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When the editor of the Washington Independent Review of Books invited me to review a recent narrative book about vaccines, I said yes. It was a natural fit, since I've been researching vaccines for the past fifteen years, participating publicly in vaccine debates, and writing about the vexing issue of childhood vaccination for nearly as long.
But when an advanced reading copy came in the mail, I recognized the author's name as someone who had mentioned me in a January 2013 article in Harper's Magazine. I flipped through the book, and since her essay from Harper's was printed there nearly verbatim, my name was also in the book.
I called the editor to ask if that might create the perception of a conflict of interest.
"Do you think you can write a fair and balanced review," the editor asked me on the phone.
I do not know this writer personally. We've never spoken or met. We aren't connected on social media. We did have a very brief email exchange after her Harper's article came out — I wrote to thank her for mentioning me. I have never taken money from her, as many scientists who are asked to review industry products routinely do.
I told the editor that I needed to read the book in its entirety to be sure, but that I thought I would be able to write an honest review. I also told the editor that I didn't feel comfortable publishing anything about the book without disclosing that my name is mentioned in it. She took my concerns seriously and we decided together that the editor would include a note of disclosure at the end of the review.
I wrote the review, and they published it on October 20. It was among the top five most read reviews for October, a fact that the Washington Independent Review of Books publicized in a second article.
On November 21st, I got an email from the editor that the review has been pulled from their site.
They've taken it off their website. Why? Because Eula Biss and her publisher contacted them to complain.
Their problem with the review? I have a conflict of interest since Eula Biss mentioned me in one sentence of her book. Here is the mention: Biss reports that in a 2009 Mothering magazine article, I "express outrage that newborn infants are routinely vaccinated for hep B" and that I wonder why I was encouraged to vaccinate my daughter "against a disease she had no chance of catching," which is a perfectly accurate and seemingly neutral report.
This "conflict of interest" would, of course, have been happily ignored if I had written a positive review.
And, of course, a conflict of interest was avoided by being properly disclosed at the bottom of the review.
Censoring this book review is part of a larger battle reasonable journalists face whenever they write issues related to vaccine safety and the very real and devastating problems in our current American vaccine system, which is sadly based more on maximizing profits and promoting special interests than it is about what is in the best interests of our children's health.
I realize a lot of people who read GreenMedInfo may disagree and I respect alternative points of view, but I am grateful to modern medicine for vaccines. I may be the most vaccinated person you've ever met, having lived and worked in West Africa twice. I've had the yellow fever vaccine and taken live oral polio before that vaccine was discontinued for safety issues. I have always supported a national vaccine program. My children, who have also been vaccinated, and I have not had any bad reactions to vaccines — that we are aware of. Nevertheless, I cannot ignore the problems with America's current childhood vaccine schedule.
A case in point: Scandinavian countries like Iceland and Norway, which enjoy much better infant health outcomes than the United States, do not vaccinate against hepatitis B in the absence of medical need. I also cannot ignore the very real financial conflicts of interest that motivate our current vaccine schedule. I encourage parents to research the issue for themselves and make their own informed decision, which should be respected by every physician and our fellow citizens.
But if Paul Offit, M.D. (whom I've interviewed and found to be smart, articulate, enthusiastic, and personable), one of the most well known proponents of America's current vaccine schedule, had his way, I would go to prison for writing about vaccines. In March 2014, Offit said that journalists who write about vaccine safety issues should go to journalism jail.
GreenMedInfo has generously agreed to reprint the censored review so readers can read it and decide for themselves where the real bias lies.
Review. On Immunity Review
On Immunity: An Inoculation
- By Eula Biss Graywolf Press 216 pp.
- Reviewed by Jennifer Margulis
- October 20, 2014
This heartfelt ode to inoculations dismisses concerns about vaccines.
On Immunity is an extended nonfiction essay — an impressionistic, metaphor-laden, first-person account of author Eula Biss' fears for her infant son's safety and the questions and concerns she has as she educates herself about vaccines. This slim book combines real-life vignettes with literary criticism, information about the history of vaccines in the United States, informal interviews with scientists, and chats Biss has had with friends and relatives.
Childhood vaccination, vaccine refusal, and vaccine exemption are evergreen topics that fascinate the American public, and this book could not be timelier.
Following on the heels of the recent disclosure by scientist William W. Thompson, Ph.D. — a strong advocate for vaccines — that the CDC, in a 2004 study of the possible relationship between the MMR vaccine and autism, "omit[ted] relevant findings ... for a particular sub-group ... for a particular vaccine," and the subsequent insistence by the CDC (and numerous television journalists) that vaccines do not cause autism, hundreds of parents who believe their children were injured by vaccines began sharing their stories online (under the hashtag #hearthiswell).
For her part, Biss is not interested in stories of vaccine injury, which she dismisses as exaggerated. Nor is she interested in the devastating fact that one in every 42 boys in America today has autism, or that we are seeing a rise in many other diseases among American children, including Type-1 diabetes and other autoimmune disorders.
Her book is ultimately such a staunch defense of the current vaccine system that she even criticizes the pro-vaccine pediatrician Robert Sears, author of the bestselling "The Vaccine Book," for giving parents worried about side effects from vaccines alternate vaccination schedules. (Sears also makes recommendations about which inoculations can be skipped entirely if doing so encourages vaccine-averse parents to have their children at least partially immunized.)
"The extra time and trouble required to follow Dr. Bob's alternative schedule are hard to justify unless the dangers of contracting infectious diseases early in life are minimized and the dangers of vaccinating early in life are exaggerated," she writes.
Though Sears' book is meticulously researched, overtly pro-vaccine (he inoculates dozens of patients every day), and extremely balanced, Biss objects to it: "Much of The Vaccine Book is devoted to this minimization and exaggeration," she writes.
Yet, ironically, Biss' own son may have been vaccine injured. She explains that he suffers from debilitating allergies that sometimes leave him unable to breathe.
"My son has unusually severe allergies, which he developed at an unusually young age," Biss writes. "His pediatrician calls him her 'outlier' because he is a statistical anomaly. By the time he turned three, his allergies had led to swelling in his nasal cavity, and this swelling had led to painful sinus infections, which we had cured with antibiotics several times, but which inevitably returned."
She is told by one doctor that her son must never get another flu vaccine because he is allergic to eggs. Scientific studies, including this one, have shown a causal relationship between food allergies and food components in vaccines. Other research indicates that vaccines may play a role in causing or exacerbating allergies, including childhood asthma.
And a recent study published in the North American Journal of Medicine and Science by physician and researcher Elizabeth Mumper suggests that children with a family history of allergies can benefit from a delayed vaccine schedule.
Despite this, Biss evokes Greek mythology, deconstructs Dracula (a metaphor for contagious disease and pestilence that must be hunted down and destroyed), and muses about Voltaire in order to reiterate what you will find in every other mainstream book: Her unnamed "friends" who are foregoing vaccines do so because they are privileged, educated, and selfish.
These moms care only about their own children to the detriment of society as a whole, minimizing the risks of contagious diseases (which are, to Biss, as terrifying as vampires), and overemphasizing the harms of vaccines.
As a thoughtful parent and journalist who is pro-vaccine and who has chosen to vaccinate her own children, but who champions parental choice and vaccine safety, I was disappointed by this book.
Biss' metaphorical musing on vaccinations and how to protect our children from harm ultimately reads like an extended attempt to justify her choice to fully vaccinate her son on the CDC's current vaccine schedule. (The only vaccine her son did not receive, because the doctor told her it was unnecessary, was the birth dose of hepatitis B.) Biss' father, an oncologist, dismisses parents who want their children to get chicken pox naturally as "idiots."
Because it so lyrically maintains the status quo, On Immunity has predictably garnered accolades. But the book is more notable for what it leaves out — the voices of thoughtful parents who are foregoing some or all vaccines; the stories of vaccine-injured children; and the nearly infinitesimal risk of catching certain communicable diseases versus the much higher risk of having autoimmune dysfunction in childhood — than what it includes.
When you feel the need to construct an enticing narrative to convince people that an orthodoxy you follow should be followed by everyone else, as well, the curtain you are weaving over it serves to draw just as much, if not more, attention to the legitimate questions that lie underneath.
[Editor's Note: We assigned this review to Jennifer Margulis because she has spent over 10 years researching and writing about childhood vaccination. Before accepting the assignment, Margulis informed us that, although she does not know Eula Biss personally, she and Biss have had cordial email correspondence, and that Biss mentions Margulis by name in both a Harper's magazine article and in On Immunity.]