Proceeds of all sales of Deadly Choices are donated to the Autism Science Foundation.
From June 15, 2011 Journal of the American Medical Association (Copyright American Medical Association 2011)
BOOK AND MEDIA REVIEWS
DEADLY CHOICES: HOW THE ANTI-VACCINE MOVEMENT THREATENS US ALL 
By Paul A. Offit 288 pp, $27.50 New York, NY, Basic Books, 2010 ISBN-13: 978-0-465-02149-9
In an ideal world, I would never be asked to review such a book as Paul Offit’s Deadly Choices. In an ideal world, a book like Deadly Choices would have no market. In an ideal world, the genius who developed a vaccine against rotavirus should not have to divert his valuable time to address such phenomena as the antivaccine movement. But the world today is far from ideal.
Deadly Choices masterfully presents the history of the antivaccine movement, which finds its origin in the time of Edward Jenner, and provides a devastating rendition of the antiscientific mentality that animates the celebrities and physicians alike who grant this movementmoral legitimacy. The book is not just a polemic; it provides ample details that unequivocally establish the enormous achievement vaccination represents. The book presents many interesting facts and anecdotes. Such facts are eye-opening because they reveal the nonobjective basis that underlies some of the operations of the courts, which have disbursed billions of dollars to those it deemed “harmed” by vaccination, despite clearly contradicting scientific information, as in the case of the diphtheria and tetanus toxoids and pertussis vaccine. Other highlights of the book include a thorough analysis of the US Supreme Court case Jacobson v Massachusetts, which addressed compulsory vaccination; a useful summary of the issues surrounding the fraudulent study, recently retracted, associating the measles-mumps-rubella vaccine with autism; and the story of Samuel Berkovic’s discovery that Dravet syndrome—a genetic disorder—was responsible for many cases of vaccine-induced neurologic disease.
Offit profiles the major figures in the modern antivaccine movement, tracing their careers, thinking, and initiatives. His focus is not just on celebrities and parents’ groups; he also appropriately singles out physicians who are complicit in this movement and lend their considerable authority to it. The author likewise provides a scholarly juxtaposition of antivaccinationists from earlier eras with those of today, highlighting the similarities and differences that exist between them. As Offit writes, several similarities are the idea that physicians are evil; the use of public rallies; paranoia; false claims of vaccine harm; the idea that vaccines are unnatural; the rejection of the germ theory; the lure of “alternative” medicine; the fear of medical advances; the idea that vaccines thwart the power of a deity; and the use of mass marketing. Important differences include the fact that in the modern era, antivaccinationists are chiefly drawn from the affluent (vs the poor in earlier eras); the involvement of personal injury lawyers; and antivaccinationists’ tactic of not using the word “antivaccine” when describing themselves. A major strength of this book is that it does not simply ignore real issues that have occurred with vaccine safety. Offit does not gloss over the problems with the Cutter version of the polio vaccine, a topic on which he has written another book, or the intussusception cases associated with an earlier version of a rotavirus vaccine. One incident described in this text—the burning in effigy of Edward Jenner in antivaccine rallies in the 19th century— is powerfully affecting. To denigrate such a benefactor of humankind as Jenner is almost unfathomable. The event is reminiscent of a passage in philosopher-novelist Ayn Rand’s masterpiece novel The Fountainhead, in which she writes, “Throughout the centuries thereweremenwho took first steps down new roads armed with nothing but their own vision. Their goals differed, but they all had this in common: that the step was first, the road new, the vision unborrowed, and the response they received—hatred.”
It is my belief that when new histories of vaccination’s prowess are written, Offit will be mentioned in the same breath as Edward Jenner, Louis Pasteur, Maurice Hileman, Jonas Salk,Albert Sabin, Baruch Blumberg,Max Theiler, Robert Austrian, and the other giants of vaccinology who have incalculably benefitted humankind. One of the proponents of vaccines quoted in Deadly Choices states that those who refuse vaccines have the right do so but “have to live on an island: their own little infectious diseases island.” Those like Offit have created a world in which many infectious diseases have been relegated to virtual islands in a sea of immunized individuals—and it will be damning if their invaluable work is destroyed. It is in this vein that I recommend Deadly Choices, in the highest possible terms, as an anecdote and tool to fight for the glory of vaccines. The survival of humankind depends on it.
Amesh A. Adalja, MD
Author Affiliation: Center for Biosecurity and Division of Infectious Diseases, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (ameshaa@aol.com).
Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Book andMedia Reviews Section Editor: John L. Zeller,MD, PhD, Contributing Editor. ©2011 American Medical Association. All rights reserved. JAMA, June 15, 2011—Vol 305, No. 23 2469
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