"The Vaccine Wars," Tuesday's edition of the PBS documentary series " Frontline," concerns the decision of a growing number of parents not to vaccinate their children — primarily out of fear that the vaccines, of which there are more today than when your critic was a boy, can cause autism and other neurological disorders — and the public-health officials who find that trend alarming and dangerous: Falling rates of vaccination can reopen the door to diseases that have all but been eradicated.
This is not a decision I have ever had to make myself; I only know what I think I'd do. But I am pretty sure that this hour will not change any minds already made up; vaccine skeptics will likely feel it does not take them seriously enough, and vaccine defenders will probably think the skeptics are given too much credit. Yet it may well clarify a few things for those who are less sure of the facts or their intuitions, if it doesn't make them more confused.
There are voices from both sides of what some would resist even calling a debate; it is an asymmetrical conversation. On one side, you have doctors, epidemiologists, pharmacologists and social scientists, whose fairly unanimous rejection of a link between vaccination and autism — or at least between the MMR (measles, mumps, rubella) triple shot and the mercury-based preservative thimerosal — also offers no reassuringly specific alternative. On the other you have, basically, parents — writers and activists, organizers and celebrities among them — who speak with the authority of individual experience.
Seen here are such lightning rods as Dr. Andrew Wakefield, whose work inspired the vaccine-autism connection — the British medical journal that published Wakefield's original article later disowned it — and Dr. Paul Offit, called "Dr. Profit" and a "biostitute" by his more emotional critics, chief of the Division of Infectious Diseases at the Children's Hospital of Philadelphia; co-creator of a vaccine against the sometimes deadly rotavirus; and author of the book "Autism's False Prophets."
There is author Jennifer Margulis of Ashland, Ore., where almost a third of parents are not vaccinating their kids, who is "not afraid of my children getting chicken pox," and there is bioethicist Art Caplan who says, "One of the bitter ironies of vaccination is it carries with it the problems of its own success" — that is, people no longer remember or fear the diseases they were vaccinated against. We get to see what pertussis, or whooping cough, looks like in an infant, and it doesn't look good.
As does just about everything in this world, the argument boils down to a matter of personal liberty versus social responsibility, the freedom to choose for oneself, or one's children, versus the benefits of maintaining a general "herd immunity." It also reflects a distrust of the medical establishment. "Physicians are going to have to get over the idea that they tell people what to do and people are going to do it without questioning," says Barbara Loe Fisher, president of the National Vaccine Information Center.
It is true that doctors can be wrong, that scientists change their mind in light of new facts, and that some of us accept as "good science" only conclusions that support what we already believe. Yet lacking answers, there will always be questions. Says Jenny McCarthy, who has an autistic son (and is unfairly described here as a "former Playboy playmate" when "actress" is more current and apt), "We don't know for sure, which is why we keep saying, ‘Study it.' " Put that way, of course, it doesn't sound unreasonable.