Book Reviews – Vaccination: Facts Alone Do Not Policy Make

Health Affairs
June 2011; Volume 30, Issue 6

Strategies For The ‘Decade Of Vaccines’
Book Reviews
Vaccination: Facts Alone Do Not Policy Make
Deadly Choices: How The Anti-Vaccine Movement Threatens Us All by Paul A. Offit New York (NY): Basic Books, 2011 288 pp., $27.50
The Panic Virus: A True Story Of Medicine, Science, And Fear by Seth Mnookin New York (NY): Simon and Schuster, 2011 488 pp.; $26.99

Arthur Caplan

If biomedical scientists, physicians, or experts in health policy were asked what they base their clinical or policy recommendations on, one would probably hear references to facts, data, evidence, and confirmed findings. Little would be said about values—but they must be at the center of any discussion. These two books make this point clearly.

Evidence-based medicine began as an effort to identify and examine regional variations in clinical practice with the goal of increasing safety and efficacy. The field has evolved into a full-fledged ideological movement that demands that clinical practice and policies rest on solid, objective evidence for their warrant and reimbursement. 1 Evidence surely is necessary and desirable in trying to decide what to do about health care at the bedside, in the legislature, or in the boardroom. But it is not sufficient. 2 Nowhere is this more in evidence than in the running battle about vaccination in the United States.

Two recent books lay out the facts about vaccine efficacy and safety. One, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, is by Paul A. Offit, a physician and infectious disease expert at the Children’s Hospital of Philadelphia. The other, by writer and editor Seth Mnookin, is The Panic Virus: A True Story of Medicine, Science, and Fear.

Offit does yeoman’s duty in showing that worries about vaccine safety rest firmly on a vast pile of nonsense, duplicity, hype, and deeply flawed science. He tracks the history of vaccine opposition from its start among the conscientious objectors to smallpox vaccine in Britain in the nineteenth century down to the gaggle of celebrities and media lights who lead the movement today. If you want a solid grasp of the worries, fears, misunderstandings, and ideology that have inspired a small minority of people to vocally oppose …