Vaccination has greatly diminished death, illness and suffering in the world. But no other medical technology has been so dogged with controversy. The book chronicles the development of the key lifesaving vaccines since the 18th century. It tells the stories of great scientists and their discoveries, of the protests and pain along the stumbling path of progress. This is the first book to tell the whole story of vaccination for a general audience. In light of controversies about flu vaccine and autism, it will be of particular interest to parents, pediatricians, public health workers and anyone fascinated by medical history. Read More>>

Also Available: Table of Contents and Index

Arthur Allen is a Washington DC-based journalist who has written on vaccine issues in The New York Times Magazine, the Washington Post Magazine, The New Republic, Atlantic Monthly, Salon and Slate.


San Francisco Chronicle

At first glance, the title of Arthur Allen's "Vaccine: The Controversial Story of Medicine's Greatest Lifesaver" seems a little contrived. I mean, how controversial can vaccines really be? A few Band-Aids and lollipops when we're kids, and polio disappears. But in this far-reaching work, Allen, a Washington journalist who has written about the subject for the New York Times, the Washington Post, the New Republic and the Atlantic, shows that those tiny syringes actually represent centuries worth of science, religion, politics and war.

In a world of hyper-specialized medicine, Allen's account of the early days of vaccine discovery has an enjoyable, "greatest generation" feel. He dusts off characters from grade-school history class to conjure a time when giants roamed the earth and wiping out all disease was seen as a noble and attainable goal. Unfortunately, the nostalgia is quickly replaced by the disquieting knowledge that the good old days weren't that good.

"Vaccine" is an exhaustive, and at times exhausting, account of seemingly every religious figure, scientist, politician, school principal and anti-vaccine activist who ever held an opinion on the matter. The book's real value lies not in its details, however, but in the difficult philosophical questions it raises, questions as relevant today as they were when Benjamin Franklin fought over them almost 300 years ago.

What is the individual's duty to society? As Allen points out, vaccination is the first obligation the state imposes on our children; unless a legal exemption is obtained, they can't enter school without them. Most people would agree this is a good thing -- that the individual risk of vaccination is small compared with the overall improvement in quality of life it provides. But, in order to help your neighbor, should the government pressure you to ingest a substance to which you may be morally opposed?

And does immunization constitute an attempt by the government to influence our morality? This question recently came to the fore with the U.S. Food and Drug Administration's approval in June of a vaccine against human papilloma virus -- a sexually transmitted virus with certain subtypes causally linked to cervical cancer -- but it was also an issue when the government was deciding whether to make the vaccine against hepatitis B -- a virus linked to liver cancer that is also spread through blood and bodily fluids -- part of the required schedule of vaccinations.

The argument that a teen girl should not be given a simple shot that may prevent her from getting cervical cancer later in life because it might promote promiscuity is as absurd as saying seat belts should be removed from vehicles because they promote reckless driving. But what if the government made the vaccine, or a similar one, mandatory for people based on sexual orientation? Or a woman was told she couldn't receive government assistance without receiving it?

Like most topics having to do with health and behavior, there are no easy answers. Allen clearly doesn't have much patience for the pseudoscience and predatory zeal with which many anti-vaccine activists use grieving parents of autistic children to push their agendas, but he presents a fair analysis of why the anti-vaccine movement has been so successful.

He rightfully points out that mainstream medicine doesn't do a good job of giving meaning to illness, something people desperately need when there is no explanation or cure. As a mother of a child who died of sudden infant death syndrome says, "If someone dies, there's a reason," and the holistic approach of anti-vaccine proponents provides that reason. Whether or not the trace amounts of mercury in vaccines contributed to her child's death, her conviction that it did has a real impact on the health of her community when she persuades others not to get vaccinated.

"Vaccine" makes it painfully clear that science is very malleable and that people tend to shape the facts to conform to their worldview rather than the other way around. Is President Bush's making a photo op out of getting vaccinated against smallpox in 2002 -- thereby using dubious germs of mass destruction to support his case for war against Iraq -- any more or less shameful than the people in Colorado who frame their anti-vaccine beliefs as a simple "alternative lifestyle choice" while they trigger pertussis (whooping cough) outbreaks that kill children?

Odds are that you'll finish "Vaccine" with more questions than answers, but Allen's detailed lessons in history, statistics, immunology and cultural theory will give you the tools to tackle them. Even more important, they'll cause you to ask some new ones you've never thought of before.

--John Vaughn is a writer and physician in Columbus, Ohio.


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