Viral Rebound, by Misha Angrist

At a dinner party back in 2008, a group of educated parents told journalist and author Seth Mnookin that they were delaying or even forgoing their kids’ scheduled shots.

“It just feels like a lot for a developing immune system to deal with,” one first-time dad told him.

Mnookin pushed back, asking for data—a single experiment or piece of epidemiological evidence demonstrating any danger posed to children by the measles-mumps-rubella (MMR) vaccine. The dad was at a loss.

This story appeared in Mnookin’s 2011 book, The Panic Virus: A True Story of Medicine, Science, and Fear. From the dinner party, the book moves back in time to the turbulent histories of other vaccines, including smallpox and polio—the vaccine for which from one lab mistakenly contained live virus and caused the paralysis and death of several dozen children—and the fears of fluoride and other public health innovations. Beyond being a compelling read, the book is somehow both prescient and naïve (clearly we were all naïve).

Cover of THE PANIC VIRUS: The True Story Behind the Vaccine-Autism Controversy (2011) by Seth Mnookin
Until a year or two ago, I used to spend a few minutes at the beginning of my science policy classes on what I called “current events,” reviewing some piece of science news—about the Hubble Telescope, for example, or the Cancer Moonshot, or the proposed de-extinction of the dodo bird. But nowadays, as my students and I review the latest in a seemingly neverending series of Health and Human Services vaccine policy self-owns, I call it “staring into the abyss.”

There’s no shortage of topics relating to the horrorshow of the current U.S. government’s vaccine policy on measles (so back!), or its position that the polio vaccine should be optional, its tightening of the vaccine schedule, the wholesale replacement of critics, its restrictions on research, and the return of conspiracy theories like the autism fixation, or the villainization of aluminum. But to make sense of it all, I found a return to Mnookin’s book helpful, re-grounding my understanding in the long history of anti-science moments that led us to this current ferocious one.

The second part of The Panic Virus deals with Andrew Wakefield, the gastroenterologist who in 1998 published an infamous paper in The Lancet claiming a link between the MMR vaccine and autism. The study was based on 12 children, included no controls, and was never replicated, either in epidemiological or virological studies. Reporter Brian Deer spent many years investigating Wakefield and his claims; Deer found that Wakefield had manipulated data; he was on the take from litigators; and he stood to gain financially from the downfall of the MMR vaccine. In 2010 the UK General Medical Council stripped Wakefield of his license, and The Lancet retracted his MMR-autism paper.

The book’s final section holds a mirror up to the media and its complicity in propagating the vaccine-autism myth, not least by way of Robert F. Kennedy Jr.’s 4,700-word article, “Deadly Immunity,” that had appeared in Salon in 2005. Now this same dude, who was labeled a charlatan during a Congressional hearing, was in charge of United States vaccine policy.

I called Mnookin (now the Director of the Graduate Program in Science Writing at MIT) to talk these matters over, and we spoke by Zoom in January. Our conversation has been edited for length and clarity.

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Misha Angrist: I had my phone on shuffle in the car last night, and “Soul Vaccination” by Tower of Power came on.

Seth Mnookin: There you go.

MA: As I was revisiting The Panic Virus, I was struck by how meticulous and transparent you were with the endnotes. “I was at this dinner party and this is what I remember.” And putting the post facto corrections on your website. I’m curious about how you look back on that.

SM: I think part of that probably just came from my OCD. But part of it also came from the fact that my first book was not just about The New York Times, but was critical of The New York Times. I’ve been a reporter for long enough to know that the least reliable thing is memory.

There had already been a lot of books written about vaccines, either from the perspective of “vaccines are evil and are killing children,” or else “the people who think vaccines are evil are [themselves] evil and they’re killing children.” Most of the population is not from either one of those two camps. I had to give people a roadmap for how I reached my conclusions, or else it wasn’t gonna have any validity.

MA: You go very deeply into the Wakefield affair. The paper was retracted in 2010, which seemed to kind of put a bow on the story. But 15 years later we suddenly have measles back in force, and decades of clinical trial data and vaccine schedules being thrown overboard.

SM: Yeah. I am…I was surprised. And I think that’s a really good example of how you need to allow for your conclusions not to be accurate. The Wakefield paper was retracted finally, and he lost his medical license, because it turned out he had been drawing blood from his kid’s friends at his son’s birthday party. (Just the worst birthday party ever, by the way.) My book came out right after those things happened. And I felt like, “Hopefully this will be a valuable historical document for why there was this movement over this period of time to sow doubt about the efficacy of vaccines.”

Finally the press was no longer treating vaccines and autism as an “on the one hand, on the other hand” kind of thing. After the retraction of the paper the coverage instead became, “Why is this still going on?”

MA: You have a chapter on RFK Jr. titled “Conspiracy of Dunces.”

SM: At the time I thought, “This is so ridiculous that maybe I shouldn’t even include it.” I wanted to avoid making the people who were concerned about vaccines look ridiculous. And one of the conclusions that I reached was that the reason you saw this vaccine hesitancy arising in a population affected by autism was that this was a population that had not been treated well by the medical establishment. I was trying to bring some empathy to that. And so I was concerned that bringing in characters like RFK Jr. and showing his absolute disregard for reality… I thought, “This is a little bit too over the top. Maybe I should leave this out?”

I was completely wrong, obviously. If you had said to me then that in a decade and a half, RFK Jr. was going to be in charge of medical, scientific, and health policy in the U.S. I would have said, “You are out of your effing mind. That’s the equivalent of saying that in 15 years, RFK Sr. is going to come back from the dead and be president.” It shows my own lack of imagination and my lack of understanding about some of the underlying forces at work here.

MA: How closely do you attend to what he is saying and doing these days? And to be clear, I wouldn’t blame you if you didn’t.

SM: I’m glad, because I don’t attend to it super closely. When my book came out there were a couple of instances when Andrew Wakefield either wanted to debate me, or there was someone who said to me, “Let’s do a TV show with you and Andrew Wakefield.” And I always said no.

I could spend all my time, every day, kind of trying to bat down all of the insane things that he is saying, or that are coming out of the government now, but I don’t think that’s useful or helpful.

And frankly, just for my own mental health. There are days where I’m like, “I am just going to read the sports page. I’m going to click on sports so quickly that I don’t even see what the front page headlines are.” If I am drowning under the weight of all of the misinformation and horrific consequences of that, I’m not going to be able to do anything.

MA: I totally get it. But to the extent that you do pay attention, do you think RFK has changed in the last 20 years, or has he simply gotten more power?

SM: I think the message is the same. One of the mysteries to me has always been how and why he adopted this issue as a campaign. He started out as an environmental lawyer and then picked this up. I think within his framework, he sees this type of thing as an extension of environmental harms that are happening: Chemicals being dumped into rivers, additives in food. I think he sees all of this as part and parcel of one thing. From what I can tell there’s never been a lot of nuance.

But what I have been surprised by is how little resistance there has been [to his ideas]. Not only are kids are going to die [as a result of these policies], but just from a pure fiscal perspective—it is so much more expensive to treat someone who’s sick as opposed to keeping someone healthy. I’ve been surprised that the GOP that I had associated with fiscal prudence—no one is even making those arguments. It takes tens of thousands of dollars to contain a single case of measles—parents missing work, the stress it’s going to put on insurance systems. I’ve just been surprised at how little resistance there has been to a revolutionary overthrow of what has been public health policy for half a century.

I hope I’m wrong. I hope that more kids do not die of measles and pertussis. But the historical evidence says that there are going to be really bad consequences.

MA: I think one of the other things your book foresaw was the devaluation of expertise. I remember your website back in the day, and you would take on these celebrity anti-vax trolls. I suspect you don’t miss that.

SM: I do not miss [the trolls]. Or the death threats.

I’ve tried really hard, in general, to not let the fact that occasionally people are interested in what I might have to say, convince me that I actually have something to say.

I’ve been willing to talk about the historical aspects. But until I do new reporting on this, I’ve tried to avoid falling into the trap of believing that there’s any reason people should hear what I have to say.

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I’ll conclude by saying he’s quite wrong about that. Reading Seth Mnookin’s The Panic Virus today will give you a powerful sense of the broken context that scientists, teachers, librarians, and others will be working to repair for years to come.

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