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.

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City Beat

Unnatural Progress - Jan. 24, 2007

Cincinnati native investigates the history of vaccination

By Stephen Paul Lansky

Cincinnati native Arthur Allen now lives in Washington, D.C. He has become a widely published and respected journalist who covered the war in El Salvador in the 1980s and spent time in Paris and later Germany in the '90s. He has followed stories about ideological and political conflict, including a powerful op-ed piece for The New York Times about Cincinnati's civil unrest in 2001. Since then he's written about public health for Salon and The Atlantic Monthly. His first book, a history of vaccination, Vaccine, is a vast, meticulous exploration of this topical and vital public health policy issue. As an authoritative history, it might serve as a resource to medical professionals while also shaping the public policy debate.

The shades of meaning employed by both sides of a public health controversy chime and wave, as if bells are tolling and flags are being hoisted. Most pointed are the comments concerning how Western political structures interact with the public when military interests shape disease control.

Once the narrative reaches mid-20th century postwar New York, Allen's prose on voluntary mass inoculation rings with patriotism: "Neither parade attendance nor vaccination were duties that could be shirked." Allen's control works behind the reader's eyes, tugging at the bones of the face, pulling muscles long dormant.

Early in the history Allen shares a country rhyme about milkmaids' clear complexions, which seems to contain a powerful grain of wisdom. Edward Jenner's discovery of cowpox and subsequent invention of the smallpox vaccine might have evolved from folklore. In detailing Jenner's 18th-century discovery, Allen's terse, direct delivery puts opposing positions fairly: "Vaccination was unnatural. It was progress."

Yet it's the ongoing saga of compulsory applications of medical science that is discussed recursively. He shares layers of pointed rhetoric, piling up medical officialdom's frustration in contrast with the stamina of the opposing less logical, less persuasive presentations of a strange coalition that has its own reasons for fearing and shunning science at its most compassionate fringe -- a fringe that by stages takes the mainstream -- as the history progresses.

Allen describes the early 20th-century laws swinging back and forth with lives and morality at stake, then he seems to vilify the health food movement, the New Age Luddites and the homeopaths, because the alternative here is better. Allen sees government by majority as a safety valve where compulsory vaccination is concerned.

His views on court decisions are nuanced -- circular logic is unveiled and named. A person cannot always be fully expected to understand medical advancement but can know that sickness is not weakness. Further, sickness does happen to individuals despite their relation to God or even to those who disdain belief.

The development of medical science from the earlier understanding of illness stands in stark relief to this reflection on Cotton Mather's early 18th-century Boston: "Disease, like a spiritual journey, was a passive experience. Disease states, like visions, were visited upon people."

CityBeat recently spoke to Allen about his illuminating new book.

CityBeat: Is there anything good about disease? Arthur Allen:

A lot of natural medicine folks talk about a "healing crisis," and I think I understand that. Sometimes when my son Ike and daughter Lucy got sick as babies, after they recovered they seemed to make a leap in their development. That's purely "anecdotal" and when I've talked about it with some friends they haven't experienced the same thing. But it stands to reason that our immune systems are designed to deal with germs and that the immune system develops, and probably kicks off other developmental processes, as part of the process of illness.

When I asked scientists whether they thought it would be bad if all exposures to germs were avoided, they generally agreed. But that won't happen, they hasten to add. The question is, which is the germ that you need? Smallpox? No. Measles? I don't think so. Polio? No. Haemophilus influenzae type B, which causes meningitis? I don't think so.

Yet every day we are bombarded with dozens of types of microorganisms against which there is no vaccine protection. They continue to prime our immune systems. There's no way that medicine can totally prevent infections, so the question of whether it would be good to avoid all disease is theoretical only. There's no real absolutism here except as a really fascinating philosophical exercise.

CB: When the military and the "military industrial complex" provides a mobilization that is a means to quarantine and inoculate against disease, isn't that a sort of ridiculous paradigm? Saving lives so that killing for some political, economic or religious purpose can be carried out more effectively? AA:

It's another paradox. That's why the chapter title is "War Is Good for Babies." Obviously it's not meant literally. Yet there are ways in which military technology drives improvements in society, vaccines being an example -- not only in that these vaccines were tried out successfully on soldiers, but that the nation's consciousness about trust in medicine was altered by this successful encounter.

CB: When doctors deny and hide their failures, they invite opposition. And when they

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