Early opposition to smallpox inoculation came in two basic forms: the disgust factor -- inoculation was achieved by rubbing smallpox pus into an open wound to cause a mild case of the disease that would confer immunity -- and the belief that the disease was divine punishment and interfering with it was interfering with God's will. Cotton Mather, a supporter of smallpox inoculation, had his house firebombed. (Later, cowpox infection was used to prevent smallpox. The word "vaccine" comes from the Latin term for the cowpox virus, variolae vaccinae.) Later opposition had considerably less to do with God's will than distrust of the government. Such distrust, as regards vaccination, was not always misplaced. Poor oversight and weak reporting rules allowed bad batches of vaccines to infect, injure, and kill. And while Mnookin spends some time on these tragedies, he devotes most of his book to the thoroughly discredited beliefs that thimerosal and the Measles, Mumps, Rubella (MMR) vaccine cause autism, and the terrible results of failure to vaccinate. (Read about thimerosal here: http://www.cdc.gov/vaccinesafety/concerns/thimerosal/)
Mnookin lays blame for the modern vaccine scare squarely on two parties -- Andrew Wakefield and the press. Wakefield first raised the alarm about the measles component in the MMR vaccine, claiming that the three-in-one jab overloaded children's immune systems and that the measles component should be delivered separately. (At the time, he and a partner were developing just such a vaccine.) His research methods were so poorly documented that it was not possible for other scientists to replicate his work. The mountain of evidence against his proposal was dismissed by Wakefield and his desperate followers as proof of a conspiracy to harm kids, at worst, or fail to protect them, at best. (Mnookin also explains why Wakefield's followers continue to support him. Having been told there is nothing that can be done to help their children, that they simply lost the genetic crap shoot -- or worse, caused their children's autism with their own bad parenting -- they found in Wakefield someone who both listened to them and gave them hope. In the cases presented in the book, parents made the "vaccine connection" only after being told there was one. This was sometimes months or even years later. Add to that the natural human tendency to hold tighter to beliefs when they are challenged, and parents' continued support of Wakefield and belief in his discredited ideas becomes easier to understand.)
Still, Wakefield's ideas wouldn't have gained traction without one more ingredient: exposure. Every time a news outlet refers to vaccines as "controversial", when vaccine conspiracy theorists with no background in public health or immunology are treated as experts, when anecdote is regarded as evidence, the ugly balloon-and-sheet ghost rises from its grave to frighten parents. And some of them (mostly liberal, well-educated whites) will choose to forgo or delay vaccination. The result is a resurgence of diseases like measles, hib, and whooping cough that have been gone from the U.S.A. for so long that many doctors don't recognize the symptoms. In some communities, herd immunity (also called community immunity) has already been compromised -- something to remember if you're planning to take your not-fully-immunized baby to Ashland, Oregon. (Read more about herd immunity here: http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx)
