(And don't forget On Immunity: An Innoculation by Eula Biss)
Who would ever have predicted that this winter’s grim medical headlines would address not the usual cold-weather pestilence — influenza — but pedestrian, forgettable old measles?
Just about everybody, that’s who. Experts have been tracking the worldwide resurgence of measles for decades now, and it was only a matter of time before the scattershot outbreaks of years past turned into this year’s newsworthy explosions.
Readers curious about this infection rising phoenixlike from its own ashes will find both less and more in the library than they may want. Aside from a few textbooks and pamphlets, I couldn’t find a whole book devoted to measles — not since the 10th century A.D., that is, when the Persian physician Al-Razi wrote “The Smallpox and Measles” to differentiate the two.
Still, quite a few recent books deliver the basics, including information on childhood infections and their medical dangers, the various ways we have learned to thwart those dangers and the ways in which those efforts have in turn been thwarted. Readers intrigued enough by vaccination to want more details on the workings of the human immune system and its potential for both harm and good will find new books discussing just that topic.
For a detailed review of diseases, vaccines and the objections the anti-vaccine lobbyists have brought to the table, books by the prolific Paul Offit are a good place to start. Offit is a pediatrician and infectious disease expert in Philadelphia whose longtime, eloquent advocacy of vaccination has made him a permanent target of anti-vaccine lobbyists — his book signings have sometimes been canceled because of credible death threats.
Offit’s “Deadly Choices” (2010) outlines the often-forgotten complications of childhood infections and rebuts the various objections of the anti-vaxxers point by point. “Autism’s False Prophets” (2008) concentrates on the thoroughly debunked assertion that the neurological condition autism results from childhood vaccines.
But it is “Bad Faith” (2015), Offit’s analysis of the tension between religious fundamentalism and vaccination, that speaks most directly to this year’s headlines with a short, unforgettable section on measles. During the winter of 1990-91, more than 1,400 adults and children in Philadelphia developed measles, and nine children, all unvaccinated, died. Offit’s dispassionate, methodical summary of the religious and political theories that enabled that giant outbreak simmers with anger. Living through that epidemic, he has since written, “was like being in a war zone.”
If expert opinion from a war zone is not an appealing perspective on the subject, readers will find similar territory covered in an utterly different voice by Seth Mnookin in his excellent “The Panic Virus” (2011). A journalist with no skin in the vaccine game — other than the fact that he was a new father when he wrote the book — Mnookin just wanted to explore the minefield for himself. As he tentatively lays out vaccine pros and cons he becomes convinced of the fallacies and dangers in the anti-vaccine movement’s rhetoric. His reflections on the actress Jenny McCarthy, whose transformation into anti-vaccine advocate revived a fading Hollywood career, make for a fun, snarky read, but the enduring importance of Mnookin’s book lies in its methodical science-based rebuttals of wild rhetoric.
If histrionic behavior and snark appeal to you, you can get quite a dose of both from the stories of some of the vaccine scientists themselves. Offit’s “Vaccinated” (2007) profiles one of the 20th century’s foremost vaccinologists, Merck’s powerful and spectacularly foul-mouthed Maurice Hilleman, and sketches out the climate of fierce scientific competition and politics in which he thrived.
The science journalist Meredith Wadman took a deep dive into similar material and created a real jewel of science history. Wadman’s “The Vaccine Race” (2017) brims with suspense and now-forgotten catastrophe and intrigue, all beginning in the 1950s and 1960s, when, as she writes, the chase for new vaccines “was as hot as today’s quest to unravel the profound mysteries of the human genome.”
The first vaccinologists were accustomed to working in happy solitude, policed by conscience alone — or not, as the case may be (some were really wildly unprincipled). Soon enough, though, the scientists were joined in their projects by academics and salesmen, then by corporate executives, then by congressmen and lawyers. All were forced to navigate the terrible early vaccine disasters, when contaminated products transmitted disease rather than protection, and all struggled with the need to reconcile centuries-old public health tools, like quarantine, with new ones like mandatory vaccination and informed consent. Wadman’s smooth prose calmly spins a surpassingly complicated story into a real tour de force.
Vaccination was only the first organized effort to harness the immune system for medical purposes. In the last two decades many other techniques have been devised, foremost among them the engineered proteins called monoclonal antibodies. These are the pricey drugs with unpronounceable names ending in “-mab” now being hawked incessantly on television for diseases from eczema to cancer. The story of the science behind these drugs and other sophisticated immunologic tools is just beginning to be written.
In his new book, “The End of the Beginning” (Pegasus, $27.95), the immunologist Michael Kinch builds on the narrative he began with last year’s “Between Hope and Fear.” That book provides a chatty, looping profile of the immune system and the historical origins of modern vaccine science, all contained in a narrative draped like a Christmas tree with sparkly digressions into biography, philosophy and historical gossip.
Kinch now changes focus slightly to review cancer biology and the promise of immune-mediated treatments. A professor at Washington University in St. Louis, he spent some of his early career at a biotechnical company and can speak with authority about the mixed promise of monoclonal antibodies for cancer treatment — some tumors vanish with these agents while others are utterly untouched, and none of the drugs is without side effects.
Kinch’s narrative is as loose and lavishly ornamented as ever, while his material is, if anything, even more scientifically complex. Some readers may enjoy the bumpy, glittery, distraction-filled ride. Others, presumably those of us with dull linear minds, will wish he would just settle down, even for a single chapter, and say what he has to say in a dull, straightforward way.
Matt Richtel wanders different paths in the same territory with “An Elegant Defense” (Morrow/HarperCollins, $28.99), also published this spring. A reporter for The New York Times, Richtel became interested in immunology after a childhood friend developed Hodgkin’s lymphoma in his early 40s. Hodgkin’s is one of the more curable cancers of adulthood, but Jason Greenstein was in the unlucky minority of patients who have terrible, prolonged downhill courses. Richtel told portions of Jason’s story in a Science Times series on the promise and perils of immunologic therapy: With a last-ditch experimental monoclonal antibody treatment, Jason’s huge, disfiguring tumors melted away like warming ice cubes — a visible miracle, if sadly short-lived.
Jason died in 2016. Richtel’s deep affection for his irrepressible friend animates much of his book, and his stories of three other individuals whose illness or wellness can be ascribed to their unique immunologic makeup are interesting enough, if less affecting. But when Richtel attempts to explain the basic science underlying autoimmune disease and immunologic treatment, he is palpably out of his depth. Dozens of different immune cells and chemicals keep us healthy and can also make us grievously sick; their habits and functions are often opaque and the nomenclature is beyond confusing. Even a professional narrator like Richtel, forced to operate without tables and figures, is bound to get all tangled up in his prose and generate a few real bloopers. That’s why some wise educator long ago created textbooks.
AUTISM’S FALSE PROPHETS: Bad Science, Risky Medicine, and the Search for a Cure, by Paul Offit. BAD FAITH: When Religious Belief Undermines Modern Medicine, by Paul Offit. DEADLY CHOICES: How the Anti-Vaccine Movement Threatens Us All, by Paul Offit. VACCINATED: One Man’s Quest to Defeat the World’s Deadliest Diseases, by Paul Offit. Offit’s multivolume bible of science-based pro-vaccine thought.
THE PANIC VIRUS: A True Story of Medicine, Science, and Fear, by Seth Mnookin. An impartial journalist reviews the evidence.
THE VACCINE RACE: Science, Politics, and the Human Costs of Defeating Disease, by Meredith Wadman. Immensely readable story of the scientific and political scrambles accompanying 20th-century vaccine development.
BETWEEN HOPE AND FEAR: A History of Vaccines and Human Immunity, by Michael Kinch. THE END OF THE BEGINNING: Cancer, Immunity and the Future of a Cure. An immunologist explains it all, at length and with lots of detours.
AN ELEGANT DEFENSE: The Extraordinary New Science of the Immune System, by Matt Richtel. Read it for the stories of patients helped and harmed.
Just about everybody, that’s who. Experts have been tracking the worldwide resurgence of measles for decades now, and it was only a matter of time before the scattershot outbreaks of years past turned into this year’s newsworthy explosions.
Readers curious about this infection rising phoenixlike from its own ashes will find both less and more in the library than they may want. Aside from a few textbooks and pamphlets, I couldn’t find a whole book devoted to measles — not since the 10th century A.D., that is, when the Persian physician Al-Razi wrote “The Smallpox and Measles” to differentiate the two.
Still, quite a few recent books deliver the basics, including information on childhood infections and their medical dangers, the various ways we have learned to thwart those dangers and the ways in which those efforts have in turn been thwarted. Readers intrigued enough by vaccination to want more details on the workings of the human immune system and its potential for both harm and good will find new books discussing just that topic.
For a detailed review of diseases, vaccines and the objections the anti-vaccine lobbyists have brought to the table, books by the prolific Paul Offit are a good place to start. Offit is a pediatrician and infectious disease expert in Philadelphia whose longtime, eloquent advocacy of vaccination has made him a permanent target of anti-vaccine lobbyists — his book signings have sometimes been canceled because of credible death threats.
Offit’s “Deadly Choices” (2010) outlines the often-forgotten complications of childhood infections and rebuts the various objections of the anti-vaxxers point by point. “Autism’s False Prophets” (2008) concentrates on the thoroughly debunked assertion that the neurological condition autism results from childhood vaccines.
But it is “Bad Faith” (2015), Offit’s analysis of the tension between religious fundamentalism and vaccination, that speaks most directly to this year’s headlines with a short, unforgettable section on measles. During the winter of 1990-91, more than 1,400 adults and children in Philadelphia developed measles, and nine children, all unvaccinated, died. Offit’s dispassionate, methodical summary of the religious and political theories that enabled that giant outbreak simmers with anger. Living through that epidemic, he has since written, “was like being in a war zone.”
If expert opinion from a war zone is not an appealing perspective on the subject, readers will find similar territory covered in an utterly different voice by Seth Mnookin in his excellent “The Panic Virus” (2011). A journalist with no skin in the vaccine game — other than the fact that he was a new father when he wrote the book — Mnookin just wanted to explore the minefield for himself. As he tentatively lays out vaccine pros and cons he becomes convinced of the fallacies and dangers in the anti-vaccine movement’s rhetoric. His reflections on the actress Jenny McCarthy, whose transformation into anti-vaccine advocate revived a fading Hollywood career, make for a fun, snarky read, but the enduring importance of Mnookin’s book lies in its methodical science-based rebuttals of wild rhetoric.
If histrionic behavior and snark appeal to you, you can get quite a dose of both from the stories of some of the vaccine scientists themselves. Offit’s “Vaccinated” (2007) profiles one of the 20th century’s foremost vaccinologists, Merck’s powerful and spectacularly foul-mouthed Maurice Hilleman, and sketches out the climate of fierce scientific competition and politics in which he thrived.
The science journalist Meredith Wadman took a deep dive into similar material and created a real jewel of science history. Wadman’s “The Vaccine Race” (2017) brims with suspense and now-forgotten catastrophe and intrigue, all beginning in the 1950s and 1960s, when, as she writes, the chase for new vaccines “was as hot as today’s quest to unravel the profound mysteries of the human genome.”
The first vaccinologists were accustomed to working in happy solitude, policed by conscience alone — or not, as the case may be (some were really wildly unprincipled). Soon enough, though, the scientists were joined in their projects by academics and salesmen, then by corporate executives, then by congressmen and lawyers. All were forced to navigate the terrible early vaccine disasters, when contaminated products transmitted disease rather than protection, and all struggled with the need to reconcile centuries-old public health tools, like quarantine, with new ones like mandatory vaccination and informed consent. Wadman’s smooth prose calmly spins a surpassingly complicated story into a real tour de force.
Vaccination was only the first organized effort to harness the immune system for medical purposes. In the last two decades many other techniques have been devised, foremost among them the engineered proteins called monoclonal antibodies. These are the pricey drugs with unpronounceable names ending in “-mab” now being hawked incessantly on television for diseases from eczema to cancer. The story of the science behind these drugs and other sophisticated immunologic tools is just beginning to be written.
In his new book, “The End of the Beginning” (Pegasus, $27.95), the immunologist Michael Kinch builds on the narrative he began with last year’s “Between Hope and Fear.” That book provides a chatty, looping profile of the immune system and the historical origins of modern vaccine science, all contained in a narrative draped like a Christmas tree with sparkly digressions into biography, philosophy and historical gossip.
Kinch now changes focus slightly to review cancer biology and the promise of immune-mediated treatments. A professor at Washington University in St. Louis, he spent some of his early career at a biotechnical company and can speak with authority about the mixed promise of monoclonal antibodies for cancer treatment — some tumors vanish with these agents while others are utterly untouched, and none of the drugs is without side effects.
Kinch’s narrative is as loose and lavishly ornamented as ever, while his material is, if anything, even more scientifically complex. Some readers may enjoy the bumpy, glittery, distraction-filled ride. Others, presumably those of us with dull linear minds, will wish he would just settle down, even for a single chapter, and say what he has to say in a dull, straightforward way.
Matt Richtel wanders different paths in the same territory with “An Elegant Defense” (Morrow/HarperCollins, $28.99), also published this spring. A reporter for The New York Times, Richtel became interested in immunology after a childhood friend developed Hodgkin’s lymphoma in his early 40s. Hodgkin’s is one of the more curable cancers of adulthood, but Jason Greenstein was in the unlucky minority of patients who have terrible, prolonged downhill courses. Richtel told portions of Jason’s story in a Science Times series on the promise and perils of immunologic therapy: With a last-ditch experimental monoclonal antibody treatment, Jason’s huge, disfiguring tumors melted away like warming ice cubes — a visible miracle, if sadly short-lived.
Jason died in 2016. Richtel’s deep affection for his irrepressible friend animates much of his book, and his stories of three other individuals whose illness or wellness can be ascribed to their unique immunologic makeup are interesting enough, if less affecting. But when Richtel attempts to explain the basic science underlying autoimmune disease and immunologic treatment, he is palpably out of his depth. Dozens of different immune cells and chemicals keep us healthy and can also make us grievously sick; their habits and functions are often opaque and the nomenclature is beyond confusing. Even a professional narrator like Richtel, forced to operate without tables and figures, is bound to get all tangled up in his prose and generate a few real bloopers. That’s why some wise educator long ago created textbooks.
AUTISM’S FALSE PROPHETS: Bad Science, Risky Medicine, and the Search for a Cure, by Paul Offit. BAD FAITH: When Religious Belief Undermines Modern Medicine, by Paul Offit. DEADLY CHOICES: How the Anti-Vaccine Movement Threatens Us All, by Paul Offit. VACCINATED: One Man’s Quest to Defeat the World’s Deadliest Diseases, by Paul Offit. Offit’s multivolume bible of science-based pro-vaccine thought.
THE PANIC VIRUS: A True Story of Medicine, Science, and Fear, by Seth Mnookin. An impartial journalist reviews the evidence.
THE VACCINE RACE: Science, Politics, and the Human Costs of Defeating Disease, by Meredith Wadman. Immensely readable story of the scientific and political scrambles accompanying 20th-century vaccine development.
BETWEEN HOPE AND FEAR: A History of Vaccines and Human Immunity, by Michael Kinch. THE END OF THE BEGINNING: Cancer, Immunity and the Future of a Cure. An immunologist explains it all, at length and with lots of detours.
AN ELEGANT DEFENSE: The Extraordinary New Science of the Immune System, by Matt Richtel. Read it for the stories of patients helped and harmed.
By Abigail Zuger
April 17, 2019
April 17, 2019
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