Thursday, February 14, 2008

Another anniversary.

Today is the second birthday of my son. The poor guy will some day have to purchase gifts for his girlfriend/wife on his birthday. But for now, it's his birthday. This morning I asked him if he knew what day it was, and he said "My birthday!". "How old are you?" I asked. "ONE!"

"No," I said, "You're two today. Today is your birthday."


Mrs. Factician and I tried to work it out with him, and in the end he may have believed us that he was two today. At his age we can't ever know for sure what he understands, but he seems to understand that, like his friends who are a few weeks older than him, he has turned two.

In honor of his birthday, I'd like to review a book that I just finished. It's particularly relevant to parents of small children. It's called Vaccine, by Arthur Allen. Search for Vaccine on, and mostly you'll find anti-vaccine pseudoscience screeds. Arthur Allen's book is a highly footnoted, very well written book.

As a molecular biologist, I found this book to be particularly enlightening. I have a fairly basic understanding the of how vaccines are made and how they function. My wife works in a lab that has developed a vaccine currently used in the third world. But the history of vaccination is something I've never read.

The bulk of this book is on the history of vaccination and variolation, as practiced over the last 300 years. For example, prior to this book, I hadn't been aware of the practice of variolation, whereby smallpox is deliberately infected into a wound in the skin, giving the patient a severe fever, and even possibly killing them, but giving them a four-fold better chance of surviving a smallpox epidemic. Imagine what it must have been like to live in a world where this seemed like a good idea. Variolation saved many, many lives. But it took quite a few as well.

Allen follows the development of attenuated pox viruses for vaccines, and the better and better development of vaccines over the last 300 years. At the same time, he talks about the risks of older vaccines, and some of the complications involved in contaminated lots of vaccines (back before the development of good aseptic technique and preservatives).

At the same time, he tracks the development of anti-vaccine populations, building towards the current anti-vaccine movement of the 21st century, who contrary to all evidence, blame vaccines for their childrens' autism. He talks about principles of risk management, and of the re-emergence of diseases like whooping cough in various anti-vaccine communities in Colorado.

There is also the story of the rotavirus vaccine developed in the late 90s. Rotavirus is a virus that kills hundreds of thousands of children in the third world every year (but is largely an unpleasant diarrheal disease in North America). In the late 90s, a vaccine was developed that protected most children from rotavirus. This vaccine would have saved millions of children. However, it was shelved, as it looked likely (though never conclusively proven) that it caused a relatively rare gastrointestinal side-effect called intussusception that could result in death if not corrected by a surgical intervention. Immediately this vaccine was shelved in North America, as the risks outweighed any possible benefit. But while this could have saved hundreds of thousands of children in third world countries (while possibly killing a much smaller number), this vaccine was never used. Politicians in India, for example, were afraid of the political blowback of a using a vaccine that wasn't "safe enough for Americans".

For the science nerd in your life, this book is a real page-turner. There's disease, death, lives saved, lives lost, politics, contaminated vaccines, highly unethical human experimentation, and finally, in the latter half of the 20th century, a largely safe and effective vaccine enterprise.

This book is an excellent treatment on the subject, and should prove relatively easy for a non-biologist to read. I'd recommend this to anyone, scientist or no. And if you have any anti-vaccine folks in your family that aren't vaccinating their children, give them a copy of this book. It may change a few minds.


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