Reviewing Deadly Choices

By Grant Jacobs 07/08/2011


Deadly Choices isn’t something I’d usually read, but spotting the book in the library I thought I’d lightly read it to see if I’d recommend it to readers outside of the USA, particularly in New Zealand.[1]

It is an excellent book for those wanting an easier read on the anti-vaccine movement in the USA, one that moves quickly. The approach taken will best appeal to readers in North America and those interested in the (modern) history anti-vaccine story in the USA.

Their is good general material on vaccines; amongst the ‘who did what’ elements are snappy introductions to a very wide range of relevant topics.

Looking closer, let’s deal with the unfavourable first–for readers outside of North America, that is. (Remember, a non-North American reader is my objective in this review.)

A running theme of the book is Barbara Loe and her emergence as an anti-vaccine campaigner in the USA and a number of television programmes shown there.[2]

Offit’s earlier chapters in particular use these media efforts and Loe’s development as a campaigner as a literary device to introduce items and further background. It makes for a running theme, and is an interesting approach, but those not familiar with her or the programmes may not identify with it well.

Some readers will be able to map what they read of these events and people in the USA to their local equivalents. Some will take a modern history perspective and see these as insights into the situation in the USA. (Reading New Zealand I found myself favouring the latter; bear in mind that I’m already familiar with the science and pseudo-science – I’m not the target audience.)

Where Offit’s writing works well for readers from any location his knack for short glosses of events or information about the vaccination and the anti-vaccine movement, conveying the point by drawing on just one or two key details. For those wanting the guts of the thing without too much cruft, and wanting a fast-paced read, his style achieves that well.

Deadly Choices opens with an Introduction giving a series of outbreaks of vaccine-preventable disease. I was particularly struck by one on measles, as we have a outbreak of measles in New Zealand. While a sideline form the review, allow me this diversion. He recounts an incident starting with a child returning from Romania who despite feeling ill attended a picnic. Offit reports that ’Among the 500 people at the picnic, 35 had never received a measles vaccine–31 of them (89 percent) became infected. Of the remaining 465 people, on 3 (0.6 percent) were infected. The girl who had contracted measles in Romania–after spending only a few hours in a crowd of 500 people–had managed to infect almost every person susceptible to the disease.’ Other readers will relate to other examples, no doubt.

The book takes a series of steps back through time, first looking at the origins of the current players, then the origins anti-vaccine protest. Initial chapters are almost in an alternating pattern: a media event in the USA, introducing a topic that is then examined. These are not ‘tit-for-tat’, but used as a writing device to raise topics.

Topics touched on include (in no particular order) the cases where governments have dropped a vaccine program and the outcome; the VAERS database, ‘vaccine courts’ and Omnibus Autism Proceeding (giving an account of the objectives of these); the issue of anecdote v. data in these trials; (earlier) vaccines that had problems; the HiB and polio vaccines among others; Andrew Wakefield and the MMR vaccine; Typoid Mary’s story; Jenny McCarthy, JB Handley, Jim Carrey and their campaigns along with a cast of several others including Bill Maher; schooling and vaccines; those who believe vaccines are a violation of Christian/Bible teaching; the herd immunity effect, notion of ‘too many vaccines’, ‘the toxins’; and so on. Naturally, the history of anti-vaccine movements is covered and, to my surprise, chiropractic (p118-).

My writing here is very dry – a simple list. Offit brings these topics up in a narrative that’s easy to read. Owing to his knack of quickly punching out the essence of a topic, a lot of ground is covered in the approx. 200 pages.

The pentultimate chapter, Trust, offers suggestions that might help.

There’s something in there for everyone to learn. For example, how many people today recognise Raggedy Ann dolls as representing ’children permanently harmed by vaccines’ ? (p135)

For myself, the reference to Samuel Berkovic’s work on Dravet’s Syndrome (pages 40-44) is  something I would like to follow up on. (Time permitting!) I’m interested in genetic conditions and this syndrome, caused by defects in the SCN1A sodium transport gene, is presented as a possible explanation for the seizures seen in some cases that have been argued to be ‘vaccine damaged’. (As another aside: these kittens suffer from an ion channel disorder, in their case from mutations in the CLCN1 gene that codes for a chloride voltage-gated channel that is active in skeletal muscle.)

Each chapter opens with a quotation. They’re worth mulling over.

The book is extensively referenced. This does not intrude on the reading in the least; there are no direct citations in the body text to interrupt the flow of a casual reader.

Being a book review, I encourage comments to be limited to the book itself.

Title: Deadly Choices: how the anti-vaccine movement threatens us all.

Author: Paul A. Offit, M.D.

Publishing details: ISBN 978-0-465-0219-9. Published by Basic Books.

Book details: Main text and epilogue, 214 pages. Also contain Prologue (2 pages), Introduction (8 pages), Notes (40 pages), Bibliography (2 pages), Acknowledgements, and Index (12 pages).


1. I’ve lightly read the book not really for myself, but with an aim of determining if I might recommend this book to readers outside of the USA, in particular in New Zealand. Some passages I have read, but others of less interest I have skimmed.

2. It’s possible to view the book is being primarily aimed to counter these media efforts that older readers (i.e. parents) in North America will have seen.

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World report on disability

Google personalised searches and the ‘echo chamber’ effect?

Haemophilia – towards a cure using genetic engineering

A Geek Nation reviewed

A forensic scientists tells it like it is

Fact or fallacy, a survey of immunisation statements in the print media

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