Paul Howard is a senior fellow at the Manhattan Institute Center for Medical Progress and the editor of the blog Medical Progress Today. In this Washington Post op-ed, Howard addresses the potential danger to public health of indulging in the current wave of trendy skepticism toward vaccinations:
Sadly, too many parents have lost faith in vaccines. Partly, this is because of a “generation gap.” In 1940, U.S. infant mortality rates stood at 40 deaths per 1,000 live births. Tens of thousands more children would go on to be killed or maimed by measles, polio and chicken pox. Today, infant mortality averages about 7 deaths per 1,000 live births, and those other diseases have been largely vanquished by vaccines. A childhood free of serious illness is now taken for granted.
When mysterious disorders like autism strike seemingly healthy children — at about the same age when childhood vaccines are typically administered — frustrated parents lash out at doctors and pharmaceutical companies. And today’s vaccine inventors must contend with a powerful force that had yet to arise when Jonas Salk created his revolutionary polio vaccine — mass litigation.
The birth of “liability without fault” in pharmaceutical litigation in 1958 — captured in Dr. Paul Offit’s riveting book The Cutter Incident — set the dangerous precedent that vaccine companies would be held liable for side effects even when their products were made using the best available science and according to government regulations. [. . .]
The debate over vaccine litigation has thus shifted from a presumption of innocence to a presumption of guilt. While the number of major studies that have failed to find any substantive link between vaccines and developmental disorders or autism is now in the double-digits (including a September 27th CDC study in the New England Journal), critics are effectively demanding that scientists prove that thimerosal does not cause illness — an impossible standard.
The very success of vaccines has become their downfall. As Dr. Offit writes in Vaccinated, “When [vaccines] work, absolutely nothing happens. Parents go on with their lives, not once thinking that their child was saved.”
The entire op-ed is here. This earlier post addresses the devastating impact that the Cutter Incident had on the production of vaccines and public health.
Try convincing people that drug companies are not intentional poisoning people for profit and you’re in on the conspiracy. Did I mention that vaccinating people has such low margins that some docs quit doing them? And many drug companies quit making them?
For the record, opposition to vaccination is as old as Jenner’s discovery of a smallpox vaccine. This is obviously way before pharmaceutical corporations formed, so it is dubious that litigation is a cause rather than an effect of some opponents of vaccinations.
Rather, as many scholars (mostly historians, anthropologists, and sociologists of medicine) have pointed out, the American phenomena of opposing vaccination is rooted in a complex set of social and cultural forces that changed and evolved over time. In the late 19th century, for example, many of those who violently opposed vaccinations in NYC and Philadelphia were immigrants or children of immigrants, who had, unfortunately, reason to be suspicious of state and city public health officials, many of whom viewed them as a subclass.
This is not to suggest that the current opposition to vaccinations makes for sound reasoning or is well-advised. Rather, the point is that we would, IMO, gain a much richer and more culturally informed understanding of why such a vocal minority opposes vaccines, then to probe beyond the presumption that litigation causes more than reflects some social unease with vaccines.
Daniel, good point on the historical underpinnings of public mistrust toward vaccinations. But wouldn’t you concede that litigation is a particularly inefficient way in which to address — much less validate — that mistrust?
Tom,
As you likely know, we differ in our opinions of the inherent value of tort liability as an allocation mechanism. I think it is generally far more valuable than many “tort reform” minded persons do, and I think such liability may well have a role to play. The Cutter Incident is only the most famous and hardly the sole instance of vaccinations causing harm, though, again, this is not to infer any connection between vaccines and autism, which is simply not evidence-based right now.
But given how little we actually understand about immunology — look what a spectacular failure Merck’s recent AIDS vaccine was — I would certainly oppose tort immunity at this point.
In any case, my ultimate point is that it is exceedingly dubious, IMO, that vaccine litigation is a major causal factor in opposition to vaccination. It is much more likely to reflect long-standing social and cultural suspicion of vaccination. If we really want to address opposition to vaccination, focusing merely on tort liability instead of the much more complicated social and cultural factors that animate opposition to vaccination is almost guaranteed to be unsuccessful policy.
There are much more productive ways of engaging the problem than to blame it on litigation, which is one of my chief differences with “tort reformers” like those at the MI.