House debates vaccine safety

Critics say mandatory inoculations may do more harm than good. But what about all the lives that have been saved?

Published August 5, 1999 9:00AM (EDT)

"We as a government can no longer keep our heads buried in the sand like
an ostrich, pretending there is no problem," said Rep. Dan Burton, R-Ind., the
arch-conservative, hatchet-faced chief of the House Government Reform
Committee, as he waved a sheath of documents that he said showed thousands of casualties over the past year.

Burton's rather surprising target: mass immunizations. The shots we get with our mother's milk constitute the single most effective medical intervention of the past
century -- but in front of a packed hearing Tuesday, Burton described mandatory
vaccination as "a good intention gone too far" that "creates an inherent
conflict between the interests of the individual and the community." He
promised to lead a thorough reexamination of the nation's vaccination

Burton's hearing marked the triumph of an Internet-based coalition of
vaccination critics who have claimed for years that inoculation does more harm
than good. The critics, who range from legitimate scientists to prodigious
yarn-spinners, claim the government is obscuring the danger of vaccines and
urge the abolition of mandatory vaccinations for schoolchildren.

The movement is swimming against a tide of new vaccines that have entered or
are about to enter childhood inoculation schedules. In the past decade,
shots to protect against meningitis, hepatitis B and viral diarrhea have
been added to the regimen protecting against polio, measles, mumps,
rubella, whooping cough, tetanus and diphtheria. Public health officials
also hold up vaccination as a key tool against the worrisome threat of
drug-resistant bacteria: By priming the body's immune system to fight a
particular organism, they argue, vaccines preempt the need for antibiotics to fight the
bacteria later, after infection.

But Tuesday's hearing showed that despite these promising developments, the tide could easily turn against vaccines unless public officials
convincingly show they are taking pains to keep vaccines safe. And while
there are surveillance systems in place -- such as the one that detected
problems in the rotavirus vaccine last month -- blunders have the capacity to undermine confidence.

The Pentagon, for one, hasn't helped matters. Since announcing in December
1997 that it would immunize 2.3 million service members against anthrax, it
has been forced to use stocks of a relatively crude anthrax vaccine that
was licensed in the 1960s and manufactured at a laboratory with quality
control problems. Coincidentally or not, many troops receiving the vaccine
have reported illness, provoking a culture of resistance within the
military -- with scores and perhaps hundreds of experienced reserve pilots
and others threatening to quit rather than take a vaccine they think is

Meanwhile, right-wing Christian groups have glommed onto the anti-vaccine
movement through their objection to the mandatory hepatitis B vaccine -- on
the grounds that only sinful drug addicts and fornicators get hep B.
(Actually, 19,000 kids contract it each year, and as much as a third of its
transmission is through means other than sex or shared needles.) Vaccination critics
have also been angered by the fact that a no-fault court created in 1986 to
compensate people killed or hurt by vaccines has ended up using such strict
guidelines to determine whether an injury was caused by a vaccine that most
alleged victims are now being turned away.

Clinton administration efforts to track mandated childhood vaccinations have led paranoids to accuse it of "Chinese Communist-style" social controls, in the words of right-wing
activist Phyllis Schlafly, who has also jumped onto the anti-vaccine bandwagon.

Tuesday's hearing was a moment of vindication for Barbara Loe Fisher, a
cherubic, brown-haired woman who sits at the center of the anti-vaccine web. Fisher has championed the battle since 1982 at the helm of a Vienna,
Va.-based group called the National Vaccine Information Center. She
claims that two of her children were damaged by vaccines (though she admits that a third, unvaccinated child almost died from whooping cough). Fisher professes not to oppose vaccination but to
favor "choice" and greater government acknowledgement of the risks of
vaccination; her group touts homeopathic and other alternatives to
vaccination. At Tuesday's hearing, Fisher wore a bright purple suit and was
surrounded by parents pinned with tiny white ribbons symbolizing children
injured by vaccines. "This issue has hit a critical mass," she said. "At
this point everybody knows somebody who had a reaction."

In fact, as it transpired during the afternoon, Dan Burton himself had a
personal interest in vaccine safety. His infant granddaughter, Burton said,
ended up in the emergency room 12 hours after receiving a hepatitis B
vaccine. (Surgeon General David Satcher, on the witness stand when Burton
revealed this fact, diagnosed it as anaphylactic shock --"which can happen
with any medication.") Burton added that his grandson had received a DTP
shot (diphtheria-tetanus-pertussis) and "is now somewhat autistic ... you
can call it a coincidence, but I think it's a concern, and that's why we're
having this hearing," Burton said.

The audience, including many parents who have struggled for years to get an
explanation and decent care for severely damaged children, was clearly
primed for Burton's routine. Listening to some of the stories, you couldn't
blame them. Pamela Lynn Wood, a 43-year-old woman from Colt's Neck, N.J., described a 10-year odyssey following her injection with a rubella
vaccination in 1989. Wood developed connective tissue disease -- a rare but
scientifically recognized side effect of that particular vaccine. A year
later she gave birth to her second son, Grant, who after 15 normal months
went into a developmental tailspin ending in autism. Wood believes her
son's illness resulted from a measles-mumps-rubella (MMR) shot; an
overabundance of rubella antibodies in his blood, she believes, caused
auto-immune disease and swelling in his brain.

While Wood delivered her written testimony to the committee, her husband and sons stood outside the hearing room against the yellow brick wall. Grant Wood, a beautiful 8-year-old with cloudy blue eyes, alternately stared into space and gripped his father's legs. "There was some chain of events that led to this, and we're sure the vaccine played a role," said Tom Wood as he tousled his son's hair. "And we feel that if the medical system was
willing to give some credence to the idea that vaccines can cause harm -- if
they weren't so dead set on vaccinating everyone with every shot -- maybe we might have avoided giving Grant the MMR, given his mother's problems with rubella."

"The science isn't out there to answer some of these questions,"
acknowledges Dr. Bruce Gellin, who directs an initiative to counter
misinformation about vaccines. But as painful as it is to observe families
stricken with life-altering illnesses, Gellin cautions, one has to
recognize that poorly understood illnesses like autism have prompted a
plethora of hypothetical causes -- everything from viral infections to
genetic predisposition to environmental toxins. Given the subtleties
involved, Gellin said, "you do wonder whether a Congressional hearing is
the best place to objectively consider these questions."

During the six-hour hearing, Burton's remarks were frequently incautious or
wrong. He claimed, for example, that five vaccinated researchers had been
killed by exposure to airborne anthrax; in fact the four researchers who
died several decades ago, in the incident Burton referred to, were
unvaccinated -- the vaccinated ones survived. He waved around documents from the FDA's Vaccine Adverse Event Reporting System that he claimed showed large numbers of vaccine-related injuries, a gross exaggeration. The numbers, from a
surveillance system the FDA set up in 1986 to improve vaccine safety,
recorded every possible vaccine reaction phoned or mailed in to FDA -- but
careful examination often found that the vaccine did not cause the problem.

Burton has insisted on further hearings -- but what Tuesday's forum demonstrated, more than anything, is that the public
health system has been a victim of its own success. Vaccines have been so
effective in reducing the diseases they aim to attack that it is the
uncommon side effects, rather than the threatened diseases, which draw
attention. In 1900, 30 percent of all deaths were children age 5 or
under. In 1997, about one in 70 deaths was a small child. This is due mainly
to clean water and vaccinations. Satcher, who is 58, remarked to Burton
that he, Satcher, had almost died of whooping cough at age 2 back in
Alabama. The disease, caused by pertussis bacteria, killed 3,500 people
that year. In 1997, six people died of the disease, and some of them may
have been exposed to it as a result of the anti-vaccine movement.

In the past three decades, vaccine scares in Britain, Japan and other
countries led to huge epidemics of infectious disease when large
populations stopped getting vaccinated. The breakdown of the Russian public
health service has resulted in hundreds of deaths each year from
diphtheria, a disease that peaked in 1921. And in the United States,
whooping cough has made a small comeback in recent years, particularly in
parts of Northern California where anti-government or alternative-medicine
movements have induced parents to refuse to vaccinate their children.
There are whooping cough outbreaks every fall in Santa Cruz and Sonoma
counties; two children died of the disease last year. And when even
relatively small populations stop getting vaccinated, endemic whooping
cough and measles germs easily jump into the breach. A study published in
JAMA last month showed that unvaccinated children in the United States are 35 times more likely to contract measles than their vaccinated peers.

"We are becoming complacent about our success against infectious
diseases," said Henry Waxman, the California Democrat and minority leader
on Burton's committee. "If children are frightened and parents discouraged
about vaccines, we will quickly become vulnerable to infectious diseases."

By Arthur Allen

Arthur Allen writes on health, science and other issues for Salon and Kaiser Health News. He lives in Washington.

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