Vaccine Nation couldn’t be more timely.
The latest book by internationally acclaimed Australian epidemiologist Raina MacIntyre traces the widespread post-pandemic drop in support for public health measures and vaccination. It was mostly written last year, but by now, as it is arriving in bookshops and anti-vax beliefs and conspiracies have
expanded to their highest levels, there’s even more confusion and a deeper decline in vaccine uptake.
MacIntyre opens with a stark reminder that it’s not so long ago that only about half of all babies lived to celebrate their first birthday. Those who did remained at risk of deadly or debilitating infectious diseases − like the protagonist of MacIntyre’s opening story, Martha Lillard, who was paralysed by polio at the age of 5 in 1953 and is now the oldest person to still rely on an iron lung to breathe.
Polio was eventually eradicated in the US in 1994 (and smallpox has been extinct globally, except for two laboratory samples, since 1980). But given the rise in vaccine hesitancy, particularly in the US, where hard-core vaccine refusal is now at 7% of the population, MacIntyre is frank in her warning of a resurgence in preventable outbreaks as the inevitable consequence of falling vaccination rates.
Measles is a case in point. MacIntyre dedicates a full chapter to this highly contagious disease, again reminding readers of its deadly nature and potential for lifelong consequences, including encephalitis and subsequent deafness.
As much as I wish it was no longer necessary, I appreciate that she also revisits the fraudulent 1998 study by Andrew Wakefield that first drew a long-debunked link between the measles vaccine (usually administered as a combined measles, mumps and rubella vaccine or MMR) and autism. She goes through all the stages: the small number of children (12) the study was based on, the lack of any control group or ethical review, the data fabrication and undisclosed financial conflicts of interest, the withdrawal of support by Wakefield’s co-authors and the retraction of the paper.
By 2010, the British General Medical Council found Wakefield had acted dishonestly and irresponsibly, but of course by that time he had become a hero of the anti-vax movement. MacIntyre writes with a palpable sense of frustration that this issue seems as hard to eradicate as measles itself.
Vaccine Nation focuses on the reasons for the rise in vaccine hesitancy, including some fundamental behavioural patterns such as the “rule of rescue” − the finding that we place more value on treating someone who is acutely ill than on preventing disease. The way this plays out, MacIntyre argues, is that during times of high risk of a serious infectious disease (such as in the early part of the Covid-19 pandemic), willingness to vaccinate is high. But it falls once a disease is more under control and the fear of potential vaccine side effects begins to dominate.
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MacIntyre has no patience for vaccine refusers, but is sympathetic to concerns about vaccine safety, not least because of several historic examples of failures, such as the Cutter incident in 1955.Cutter Laboratories was the manufacturer of a polio vaccine, but failed to properly inactivate the virus, resulting in 120,000 children being injected with the live virus. Some 40,000 contracted polio, 51 became paralysed and five died. What’s worse, a scientist at the National Institutes of Health identified the problem while testing the Cutter vaccines, but her supervisor failed to take action. As a result, the entire programme was stopped and switched to a different type of vaccine.
Closer to home, when abnormal blood clotting emerged as a rare but serious side effect of the AstraZeneca Covid vaccine (which was not based on RNA technology), Australia continued to administer it because it had over-invested in it. Out of 14 million doses, two deaths were attributed to the vaccine.
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While MacIntyre acknowledges these incidents and that no vaccine is 100% safe or effective, she also explains how clinical trials and post-release monitoring work, and why only vaccines can achieve true herd immunity.
It’s chilling to read quotes from US scientists who have since either resigned or lost their jobs. Among them is former US science adviser Francis Collins. He had warned that coercive measures to encourage Covid vaccine uptake were likely to backfire.
And so it was. This became one of the major reasons for the backlash against vaccines, together with a rising tide of disinformation on social media, predatory junk journals that pollute scientific debate, and governments’ failure to counter false information.
MacIntyre agrees that facts and figures are not enough to shift mindsets. Instead, she argues, public health scientists should use the same emotive storytelling anti-vax movements employ so effectively.
She follows her advice, at least partly. While many passages are explanatory, there are plenty of stories, including her own, of people struck by disease or protected by vaccines and masking. Her hope lies in new vaccines against some cancers and elusive infectious diseases such as HIV, which may change the narrative and reverse the backslide − ideally before the next pandemic hits.
Vaccine Nation: Science, Reason and the Threat to 200 Years of Progress, by Raina MacIntyre (NewSouth, $39.99), is out now. Photos / SuppliedSave
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