By David N. Brown
In a recent article for Age of Autism, JB Handley refers to Rotateq in the headline as “the vaccine nobody wants”. On this occasion, there can be little doubt that Handley has a valid point. He argues, in a straightforward fashion, that despite ACIP/CDC recommendations, there is limited interest in Rotateq.. Most significantly, he reports that “27 of 29 other first world countries besides the United States DO NOT think Rotavirus is an important enough disease that the children of their country should receive a vaccine for it.” Unfortunately, Handley does not give details or cite sources, but his figures are approximately reproducible: Of 31 countries whose “official” childhood vaccination scheduled are available at euvac.net, only two (Belgium and Luxembourg) include rotavirus. Handley may also be right in implicating Paul Offit as responsible for the US decision to recommend rotavirus vaccination (notwithstanding his uncritical parroting of the canard that Offit made “tens of millions”). The lack of general concern over rotavirus which Handley reports parallels a suspicion I have long held about rotavirus vaccines: that safety issues with these vaccines, including the very real failure of Rotashield, lack what is necessary to draw significant concern from the general public.
For the purposes of this essay, I finally put my suspicion to the test. Using Google News searches, I compiled the number of articles about Rotashield and MMR from 1998 to 2005, the approximate time frame of the failure of Rotashield and the scare over MMR and autism. The results were as follows:
98-99 503 145
00-01 1,540 84
02-03 2,990 32
04-05 3,120 76
Total: 8,153 337
In summary, MMR received more than 24 times the press coverage of Rotashield, despite the fact that the claims against MMR were never supported by a compelling volume of scientific evidence and opinion while problems with Rotashield were accepted by medical professionals as real and sufficient cause to remove the vaccine from use. I will offer several reasons for this, apart from the media circus created by Wakefield, Barr, Handley etc:
1. Measles is a well-known disease; rotavirus is not.
2. MMR was already widely used, creating a large pool for unsubstantiated claims.
3. As an older vaccine, MMR had already been a subject of many claims of injury, included substantiated reports involving the “Urabe” lot, making it a subject of pre-existing suspicion.
4. Autism was (increasingly) a heavily publicized disorder; intussusspection is not.
5. The claimed relationship of autism to MMR was based in no small part on other claims that both were associated with a number of other disorders, such as “leaky gut”, demyelinating nerve disorders and chemical poisoning. This maximized the basis for shared concern among members of the general public.
6. Portrayals of autism, particularly by those who attribute it to vaccines, resonate with psychologically powerful archetypes of myth and folklore, particularly the “changeling” legend. The known or alleged adverse effects of rotavirus vaccines lack these connotations.
There can be little doubt that “anti-vax” groups like Age of Autism would like to make Rotateq a subject of scandal comparable to that which beset MMR. Ironically, they could probably make a better case against it than they ever did against MMR. It would seem conceivable that, as it becomes better known and more widely used, Rotateq could eventual become the subject of a general scare. But I, for one, doubt it. I am (as I have written elsewhere) entirely satisfied that vaccine “scares” are impossible on a substantial scale unless medical concerns (valid or invalid) are complimented by psychological and cultural ones. To arrange such a confluence purposefully and successfully would be difficult even for those who understood the underlying forces involved. Of course, there is virtually no chance of such comprehension for those sincerely caught up in anti-vaccine ideology.
That, in my opinion, is why there has not been and may never be a “Rotateq scare”.