Rallying resistance to the antivaccine jihad

About four weeks ago, I wrote what I thought to be an amusing piece about how our blog “buddy” J. B. Handley, antivaccine advocate extraordinaire and now second fiddle in the organization he founded (Generation Rescue) to a Jenny-come-lately former purveyor of Indigo Child woo previously best known for being Playboy Playmate of the Year, a game show hostess on MTV, the star of her own short-lived sitcom, and a gross-out comedienne known for eating her own vomit or sitting in a pool of her own menstrual blood. Unfortunately, along with her A-list boyfriend Jim Carrey, this former D-list star has become the public face of the antivaccine movement, even going so far as to lead rallies in Washington, DC against current vaccine policies, while spewing the most incredible bits of idiocy about “toxins” in vaccines and autism quackery.

One of my complaints has been just how little and how late the pushback has been from the scientific community to combat the dangerous quackery of the antivaccine movement that insists against the preponderance of scientific evidence that either mercury in vaccines or, more recently, vaccines themselves cause autism and all sorts of other problems. For over a year and a half, or so it seems, defenders of science- and evidence-based medicine mostly slumbered while the Jenny juggernaut grew stronger until now measles outbreaks are occurring in populations with large numbers of unvaccinated children. Only in the last three or four months have there been signs that that slumber is ending. One of the first among these signs was the release of a book by the man whom antivaccine zealots consider to be Satan Incarnate (or at least the Dark Lord of Vaccination), Dr. Paul Offit, entitled Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. It turns out that I’m not the only one who sees this book as a focal point to rally resistance to the spreading of antiscientific woo about autism and vaccines. In the New York Times, there’s an article entitled Book Is Rallying Resistance to the Antivaccine Crusade.

I’m predicting that the vaccine pseudoscience-loving crew at Age of Autism will not like it. Look for J.B. Handley to write another hit piece now that the actual article the interviews for which he so whined about in December has finally seen print. The article begins:

A new book defending vaccines, written by a doctor infuriated at the claim that they cause autism, is galvanizing a backlash against the antivaccine movement in the United States.

But there will be no book tour for the doctor, Paul A. Offit, author of “Autism’s False Prophets.” He has had too many death threats.

“I’ll speak at a conference, say, to nurses,” he said. “But I wouldn’t go into a bookstore and sign books. It can get nasty. There are parents who really believe that vaccines hurt their children, and to them, I’m incredibly evil. They hate me.”

[…]

“When Jonas Salk invented polio vaccine, he was a hero — and I’m a terrorist?” he jokes, referring to a placard denouncing him at a recent demonstration by antivaccine activists outside the Centers for Disease Control and Prevention in Atlanta.

The reason?

As a result, “a few years ago this ceased to be a civil scientific discourse and became about crucifying individuals,” said Dr. Gregory A. Poland, chief of vaccine research at the Mayo Clinic, who says he has had threats against his children. “Paul is a lightning rod, a figure who goes charging into the fray.”

Those backing Dr. Offit say he was forced into the role. Opponents of vaccines have held rallies, appeared on talk shows like “Oprah” and “Imus in the Morning,” been the heroes of made-for-TV movies and found a celebrity spokeswoman in Jenny McCarthy, the actress and former Playboy model who has an autistic son. Meanwhile, the response from public health officials has been muted and couched in dull scientific jargon.

“If the surgeon general or the secretary of health or the head of the C.D.C. would come out and make a really strong statement on this, I think the whole thing would go away,” said Dr. Peter J. Hotez, president of the Sabin Vaccine Institute, who has a severely autistic daughter whose disease, he argues, is genetic.

I’m afraid that Dr. Hotez is very idealistic–and very wrong. I wish he were right and that that would be all it would take, but he’s not.

If every single high-ranking health official in the federal government, including the head of the CDC, FDA, the Surgeon General, and the Secretary of Health and Human Services came out and issued strong statements supporting the safety of vaccination, reiterating the science showing that multiple studies have failed to find a link between mercury in vaccines or vaccines themselves and autism, and trying to reassure parents, it might succeed in reassuring some of the fence-sitters, but you can bet that the hardcore antivaccine contingent would pay it no mind. In fact, not only would they pay it no mind, but it would probably harden their position. Their conspiracy mongering nature would be activated by such a display, and they would probably go into further heights of wingnuttery. AoA, that clearinghouse for all things antivaccine, would likely go into full mental jacket mode and post a series of articles about how the government was in the pocket of big pharma.

One thing I noticed in this article was an astounding revelation:

Asked why public health officials have been reticent, the acting surgeon general, Dr. Steven K. Galson, issued a statement saying that “childhood immunizations are one of the greatest achievements of all time” and that “scientific evidence clearly shows that vaccines do not contribute to autism.” He has spoken on issues like obesity, tobacco, air travel and exercise, but his office said he had not been questioned by journalists about vaccines and autism.

Here’s one issue where an effective Surgeon General with the trust of the public could make a difference. One advantage that the Surgeon General has is that he is not part of the CDC or FDA, two organizations deeply distrusted, and not just by antivaccine advocates. He is, as far as it is possible to be, “America’s doctor,” not affiliated with partisan interests. Can you imagine C. Everett Koop staying silent in the face of J.B. Handley and Jenny McCarthy? I can’t. Could you imagine the press not asking C. Everett Koop about the antivaccine movement if he were still Surgeon General? Again, I can’t. That’s because Dr. Koop was a strong and outspoken Surgeon General. In marked contrast, “acting” Surgeon General or not, by not speaking out for immunization and against the kooks, Dr. Galson has abdicated his responsibility by not combatting an obvious and immediate threat to public health. He shouldn’t think it necessary to wait to be asked by reporters about this topic in order to speak up.

As for Dr. Offit’s book, it does appear to be having an effect:

Dr. Nancy J. Minshew, a neurologist at the University of Pittsburgh Medical Center and a leading autism expert, said she had begun telling any parent asking about vaccines to read the Offit book. A brain-imaging specialist who gets no money from vaccine companies, she said she had never met or spoken with Dr. Offit.

Autism, she said, is one of many diseases, like dyslexia, Elephant Man’s disease, tuberous sclerosis and schizophrenia, that are caused by genetic flaws but show no symptoms for years.

She blamed journalists for “creating a conspiracy where there was none.” By acting as if there were two legitimate sides to the autism debate, she said, “the media has fed on this — it’s great for ratings.”

Many doctors now argue that reporters should treat the antivaccine lobby with the same indifference they do Holocaust deniers, AIDS deniers and those claiming to have proof that NASA faked the Moon landings.

Exactly. What Minshew is describing is a manufactroversy, the favorite tool of cranks. In this, the antivaccine lobby is indeed very much like HIV/AIDS denialists, 9/11 Truthers, creationists, Holocaust deniers, those who believe in alien abductions, and people who think that NASA faked the Moon landings. To them, evidence doesn’t matter. Science doesn’t matter. History doesn’t matter. At least neither evidence, science, nor history matters except to the extent that they can cherry pick it, twist it, and misrepresent it to support their point of view. Science has conclusively demonstrated that, whatever rare adverse reactions it may produce, immunization is not associated with autism. That’s reality. That’s science. But the antivaccine lobby is not interested in reality or science. Its members “believe” that vaccines cause autism, and that’s enough for them, evidence be damned.

Although I agree in principle that this is how reporters should treat Jenny McCarthy and her ilk, I doubt that it will ever happen. The reason is that antivaccine advocates tell a compelling story, and journalism is about nothing if not the story. They have cute children, stories of children regressing into autism, and long quests to find a cure that does not at present exist. It can provide a compelling narrative, particularly for anecdotes that might on the surface look as though “biomedical interventions” worked. Sorry, Dr. Minshew, it’s just not going to happen.

One thing we as health care professionals can do is to treat the antivaccine lobby in just the fashion suggested. No debates. Staged debates are not how science is determined, and for a reputable physician or scientist to appear on the same stage with an antivaccine advocate automatically implies to the audience that there is a real controversy. This is not to say that we should not refute antivaccine pseudoscience when we see it or when we can. It’s just that we should not give antivaccine advocates a chance to do their version of the Gish gallop that biologists who try to refute creationist nonsense have become so familiar with. No more appearances with Jenny McCarthy on Larry King Live. No more appearances on The Doctors opposite Dr. Jay Gordon. In my fantasy world, antivaccination advocates would be relegated to late night radio like Coast to Coast AM with George Noory, along with all the alien abduction believers, Bigfoot siting insomniacs, and chemtrails chasers. It would be appropriate, but it will never happen.

Although I liked this article and commend Donald McNeil, Jr. for his work, I do have a bit of a worry. That worry comes from the last sentence:

Next week: In the Personal Health column, Jane E. Brody will write about efforts, so far fruitless, to find a cure for autism.

I fear it will include woo. I hope I’m wrong, but such a description worries me. Here’s hoping I’m wrong.