Medical nihilism and the HPV vaccine
ON APRIL 1, 1954, Walter Winchell took to the airwaves, as he did every Sunday, and told millions of Americans that the polio vaccine, then still in testing, "may be a killer." This was no April Fool's joke. Winchell was responding to a tip from Paul de Kruif, the author of "Microbe Hunters," that some live -- and therefore dangerous -- polio virus had been found in batches of the vaccine that were about to be tested in trials across the country.
Winchell's power was evident: Washington, D.C., which had planned one trial, decided not to give the killed-virus vaccine. In other areas, parents withdrew their children from planned trials.
So was Winchell right?
In fact, some children did become infected as a result of taking the vaccine, as Paul Offit details in "The Cutter Incident." On balance, however, the benefits by far outweighed the risks. The Salk vaccine cut the risk of polio by 96 percent and prevented thousands of cases of the disease.
What the Winchell episode foretold, however, was the rise of a kind of medical nihilism. Society has somehow swallowed the idea that it's not disease that's killing us, it's drugs and the evil drug companies that make them.
To parents of the 1950s watching their children and their friends become paralyzed by polio, the infinitesimal risks inherent in a vaccine were tolerable. Today, we seem to have forgotten the existence of so many diseases that maim and kill -- polio, measles, mumps, rubella -- that no degree of risk due to medical treatment are acceptable.
Pharmaceutical companies have committed sins that should prompt skepticism and criticism. But the nihilists have held up progress too much. Sometimes well-intentioned, other times motivated by their own financial interests -- selling scientifically unproven "natural" remedies, or filing huge lawsuits, while railing against Big Pharma -- the nihilists are often scientific illiterates on the hunt for new drugs to scapegoat. And that is how the lifesaving measles-mumps-rubella vaccine becomes falsely accused of causing autism.
We are watching the same thing happen with Gardasil,
But the nihilists have a response for that too: "It reinforces our concerns that we know too little about the epidemiology of this disease in this country," Barbara Loe Fisher, president of the National Vaccine Information Center, an advocacy group, told The New York Daily News. (To save the nihilists some time: The study was funded and carried out by the Centers for Disease Control and Prevention, not Merck.)
The situation is even worse when it comes to the developing world. In 1998, the FDA approved Rotashield, a vaccine for another infection, rotavirus, which causes debilitating diarrhea. Soon thereafter, the vaccine was linked to a serious side effect that affected a small number of people. In the West, there is little risk of death due to rotavirus, so
The nihilists don't get that. Their power over public opinion sank proposals to have the World Health Organization promote the vaccine. As a result, hundreds of thousands of children will die -- deaths that could have been prevented. A new vaccine by Merck was approved last year, but its story is likely to follow the same trajectory, as there have been reports of the same side effect after use of that vaccine.
The power of the nihilists also means that vaccine development is woefully underfunded, both by federal agencies and drug companies. Perhaps as a kind of penance, Winchell founded the Damon Runyon Cancer Research Foundation in 1946 after his friend Runyon died. If the nihilists want to benefit humanity, let's see them pony up even a fraction of the kind of money the foundation has spent on cancer research.
Dr. Ivan Oransky is deputy editor of The Scientist. 
