The Panic Virus: By doing nothing we are doing something

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The Panic Virus: A True Story of Medicine, Science, and Fear by Seth Mnookin

“Those who cannot remember the past are condemned to repeat it.”

Wise words from George Santayana, US philosopher and poet (in Life of Reason, ‘Reason in Common Sense,’ ch. 12). William L. Shirer made these words the epigraph for his Rise and Fall of the Third Reich (1959).

Seth Mnookin’s just released The Panic Virus is about the autism – MMR vaccine controversy. But there are compelling reasons for all participants involved in the debate about genetically modified organisms to read it.

We should all strive to fully understand how we can avoid the mistakes of the past. We should all try and do no harm. And in Panic Virus there are instructive lessons for both sides of the vaccine and the GMO debates that can help us all avoid doing harm. To borrow Paul Offit‘s aphorism, we all need to remember that by doing nothing we are doing something. By attempting to stop remedies for great ills we can do enormous harm. Tragically, the anti-vaccine crusade, despite being undoubtedly driven by the best of intentions to do good, has caused the resurgence of measles and whooping cough and many unnecessary infant deaths. These are genuine and horrible consequences of not using vaccines which demand careful attention to the full scientific evidence by all involved in public communication on these issues, especially communication through the internet. In the GMO debate, this vaccine history should make us all pause to consider the harmful consequences of not using new crops such as Golden Rice, which also promise, like vaccines do, to save infant lives.

The numerous instructive parallels — between the history of vaccine misadventures as laid out in impressive full detail by Mnookin, and the ongoing and unfinished public controversy about newer agricultural technologies — are uncanny. In both cases, persistent myths circulate widely with the help of the Internet, aided by lazy and credulous journalism, and active disemination of the myths is driven by zealous coalitions of ordinary citizens who convinced about the existence of an alleged evil conspiracy between greedy scientists and corporations which according to them, does great harm.

In the vaccine debate, the “Public Health Community” and the Center for Disease Control take the place of Monsanto, the super-bad guy of the GMO debate.

Yes, dear reader, you read that right. The “Public Health Community” are EVIL in the eyes of the more-extreme anti-vaccine zealots.

And in the vaccine debates (as with GMOs), there are a small cadre of renegade scientists who put forward shoddy experiments, then read into them flawed, controversial and dangerous speculations. This low quality science then circulates endlessly in the echo-chambers of the closed communities of the internet which also give any dissenting voices fusilades of anonymous personal abuse. The small cadre renegrade scientists then move on to become heroes of the antitechnology coalitions, while at the same time providing no credible arguments that are accepted by their peers. There is even a Vaccine Roulette to go with Genetic Roulette.

A particularly good illustration of the similarities between the vaccine story and the big food fight  is provided by the actions of Andrew Wakefield, a disgraced medical scientist with a retracted publication from the Journal Lancet, and a central figure in the tragic story outlined in Panic Virus. Wakefield has written a book to defend himself called Callous Disregard: Autism and Vaccines: The Truth Behind a Tragedy. It has (thanks to his energetic supporters) fabulous reviews at Amazon.com, together with a scathing rebuttal which is reproduced below:

One star review at Amazon.com of Callous Disregard from May 28, 2010: An Unsuccessful Attempt at Damage Control by Harriet Hall

Dr. Andrew Wakefield was almost single-handedly responsible for frightening the public about a possible association between autism and the MMR vaccine. His alarmist recommendations directly led to lower vaccination rates and a resurgence of measles to endemic levels in the UK. His 1998 article in The Lancet was retracted by 10 of his 12 co-authors, and then was “fully retracted from the public record” by The Lancet. He lost his license to practice medicine for unethical behavior. Other scientists attempted to replicate his research findings and failed. The scientific community reached a clear consensus that Wakefield’s research was flawed and that the evidence shows no link between MMR vaccine and autism.

There was only one way left for him to fight back: to write a book. It boils down to self-serving apologetics and misleading rhetoric.

The book makes claims that are demonstrably untrue. It says anaphylaxis from the vaccine is a serious concern and that the mortality rate from MMR vaccines approaches the pre-vaccination mortality rates for measles. But in an Australian study of 1.7 million school children vaccinated with MMR, there was only one anaphylactic reaction and no deaths. And before the introduction of vaccines, measles used to kill 100 people in the UK every year, while there is no evidence that the MMR vaccine ever killed anyone.

He claims that the US vaccine court has been compensating for cases of vaccine-caused autism and secretly settling cases out of court. Not true. In reality, the vaccine court has evaluated the best test cases lawyers could come up with and has determined that there is no evidence for vaccines causing autism.

He says his findings of a new gastrointestinal syndrome related to measles virus and autism have been replicated around the world. They have not.

Wakefield does not recognize that he has done anything wrong. Instead, he throws wild accusations at everyone else. He still doesn’t understand what was wrong about paying children to let him draw blood samples at his son’s birthday party. He doesn’t even have the decency to apologize for making fun of the children in public, joking about them crying, fainting, and vomiting.

The book fails to address many items from the long list of criticisms that have been leveled against Wakefield, and his excuses for the items it does cover are unconvincing. In my opinion, it amounts to an embarrassing, tedious, puerile, and ultimately unsuccessful attempt at damage control. Wakefield has been thoroughly discredited in the scientific arena and this appeal to the public arena does nothing to rehabilitate him.

[Pundit’s Note: But it is reader comments to this review that exemplify the striking parallels between the vaccine debate and the GMO debate:]

Reader Comment on Harriet Hall’s review, written on May 31, 2010 by Clara Corbin:

Written like a true Merck representative. Why don’t you reveal yourself and the vested financial interest you have in protecting vaccines. Dr. Wakefield’s findings have indeed been replicated, by no fewer than five major studies around the world. You are the one telling big whoppers here, not Wakefield.

In reply to an earlier post on May 31, 2010, J Donahue says:

Dr. Hall has revealed herself – that is her real name. You can read more about her and her lack of conflict of interst [sic] here: http://www.sciencebasedmedicine.org/?author=7 and http://www.skepdoc.info/.

What “five major studies around the world” have replicated Wakefield’s findings?

Then we have a minority review on a professional vaccine text that’s typical of the internet abuse routinely seen meted out to any people who speak out positively about food GMOs.

This review is from Vaccines: Expert Consult by Stanley A. Plotkin MD, Walter Orenstein MD, and Paul A. Offit MD.

Comment titled “One sided Pro vaccines book, not a balanced” one on June 4, 2010 by “Truth Wins” of Charlotte, NC:

This one sided Pro vaccines book is co authored by Vaccine billionaire [sic] Paul Offit who has many conflicts of finalcial [sic] interests with Vaccine manufacturers. Totally waste of money to buy this book, waste of time to read this book.

The point about this excursion into vaccine controversies is, that if we are to gain wider community  understanding of GMO food crops, and make progress in the debates about them, we need first to learn from the existing lessons of history. In Panic Virus we do indeed have a rich history lesson. Besides that, Panic Virus is arguably the most significant readable and well researched book on scientific controversies published this century, a gripping and richly thoughtful saga that held my interest right to the end. It inspires great hope about the eventual outcome of both the tragic misadventures with vaccines, and food crop GMOs.

Book review by David Tribe Ph.D.

The Panic Virus: A True Story of Medicine, Science, and Fear, available as The Panic Virus: Fear, Myth, and the Vaccination Debate, from local Australian publisher Black Inc Inc, with a tragic and compelling Australian Preface.

“Seth Mnookin shows us just how dangerous it can be when emotion drives good people to abandon critical thought.” – Peter Doherty winner of the Nobel Prize for Medicine.

Other relevant literature

Stanley Plotkin, Jeffrey S. Gerber and Paul A. Offit (2009) Vaccines and Autism: A Tale of Shifting Hypotheses. Clinical Infectious Diseases Volume 48, Issue 4 P. 456-461

Although child vaccination rates remain high, some parental concern persists that vaccines might cause autism. Three specific hypotheses have been proposed: (1) the combination measles-mumps-rubella vaccine causes autism by damaging the intestinal lining, which allows the entrance of encephalopathic proteins; (2) thimerosal, an ethylmercury-containing preservative in some vaccines, is toxic to the central nervous system; and (3) the simultaneous administration of multiple vaccines overwhelms or weakens the immune system. We will discuss the genesis of each of these theories and review the relevant epidemiological evidence.

Dr. Paul Offit: Polarizing Figure Only On The Fringe
by Kim Wombles, 31 January 2011 on Science 2.0

Dr. Paul Offit is the Hillary Clinton of the autism world. Or is he? It seems really unfair that a well-respected pediatrician and infectious disease expert who has devoted his career to saving lives is the recipient of the vitriol that places like Age of Autism and people like its editors and followers heap on him, all because he has the courage to stand up to their intimidating tactics and speak out honestly about vaccines. He’s one of the first to admit that vaccines have caused damage; he writes openly and honestly about the live polio vaccine causing polio, about Cutter laboratories.

He writes eloquently of the role that concerned parents and consumers can have in calling for safer vaccines, in more vaccine research to minimize the unfortunately occasional severe side effect (like the Sabin polio vaccine had in infecting six to eight kids per year in the US with polio rather than preventing the disease (page 58 of Deadly Choices).

GMO Pundit Post: First Voodoo Science, Now Voodoo History

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David Tribe is an applied geneticist, teaching graduate/undergrad courses in food science, food safety, biotechnology and microbiology at the University of Melbourne.