Exhibit A: This year’s incoming class of the Perelman School of Medicine at the University of Pennsylvania was assigned to read Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, by Paul A. Offit, MD. Issued by Basic Books in 2011, the book came out this year in paperback. During their orientation period, Offit spoke to the students; then the students discussed the book in small groups.
Exhibit B: A reader of Deadly Choices posted this review on Amazon.com: “I find this book to be an outrage; . . . the public needs to know the facts about vaccines and that this author is one of the most uninformed, even dangerous men to the health of America.”
Sometimes there seem to be two kinds of people in the world: those who admire Offit and the work he has done in the fields of virology and immunology, and those who call him a fraud and profiteer. There appears to be no middle ground.
Offit, the Maurice R. Hilleman Professor of Vaccinology and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania, is also chief of the Division of Infectious Diseases at the Children’s Hospital of Philadelphia. He is a co-inventor of RotaTeq, a rotavirus vaccine. In addition, he directs CHOP’s Vaccine Education Center, which is regarded by the second group of people as a purveyor of propaganda. According to the center’s site, it was launched in October 2000 “to provide accurate, comprehensive, and up-to-date information about vaccines and the diseases they prevent to parents and health-care professionals.” It also “seeks to dispel some of the common misconceptions and misinformation surrounding vaccines. The goal is to communicate the facts about each vaccine as well as how vaccines are made, how and why vaccines work, who recommends them, whether they are safe, whether they are still necessary, and when they should be given.” Funded by CHOP, the center does not receive support from vaccine manufacturers.In the last few years, Offit has assumed a more forceful role as advocate beyond the Vaccine Education Center. He has been dismayed by what he sees as rampant “misconceptions and misinformation,” which are often given a free pass in the media and are increasingly spread by celebrities such as Jenny McCarthy, Jim Carrey, Cindy Crawford, and Bill Maher. In 2008, Offit published Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure (Columbia University Press). The second chapter recounts Dr. Andrew Wakefield’s claim in 1998 to have discovered the cause of autism: the MMR (measles, mumps, and rubella) vaccine. (A few years earlier, Offit notes, Wakefield, a British gastroenterologist, had claimed that the same vaccine caused Crohn’s disease –- a claim he subsequently admitted was wrong.)
In the book’s prologue, Offit writes: “Some people who believe vaccines cause autism hate me because they think I’m in the pocket of the pharmaceutical industry, that I say vaccines are safe because I am paid to do it. . . . But the reason I say vaccines don’t cause autism is that they don’t. I say this because the false alarm about vaccines and autism continues to harm a lot of children –- harm from not getting needed vaccines, harm from potentially dangerous treatments to eliminate mercury, and harm from therapies as absurd as testosterone ablation and electric shock. I say this because the feared vaccine-autism link, which has now been disproved, diverts research dollars from more promising leads. I say this because I care about children with autism.” Also in the prologue, he mentions that he had his own children vaccinated.
In Deadly Choices, Offit continues to examine and deconstruct the “bad science” of the anti-vaccine movement. I was surprised to find that Offit includes among the doubters Mehmet Oz, M.D., the well-known TV doctor and a graduate of Penn’s medical school. Oz’s children did not receive flu shots or swine flu shots, and he is quoted as saying that “my wife makes most of the important decisions as most couples have in their lives.” As Offit notes, Lisa Oz is a “reiki master,” a follower of Mikao Usui, who claims to be able to heal through his palms. Offit also notes that Jenny McCarthy, the actress and one of America’s most recognized anti-vaccine activists, had followed tarot cards in the past. At the same time, Offit has recognized the circumstances that can lead parents to look beyond traditional medicine. As he put it in Autism’s False Prophets: “Parents of severely affected autistic children often face unimaginable emotional and financial stress.”
As shown by his interactions with the medical school’s Class of 2016, Offit certainly has the support of the medical establishment. In 2008, the Perelman School of Medicine honored him with its Luigi Mastroianni Clinical Innovator Award. Last year, he was elected to the Institute of Medicine, one of the highest honors in biomedicine. Offit also received the 2011 David E. Rogers Award from the Association of American Medical Colleges, in recognition both for his work with RotaTeq and for his public advocacy.
But many people beg to differ, as shown by their responses to Deadly Choices. The paperback edition bears praise from New Scientist, The Journal of the American Medical Association, Nature, Health Affairs, and many others. At the same time, I suspect few books reviewed by readers on Amazon.com show such a dramatic disparity. A recent look at Deadly Choices shows 43 five-star reviews and 22 one-star reviews, the lowest score accepted. One of the negative responses points out that Offit “shared the patent on the Rotavirus vaccine, RotaTeq. He makes millions every year off the vaccines he claims are safe. What does he have to loose [sic] if the ‘anti-vaccine’ movement continues? A whole lot of money. Conflict of interest?” Although the paperback version of Deadly Choices doesn’t mention Offit’s role in inventing Rotateq, it is cited in Autism’s False Prophets and the patent he shares is listed in his CV on his web site.
Last month, the International Medical Council on Vaccination, an anti-vaccine organization, posted a blog called “In Vaccines We Trust?” The piece is by Suzanne Humphries, MD, a nephrologist who now identifies herself as a homeopath. She was responding to a short video by Offit that appeared on Medscape, in which he questions vaccine exemptions. A medical exemption is “a reasonable reason,” he says, but Offit argues that the philosophical/personal belief or religious exemption “does not make a lot of sense.” In response to Offit, whom she calls “Millionaire vaccine inventor and mandatory vaccine advocate,” Humphries argues, with justification, that if parents were convinced that vaccines were safe and effective, “there would be no anti-vaccination movement.” But then she goes on assert that global immunization efforts and the like are “reminiscent of policies found in National Socialist empires, Stalinist countries, or Communist China.” She also asserts “the hypocrisy of the vaccine faithful” and, as she writes it, “CORRUPTION.”
On the matter of “corruption,” Offit suggests in Deadly Choices that “Conspiracy theories lie at the heart of the anti-vaccine movement, claiming that the pharmaceutical industry, using undue influence, causes eighty thousand practicing pediatricians and family physicians to lie about vaccine safety.”
The other rebuttal approach that Humphries takes involves religion. Religious principles, she writes, still stand. “God could have instructed Moses on how to inoculate the Israelites in the desert when the diseases came upon them.” But, she continues, “medical vaccination or inoculation of any sort was never part of God’s instruction.” Nor did “Jesus, the greatest human healer of all time,” ever heal through vaccines. In fact, according to Humphries, “the Christian scriptures, both old testament and new, make it perfectly clear that good health is solely predicated on a living relationship with God.”
That statement suggests that only those with such a relationship –- as prescribed in scriptures –- will have good health. That’s an astounding view for a physician to hold.
What would happen in a world without vaccines? According to the Vaccine Education Center, before there were vaccines, parents in the United States could expect that every year, polio would paralyze 10,000 children; rubella (German measles) would cause birth defects and mental retardation in as many as 20,000 newborns; measles would infect about 4 million children, killing about 500; diphtheria would be one of the most common causes of death in school-aged children; a bacterium called Haemophilus influenzae type b (Hib) would cause meningitis in 15,000 children, leaving many with permanent brain damage; and pertussis (whooping cough) would kill thousands of infants. That’s not a world anyone would want to return to.