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Deadly Choices: How the Anti-Vaccine Movement Threatens Us All

Deadly Choices: How the Anti-Vaccine Movement Threatens Us All

4.4 12
by Paul A. Offit

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In 2010, California suffered the largest and deadliest outbreak of pertussis, also known as “whooping cough,” in more than fifty years. This tragedy was avoidable. An effective vaccine has been available since the 1940s. In recent years other diseases, like measles and mumps, have also made a comeback. The reason for these epidemics can be traced to a


In 2010, California suffered the largest and deadliest outbreak of pertussis, also known as “whooping cough,” in more than fifty years. This tragedy was avoidable. An effective vaccine has been available since the 1940s. In recent years other diseases, like measles and mumps, have also made a comeback. The reason for these epidemics can be traced to a group whose vocal proponents insist, despite evidence to the contrary, that vaccines are poison. As a consequence, parents and caretakers are rejecting vaccines for themselves and their families.

In Deadly Choices, infectious-disease expert Paul Offit takes a look behind the curtain of the anti-vaccine movement. What he finds is a reminder of the power of scientific knowledge, and the harm we risk if we ignore it.

Editorial Reviews

From the Publisher

Perri Klass, Professor of Journalism and Pediatrics, New York University; author of Treatment Kind and Fair
Deadly Choices carries a very important message for parents, journalists, physicians, and everyone who cares about children and health. It is a passionate, but also compassionate, call for civil discourse and rational conversation on a subject which matters so much to each of us individually and to us all as a society. It is a fascinating account of society and science, politics, publicity, and public health.”

David Oshinsky, Professor of History at the University of Texas at Austin; author of the Pulitzer Prize-winning Polio: An American Story
“A medical crisis has come to America. Diseases of our grandparents' generation are making a deadly comeback as more and more parents choose not to vaccinate their children. How did this happen? Who is responsible? And what can be done to reverse this unconscionable assault upon our nation's public health? For the answers, provided in clear, common sense, page-turning fashion, I recommend Deadly Choices by Dr. Paul Offit — a timely and courageous call to arms by the nation's foremost expert on pediatric infectious disease.”

Booklist (starred review)
“Infectious disease expert Offit, long an outspoken and prolific champion of universal immunization via vaccines, ratchets up the urgency of his crusade by taking on the loudest and highest-profile spokespersons for the anti-vaccine movement.... Armed with his own arsenal of anecdotal horror stories that focus on worst case histories of the unvaccinated, mostly children, in addition to pages of scientific study citations supporting his premise, Offit pulls no punches. His tone is edgier than usual this time, his arguments more virulent. It is clear that he wants his message and the facts, not rumors or infectious diseases, to go viral.”

Science News
“In a meticulously researched tour de force, Offit exposes the lack of science underlying the claims of the anti-vaccine movement.... In 2009 and 2010, U.S. courts ruled against claims linking autism with vaccines. Still, many vaccine opponents aren't persuaded, and they have talk show access and Hollywood friends. To level the playing field, every doctor's office should have a copy of Offit's book, giving parents the other side of the story.”

Financial Times
“Offit…is a rare combination of scientist, doctor, communicator and advocate. In Deadly Choices, he powerfully lays out the history of vaccinations and their net benefit to society today.”

Michael Specter, Staff Writer, The New Yorker; author of Denialism
“With Deadly Choices, Paul Offit has once again brought clarity and reason to a subject that desperately needs them both. If you care about the health of your children — or the health of anybody's children — you need to read this book as soon as you can.”

Robert M. Goldberg, Ph.D., Vice President, Center for Medicine in the Public Interest and author of Tabloid Medicine: How the Internet is Being Used to Hijack Medical Science for Fear and Profit
“This is a courageous book by a courageous researcher and physician. Paul Offit's new book tells the truth about the anti-vaccine movement, its unquestioning followers in the media and about the deadly consequences of their campaign of fear. Deadly Choices demonstrates that the enemies of immunizations are successful because too many of us have remained silent in the face of their falsehoods and intimidation. Dr. Offit shows that by standing up for science we can win the war against those who would leave our children defenseless against infectious disease.”

Steven Novella, Assistant Professor and Director of General Neurology, Yale University School of Medicine
“Dr. Offit brings to life in careful and compelling detail the story of misguided and dangerous activists using bad science to attack one of the most effective public health interventions ever devised. It is a must-read cautionary tale of the abuse of celebrity, the media, misinformation and fear.”

Chris Mooney, author of Unscientific America
“Paul Offit is that rarity: An eloquent, outspoken scientist with a gift for writing narrative. I cannot imagine a better counter to the scientifically challenged — and just plain dangerous — anti-vaccination movement. We're fortunate to have him.”

Kirkus (starred review)
“Offit takes aim at the anti-vaccine movement in America and scores a bull's-eye.... A much-needed book with solid evidence — deserves all the publicity it can get.”

Publishers Weekly
In the second book this season (after journalist Seth Mnookin's The Panic Virus) to attack vaccine paranoia, Offit—who drew antivaccinist fire for Autism's False Prophets—presents a smart, hard-hitting exposé of vaccine pseudoscience. Offit brings outstanding credentials to the subject: he's a vaccinologist at Children's Hospital in Philadelphia and an expert in infectious diseases, and he tackles claims that childhood inoculations cause brain damage, autism, diabetes, and cancer, finding a farrago of misinformation, faulty research, and sly deceptions fed to distraught parents by media hype, ax-grinding activists, and personal-injury lawyers. He embellishes his account with a sprightly history of paranoid medical populism—19th-century critics of the cowpox-derived smallpox vaccine insisted it could turn people into cows—and a blistering attack on celebrity antivaccine ideologues Jenny McCarthy, Jim Carrey, and Bill Maher and the medical writers who pander to parental anxieties. Offit dwells less than Mnookin on the sociology of the controversy and more on the science. The result is a thorough dismantling of antivaccine notions and a sober warning about the resurgence of deadly childhood infections stemming from declining vaccination rates. Worried parents, especially, will find this a lucid, compelling riposte to antivaccine fear-mongering. Photos. (Feb.)
Kirkus Reviews

Offit (Vaccinology and Pediatrics/Univ. of Pennsylvania; Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure, 2008, etc.) takes aim at the anti-vaccine movement in America and scores a bull's-eye.

If only people would listen. Unfortunately, it's often a case of irrational behavior fueled by hostility toward doctors, researchers, drug companies and government. The issue comes down to coincidence vs. causality. A baby is vaccinated and thereafter develops seizures, brain damage, autism or other disorders. So powerful is the need to find a cause that vaccines become the target and no amount of clinical or epidemiological evidence will change opinions. Abetting belief are the activists and celebrities who champion the cause on the nightly news or on their own inflammatory blogs. What Offit offers in response is a well-documented history dating back to the first vaccine for smallpox. That, too, occasioned widespread attack once vaccination was made compulsory, with protesters even claiming that children would develop little cows at the inoculation site (because the vaccine is based on the cowpox virus. The author traces recent anti-vaccine activism in America to the 1982 documentaryDPT: Vaccination Roulette, which inveighed against the pertussis part of the DPT regimen (diphtheria, pertussis, tetanus). In spite of exonerating evidence, negative publicity and lawsuits drove drug companies out of the vaccine business and led to the National Childhood Vaccine Injury Act. But the battle was renewed with the association between autism and the measles, mumps and rubella vaccine or its mercury component. Now that vaccine is mercury-free, and countless studies have discounted any association, but the protests mount, with many states allowing parents to opt out of vaccine programs. The danger is that with too many kids unvaccinated, herd immunity is lost and epidemics become a reality. Offit rightly points out that it would be a mistake to go this route to demonstrate why vaccines are essential; what we need is a restoration of trust. He suggests that this could happen if concerned parents and public health workers who have seen the devastation wrought by childhood disease speak out.

A much-needed book with solid evidence—deserves all the publicity it can get.

Product Details

Basic Books
Publication date:
Edition description:
First Trade Paper Edition
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Product dimensions:
5.40(w) x 8.20(h) x 1.10(d)
Age Range:
18 Years

Meet the Author

Paul A. Offit, MD is the Chief of the Division of Infectious Diseases and the Director of the Vaccine Education Center at the Children's Hospital of Philadelphia. He is the Maurice R. Hilleman Professor of Vaccinology and a Professor of Pediatrics at the University of Pennsylvania School of Medicine. Dr. Offit is a founding advisory board member of the Autism Science Foundation—to which he is donating the royalties from this book—and the author of five books including Autism's False Prophets and Vaccinated. He lives in Bala Cynwyd, Pennsylvania.

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Deadly Choices: How the Anti-Vaccine Movement Threatens Us All 4.4 out of 5 based on 0 ratings. 12 reviews.
dsimons More than 1 year ago
The focus of Deadly Choices is on the history of the introduction of new vaccines and the anti-vaccine movements that tend to follow. Offit is a prominent virologist and he doesn't hide his scorn for some in the anti-vaccine movement. His book is unlikely to change the minds of anyone who is firmly within that movement, but I'm not sure what would. The book is a must read for anyone interested in a detailed, well-written, and thoroughly sourced discussion of the scientific basis of vaccines, the real and imagined risks of vaccination, and the consequences of the choices we make about vaccines. The book thoroughly documents some of the unfounded claims that the anti-vaccine movement has made and explains the biological reasons why some of the perceived risks of vaccines either are not a risk or physiologically CAN'T be a risk. The book is not one-sided, though. The first chapters discuss all of the well-documented cases of actual vaccine injury and the real side effects of vaccines (e.g., the live polio vaccine could cause polio, although most vaccines don't use live viruses). Offit makes the case that anti-vaccine movements raise fears of vaccines that are inconsistent with the science. In so doing, he draws parallels between current anti-vaccine claims and those made over a century ago after the introduction of the smallpox vaccine. Many of the fears of that vaccine are laughable by today's standards (e.g., that children would develop cow-like facial features because the vaccine was initially taken from cows infected by cowpox). But Offit argues, fairly convincingly, that the logic and nature of current anti-vaccine scares are largely the same as those raised over a century ago and in each subsequent anti-vaccine movement. The most compelling chapter is the last one, in which Offit describes what happens when someone who could not be vaccinated (because they were too young) comes into contact with an infected child whose parents decided not to vaccinate. The choice not to vaccinate affects people other than your own child--it puts young infants and others whose bodies lack a typical immune response can't be vaccinated at risk. The chapter is reminiscent of the recent PBS Frontline documentary on vaccinations. At times, the book can be a bit heavy handed in its tone-Offit's perspective is clear throughout, and he doesn't hold his punches. Sometimes his parallels between historical anti-vaccine movements and current ones are a little forced, and in a few cases, the book is perhaps a bit more dismissive than is necessary. Overall, though, the book presents the scientific evidence in a compelling, comprehensive, thoroughly documented, and engaging way. For prospective parents whose prior information about vaccines comes from friends, the internet, or even their pediatrician, this book is a must read by one of the top scientific experts in the field. It provides the background and evidence you need to evaluate claims about the dangers and benefits of vaccines and to make the best choice for your children AND your community.
Anonymous More than 1 year ago
Paul Offit presents an incredible version of the anti-vaccine discussion. While Offit clearly has a firm opinion that everyone should be vaccinated, I appreciate that he still thoroughly researched and discussed both sides of the argument. Amid the scientific and political details, Offit artfully weaves in personal stories of families and parents who are both in support of and against the anti-vaccine movement. My one complaint is that the writing did at times feel repetitive and lengthy. However, after finishing the book it was apparent that each individual story was carefully selected to support Offit’s viewpoint on the anti-vaccine movement. I highly recommend this engaging read for anyone who is a soon-to-be parent, a student studying public health, and everything in between!
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Dear Dr. Offit: You speak of the "terrible" outbreak of pertussis in California in 2010 which was entirely preventable. I will refer you to the investigation posted by the Digital Journal on April 18, 2012, titled "Study: Whooping cough outbreak liked to Vaccinated children." The study, led by infectious disease specialist Dr. David Witt, was initiated by Kaiser Permanente in 2010. After examining the records of juvenile whooping cough patients over an 8 month period, the doctors discovered that 81 percent of patients had the full series of whooping cough shots, and 11 percent of patients had received some of the shots. Only 8 percent had not received any immunization for whooping cough. "What was very surprising was the majority of cases were in fully vaccinated children," Witt said. "That's what started catching our attention." According to The New York Times, vaccination rates remained steady (in California) as cases of whooping cough skyrocketed in the state. In regard to your objectivity, how does your making millions of dollars each year from Merck and your own vaccine patents qualify you to be an unbiased reporter of truth.
willyvan More than 1 year ago
This excellent book, like Dr Offit’s successful Autism’s false prophets, exposes the dangers of choosing faith-based medicine rather than evidence-based medicine. Dr Offit is the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. Before vaccination, in the USA, measles killed 500 children a year; whooping cough infected as many as 147,000 people each year between 1940 and 1945 and killed nearly 8,000 a year; polio killed 1,000 children a year, and diphtheria killed 12,000 people, mostly young people. In epidemics of mumps and bacterial meningitis, hundreds more suffered and some died. The claim that whooping cough vaccine, not whooping cough itself, causes permanent brain damage is just plain wrong. But the scare about the vaccine in England in 1973 led to the immunisation rate falling from 79 per cent in 1972 to 31 per cent in 1977. Subsequently, 100,000 children got whooping cough and 600 died. By 1976, the USA had only 1,010 cases of whooping cough, the lowest number ever reported. But in 2010 California suffered the largest and deadliest outbreak in more than fifty years. 9,000 people were diagnosed with the disease, and ten infants died of it. Some alternative medicine practitioners oppose vaccination. Rudolf Steiner, for instance, wrote absurdly that vaccination ‘interferes with karmic development and the cycles of reincarnation’. Contrary to the deniers, vaccines are tested for safety in larger numbers of people for longer periods than any drug. Vaccines do not have a high rate of serious side effects. Vaccines don’t contain dangerous quantities of dangerous ingredients. Vaccines prevent some very serious illnesses. Dr Offit urges US states to end health laws that allow religious exemptions even for lifesaving medicines (and for vaccines), which exist in all US states but three. It is often claimed, by, ironically, well-funded advocacy groups backed by very rich personal-injury lawyers, that big pharma engages in illicit marketing practices for vaccines. But there is no example of this.