The New York Times Magazine

May 6, 2001

QUESTIONS FOR BARBARA LOE FISHER

A Shot in the Dark 

The president of the National Vaccine Information Center argues that we don't know nearly enough about a procedure that almost all American kids undergo. 

Q: Many people consider vaccination one of the great medical successes of the 20th century. Do you disagree with that assessment? Certainly with the implementation of mass-vaccination policies in the last 40 years we've seen a decline in infectious diseases of childhood. However, we have at the same time seen a doubling of asthma and learning disabilities. A tripling of diabetes. Autism is affecting one in 500 children. We need to look at whether an intervention used with every child is perhaps contributing to the background rate of chronic disease or disability. 

Q:  The F.D.A. says that in most of the cases, there's no way to prove a connection between a vaccine and the adverse reaction that's attributed to it. How much of a case can be made? Less than 10 percent of all doctors report serious health problems following vaccination, and the F.D.A. doesn't have the money or staff to investigate the ones that are reported. So we don't really know. It's scientifically and ethically irresponsible to write off most of these injuries as "coincidental" to vaccination when the government has funded very little research into biological mechanisms of vaccine injury and death. 

Q: Take autism. It seems to be on the rise, and there's a theory that the measles-mumps-rubella vaccine can trigger it. But several recent studies show that reports of autism are rising in areas where M.M.R. vaccination rates remain steady. Isn't this proof that vaccines are not to blame? We have never felt the M.M.R. was the only vaccine implicated in autism. The larger question is whether there is a group of genetically or biologically susceptible children who not handling the ever-increasing number of vaccines. If you have biologically susceptible children and give them three vaccines, that may not trigger dysfunction. But if you give them 37 doses of 11 different vaccines, including M.M.R., you could be creating a larger and larger group of genetically susceptible children, tipping them into neuroimmune dysfunction.

Q: You're not a doctor, but you are an established expert on this topic. And you have three children. Did you have them vaccinated? How did you make that decision? In 1980, my healthy, precocious 2 1/2-year-old son suffered a convulsion, went into shock and lost consciousness for six hours a few hours after his fourth DPT shot. He was left with minimal brain damage that took the form of learning disabilities and attention deficit disorder. In 1982, I joined with other parents of vaccine-injured children and founded the National Vaccine Information Center with the goal of preventing vaccine injuries and deaths through public education and safety reforms. I got my second and third children all their vaccines with the exception of whole-cell pertussis -- because it had hurt my oldest son. At age 4, my younger son developed a pseudo-tumor of the brain after getting two other vaccines. Thankfully there was no permanent damage. In 1993, he and my 5-year-old daughter both got whooping cough. She had a particularly bad case; she coughed until she was blue in the face. It was terrifying. After these experiences, I don't underestimate the effects of infectious diseases or vaccine reactions on young children. 

Q: But in recent years outbreaks of just those infectious diseases have been attributed to pockets of unvaccinated children - including those who were not vaccinated on principle. Does it worry you that your message of personal choice might be contributing to the spread of these diseases? Many of those outbreaks are not solely in unvaccinated children. You're seeing organisms that are becoming resistant to the vaccines no matter how high the vaccination rate is. It's not just the less than 1/2 of 1 percent who choose not to vaccinate who are causing outbreaks. 

Q: Still, isn't discouraging vaccination more harmful than the occasional bad reaction? The vaccine-safety and informed-consent movement has never been about telling parents not to vaccinate. We're pro-education and pro-informed consent, not antivaccine. There is a difference. It is immoral to write off an unknown number of children as expendable in the name of the greater good to justify public health policy.

 Arthur Allen