Campaign for the American Reader: Pg. 69: "Vaccine"

Arthur Allen is a Washington-based journalist who has written for the New York Times Magazine, The New Republic, the Washington Post, The Atlantic, Slate and Salon.

His new book is Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver.

I asked him to apply the "page 69 test" to the book; here is what he reported:

Congratulations, Number 69. You are an exemplary digit to fall upon the paradoxical issues of vaccination that run through my book, Vaccine.

Sixty-nine is the final page of chapter 2,"The Peculiar History of Vaccinia," which describes the bizarre history of smallpox vaccine from the time that Edward Jenner discovered it in 1796 until a century later, when states began imposing mandatory vaccination in the United States. It concludes with the following paragraph:

Having struggled for half a century with compulsory vaccination, Britain made peace with the antivaccinators by essentially surrendering to them. In the United States, compulsory vaccination was only beginning, and so was the struggle over it. There was no federal vaccination law, but as the public health movement grew, state laws tightened, and many cities began excluding unvaccinated pupils from schools. These laws and practices galvanized the previously passive resistance to immunization. The more the public resisted, the more stridently the newly empowered public health officials defended the vaccine. The smarter among them understood the need for improvement in smallpox vaccination. Vaccines were unreliably available, of uncertain origin, and difficult to make safe. They did not always offer good protection. But medicine was not powerful enough to be self-critical, so it persisted in its blinkered unanimity: whatever the dangers and drawbacks of vaccinating, it had to be done, unquestioningly. With a single voice, public health cried, "Vaccinate! Vaccinate!"

Sound familiar? It will if you are a parent or a public health official or anyone who has followed the recent history of vaccine controversies. As I write (Feb. 3, 2007), my New York Times carries the announcement that Texas has become the first state, amid much controversy, to require that girls 11 and 12 years old be vaccinated against human papilloma virus, which causes cervical cancer. Not surprisingly, the Christian right is up in arms, accusing Governor Perry of being a shill of the pharma industry. No doubt Merck, which is racing to sell its HPV vaccine before competitor GlaxoSmithKline comes out with its version later this year, has been lobbying hard for mandatory use of the vaccine. On the other hand, it’s clear – and will be to anyone who reads my book – that vaccines against infectious diseases like HPV do not do the job they’re designed to do until they are giving to a large percentage of the population, something that, in our country at least, is only achieved through coercion of some kind. There’s something about vaccines that creeps people out – always has been, since Cotton Mather’s time (he brought the first form of smallpox vaccination to the Colonies, in 1721). Like Mather’s "Wonders of the Invisible World" they can achieve great things, yet are often accused of subterranean mischief in the human body.

Many thanks to Art for the input.

Among the praise for Vaccine:

Arthur Allen's fantastic new book Vaccine ... is more entertaining than any book about shots has a right to be.
--David Plotz, author of The Genius Factory: The Curious History of the Nobel Prize Sperm Bank

As more children go unvaccinated in the United States, there has been a rise in vaccine-preventable diseases. Meanwhile, fewer pharmaceutical companies are now producing vaccines, citing the high cost of testing, diminishing markets and a fear of litigation. For Allen, a reversal of these trends will require something long overdue: a frank national discussion about the risks and benefits of vaccination. His splendid book is a smart place to begin.
--David Oshinsky, author of the Pulitzer Prize-winning Polio: An American Story, New York Times Book Review

Allen's comprehensive, often unexpected and intelligently told history illuminates the complexity of a public health policy that may put the individual at risk but will save the community. This book leaves the reader with a sense of awe at all that vaccination has accomplished and trepidation over the future of the vaccine industry.
--Publishers Weekly

This compelling narrative of the vaccine's undoubted triumphs and troubling challenges is highly recommended to serious readers interested in medicine and public health.
--Library Journal

Allen deftly maneuvers as he wrangles myriad aspects of a very complicated issue into a comprehensible text.
--Booklist

The vaccine debate has been raging for hundreds of years, because immunizations have a long and complicated history of both saving our lives and hurting us. We needed a book that laid out the history and made sense of it. There have been at least twenty books on smallpox and polio alone. But until Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver, by the science journalist Arthur Allen, no book had so carefully and clearly catalogued the history of immunization.
--Rebecca Skloot, Columbia Journalism Review
Allen['s] … analysis of the current state of anti-vaccine sentiments in the United States … alone is well worth the price of admission. With genuine panache, Allen describes the "legislative jihad against vaccines" led by Rep. Dan Burton (R-Ind.), as well as the mind-boggling array of political and religious forces that have, over the last decade, claimed child vaccination to be responsible for everything from brain disorders and autism to causing the very diseases the products are designed to prevent.
--Laurie Garrett, author of Betrayal of Trust: The Collapse of Global Public Health, Washington Post
[T]his is a well-researched portrayal of immunisation, from the earliest pioneers to an arm of preventive medicine now thoroughly entangled in politics, commerce and public relations. A vivid corrective to the idealised, wholly triumphant version of the development of vaccines.
--New Scientist

The bottom line of Art's recent New York Times article, "For the Good of the Herd:"

We don't know whether the deadly avian flu virus, which has claimed a small number of victims in Asia and Africa, will evolve in a way that allows it to sweep across the globe. But the experts are certain that it is only a matter of time before a flu pandemic strikes. Keeping the vaccine pipeline running and building immunity against all types of flu will help us prepare. Even in apparently humdrum flu years like this one, it behooves us to join the herd and be vaccinated.

For a fuller treatment of Texas Governor Perry's recent decision to vaccinate girls against human papilloma virus, see Art's Op-Ed, “Idea behind the decision is sound, but Perry's timing is off,” in the Dallas Morning News. For background, see his June 2006 article in Slate, "And Now, the HPV Vaccine."

Read Arthur Allen on the problems with animal testing, whether SARS was a fire drill for the avian flu, and why there's no autism epidemic.