…is the bold title of Seth Mnookin’s exploration of the ‘vaccination debate’.[1]

The Panic Virus® is a ruminative, thoughtful, exploration of vaccine history and, in particular, how people come to think the things that they do.

Not too many popular science books are headlined with the support of Nobel laureate – if you look closely you’ll see Peter Doherty’s praise for the book at the top of the cover to the left.

It surveys key events – without minutiae that you might get from an historian. It draws on the reader to do their own thinking slightly more than Offit’s Deadly Choices but is lighter than Allen’s Vaccine, which at 500+ pages is a much more lengthy affair.

I especially appreciated that the material seemed well-balanced with negative points in public health, for example, presented plainly without excuses and criticism given where it seemed deserved.[2] Vaccination is a topic that’s easy to polarise or to stick to one side of the fence. Mnookin does pretty well to see it both ways.

He touches on some of cognitive dissonances involved, where some of the poor thinking arises from and these emerge as a key underlying themes.

This from the blurb,

“Wakefield eventually lost his medical licence, yet the myth that vaccines cause developmental disorders lives on. In The Panic Virus Seth Mnookin examines how the anti-immunisation panic spread and looks at a controversial Australian case that exposed the claims and tactics of the movement to new scrutiny. Sorting fact from rumour, he confronts fundamental questions: with more facts at our fingertips than ever, why is our trust in science so fragile? Has the internet made us better informed, or simply enabled panic to spread more quickly? And how might we balance fact and intuition when it comes to decisions about children’s health?”

The book, in part, tracks the author‘s personal exploration into parents and their relationship with vaccination information starting from his own new parenthood and dinner parties,

“The more I pushed my friend, the more defensive he grew. Sure, I said, there had to be something tangible, some experiment of epidemiological survey, that informed his decisions. There wasn’t I was even more taken aback when he said he likely would have done the same thing even if he’d been present with conclusive evidence that the MMR vaccine was safe.” (From the Introduction, p11.)

From this start, it proceeds through adroitly condensed accounts of some of the key events in vaccine history,[3] the early innoculation attempts and smallpox, the polio vaccine, and the development of the Epidemic Intelligence Service (p54), fluoride, swine flu, the Vaccine Roulette show and Barbara Fisher, autism, the truly bizarre nondelusional parasitosis and Moregellons syndrome,[4] Andrew Wakefield and his Lancelet paper, thimerosal, the ‘Mercury Moms’, the development of the VAERS database of case reports (p148) and the USA’s vaccine trial system, Mark Geier[5] and so on.

Media issues are covered (chapter 13), featuring Oprah Winfrey, Jenny McCarthy, David Kirby’s journalism and more. An outline of ‘the’ scientific method is given from p154[6]; logical and cognitive issues are also addressed for example in chapter 16, Cognitive Biases and Availability Cascades.

My readers shouldn’t be put off these long lists – each aspect is covered lightly and the text flows well.

Similarly Mnookin does well with most of his attempts to explain logic through analogies, for example -

“Virtually anything having to do with technology provides a good example of how often commonsense asumptions end up being wrong. Think about how recently it would have sounded ludicrous to propose that an invisible worldwide communication network would be capable of beaming movies into a device smaller than a deck of cards, or that shooting lasers into people’s eyeballs could improve their sight.”

A frontispiece carries a quote,

“A lie will go round the world while truth is pulling its boots on.”

- Proverb popularised by Baptist preacher Charles Haddon Surgeon in an 1855 sermon; often attributed to Mark Twain

Science bloggers will know that one well.[7] It’s hard to haul back a notion once it’s spread.

Some may criticise the book for not examining more of the underlying science – Mnookin’s focus is on the approaches taken by typical parents to come to conclusions. A related concern might be that the book will favour ‘the choir’. I suspect this is true of any book on any polarised topic, whatever ‘side’ is ‘favoured’ will read it more kindly. Mnookin at least criticises medicine and public health where it seems due.

Will it convince anyone? I couldn’t tell you. I suspect all you can wish for is for people to tackle it.

The body text has no reference citations, making for easier reading. Readers wanting more will want to dig into the chapter notes at the end of the book.[8] Footnotes are used for asides or  additional info.[9]

For further reviews, the reviews at GoodReads.com are worth exploring – many are quite detailed.[10]

Book details

The Panic Virus®
Fear, Myth and the Vaccination Debate

Black Inc. imprint of Schwatz Media Pty Ltd.
Copyright Seth Mnookin 2011
First pub. in US by Simon & Schuster, 2011.
ISBN: 9781863955188 (pbk.)
Dewey classification: 614 .47 MNO

Main text 308 pp, incl. Epilogue.

Notes pp 311-369

Bibliography pp371-406

Index pp4-7-425


1. The full title is The Panic Virus®, with ® mark. I’ve left the ® mark out of the title of my article as I’ve seen non-ASCII characters travel poorly by RSS, etc.

2. Another was the useful reminder that during the polio epidemics in the 1940s in the USA, influenza was in fact the bigger killer of the two. Polio captured the mindshare at tens of thousands of cases, but, according to Mnookin, “for much of the 1940s, an average of 190,000 Americans died of the flu each year”. (page 42, The Polio Vaccine.) It’s perhaps a reminder, too, that annual flu vaccinations are more than just about avoiding the chance of awful week or so. (Truly awful from personal experience.)

3. I’m a bit too familiar with some of the history now, but there were still interesting corners new to me like military aspects of early vaccination campaigns in the USA. (From chapter 1, The Spotted Pimple of Death.)

4. Including relating a case who believed fibres were growing out of their eyeballs.

5. Coincidentally, Mark Geier had his medical license in Maryland revoked today. He earlier had his medical license revoked in Indiana.

6. I’d argue here that there really is no one ‘scientific method’, but exploring all of that would require a very length chapter and would be too academic for The Panic Virus®.

7. So should readers of Terry Pratchett.

8. I’m not sure there is any way to ‘win’ this, as citations disrupt the flow of reading for someone who is not interested in them to whatever extent. My personal preference is for superscripted numbers, which in my experience are easy to read past, but, as the saying goes, other’s mileage may vary.

9. Something I confess to be a fan of. I’m not sure if this comes from reading Terry Pratchett, popular non-fiction, or more formal literature. But I’ll ‘blame’ Pratchett for the sakes of it!

10. I should emphasise that my review is not based on these.

Other articles at Code for life:

Reviewing Deadly Choices

Thoughts on, and for, those trying to choose to vaccinate or not

Immunisation, then and now

Whooping cough, vaccines, cocooning and the IAS

IAS talks about vaccination