Deadly Choices: How the Anti-Vaccine Movement Threatens Us All - Paul A. Offit (2010)
Chapter 4. Roulette Redux
If you watch TV you know less about the world than if you just drink gin out of a bottle.
Lea Thompson began DPT: Vaccine Roulette in 1982 with a clear statement of purpose: “Our job in the next hour is to provide enough information so that there can be an informed discussion about this important subject. It affects every single family in America.” Unfortunately, throughout Vaccine Roulette, Thompson did much to misinform her viewers.
When Thompson interviewed Larry Baraff of the UCLA Medical Center about his study of the side effects of pertussis vaccine, she said, “The study estimates one of every seven hundred children had a convulsion or went into shock.” But Baraff’s study never mentioned the word shock. Rather, it described nine children who developed hypotonic hyporesponsive episodes, in which a child is temporarily limp and unresponsive. The hallmark of shock is low blood pressure resulting in decreased blood flow to critical organs. No such problem was mentioned in Baraff’s study nor has such a problem ever been found to be caused by pertussis vaccine.
Toward the beginning of Vaccine Roulette, Thompson stood facing the camera with a book in her hand: the Physicians’ Desk Reference , or PDR. Published once a year, the PDR contains a compendium of package inserts for medicines and vaccines. “The Physicians’ Desk Reference, prepared by manufacturers, says the ‘P’ part of the DPT vaccine is a possible link to Sudden Infant Death Syndrome,” said Thompson, briefly showing a highlighted section of the book. Thompson should have kept the book on the screen longer, allowing the viewer to read what was actually written. “The occurrence of Sudden Infant Death Syndrome (SIDS) following receipt of DTP vaccine has been reported,” it read. “The significance of these reports is unclear. It should be kept in mind that the three preliminary immunizing doses of DTP are usually administered to infants between the ages of 2 and 6 months, and that about 85 percent of SIDS cases occur in the period 1 to 6 months of age.” In other words, the association is likely to be coincidental. Indeed, a study published in 1982 showed that pertussis vaccine didn’t cause SIDS. Despite this evidence Thompson ended her program by saying, “It is difficult to come up with a definitive answer as to how many children are being severely damaged or are dying from the DPT vaccine.”
When Lea Thompson introduced the story of Scott Grant, she implied that infantile spasms, a type of seizure, were caused by DTP. Infantile spasms have a unique pattern of brain wave activity on EEG, so they’re easy to diagnose. Because they’re easily diagnosed, they’re easily studied. Five years before Vaccine Roulette, a study from Denmark clearly showed that DTP didn’t cause infantile spasms. This study was well known, having been included in review articles and book chapters for several years. Subsequent studies confirmed the Denmark study. Unfortunately, by including Scott Grant’s story, Thompson left her viewers with the false impression that his epilepsy was caused by DTP.
Thompson also understated the severity of pertussis infection. While showing many children with alleged brain damage following vaccination, she showed only one child with whooping cough. And she said that the massive pertussis epidemic in England in the late 1970s—during which thousands of children were hospitalized and hundreds died—wasn’t as bad as doctors had claimed. Gordon Stewart referred to it as the “so-called epidemic.” This created the impression that if Americans stopped giving pertussis vaccine, nothing bad would happen. When the Centers for Disease Control and Prevention and the American Academy of Pediatrics criticized Thompson for failing to point out the devastating effects of whooping cough, she argued that she couldn’t find any evidence that it was a problem in the United States. “In fact, whooping cough disease in this country is almost gone,” she said. In 1982, when Vaccine Roulette aired, three thousand children were hospitalized with whooping cough and ten died from the disease.
Robert Mendelsohn, a self-described medical heretic, was prominently featured in DPT: Vaccine Roulette. (Courtesy of WRC-TV/NBC News.)
Perhaps most disturbing, Thompson misrepresented published information. “The 1977 Red Book lists high fever, collapse, shock-like collapse, inconsolable crying, convulsions, and brain damage as reactions to the DPT vaccine,” she said. “Those complications are associated with varying degrees of retardation.” However, nowhere in the Pediatric Red Book of 1977 is pertussis vaccine listed as a cause of brain damage or retardation. William Foege, who had worked on the successful campaign to eradicate smallpox and was head of the CDC, said of Vaccine Roulette, “If journalistic malpractice was a recognized entity, I think this program would qualify.”
Thompson chose several experts to support her contention that pertussis vaccine was dangerous. Her choices were unfortunate.
Early in her program, Thompson introduced Dr. Robert Mendelsohn: “author, lecturer and former head of pediatric departments at the University of Illinois Medical School and the Michael Reese Hospital in Chicago.” In fact, Robert Mendelsohn had never been the head of pediatric departments at the University of Illinois Medical School or the Michael Reese Hospital.
Mendelsohn had made a career of setting himself against the medical establishment, including writing three books: Confessions of a Medical Heretic, Male Practice: How Doctors Manipulate Women, and How to Raise a Healthy Child in Spite of Your Doctor . During the program, Mendelsohn said of the pertussis vaccine, “It’s probably the poorest and most dangerous vaccine that we now have,” “the statistics of this country are wrong,” and “the dangers are far greater than any doctors have been willing to admit.” But it wasn’t that Mendelsohn thought that children shouldn’t get pertussis vaccine; he believed they shouldn’t get any vaccines. And it wasn’t only vaccines that he thought were useless; he also opposed water fluoridation, coronary bypass surgery, licensing of nutritionists, and mammography screening for breast cancer.
Mendelsohn had enormous disdain for his profession. In 1979, for example, he wrote, “Doctors turn out to be dishonest, corrupt, unethical, sick, poorly educated, and downright stupid more often than the rest of society. When I meet a doctor, I generally figure I’m meeting a person who is narrow-minded, prejudiced, and fairly incapable of reasoning and deliberation. Few of the doctors I meet prove my prediction wrong.” Regarding surgeons, he said in 1983, “There is never enough blood in the hospital temples of Modern Medicine to satisfy the surgeon’s desire as he seduces his victims—primarily women—virgin and otherwise—to mount the holy altar so he can carry out his ritual mutilations. The wild blood-lust, starting with animal vivisection and proceeding to human mutilation, stamps Modern Medicine as the most primitive weapon this world has ever seen.”
Mendelsohn, whose distrust of modern medicine made him a perfect spokesman for Thompson’s program, loved Vaccine Roulette, saying it was “the greatest thing since apple pie. For the first time the American people got the truth about pertussis vaccine.”
Thompson also interviewed a microbiologist named Bobby Young, asking him to comment on an apparent government conspiracy to hide the truth. “I was employed at the Bureau of Biologics [part of the Food and Drug Administration] for several years,” said Young, “and it is my opinion that they very much do not wish to know adverse reactions.”
“Why?” asked Thompson.
“Well, this will complicate their lives considerably,” replied Young.
Then Thompson asked Young about Larry Baraff’s study. “The UCLA study found more reactions than had ever been seen before,” she said. “The study estimates that one of every thirteen children had persistent or high-pitched crying after the shot.”
Young replied, “This may be indicative of brain damage in the recipient child.”
There were a few problems with this exchange. First: Thompson implied that Young had worked on the pertussis vaccine while at the FDA, but he hadn’t. Second: Bobby Young had no specific expertise in neurology or pediatrics and had never taken care of a patient, so he was ill-equipped to comment on the relationship between crying and brain damage. It’s not only that crying—high-pitched or otherwise—doesn’t cause permanent harm; even seizures, whether associated with fever or not, do not of themselves cause brain damage. Had Bobby Young been a clinician, he likely would have known that. Finally, and most disturbing, Young appeared to be answering questions about Larry Baraff’s study—impossible, given that Young was interviewed and had died before the study was published. This raised questions about whether Thompson had juxtaposed questions and answers. Thompson denied the allegation. “I am not going to risk my reputation by moving someone’s words around,” she said. “That speaks to my journalistic integrity.”
But Young’s interview wasn’t the only one that raised questions. Ed Mortimer, a former chairman of the AAP’s committee on infectious diseases, said that during his interview Thompson asked the same question “repeatedly in slightly different ways, apparently to develop or obtain an answer that fit with the general tone of the program.” Mortimer felt that “cutting and splicing remarks taken out of context gave a very different meaning from what I intended or what I believe.”
Gordon Stewart was another of Thompson’s experts with questionable credentials.
At the beginning of Vaccine Roulette, Thompson introduced Stewart as a member of the United Kingdom’s Committee on the Safety of Medicines. But Stewart had never been a member of that group. Stewart said, “I believe that the risk of damage from the vaccine is now greater than the risk of damage from the disease.” What Thompson didn’t say was that five years earlier, in 1977, Stewart had published an article claiming not only that the pertussis vaccine was unsafe but that it didn’t work. Like Mendelsohn, Stewart believed the decline in pertussis in the United Kingdom had nothing to do with the vaccine; it was simply a matter of improved sanitation. Given abundant evidence that the incidence of pertussis is inversely related to vaccine use, Stewart’s proclamations were at best ill-informed and at worst dangerous. Indeed, in 1977, after British health officials called for a pertussis immunization campaign, Gordon Stewart cried foul. “I accuse the committee [on the safety of medicines] of deceit,” he proclaimed. “There are no grounds for saying a major epidemic is on the way and I don’t agree with the way their figures have been collected.” During the next two years, more than a hundred thousand children were hospitalized and six hundred killed by pertussis.
Soon after Vaccine Roulette, Gordon Stewart retired. But he didn’t retire from educating the press and the public about infectious diseases. In 1981, one year before Thompson’s program, an unusual organism then called Pneumocystis carinii killed five homosexual men in Los Angeles; all of these men had severe immunological deficiencies. The CDC eventually called it Acquired Immune Deficiency Syndrome, or AIDS. At first, no one knew what caused the disease. But by 1983, a group of French researchers headed by Luc Montagnier had found the culprit: a virus later named human immunodeficiency virus (HIV). (Montagnier won a Nobel Prize for his discovery.)
Stewart didn’t buy it. He took on a medical profession that he believed had been duped into believing that HIV caused AIDS with the same ferocity as those who claimed the pertussis vaccine worked. Stewart believed AIDS was caused by the gay lifestyle, not HIV. In 1995, more than ten years after the discovery and confirmation of HIV as the cause of AIDS, Stewart wrote, “AIDS and AIDS-related complexes develop, with and without HIV, because [foreign proteins] in spermatozoa enter the rectum and bloodstream ... and elicit antibodies which are toxic to [white blood cells].” Stewart didn’t believe HIV caused immune deficiency; he believed sperm in the rectum did it. He also believed yeast infections in homosexual men did the same thing. Stewart blamed the victim, not the virus, writing: “Every time an avowedly homosexual or bisexual rock or film star dies of the disease he is elevated to martyr and hero. Yet it is an unpalatable and unpopular fact, seldom articulated, that those who die of AIDS, like the smokers who die of lung cancer and heart disease, facilitated their own death.” Stewart concluded, “We should take the sentimentality out of AIDS and recognize that the disease is, with few exceptional cases, directly caused by the behavior of the victim. If we do that, it would be better for all concerned.”
In 1995, Stewart also argued against giving azidothymidine, an anti-viral medication, to pregnant women with AIDS. His plea came at a time when AZT had already been shown to prevent transmission of HIV from pregnant women to their unborn babies. His unconscionable rants against AIDS victims, his ill-founded notions about the cause of the disease, and his strident campaign against a valuable drug made Gordon Stewart a target of ridicule.
These were the men Lea Thompson chose to educate the American public about pertussis vaccine.
During Vaccine Roulette, Lea Thompson interviewed a personal-injury lawyer named Allen McDowell. McDowell claimed that he had uncovered a conspiracy among doctors to hide the truth about pertussis vaccine. “[In] some institutions that I’ve seen in this state [Illinois],” said McDowell, “certain administrators ... have indicated that they have children there as a result of the DPT. Brain-damaged children.” And he believed that it wasn’t only doctors who covered up the fact that the damage had been caused by the vaccine; vaccine makers were in on it, too. Thompson said that attorneys had accused “the vaccine manufacturers of destroying vaccine records before they [could] be subpoenaed for a DPT lawsuit.” Then Thompson served the home run pitch—the kind of question personal-injury lawyers can only dream about. “Do you think that some children have been damaged by the DPT shot and their parents don’t even know it?” she asked, arguing that the few patients she had described were only the tip of an iceberg—an iceberg of children whose parents could ask Allen McDowell to represent them. “Absolutely,” enthused McDowell. “I don’t think the parents would be aware of [the alleged vaccine harm] and normally the pediatrician, or whoever, the GP, wouldn’t tell them.” Later, Thompson concluded, “What about the children who have already been damaged—who’s helping them? Unless they sue—and many families don’t have the money or don’t want to do that—nobody is helping them to pay the enormous costs that a brain-damaged child brings upon the family.” “A child like [Scottie] deserves to stay out of an institution,” said Marge Grant, seemingly in response to McDowell. “And, unless there’s compensation, you simply cannot do it.” If personal-injury lawyers had wanted to make an infomercial on alleged harm caused by pertussis vaccine, they couldn’t have done much better than Vaccine Roulette.
In 2007, John Stossel interviewed Allen McDowell on an ABC News program titled “Scared Stiff: Worry in America.” During the program, Stossel showed a clip of news reporter Robin Roberts and Allen McDowell during the pertussis vaccine scare. “Sudden infant death,” said Roberts. “You put your baby into the crib, you wake up the next morning, and your baby is dead.” “It’s extremely dangerous,” said McDowell. “They had the ability to make a safer vaccine.” Twenty-five years had passed since Lea Thomspon’s program. During that time, epidemiological studies had clearly shown that pertussis vaccine didn’t cause brain damage or Sudden Infant Death Syndrome, and advances in neurology and genetics had better defined the real causes of the problems. But Allen McDowell was unbowed. “The vaccine just wasn’t as safe as it could have been?” asked Stossel. “There’s no dispute about that,” replied McDowell. “They were making so much money off the old vaccine that they didn’t really have any incentive to improve it.” Stossel, in voice-over, said, “McDowell made money, too. The lawyer who now works out of his house won lots of lawsuits—for how much money?” “I made a good chunk of money,” said McDowell. “One hundred million?” asked Stossel. “I really can’t say,” McDowell demurred. “It’s under protective order.”
During his interview with Stossel, McDowell never mentioned his law partner, Anthony Colantoni. Between July 1990 and October 1991, Colantoni received $1.53 million in compensation checks from the Vaccine Injury Compensation Program for families of children presumably damaged by pertussis vaccine. But Colantoni gave only $124,000 to his clients, putting the remaining $1.4 million into the account of McDowell & Colantoni. His method of concealing what he’d done was simple. “When the victims or family members of the estates [of plaintiffs] would call,” said U.S. Attorney James B. Burns, “he would deny he had received the checks.” In March 1993, by consent of the Illinois Supreme Court, Anthony Colantoni was disbarred. McDowell was never implicated in his partner’s scheme.
Vaccine Roulette was arguably one of the most powerful programs ever to air on American television: thousands of parents stopped giving pertussis vaccine to their children; personal-injury lawyers pummeled pharmaceutical companies, causing many to stop making vaccines; and Congress passed a law to protect vaccine makers, while at the same time compensating those who were allegedly harmed by vaccines.
During the next fifteen years the tide turned. David Miller’s study lay in ruins at the hands of a British judge. And study after study showed that children immunized with DTP weren’t at greater risk of brain damage. As a consequence, public health agencies and medical societies throughout the world no longer considered pertussis vaccine to be a rare cause of permanent harm. Even the Vaccine Injury Compensation Program, a system designed to compensate those who felt wronged by vaccines, had removed epilepsy as a possible consequence of pertussis vaccine.
Despite this overwhelming evidence, and despite all of the harm that had been done by the false notion that pertussis vaccine was maiming America’s children, Lea Thompson was without remorse. In 1997, during a celebration in her honor held by the National Vaccine Information Center, the group once called Dissatisfied Parents Together, Thompson remembered Vaccine Roulette: “The reason it was important to me is not because it was great research, although we did a pretty good job, or that [it] was a beautifully produced piece of work. DPT [Vaccine Roulette] was important to me personally because it spawned a movement.” A movement that almost eliminated vaccines for American children, a movement that continues to cause many parents to reject vaccines in favor of the diseases they prevent, and a movement that was based on a notion that has been shown again and again to be incorrect.
In retrospect, it isn’t surprising that an anti-vaccine movement sprang up in the United States in the 1980s. The surprise is that it didn’t happen sooner.
In the early 1940s, a yellow fever vaccine was routinely given to American soldiers. Everyone got it. To make sure the vaccine virus was stable across a broad range of temperatures, manufacturers added human serum, a decision that proved disastrous. (Serum is blood without red blood cells or clotting factors.) Unbeknownst to the manufacturer, some of the blood donors had hepatitis. At the time, scientists didn’t know about the different types of hepatitis viruses or how they were spread. In March 1942, the Surgeon General’s Office noted a striking increase in the number of recruits with hepatitis; more than three hundred thousand soldiers were infected with what we now know as hepatitis B virus; sixty-two died from the disease.
In the early 1950s, Jonas Salk made a vaccine to prevent polio. Horrified that children could be fine one minute and wheelchair-bound the next, Americans gave their money to the March of Dimes, which gave it to Jonas Salk. Salk reasoned that killed poliovirus would induce a protective immune response without causing disease. Working with mice and then monkeys, Salk figured out how to make a vaccine by growing poliovirus in laboratory cells, purifying it away from the cells, and killing it with formaldehyde. In 1954, the March of Dimes tested Salk’s vaccine in a trial of almost two million children. (It was then and remains today the largest vaccine trial ever performed.) When the results of the study were announced, church bells rang across the country, factories observed moments of silence, synagogues held special prayer meetings, and parents, teachers, and students wept. “It was as if a war had ended,” one observer recalled. The euphoria didn’t last long. Two weeks later, public health officials recalled every lot of polio vaccine.
When the March of Dimes had tested Salk’s vaccine, it relied on two veteran vaccine makers: Eli Lilly and Parke-Davis. But when the vaccine was licensed for sale, three other companies joined in: Wyeth, Pitman-Moore, and Cutter Laboratories. It soon became clear that Cutter, a small pharmaceutical company in Berkeley, California, had made it badly, failing to fully inactivate the virus. As a consequence, one hundred and twenty thousand children were inadvertently injected with a vaccine that contained live, potentially deadly poliovirus: seventy thousand suffered mild polio, two hundred were severely and permanently paralyzed, and ten died. It was one of the worst biological disasters in American history. Cutter Laboratories never made another dose of polio vaccine again.
Perhaps the worst vaccine disaster in history didn’t occur in America; it occurred in Germany. In 1921, two French researchers, Albert Calmette, a physician, and Camille Guérin, a veterinarian, reasoned that a bacterium (Mycobacterium bovis) that caused tuberculosis in cows could protect people against human tuberculosis. They developed a vaccine later called BCG (Bacillus of Calmette and Guérin), a modified form of which is still used today. In 1929, however, 250 ten-day-old children in Lubeck were given a BCG vaccine that wasn’t made of BCG. It was made of pure, highly lethal human tuberculosis bacteria. Seventy-two babies died from the mistake.
The yellow fever, Cutter, and BCG vaccine disasters didn’t spur significant anti-vaccine activity. (However, the Cutter incident led to the creation of a vaccine regulatory system that prevented these kinds of tragedies from happening again.) In America, people still trusted vaccines; and they trusted those who made and recommended them. It would take fear of pertussis vaccine to turn the tide; ironic, given that the pertussis vaccine tragedy was imagined.