2/25/2011

The Red, White and Black Club: Two of These are NOT Like the Other

Buy on Amazon

Mnookin's site


Deadly Choices

Offit's site


Vaccine Epidemic Book

Vaccine Epidemic's site


All three of these books came out on the heels of each other. Two, as most readers familiar with the subject area know, are books that analyze the anti-vaccine movement and how it poses a danger to society. The third book, published by Skyhorse Publishing who also published Wakefield and Stagliano's books, has a very different take on vaccines and view vaccines as the danger.

What struck me as these books arrived, was how very similar they were in packaging: bold capitalized black titles on a bright white background with red print to make a fiery counterpoint to the starkness of the black an white. It's not just the message, you know: it's the packaging.

And that concept: that it's the packaging that matters most, can't be missed with any of these works. All three books have significant portions of text dedicated to footnotes to substantiate the claims made in the works. Of the three, Mnookin's prose is the most pleasing, and the easiest to read.Offit is the most credentialed author: this is his field of expertise, and portions of it are familiar reading for those who have traversed this ground with Offit in his other works. One writer, Orac, criticized Offit for not placing Wakefield more front and center in Deadly Choices, but having spent previous time and attention to Wakefield's role, I was satisfied with the amount of attention of Offit gave Wakefield: about five pages. 

Offit details the rise of anti-vaccine movements both in present day and in the past, here in America and in England and looks at the commonalities between the past movements and the present movements. He closes strongly, with a look at the story surrounding one of Dr. Robert Sears' patients who spread measles to others in San Diego in 2008 and the anger of parents whose children were exposed and quarantined and whose children caught measles. While Offit does not share that it was Sears' patient, Mnookin does, and the irony that the doctor who wrote a book on vaccines and an alternative schedule contributed to an outbreak that cost, according to Mnookin, "more than 10 million to contain" cannot be missed.

Both Offit and Mnookin's books work well together, covering much of the same ground, but with different emphases. Together they provide a compelling argument that the anti-vaccine movement is one that is not predicated on scientific evidence but on fear and emotion instead. Their perspectives are clear and decisive, and leave no room for doubt. The same can be said about the authors and contributors that comprise Vaccine Epidemic, many of whom are also familiar to readers aware of the autism-vaccine controversy. 

All three books aim at a wider audience than the autism community; all three books have similar aims: to convince the reader of the rightness of the authors' positions. Mnookin's book is more far-reaching and incorporates other areas of interest where people's fear and panic lead them to believe in things that do not exist, like Morgellons. Mnookin's aim is the broadest: to explain how and why people come to believe the things they do, how they allow panic to spread like a virus, and how the internet has allowed this to happen. Offit has suited up to do battle again against a foe that will not disappear. He pushes the emotion buttons where appropriate, and he brings credibility to his perspective by clearly indicating what the dangers of vaccines are, how the CDC responds to those dangers, and what improvement could still be made. He does not ever suggest that vaccines are entirely safe: he is realistic and honest about the risks. Vaccines carry risks; we should continue to work towards more safe and effective vaccines, but those risks do not include autism and they are far less than the risks of the diseases themselves.

In contrast to these two works, Vaccine Epidemic is a veritable who's who in the anti-vaccine community: Wakefield, Tenpenny, Boyd Haley of the mining chelator fiasco, and prominent autism-as-vaccine injury bloggers and others contribute chapters to this work. While Offit and Mnookin's books close with the hope that knowledge and reason will ultimately prevail and that the suffering and death caused by infectious diseases will be prevented because reason and knowledge prevail, Vaccine Epidemic ends with a chapter by Wakefield in which he insists that there's been a massive conspiracy to cover up the link between autism and vaccines, and he invokes JB Handley's "big hungry lie" and engages in pitching his book to readers, with a flashy closing that replays in similar fashion but much more grandiosely than Mnookin and Offit: "The day will belong to Reason."

All three of these books are packaged similarly. One can even imagine them sitting side-by-side on bookstores' shelves, but two of these book are not like the other. And despite the shared hope that reason will prevail, the authors of Vaccine Epidemic are defining the outcome of reason prevailing entirely differently than Mnookin and Offit are.

Is the anti-vaccine movement (or Habakus and Holland's preference of pro-safety terminology despite the openly anti-vaccine sentiments of Sherri Tenpenny) dangerous to society at large? If it remains a marginalized, fringe group, the dangers they pose are buffered by community immunity. Some, like those exposed by the lone Robert Sears' patient, suffer because of the actions one family's decision to engage in risk assessment. 

If vaccination rates decrease, if community immunity collapses under the weight of people who are swayed by the inflammatory rhetoric of people who make their living off of fear, then we will have a brand new set of questions to answer: where does my right to choose medical interventions end and the public health's needs begin? What right do I have as a parent to decide which vaccines my children receive and when?

Until that day arrives, working at combating misinformation is something that we must continue to do. Seeking ever-better and more exhaustive science into vaccine safety and efficacy is something all reasonable people can get behind. Understanding the real risks and the real benefits of vaccination and making truly informed consent is something reasonable people can get behind. Conflating the idea that true informed consent means people wouldn't vaccinate is not, however, and while the rhetoric that Vaccine Epidemic cloaks itself in is an appeal to rugged individualism as patriotically American, it overplays its hand by including individuals who are unashamedly anti-vaccine, misinformed, disgraced, and discredited in its pages.

In the end, will most readers take the time to read all three of these works, pick through the notes, work to ascertain where the truth is? Perhaps not. It's a significant investment of time and energy.

I think, though, that Mnookin's and Offit's works will be more compelling. But that may be the optimist in me.


Disclosures:

I was not paid for these reviews.
I did, however, receive all three books to review free of charge.
I have communicated via email with Dr. Paul Offit over the last two years. He has been kind in answering questions promptly.
I have communicated via email with Seth Mnookin and I follow his tweets (I also follow Dr Jay "Nimby" Gordon, so make of that what you will).
I have written negatively on Haley, Wakefield, Tenpenny, and Ginger Taylor before.
I think, based on the studies to date, that the science does not back up a link between autism and vaccines.
I think that vaccines for those who can safely do so are an important tool in the prevention of disease and that we have a moral obligation to protect our children and those who cannot be safely immunized. Yes, I am willing to take one for the team.


Additional disclosures:

All royalties from Offit's book go to the Autism Science Foundation.

9 comments:

farmwifetwo said...

I think the day that gov't's demand that public health outways personal consent is the day they are no longer in power so it'll never come.

The 2 pro-vaccine books make one huge and fatal mistake... they lecture. People no longer like to be lectured to. We no longer live in a time where we automatically believe gov'ts, scientists or anyone for that matter unless we feel we have received the information we need to or wish to, hear. People tune out lecturing and guilt... fact of life.

Therefore public opinion will simply be decided at the Dr's office.

kathleen said...

I think that if it is unfamiliar territory most science reads like a lecture. I haven't looked at any of these books so I can not comment on the prose. It is only because of autism that I know anything about the topic. I talk to my doctor. I ask him what he thinks. I like to think that he has my kids best interests in mind. Because he went to medical school-and I did not. But then I read things that people like..oh..doctor Jay say..wow..just wow. Then I think about how lucky I am to have a doctor that reads studies..and who is willing to explain things to me in laymen's terms. I think that two of those books will appeal to science based people and that one..well, it will appeal to emotion. *sigh*

Life in the House That Asperger Built said...

Great analysis, Kim. I hope it does remain a fringe group, and more people will read and appreciate the Offit and Mnookin more than the other. My fear however, is that the plays to fear and sensationalism will win out.

Chris said...

farmwifetwo: The 2 pro-vaccine books make one huge and fatal mistake... they lecture.

Funny, I did not notice that.

I liked how Offit compared and contrasted the vaccine activism of Barbara Loe Fisher and John John Salamone. Granted, the chapter on Bob Sears is a bit of a lecture. Though on the most part, Offit tells stories about the people and the circumstances. From the mother who found out her family was living in an island suburb with low vaccine uptake, to the mother whose immune compromised child almost died from Hib, and may still be permanently disabled.

Seth Mnookin does not lecture, but seems to explain his methods of discovery, and his take down of RJK, Jr's Salon/Rolling Stone article was wonderful. That was definitely not a lecture, but a hoot to read! He also tells the stories about the people, he gives a great deal of detail into the lives of both Bernard and Redwood, and how Evidence of Harm got to be written.

Autism and Oughtisms said...

Thanks for those reviews. The next two books on my reading list (I'm currently working my way through "Bad Science") were "The Panic Virus", then Offit's "Autism's False Prophets". I'm more specifically interested in autism than the vaccination debate per-se, so I suspect my money and time is better invested in AFP than Deadly Choices (at this point). Suffice to say that I will not be adding "Vaccine Epidemic" to my reading list.

Chris said...

Autism and Oughtisms, have you read R.R. Grinker's Unstrange Minds?

Autism and Oughtisms said...

No I haven't Chris. I've just had a look at it on Amazon, definitely looks interesting and relevant. Would you particularly recommend it, maybe over and above the other books I'm intending to get? Always happy to take advice on where my money on books is best spent - I don't have a heck of a lot of time or money, so I'd like to spend it wisely!

Chris said...

Yes, I would recommend it. It has an overview of the diagnosis of autism over the years, plus the attitudes in different countries. Countries like Korea, India and South Africa. While all the time referencing his oldest daughter, Isabel (who I believe is pictured on the cover of the UK edition).

It is different than the other books you are reading in that it is about autism itself, not any controversies about causes. It might help to read the authors's website, unstrange.com (where under the menu tab "About the Book" is a link to the changes in the DSM diagnosis for autism over the years).

I know what you mean by time and money. Fortunately, I have been able to borrow most of the books from my local library.

Chris said...

For some reason I screwed up the link to the website:
http://www.unstrange.com/