The Cutter Incident: How America's First Polio Vaccine Led to the Growing Vaccine Crisis

"Yes, that’s also why I thought The Cutter Incident was so impressive. Here’s a book that’s written by the person who is probably the most identifiable vaccine advocate in the US. He has received death threats for his work with vaccines, and there he goes and writes the first book-length study of what, by any measure, was really the worst vaccine crisis in American history. Paul Offit is Chief of the Division of Infectious Diseases and the Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, one of the leading vaccine centres in the country. He also invented one of the rotavirus vaccines. More than anyone else he has put himself on the frontlines of this debate. He has written a number of books about the anti-vaccine movement and about the autism controversy. He’s very passionate and willing to go on TV news shows and talk to reporters. He is someone who has not only developed vaccines but has chosen to make himself a very public spokesperson. If you look at some of his more recent books , you can see some of the topics that he’s bitten off. So, for someone who is really out there — defending vaccines and arguing for their importance and their safety on a daily basis — to then write a book about a time when all of the safety checks and everything that we hoped would protect people from a vaccine disaster failed, I thought was illustrative of his willingness to go wherever the evidence and the facts led him. And on top of that, it’s another incredible, fascinating story. You get this in a couple of the other books as well, this picture of just how massive the polio vaccine rollout was in the 1950s when it happened. So there were a small number of labs that were licensed to produce the polio vaccine. Within weeks of the vaccine being given to the public for the first time — it had been given in schools and people were lining up to get it — there started to be some evidence that there might be something going wrong with some of these vaccines. There were children who were dying or getting really sick or in some cases being paralyzed. It turned out that there was a batch at the Cutter Labs — one of the labs that had been licensed to produce vaccines — that had been contaminated. It’s a remarkable story. It’s also a remarkable story because it’s fascinating to see why and how that didn’t completely scuttle the polio vaccine campaign, which at that point had really just gotten off the ground. Support Five Books Five Books interviews are expensive to produce. If you're enjoying this interview, please support us by donating a small amount . Exactly. And even though that incident wasn’t a good example of a really effective way to deal with a public health crisis, I think once the scope of what was going on became clear, there was a pretty quick movement both to figure out what had happened and to make sure it wasn’t happening any more and also to reassure the public to whatever extent they could. Yes, that’s one of the issues that he talks about. This came to a head — and this is something that’s addressed in Arthur Allen’s book — in the 1980s when, for a period, it looked like there weren’t going to be any companies that were willing to produce vaccines to be used in the US because of anxieties about liability and fears of crippling lawsuits. That led to something called the Vaccine Court being created. Out of the Cutter incident you had a jury verdict that made the stakes for developing new vaccines much higher. There are certainly people, and Paul Offit is one of them, who feel that, as a result, there has been less development of new vaccines than there might have been otherwise. It’s not an issue in terms of vaccine supply. Right now there are enough vaccine manufacturers supplying vaccines to the US that there is no imminent danger of huge vaccine shortages, although when there are epidemics — like the swine flu, H1N1 — oftentimes there are shortages in those situations. What we’ve seen more is that there’s a pretty high bar for pharmaceutical companies to develop new vaccines. They’re not worried about lawsuits anymore, but financially there’s not a lot of appetite for taking on the research and development expense as well as the risk in terms of public relations to spur as much creative work as maybe there could be. It’s not that no new vaccines are being developed, but the HPV vaccine is actually a pretty good illustration of all this. We now have a vaccine against a type of cancer. To me that’s an absolutely incredible, just mind-blowing story. If 20 years ago you had said “We are on the verge of developing a vaccine against cancer,” that would have seemed like science fiction . Instead, if you look at what’s happened with the HPV vaccine, there have been huge, huge fights over it. Any time there have been efforts to either add it to the [official vaccination] schedule or to get more teenagers to get it, it’s become an enormous issue. So there’s a situation in which a pharmaceutical company has an incredible product, a product that could save thousands of lives annually, that’s been mired in various political and public perception controversies now for years. Which isn’t to say it’s not being used or not being recommended, but you contrast that to the polio vaccine: there’s this disease, they’ve developed a vaccine and everyone is lining up to get it, and you realize what a different environment we’re living in… One of the things that’s so interesting about the growing pockets of people who aren’t vaccinating their children is that if you look at what diseases people are getting vaccinated against and which ones they aren’t, it makes no sense. A lot of anxiety tends to focus on the MMR vaccine or the DTP vaccine. Oftentimes someone will delay or choose not to get one of those vaccines, but they will get the polio vaccine. To me that just seems crazy. We haven’t had a case of wild polio in the US in years. The chances of getting polio — unless you’re travelling to one of a tiny number of countries, is close to zero — versus the chances of getting infected with measles or pertussis…Pertussis there have been thousands and thousands of cases recently, measles there have been hundreds of cases and measles is the most infectious disease known to humanity. I think it’s a nice illustration of how facts don’t always intrude. Yes, to say that Andrew Wakefield — who was the lead author on the study published in the late 1990s that first posited a potential link between some developmental disorders and the MMR vaccine — has been discredited is putting it nicely. That paper has been retracted by the publication, he has been accused of perpetrating a widespread fraud, and he’s lost his medical license. The data in that paper was shown not to have come about in the way he said it came about. This is not a situation where there is one guy who thinks one thing and someone else who thinks something else and there’s a controversy. He has lost 100% of his credibility. But one issue with conspiracy theories is that any evidence that shows that a conspiracy theory isn’t true is taken by true believers as further proof of the conspiracy. So every time a new revelation comes out about Wakefield, his most ardent supporters see that as just another case of the establishment doing whatever they can to silence this maverick researcher. Which would be funny if it wasn’t so potentially damaging. Yes. I wanted to do a couple of things with my book. One, I started writing this before my wife and I had children, but at a time when a lot of our friends were having kids, and this was clearly an issue that they were going through. I was in a unique place — I’m a journalist and I wasn’t working on a long-term project at the time — and I could do what a lot of parents wished they had time to do, which is spend two years just looking at these issues, and doing the research, and talking to the people involved. Then I was able to say, “Ok, here I am. I’m not someone who works with pharmaceutical companies, I’m not someone who is part of the medical establishment. Here’s what I found.” Get the weekly Five Books newsletter Another theme I really wanted to look at is why it is that all of us find it so hard to accept that things that we might have believed or thought were true, in fact aren’t, when there’s evidence that shows that they’re not. One of my conclusions in the book — especially looking at parts of the autism community that have organized around anti-vaccine principles — is that what you were seeing was not so much a reaction against vaccines, as the fact that there were lots and lots of families who were scared and frustrated and upset and angry about the situation they found themselves in. Oftentimes they were not getting the type of support or medical care that they needed or deserved. And I think it’s a natural human tendency to look for answers. In looking for answers to unanswerable questions — Why did this happen? Why did this happen to me? What can I do about it now? — questions to which we still don’t have a lot of answers, you have a group of people who decided “OK, this is going to be the answer that answers those questions.” One of the things I hoped to do in the book is show how that happened in this particular case, but it’s something we all do, whether we know it or not, every single day. We need to be on the lookout in ourselves, to make sure that when we are making decisions and reaching conclusions we are doing so because of facts and evidence and not because of an emotional reaction."