THIS STORY HAS BEEN FORMATTED FOR EASY PRINTING

Anatomy of a panic

How skeptics, media helped a flawed study linking a vaccine, autism gain credence

British researcher Andrew Wakefield’s 1998 paper suggesting that the measles-mumps -rubella vaccine could cause autism has since been widely discredited. British researcher Andrew Wakefield’s 1998 paper suggesting that the measles-mumps -rubella vaccine could cause autism has since been widely discredited. (Alexander F. Yuan/ Associated Press)
By David M. Shribman
Globe Correspondent / January 9, 2011

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In the past decade Seth Mnookin has become a chronicler of some of the icons of American popular culture. He wrote a popular book, “Feeding the Monster,’’ on the ascent of the Red Sox, and a controversial book, “Hard News,’’ on the scandals of The New York Times. Now he is taking on another modern phenomenon, the movement against vaccinations.

“The Panic Virus’’ is sure to attract attention — and the virulent criticism of one of contemporary life’s most ardent insurgencies, those who believe inoculations possess the power to injure. Specifically the book focuses on the scare triggered by a flawed 1998 scientific paper suggesting that the measles-mumps-rubella vaccine could cause autism. The paper, by Andrew Wakefield, has since been discredited, most recently in a report Thursday saying that Wakefield had altered facts in his study. In his book, Mnookin traces the spread of the panic and the role of the media in it.

A new parent himself, Mnookin admits a certain fear of vaccines — but an even greater fear that his child might encounter someone with measles or whooping cough before he gets all his shots. He understands the panic and passion of parents with sick children — but fears that waves of “self-righteous hysteria’’ have the power of overcoming “critical thinking.’’ He knows the limits of science — but believes it should be regarded “not as an ideology but as the best tool we have for understanding the universe.’’

Mnookin’s book is an unsparing brief against the vaccine skeptics. But in a larger sense, this volume is less about the insurrection against inoculations than it is about the democratization of information. It is less about the movement to battle the medical establishment than it is about the ability of social networks to mobilize for what Mnookin and most mainstream scientists and doctors believe is a bad cause. It is less about reasoned debate than about the free flow of information through the Internet. It is less about the contagion of ideas than about the contagion of misinformation and mistrust that metastasizes in the new technology.

And in some ways it is less about the modern autism wars than about cultural resistance to vaccines over the centuries, for in setting forth his argument he provides a history of disease and vaccines that is one of the high points of this volume. We’ve come a long way from the early methods used to combat smallpox, which in 1717 included spreading pus from an infected person onto the open wound of an uninfected person.

But these asides involving medical history are more than a curiosity. They underline the power of humans’ distrust of inoculation, the roots of which Mnookin sees in the American Colonists’ “hair-trigger resistance to anything that was perceived as infringing upon individual liberties.’’ Resistance to inoculation is as American as resistance to oppression — often the rationale summoned in these battles, which combine science and ideology in a toxic brew.

In time, freedom from disease has become an important American freedom. But skepticism of the American medical establishment became (and remains) an important part of the civic landscape, often inflamed, Mnookin contends, by shoddy shock-seeking journalism.

This is Mnookin’s argument: The evidence for the conviction that vaccines are dangerous is sketchy — a medical problem. The paroxysms and panics were appealing to document — a journalistic problem. Journalists — not all, but enough — are drawn to the dramatic, to the romance of lone-wolf skeptics tilting against well-established assumptions taught in well-established institutions by well-established practitioners.

Plus this: Science has not exactly been infallible. These code words speak volumes — Bhopal. The Challenger. Love Canal. Three Mile Island.

The notion that autism is a form of mercury poisoning has been persistent in recent years, and proponents of this view have taken a position with a built-in defense mechanism:

“Instead of trying to collaborate with the scientific community, their real goal was to get officials to admit they’d been wrong — and when they didn’t, that refusal only served to confirm their suspicions of a broad, international conspiracy.’’

Fueled by activists and parents convinced of “the dangers of vaccines and the venality of the medical establishment,’’ the movement of vaccine skeptics produced “a growing sense of distrust and paranoia.’’ One of Mnookin’s chapter titles summarizes his argument: “How to Turn a Lack of Evidence into Evidence of Harm.’’

One important result was a merger of vaccine skeptics and autism activists and the growth of a narrative and conspiracy theory that considered inoculations a threat to the public health rather than a means of protecting the public health. “By 2005,’’ Mnookin writes, “a preoccupation with vaccine safety and an opposition to traditional institutions were viewed by an ever-growing number of ‘autism advocates’ as prerequisites for membership in their community.’’

Another result is the decline in vaccinations in many communities, especially those with a liberal orientation and high incomes. Ashland, Ore., has a vaccine exemption rate of about 30 percent. The rate of people not vaccinated in California’s Marin County, one of the wealthiest in the nation, is three times greater than that of the rest of the state.

Mnookin compares the vaccination opponents to those who don’t believe in global warming or evolution. And he blames the media for tolerating misinformation and validating “the notion that our feelings are a more reliable barometer of reality than the facts.’’ The ironic thing about Mnookin’s book is that he implicitly summons his profession to the admonition from the Book of Luke addressed to physicians: Heal thyself. This book is Mnookin’s effort to begin the healing process.

David M. Shribman, executive editor of the Pittsburgh Post-Gazette, can be reached at dshribman@post-gazette.com.

THE PANIC VIRUS: A True Story of Medicine, Science, and Fear
By Seth Mnookin
Simon & Schuster, 448 pp., $26.99