Junk Medicine

It’s popular among politicians on both sides of the aisle, as well as the public, to blame corporations, capitalism, and even science itself for our ills. Whether it is obesity (soda), cancer (chemicals), or autism (vaccines), an industrial villain is an easy and satisfying target. Rare is the defense of sound science that holds activists accountable for their scientific misstatements and the consequences of their scare campaigns. The public policy implications of this failure are enormous.

In Denialism Michael Specter, science and technology writer for the New Yorker, goes after low-hanging fruit in chapters as entertainingly titled as “Vaccines and the Great Denial,” “The Organic Fetish,” and “The Era of Echinacea.” That’s good, as far as it goes. He fails, however, to take on equally groundless but more sacrosanct examples of junk science. For instance, Specter writes that the alternative medicine guru Dr. Andrew Weil “offers sound advice in his many books—calling .  .  . corn sweeteners and trans fats dangerous.” These products, like their “natural” alternatives, sugar and saturated fat, are not particularly dangerous at moderate levels, and Specter’s readers deserve to know that, as surely as they deserve to know that anti-vaccine conspiracy theories are false.

Instead of following popular wisdom about trans fats, for instance, he’d have done a greater service by identifying the crusade against them as another example of, as he puts it elsewhere, “the ‘precautionary principle,’ which holds that potential risks, no matter how remote, must be given more weight than any possible benefit, no matter how great.” At a time when activists claim misleadingly that “there is no safe level” of lead, or that the plastic additives bisphenol-A and phthalates are the most dangerous chemicals known to man, Specter doesn’t quite finish the job. But he does deserve credit for his broader message about how those who reject mainstream science (which is a more refined thing than mere conventional wisdom) have the power to distort public policy and undermine public health.

In his vaccine chapter, Specter holds anti-vaccine groups such as the National Vaccine Information Center accountable. The “denialists” have fomented an “epidemic of doubt,” which has demonstrably caused an increase in preventable illnesses by scaring people away from using potentially lifesaving, safe vaccines. Falling for unscientific claims is one thing when it hurts only you—go ahead, for instance, and waste your money on organic foods (which Specter reminds us are no safer or healthier than conventional produce)—but when junk science hurts the rest of us, it is time to call a quack a quack. When parents fail to vaccinate their children, they endanger your children, too, because their children undermine our ability to develop “herd immunity,” which provides a layer of protection for all.

Specter also gets it right when he points out what happens when industry and the government fail to stand up to junk science. One of the many unfounded claims from denialists is that a vaccine preservative, thimerosal, is harmful, especially to children. The preservative, which contains a very low level of mercury, has been well studied, and no credible evidence exists to indicate that it is harmful in any way. Yet in the summer of 1999 the federal government ordered it removed from vaccines as a “precaution.” Specter rightly chides vaccine-makers who, “under fierce public pressure,” went along with the Centers for Disease Control and the American Academy of Pediatrics in saying that “the current levels of thimerosal will not hurt children, but reducing those levels will make safe vaccines even safer.” Placating denialists seems to be the path of least resistance. It is also a path to more problems.

Today we are feeling the consequences of such woeful governance. Consider the recent shortage of novel H1N1 (swine flu) vaccine. A variety of factors are to blame for the widespread shortage of the vaccine, but one reason is the federal government’s failure to permit the use of vaccine-boosting additives called adjuvants. Adjuvants are particularly useful at times like these, when there is a rush to make enough vaccine in the face of a novel strain of virus. The use of adjuvants could have quadrupled the number of doses available and would have undoubtedly helped tamp down the worldwide spread of H1N1. But activists who oppose additives (and, usually, vaccines themselves) as a form of contamination were ready to pounce, and what happened next resembled a small child cowering before a big needle. Except the infant was your government.

At a November hearing before the Senate Committee on Homeland Secur-ity and Governmental Affairs, senators wanted to know why the Department of Health and Human Services opted not to use adjuvants despite their strong safety record and obvious need. Dr. Nicole Lurie, chief of preparedness and response for HHS, said one reason they hadn’t approved adjuvant use was the concern of anti-vaccine activists: “We didn’t really want to rock the public confidence in a new vaccine with adjuvant,” she testified.

This approach supports Specter’s boldest claim: “Caution is simply a different kind of risk, one that is even more likely to kill people.” Such lack of leadership in the face of unscientific fears will lead to a race to the bottom in the formulation of public health policy: Science and standards are put aside in favor of expediency, and industry and government continue to lower the bar and give in to agenda-driven activists. The science of fear is being used to create a fear of science, and as Specter writes, “Fear is more infectious than any virus.”

Jeff Stier is the associate director of the American Council on Science and Health.