Claiming the High Road in the Vaccine Controversy

From our Spring 2011 issue.

Offit is co-inventor of the rotavirus vaccine RotaTeq, which was recommended for routine immunizations in infants by the World Health Organization. (Illustration Frank Harris/Photo courtesy Amy Saul)

When Paul Offit (Res ’80) was a resident in the emergency department at Children’s Hospital of Pittsburgh in the late 1970s, he had a patient—a 9-month- old infant—who died of rotavirus. Offit was shocked to realize that this common intestinal infection still killed children in the United States. A leading cause of severe diarrhea in infants and young children, rotavirus contributes to more than half a million deaths worldwide each year.
Some three decades later, in 2009, RotaTeq—a vaccine for rotavirus—was recommended by the World Health Organization to protect against the deadly infection. RotaTeq is the fruit of 25 years of labor for Offit, the vaccine’s coinventor who is now a renowned expert in virology and immunology. Helping to develop a vaccine that is administered around the world has made him “enormously proud,” says Offit. “Professionally, it’s the best thing I’ve ever done, and I did it for the right reasons.”
That he would be in a position of defending his intentions has come as a surprise to Offit. Yet he has found himself at the center of a heated debate over whether childhood immunizations—arguably one of the greatest achievements in public health in the past century—are safe.
Offit is the Maurice R. Hilleman Professor of Vaccinology and a professor of pediatrics at the University of Pennsylvania. He also heads the infectious diseases division at the Children’s Hospital of Philadelphia and was a member of the Advisory Committee on Immunization Practices for the Centers for Disease Control and Prevention.
Offit’s research has led to his becoming a prominent defender of vaccines, which in turn has led to his publication of mass-market books on the topic—most recently, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, which was released in December 2010.
Since the early ’80s, some activist groups have advanced the belief that there’s a link between vaccines and autism. The suspect vaccines change, but the story remains the same: Citing anecdotes or data taken out of context, activist groups accuse physicians and pharmaceutical companies of concealing what they believe are harmful effects associated with vaccines. These accusations are widely publicized; the epidemiological and other studies that disprove them, however, are not.
It’s been wearing for Offit, who has been threatened, sued for libel, vilified on television by actress Jenny McCarthy, and accused of profiteering. (Offit was copatent holder when Children’s Hospital of Philadelphia sold the RotaTeq patent to Merck and does not receive payments for subsequent sales.) One study linking vaccines to autism has been widely discredited and recently described as “an elaborate fraud” by the British Medical Journal. Yet, Offit says, the general confusion and controversy won’t go away completely until a clear cause for autism is identified.
The contrast between the hype-driven mass media and the stories told by scientists—who work within a very different conceptual framework than the journalists, politicians, and lawyers shaping the vaccine debate—is striking to Offit. His advice: “Scientists and physicians need to claim the emotional high ground. I’m in this because I’m motivated by kids being hurt. We need to show the concern that motivates the science.”
Offit, who has testified in congressional hearings on vaccine safety, says the consequences of skipping vaccines are not theoretical. He points to the pertussis outbreak in California in 2011, which killed 10 infants and infected 9,000 people. “We’re past the tipping point,” he says. “We’re losing the herd immunity, where enough people are vaccinated to protect those who can’t be vaccinated.”
The age of the observer makes a great difference in how the vaccine debate is perceived. Younger people have simply never encountered a child blinded by measles, for instance. But Offit is old enough to remember the toll of childhood diseases.
In 1956, when he was 5 years old, he had surgery for a clubfoot and spent three weeks in a Baltimore polio ward. Jonas Salk and his team at the University of Pittsburgh had developed a vaccine that had been approved the previous spring, following a nationwide clinical trial. New cases were declining—but thousands of victims still lived with braces and iron lungs.
It was a life-shaping experience for Offit, who never forgot the vulnerable children in that ward. Those memories helped drive his choice to become a pediatrician and infectious disease specialist.
“When I take criticism—or praise—I think of those kids and others,” Offit says.
“Fear of vaccines causes children to get sick and die.”