An Interview With Seth Mnookin, Author of The Panic Virus: A True Story of Medicine, Science, and Fear

Article first published as An Interview With Seth Mnookin, Author of The Panic Virus: A True Story of Medicine, Science, and Fear on Blogcritics.

Seth Mnookin could have taken the easy way out in The Panic Virus: A True Story of Medicine, Science, and Fear: He could have written a book just taking down medical researcher Andrew Wakefield, who started — using unethical methods — the myth that there is a correlation between vaccinations and autism.

Or Mnookin could have done what Michael Specter did in an excellent book called Denialism — namely focus on those who are letting emotions dictate their decisions in issues ranging from the vaccination debate to fears about other issues.

Instead, Mnookin takes the long view, looking at the big picture, tracing back vaccines and prior vaccination debates (there was one about polio and other ailments).

The result is a fascinating book that has elements of each of those ideas listed above: It explains the history of these issue going way back before autism was even given that name, explaining how Andrew Wakefield stirred up this long-standing myth as well as looking at why there are still organizations and celebrities spreading the myth.

In prior writings for Vanity Fair and a book about The New York Times (Hard News) Mnookin doesn't spare news media its due criticism for handling of the issues, and such is also the case here. Part of the problem was too many journalists used the old framework of two sides to every story which meant as long as there were people suggesting a correlation between vaccination and autism they would print that story long after science and study after study had disproven it.

In his epilogue he writes this after talking about people being injured and in some cases dying as a result of family decisions — sparked partly by people like Jenny McCarthy and Oprah Winfrey suggesting the vaccine-autism link exists where it doesn't — not to vaccinate their children.

It's tempting to place the blame for this state of affairs squarely on the shoulders of people like Andrew Wakefield; after all, it would be hard to think up a character more sinister than someone who pays children for their blood. But that's the easy way out: Wakefield might have provided the spark, and any number of other charlatans and hucksters might have fanned the flames, but it's the media that provided — and continues to provide — the fuel for this particular fire...

The type of journalism that relies on the reporter's notion of what does or doesn't 'seem' correct or controversial is self-indulgent and irresponsible. It gives credence to the belief that we can intuit our way through all the various decisions we need to make in our lives and it validates the notion that our feelings are a more reliable barometer of reality than facts...

He ends the book by noting that as he was finishing researching the book his wife had their first child and his concern is not that vaccines will harm the child but rather that someone not vaccinated will cause pain and ailments. "I worry that he'll end up in a pediatric ICU because some parent decided the Internet was more trustworthy than the AMA and the AAP."

I want to end this introduction with his final paragraph in the book:

As my son grows older, I hope that ... he will feel empowered to make his own decisions and will have the self-confidence to challenge traditional wisdom. I also hope that he learned the difference between critical thinking and getting swept up in a wave of self-righteous hysteria, and I hope he considers the effects of his actions on those around him. Finally, for his sake and for that of everyone else alive, I hope he grows up in a world where science is acknowledged not as an ideology but as the best tool we have for understanding the universe, and where striving for the truth is recognized as the most noble quest humankind will ever undertake.

For some background, you can watch here Seth responding to Wakefield who refused to talk to Mnookin directly.

Why did you decide to write this book? What is your goal with this book?

I started working on the book about three years ago, after a series of conversations with my friends about their concerns regarding vaccine safety efficacy and safety. At the time, I didn’t have any children, but I was surprised that so many of the people I knew were making their decisions about whether or not to vaccinate their own children based on their instinct about what was best and not on the evidence. At the time, I didn’t know where the truth lay, but I thought it was an interesting and important topic to explore.

What has been the response to this book from those camps who still think there's a vaccination-autism link? I came across this when I googled Autism One, shocked that they seem to still be sticking to their story. I was not sure if their response was to your book and others or what?

In general, the response from those that have been most vocal about their belief that there is a causal link between vaccines and autism has been to dismiss me either as someone who is misguided, uninformed, unintelligent, or corrupt. I think overall, however, that segment of the population is very small. There are many parents who are concerned about vaccines and vaccine safety, but the vast majority of them are looking to have their questions answered and their concerns addressed and are not convinced that the government, the health care industry, and pharmaceutical companies are engaged in a massive conspiracy to harm children.

Would you encourage people to get every vaccination offered by their doctors?

If people are worried about vaccinations, I’d encourage them to talk about their concerns with their children’s pediatricians. I certainly wouldn’t make recommendations to individuals about what they should or shouldn’t do; I do think these are decisions that should be made in consultation with doctors.

What's your verdict on the news media regarding this issue: Were they duped? Did they drop the ball in attempt for simple answers?

I think the news media’s coverage was very deficient in this issue. Initially, a lot of the coverage seemed to be based on a misapprehension that objectivity is the same thing as presenting every controversy or debate as if both sides are equally legitimate. That’s obviously not true.

What do you think of Michael Specters' book, Denialism, (I interviewed him here) and his theory that the believed vaccine myth is part of something bigger, namely people choosing to believe emotion rather than scientific fact?

That’s one of the central themes in my book. A lot of my initial thinking in this regard was sparked by Jonah Lehrer’s book How We Decide, which I think is an excellent discussion of the reasons we make what we think are rational decisions based on emotion or intuition.

Do you think some people's continued belief in this vaccine-autism link is due partly to us living in a culture of fear where some long for simple explanations — i.e., avoid vaccine, avoid autism — in a more complicated world?

I’m not sure it’s so much as people longing for simple answers; when it comes to autism, at least, there aren’t any satisfying answers. Autism is something about which we as a society are much more aware of than we were, say, 20 years ago — and yet we still don’t know a lot about its precise etiology, the most effective early interventions, etc. As long as that’s the case, I think there’ll be theories about the causes of autism that continue to have adherents regardless of the evidence.

Do you think those who most need to read this book — those believing in such a link — are going to? Or are they your target audience? Put another way, who IS your target audience with this book?

I hope the book is of interest to anyone curious about why we think the things we do, how we interpret the information we receive, the foundation of scientific knowledge, the history of vaccines — really anyone interested in reading non-fiction. One of the reasons I didn’t put the words “autism” or “vaccines” in the title is that it’s a book about much larger themes that uses this specific debate as a narrative framework.

In terms of the audiences most intimately connected with this issue, I hope doctors, health care and public health officials, and parents/expectant parents would all find the book valuable for different reasons. Since I didn’t start from the perspective of one “side” or the other, I think parents can look at this as an example of what they might learn if they spent two years looking at the issue. Since I spent a lot of time interviewing people on all sides of this debate, I think doctors can read it and gain insight into more effective ways to communicate with their patients.

Is part of the problem with this debate that so many people distrust the health care system and big pharma?

Absolutely — and certainly, there are plenty of examples that have come up over the last several years that provide reasons why people should be skeptical of claims made by drug companies. Fortunately, this is not an issue about which we need to take the drug companies’ words about the safety or importance of vaccines: We have decades of research conducted by scientists in the public health sector, independent researchers, epidemiologists, and doctors — and we have research from countries around the world.