He says the media and celebrity culture has much to answer for in stoking anti-science sentiment but believes the tide may be turning towards a more rationale debate on immunisation.
Offit, who has written a new book on vaccines called , has made high-profile media appearance on everything from 24-hour news channels to comedy shows. For his trouble, he has been vilified and threatened by anti-vaccine activists who accuse him of having an interest in promoting vaccination given that he co-developed the rotavirus vaccine.
However, being cast as the villain has not yet deterred Offit. “I’ve taken some flak but I get a lot of praise for it too. But I think that it’s important because the problems associated with declining immunisation rates are not theoretical any more – they are real. We are seeing declining herd immunity which is leading to rising measles rates, and whooping cough and children suffering and dying unnecessarily.”
The curse of celebrity culture
Offit is frustrated by the influence celebrities like Jenny McCarthy have had on public perceptions of vaccines, but he refuses to fight fire with fire by deploying pro-vaccine celebrities to speak for science.
Just this week a survey showed that while most parents believe their child’s doctor is the most reliable source of vaccination advice, 24% place “some faith” in what celebrities have to say about vaccine safety.
“It’s for the same reason that I don’t like people listening to McCarthy that I can’t say it’s great for people to listen to celebrities that agree with what doctors are saying. I’d prefer if people listened to their doctors – the vast majority of whom are strongly in favour of vaccination. In a better world I’d like to feel like we can appeal to reason but maybe I’m being an idealist!”
A turning tide
However, Offit sees some cause for hope. The media – at whose door he places a healthy dose of blame for declining vaccination rates – are now taking a more responsible approach. Newspapers and television journalists have woken up to the harm that can be caused by stoking vaccine scares, he says, and this can only be good news for science.
There’s cause for hope in the blogosphere too. Blogs like Respectful Insolence are effectively debunking myths pedalled by prominent anti-vaccine websites.
Offit’s own efforts to influence public thinking on immunisation continue apace. In addition to his frequent media appearances – and treating patients at the Children’s Hospital of Philadelphia – he is promoting his latest book, Deadly Choices.
The book is an effort to learn lessons from the vaccine scares that have shaken public trust in immunisation. The aim, he says, is to explain the real risk of not vaccinating and appeal to our sense of community spirit to undo the damage.
“In my view, it’s not going to be coercion that works. It’s an innate willingness to support out neighbor – our basic sense of togetherness. We see ourselves as part of a community and pull together to protect one another.”
Tapping into this desire to support our neighbour, says Offit, offers real hope of convincing people to be vaccinated in order to boost .
“I accept we have grown selfish in recent times but we need to find a way to appeal to that deeper sense of community, of acting in the interests of those around us so as to support and protect everyone.”
Below is a full transcript of an exclusive interview with Dr Paul Offit, Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia
Vaccines Today: You’ve been a high-profile campaigner advocating for vaccines, even though you have been criticised and threatened. Why is it so important for doctors to put their heads above the parapet?
Dr Paul Offit: I’ve taken some flak but I get a lot of praise for it too. But I think that it’s important because the problems associated with declining immunisation rates are not theoretical any more – they are real. We are seeing declining herd immunity which is leading to rising measles rates and whooping cough and children suffering and dying unnecessarily.
Vaccines Today: Who else can be effective advocates given that some members of the public are inclined not to trust to the establishment?
Dr Paul Offit: The most important spokesperson for vaccine is the person who administers them: paediatricians and family physicians. Nurse practitioners are also in a crucial positions to talk to parents.
About 15% of parents simply see it as a conspiracy between doctors, government and industry. I don’t think that’s who we are trying to reach – some people are beyond reaching.
Vaccines Today: But who else can help influence public opinion? has been vocal recently but do you need a ‘Jenny McCarthy’ figure to speak for vaccines?
Dr Paul Offit: Bill Gates has had an impact. He did a very effective pointing out that children are dying as a result of anti-vaccine campaigns. But to be honest I sometimes wish he’d hit out harder at the anti-science lobby. Nobody could accuse a guy like him of being in the pocket of industry.
Still, I’d prefer if the message were coming from doctors and scientists. Would a Jenny McCarthy figure help? No. It would feel wrong to do that. It’s great to see Salma Hayek or Amanda Peet speaking in favour of vaccination.
However, it’s for the same reason that I don’t like people listening to McCarthy that I can’t say it’s great for people to listen to celebrities that agree with what doctors are saying.
I’d prefer if people listened to their doctors – the vast majority of whom are strongly in favour of vaccination. The fact is there are outbreaks now and people are getting scared. In a better world I’d like to feel like we can appeal to reason but maybe I’m being an idealist!
Vaccines Today: You mention that some celebrities are publicly supporting vaccination. Is it also fair to say that the tide has turned in how the media handle vaccine-related issues?
Dr Paul Offit: Yes, I think that’s exactly what’s happened. The media is feeling burned by how it dealt with the MMR controversy because of the real impact that story is having on children now. Take the LA Times for example: ten years ago they had a journalist who wrote weekly articles on the harm of vaccines. Just about every week without fail. Now he has been replaced and you’re seeing articles which are much more on the side of science.
In the past decade, the New York Times Sunday magazine ran articles on vaccines and autism which would never be published today. People are now writing responsible. The mainstream media has backed off. Even entertainment television is mindful of what happened with measles, for example.
Vaccines Today: How about the impact of the net. Is that a medium where the scientific community has been slow out of the blocks?
Dr Paul Offit: Yes, but they are there. Blogs like Respectful Insolence by Orac, and bloggers like Prometheus are countering it pretty well. When the classic anti-vaccine blogs – like Age of Autism – do things that need to be exposed as flawed, I think the net has been a great way for pro-science forces to get together and call them out.
Vaccines Today: Do you see parallels between the global warming debate and vaccine debate? In both cases the scientific community holds a near-consensus view but the argument is often presented as a two-sided debate between equally valid sides.
Dr Paul Offit: Absolutely. It’s all part of the anti-science feeling that has been fashionable. The idea is that “my beliefs are as valid as yours just because I have them”. I don’t accept that. To me, some ideas – those tested by rigorous scientific research – carry more weight than a belief which is not supported by any evidence.
Vaccines Today: Isn’t it odd though that some – often educated, liberal-minded – people are keen to go with the scientific majority on global warming, while ignoring the evidence when making vaccination decisions?
Dr Paul Offit: It’s a very good point but I’m not sure I have an answer yet. Historically, in the 1800s, it was less well-to-do people who chose not to vaccinate. Now, it’s often professional, educated people who shy away from immunisation in spite of the evidence.
Essentially, it’s a fight between fear and reason. Perhaps we’re more wired to the limbic system which governs our emotions. In evolutionary terms, the cerebrum is a much more recent development.
But beyond that, it’s currently beyond me as to why educated people can buy into the science of global warming but not the science of vaccination.
Vaccines Today: You co-invented the rotavirus vaccine. Are you optimistic above the future of vaccine research?
Dr Paul Offit: About vaccine research, yes. The technology is in hand and a lot of money is being invested to try to develop vaccines for diseases that kill huge numbers of people – malaria, HIV, cancer and so on.
What scares me is the more stringent regulatory requirements which could make it more difficult to get vaccines into developing world. One positive trend is what’s happening with the Gates Foundation, Gavi and others. They are helping get vaccines to millions of children all over the world.
Vaccines Today: What is the main message of your book, Deadly Choices?
Dr Paul Offit: I try in this book to sound a warning bell and talk about the history of this vaccine scare. We invariably end up repeating history so we should at least try to learn from our mistakes.
The last chapter talks about how we’re going to undo the damage that has been done over the past decade or so. In my view, it’s not going to be coercion that works. And, I hope, it’s not going to be a disease outbreaks that makes people realise the real risk of not vaccinating – it’s an innate willingness to support out neighbor, our basic sense of togetherness. We see ourselves as part of a community and pull together to protect one another.
Our instinct is to help others. Yes, I accept we have grown selfish in recent times but we need to find a way to appeal to that deeper sense of community, of acting in the interests of those around us so as to support and protect everyone.