at the University of Texas Medical Branch and the executive director of the National Network for Immunization Information (NNii). Pineda is a science writer and associate editor at the NNii. Together, they have written the single best stand-alone resource for parents who are concerned about the safety of vaccines and for health care professionals who are looking for a way to answer parents' questions.
The book's chapters progress logically. First, the authors make a case for the necessity of vaccines, recognizing that most vaccine-preventable diseases are rarely seen and, therefore, are no longer compelling. Second, the authors describe the psychology of decisions made under uncertainty and compare the risks from vaccines with other risks, such as driving to the pediatrician's office. Third, in a chapter titled "Missing Information and Technical Jargon: Why Can't Medical Researchers Talk Normally?!," they describe differences between what scientists mean when they use certain words or phrases and how parents perceive their meaning. (An extensive glossary of scientific terms is also included as an appendix.) Fourth, in one of several chapters that make this book unique, the authors provide a method by which parents can evaluate scientific information and separate causal from coincidental associations. Fifth, in a manner similar to Robert Park's Voodoo Science: The Road From Foolishness to Fraud,4 the authors provide several tips on how to recognize junk science and those who represent it. Again uniquely, in a section titled "Argument Against the Person (the ‘Ad Hominem’ Fallacy)," the authors confront the weapon of conflict of interest, often used to denigrate those who stand up for good science. Sixth, the authors direct parents to resources that are most likely to provide accurate, up-to-date information and offer tips on how to separate resources that are science based from those that are pseudoscience based.
These first 6 chapters are unflinching. Myers and Pineda trust their readers by describing in vivid detail serious adverse events that, although rare, were clearly caused by vaccines, such as vaccine-associated paralysis caused by Sabin's live, attenuated polio vaccine; pneumonia exacerbated by an experimental respiratory syncytial virus vaccine; intussusception caused by a rotavirus vaccine available in the late 1990s; and paralysis and death caused by an inactivated polio vaccine made in the mid-1950s, one of the worst biological disasters in our country's history. Similarly, the authors bravely name names when discussing the politicians (Dan Burton), activists (Robert F. Kennedy, Jr), journalists (David Kirby, Edward Hooper, and Dan Olmstead), and doctors (Andrew Wakefield and Mark Geier) who have misrepresented vaccine science to the public.
In the second half of the book, the authors examine vaccine safety issues individually, addressing concerns that vaccines might cause asthma, autism, diabetes, Guillain-Barré syndrome, multiple sclerosis, inflammatory bowel disease, arthritis, Gulf War illnesses, macrophagic myofascitis, encephalopathy, encephalitis, sudden infant death syndrome, cancer, AIDS, birth defects, and mad cow disease. The chapter on asthma is typical of the authors' clear, critical, and compelling thinking. Section subheadings include: "What is Asthma?"; "What Causes Asthma?"; "Missing Information and the Asthma Epidemic" (which describes possible contributions from obesity, tobacco smoke exposure, and the hygiene hypothesis); "Asthma and Vaccines" (which summarizes the epidemiologic evidence); and "The Bottom Line" (which proffers a conclusion).
In Do Vaccines Cause That?!, the authors have followed ancient teachings. Somewhere between the 4th and 6th century BC, Lao Tzu, the founder of Taoism, wrote, "Give a man a fish; feed him for a day. Teach a man to fish; feed him for a lifetime."5 By providing parents with information that they need to make decisions today, as well as educating them on how to analyze and interpret misinformation in the future, Myers and Pineda have provided a timeless resource. Every pediatrician who sees parents who are concerned about vaccines and every parent who seeks accurate information about vaccine safety should read this book.
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FOOTNOTES |
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Accepted Jul 31, 2008.
Address correspondence to Paul A. Offit, MD, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Division of Infectious Diseases, Vaccine Education Center, Abramson Research Building, Room 1202D, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104. E-mail: offit{at}email.chop.edu
Financial Disclosure: Dr Offit is a coinventor and co–patent holder of the human-bovine reassortant rotavirus vaccine, RotaTeq.
Opinions expressed in these commentaries are those of the author and not necessarily those of the American Academy of Pediatrics or its Committees.
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REFERENCES |
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 TOP REFERENCES |
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1. Omer SB, Pan WKY, Halsey NA, et al. Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence. JAMA. 2006;296 (14):1757 –1763
2. Feikin DR, Lezotte DC, Hamman RF, et al. Individual and community risks of measles and pertussis associated with personal exemptions to immunization.
JAMA. 2000;284
(24):3145
–3150
3. Myers MG, Pineda D. Do Vaccines Cause That?! A Guide for Evaluating Vaccine Safety Concerns. Galveston, TX: Immunizations for Public Health; 2008
4. Park R. Voodoo Science: The Road From Foolishness to Fraud. Oxford, England: Oxford University Press; 2000
5. Lao Tsu quotations. Available at: www.brainyquote.com/quotes/quotes/1/laotzu121559.html. Accessed August 21, 2008
PEDIATRICS (ISSN 1098-4275). ©2008 by the American Academy of Pediatrics
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