NOTES

INTRODUCTION

1. Popular debate over vaccination is, as other historians have argued, a proxy for other cultural tensions or societal disagreements. Most recently, Mark Largent argued that the debate over vaccines and autism that took place in the 2000s was a proxy debate about “a complex set of concerns about the modern vaccine schedule.” Mark Largent, Vaccine: The Debate in Modern America (Baltimore: Johns Hopkins University Press, 2012), 1.

2. Centers for Disease Control and Prevention (CDC), “National, State, and Local Area Vaccination Coverage among Children Aged 19–35 Months—United States, 2009,” Morbidity and Mortality Weekly Report 59, no. 36 (2010): 1171–77.

3. Scholars agree that a new era of compulsory immunization began in the 1960s. See, for example, James Colgrove, State of Immunity: The Politics of Vaccination in Twentieth-Century America (Berkeley: University of California Press, 2006); Judith Sealander, The Failed Century of the Child: Governing America’s Young in the Twentieth Century (New York: Cambridge University Press, 2003); and Michael Willrich, Pox: An American History (New York: Penguin, 2011), 339.

4. Colgrove, State of Immunity. For more details on how vaccines provide community benefits, see the appendix.

5. Ibid., 38–44, 96–97; Ramunas Kondratas, “Biologics Control Act of 1902,” in The Early Years of Federal Food and Drug Control, ed. James Harvey Young (Madison, WI: American Institute of the History of Pharmacy and the American Pharmaceutical Association, 1982), 8–27; Willrich, Pox, 166–210; Lawrence Gostin, Public Health Law: Power, Duty, Restraint (Berkeley: University of California Press, 2000), 66–69.

6. See, for example, Samuel Woodward, “An Argument in Favor of Vaccination, with Statistics of the Incidence of Smallpox in the United States, Its Dependencies and Canada,” New England Journal of Medicine 202, no. 3 (1930): 122–24.

7. Smallpox, which sickened 21,000 Americans and killed nearly 900 in 1900, claimed its last U.S. victim in 1949. Diphtheria, a top killer in 1900, caused just 628 cases of disease in 1960. The United States often saw upwards of 100,000 cases of pertussis early in the century; decades later, the number of annual cases had fallen to just over 1,000. Vaccines were not alone responsible for these shifts, but they did play a critical role, along with improvements in nutrition, sanitation, and overall standard of living. Stanley A. Plotkin and Walter A. Orenstein, Vaccines, 5th ed. (Philadelphia: Saunders, 2008), 467; CDC, “Impact of Vaccines Universally Recommended for Children—United States, 1990–1998,” Morbidity and Mortality Weekly Report 48, no. 12 (1999): 243–48.

8. Woodward, “An Argument in Favor of Vaccination.”

9. Samuel Woodward, “Arguments in Favor of Compulsory Vaccination for Private School Children,” New England Journal of Medicine 206, no. 11 (1932): 570–72. See also Robert Johnston, The Radical Middle Class: Populist Democracy and the Question of Capitalism in Progressive Era Portland, Oregon (Princeton, NJ: Princeton University Press, 2003), chaps. 12, 13. For other examples, see Colgrove, State of Immunity, chap. 2; William J. Reese, Power and the Promise of School Reform: Grassroots Movements during the Progressive Era (Boston: Routledge & Kegan Paul, 1986), 232–35; and Michael Willrich, “‘The Least Vaccinated of Any Civilized Country’: Personal Liberty and Public Health in the Progressive Era,” Journal of Policy History 20, no. 1 (2008): 76–93.

10. Attempts to make diphtheria immunization compulsory in the 1930s and early 1940s got caught up in this dispute, for instance, and, as a result, few such laws were passed. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), 196; Evelynn Maxine Hammonds, Childhood’s Deadly Scourge: The Campaign to Control Diphtheria in New York City, 1880–1930 (Baltimore: Johns Hopkins University Press, 2002). See also, for example, G. W. Anderson and G. H. Bigelow, “Diphtheria Immunization in Private Practice,” American Journal of Public Health and the Nations Health 23, no. 7 (1933): 655–62.

11. Gerald Gross, “U.S. Army Better Equipped Today to Fight Disease than in 1917,” Washington Post, October 8, 1940, 10; “Influenza Immunization Test Started by Navy,” Los Angeles Times, July 29, 1941, A5.

12. United Press International, “France Fights Epidemics,” New York Times, August 5, 1940, 4; Alvin Steinkopf, “Reich at War with Typhoid in Polish State,” Washington Post, October 14, 1940, 6.

13. Associated Press, “Tell Discovery of a Vaccine to Avoid Measles,” Chicago Daily Tribune, September 18, 1940, 1. The marginally effective vaccine would be replaced by a more reliable one in the 1960s; see chapter 2.

14. “Adults Are Urged to Be Vaccinated,” New York Times, May 24, 1942, 28; Adele Bernstein, “U.S. Postwar Epidemics Foreseen,” Washington Post, October 3, 1943, M12.

15. Leona Baumgartner, “Attitude of the Nation toward Immunization Procedures,” American Journal of Public Health 33 (1943): 256–60.

16. “Immunization against Smallpox, Diphtheria, Tetanus, and Poliomyelitis,” speech given by James L. Goddard before the Clinical Meeting of the American Medical Association, December 3, 1963, Folder: Info 3 Tr.—1963, Box 334065, No. 5, Record Group 442, CDC, Office of the Director Files, NARA Southeast Region. See also Judith Leavitt, “‘Be Safe, Be Sure’: New York City’s Experience with Epidemic Smallpox,” in Sickness and Health in America, ed. Judith Leavitt and Ronald Numbers (Madison: University of Wisconsin Press, 1997), 407–17.

17. For accounts of the polio vaccine trials and the related activities of the March of Dimes, see, for example, Jane S. Smith, Patenting the Sun: Polio and the Salk Vaccine (New York: William Morrow, 1990); and David M. Oshinsky, Polio: An American Story (New York: Oxford University Press, 2005).

18. Otis Anderson, “The Polio Vaccination Assistance Act of 1955,” American Journal of Public Health 45, no. 10 (1955): 1349–50.

19. Patrick Vivier, “National Policies for Childhood Immunization in the United States: An Historical Perspective” (PhD diss., Johns Hopkins University, 1996).

20. Elizabeth W. Etheridge, Sentinel for Health (Berkeley: University of California Press, 1992).

21. Extension of Poliomyelitis Vaccination Assistance Act, Hearing Before a Subcommittee of the Committee on Interstate and Foreign Commerce, House of Representatives, 84th Cong. (January 24, 1956), 60.

22. “Surveillance of Poliomyelitis in the United States, 1958–61,” Public Health Reports 77, no. 12 (1962): 1011–20.

23. Baby’s Milestones: Birth to Seven Years (Completed for “Sarah W.” b. June 1964), (Norwalk, CT: C. R. Gibson, 1957); Baby Books Collection, Louise M. Darling Biomedical Library, History & Special Collections for the Sciences, UCLA. “Sarah W.” is not the baby’s real name, though her real name does appear in the baby book cited here.

24. Minn. Stat. 121A.15, https://www.revisor.mn.gov/statutes/?id=121A.15 (accessed June 2012). See History 1967 c 858 s 1, 2 at the cited link.

25. These laws are typically referred to as vaccine “mandates,” even though exemptions exist for each required vaccine. In all states, children may be exempted from required vaccines for medical reasons; in most states (save Mississippi and West Virginia), they may be exempted for religious reasons. At time of writing, eighteen states also permit “personal” or “philosophical” exemptions. See National Conference of State Legislatures, “States with Religious and Philosophical Exemptions from School Immunization Requirements,” February 2012, http://www.ncsl.org/default.aspx?tabid=14376 (accessed August 2012). Though NCSL counts twenty states with philosophical exemptions, Missouri’s applies only to preschool children, and New Mexico health officials contend that their religious exemption does not cover philosophical beliefs. Associated Press, “New Mexico Alters Child Vaccination Waiver Form,” SFGate.com, August 29, 2012; Phaedra Haywood, “State Alters Vaccination Waiver Form, Asking Parents to Cite Religion,” Santa Fe New Mexican, August 28, 2012.

26. Benjamin Spock, Baby and Child Care (New York: Pocket Books, 1964); Report of the Committee on the Control of Infectious Diseases (Evanston, IL: American Academy of Pediatrics, 1961).

27. The CDC recommends that all children receive vaccines against hepatitis B, rotavirus, diphtheria, tetanus, pertussis, Haemophilus influenzae type b (Hib), pneumococcus, meningococcus, polio, flu, measles, mumps, rubella, and varicella (chicken pox). Some of these are administered as combined vaccines; all of the recommended vaccines (combined or not) are administered in multiple doses, usually totaling between two and four doses. Children with certain risk factors are also advised to be vaccinated against hepatitis A and meningococcus; the latter is recommended for all children beginning at age eleven. CDC, “Recommended Immunization Schedules for Persons Aged 0 through 18 Years—United States, 2012,” Morbidity and Mortality Weekly Report 61, no. 5 (2012): 1–4.

28. Letter from Lewis Thomas, November 1976, Folder: Immunization, Box 32, Collection JC-DPS: Records of the Domestic Policy Staff, Jimmy Carter Library.

29. My analysis of the framing of vaccines and their target infections is strongly influenced by the work of Charles Rosenberg. See Charles Rosenberg, “Disease in History: Frames and Framers,” Milbank Quarterly 67, no. S1 (1989): 1–15; Charles Rosenberg, “Framing Disease: Illness, Society, and History,” in Framing Disease: Studies in Cultural History, ed. Charles Rosenberg and Janet Golden (New Brunswick, NJ: Rutgers University Press, 1997), xxi–xxvi; and Charles Rosenberg, “What Is Disease?” Bulletin of the History of Medicine 77 (2003): 491–505.

30. This articulation borrows from Siddhartha Mukherjee’s eloquent explanation of the process by which diseases are framed: “Every era casts illness in its own image. Society, like the ultimate psychosomatic patient, matches its medical afflictions to its psychological crises; when a disease touches such a visceral chord, it is often because that chord is already resonating.” Siddhartha Mukherjee, The Emperor of All Maladies: A Biography of Cancer (New York: Scribner, 2010), 182.

31. For these reasons, I do not use the terms “anti-vaccinationist” or “anti-vaccine” to describe individuals or groups active in the last century unless those groups or individuals defined themselves by their opposition to all vaccines.

32. On the subject of health citizenship, see, for example, Dorothy Porter, Health, Civilization, and the State (London: Routledge, 1999).

33. Some such critics believe, for instance, that vaccines are behind a subtle, chronic deterioration of the human immune system that is passing from one generation to the next. Such fears are based partly on the fact that vaccines replace natural immunity with vaccine-induced immunity. These fears also fit the pattern of the modern “risk society” articulated by sociologist Ulrich Beck, in Risk Society: Towards a New Modernity (Los Angeles: Sage, 1992).

34. Arthur Allen, Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver (New York: Norton, 2007), 15; Colgrove, State of Immunity, 8; Sabrina Tavernise, “Washington State Makes It Harder to Opt Out of Immunizations,” New York Times, September 20, 2012, A18.

35. See note 25.

CHAPTER ONE

1. Press Conference No. 9 of the President of the United States, April 12, 1961, Digital Identifier JFKPOF-054-011, Press Conference Series, Papers of John F. Kennedy, John F. Kennedy Library.

2. James Colgrove provides an overview of the act in the context of 1960s campaigns to eliminate polio in State of Immunity: The Politics of Vaccination in Twentieth-Century America (Berkeley: University of California Press, 2006), 144–47.

3. Testimony by Walter Orenstein on the Immunization Grant Program of the PHS Act, Before the Senate Committee on Labor and Human Resources, Subcommittee on Public Health and Safety, May 6, 1997, Assistant Secretary for Legislation, Department of Health and Human Services, http://www.hhs.gov/asl/testify/t970506a.html (accessed May 2013).

4. A. R. Hinman, W. A. Orenstein, and L. Rodewald, “Financing Immunizations in the United States,” Clinical Infectious Diseases 38, no. 10 (2004): 1440–46. Since the early nineties, a separate program—passed under Clinton and discussed in chapter 7—has provided the lion’s share of public-sector support for child immunization.

5. Historians and medical experts have debated whether Roosevelt actually suffered from polio or another disease with neurological effects, but as historian David Oshinsky points out, what matters is that in his own time, Roosevelt’s disease was considered to be polio. David M. Oshinsky, Polio: An American Story (New York: Oxford University Press, 2005), 28. On Roosevelt’s illness, see, for instance, A. S. Goldman et al., “What Was the Cause of Franklin Delano Roosevelt’s Paralytic Illness?,” Journal of Medical Biography 11, no. 4 (2003): 232–40; and Barron H. Lerner, “Crafting Medical History: Revisiting the ‘Definitive’ Account of Franklin D. Roosevelt’s Terminal Illness,” Bulletin of the History of Medicine 81, no. 2 (2007): 386–406.

6. Oshinsky, Polio.

7. For accounts of the Salk and Sabin vaccine trials and the activities of the National Foundation for Infantile Paralysis, see, for example, Jane S. Smith, Patenting the Sun: Polio and the Salk Vaccine (New York: William Morrow, 1990); and Oshinsky, Polio.

8. See Associated Press, “48 to Check Polio Vaccine Black Market,” Washington Post, August 18, 1955, 32; and “Racket Is Feared in Polio Vaccine,” New York Times, March 29, 1955, 26.

9. David Blumenthal and James A. Morone, Heart of Power: Health and Politics in the Oval Office (Berkeley: University of California Press, 2009), 109; Jill S. Quadagno, One Nation, Uninsured: Why the U.S. Has No National Health Insurance (New York: Oxford University Press, 2005), 43–44.

10. C. F. Trussell, “House Approves Polio Vaccine Aid,” New York Times, August 2, 1955, 26; Associated Press, “2 Rows Delay Congress Windup,” Chicago Daily Tribune, August 1, 1955, 3.

11. Otis Anderson, “The Polio Vaccination Assistance Act of 1955,” American Journal of Public Health 45, no. 10 (1955): 1349–50.

12. “U.S. Gives States Full Control over Polio Vaccine Distribution,” New York Times, August 1, 1955, 1; Trussell, “House Approves Polio Vaccine Aid.”

13. Colgrove, State of Immunity, 113–48.

14. Oshinsky, Polio, 268.

15. Philip J. Smith, David Wood, and Paul M. Darden, “Highlights of Historical Events Leading to National Surveillance of Vaccination Coverage in the United States,” Public Health Reports 126, no. S2 (2011): 3–12.

16. Colgrove, State of Immunity, 138.

17. Sydney A. Halpern, American Pediatrics: The Social Dynamics of Professionalism, 1880–1980 (Berkeley: University of California Press, 1988), 14.

18. Joseph M. Hawes and N. Ray Hiner, American Childhood: A Research Guide and Historical Handbook (Westport, CT: Greenwood Press, 1985); Joseph M. Hawes and N. Ray Hiner, eds., Children in Historical and Comparative Perspective (Westport, CT: Greenwood Press, 1991); Hugh Cunningham, Children and Childhood in Western Society since 1500 (New York: Longman, 1995).

19. George Rosen, A History of Public Health, MD Monographs on Medical History, no. 1 (New York: MD Publications, 1958), 360–61.

20. Ibid., 363–64. On the child health and welfare movement generally, see Richard A. Meckel, Save the Babies: American Public Health Reform and the Prevention of Infant Mortality, 1850–1929 (Ann Arbor: University of Michigan Press, 1998); and Alexandra Stern and Howard Markel, Formative Years: Children’s Health in the United States, 1880–2000 (Ann Arbor: University of Michigan Press, 2002).

21. Jeffrey Brosco, “Weight Charts and Well-Child Care: How the Pediatrician Became the Expert in Child Health,” Archives of Pediatric Adolescent Medicine 155, no. 12 (2001): 1385–89.

22. Halpern, American Pediatrics.

23. “Vaccination Assistance Act of 1962,” Congressional Record—House (1962): 11739–53. States could also apply for grants to provide immunizations through title V of the Social Security Act and Section 314(c) of the Public Health Service Act. U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs (Washington, DC: U.S. Government Printing Office, 1962), 73.

24. U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs, 2.

25. “Vaccination Assistance Act of 1962,” 11745.

26. “Memorandum for the President, from the Secretary for Health, Education, and Welfare,” not dated, Folder: Health, Education, and Welfare 1/62–6/62, Box 79A, President’s Office Files, Departments and Agencies, John F. Kennedy Library.

27. John F. Kennedy, “Annual Message to the Congress on the State of the Union,” January 11, 1962, American Presidency Project, UCSB.

28. News Roundup, “Kennedy Calls for ‘Mass Immunization’ against Diseases; No Details Supplied,” Wall Street Journal, January 12, 1962, 2.

29. John F. Kennedy, “Special Message to the Congress on National Health Needs,” February 27, 1962, American Presidency Project, UCSB.

30. John F. Kennedy, “Special Message to the Congress on the Nation’s Youth,” February 14, 1963, American Presidency Project, UCSB.

31. Kennedy, “Special Message to the Congress on National Health Needs.”

32. Kennedy, “Special Message to the Congress on the Nation’s Youth.”

33. Allan M. Brandt, No Magic Bullet: A Social History of Venereal Disease in the United States since 1880 (New York: Oxford University Press, 1985).

34. The 1955 figure is taken from Oshinsky, Polio, 255. The 1961 figure is taken from the “Fact Book Relating to the Vaccination Assistance Act of 1962,” Folder: Information 3—Immunization, 1963, Box 334062, No. 2, Record Group 442, CDC, NARA Southeast Region.

35. For figures on vaccination coverage rates in 1962 and 1963, see “Memo from Albert Sabin to William Seidman, August 16, 1976,” Folder: CDC Liability Proposal, Box 8, Swine Flu Immunization Program Files, Record Group 442, CDC, NARA Southeast Region. “Sabin Sundays” were chronicled in many media outlets; see, for example, “Medicine: Wiping Out Polio,” Time, July 6, 1962, http://content.time.com/time/magazine/article/0,9171,940023,00.html (accessed May 2013). Sabin’s race to develop an alternative to the Salk vaccine is described in Oshinsky, Polio; and Smith, Patenting the Sun.

36. Lawrence O’Kane, “Broad Search on in Smallpox Case,” New York Times, August 21, 1962, 21; Associated Press, “3,000 Vaccinated as Result of Smallpox Scare in the East,” Los Angeles Times, August 21, 1962, 3; Nate Haseltine, “Is America Safe from Smallpox?,” Washington Post, September 2, 1962, E7.

37. News release from Louisiana State Board of Health, September 19, 1963, Folder: Information 3—1963, Box 334062, Office of the Director Files, No. 2, Record Group 442, CDC, NARA Southeast Region.

38. “Vaccination Assistance Act of 1962.”

39. Benjamin Spock, The Common Sense Book of Baby and Child Care (New York: Duell, Sloan and Pearce, 1960), 221.

40. News Roundup, “Kennedy Calls for ‘Mass Immunization’ against Diseases.”

41. Disease incidence figures are taken from “Fact Book Relating to the Vaccination Assistance Act of 1962.” A search of seventeen different newspapers—including the Atlanta Constitution, Chicago Tribune, and Pittsburgh Courier—turned up just ten articles that mentioned either tetanus, diphtheria, or whooping cough in 1962; for 1963, the same search turned up just four mentions of these three diseases.

42. “Diphtheria Immunization: A Survey of Existing Legislation,” International Digest of Health Legislation 8 (1957): 171–98.

43. Ibid.

44. Gaylord West Anderson and Margaret G. Arnstein, Communicable Disease Control: A Volume for the Health Officer and Public Health Nurse (New York: Macmillan, 1953), 92.

45. “Vaccination Assistance Act of 1962,” 11740.

46. U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs, 74.

47. Vaccination Assistance Act of 1962, Senate Report Submitted by Mr. Hill, to Accompany H.R. 10541, August 22, 1962, 87th Congress, 2nd Session (Washington, DC: U.S. Government Printing Office), 2.

48. Other scholars have made this same point. See Patrick Vivier, “National Policies for Childhood Immunization in the United States: An Historical Perspective” (PhD diss., Johns Hopkins University, 1996); and Colgrove, State of Immunity, 144–47.

49. Vaccination Assistance Act of 1962.

50. U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs, 46–47.

51. “Health and Social Security for the American People, a Report to President-Elect John F. Kennedy, January 10, 1961,” Folder: Health and Social Security Task Force Report, Box 1071, Pre-Presidential Papers of John Fitzgerald Kennedy, John F. Kennedy Library. The report was also excerpted in “Task Force on Health and Social Security Reports,” Journal of the American Osteopathic Association 60 (1961): 502–6.

52. W. H. Foege, “Centers for Disease Control,” Journal of Public Health Policy 2, no. 1 (1981): 8–18.

53. F. Robert Freckleton, “Federal Government Programs in Immunization,” Archives of Environmental Health 15 (1967): 514.

54. Meeting Minutes, Meeting No. 1 of the Advisory Committee on Immunization Practices, May 25–26, 1964, Folder: Info 3 ACIP Immunization 1964–5, Box 334062, No. 2, Record Group 442, CDC, NARA Southeast Region. The committee’s formation was prompted by disputes over the relative risks and benefits of the Salk and Sabin polio vaccines. See Elizabeth W. Etheridge, Sentinel for Health (Berkeley: University of California Press, 1992), 147.

55. Edward Shorter, The Kennedy Family and the Story of Mental Retardation (Philadelphia: Temple University Press, 2000), 36–37, 41; Robert Dallek, An Unfinished Life: John F. Kennedy, 1917–1963 (Boston: Little, Brown, 2003), 71–73.

56. Eunice Kennedy Shriver, recorded interview by John Stewart, May 7, 1968, John F. Kennedy Library Oral History Program.

57. Ibid.

58. Ibid. On the work and objectives of the task force, see also Wilbur J. Cohen, recorded interview by Charles T. Morrissey, November 11, 1964, John F. Kennedy Library Oral History Program; and Robert E. Cooke, recorded interview by John F. Stewart, March 29, 1968, John F. Kennedy Library Oral History Program. Cooke’s interview also suggests that the task force championed age-related approaches to health research and health care in part because they found the approach novel and innovative. He, like Shriver, felt that child health in particular had been overlooked in federally supported health research. Elevating the stature of children’s health as an area of scientific research was, for them, one means of increasing support for mental retardation, which Eunice called “the single most frequent and serious disabling problem of childhood.”

59. “Remarks at the National Association for Retarded Children Convention,” October 24, 1963, Digital Identifier JFKPOF-047-040, Speech Files Series, Papers of John F. Kennedy, John F. Kennedy Library.

60. Patrick’s diagnosis at the time was hyaline membrane disease. Eunice Kennedy Shriver, recorded interview by John Stewart.

61. Dallek, An Unfinished Life, 27.

62. Ibid., 489–90.

63. List of major proposals for 1962, Folder: Legislative Files 5/1–18/62, Box 50, President’s Office Files, Legislative Files, John F. Kennedy Library.

64. Memo, not dated, Folder: Legislative Files 5/1–18/62, Box 50, President’s Office Files, Legislative Files, John F. Kennedy Presidential Library.

65. Kennedy, “Special Message to the Congress on the Nation’s Youth.”

66. “Fact Book Relating to the Vaccination Assistance Act of 1962.”

67. Speech given by Assistant Secretary of HEW Boisfeuillet Jones, University of Pennsylvania, April 29, 1963, Folder: FA5 12-16-62–4-30-63 General, Box 99, White House Central Files, John F. Kennedy Presidential Library.

68. Editorial, “Two Kinds of Immunity,” Christian Science Monitor, May 12, 1962, 16; Editorial, “Health Insurance, Plus Mass Inoculations,” Christian Science Monitor, February 28, 1962, 14; Editorial, “A Subsidy for Medical Compulsions,” Christian Science Monitor, March 10, 1962, 16.

69. Hugh White, “Vaccination Act,” Christian Science Monitor, August 2, 1962, 16.

70. Letter to the President, Leslie Gampp, Laura Oard et al., June 16, 1962, Folder: LE/HE–LE/HE 6, Box 481, White House Central Files, John F. Kennedy Presidential Library.

71. Letter from Mr. and Mrs. James De Haan, July 12, 1962 Folder: LE/FA 5, Box 473, White House Central Files, John F. Kennedy Library.

72. “Nationwide Mass Vaccine Program,” Congressional Record—Senate (1962): 8379–80.

73. Otherwise, the AMA said it endorsed “the principle” of the bill. U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs, 129–30.

74. “Immunization against Smallpox Diphtheria Tetanus and Poliomyelitis,” speech given by James L. Goddard before the Clinical Meeting of the American Medical Association, December 3, 1963, Folder: Info 3 Tr.—1963, Box 334065, No. 5, Record Group 442, CDC, Office of the Director Files, NARA Southeast Region; emphasis in original.

75. U.S. Congress, House Committee on Interstate and Foreign Commerce, Subcommittee on Health and Safety, Polio Vaccines (Washington, DC: U.S. Government Printing Office, 1961); “Vaccination Assistance Act of 1962,” 11744–45.

76. “Vaccination Assistance Act of 1962,” 11745–46.

77. U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs, 50–51.

78. Freckleton, “Federal Government Programs in Immunization.”

CHAPTER TWO

1. Details of the outbreak and the eleven-year-old girl’s symptoms appear in T. E. Corothers and Gabriel S. Zatlin, “An Outbreak of Diphtheria: A Story of Investigation and Control,” Clinical Pediatrics 5, no. 1 (1966): 29–33.

2. “End to Measles Possible, Says MD,” AMA News, October 31, 1966.

3. U.S. Department of Health, Education, and Welfare, “Polio Packet,” 1959, Object 2011.12.5, CDC Museum Collection.

4. “Preliminary Report—Rhode Island Poliomyelitis Epidemic 1960,” Folder: Communicable Disease Center 34, Joseph Stokes Papers, American Philosophical Society.

5. “Polio Surveillance Report,” January 13, 1961, Folder: Communicable Disease Center 33, Joseph Stokes Papers, American Philosophical Society.

6. Ibid.

7. U.S. Department of Health, Education, and Welfare, “Polio Packet.”

8. Luther Terry, “The City in National Health,” November 16, 1961, Folder: Speeches and Conferences, Box 20, Luther L. Terry Papers, 1957–1995 (MS C 503), NLM.

9. Kenneth T. Jackson, Crabgrass Frontier: The Suburbanization of the United States (New York: Oxford University Press, 1985), 8.

10. David R. Farber and Beth L. Bailey, The Columbia Guide to America in the 1960s (New York: Columbia University Press, 2001), 263–64.

11. “Preliminary Report—Rhode Island Poliomyelitis Epidemic 1960.”

12. U.S. Department of Health, Education, and Welfare, “Polio Packet”; U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs (Washington, DC: U.S. Government Printing Office, 1962).

13. See, for example, Charles E. Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago: University of Chicago Press, 1962); Marilyn Chase, The Barbary Plague: The Black Death in Victorian San Francisco (New York: Random House, 2003); G. B. Risse, “‘A Long Pull, a Strong Pull, and All Together’: San Francisco and Bubonic Plague, 1907–1908,” Bulletin of the History of Medicine 66, no. 2 (1992): 260–86; James H. Jones, Bad Blood: The Tuskegee Syphilis Experiment (New York: Maxwell McMillan, 1993); Susan Reverby, Examining Tuskegee: The Infamous Syphilis Study and Its Legacy (Chapel Hill: University of North Carolina Press, 2009); and Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, NJ: Rutgers University Press, 1992).

14. U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs.

15. U.S. Department of Health, Education, and Welfare, “Polio Packet.”

16. See, for example, U.S. Congress, House Committee on Interstate and Foreign Commerce, Intensive Immunization Programs, 131.

17. “No Pockets of Polio,” Science News-Letter 85, no. 24 (1964): 374.

18. Lola M. Irelan, Low-Income Life Styles (Washington, DC: U.S. Department of Health, Education, and Welfare, Welfare Administration, Division of Research, 1966); Regional Field Letter No. 695, August 1, 1966, Folder: Department of Health, Education, and Welfare Regional and Field Letters Nos. 560–699, December 30, 1963–August 29, 1966, Box 108, General Records of the Department of Health and Human Services, NARA College Park.

19. I. M. Rosenstock, M. Derryberry, and B. K. Carriger, “Why People Fail to Seek Poliomyelitis Vaccination,” Public Health Reports 74, no. 2 (1959): 98–103.

20. In a striking turn of events decades later, the affluent and their lifestyles would similarly be held to blame for the persistence of vaccine-preventable disease; see chapter 9.

21. U.S. Department of Health, Education, and Welfare, “Polio Packet.”

22. This very pattern had likely biased the outcome of the field trials that tested the Salk vaccine in the first place; families who volunteered their children to participate in the trials were wealthier and better educated than those families whose children constituted the control group. David M. Oshinsky, Polio: An American Story (New York: Oxford University Press, 2005), 204.

23. U.S. Department of Health, Education, and Welfare, “Polio Packet.”

24. See, for example, John Kenneth Galbraith, The Affluent Society (Boston: Houghton Mifflin, 1958); Michael Harrington, The Other America: Poverty in the United States (New York: Macmillan, 1962); and Dwight MacDonald, “Our Invisible Poor,” New Yorker, January 19, 1963.

25. David Mark Chalmers, And the Crooked Places Made Straight: The Struggle for Social Change in the 1960s (Baltimore: Johns Hopkins University Press, 1991), 65–67.

26. Press release dated July 18, 1961, Folder: June–August 1961, Box 1, US HEW Secretaries’ Speeches 1961–1979 (MS C 388), NLM.

27. Address by Anthony Celebrezze, 3rd Anniversary Celebration of the North Carolina Joint Council on Health and Citizenship, Nov. 10, 1963, Folder: November–December 1963, Box 1, US HEW Secretaries’ Speeches 1961–1979 (MS C 388), NLM.

28. Lyndon B. Johnson, “Remarks upon Signing the Higher Education Facilities Act,” December 16, 1963, American Presidency Project, UCSB.

29. Lyndon B. Johnson, “Remarks at the University of Michigan, May 22, 1964,” American Presidency Project, UCSB; Lyndon B. Johnson, “Annual Message to the Congress on the State of the Union,” January 4, 1965, American Presidency Project, UCSB.

30. Speech by Luther Terry before Political Science Club, May 27, 1961, Folder: January–May 1961, US HEW Secretaries’ Speeches 1961–1979 (MS C 388), NLM.

31. Luther Terry, Conference on the Super-City of Tomorrow, October 30, 1963, Folder: Speeches and Conferences, Box 20, Luther L. Terry Papers, 1957–1995 (MS C 503), NLM.

32. Regional Field Letter No. 699, August 29, 1966, Folder: Department of Health, Education, and Welfare Regional and Field Letters Nos. 560–699, December 30, 1963–August 29, 1966, Box 108, General Records of the Department of Health and Human Services, NARA College Park.

33. Joe William Trotter, Earl Lewis, and Tera W. Hunter, African American Urban Experience: Perspectives from the Colonial Period to the Present (New York: Palgrave Macmillan, 2004), 1.

34. Regional Field Letter No. 682, May 2, 1966, Folder: Department of Health, Education, and Welfare Regional and Field Letters Nos. 560–699, December 30, 1963–August 29, 1966, Box 108, General Records of the Department of Health and Human Services, NARA College Park.

35. Community Health Services Extension Amendments of 1965, Public Law 89-109, 89th Cong., 1st sess. (August 5, 1965), 436.

36. U.S. Congress Senate, Committee on Labor and Public Welfare, Subcommittee on Health, Public Health Grants and Construction of Health Research Facilities Hearing, 89th Congress, 1st Session, on S. 510 and S. 512. January 27, 1965 (Washington, DC: U.S. Government Printing Office, 1965), 20–21.

37. In some states, Wellbee promoted causes other than immunization: dental health, community sanitation, smoking, and even gun safety. (“A hunter climbed over a fence with his gun cocked,” said a wry Wellbee in Kentucky. “He is survived by his widow, three children, and a rabbit.”) Box of Wellbee materials, Object No. 1995.464, CDC Museum Collection.

38. Luther Terry, Speech before the Political Science Club, May 27, 1961, Folder: January–May 1961, US HEW Secretaries’ Speeches 1961–1979 (MS C 388), NLM.

39. Chicago Board of Health Newsletter, June 15, 1965, Object 1995.464.37, CDC Museum Collection; emphasis added.

40. “Right from the Start,” press release, November 25, 1963, Folder: Information 3—1963, Box 334062, Record Group 442, CDC, NARA Southeast Region.

41. In the 1950s, a live attenuated vaccine was developed by Harvard scientist John Enders; it was often given with serum (also called immune globulin) to reduce its frequent side effects. J. Stokes et al., “Efficacy of Live, Attenuated Measles-Virus Vaccine Given with Human Immune Globulin,” New England Journal of Medicine 265, no. 11 (1961): 507–13; Correspondence Concerning Measles Vaccine, 1958, Folder: Measles 4, Joseph Stokes Papers, American Philosophical Society.

42. Stanley A. Plotkin and Walter A. Orenstein, Vaccines, 5th ed. (Philadelphia: Saunders, 2008), 359–62.

43. Harold Schmeck, “Measles Have Just about Had It,” New York Times, March 26, 1967, 151.

44. “Current Status of Measles Immunization,” Journal of the American Medical Association 194, no. 11 (1965): 1237–38; “Measles Immunization,” Journal of the American Medical Association 198, no. 8 (1966): 837–38.

45. S. Dandoy, “Measles Epidemiology and Vaccine Use in Los Angeles County, 1963 and 1966,” Public Health Reports 82, no. 8 (1967): 659–66.

46. “Twelve Million Children Immunized against Measles; Cases Drop Sharply,” Journal of the American Medical Association 196, no. 8 (1966): 29–30, 38–39.

47. Harris D. Riley, “Recent Advances in the Study of Measles and Measles Vaccination,” Journal of the American Medical Association 174, no. 15 (1960): 1968–69.

48. Dandoy, “Measles Epidemiology and Vaccine Use in Los Angeles County.”

49. “A Measles Death,” Philadelphia Department of Public Health Reported Communicable Diseases Weekly Report, 1961, Folder: Measles Vaccination 3, Joseph Stokes Papers, American Philosophical Society.

50. Editorial, “Vaccination against Measles,” Journal of the American Medical Association 194, no. 11 (1965): 185.

51. Luther Terry, Speech Given at International Conference on Measles Immunization, November 7, 1961, Folder: November 1961, Box 1, US HEW Secretaries’ Speeches 1961–1979 (MS C 388), NLM.

52. Merck Review 24, no. 2 (Fall 1963). For a history of Merck’s vaccine development efforts in this period, see Louis Galambos and Jane Eliot Sewell, Networks of Innovation: Vaccine Development at Merck, Sharp & Dohme and Mulford, 1895–1995 (New York: Cambridge University Press, 1995).

53. National Communicable Disease Center, “Immunization against Disease 1966–67,” 1968, Folder: Information 3—Imm 1967, Box 334062, No. 2, Record Group 442, CDC, NARA Southeast Region.

54. Merck Review 24, no. 2.

55. Norman Lewak, “Importance of Vaccination against Measles,” Pediatrics 34, no. 3 (1964): 438–39.

56. N. A. Harvey, “Measles Vaccine,” Pediatrics 35, no. 4 (1965): 719–20; Seymour Musiker, “The Silence Is Deafening,” Pediatrics 36, no. 1 (1965): 145.

57. Minutes from Meeting No. 1, Advisory Committee on Immunization Practices, May 25–26, 1964, Folder: Info 3 ACIP Immunization 1964–5, Box 334062, No. 2, Record Group 442, CDC, NARA Southeast Region.

58. Minutes from Meeting No. 4, Advisory Committee on Immunization Practices, Folder: Information 3—Imm 1964–1965, Box 334062, Record Group 442, CDC, NARA Southeast Region.

59. Lyndon B. Johnson, “Remarks at the Signing of the Health Research Facilities Amendments of 1965,” August 9, 1965, American Presidency Project, UCSB; Nan Robertson, “President Signs $280 Million Bill for Health Study,” New York Times, August 10, 1965, 1.

60. Merck Sharp and Dohme Research Laboratories, By Their Fruits (Rahway, NJ: Merck & Co., 1963).

61. E. Harold Hinman, “How Much Control of Communicable Diseases?,” American Journal of Tropical Medicine and Hygiene 15, no. 2 (1966): 125–34.

62. Donald Hopkins, The Greatest Killer: Smallpox in History (Chicago: University of Chicago Press, 1983), 304.

63. Horace G. Ogden, CDC and the Smallpox Crusade (Washington, DC: U.S. Government Printing Office, 1987). Eradication was made feasible by the existence of the WHO and technological developments including freeze-dried vaccine and a jet-injector, which made it possible to immunize 1,000 people per hour. “Smallpox Eradication and Measles Control in Africa,” Brochure Published by the National Communicable Disease Center and the Agency for International Development, 1967, Folder: Information 3 SE-1966, Box 334065, No. 5, Record Group 442, CDC, Office of the Director Files, NARA Southeast Region.

64. Hopkins, The Greatest Killer, 302–3; Ian Glynn and Jenifer Glynn, The Life and Death of Smallpox (New York: Cambridge University Press, 2004).

65. Hopkins, The Greatest Killer, 305. See also Donald Hopkins, Princes and Peasants: Smallpox in History (Chicago: University of Chicago Press, 1985). On the eradication campaign, see Donald A. Henderson, Smallpox: The Death of a Disease (New York: Prometheus Books, 2009).

66. “Measles Eradication 1967,” Supplement to the Morbidity and Mortality Weekly Report, April 15, 1967, Folder: Information 3 Imm 1964–1967, Box 343357, Record Group 442, CDC, NARA Southeast Region. See also National Communicable Disease Center, “Immunization against Disease 1966–67.”

67. David J. Sencer, H. Bruce Dull, and Alexander Langmuir, “Epidemiologic Basis for Eradication of Measles in 1967,” Public Health Reports 82, no. 3 (1967): 253–56.

68. Historian Elizabeth Etheridge also notes that when the Vaccination Assistance Act was renewed in 1965, federal funds became available expressly for measles vaccination. “Thus, a disease previously given little thought worked its way to the top of the health agenda.” Elizabeth W. Etheridge, Sentinel for Health (Berkeley: University of California Press, 1992), 169.

69. A. D. Langmuir, “Medical Importance of Measles,” American Journal of Diseases of Children 103 (1962): 224–26.

70. “Immunization: Theory and Practice,” Report by V. F. Guinea, D. S. Martin, and Other Members of the CDC Immunization Seminar Services Committee, Folder: Info 3 Tr.—1963, Box 334065, No. 5, Record Group 442, CDC, NARA Southeast Region.

71. There were certainly those who dissented from this view, including most notably René Dubos, who warned against the hubris and misguided intents he saw in eradication programs. See René J. Dubos, Man Adapting (New Haven, CT: Yale University Press, 1965).

72. Radio-TV Bulletin, the Advertising Council, March–April 1967, Folder: Information 3 Imm 1964–1967, Box 343357, Record Group 442, CDC, NARA Southeast Region.

73. “Ann Landers: Get Kids Vaccinated Against Measles Now!,” April 4, 1967, Folder: Information 3 Imm 1964–1967, Box 343357, Record Group 442, CDC, NARA Southeast Region; press release, November 1, 1966, Folder: Information 3 Imm 1964–1967, Box 334062, No. 2, Record Group 442, CDC, NARA Southeast Region. Surgeon General William H. Stewart argued that there was “no excuse for needlessly prolonging the fight against this disease, which for centuries has attacked virtually all children and left many of them mentally retarded.” This particular comment of his played to parental fears of disability exacerbated by the recent rubella epidemic of 1964–65, which caused birth defects in some 20,000 children.

74. Quoted in Galambos and Sewell, Networks of Innovation, 115.

75. Trudy Stamm, “Kim Aids Measles Drive,” Children Limited 15, no. 5 (1966): 1. For a description of the inaugural polio poster child, see Oshinsky, Polio, 82–86; and Heather Green Wooten, The Polio Years in Texas: Battling a Terrifying Unknown (College Station: Texas A&M University Press, 2009), 92–94. Kim was also the 1966 poster girl for the National Association for Retarded Children. Joy Miller, “Kim Is Example: Measles Can Cause Retardation,” Free-Lance Star, May 9, 1967, 9.

76. Lewak, “Importance of Vaccination against Measles.”

77. “Spot Prevention” coloring book, U.S. Department of Health, Education, and Welfare, Public Health Service, not dated, Folder: Information 3—Imm 1967, Box 334062, Record Group 442, CDC, NARA Southeast Region.

78. Brochure: “Emmy Immunity and the Dirty Disease Gang,” not dated, Folder: Information 3 Tr.—1963, Box 334065, Record Group 442, CDC, NARA Southeast Region; William Lakeman, “Immunizations Stir Concern,” Free-Lance Star, October 23, 1974, 26.

79. “Memo to Vaccination Assistance Program Field Personnel from Immunization Activities Office,” CDC, June 25, 1965, Folder: Information 3 Imm 1964–1967, Box 334062, No. 2, Record Group 442, CDC, NARA Southeast Region.

80. Edward F. Gliwa and Harold Horoho, “The Vaccination Assistance Act,” Delaware Medical Journal 38, no. 9 (1966): 275–76.

81. National Communicable Disease Center, “Immunization against Disease 1966–67.”

82. “Measles Remain Serious Health Menace Despite Proven Success of Rubeola Vaccine,” Journal of the Medical Association of the State of Alabama 36, no. 6 (1966): 663–65.

83. CDC, “Current Trends—Measles,” Morbidity and Mortality Weekly Report (1967): 2.

84. Etheridge, Sentinel for Health, 174.

85. Letter to Hermann Rinne, February 5, 1970, Folder: General Correspondence—Dr. Wallace, Box 338638, Record Group 442, CDC, NARA Southeast Region; Robert J. Bazell, “Health Programs: Slum Children Suffer Because of Low Funding,” Science 172, no. 3986 (1971): 921–25.

86. Letter from John Witte to Adolf Karchmer, February 9, 1970, Folder: General Correspondence—Dr. Abrutyn, Box 338638, Record Group 442, CDC, NARA Southeast Region.

87. Letter to Hermann Rinne.

88. “Measles—United States, Epidemiologic Year 1969–70,” reported in MMWR 19, no. 6 (February 14, 1970), Folder: General Correspondence—Dr. Wallace, Box 338638, Record Group 442, CDC, NARA Southeast Region.

89. Secretary of Health, Education, and Welfare Wilbur J. Cohen (he occupied the post from 1968 to 1969) pointed a finger at “the interrelated problems of poverty, slums, discrimination, ill health, inadequate education, disgraceful housing, despair, neglect and raised but unfulfilled aspirations,” for a crisis that had shaken all institutions, including the health care system. How could the nation deliver health resources to children so poor and bereft that when shown a picture of a teddy bear, they identified it as a rat, he asked. Wilbur Cohen, “A New Day in Health Care,” December 14, 1968, Folder: December 14–January 16, 1969, Box 3, US HEW Secretaries’ Speeches 1961–1979 (MS C 388), NLM.

90. Note from John Witte to Robert Wallace, not dated, Folder: EPI-70-40-2, Measles, Chicago, Illinois, Box 338638, Record Group 442, CDC, NARA Southeast Region; G. E. Hardy Jr. et al., “The Failure of a School Immunization Campaign to Terminate an Urban Epidemic of Measles,” American Journal of Epidemiology 91, no. 3 (1970): 286–93.

91. Under Nixon, states were typically given block grants to spend as they wish, instead of funds targeted for specific health programs, such as immunization. Bazell, “Health Programs”; K. A. Johnson, A. Sardell, and B. Richards, “Federal Immunization Policy and Funding: A History of Responding to Crises,” American Journal of Preventive Medicine 19, no. S3 (2000): 99–112.

92. Letter from Alfred Sommer to Donald Putnoi, October 30, 1969, Folder: General Correspondence—Dr. Sommer, Box 338638, Record Group 442, CDC, NARA Southeast Region; Notes, JP Friedman—EIS Conference, 1969, not dated, Folder: “The Simultaneous Administration of Multiple Live Virus Vaccines,” Box 343357, Record Group 442, CDC, NARA Southeast Region; “Multiple Antigen” manuscript, not dated, Folder: Multiple Antigen Manuscript by Dr. Karchmer, Box 343357, Record Group 442, CDC, NARA Southeast Region.

93. “Current Trends: Measles—United States,” Morbidity and Mortality Weekly Report 26, no. 14 (1977): 109–11; letter to Dr. Frank Perkins, August 10, 1970, Folder: General Correspondence—Dr. Wallace, Box 338638, Record Group 442, CDC, NARA Southeast Region; letter from Robert Wallace to Harold Yates, December 1, 1969, Folder: General Correspondence—Dr. Wallace, Box 338638, Record Group 442, CDC, NARA Southeast Region.

94. Letter from Alfred Sommer to Robert Israel, October 31, 1969, Folder: General Correspondence—Dr. Sommer, Box 338638, Record Group 442, CDC, NARA Southeast Region; note, “Regarding Death of 2½ Year Old Negro Female, October 1968,” Folder: General Correspondence—Dr. Abrutyn, Box 338638, Record Group 442, CDC, NARA Southeast Region.

95. James Colgrove argues that this policy shift marks a new era of vaccination in the late 1960s. For more on the adoption of school laws in the 1970s, see James Colgrove, State of Immunity: The Politics of Vaccination in Twentieth-Century America (Berkeley: University of California Press, 2006), 174–78.

96. Note from John Witte to Robert Wallace.

97. “End to Measles Possible, Says MD.”

CHAPTER THREE

1. The live virus mumps vaccine, first licensed in 1968, is referred to simply as the mumps vaccine or Mumpsvax from here forward. “Additional Standards—Mumps Virus Vaccine, Live,” Federal Register 33, no. 14 (1968): 744–46.

2. Faye Marley, “Vaccine for Mumps Not Widely Used,” Los Angeles Times, May 30, 1969, B4.

3. This analysis is influenced by Rosenberg’s theoretical work on the framing of disease. See, for example, Charles Rosenberg, “Disease in History: Frames and Framers,” Milbank Quarterly 67, no. S1 (1989): 1–15; Charles Rosenberg, “Framing Disease: Illness, Society, and History,” in Framing Disease: Studies in Cultural History, ed. Charles Rosenberg and Janet Golden (New Brunswick, NJ: Rutgers University Press, 1997), xxi–xxvi; and Charles Rosenberg, “What Is Disease?” Bulletin of the History of Medicine 77 (2003): 491–505.

4. On the rubella vaccine, which is not addressed at length in this work, see Jacob Heller, The Vaccine Narrative (Nashville: Vanderbilt University Press, 2008); and Leslie J. Reagan, Dangerous Pregnancies: Mothers, Disabilities, and Abortion in America (Berkeley: University of California Press, 2010).

5. Maurice Hilleman, credited with developing several dozen vaccines (against human and animal infections), is a legendary figure in the fields of vaccine development and public health. His measles vaccine, notably, was licensed the same month his daughter came down with mumps. Hilleman’s work at Merck is recounted in Louis Galambos and Jane Eliot Sewell, Networks of Innovation: Vaccine Development at Merck, Sharp & Dohme and Mulford, 1895–1995 (New York: Cambridge University Press, 1995). A popular account of his life and scientific work is given in Paul A. Offit, Vaccinated: One Man’s Quest to Defeat the World’s Deadliest Diseases (Washington, DC: Smithsonian Books, 2007). See also Lawrence Altman, “Maurice Hilleman, Master at Creating Vaccines, Dies at 85,” New York Times, April 12, 2005, A1; and Associated Press, “Vaccine Researcher Saved ‘Millions of Lives,’” Chicago Tribune, April 12, 2005, 7.

6. The development of the mumps vaccine is described in several popular accounts, including Arthur Allen, Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver (New York: Norton, 2007); Offit, Vaccinated, 20–25; Richard Conniff, “A Forgotten Pioneer of Vaccines,” New York Times, May 6, 2013, D1. See also Galambos and Sewell, Networks of Innovation, 100–101.

7. Clara Councell, “War and Infectious Disease,” Public Health Reports 56, no. 12 (1941): 547–73.

8. Milton Levine, “A Sponsored Epidemic of Mumps in a Private School,” American Journal of Public Health 34, no. 12 (1944): 1274–76. See also Councell, “War and Infectious Disease.” Flu and measles were of equal importance to mumps as causes of illness among troops during the First World War; measles and flu, but not mumps, were among leading causes of death in that war.

9. A. C. McGuiness and E. A. Gall, “Mumps at Army Camps in 1943,” War Medicine 5 (1943): 95.

10. C. D. Johnson and E. W. Goodpasture, “Investigation of Etiology of Mumps,” Journal of Experimental Medicine 59 (1934): 1–19.

11. Karl Habel, “Cultivation of Mumps Virus in the Developing Chick Embryo and Its Application to Studies of Immunity to Mumps in Man,” Public Health Reports 60, no. 8 (1945): 201–12.

12. J. E. Gordon and L. Kilham, “Ten Years in the Epidemiology of Mumps,” American Journal of the Medical Sciences 218, no. 3 (1949): 338–59.

13. J. F. Enders et al., “Immunity in Mumps I: Experiments with Monkeys (Macacus Mulatta). The Development of Complement-Fixing Antibody Following Infection and Experiments on Immunization by Means of Inactivated Virus and Convalescent Human Serum,” Journal of Experimental Medicine 81, no. 1 (1945): 93–117; J. F. Enders, S. Cohen, and L. W. Kane, “Immunity in Mumps II: The Development of Complement-Fixing Antibody and Dermal Hypersensitivity in Human Beings Following Mumps,” Journal of Experimental Medicine 81, no. 1 (1945): 119–35; L. W. Kane and J. F. Enders, “Immunity in Mumps III: The Complement Fixation Test as an Aid in the Diagnosis of Mumps Meningoencephalitis,” Journal of Experimental Medicine 81, no. 1 (1945): 137–50.

14. Habel, “Cultivation of Mumps Virus”; John Enders et al., “Attenuation of Virulence with Retention of Antigenicity of Mumps Virus after Passage in the Embryonated Egg,” Journal of Immunology 54 (1946): 283–91.

15. K. Habel, “Vaccination of Human Beings against Mumps: Vaccine Administered at the Start of an Epidemic. I. Incidence and Severity of Mumps in Vaccinated and Control Groups,” American Journal of Hygiene 54, no. 3 (1951): 295–311. Although the experiments were performed in 1945 and 1946, Habel did not publish the results until 1951.

16. Enders et al., “Attenuation of Virulence.”

17. See, for example, H. R. Morgan, J. F. Enders, and P. F. Wagley, “A Hemolysin Associated with the Mumps Virus,” Journal of Experimental Medicine 88, no. 5 (1948): 503–14.

18. David M. Oshinsky, Polio: An American Story (New York: Oxford University Press, 2005), 122–30. Polio virus cultivation ultimately led to Salk’s polio vaccine and won Enders a Nobel Prize.

19. See, for example, A. A. Smorodintsev and N. S. Kliachko, “[Specific Prevention of Mumps; Preliminary Communication],” Zh Mikrobiol Epidemiol Immunobiol 11 (1954): 6–11; and N. S. Kliachko and L. K. Maslennikova, “[Specific Prevention of Mumps. II. Study of Safety and Immunogenicity of Living Attenuated Mumps Vaccine by Intradermal Immunization of Children],” Vopr Virusol 2, no. 1 (1957): 13–17.

20. Council on Drugs, “New and Nonofficial Drugs: Mumps Vaccine,” Journal of the American Medical Association 164, no. 8 (1957): 874–75.

21. Ibid.

22. Edward B. Shaw, “Mumps Immunization,” Journal of the American Medical Association 167, no. 14 (1958): 1744.

23. T. R. Van Dellen, “How to Keep Well: Salivary Gland Enlargement,” Chicago Daily Tribune, February 26, 1950, 20.

24. Ibid.

25. “Mumps” (Albany: NY State Department of Health, 1955), Mothering collection.

26. ANP, “He Can’t Whistle—He’s Got the Mumps!,” Atlanta Daily World, November 21, 1961, 6; United Press International, “Not Immune,” Chicago Defender, May 18, 1963, 11; “Bridegroom Missing, They Wed by Phone,” Los Angeles Times, June 30, 1953, A1.

27. Frank Colby, “Take My Word for It,” Los Angeles Times, June 2, 1950, A5; United Press International, “It Only Hurts When We Swallow,” Daily Defender, December 31, 1963, 4.

28. Associated Press, “Tony, the Boxer,” Chicago Daily Tribune, March 25, 1957, C10.

29. See, for example, “World of Sports,” Washington Post and Times Herald, February 14, 1958, D3; Associated Press, “VPI Tackle Richards Sidelined with Mumps,” Washington Post and Times Herald, August 30, 1955, 15; Associated Press, “Mumps Bench Ram Star,” Chicago Daily Tribune, December 21, 1955, B1; and United Press International, “Albert Has Mumps,” Los Angeles Times, July 13, 1958, C2.

30. “Redskin Takes His Mumps,” Washington Post, September 28, 1950, 12.

31. United Press International, “Mumps Hits F. Robinson,” Daily Defender, April 23, 1968, 24.

32. United Press International, “Mumps Vaccine Gains Government Approval,” Los Angeles Times, January 5, 1968, 12.

33. Peter Yates, dir., Bullitt (Warner Brothers, 1968).

34. United Press International, “Mumps Vaccine Gains Government Approval”; Harold Schmeck, “A Mumps Vaccine Is Licensed by U.S.,” New York Times, January 5, 1968, 72. Among the nation’s papers, only the Washington Post placed the story on the front page: Associated Press, “Vaccine for Mumps Licensed,” Washington Post, January 5, 1968, A1.

35. Advisory Committee on Immunization Practices, “Recommendation of the Public Health Service Advisory Committee on Immunization Practices,” Morbidity and Mortality Weekly Report 16, no. 51 (1967): 430–31.

36. “New Mumps Vaccine Not for Everyone,” Consumer Reports, July, 1968, 377.

37. Editorial, “Mumps Vaccine: More Information Needed,” New England Journal of Medicine 278, no. 5 (1968): 275–76.

38. Editorial, “Vaccination against Mumps,” Lancet 292, no. 7576 (1968): 1022–23.

39. Adolf Karchmer, “Mumps: A Review of Surveillance, Vaccine Development, and Recommendations for Use,” Folder: Paper for Immunization Conference, Box 343357, Record Group 442, CDC, NARA Southeast Region.

40. Thomas Shope, Adolf Karchmer, and F. Robert Freckleton, “Immunizations in the Future,” Journal of the Oklahoma State Medical Association 62 (1969): 111–15.

41. Harris D. Riley, “Current Concepts in Immunization,” not dated, Folder: Info 3 Tr.—1963, Box 334605 No. 5, Record Group 442, CDC, NARA Southeast Region.

42. Marley, “Vaccine for Mumps Not Widely Used.” Some commentators cited a set of five principles outlined by British doctor G. S. Wilson at an international immunization conference held in 1961. Wilson argued that (1) vaccines should be harmless to the healthy; (2) they should cause no more disturbance (fever, discomfort) than the disease itself; (3) they must be easy to administer; (4) they must provide both herd and individual benefit; and (5) the immunity conferred should not require frequent revaccination. Cited in Samuel Katz, “Immunization with Live Attenuated Measles Virus Vaccines: Five Years’ Experience,” Paper Selected for Distribution at CDC Seminars on Immunization, not dated, Folder: Info 3 Tr.—1963, Box 334605 No. 5, Record Group 442, CDC, NARA Southeast Region.

43. See the appendix for a brief overview of vaccine licensing and approval.

44. Editorial, “Vaccination against Mumps.”

45. Notes, March 12–15, 1968, Folder: Paper for Immunization Conference, Box 343357, Record Group 442, CDC, NARA Southeast Region.

46. Karchmer, “Mumps: A Review.”

47. CDC, “Current State of Mumps in the United States,” Journal of Infectious Diseases 132, no. 1 (1975): 106–9.

48. Memo, January 14, 1968, Folder: Epi Aid 58-51-1, Box 343357 No. 1, Record Group 442, CDC, NARA Southeast Region.

49. Documents pertaining to these outbreaks are located in folders titled Epi Aid 68-51-1; Epi Aid Memo 68-57-1; West Virginia Study; Epi 68-20-1; and Epi Aid 68-20-2, all in Box 343357 No. 1, Record Group 442, CDC, NARA Southeast Region. The term “mentally retarded” is used here as it was used at the time, as an accepted medical diagnosis.

50. Notes, Fort Custer EIS Study, not dated, Folder: Fort Custer—Work Sheets and Potpourri, Box 343357 No. 1, Record Group 442, CDC, NARA Southeast Region.

51. On the subject of popular attitudes toward mentally retarded children in the 1950s and 1960s, see Steven Noll and James W. Trent, Mental Retardation in America, The History of Disability (New York: New York University Press, 2004), part 4.

52. Manuscript, November 4, 1967, Folder: MMWR—Mumps at Fort Custer, Box 343357 No. 1, Record Group 442, CDC, NARA Southeast Region.

53. Abstract, not dated, Folder: Fort Custer—Presentation and Abstracts, Box 343357 No. 1, Record Group 442, CDC, NARA Southeast Region.

54. A reviewer at the CDC noted that while many often claimed that it was a challenge to immunize teens and adults, few had adequately produced quantitative support for this claim. Reviewer comments, “Re: Public Acceptance of Mumps Immunization,” not dated, Folder: Public Acceptance of Mumps, Box 343357, Record Group 442, CDC, NARA Southeast Region.

55. Phillip Jones, “Public Acceptance of Mumps Immunization,” Journal of the American Medical Association 209, no. 6 (1969): 901–5.

56. Ibid.

57. Historians have argued that earlier diphtheria immunization campaigns achieved this effect as well. See chapter 3 in James Colgrove, State of Immunity: The Politics of Vaccination in Twentieth-Century America (Berkeley: University of California Press, 2006); and Evelynn Maxine Hammonds, Childhood’s Deadly Scourge: The Campaign to Control Diphtheria in New York City, 1880–1930 (Baltimore: Johns Hopkins University Press, 2002).

58. Stuart Auerbach, “D.C. Has Rash of 261 Measles Cases,” Washington Post, February 10, 1970, C1.

59. T. R. Van Dellen, “How to Keep Well: Mumps Vaccine,” Chicago Tribune, September 30, 1967, B14.

60. Brochure, not dated, Folder: 1964 Rubella Epidemic Cost Analysis, Box 343357, Record Group 442, CDC, NARA Southeast Region.

61. Meeting Minutes, Meeting No. 1 of the Advisory Committee on Immunization Practices, May 25–26, 1964, Folder: Info 3 ACIP Immunization 1964–5, Box 334062 No. 2, Record Group 442, CDC, NARA Southeast Region.

62. Memo from Adolf Karchmer to Martin D. Skinner, “Draft of Rubella Control Program,” December 2, 1968, Folder: Rubella Control Program—Montana, Box 343357, Record Group 442, CDC, NARA Southeast Region.

63. Ibid.

64. “Rubella Vaccination Seen for School Children,” New York Amsterdam News, September 13, 1969, 6.

65. See, for example, Harry Meyer, Paul Parkman, and Hope Hopps, “The Control of Rubella,” Pediatrics 44, no. 1 (1969): 5–23.

66. Heller, The Vaccine Narrative, 62–63; Reagan, Dangerous Pregnancies, 180–81.

67. On perceptions of mental retardation in this period, see Katherine Castles, “Nice Average Americans: Postwar Parents’ Groups and the Defense of the Normal Family,” in Mental Retardation in America, ed. Steven Noll and James W. Trent (New York: New York University Press, 2004), 351–70. See also Edward Shorter, The Kennedy Family and the Story of Mental Retardation (Philadelphia: Temple University Press, 2000).

68. Reagan, Dangerous Pregnancies, 191.

69. See, for example, R. E. Weibel et al., “Live Attenuated Mumps-Virus Vaccine. 3. Clinical and Serologic Aspects in a Field Evaluation,” New England Journal of Medicine 276, no. 5 (1967): 245–51; and J. Stokes Jr. et al., “Live Attenuated Mumps Virus Vaccine. II. Early Clinical Studies,” Pediatrics 39, no. 3 (1967): 363–71.

70. “Mumps War Is Declared at Halsted UPC,” Daily Defender, June 22, 1967, 5.

71. Several studies from the 1960s and 1970s found meningo-encephalitis to occur in about 15 to 18 percent of cases, without lasting effect other than headache and “nervousness.” See, for example, H. G. Murray, C. M. Field, and W. J. McLeod, “Mumps Meningo-Encephalitis,” British Medical Journal 1, no. 5189 (1960): 1850–53; P. H. Azimi, H. G. Cramblett, and R. E. Haynes, “Mumps Meningoencephalitis in Children,” Journal of the American Medical Association 207, no. 3 (1969): 509–12; and CDC, “Mumps Vaccine,” Morbidity and Mortality Weekly Report 26, no. 48 (1977): 393–94.

72. Sherwood Schwartz, “Never Too Young,” The Brady Bunch, season 5, episode 4 (American Broadcasting Company, 1973).

73. Karchmer, “Mumps: A Review.” See also Editorial, “Mumps Vaccine.”

74. Ronald Kotulak, “New Lease on Life Given Man: A Tale of Nine Future Vaccines,” Chicago Tribune, December 24, 1967, 6.

75. Galambos and Sewell, Networks of Innovation, 121.

76. Joan Beck, “It’ll Be Vintage Year for Babies Born in the U.S.,” Chicago Tribune, January 3, 1967, B1.

77. Mary Ann Mason, “The State as Superparent,” in Childhood in America, ed. Paula Fass and Mary Ann Mason (New York: New York University Press, 2000), 549–54.

78. “Immunization: Theory and Practice,” report by V. F. Guinea, D. S. Martin, and Other Members of the CDC Immunization Seminar Services Committee, Folder: Info 3 Tr.—1963, Box 334065 No. 5, Record Group 442, CDC, NARA Southeast Region. An inverted version of this adage would later be embraced by vaccine critics in order to emphasize the significance of the small risks posed by vaccines. See chapters 8, 9, and 10.

79. Paula S. Fass, Children of a New World: Society, Culture, and Globalization (New York: New York University Press, 2007), 181–83.

80. Ibid., 182.

81. See, for example, “Mumps May Be on Its Way Out,” Daily Defender, June 27, 1966, 2; and Van Dellen, “How to Keep Well: Mumps Vaccine.”

82. “A Shot in Time,” Mademoiselle, July, 1977, 126.

83. National Communicable Disease Center, Immunization against Disease (Washington, DC: U.S. Department of Health, Education, and Welfare, 1967).

84. “Vaccinations Everyone Ought to Have,” Changing Times, September, 1974, 11–13. For a similar representation of mumps, see also “Immunization = Self Defense,” Current Health, October, 1979, 23–25.

85. Nicholas Fiumara, “Use of Mumps Vaccine,” New England Journal of Medicine 278, no. 12 (1968): 681–82.

86. Merck, “The First Live Mumps Vaccine,” British Medical Journal 2, no. 5910 (1974), advertisement in front matter.

87. The Merck sales figure comes from Galambos and Sewell, Networks of Innovation, 115. Population immunization figures are cited in CDC, United States Immunization Survey (Washington, DC: U.S. Department of Health, Education, and Welfare and Bureau of the Census, 1971).

88. CDC, “Current State of Mumps in the United States.”

89. E. B. Buynak et al., “Combined Live Measles, Mumps, and Rubella Virus Vaccines,” Journal of the American Medical Association 207, no. 12 (1969): 2259–62.

90. “Mumps Vaccine,” Morbidity and Mortality Weekly Report 21, suppl. (1972): 13–14.

91. CDC, “Mumps Vaccine.”

92. Colgrove makes a similar point about pertussis and the DPT vaccine. Colgrove, State of Immunity, 112.

93. Galambos and Sewell, Networks of Innovation, 118.

94. “7 Health Sins Listed; Immunizations Urged for County Children,” Los Angeles Times, December 6, 1973, OC-A16.

95. See, for example, Dan Kaercher, “Immunization: A Call to Action,” Better Homes and Gardens, September, 1979, 70.

96. Midge Lasky Schildkraut, “The New Threat to Your Children’s Health,” Good Housekeeping, August 1978, 219–20.

97. Calls to eradicate mumps were in fact infrequent, but see, for example, “Georgians Play Major Role in Developing New Vaccine,” Atlanta Daily World, January 7, 1968, 1; and Reviewer comments, “Re: Public Acceptance of Mumps Immunization.” In 1968 Massachusetts health officials announced that they had unanimously decided to eradicate mumps; the announcement sparked a debate between health officials and physicians, who argued that the vaccine’s use should be left to their discretion. See, for example, Fiumara, “Use of Mumps Vaccine”; and T. C. Peebles et al., “Use of Mumps Vaccine,” New England Journal of Medicine 281, no. 12 (1969): 679.

98. “Mumps Vaccine Now Ready for Public,” Los Angeles Sentinel, March 28, 1968, E7; Associated Press, “Vaccine for Mumps Licensed”; Schmeck, “A Mumps Vaccine Is Licensed by U.S.”

99. Dodi Schultz, “Why Childhood Diseases Are Coming Back,” New York Times Sunday Magazine, May 7, 1978, 35.

100. “Measles, Mumps and Rubella Threaten the Unprotected,” Atlanta Daily World, January 3, 1978, 3.

101. Schildkraut, “The New Threat to Your Children’s Health.”

102. Interestingly, Merck displayed relatively little interest in portraying mumps as a serious disease at this time. With MMR on the market and endorsed by the ACIP, company materials pointed out the dangers of measles and rubella, but tended to say little about the hazards of mumps. See, for example, Fifty Years of Research: Merck Sharp & Dohme Research Laboratory (Rahway, NJ: Merck Sharp & Dohme, 1983).

103. U.S. Department of Health, Education, and Welfare, Protect Your Child, DHEW Publication No. OHDS 78-02027 (Washington, DC: Office of Human Development Services, 1978).

104. CDC, “Current Trends Mumps—United States, 1984–1985,” Morbidity and Mortality Weekly Report 35, no. 13 (1986): 216–19.

105. Ibid.

106. Mumps vaccination in the United States thus exemplified what historian Dorothy Porter has described as the modern democratic, free-enterprise state’s configuration of the individual citizen as a “political and economic unit of a collective whole.” Dorothy Porter, Health, Civilization, and the State (London: Routledge, 1999), 57.

107. Jimmy Dean, To a Sleeping Beauty (Columbia Records, 1962).

CHAPTER FOUR

1. Joseph A. Califano, “Immunizing Our Children,” Parents, November, 1977, 122.

2. U.S. Congress, Senate Committee on Labor and Human Resources, Immunization and Preventive Medicine (Washington, DC: U.S. Government Printing Office, 1982), 44.

3. On Carter’s campaign and core messaging, see, for example, Patrick Anderson, Electing Jimmy Carter: The Campaign of 1976 (Baton Rouge: Louisiana State University Press, 1994); Peter G. Bourne, Jimmy Carter: A Comprehensive Biography from Plains to Post-Presidency (New York: Scribner, 1997); and Frye Gaillard, Prophet from Plains: Jimmy Carter and His Legacy (Athens: University of Georgia Press, 2007).

4. Edward D. Berkowitz, Something Happened: A Political and Cultural Overview of the Seventies (New York: Columbia University Press, 2006), 104–10.

5. Jimmy Carter, “Inaugural Address, January 20, 1977,” American Presidency Project, UCSB.

6. Jimmy Carter, Address to the Nation on Energy and National Goals: “The Malaise Speech,” July 15, 1979, American Presidency Project, UCSB.

7. On the inflation of health care costs, see “The Problem of Rising Health Care Costs,” Executive Office of the President Council on Wage and Price Stability Staff Report, April 1976, Folder: Health Costs, Box 305, Carter Presidential Papers, Jimmy Carter Library.

8. “Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention, 1979,” Folder FG 22-10 1/20/77–1/20/81, Box FG-136, White House Central Files, Jimmy Carter Library.

9. Memo from Stu Eizenstat to Jody Powell, February 28, 1977, Folder: HE 1/20/77–7/22/77, Box HE-1, White House Central File, Jimmy Carter Library.

10. David Blumenthal and James A. Morone, The Heart of Power: Health and Politics in the Oval Office (Berkeley: University of California Press, 2009), 261; Bourne, Jimmy Carter, 432.

11. Blumenthal and Morone, The Heart of Power, 270–71.

12. Ibid., 275.

13. Letter from Leila West Lehde to Mrs. Nell Balkman, February 6, 1973, Folder: Children’s Immunization Program, 2/77–12/78 [2], Box 7, First Lady’s Office—Projects Office—Cade Subject File, Jimmy Carter Library.

14. Memorandum, Jimmy Carter to Heads of Executive Offices and Agencies, April 7, 1977, Folder: Immunization, Box 32, Collection JC-DPS: Records of the Domestic Policy Staff, Jimmy Carter Library.

15. “World Health Day,” International Review of the Red Cross 17, no. 193 (1977): 218–19; Memorandum, Jimmy Carter to Heads of Executive Offices and Agencies; “Memo to Health Cluster Members from Donna Brown,” National Council of Organizations for Children and Youth, March 2, 1977, Folder: Children’s Immunization Program, 2/77–12/78 [1], Box 7, Collection JC-FL: Records of the First Lady’s Office, Jimmy Carter Library. The theme for World Health Day reflected the formalization of a 1974 World Health Assembly decision to adopt an Expanded Programme on Immunization, which aimed to provide immunization services against diphtheria, polio, pertussis, tetanus, measles, tuberculosis, and smallpox globally by the year 1995. K. Keja and R. H. Henderson, “Expanded Programme on Immunization: The Continuing Role of the European Region,” WHO Chronicle 39, no. 3 (1985): 92–94.

16. “President Carter’s Proposed Statement for World Health Day,” April 7, 1977, Folder: Trips/Events, Health Center for Mothers and Children in DC, 1977, Box 42, Collection JC-FL: Records of the First Lady’s Office, Jimmy Carter Library.

17. Letter from George Gallup to Attorney General Griffin Bell, October 11, 1978, Folder: WE 1 Welfare, Children, Box 138, Collection JC-FL: Records of the First Lady’s Office, Jimmy Carter Library.

18. Bourne, Jimmy Carter, 432.

19. Blumenthal and Morone provide a detailed analysis of Carter’s personal views on both medicine and government involvement in health care. Blumenthal and Morone, The Heart of Power, 252.

20. U.S. Congress, House Committee on Appropriations, Supplemental Appropriations for Fiscal Year 1977: Hearings before Subcommittees of the Committee on Appropriations, House of Representatives, 95th Congress, 1st Session, Part 2 (Washington, DC: U.S. Government Printing Office, 1977), 572.

21. James Colgrove, State of Immunity: The Politics of Vaccination in Twentieth-Century America (Berkeley: University of California Press, 2006), 172.

22. U.S. Department of Health, Education, and Welfare, “Secretary Califano’s Address to the Second National Immunization Conference [sic],” press release, April 6, 1977, Folder: Immunization, Box 32, Collection JC-DPS: Records of the Domestic Policy Staff, Jimmy Carter Library.

23. U.S. Congress, House Committee on Appropriations, Subcommittee on Departments of Labor and Health, Education, and Welfare and Related Agencies, Departments of Labor and Health, Education, and Welfare Appropriations for 1978: Hearings before a Subcommittee of the Committee on Appropriations, House of Representatives, 95th Congress, 1st Session (Washington, DC: U.S. Government Printing Office, 1977), 443; U.S. Congress House Committee on Appropriations, Supplemental Appropriations for Fiscal Year 1977, 571.

24. On Merck’s advertising efforts, see Louis Galambos and Jane Eliot Sewell, Networks of Innovation: Vaccine Development at Merck, Sharp & Dohme and Mulford, 1895–1995 (New York: Cambridge University Press, 1995), 115.

25. Colgrove, State of Immunity, 175–76.

26. Many cited an outbreak of measles in the “divided” city of Texarkana when making the case for such laws. Many more cases of measles occurred on Texarkana’s Texas side, which had no measles vaccination law, than on the Arkansas side, which did have such a law. See for example, P. J. Landrigan, “Epidemic Measles in a Divided City,” Journal of the American Medical Association 221, no. 6 (1972): 567–70.

27. Colgrove, State of Immunity, 177; “Current Trends: Measles—United States,” Morbidity and Mortality Weekly Report 26, no. 14 (1977): 109–11.

28. Fact Sheet, “Childhood Immunization Initiative,” Folder: Immunization, Box 32, Collection JC-DPS, Jimmy Carter Library; “Current Trends: Measles—United States.”

29. Fact Sheet, “Childhood Immunization Initiative.”

30. U.S. Department of Health, Education, and Welfare, “Secretary Califano’s Address to the Second National Immunization Conference [sic].”

31. U.S. Congress, House Committee on Appropriations, Supplemental Appropriations for Fiscal Year 1977, 574.

32. Letter and Fact Sheet to Parents and Volunteers from Betty Bumpers, “Every Child by 74,” 1974, Folder: Children’s Immunization Program, Box 7, Collection JC-FL: Records of the First Lady’s Office, Jimmy Carter Library.

33. “Memo to Health Cluster Members from Donna Brown.”

34. “The Immunization of Children,” Congressional Record—Senate (1977): 2679.

35. Immunization promotional materials, Folder: Immunization, Box 32, Collection JC-DPS: Records of the Domestic Policy Staff, Jimmy Carter Library.

36. U.S. Department of Health, Education, and Welfare, “Secretary Califano’s Address to the Second National Immunization Conference [sic].”

37. “The Immunization of Children,” 2680.

38. For safety reasons, children under three were excluded. Memo from Ted Cooper to Richard Friedman, May 5, 1976, Folder: CDC Influenza Conference, Box 8, Swine Flu Immunization Program Files, Record Group 442, CDC, NARA Southeast Region; Minutes from May 6–7 meeting on flu, Advisory Committee on Immunization Practices, 1976, Folder: Flu ACIP Meeting 5/6–7/76, Box 8, Swine Flu Immunization Program Files Record Group 442, CDC, NARA Southeast Region.

39. On the 1918 pandemic, see John M. Barry, The Great Influenza: The Epic Story of the Deadliest Plague in History (New York: Penguin, 2005), 397.

40. Editorial by Sidney Wolfe, April 11, 1976, Folder: ACIP Meeting of June 21–22, 1976, Box 8, Swine Flu Immunization Program Files, Record Group 442, CDC, NARA Southeast Region; Letter from Ronald Hattis to David Sencer, not dated, Folder: ACIP Meeting of June 21–22, 1976, Box 8, Swine Flu Immunization Program Files, Record Group 442, CDC, NARA Southeast Region.

41. On the swine flu immunization program, see Elizabeth W. Etheridge, Sentinel for Health (Berkeley: University of California Press, 1992), chap. 18; Richard E. Neustadt and Harvey V. Fineberg, The Swine Flu Affair: Decision-Making on a Slippery Disease (Washington, DC: U.S. Department of Health, Education, and Welfare, 1978); and Richard E. Neustadt and Harvey V. Fineberg, The Epidemic that Never Was: Policy-Making and the Swine Flu Scare (New York: Vintage, 1983).

42. G. Timothy Johnson, “Immunizations Important Despite Swine Results,” Chicago Tribune, March 18, 1977, A9.

43. Letter from Ronald Hattis to David Sencer.

44. Harris Survey, Activity under Secretary of HEW Joseph Califano, March 7, 1977, Folder: Immunization, Box 32, Collection JC-DPS: Records of the Domestic Policy Staff, Jimmy Carter Library.

45. Note from Kathy Cade to Rosalynn Carter, Folder: Children’s Immunization Program, 2/77–12/78 [1], Box 7, Collection JC-FL: Records of the First Lady’s Office, Jimmy Carter Library.

46. Even before the swine flu immunization campaign was launched, the CDC envisioned using the mobilized volunteers to promote widespread childhood immunization after the swine flu campaign concluded. Immunization Action: Every Child in 76/77—Draft, Centers for Disease Control Immunization Division, Folder: Children—Immunization Program, 2/77–12/78 [1], Box 7, Collection JC-FL: Records of the First Lady’s Office, Jimmy Carter Library.

47. “HEW Developing Plan to Immunize 20 Million Youths,” Congressional Record—Senate (1977): 10508.

48. Associated Press, “HEW Plans Drive to Inoculate Children,” Chicago Tribune, April 5, 1977, 10.

49. “President Carter’s Proposed Statement for World Health Day.”

50. “The Immunization of Children,” 2679.

51. U.S. Department of Health, Education, and Welfare, “Secretary Califano’s Address to the Second National Immunization Conference [sic].”

52. Joseph A. Califano, Inside: A Public and Private Life (New York: Public Affairs, 2004), 127–28.

53. Robert G. Kaiser, “HEW’s Califano: Flashy First Four Months,” Washington Post, May 15, 1977, 1.

54. Rudy Abramson, “Joe Califano: 1-Man Band in LBJ Style,” Los Angeles Times, May 16, 1977, B1.

55. “President Carter’s Proposed Statement for World Health Day.”

56. Ibid.; U.S. Congress, House Committee on Interstate and Foreign Commerce, Subcommittee on Oversight and Investigations, National Child Immunization Programs: Hearing before the Subcommittee on Oversight and Investigations of the Committee on Interstate and Foreign Commerce, House of Representatives, 95th Congress, 1st Session, August 31, 1977 (Washington, DC: U.S. Government Printing Office, 1977), 7.

57. Star Wars Immunization Poster, 1977, Object 2005.005.03, CDC Museum Collection.

58. U.S. Department of Health, Education, and Welfare, “Secretary Califano’s Address to the Second National Immunization Conference [sic].”

59. Ibid. The AMA, in response, answered the campaign’s entreaties with a seemingly token gesture: a proposal to alter the children’s game of hopscotch, by giving each square in the game the name of a different disease and labeling the home square “Immunization.” “The American Medical Association’s Immunization Campaign,” Congressional Record—Extension of Remarks (1977): 38877.

60. “HEW Developing Plan to Immunize 20 Million Youths,” 10508.

61. U.S. Department of Health, Education, and Welfare, “Secretary Califano’s Address to the Second National Immunization Conference [sic].”

62. Victor Cohn, “HEW Developing Plan to Immunize 20 Million Youths: Vaccination of 20 Million Eyed,” Washington Post, April 5, 1977, A1.

63. Califano, “Immunizing Our Children.”

64. “Feature,” not dated, Folder: Immunization, Box 32, Collection JC-DPS: Records of the Domestic Policy Staff, Jimmy Carter Library.

65. Rosalynn Carter, Notes, December 1978, Folder: Children—Immunization, Box 7, Collection JC-FL, Records of the First Lady’s Office, Jimmy Carter Library.

66. Helen H. Doane, “Letters to the Times,” Los Angeles Times, May 11, 1977, E4.

67. ABC News Special: A Conversation with the Carters, December 14, 1978, Jimmy Carter Library.

68. Letter from Mrs. James Conrad McLarnan to Rosalynn Carter, 5/22/79, Folder WE 1, Box 138, Collection JC-FL, Records of the First Lady’s Office, Jimmy Carter Library.

69. U.S. Department of Health, Education, and Welfare, “Secretary Califano’s Address to the Second National Immunization Conference [sic].”

70. Immunization promotional materials.

71. Vernon Thompson, “Red Measles Outbreak Alarms Health Officials,” Washington Post, February 5, 1977, B7. The outbreaks were a focus of congressional hearings held in Los Angeles in August 1977. U.S. Congress, House Committee on Interstate and Foreign Commerce, Subcommittee on Oversight and Investigations, National Child Immunization Programs.

72. Harry Nelson, “Measles Ultimatum: L.A. Students to Be Ousted If They Don’t Have Shots,” Los Angeles Times, March 31, 1977, A1.

73. Jack McCurdy and Harry Nelson, “Schools Bar Thousands Lacking Measles Shots,” Los Angeles Times, May 3, 1977, C1.

74. “Warn Parents on Shots,” Chicago Tribune, February 11, 1978, F9; Carla Hall, “Pupils Suspended in Crackdown on Measles Shots,” Washington Post, December 2, 1977, B8; Associated Press, “5 N.Y. Students Suspended in Immunization Crackdown,” Washington Post, September 24, 1977, A4.

75. Mumps was a less common addition to state laws than rubella was. CDC, State Immunization Requirements for School Children (Atlanta: Department of Health and Human Services, Public Health Service, 1981).

76. “Remarks by Secretary Califano,” Conference on Immunization Held December 12, 1978, Folder: Children—Health, Education, and Welfare (HEW) Conference—Childhood Immunization, 12/12/78, Box 7, Collection JC-FL: Records of the First Lady’s Office, Jimmy Carter Library.

77. Ibid.

78. “Policy Perspectives,” National Immunization Conference, NIH, November 12–14, 1976, Folder: Immunization, Box 32, Records of the Domestic Policy Staff, Jimmy Carter Library. For an extended discussion on informed consent debates at this time, see Colgrove, State of Immunity, 187–97. On the patients’ rights movement and health care consumer movements, see, for example, David J. Rothman, Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision Making (New Brunswick NJ: Aldine Transaction, 2008); and Beatrix Hoffman, Health Care for Some: Rights and Rationing in the United States since 1930 (Chicago: University of Chicago Press, 2012), 142–63.

79. Cohn, “HEW Developing Plan to Immunize 20 Million Youths.”

80. A Department of Health, Education, and Welfare study concluded that one case of paralytic polio occurred in every 11.5 million recipients of the oral polio vaccine, which contained live vaccine. A World Health Organization study found that in some countries, there were two cases for every million people vaccinated. Before Congress, Jonas Salk (not necessarily an objective source) testified that one case of the disease occurred for every 300,000 children fully vaccinated with OPV. Elena O. Nightingale, “Recommendations for a National Policy on Poliomyelitis Vaccination,” New England Journal of Medicine 297, no. 5 (1977): 249–53; “The Relation between Acute Persisting Spinal Paralysis and Poliomyelitis Vaccine (Oral): Results of a WHO Enquiry,” Bulletin of the World Health Organization 53, no. 4 (1976): 319–31; “Testimony before Subcommittee on Health, Committee on Labor and Public Welfare, U.S. Senate, by Jonas Salk,” Congressional Record—Senate (1977).

81. Department of Health, Education, and Welfare, “Parents’ Guide to Childhood Immunization,” October 1977, Folder: Children’s Immunization Program, 2/77–12/78 [2], Box 7, Collection JC-FL: Records of the First Lady’s Office—Cade Subject File, Jimmy Carter Library.

82. U.S. Congress, House Committee on Interstate and Foreign Commerce, Subcommittee on Oversight and Investigations, National Child Immunization Programs, 9.

83. For a more detailed discussion on the issues of informed consent and liability, see Colgrove, State of Immunity, chap. 6.

CHAPTER FIVE

1. “Mrs. Carter’s Remarks,” HEW Immunization Conference, December 12, 1978, Folder: Children, HEW Conference, Childhood Immunization, Box 7, Collection JC-FL, Jimmy Carter Library.

2. The phrase “vaccine-safety movement” was employed by the activists themselves and accurately describes their worries and predominant demands. They were not anti-vaccinationists in the historical sense, as they did not oppose all vaccines or all vaccination. For a related argument on the politics of contemporary “anti-vaccinationism,” drawn from a different set of episodes in modern vaccination history, see Robert Johnston, “Contemporary Anti-Vaccination Movements in Historical Perspective,” in The Politics of Healing: Histories of Alternative Medicine in Twentieth-Century North America, ed. Robert Johnston (New York: Routledge, 2004), 259–86.

3. A few historians have pointed out that social movements, including women’s movements, have historically given momentum to vaccination resistance. Michael Willrich, for instance, has noted that women’s rights advocates were among those who threw their support behind Progressive Era anti-vaccinationism. Colgrove has pointed out the link between the social movements of the sixties and seventies, broader challenges to the paternalistic authority of science and medicine, and growing popular discontent with respect to vaccines. An in-depth exploration of the specific influence of feminism or gender norms on vaccination policies and reception, however, was not the objective of either scholars’ work. Michael Willrich, Pox: An American History (New York: Penguin, 2011), 252–53; James Colgrove, State of Immunity: The Politics of Vaccination in Twentieth-Century America (Berkeley: University of California Press, 2006), 187–91, 236.

4. Edward D. Berkowitz, Something Happened: A Political and Cultural Overview of the Seventies (New York: Columbia University Press, 2006).

5. Jane S. Smith, Patenting the Sun: Polio and the Salk Vaccine (New York: William Morrow, 1990), 77.

6. Immunization Project Meeting Agenda, Governor’s Mansion, Little Rock, AR, March 8, 1973, Folder: Children’s Immunization Program, 2/77–12/78 [2], Box 7, Collection JC-FL, Jimmy Carter Library.

7. Walter Alvarez, “Epidemic of Measles Feared,” Los Angeles Times, January 6, 1972, F12.

8. Rebecca Jo Plant, Mom: The Transformation of American Motherhood (Chicago: University of Chicago Press, 2010), 2–17.

9. Ann Landers, “Ann Landers: Consequences,” Washington Post, April 14, 1975, B5.

10. Stuart Auerbach, “D.C. Has Rash of 261 Measles Cases,” Washington Post, February 10, 1970, C1.

11. Editorial, “Measles’ New Muscle,” Chicago Tribune, August 3, 1971, 10.

12. Walter Alvarez, “Poverty, Ignorance Halting Vaccination,” Los Angeles Times, April 19, 1973, G20.

13. Harold Schmeck, “Health Strategy for U.S. Urged to Reduce Unnecessary Illness,” New York Times, March 12, 1976, 47.

14. Jonathan Spivak, “Measles Resurgence Sparks New Campaign to Immunize Children,” Wall Street Journal, February 20, 1970, 1.

15. Michael Stern, “Immunizations Lag Called Peril in City,” New York Times, June 17, 1971, 1.

16. Dodi Schultz, “Why Childhood Diseases Are Coming Back,” New York Times Sunday Magazine, May 7, 1978, 35.

17. “645 Measles Cases Reported by State,” New York Times, February 1, 1974, 64.

18. Philip Jones, “Public Acceptance of Mumps Vaccination,” JAMA 209 (August 11, 1969): 901–5.

19. Alvarez, “Poverty, Ignorance Halting Vaccination.” For more details on the promotion of rubella vaccination, see Jacob Heller, The Vaccine Narrative (Nashville: Vanderbilt University Press, 2008), 57–83, chap. 3; and Leslie J. Reagan, Dangerous Pregnancies: Mothers, Disabilities, and Abortion in America (Berkeley: University of California Press, 2010), esp. 180–220.

20. Reagan, Dangerous Pregnancies, 181, 194, 207.

21. Philip Jenkins, Decade of Nightmares: The End of the Sixties and the Making of Eighties America (New York: Oxford University Press, 2006). 28; Gail Collins, When Everything Changed: The Amazing Journey of American Women from 1960 to the Present (New York: Little, Brown, 2010), 96–100.

22. Auerbach, “D.C. Has Rash of 261 Measles Cases”; Stern, “Immunizations Lag Called Peril in City”; Rudy Johnson, “Paterson Fights Rise in Measles,” New York Times, December 27, 1973, 78.

23. Meg Rosenfeld, “Many Va. Children Not Getting Shots,” Washington Post, April 27, 1975, 1.

24. “List of Lead Voluntary Organizations,” Folder: Children—Health, Education, and Welfare (HEW) Conference—Childhood Immunization, 12/12/78, Box 7, Collection JC-FL, Jimmy Carter Library.

25. Rhoda Gilinsky, “Volunteerism and Women: A Status Report,” New York Times, November 12, 1978, WC16.

26. Diane M. Blair and Shawn Parry-Giles, “Rosalynn Carter: Crafting a Presidential Partnership Rhetorically,” in Inventing a Voice: The Rhetoric of American First Ladies of the Twentieth Century, ed. Molly Meijer Wertheimer (Lanham, MD: Rowman & Littlefield, 2004), 341–64.

27. Notes from an interview conducted by Suzanne Wilding, Folder: Suzanne Wilding, Town and Country Magazine Interview with RSC, November 16, 1978, Box 7, Collection JC-FL, Jimmy Carter Library.

28. Letter from Mrs. James Conrad McLarnan to Rosalynn Carter, 5/22/79, Folder: WE 1, Box 138, Collection JC-FL, Jimmy Carter Library.

29. Landers, “Ann Landers: Consequences.”

30. Ann Landers, “Ann Landers,” Washington Post, June 1, 1976, B4.

31. Ann Landers, “Ann Landers,” Washington Post, February 9, 1979, C5.

32. Ann Landers, “Ann Landers,” Washington Post, November 8, 1977, B7.

33. Elaine Fein, “Immunization: Is Your Child Protected?” Harper’s Bazaar, July 1979, 75–76.

34. Morris Wessel, “Immunizations Are Important,” Parents, December 1979, 28.

35. See, for instance, Wendy Kline, Bodies of Knowledge: Sexuality, Reproduction, and Women’s Health in the Second Wave (Chicago: University of Chicago Press, 2010); Sandra Morgen, Into Our Own Hands: The Women’s Health Movement in the United States, 1969–1970 (New Brunswick, NJ: Rutgers University Press, 2002); and Sheryl Ruzek, The Women’s Health Movement: Feminist Alternatives to Medical Control (New York: Praeger, 1978).

36. Elizabeth Siegel Watkins, On the Pill: A Social History of Oral Contraceptives, 1950–1970 (Baltimore: Johns Hopkins University Press, 1998), 103–31; Elizabeth Siegel Watkins, “Doctor, Are You Trying to Kill Me?: Ambivalence about the Patient Package Insert for Estrogen,” Bulletin of the History of Medicine 76 (Spring 2002): 84–104.

37. Susan Speaker, “From ‘Happiness Pills’ to ‘National Nightmare’: Changing Cultural Assessment of Minor Tranquilizers in America, 1955–1980,” Journal of the History of Medicine 52 (July 1997): 338–76.

38. Boston Women’s Health Collective, Ourselves and Our Children: A Book by and for Parents (New York: Random House, 1978), 217.

39. Mothering readers in general—and those who debated vaccines—embraced varied feminisms. However, as with all of the vaccine critics in this chapter, whether they self-identified as one type of feminist or another was not always obvious from their thoughts on vaccines. But as historian Wendy Kline has noted, women could identify as feminists or adopt feminist ideas without participating in organized feminist groups. Kline, Bodies of Knowledge, 25.

40. See letters to the editor in Mothering issues 1–47 (1979–86), held at Mothering’s offices in Santa Fe, New Mexico. Selected correspondence and features on immunization were compiled in Peggy O’Mara, Vaccinations, 3rd ed. (Santa Fe, NM: Mothering Magazine, 1989); and Peggy O’Mara, Vaccination: The Issue of Our Times (Santa Fe, NM: Mothering Magazine, 1997).

41. Carol Horowitz, “Immunizations and Informed Consent,” Mothering, Winter 1983, 37–41.

42. Peggy O’Mara, “Editorial,” Mothering, Summer 1996, 25.

43. As a result, pertussis vaccination rates declined in those countries. Jeffrey P. Koplan et al., “Pertussis Vaccine: an Analysis of Benefits, Risks and Costs,” New England Journal of Medicine 301, no. 17 (1979): 906–11.

44. The figure of 1 in 7,000 appeared in government vaccination promotion materials, which noted that 1 in 7,000 children could suffer a “serious” side effect of the DPT vaccine, such as high fever or convulsion. The same sources listed the risk of encephalitis or brain damage as occurring “more rarely,” roughly once in every 100,000 doses. See, for example, Department of Health, Education, and Welfare, “Parents’ Guide to Childhood Immunization,” October 1977, Folder: Children’s Immunization Program, 2/77–12/78 [2], Box 7, Collection JC-FL: Records of the First Lady’s Office, Jimmy Carter Library. The risk of severe brain damage or death following pertussis vaccination was widely disputed in the seventies and early eighties; later estimates ranged from 1 in 174,000 to 1 in 1 million shots. See Roy Anderson and Robert May, “The Logic of Vaccination,” New Scientist 96 (November 18, 1982): 410–15.

45. Lea Thompson, producer, DPT: Vaccine Roulette (Washington, DC: WRC-TV, April 19, 1982).

46. U.S. Senate, Committee on Labor and Human Resources, Immunization and Preventive Medicine: Hearing before the Subcommittee on Investigations and General Oversight of the Committee on Labor and Human Resources, 97th Congress, 2nd Session (Washington, DC: U.S. Government Printing Office, 1982), 7.

47. Donna Hilts, “The Whooping Cough Vaccine: A Protector or a Killer?” Washington Post, April 28, 1982, Va2.

48. U.S. Senate, Committee on Labor and Human Resources, Immunization and Preventive Medicine.

49. Robert Galano, “Crusading Camera’d Champions of the Consumer,” Washington Post, March 30, 1980, TV3.

50. Susan Okie, “How Two Angry Mothers Beat Uncle Sam at His Own Game,” Washington Post, October 11, 1980, A3.

51. Kline, Bodies of Knowledge, 1–4.

52. Thompson, DPT: Vaccine Roulette.

53. Ibid.

54. Harris L. Coulter and Barbara Loe Fisher, DPT: A Shot in the Dark (New York: Harcourt, Brace, Jovanovich, 1985), 61. The book was reissued in 1991, by a different publisher. Harris L. Coulter and Barbara Loe Fisher, A Shot in the Dark: Why the P in the DPT Vaccination May Be Hazardous to Your Child’s Health (Garden City, NY: Avery Pub. Group, 1991).

55. Ibid., 13. The parents interviewed in Coulter and Fisher’s book are identified by first names only. I use Janet’s last name here because she spoke out under her full name in various arenas, even though she is identified only as “Janet” in the book.

56. On maternalist activism, see, for example, Amy Hay, “Recipe for Disaster: Motherhood and Citizenship at Love Canal,” Journal of Women’s History 21, no. 1 (2009): 111–34; and Molly Ladd-Taylor, Mother-Work: Women, Child Welfare, and the State, 1890–1930 (Urbana: University of Illinois Press, 1994).

57. Suzanne Arms, Immaculate Deception: A New Look at Women and Childbirth in America (Boston: Houghton Mifflin, 1975); Gail Sforza Brewer and Tom Brewer, What Every Pregnant Woman Should Know: The Truth about Diet and Drugs in Pregnancy (New York: Penguin, 1977); Gena Corea, The Hidden Malpractice: How American Medicine Treats Women as Patients and Professionals (New York: William Morrow, 1977).

58. Arms, Immaculate Deception, 22–23.

59. Sandra Sugawara, “Two Parents Groups Speak out against Multiple DPT Vaccine; Side Effects Blamed for Brain Damage,” Washington Post, February 8, 1985, D5.

60. Ivan Illich, Medical Nemesis: The Expropriation of Health (New York: Pantheon, 1976), 16.

61. Robert S. Mendelsohn, Male Practice: How Doctors Manipulate Women (Chicago: Contemporary Books, 1981), 188–91.

62. Robert S. Mendelsohn, Confessions of a Medical Heretic (Chicago: Contemporary Books, 1979), 143–45. Vaccine resisters were mostly but not exclusively mothers; among the men who spoke out against vaccines were unorthodox physicians like Mendelsohn, adherents of natural or alternative healing methods, and some fathers.

63. Britain, by contrast, faced a pertussis outbreak in 1977–79 that health officials blamed on a vaccination rate that had fallen 50 percent since 1970. Three deaths and seventeen cases of brain damage resulted. See Anderson and May, “The Logic of Vaccination.” In 1998 a group of resarchers contested the argument that Sweden, West Germany, and other countries did not face increased rates of pertussis in the wake of popular vaccine resistance; see Eugene J. Gangarosa et al., “Impact of Anti-Vaccine Movements on Pertussis Control: The Untold Story,” Lancet 351 (January 31, 1998): 356–61.

64. Coulter and Fisher, DPT: A Shot in the Dark, 9.

65. Ibid., 40.

66. By 1980 upwards of 96 percent of all children entering school were vaccinated against measles, rubella, polio, diphtheria, pertussis, and tetanus, achieving some of the highest rates of vaccine coverage the country had ever seen. U.S. Senate, Committee on Labor and Human Resources, Immunization and Preventive Medicine, 4.

67. U.S. Senate, Committee on Labor and Human Resources, Task Force Report on Pertussis: Hearing before the Committee on Labor and Human Resources, United States Senate, 98th Congress, 1st session (Washington, DC: U.S. Government Printing Office, 1983), 77.

68. U.S. Senate, Committee on Labor and Human Resources, Immunization and Preventive Medicine, 41.

69. Thompson, DPT: Vaccine Roulette.

70. On the women’s movement’s commitment to “informed medical consumerism,” see Morgen, Into Our Own Hands, 95; and Elizabeth Watkins, The Estrogen Elixir: A History of Hormone Replacement Therapy in America (Baltimore: Johns Hopkins University Press, 2007), 130.

71. Horowitz, “Immunizations and Informed Consent,” 37.

72. Thompson, DPT: Vaccine Roulette.

73. Coulter and Fisher, DPT: A Shot in the Dark, 10.

74. Ibid., 408.

75. Watkins, The Estrogen Elixir.

76. Coulter and Fisher, DPT: A Shot in the Dark, 408.

77. Thompson, DPT: Vaccine Roulette.

78. U.S. Senate, Committee on Labor and Human Resources, Task Force Report on Pertussis, 74–87.

79. Barbara Loe Fisher, “Why Not Use a Safer Vaccine?,” Washington Post, May 9, 1988, A14.

80. Elsa Walsh, “State Defends Vaccine,” Washington Post, June 30, 1982, MD6.

81. Coulter and Fisher, DPT: A Shot in the Dark, 83.

82. U.S. Senate, Committee on Labor and Human Resources, Immunization and Preventive Medicine, 6.

83. Ibid., 55; emphasis in original. The parents’ group DPT later adopted this phrase as a motto, placing it on the front page of its newsletters.

84. See chapter 3, note 78.

85. Jenkins, Decade of Nightmares, 108–33.

86. Susan Brownmiller, In Our Time: Memoir of a Revolution (New York: Dial Press, 1999).

87. Jenkins, Decade of Nightmares, 109, 256–60.

88. Thompson, DPT: Vaccine Roulette. For more details on the types of exemptions included in school vaccination laws, see note 25 in the introduction.

89. Peter Kelley, “Whooping Cough Vaccine’s Tragic Side Effects Unmasked,” Patriot-News, October 8, 1986, C1.

90. Sonia Nazario, “A Parental-Rights Battle Is Heating up over Fears of Whooping-Cough Vaccine,” Wall Street Journal, June 20, 1990, 17.

91. Emily Isberg, “No School for Non-Immunized Child,” Montgomery County Sentinel, February 22, 1979.

92. U.S. Senate, Committee on Labor and Human Resources, Immunization and Preventive Medicine, 137.

93. Coulter and Fisher, DPT: A Shot in the Dark, 406.

94. Gerri Cohn, “DPT Pushes Vaccine Bill in Maryland,” Dissatisfied Parents Together News 1, no. 1 (1983): 1.

95. Jeff Schwartz, “Support for Vaccine Damage Compensation Bill Grows,” Dissatisfied Parents Together News 1, no. 1 (1983): 10–11.

96. The coalition formed in favor of the National Vaccine Injury Compensation Act was fragile by the time the act was signed. Although he openly opposed the act, Reagan signed it upon inclusion of a provision allowing pharmaceutical companies to sell abroad drugs that were unapproved for use in the United States. See Robert Pear, “Reagan Signs Bill on Drug Exports and Payment for Vaccine Injuries,” New York Times, November 15, 1986, 1; and “President Reagan Signs Vaccine Injury Compensation and Safety Bill into Law,” Dissatisfied Parents Together News 3, no. 1 (1987): 1.

97. Public Law 99-660, 99th Congress, November 14, 1986.

98. “CDC Unclear about DPT Vaccine Death Definition,” Dissatisfied Parents Together News 3, no. 1 (1987): 9; “New Jersey Passes Law Limiting Most Vaccine Injury Lawsuits,” Dissatisfied Parents Together News 3, no. 2 (1987): 1; “House Votes to Appropriate Funds to Compensate Children Injured by Vaccines before October 1988,” Dissatisfied Parents Together News 4, no. 1 (1988): 1.

99. Barbara Loe Fisher, “Editorial,” Dissatisfied Parents Together News 3, no. 2 (1987): 11.

100. NVIC’s mission included “1) informing the public about childhood diseases and vaccines in order to prevent vaccine injuries and deaths; 2) assisting those who have suffered severe reactions to vaccinations; 3) representing the vaccine consumer by monitoring vaccine research and development, vaccine policymaking, and vaccine related federal and state legislation; 4) working to obtain the right of parents to choose which vaccines their children will receive; and 5) promoting the development of safer and more effective vaccines.” “NVIC/DPT,” NVIC News 2, no. 2 (1992): 3.

101. Lameiras, “Fighting for a Choice,” 36.

102. Barbara Loe Fisher, “Editorial,” Dissatisfied Parents Together News 1, no. 1 (1983): 17.

103. Personal communication, June 15, 2012.

104. Maria M. Lameiras, “Fighting for a Choice: Vaccination—One Mother’s Crusade,” Today’s Chiropractic Lifestyle, August 2006, 31–36, 32.

105. Coulter and Fisher, DPT: A Shot in the Dark, 40–41.

CHAPTER SIX

1. Robert S. Mendelsohn, The Risks of Immunization and How to Avoid Them (Evanston, IL: The People’s Doctor, 1988).

2. See, for example, Arthur Allen, Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver (New York: Norton, 2007), 52, 58; Nadja Durbach, Bodily Matters: The Anti-Vaccination Movement in England, 1853–1907 (Durham, NC: Duke University Press, 2005), 131–32; Gareth Williams, Angel of Death: The Story of Smallpox (Basingstoke, UK: Palgrave Macmillan, 2010), 265; and Michael Willrich, Pox: An American History (New York: Penguin, 2011), 93–94, 154.

3. Durbach, Bodily Matters, 41.

4. Martin Kaufman, “The American Anti-Vaccinationists and Their Arguments,” Bulletin of the History of Medicine 41, no. 5 (1967): 463–78. Not all subscribers to these schools of healing thought opposed vaccines. See, for example, Nadav Davidovitch, “Negotiating Dissent: Homeopathy and Anti-Vaccinationism at the Turn of the Twentieth Century,” in The Politics of Healing: Histories of Alternative Medicine in Twentieth-Century North America, ed. Robert Johnston (New York: Routledge, 2004), 11–28.

5. See James Colgrove, State of Immunity: The Politics of Vaccination in Twentieth-Century America (Berkeley: University of California Press, 2006), chap. 2; and Michael Willrich, “‘The Least Vaccinated of Any Civilized Country’: Personal Liberty and Public Health in the Progressive Era,” Journal of Policy History 20, no. 1 (2008): 76–93.

6. See Robert Johnston, The Radical Middle Class: Populist Democracy and the Question of Capitalism in Progressive Era Portland, Oregon (Princeton, NJ: Princeton University Press, 2003), part 4.

7. Colgrove, State of Immunity, 74. For details on the activism of Lora Little, see Johnston, The Radical Middle Class, chap. 14. For more on Higgins, see Colgrove, State of Immunity, 52–54; and Kaufman, “The American Anti-Vaccinationists and Their Arguments.”

8. Annie Riley Hale, The Medical Voodoo (New York: Gotham House, 1935).

9. Eleanor McBean, The Poisoned Needle: Suppressed Facts about Vaccination (Mokelumne Hill, CA: Health Research, 1957).

10. Alfred Russel Wallace, The Wonderful Century: Its Successes and Its Failures (New York: Dodd, Mead, 1898).

11. McBean, The Poisoned Needle, 28.

12. Ibid.

13. Ibid., 27.

14. Ibid., 44; emphasis in original.

15. Eleanor McBean, The Poisoned Needle, 3rd ed. (Mokelumne Hill, CA: Health Research, 1974). See message from the publisher, inside front cover. According to Nikki Jones Roberts, current co-owner of Health Research Books, now located in Pomeroy, Washington, the book was probably reissued in 1974 because that is when the first print run ran out, but no specific sales or distribution figures from that time remain. Personal communication, July 2011.

16. See, for example, Harry Nelson, “1.1 Million Immunizations: Clinics Plan Massive Attack on German Measles Threat,” Los Angeles Times, September 11, 1970, 9A; “Center Will Give Shots to Children,” Los Angeles Times, July 2, 1972, SF B3; and “1st in Decade: Polio Case Suspected in L.A. County,” Los Angeles Times, July 19, 1973, OC3.

17. Samuel Hays and Barbara Hays, Beauty, Health, and Permanence: Environmental Politics in the United States, 1955–1985 (New York: Cambridge University Press, 1987), 175; Thomas R. Dunlap, DDT: Scientists, Citizens, and Public Policy (Princeton, NJ: Princeton University Press, 1981).

18. Ida Honorof and Eleanor McBean, Vaccination: The Silent Killer (Sherman Oaks, CA: Honor Publications, 1977); Eleanor McBean, Swine Flu Expose (Los Angeles: Better Life Research Center, 1977); Eleanor McBean, Vaccinations Do Not Protect (Yorktown, TX: Life Science, 1980); John Crawford, “The Poisoned Needle,” Mothering, Winter 1979, 40.

19. Hays and Hays, Beauty, Health, and Permanence.

20. Ibid.; Joseph Melling and Christopher Sellers, “Introduction,” in Dangerous Trade: Histories of Industrial Hazard across a Globalizing World, ed. Joseph Melling and Christopher Sellers (Philadelphia: Temple University Press, 2011), 1–14.

21. Allan M. Brandt, The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product that Defined America (New York: Basic Books, 2007).

22. On the evolution of popular understanding of environment risks in this period, see Gerald Markowitz and David Rosner, Deceit and Denial: The Deadly Politics of Industrial Pollution (Berkeley: University of California Press, 2002); and Melling and Sellers, “Introduction.”

23. Elena Conis, “Debating the Health Effects of DDT: Thomas Jukes, Charles Wurster, and the Fate of an Environmental Pollutant,” Public Health Reports 125, no. 2 (2010): 337–42; Dunlap, DDT.

24. Daniel A. Lander, “On Immunization,” Mothering, Fall 1981, 32–35; Daniel A. Lander, Immunization: An Informed Choice (Glen Cove, ME: Dr. Daniel Lander, Family Chiropractor, 1978).

25. Cynthia Cournoyer, What about Immunizations? (Canby, OR: Concerned Parents for Information, 1983).

26. Richard Moskowitz, “Immunizations: The Other Side,” Mothering, Spring 1984, 32–37.

27. Peter A. Coates, Nature: Western Attitudes since Ancient Times (Berkeley: University of California Press, 1998).

28. Crawford, “The Poisoned Needle,” 40.

29. Barry Commoner, Science and Survival (New York: Viking Press, 1966).

30. Richard Knox, “A Shot in Arm, a Shot in Dark,” Boston Globe, December 26, 1976, A2.

31. Moskowitz, “Immunizations.”

32. Robert S. Mendelsohn, How to Raise a Healthy Child . . . in Spite of Your Doctor (Chicago: Contemporary Books, 1984), 232.

33. Marian Tompson, “Viewpoint,” The People’s Doctor 6, no. 12 (1982).

34. Leonard Jacobs, “Eating Well—the Best Vaccine,” Mothering, Fall 1978, 17.

35. Ibid.

36. Patricia Savage, “A Mother’s Research on Immunization,” Mothering, Fall 1979, 76.

37. Victor LaCerva, “Letter to the Editor,” Mothering, Spring 1979, 6.

38. James C. Whorton, Nature Cures: The History of Alternative Medicine in America (New York: Oxford University Press, 2002).

39. Brown’s letter was published in a later compilation issued by Mothering magazine: Sue Brown, “More on Immunizations,” in Vaccinations, ed. Peggy O’Mara (Santa Fe, NM: Mothering Magazine, 1988), 21.

40. Lander, “On Immunization.” Chiropractors have a long tradition of rejecting vaccines. See, for example, Mark Largent, Vaccine: The Debate in Modern America (Baltimore: Johns Hopkins University Press, 2012), 42–51.

41. Jacobs, “Eating Well—the Best Vaccine.”

42. Cynthia Cournoyer, What about Immunizations?: Exposing the Vaccine Philosophy, 5th ed. (Santa Cruz, CA: Nelson’s Books, 1991).

43. Marian Tompson, “Viewpoint (1982),” in The Risks of Immunization and How to Avoid Them, ed. Robert S. Mendelsohn (Evanston, IL: The People’s Doctor, 1988), 31. It is unclear where Tompson found these figures, or whether they refer to immunization generally or against a specific infection.

44. Diane Rozario, The Immunization Resource Guide, 2nd ed. (Burlington, IA: Patter Publications, 1994).

45. Google’s Ngram Viewer (https://books.google.com/ngrams) produces a vivid illustration of the use of these two terms over time. Use of the term “poison” declined steadily from 1900 to 2000, whereas use of the term “toxic” peaked briefly in the 1910s (though it was still less commonly used than “poison”) and then surpassed use of the term “poison” around 1960, with a sharp and steady increase in use from 1970 to the early 1990s. It is also worth noting that in the many sources I reviewed, lay use of the terms “toxic” and “toxin” not infrequently conflated the meaning of the two words. Both words were often used to refer to chemical contaminants when in fact “toxin” connotes a poison derived from a living organism.

46. Hays and Hays, Beauty, Health, and Permanence.

47. Grace Girdwain, “Immunizations for Public Schools and Passports,” Mothering, Spring 1979, 10.

48. Roxanne Bank, “A Mother Researches Immunization,” in Vaccinations, ed. Peggy O’Mara (Santa Fe, NM: Mothering Magazine, 1988), 18–20.

49. Cynthia Cournoyer, What about Immunizations?, 4th ed. (Grants Pass, OR: Cynthia Cournoyer, 1987). Cournoyer began publishing this tract in 1983; later editions are available in many public libraries, but the earlier editions are in Cournoyer’s own collection, some of which she generously shared with me.

50. McBean, The Poisoned Needle, 3rd ed. See also Durbach, Bodily Matters.

51. Carol Horowitz, “Immunizations and Informed Consent,” Mothering, Winter 1983, 37–41.

52. Cournoyer, What about Immunizations?, 1st ed.

53. Lora Little, Crimes of the Cowpox Ring: Some Moving Pictures Thrown on the Dead Wall of Official Silence (Minneapolis: Liberator Publishing, 1906); Hale, The Medical Voodoo.

54. McBean, The Poisoned Needle, 3rd ed., 21.

55. Ibid., 7.

56. Mendelsohn, How to Raise a Healthy Child, 211; Cournoyer, What about Immunizations?, 5th ed., 30.

57. Mendelsohn, The Risks of Immunization, 2.

58. Mendelsohn, How to Raise a Healthy Child, 211.

59. See chapter 9.

60. Harold E. Buttram and John Chriss Hoffman, “Bringing Vaccines into Perspective,” Mothering, Winter 1985, 42.

61. Ibid. Buttram was no traditional allopathic practitioner and had personal ties to the anti-immunization groups of the early part of the century, including the Anti-Vaccination Society of America. Biographical details on Buttram appear in Allen, Vaccine, 338–42.

62. J.M., “Reader Letter,” in The Risks of Immunization and How to Avoid Them, ed. Robert S. Mendelsohn (Evanston, IL: The People’s Doctor, 1988), 90.

63. Harris L. Coulter and Barbara Loe Fisher, DPT: A Shot in the Dark (New York: Harcourt, Brace, Jovanovich, 1985). For more details on DPT: A Shot in the Dark, see chapter 5. The book was reissued in 1991. Harris L. Coulter and Barbara Loe Fisher, A Shot in the Dark: Why the P in the DPT Vaccination May be Hazardous to Your Child’s Health (Garden City Park, NY: Avery Publishing, 1991).

64. Ibid., 110.

65. Ibid., 124.

66. Harris Coulter, Vaccination, Social Violence, and Criminality: The Medical Assault on the American Brain (Berkeley, CA: North Atlantic Books, 1990).

67. Walene James, Immunization: The Reality Behind the Myth (South Hadley, MA: Bergin & Garvey, 1988); Neil Z. Miller, Vaccines: Are They Really Safe and Effective?: A Parent’s Guide to Childhood Shots (Santa Fe, NM: New Atlantean Press, 1992); Jamie Murphy, What Every Parent Should Know about Childhood Immunization (Boston: Earth Healing Products, 1994); Randall Neustaedter, The Immunization Decision: A Guide for Parents (Berkeley, CA: North Atlantic Books, Homeopathic Educational Services, 1990); Viera Scheibner, Vaccination: 100 Years of Orthodox Research Shows that Vaccines Represent a Medical Assault on the Immune System (Santa Fe, NM: New Atlantean Press, 1993). Such titles were on the whole published by small specialized alternative presses.

68. Whorton, Nature Cures, ix.

69. Murphy, What Every Parent Should Know, 20.

70. Neustaedter, The Immunization Decision, 8.

71. Miller, Vaccines, 49.

72. Scheibner, Vaccination, 92.

73. Murphy, What Every Parent Should Know, 53. Largent has argued that popular worries about thimerosal were linked to the public health community’s “aggressive campaign against environmental toxins like lead, mercury, and arsenic” from the 1970s through the 1990s. Largent, Vaccine, 12.

74. Randall Neustaedter, The Vaccine Guide: Making an Informed Choice, 2nd ed. (Berkeley, CA: North Atlantic Books, 1996), 51–52.

75. Associated Press, “High Mercury Levels Found in Everglades Fish,” Washington Post, March 13, 1989, A16.

76. Jane Brody, “Personal Health: Safety Questions about Eating Fish,” New York Times, June 12, 1991, C10.

77. K. R. Mahaffey et al., An Assessment of Exposures to Mercury in the United States: Mercury Study Report to Congress (Washington, DC: U.S. Environmental Protection Agency, 1997).

78. Associated Press, “Minnesota Bans Flashing Sneakers as Toxic,” New York Times, May 10, 1994, A18.

79. Nancy Beth Jackson, “Groups Debate Safety of Canned Tuna for the Very Young,” New York Times, May 11, 1999, F14.

80. “Ending Mercury Madness,” Mothering, July/August 1999, 11. See note 45 regarding use of the word “toxin.”

81. Public Health Service and American Academy of Pediatrics, “Notice to Readers: Thimerosal in Vaccines—a Joint Statement of the American Academy of Pediatrics and the Public Health Service,” Morbidity and Mortality Weekly Report 48, no. 26 (1999): 563–65.

82. Leslie Ball, Robert Ball, and R. Douglas Pratt, “An Assessment of Thimerosal Use in Childhood Vaccines,” Pediatrics 107, no. 5 (2001): 1147–54.

83. Environmental Protection Agency, Mercury Study Report to Congress, 1997, http://www.epa.gov/hg/report.htm (accessed August 2012).

84. Jane M. Hightower, Diagnosis Mercury: Money, Politics, and Poison (Washington, DC: Island Press/Shearwater Books, 2009), 37–38.

85. Paul Offit, “Letter to the Editor: Preventing Harm from Thimerosal in Vaccines,” Journal of the American Medical Association 283, no. 16 (2000): 2104.

86. Stanley Plotkin, “Letter to the Editor: Preventing Harm from Thimerosal in Vaccines,” Journal of the American Medical Association 283, no. 16 (2000): 2104–5. The hepatitis B vaccine was one of three vaccines, along with the DPT and Hib vaccines, that contained thimerosal.

87. Neal Halsey, “Limiting Infant Exposure to Thimerosal in Vaccines and Other Sources of Mercury,” Journal of the American Medical Association 282, no. 18 (1999): 1763–66.

88. Arthur Allen, “The Not-So-Crackpot Autism Theory,” New York Times, November 10, 2002, F66.

89. Ball, Ball, and Pratt, “An Assessment of Thimerosal Use in Childhood Vaccines.”

90. Bruce G. Gellin, Edward W. Maibach, and Edgar K. Marcuse, “Do Parents Understand Immunizations?: A National Telephone Survey,” Pediatrics 106, no. 5 (2000): 1097–102.

91. National Vaccine Information Center, “Autism and Vaccines,” NVIC Newsletter, Spring 2000, http://www.nvic.org/nvic-archives/newsletter/autismandvaccines.aspx (accessed August 2010). The now-infamous report in the Lancet is further discussed in chapters 9 and 10. Andrew J. Wakefield et al., “Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis, and Pervasive Developmental Disorder in Children,” Lancet 351, no. 9103 (1998): 637–41.

92. Thomas R. Dunlap, Faith in Nature: Environmentalism as Religious Quest, Weyerhaeuser Environmental Books (Seattle: University of Washington Press, 2004), 4, 149.

93. Coulter and Fisher, DPT: A Shot in the Dark, 408. See also Harris Coulter and Barbara Loe Fisher, A Shot in the Dark: Why the P in the DPT Vaccination May Be Hazardous to Your Child’s Health (Garden City Park, NY: Avery Publishing, 1991), 220.

94. Shannon Henry, “A Pox on My Child: Cool!,” Washington Post, September 20, 2005, F1.

95. Jon Bowen, “Germs Invited to the Party,” Chicago Sun-Times, August 6, 2000, 8.

96. Brian Wimer, Jacquelyn Emm, and Deren Bader, “A Few Tips for Chickenpox Parties,” Mothering, January/February 2004, 35.

97. Fran Pado, “Where the Play Dates Are Fun, but Itchy,” New York Times, August 21, 2005, B5.

98. Richard Halstead, “Marin Fights Outbreak of Chicken Pox,” Marin Independent Journal, November 15, 2006, 15.

99. In his introduction to Dunlap’s book, environmental historian William Cronon noted that environmentalism and religion share a predilection for predictions of disaster as “a platform for critiquing the moral failings of our lives in the present.” Dunlap, Faith in Nature, xii.

100. Roderick Nash, The Rights of Nature: A History of Environmental Ethics, History of American Thought and Culture (Madison: University of Wisconsin Press, 1989), 12.

101. Whorton, Nature Cures; Dunlap, Faith in Nature.

102. Moskowitz, “Immunizations.”

103. Coulter and Fisher, DPT: A Shot in the Dark, 407.

CHAPTER SEVEN

1. Office of the Press Secretary, “Remarks by the President at Reading of Immunization Proclamation, April 12, 1993,” William J. Clinton Presidential Library, http://clinton6.nara.gov/1993/04/ (accessed February 2010).

2. Early in his first term, the speech was not technically a State of the Union address. See William J. Clinton, “Address before a Joint Session of Congress on Administration Goals,” February 17, 1993, American Presidency Project, UCSB.

3. A. R. Hinman, W. A. Orenstein, and L. Rodewald, “Financing Immunizations in the United States,” Clinical Infectious Diseases 38, no. 10 (2004): 1440–46.

4. Ibid. Today the Vaccines for Children Program provides 43 percent of all childhood vaccines. Jason T. Shafrin and John M. Fontanesi, “Delivering Vaccines: A Case Study of the Distribution System of Vaccines for Children,” American Journal of Managed Care 15, no. 10 (2009): 751–54.

5. CDC, “Goal to Eliminate Measles from the United States,” Morbidity and Mortality Weekly Report 27 (1978): 391.

6. Inspired by the achievements at home and abroad, they also began to make a case for eliminating measles globally. A. R. Hinman et al., “Progress in Measles Elimination,” Journal of the American Medical Association 247, no. 11 (1982): 1592–95; CDC, “Elimination of Indigenous Measles—United States,” Morbidity and Mortality Weekly Report 31, no. 38 (1982): 517–19; D. R. Hopkins et al., “The Case for Global Measles Eradication,” Lancet 1, no. 8286 (1982): 1396–98.

7. CDC, “Measles—United States, 1983,” Morbidity and Mortality Weekly Report 33, no. 8 (1984): 105–8.

8. CDC, “Current Trends Measles—United States, 1990,” Morbidity and Mortality Weekly Report 40, no. 22 (1991): 369–72; “Memorandum for the President from Donna E. Shalala,” February 11, 1993, Folder 7, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

9. CDC, “Current Trends Measles—United States, 1990.”

10. CDC, “Measles Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP),” Morbidity and Mortality Weekly Report 38, no. S9 (1989): 1–18; American Academy of Pediatrics Committee on Infectious Diseases, “Measles: Reassessment of the Current Immunization Policy,” Pediatrics 84, no. 6 (1989): 1110–13.

11. National Vaccine Advisory Committee, “The Measles Epidemic: The Problems, Barriers, and Recommendations,” Journal of the American Medical Association 266, no. 11 (1991): 1547–52.

12. Philip Hilts, “Panel Ties Measles Epidemic to Breakdown in Health System,” New York Times, January 9, 1991, A17.

13. Susan Okie, “Vaccination Record in U.S. Falls Sharply,” Washington Post, March 24, 1991, A1.

14. “The Shame of Measles,” New York Times, May 22, 1990, A26.

15. Despite this, immunization rates among schoolchildren remained 90 percent or higher through the eighties. A. R. Hinman, “What Will It Take to Fully Protect All American Children with Vaccines?,” American Journal of Diseases of Children 145, no. 5 (1991): 559–62.

16. Susan Dentzer and Dorian Friedman, “America’s Scandalous Health Care,” U.S. News & World Report, March 12, 1990, 24–28, 30.

17. Janice Castro, “American Health Care Condition: Critical,” Time, November 25, 1991.

18. Lloyd Grove, “That Other Southern President,” Washington Post, January 14, 1993, C1.

19. “Health Security for All Americans,” address of President William Jefferson Clinton before a Joint Session of Congress, September 22, 1993, William J. Clinton Presidential Library, http://clinton6.nara.gov/1993/09/ (accessed February 2010); Carol H. Rasco, “Special Update on Healthcare Reform from the White House,” Infection Control and Hospital Epidemiology 16, no. 9 (1995): 526–28.

20. Hart and Teeter Research, “NBC News/Wall Street Journal Poll,” January 1993.

21. Dana Priest, “Clinton Names Wife to Head Health Panel,” Washington Post, January 26, 1993, A1. On the series of events that led to the delay, see David Blumenthal and James A. Morone, The Heart of Power: Health and Politics in the Oval Office (Berkeley: University of California Press, 2009), 355–75; and Theda Skocpol, Boomerang: Clinton’s Health Security Effort and the Turn against Government in U.S. Politics (New York: Norton, 1996).

22. Clinton, “Address before a Joint Session of Congress on Administration Goals.”

23. Ibid.

24. Memo from Ruth Katz and Tim Westmoreland to Josh Steiner, December 9, 1992, Folder 15, Box 204, White House Health Care Interdepartmental Working Group, Participants’ Working Papers, William J. Clinton Presidential Library.

25. N. A. Vanderpool and J. B. Richmond, “Child Health in the United States: Prospects for the 1990s,” Annual Review of Public Health 11 (1990): 185–205.

26. “Mandate for Children,” news release, April 19, 1993, Folder 7, Box 9, Domestic Policy Council, Rasco Subject Files, William J. Clinton Presidential Library.

27. List of national health care plan options, not dated, Folder 1: Transitional Issues and Congressional Bills, Box 350, White House Health Care Interdepartmental Working Group, Participants’ Working Papers, William J. Clinton Presidential Library; memo from David Nather to Atul Gawande, October 10, 1992, Folder 24, Box 204, White House Health Care Interdepartmental Working Group, Participants’ Working Papers, William J. Clinton Presidential Library.

28. “Memorandum for the President from Donna E. Shalala”; “Stories,” memo from the Director of the National Vaccine Program Office to Jerry Klepner, February 11, 1993, Folder 8, Box 14, Domestic Policy Council, Rasco Subject Files, William J. Clinton Presidential Library.

29. U.S. Congress, House Committee on Appropriations, Emergency Supplemental Appropriations for Fiscal Year 1993: Hearings before the Subcommittees of the Committee on Appropriations, House of Representatives, One Hundred Third Congress, First Session (Washington, DC: U.S. Government Printing Office, 1993).

30. William J. Clinton, “To the Congress of the United States,” April 1, 1993, Folder 8, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

31. “Memorandum to the President,” 2/7/93, Folder 7, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library; memo from Kevin Thurm to Christine Varney, “Re: Childhood Immunization Initiative,” 3/21/93, Folder 8, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

32. Letter from David Williams to Carol Rasco, March 2, 1993, Folder 8, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

33. Robert Pear, “Clinton Considers Plan to Vaccinate All U.S. Children,” New York Times, February 1, 1993, A1.

34. Press release from American Cyanamid Company, March 24, 1993, Folder 8, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

35. “Memorandum for the President from Donna E. Shalala.” Part of the price increase came from health inflation that affected the prices of all drugs; another part of the increase was attributed to the excise tax added to vaccines as a result of the National Childhood Vaccine Injury Compensation Act of 1986.

36. Office of the Press Secretary, “Remarks by the President at Reading of Immunization Proclamation.”

37. “Statement of the President, Arlington County Department of Human Services,” 2/12/93, Folder 7, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

38. Ibid.

39. Christopher Connell, “Clinton Knocks Drug Prices, Launches Plan for Kids’ Shots,” Chicago Sun Times, February 12, 1993, 1; Spencer Rich and Ann Devroy, “President Blasts Cost of Vaccines,” Washington Post, February 13, 1993, A1; P-I News Services, “Profits at the Expense of Children; Clinton Calls Pharmacy Prices Shocking,” Seattle Post-Intelligencer, February 13, 1993, A1.

40. Robert Samuelson, “Nationalize Health Care,” Newsweek, October 26, 1992, 50.

41. Federal News Service, “News Conference Transcript: Vaccines for Children Program,” 7/19/94, Folder 8, Box 33, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library. At the time, half of all children were immunized in public clinics. C. A. Robinson, S. J. Sepe, and K. F. Lin, “The President’s Child Immunization Initiative: A Summary of the Problem and the Response,” Public Health Reports 108, no. 4 (1993): 419–25.

42. “Memo on Immunization Bill,” Folder 6, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

43. “Statement of the President, Arlington County Department of Human Services.”

44. Robert Pear, “Clinton, in Compromise, Will Cut Parts of Childhood Vaccine Plan,” New York Times, May 5, 1993, A1, A20; “Memorandum for the President, Legislative Initiative to Comprehensively Address the Nation’s Childhood Immunization Crisis,” February 7, 1993, Folder 7, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

45. Kay Johnson, Who Is Watching Our Children’s Health?: The Immunization Status of American Children (Washington, DC: Children’s Defense Fund, 1987).

46. “Public Clinics Found to Lack Children’s Vaccine,” New York Times, June 19, 1991, C9.

47. “Memo from Marian Wright Edelman to the President and First Lady,” February 18, 1993, Folder 7, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

48. “Memo from Donna Shalala to the President,” February 7, 1993, Folder 7, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

49. Robert Pear, “Bush Announces New Effort to Immunize Children,” New York Times, May 12, 1992, A18.

50. Felicia Lee, “Immunization of Children Is Said to Lag; Third World Rate Seen in the New York Area,” New York Times, October 16, 1991, B1; “The Shame of Measles.”

51. Jay P. Sanford et al., The Children’s Vaccine Initiative: Achieving the Vision (Washington, DC: National Academy Press, 1993).

52. Lisa Belkin, “A Resurgence of Plagues and Pestilences of Yesteryear,” New York Times, January 19, 1992, E4.

53. “Presidential Briefing Book, Population-Based Prevention and Public Health,” March 17, 1993, Folder 5, Box 654, Records of the White House Health Care Interdepartmental Working Group, Participants’ Working Papers, William J. Clinton Presidential Library.

54. David Satcher, “Emerging Infections: Getting Ahead of the Curve,” Emerging Infectious Diseases 1, no. 1 (1995): 1–6.

55. Laurie Garrett, The Coming Plague: Newly Emerging Diseases in a World out of Balance (New York: Farrar, Straus and Giroux, 1994); Richard Preston, The Hot Zone (New York: Random House, 1994).

56. William J. Clinton, “Inaugural Address, January 20, 1993,” American Presidency Project, UCSB.

57. “Letters to the First Lady,” Folder 6, Box 358, White House Health Care Interdepartmental Working Group, Participants’ Working Papers, Ira Magaziner, William J. Clinton Presidential Library.

58. Amy Goldstein and Spencer Rich, “Health Experts Skeptical about Immunization Plan,” Washington Post, April 2, 1993, B1.

59. C. Everett Koop, “In the Dark about Shots,” Washington Post, February 10, 1993, A21.

60. “The Drive to Vaccinate,” Washington Post, May 3, 1993, A18.

61. Spencer Rich, “Childhood Vaccines Program Cut Back by Administration,” Washington Post, May 6, 1993, A25.

62. Note from Christopher “Kit” Ashby to Bill and Hillary, February 22, 1993, Folder 8, Box 14, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

63. Memo from Ruth Katz and Tim Westmoreland to Josh Steiner, December 9, 1992, Folder 15, Box 204, White House Health Care Interdepartmental Working Group—Participants’ Working Papers, William J. Clinton Presidential Library.

64. One outbreak occurred in a school with a 99 percent measles vaccination rate. CDC scientists concluded that the children were either vaccinated too young (when maternal antibodies would have interfered with their ability to mount an immune response), or before a new stabilizer was added to the vaccine, in 1979. See R. T. Chen et al., “An Explosive Point-Source Measles Outbreak in a Highly Vaccinated Population: Modes of Transmission and Risk Factors for Disease,” American Journal of Epidemiology 129, no. 1 (1989): 173–82; E. E. Mast et al., “Risk Factors for Measles in a Previously Vaccinated Population and Cost-Effectiveness of Revaccination Strategies,” Journal of the American Medical Association 264, no. 19 (1990): 2529–33; and W. A. Orenstein et al., “Appropriate Age for Measles Vaccination in the United States,” Development of Specifications for Biotechnology Pharmaceutical Products 65 (1986): 13–21.

65. Blumenthal and Morone, The Heart of Power, 355, 359–64.

66. “Atlanta Project Pulled It Off,” Atlanta Journal-Constitution, May 5, 1993, A12.

67. The program required states to amend their Medicaid programs to include “a pediatric immunization distribution program.” The cost of the program was $1.4 billion over four years, but it was projected to result in federal and state Medicaid savings of roughly the same amount. The program also made the vaccine taxes used to fund the National Vaccine Injury Compensation Program permanent. The national registry did not survive the final bill. See Omnibus Budget Reconciliation Act of 1993, PL103-66; and Melvina Ford, “Health Care Fact Sheet: Child Immunization Provisions in the Omnibus Budget Reconciliation Act of 1993, P.L. 103-66, September 2, 1993,” CRS Report for Congress 93-781 EPW, Congressional Research Service.

68. “How to Help Immunization,” Atlanta Journal-Constitution, May 5, 1993, A14.

69. Editorial, “Immunity for the Children,” Washington Post, February 4, 1993, A20.

70. Editorial, “The Drive to Vaccinate,” Washington Post, May 3, 1993, A18.

71. Jason DeParle, “With Shots, It’s Not Only about Costs, but Stories,” New York Times, May 16, 1993, E18.

72. Talking points, January 1, 1994, Folder 8, Box 13, Domestic Policy Council, Reed Welfare Reform Subject File, William J. Clinton Presidential Library.

73. Ann Devroy, “Bush Announces New Push to Improve Vaccination Programs,” Washington Post, June 14, 1991, A17.

74. Okie, “Vaccination Record in U.S. Falls Sharply.”

75. Devroy, “Bush Announces New Push to Improve Vaccination Programs.”

76. Mary G. Fontrier, “Price of Vaccines for Measles Criticized,” New York Times, September 17, 1989, LI25.

77. Robert M. Goldberg and American Enterprise Institute for Public Policy Research, The Vaccines for Children Program: A Critique, AEI Studies in Policy Reform (Washington, DC: AEI Press, 1995).

78. See, for example, Robert Pear, “Clinton Criticized as Too Ambitious with Vaccine Plan,” New York Times, May 29, 1994, 1; K. A. Johnson, A. Sardell, and B. Richards, “Federal Immunization Policy and Funding: A History of Responding to Crises,” American Journal of Preventive Medicine 19, no. S3 (2000): 99–112; memo from Sara Rosenbaum to Carol Rasco, July 19, 1994, Folder 7, Box 33, Domestic Policy Council, Rasco Subject Files, William J. Clinton Presidential Library; and letter from Dale Bumpers and John Danforth to Donna Shalala, April 13, 1994, Folder 9, Box 33, Domestic Policy Council, Rasco Subject File, William J. Clinton Presidential Library.

79. William A. Galston and Geoffrey L. Tibbetts, “Reinventing Federalism: The Clinton/Gore Program for a New Partnership among the Federal, State, Local, and Tribal Governments,” Publius 24, no. 3 (1994): 23–47.

80. Hillary Rodham Clinton, It Takes a Village: And Other Lessons Children Teach Us (New York: Simon & Schuster, 1996), 110–15.

81. Hinman, Orenstein, and Rodewald, “Financing Immunizations in the United States.”

CHAPTER EIGHT

1. CDC, “National, State, and Urban Area Vaccination Coverage Levels among Children Aged 19–35 Months, United States, 1999,” Morbidity and Mortality Weekly Report 49, no. 26 (2000): 585–89.

2. World Health Organization, “WHO/UNICEF Estimates of National Immunization Coverage: Estimated Coverage by Country, Year, and Vaccine,” Immunization Surveillance, Assessment, and Monitoring, http://www.who.int/immunization_monitoring/routine/immunization_coverage/en/index4.html (accessed February 2011).

3. Leon Jaroff, “Vaccine Jitters,” Time, September 13, 1999, 64–65.

4. See Baruch S. Blumberg, Hepatitis B: The Hunt for a Killer Virus (Princeton, NJ: Princeton University Press, 2002), introduction, chap. 11.

5. William Muraskin, “Hepatitis B as a Model (and Anti-Model) for AIDS,” in AIDS and Contemporary History, ed. Virginia Berridge and Philip Strong (Cambridge: Cambridge University Press, 1993), 108–32.

6. Blumberg, Hepatitis B, chap. 5.

7. Ibid., 134–36. See also B. S. Blumberg, A. I. Sutnick, and W. T. London, “Australia Antigen and Hepatitis,” Journal of the American Medical Association 207, no. 10 (1969): 1895–96; A. I. Sutnick, W. T. London, and B. S. Blumberg, “Australia Antigen and the Quest for a Hepatitis Virus,” American Journal of Digestive Diseases 14, no. 3 (1969): 189–94; W. T. London, A. I. Sutnick, and B. S. Blumberg, “Australia Antigen and Acute Viral Hepatitis,” Annals of Internal Medicine 70, no. 1 (1969): 55–59; and B. S. Blumberg et al., “Australia Antigen and Hepatitis,” New England Journal of Medicine 283, no. 7 (1970): 349–54.

8. Norman Pastorek, “Hepatitis,” Today’s Health, September 1974, 46–69.

9. Boyce Rensberger, “Sketches of Two Winners of Nobel Prizes in Medicine,” New York Times, October 15, 1976, 13.

10. “A Wave of Death from Hepatitis,” Newsweek, August 27, 1979, 72.

11. CBS Evening News, September 29, 1980, Vanderbilt Television News Archive (hereafter VTNA).

12. CBS Evening News, November 16, 1981, VTNA.

13. Ibid.

14. See, for example, W. Szmuness et al., “Hepatitis B Vaccine in Medical Staff of Hemodialysis Units: Efficacy and Subtype Cross-Protection,” New England Journal of Medicine 307, no. 24 (1982): 1481–86.

15. William Muraskin, “The Silent Epidemic: The Social, Ethical, and Medical Problems Surrounding the Fight against Hepatitis B,” Journal of Social History 22 (1988): 277–98.

16. CDC and Prevention, National Center for Health Statistics, Health Data Interactive, available at www.cdc.gov/nchs/hdi.htm (accessed March 2011). See also “Medicine: Cardiac Shocks,” Time, August 18, 1980.

17. “Medicine: New Plagues for Old?,” Time, November 24, 1980.

18. The vaccine’s development is described in Louis Galambos and Jane Eliot Sewell, Networks of Innovation: Vaccine Development at Merck, Sharp & Dohme and Mulford, 1895–1995 (New York: Cambridge University Press, 1995), 181–93. Merck listed the plasma-based vaccine among its all-time top discoveries, and Maurice Hilleman, who oversaw its development, was particularly proud of it. Fifty Years of Research: Merck Sharp & Dohme Research Laboratory (Rahway, NJ: Merck Sharp & Dohme, 1983), 3; Louis Galambos and Merck & Co., Values and Visions: A Merck Century (Rahway, NJ: Merck & Co., 1991).

19. CBS Evening News, November 16, 1981.

20. “Hepatitis Hope,” Time, October 13, 1980; Jean Seligman, “A Vaccine for Hepatitis,” Newsweek, October 13, 1980, 132; Carl Sherman, “Hepatitis: Why It’s So Common,” Glamour, March, 1981, 268–70.

21. See, for example, Seligman, “A Vaccine for Hepatitis”; and Lawrence Altman, “Tests of Hepatitis B Vaccine Show Nearly Complete Rate of Protection,” New York Times, September 29, 1980, A1.

22. W. A. Check, “Looks Like Smooth Sailing for Experimental Hepatitis B Vaccine,” Journal of the American Medical Association 246, no. 19 (1981): 2111–12.

23. “Recommendation of the Immunization Practices Advisory Committee (ACIP) Inactivated Hepatitis B Virus Vaccine,” Morbidity and Mortality Weekly Report 31, no. 24 (1982): 317–22.

24. Harvey J. Alter, “The Evolution, Implications, and Applications of the Hepatitis B Vaccine,” Journal of the American Medical Association 247, no. 16 (1982): 2272–75.

25. Lawrence Altman, “New Homosexual Disorder Worries Health Officials,” New York Times, May 11, 1982, C1. See also Associated Press, “Rare Cancer Found in Gay Men,” Washington Post, June 5, 1982, A2.

26. David Dickson, “AIDS Fears Spark Row over Vaccine,” Science, no. 221 (1983): 437.

27. United Press International, “Two Doctors in U.S. Agency Back Hepatitis B Vaccine,” New York Times, February 11, 1983, A14; “French Doctors Ban American Blood Imports,” New Scientist, May 26, 1983, 529.

28. This comment, allegedly made in 1985, was recounted in Pat Griffin Mackie, “Hepatitis B Vaccine and Newborn,” National Immunity Information Network Newsletter, September/October, 1997, 1.

29. CDC, “The Safety of Hepatitis B Virus Vaccine,” Morbidity and Mortality Weekly Report 32, no. 10 (1983): 134–36. Follow-up data was published the following year: CDC, “Hepatitis B Vaccine: Evidence Confirming Lack of AIDS Transmission,” Morbidity and Mortality Weekly Report 33 (1984): 685–87.

30. In the mid-1980s, some commentators in the black and gay media in particular speculated on a link between the emergence of HIV and the hepatitis B vaccine. Dermatologist Alan Cantwell blamed AIDS on hepatitis B trials conducted in homosexual men in the 1970s. See, for example, John Fiske, Media Matters: Everyday Culture and Political Change (Minneapolis: University of Minneota Press, 1994), 201, 213–14; Alan Cantwell, AIDS and the Doctors of Death: An Inquiry into the Origin of the AIDS Epidemic (Los Angeles: Aries Rising Press, 1988); and Alan Cantwell, Queer Blood: The Secret AIDS Genocide Plot (Los Angeles: Aries Rising Press, 1993).

31. CDC, “Current Trends Acquired Immunodeficiency Syndrome (AIDS) Update—United States,” Morbidity and Mortality Weekly Report 32, no. 24 (1983): 309–11; “Recommendation of the Immunization Practices Advisory Committee (ACIP) Inactivated Hepatitis B Virus Vaccine.” This pattern has also been noted by historian Gerald Oppenheimer, “In the Eye of the Storm: The Epidemiological Construction of AIDS,” in AIDS: The Burdens of History, ed. Elizabeth Fee and Daniel Fox (Berkeley: University of California Press, 1988), 267–300.

32. Claudia Wallis, “AIDS: A Growing Threat,” Time, August 12, 1985.

33. See, for example, Cheryl Sacra, “A Vaccine for Lovers,” Health 21 (1989): 47.

34. Sanford Kuvin, “Vaccination Can Halt Epidemic of Hepatitis B, Cousin of AIDS,” New York Times, April 9, 1989, E24.

35. “Hepatitis, Health, and the Hard Sell,” Gay Community News, September 10, 1983.

36. Natalie Geary, “Health News: Hepatitis B,” Mademoiselle, April, 1993, 120.

37. Alter, “The Evolution, Implications, and Applications of the Hepatitis B Vaccine.”

38. “Uncorking the Genes: Biotech Stocks Just Coming into Own, Analyst Says,” Barron’s National Business and Financial Weekly, May 5, 1986, 10–16.

39. Claudia Wallis, “Made-to-Order Vaccines,” Time, October 31, 1983; Janice Castro, “A Breakthrough for Biotech,” Time, August 4, 1986.

40. Harold Schmeck, “The New Age of Vaccines,” New York Times Magazine, April 29, 1984, 58. Merck, too, made optimistic predictions about the promise of genetically engineered vaccines. Fifty Years of Research, 16.

41. See, for example, Judy Packer, “Chiron Nears Sale of New Hepatitis Vaccine,” San Jose Business Journal 3, no. 41 (1986); and Tom Post et al., “The Year’s Best Entrepreneurial Ideas,” Venture 8, no. 12 (1986): 6. Though the vaccine was developed by Chiron, Merck brought it to market; it quickly became the company’s most profitable vaccine. Company reports suggest that Merck was focused on the global market over the domestic one at the time, given the high prevalence of hepatitis B in Asia in particular. Annual Report: Innovations for Global Health (Rahway, NJ: Merck & Co., 1988), 17, 38.

42. Philip Boffey, “U.S. Approves a Genetically Altered Vaccine,” New York Times, July 24, 1986, A1; Marlene Cimons, “First Human Vaccine Produced by Genetic Engineering Ok’d by FDA,” Los Angeles Times, July 24, 1986, 1; Joe Davidson, “Lab-Made Vaccine for Hepatitis B Is Cleared by FDA,” Wall Street Journal, July 24, 1986, 1. Some vaccine critics also saw genetic engineering as the answer to risks posed by vaccination. See National Vaccine Information Center, “Pertussis Vaccine Research Update,” Vaccine News 5, no. 1 (1990): 5. The first genetically engineered drug, a recombinant form of human insulin, was approved by the FDA in 1982; the approval of recombinant human growth hormone followed in 1985. Suzanne White Junod, “Celebrating a Milestone: FDA Approval of First Genetically-Engineered Product,” Update, no. 5 (2007), http://www.fdli.org/pubs/update/toc/2007/issue5.html (accessed December 2008).

43. This was a long-anticipated advantage of genetically engineered vaccines, particularly the genetically engineered hepatitis vaccine. However, when it was first introduced, Heptavax B (the plasma-derived vaccine) was the most expensive vaccine ever marketed. See, for example, Alter, “The Evolution, Implications, and Applications of the Hepatitis B Vaccine.”

44. Editorial, “Science and Demagoguery,” Wall Street Journal, July 31, 1986, 1.

45. Dori Stehlin, “Hepatitis B: Available Vaccine Safe and Underused,” FDA Consumer Magazine, May 1990.

46. Wallis, “Made-to-Order Vaccines.”

47. Associated Press, “FDA Approves Gene-Engineered Hepatitis Vaccine,” Dallas Morning News, July 24, 1986, 5A.

48. CDC, “Surveillance Summary Viral Hepatitis—1984,” Morbidity and Mortality Weekly Report 36, no. 3 (1987): 42–43.

49. The targeting of women identified through their sexual (in this case reproductive) behavior is reminiscent of countless historical attempts to curb the spread of sexually transmitted infections by detaining and treating women, especially prostitutes, over men. See, for example, Allan M. Brandt, No Magic Bullet: A Social History of Venereal Disease in the United States since 1880 (New York: Oxford University Press, 1985); and Dorothy Porter and Roy Porter, “The Enforcement of Health: The British Debate,” in AIDS: The Burdens of History, ed. Elizabeth Fee and Daniel Fox (Berkeley: University of California Press, 1988), 97–120.

50. CDC, “Recommendation of the Immunization Practices Advisory Committee (ACIP): Postexposure Prophylaxis of Hepatitis B,” Morbidity and Mortality Weekly Report 33, no. 21 (1984): 285–90.

51. CDC, “Recommendations of the Immunization Practices Advisory Committee Prevention of Perinatal Transmission of Hepatitis B Virus: Prenatal Screening of All Pregnant Women for Hepatitis B Surface Antigen,” Morbidity and Mortality Weekly Report 37, no. 22 (1988): 341–46, 351.

52. Ibid.

53. M. J. Alter et al., “The Changing Epidemiology of Hepatitis B in the United States: Need for Alternative Vaccination Strategies,” Journal of the American Medical Association 263, no. 9 (1990): 1218–22.

54. CDC, “Hepatitis B Virus: A Comprehensive Strategy for Eliminating Transmission in the United States through Universal Childhood Vaccination: Recommendations of the Immunization Practices Advisory Committee (ACIP),” Morbidity and Mortality Weekly Report 40, no. RR-13 (1991): 1–19.

55. Ibid.

56. Dolores Kong, “U.S. to Urge All Children Be Vaccinated for Hepatitis B,” Boston Globe, June 11, 1991. The official’s comment was not entirely accurate; children were vaccinated to protect pregnant women from rubella infection. See chapter 3 and Leslie J. Reagan, Dangerous Pregnancies: Mothers, Disabilities, and Abortion in America (Berkeley: University of California Press, 2010).

57. “Hepatitis B 200x More Contagious than AIDS,” Philadelphia Tribune, December 31, 1991, 4B; Lisa Holland, “The ABC’s of Hepatitis,” Good Housekeeping, April, 1991, 239.

58. Leslie Laurence, “Beware the Quiet Killer,” Redbook, October 1991, 24, 28, 32; Sandy Coleman, “Q&A with Leslie Hsu, South Cove Health Center in Chinatown,” Boston Globe, February 15, 1998, 2.

59. Janice Hopkins Tanne, “The Other Plague: Potentially Deadly Hepatitis Is Fifteen Times More Common than AIDS,” New York, July 11, 1988, 34–40.

60. Ibid., 35.

61. Ann Devroy, “Bush Announces New Push to Improve Vaccination Programs,” Washington Post, June 14, 1991, A17.

62. Robert Pear, “Proposal Would Tie Welfare to Vaccinations of Children,” New York Times, November 29, 1990, A1.

63. Phyllis Freeman and Anthony Robbins, “An Epidemic of Inactivity,” New York Times, July 10, 1991, A19; Jeremy Waldron, “There We Go Again, Punishing the Poor,” New York Times, December 12, 1990, A22.

64. CDC, “Measles Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP),” Morbidity and Mortality Weekly Report 38, no. S9 (1989): 1–18. College students were presumed to be at risk because the vaccine they received back in the 1960s, scientists had concluded, was too weak to confer lasting immunity.

65. L. McTaggart and D. Zakruczemski, “The MMR Vaccine,” Mothering, Spring 1992, 56–62. See also “Are Vaccines Generally Detrimental to the Human Defense System?,” Townsend Letter for Doctors & Patients, February/March 1994.

66. CDC, “Measles Prevention.”

67. Joanne Hatem, “MMR Update,” NVIC News 1, no. 3 (1991): 9.

68. See chapter 7 for an extensive discussion of Clinton’s childhood immunization initiative.

69. Office of the Press Secretary, “Remarks by the President at Reading of Immunization Proclamation, April 12, 1993,” William J. Clinton Presidential Library, http://clinton6.nara.gov/1993/04/ (accessed February 2010). See also Omnibus Budget Reconciliation Act of 1993, PL103-66; and Gary Freed and Samuel Katz, “The Comprehensive Childhood Immunization Act of 1993,” New England Journal of Medicine 329, no. 26 (1993): 1957–60.

70. Harold Margolis et al., “Prevention of Hepatitis B Virus Transmission by Immunization: An Economic Analysis of Current Recommendations,” Journal of the American Medical Association 274, no. 15 (1995): 1201–8.

71. CDC, “Notice to Readers Update: Recommendations to Prevent Hepatitis B Virus Transmission—United States,” Morbidity and Mortality Weekly Report 44, no. 30 (1994): 574–75.

72. U.S. House of Representatives, Subcommittee on Criminal Justice, Drug Policy, and Human Resources of the Committee on Government Reform, Hepatitis B Vaccine: Helping or Hurting Public Health?, 106th Congress, 1st session, May 18, 1999 (Washington, DC: Government Printing Office, 2000).

73. Editorial, “AIDS and Immigration,” Washington Post, February 12, 1993, A26; Clifford Krauss, “Senate Opposes Immigration of People with AIDS Virus,” New York Times, February 19, 1993, A11.

74. Robert Greenberger, “Clinton Team Seeks Policy to Aid Haiti and Avert Feared Surge of Emigration,” Wall Street Journal, January 4, 1993, A5; Laura Hawkins, “Facing TB—in the Mirror,” Washington Post, January 12, 1993, 17.

75. Roberto Suro, “Proposition 187 Could Open Pandora’s Box for GOP,” Washington Post, November 11, 1994, A24; Bruce Nelan, David Aikman, and David Jackson, “Not Quite So Welcome Anymore,” Time, December 2, 1993. As historian Alan Kraut has pointed out, policies like California’s Proposition 187 were simply “old wine in new bottles,” as throughout American (and human) history, immigrants have often been held to blame for outbreaks and epidemics—real or imagined—and the resources they consume. Alan M. Kraut, Silent Travelers: Germs, Genes, and the “Immigrant Menace” (Baltimore: Johns Hopkins University Press, 1995), 3. Kraut’s work describes the treatment of Haitian immigrants to the United States during the height of the AIDS epidemic, as well as many other episodes in American history in which immigration concerns have influenced public health policy and perceptions of disease and vice versa. Similar themes are addressed in Marilyn Chase, The Barbary Plague: The Black Death in Victorian San Francisco (New York: Random House, 2003); Judith Walzer Leavitt, Typhoid Mary: Captive to the Public’s Health (Boston: Beacon Press, 1996); Howard Markel, Quarantine!: East European Jewish Immigrants and the New York City Epidemics of 1892 (Baltimore: Johns Hopkins University Press, 1997); Howard Markel, When Germs Travel: Six Major Epidemics that Have Invaded America since 1900 and the Fears They Have Unleashed (New York: Pantheon, 2004); Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, NJ: Rutgers University Press, 1992).

76. Tom Majeski, “State Endorses Hepatitis Shots—Minnesota Is First to Recommend Immunizations for All Adolescents,” St. Paul Pioneer Press, November 6, 1993, 1A.

77. Peter Shinkle, “Vaccination Line Long as School Opening Nears,” Advocate (Baton Rouge, LA), August 19, 1993, 1A; Reuters, “Hepatitis B Vaccine for Babies Urged; Most of the Affected Americans Are First Infected as Young Adults,” Philadelphia Inquirer, October 18, 1995, A12; Michael Romano, “Colorado Will Add Hepatitis B to Required Inoculations for Schoolchildren,” Rocky Mountain News, April 20, 1996.

78. Andrea Vogt, “CDA Schools First in Idaho to Offer Hepatitis B Shots,” Idaho Spokesman-Review, October 7, 1997, A1; Diane Eicher, “Hepatitis B Vaccine Carries a Quandary; Debate Rages over Necessity of Wide Usage,” Denver Post, June 27, 1994, F1; Tina Nguyen, “Parents Need to Get Started on Schools’ Hepatitis B Mandate,” Los Angeles Times, December 26, 1998, 1.

79. Paula S. Fass, Children of a New World: Society, Culture, and Globalization (New York: New York University Press, 2007), 215.

80. “A Piercing Look,” Prevention, November 1996, 46.

81. “If Body Piercing Is So Hazardous, Why Is It So Popular?,” Jet, April 19, 1999, 56.

82. Eicher, “Hepatitis B Vaccine Carries a Quandary.”

83. Romano, “Colorado Will Add Hepatitis B.”

84. Eicher, “Hepatitis B Vaccine Carries a Quandary.”

85. Rick Ansorge, “State Adds Hepatitis B to Immunization List—Shots Required for Schoolkids Beginning 1997,” Gazette (Colorado Springs, CO), April 26, 1996, 1.

86. Eicher, “Hepatitis B Vaccine Carries a Quandary”; emphasis in original.

87. Diane Eicher, “HBV Shot Series Must Start Now,” Denver Post, April 14, 1997, F2.

88. Patti Johnson, “Need for Hepatitis B Vaccine Questioned,” Rocky Mountain News, July 12, 1999, 30A. That same year, Johnson led a separate campaign targeting the use of Ritalin, the widespread use of which she believed was symptomatic of society’s overmedication of children. See Marcela Gaviria, “Medicating Kids,” Frontline (PBS, 2001). Chiron was not a target of these complaints because its vaccine was developed in cooperation with and subsequently marketed by Merck.

89. Al Knight, “The Limits of Mandatory Medicine,” Denver Post, March 4, 1999, B11; Al Knight, “Pinning Down the Risks of Vaccinations,” Denver Post, August 5, 1999, B9.

90. Donna Leusner, “Some Bills Perish in Governor’s Pocket,” Star-Ledger (Newark, NJ), January 21, 1998, 15.

91. Todd Hartman, “Vaccinations’ Success Backfiring—Thousands in Colorado Forgo Shots,” Gazette (Colorado Springs, CO), January 19, 1997, 1; Arthur Allen, “Bucking the Herd,” Atlantic Monthly, September 2002, 40–42. Overall vaccination coverage in this period was generally high in Colorado and the rest of the United States: 75 to 90 percent of children were fully vaccinated (against diphtheria, tetanus, pertussis, polio, measles, Hib, hepatitis B, and varicella) in each state, although at 75.8 percent Colorado’s coverage rate was lower than that of most other states. CDC, “National, State, and Urban Area Vaccination Coverage Levels among Children Aged 19–35 Months—United States, 1998,” Morbidity and Mortality Weekly Report 49, no. S S09 (2000): 1–26. For more details on vaccination mandate exemption clauses, see note 25 in the introduction.

92. National Vaccine Information Center, “CDC Considers Mass Vaccination with Hepatitis B Vaccine,” Vaccine News 5, no. 1 (1990): 7; National Vaccine Information Center, “AAP Recommends All Newborn Infants Be Vaccinated with Hepatitis B Vaccine,” NVIC News 2, no. 1 (1992): 12.

93. “Update: Recommendations to Prevent Hepatitis B Virus Transmission—United States,” Morbidity and Mortality Weekly Report 48, no. 2 (1999): 33–34; “Global Progress toward Universal Childhood Hepatitis B Vaccination, 2003,” Morbidity and Mortality Weekly Report 52, no. 36 (2003): 868–70.

94. See, for example, Agence France-Presse, “France Ends Program of Hepatitis B Shots,” New York Times, October 3, 1998, A4.

95. “Who’s Calling the Shots?” 20/20, ABC News, January 22, 1999. See also Anita Manning, “Now Parents Fear Shots; Kids in USA Get 21 Shots before Start of 1st Grade,” USA Today, August 3, 1999, 1A.

96. U.S. House of Representatives, Hepatitis B Vaccine: Helping or Hurting Public Health?, 7–31, 280–84.

97. Ibid., 67.

98. Introduction to Paula S. Fass and Mary Ann Mason, eds., Childhood in America (New York: New York University Press, 2000).

99. U.S. House of Representatives, Hepatitis B Vaccine: Helping or Hurting Public Health?, 258.

100. Ibid., 94.

101. Ibid., 112.

102. Charles Marwick and Mike Mitka, “Debate Revived on Hepatitis B Vaccine Value,” Journal of the American Medical Association 282, no. 1 (1999): 15–17.

103. Lisa Suhay, “A Skirmish over the Hepatitis B Vaccination,” New York Times, July 18, 1999, NJ1.

104. Laura Maschal, “Debating Hepatitis B Vaccine,” New York Times, July 25, 1999, NJ13.

105. Mary Ann Mason, “The State as Superparent,” in Childhood in America, ed. Paula Fass and Mary Ann Mason (New York: New York University Press, 2000), 549–54.

106. World Health Organization, “WHO/UNICEF Estimates of National Immunization Coverage: Estimated Coverage by Country, Year, and Vaccine.”

107. Elisabeth Rosenthal, “Parents Face Questions on Vaccinating Infacts for Hepatitis B,” New York Times, March 3, 1993, C12.

108. This articulation borrows from the concept of the “policy window” developed by political scientist John Kingdon. See John W. Kingdon, Agendas, Alternatives, and Public Policies (New York: Longman, 1995).

CHAPTER NINE

1. Andrea Rock, “The Lethal Dangers of the Billion-Dollar Vaccine Business,” Money, December 1, 1996, 148; emphasis in original.

2. The investigation reported that DPT vaccine caused brain damage in 1 in every 62,000 children immunized and one to two deaths per year. Ibid., 150, 164.

3. See chapter 6.

4. Mark Largent, Vaccine: The Debate in Modern America (Baltimore: Johns Hopkins University Press, 2012), 1, 157.

5. An analysis by Christopher E. Clarke found that in a representative sample of U.S. media coverage of the vaccine-autism link, a majority of reports—roughly 80 percent—dismissed the link. Christopher E. Clarke, “A Question of Balance: The Autism-Vaccine Controversy in the British and American Elite Press,” Science Communication 30, no. 1 (2008): 94.

6. CDC, “Intussusception among Recipients of Rotavirus Vaccine—United States, 1998–1999,” Morbidity and Mortality Weekly Report 48, no. 27 (1999): 577–81.

7. Lawrence Altman, “U.S. in a Push to Bar Vaccine Given to Infants,” New York Times, July 16, 1999, A1; “Rotavirus Vaccine Pulled after Illnesses,” Gainesville (FL) Sun, July 18, 1999, 4G; “Doctors Stop Giving Vaccine after Warning,” Virginian-Pilot, July 17, 1999, C5; “U.S. Recommends Suspension of a Wyeth Vaccine,” Philadelphia Inquirer, July 16, 1999, C1.

8. CDC, “Withdrawal of Rotavirus Vaccine Recommendation,” Morbidity and Mortality Weekly Report 48, no. 43 (1999): 1007; Lawrence Altman, “In Turnabout, Federal Panel Votes against a Vaccine,” New York Times, October 23, 1999, A11. The rotavirus vaccination recommendation was later reinstated.

9. Edward Hooper, The River: A Journey to the Source of HIV and AIDS (Boston: Little, Brown, 1999).

10. Robin Weiss, “Is AIDS Man-Made?,” Science 286, no. 5443 (1999): 1303; John P. Moore, “Up the River without a Paddle?” Nature 401, no. 6751 (1999): 325–26. The culprit vaccine’s developer, the Philadelphia-based Wistar Institute, invited independent labs to test remaining stores of the vaccine to see if it did indeed contain chimp virus. It did not—but this finding did not conclusively disprove Hooper’s theory. On the results of the independent testing, see Rebecca Voelker, “The World in Medicine: No Chimp DNA in Vaccine,” Journal of the American Medical Association 284, no. 14 (2000): 1777.

11. Lawrence Altman, “New Book Challenges Theories of AIDS Origins,” New York Times, November 30, 1999, F1.

12. Michael Woods, “How HIV Started Is Debated,” Blade (Toledo, OH), December 13, 1999, 32.

13. The CDC’s ACIP and the AAP had recently begun coordinating their vaccination recommendations; previously, the AAP had continued to issue its own recommendations distinct from those of the ACIP.

14. Committee on Infectious Diseases, “Prevention of Poliomyelitis: Recommendations for Use of Only Inactivated Poliovirus Vaccine for Routine Immunization,” Pediatrics 104, no. 6 (1999): 1404–6; “Revised Recommendations for Routine Poliomyelitis Vaccination,” Journal of the American Medical Association 282, no. 6 (1999): 522; CDC, “Recommendations of the Advisory Committee on Immunization Practices: Revised Recommendations for Routine Poliomyelitis Vaccination,” Morbidity and Mortality Weekly Report 48, no. 27 (1999): 590.

15. Denise Grady, “Doctors Urge Polio Shots to Replace Oral Vaccine,” New York Times, December 7, 1999; “Polio Vaccine Switch,” Pittsburgh Post-Gazette, December 8, 1999, A2.

16. “Vaccine Roulette: Weighing the Odds,” Mothering, November/December 1999, 30. The last point was a bit of an overstatement; the suspension, which was based on the presence of thimerosal in hepatitis B vaccine, was temporary and the agency actually advised that infants whose mothers did not carry the hepatitis B virus be vaccinated at six months instead of right after birth. Public Health Service and American Academy of Pediatrics, “Notice to Readers: Thimerosal in Vaccines—a Joint Statement of the American Academy of Pediatrics and the Public Health Service,” Morbidity and Mortality Weekly Report 48, no. 26 (1999): 563–65.

17. “A Closer Look (Medicine—Vaccinations),” ABC Evening News, February 16, 1998; “Medicine/Childhood Vaccines,” CBS Evening News, September 28, 1999, VTNA.

18. Tim Vollmer, “Who Should Call the Shots,” San Francisco Chronicle, October 10, 1999, 1; Huntly Collins, “Life Giver or Life Taker: A Debate on the Value of Vaccines Special Report, Immunizations: A Public-Health Staple Comes under Siege,” Philadelphia Inquirer, October 3, 1999, A1.

19. The full list of meetings and links to complete reports are available at http://www.iom.edu/Activities/PublicHealth/ImmunizationSafety.aspx (accessed August 2012). Burton requested that none of the committee members be connected in any way to industry, leading some medical professionals to complain that the resulting committees were, as a result, devoid of vaccine experts. Brian Vastag, “Congressional Autism Hearings Continue: No Evidence MMR Vaccine Causes Disorder,” Journal of the American Medical Association 285, no. 20 (2001): 2567–69.

20. U.S. Congress, House Committee on Government Reform, Autism: Present Challenges, Future Needs—Why the Increased Rates? Hearing before the Committee on Government Reform, House of Representatives, 106th Congress, 2nd Session, April 6, 2000 (Washington, DC: U.S. Government Printing Office, 2001), 5–6.

21. Andrew J. Wakefield et al., “Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis, and Pervasive Developmental Disorder in Children,” Lancet 351, no. 9103 (1998): 637–41.

22. U.S. Congress, House Committee on Government Reform, Autism, 20–21. For a fuller discussion of Wakefield and his work, see Largent, Vaccine, chap. 4.

23. See, for example, Brian Lavery, “As Vaccination Rates Decline in Ireland, Cases of Measles Soar,” New York Times, February 8, 2003.

24. Norman Begg et al., “Medicine and the Media: Media Dents Confidence in MMR Vaccine,” British Medical Journal 316, no. 7130 (1998): 561. Media studies experts attribute the reaction in Britain in part to the nation’s recent experience with mad cow disease, which left the media and the public distrustful of authorities and their reassurances. See, for example, Clarke, “A Question of Balance.”

25. Quantitative analyses support this observation; see, for example, Clarke, “A Question of Balance.”

26. See, for example, “Measles Study Finds No Evidence that Vaccine Causes Autism,” Chicago Tribune, May 8, 1998, 7; Michael Day, “MMR/Autism: Have We Fully Investigated the Risks?” New Scientist, March 7, 1998; “Vital Signs,” State Journal-Register (Springfield, IL), May 11, 1998, 9; and Collins, “Life Giver or Life Taker.”

27. John Wilkens, “A Father’s Day Story: The Rimlands Where There’s Hope,” San Diego Union-Tribune, June 21, 1998, D1.

28. Associated Press, “Parents: Vaccine Likely Caused Son’s Autism—Mississippi Couple Seeks Their Day in Court,” Advocate (Baton Rouge, LA), December 13, 1998, 6B; Judy Foreman, “Answers to Mysteries of Autism May Be Starting to Emerge,” Lewiston (ID) Morning Tribune, December 30, 1998, 2D. A few media analyses have also found that vaccine blame was a common feature of autism reporting. Juanne Nancarrow Clarke, “Representations of Autism in U.S. Magazines for Women in Comparison to the General Audience,” Journal of Children and Media 6, no. 2 (2012): 182–97; Seok Kang, “Coverage of Autism Spectrum Disorder in the U.S. Television News: An Analysis of Framing,” Disability and Society 28, no. 2 (2013): 245–59.

29. See, for example, Leslie Koren, “Doctor’s Daughters Pass on Some Vaccinations,” Washington Times, September 4, 1998, C4; and Karyn Miller-Medzon, “Taking a Shot at Vaccines—Mass. Group Wants to Make Immunizations Optional,” Boston Herald, August 30, 1998.

30. E. Atlee Bender, “Letter: Sylvia Wood Deserves Praise for Vaccine Story,” Times Union (Albany, NY), September 5, 1998, A6; Raymond Gallup, “Reader Forum: Vaccine Danger,” Star-Ledger (Newark, NJ), July 31, 1998, 28; Natalie Veit, “To the Editor,” Erie (PA) Times-News, April 10, 1988.

31. This claim abounded in media reports on parental vaccination fears and childhood vaccination coverage between 2010 and 2012. See also Seth Mnookin, The Panic Virus: A True Story of Medicine, Science, and Fear (New York: Simon & Schuster, 2011); and Paul A. Offit, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All (New York: Basic Books, 2011).

32. Largent makes a similar argument about autism advocate Jenny McCarthy, whom health officials also blamed for igniting parental fears of a vaccine-autism link. Largent, Vaccine, 151.

33. Sandra Blakeslee, “Increase in Autism Baffles Scientists,” New York Times, October 18, 2002, A1; Polly Morrice, “What Caused the Autism Epidemic?,” New York Times, April 17, 2005, F20.

34. “A Mysterious Upsurge in Autism,” New York Times, October 20, 2002, C10.

35. But it couldn’t be ruled out entirely. In a statement included in bold type in the final report, the committee noted that because of limitations inherent to the epidemiological research, it was possible that MMR vaccine could contribute to autism “in a small number of children.” Institute of Medicine Immunization Safety Review Committee, Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism (Washington, DC: National Academies Press 2001).

36. The report focused on MMR and thimerosal-containing vaccines. Institute of Medicine Immunization Safety Review Committee, Immunization Safety Review: Vaccines and Autism (Washington, DC: National Academies Press, 2004).

37. “In Depth: MMR Vaccine and Autism,” NBC Evening News, April 23, 2001, VTNA. See also, for example, “No Link Found between MMR Vaccine and Autism,” CNN Health, April 23, 2001; and Sandra Blakeslee, “No Evidence of Autism Link Is Seen in Vaccine, Study Says,” New York Times, April 24, 2001, A16.

38. “Are Vaccines Safe?: Saying No to Immunization,” 60 Minutes, CBS News, December 27, 2004, http://www.cbsnews.com/video/watch/?id=650462n (accessed June 2012).

39. “Lifeline: Childhood Vaccines,” NBC Evening News, May 18, 2004, VTNA. See also, for example, “Inside Story: Childhood Vaccines,” CBS Evening News, May 18, 2004, VTNA; Tina Hesman, “No Link between Vaccines and Autism, Study Says—Report Draws Fire from Parents, Other Researchers,” St. Louis Post-Dispatch, May 19, 2004, A1; and Robyn Shelton, “Vaccines Don’t Cause Autism, Panel Agrees—but Some Parents of Autistic Children Said the Experts’ Findings Were Severely Flawed,” Orlando Sentinel, May 19, 2004, A1.

40. These figures are based on a count of U.S. media reports including the words “vaccine(s)” and “autism” in Newsbank and the VTNA. The same trend is evident in other databases of news reports, including Google News Archive (41 results for 2001; 571 results for 2010) and Lexis-Nexis (260 results for 2001; 856 results for 2010). The number of reports increased and decreased from year to year but generally increased over the course of the decade. The pattern also holds for reports mentioning Andrew Wakefield.

41. See, for example, Sandy Kleffman, “Autism, Heavy Metals Linked; Study Suggests Toxin Can Act as a Trigger in Some Children,” Pittsburgh Post-Gazette, December 14, 2004, A3.

42. See, for example, “Medicine: Autism and Vaccines,” CNN Evening News, March 4, 2004, VTNA; Mary Ann Roser, “Censured Doctor Says He’ll Resume Autism Research,” Austin American-Statesman, May 20, 2010, B1; and Susan Dominus, “The Denunciation of Dr. Wakefield,” New York Times Sunday Magazine, April 24, 2011, MM36.

43. Morrice, “What Caused the Autism Epidemic?”; Miriam Falco, “Study: 1 in 110 U.S. Children Had Autism in 2006,” CNN Health, December 17, 2009, http://www.cnn.com/2009/HEALTH/12/17/autism.new.numbers/ (accessed January 2010); Jonathan Serrie, “1 in 88 Us Kids Have Autism, CDC Reports,” FoxNews.com, March 29, 2012, http://www.foxnews.com/health/2012/03/29/1-in-88-us-kids-have-autism-cdc-reports/ (accessed July 2012). Numerous theories have been put forth to account for the startling rise, from new diagnostic methods to greater awareness to increasing paternal and maternal age.

44. See, for instance, Allan Mazur, The Dynamics of Technical Controversy (Washington, DC: Communications Press, 1981); and Nick F. Pidgeon, Roger E. Kasperson, and Paul Slovic, The Social Amplification of Risk (New York: Cambridge University Press, 2003).

45. Pew Research Center’s Project for Excellence in Journalism, “The State of the News Media 2004,” www.stateofthemedia.org/2004 (accessed August 2012).

46. Paul Coelho, “The Internet: Increasing Information, Decreasing Certainty,” Journal of the American Medical Association 280, no. 16 (1998): 1454; Lee Rainie and Susannah Fox, The Online Health Care Revolution (Washington, DC: Pew Internet & American Life Project, 2000).

47. Pam Rajendran, “The Internet: Ushering in a New Era of Medicine,” Journal of the American Medical Association/MSJAMA 285, no. 6 (2001): 804; A. Risk and C. Petersen, “Health Information on the Internet: Quality Issues and International Initiatives,” Journal of the American Medical Association 287, no. 20 (2002): 2713–15; Scott Lafee, “Mental Blocked Parents and Researchers at Odds over Treatment “San Diego Union-Tribune, January 9, 2002, F1.

48. Foreman, “Answers to Mysteries of Autism.”

49. Karen Thacker, “Parents Put Spotlight on Autism,” Los Angeles Times, August 2, 1999, AV4.

50. Scott Hilyard, “Some Are Seeing Correlation between Autism, Immunizations,” Copley News Service, December 12, 2001.

51. See, for example, May 8, 1999, snapshot of www.littleangels.org and April 16, 2001, snapshot of www.gti.net/truegrit, accessed July 2012 through the Internet Archive Wayback Machine (archive.org/web).

52. See, for example, October 16, 2003, snapshot of www.tacanow.org (Talk About Curing Autism), accessed July 2012 through the Internet Archive Wayback Machine. The same advice was given by Defeat Autism Now! and the National Vaccine Information Center, among others.

53. Steven Waldman and U.S. Federal Communications Commission, The Information Needs of Communities: The Changing Media Landscape in a Broadband Age (Durham, NC: Carolina Academic Press, 2011).

54. Jenny McCarthy, Louder than Words: A Mother’s Journey in Healing Autism (New York: Dutton, 2007), 11, 166.

55. Data taken from the New York Times Bestseller List Archive at http://www.hawes.com/pastlist.htm.

56. Wendy Kline, Bodies of Knowledge: Sexuality, Reproduction, and Women’s Health in the Second Wave (Chicago: University of Chicago Press, 2010).

57. Boston Women’s Health Book Collective, Ourselves and Our Children: A Book by and for Parents (New York: Random House, 1978), 215.

58. McCarthy, Louder than Words, 76.

59. Ibid., 40, 22.

60. Jenny McCarthy, Mother Warriors: A Nation of Parents Healing Autism against All Odds (New York: Plume, 2008).

61. “Jenny McCarthy and Holly Robinson Peete Fight to Save Their Autistic Sons,” Oprah Winfrey Show, September 18, 2007, http://www.oprah.com/oprahshow/Mothers-Battle-Autism (accessed July 2012).

62. An analysis of autism coverage in U.S. women’s magazines in the 2000s found that such coverage underscored mothers’ unique and all-consuming role in caring for their children, as well as the need for them to trust in the power of their instincts. Clarke, “Representations of Autism in U.S. Magazines.”

63. McCarthy, Louder than Words, 200.

64. “Jenny Mccarthy’s Autism Fight,” Larry King Live, CNN, April 2, 2008. Transcript available at http://transcripts.cnn.com/TRANSCRIPTS/0804/02/lkl.01.html (accessed April 2009).

65. The parallels to 1982’s DPT: Vaccine Roulette (see chapter 5) are striking. Jon Palfreman and Katie McMahon, prod., “The Vaccine War,” Frontline (PBS, 2010). Full episode available online at http://www.pbs.org/wgbh/pages/frontline/vaccines/ (accessed June 2013).

66. “Jenny McCarthy and Holly Robinson Peete Fight to Save Their Autistic Sons.” For an extensive discussion of McCarthy’s vaccine activism, see Largent, Vaccine, chap. 5. Many thanks to the Spring 2013 participants in the Johns Hopkins University History of Science, Technology, and Medicine Colloquium for their insightful observations on this point.

67. McCarthy details some of these appearances in Mother Warriors.

68. “Jenny Mccarthy’s Autism Fight”; “Jenny McCarthy and Jim Carrey Discuss Autism; Medical Experts Weigh In,” Larry King Live, CNN, 2009, transcript available at http://transcripts.cnn.com/TRANSCRIPTS/0904/03/lkl.01.html.

69. Pew Research Center’s Project for Excellence in Journalism, “The State of the News Media 2004.”

70. See, for example, CNN News, March 4, 2004; NBC Evening News, May 18, 2004; and CBS Evening News, May 18, 2004; all VTNA.

71. Amy Wallace, “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All,” Wired, November, 2009, 128; reader comments by “Aloisius” and “richardlefew,” http://www.wired.com/magazine/2009/10/ff_waronscience/all (accessed June 2011, July 2012).

72. “Are Vaccines Safe?”

73. “Jenny McCarthy’s Autism Fight.”

74. See chapter 10 for more on this point.

75. Ibid. Gordon worked closely with McCarthy and authored the introduction to her 2008 book, Mother Warriors.

76. “The Vaccine War,” Frontline (PBS, April 2010), available at http://www.pbs.org/wgbh/pages/frontline/vaccines (accessed January 2012).

77. “Selfish,” Law and Order: Special Victims Unit, season 10, episode 19, April 28, 2009.

78. “The Vaccine War”; “Selfish.”

79. Robert F. Kennedy, “Deadly Immunity,” Rolling Stone, July 14, 2005, 57–66.

80. Jonann Brady and Stephanie Dahle, “Celeb Couple to Lead ‘Green Vaccine’ Rally,” ABC News.com, June 4, 2008, http://abcnews.go.com/GMA/OnCall/story?id=4987758 (accessed August 2012).

81. Mary Douglas and Aaron B. Wildavsky, Risk and Culture: An Essay on the Selection of Technical and Environmental Dangers (Berkeley: University of California Press, 1982), 10, 11.

82. Ulrich Beck, Risk Society: Towards a New Modernity (Los Angeles: Sage, 1992).

83. Sharon R. Kaufman, “Regarding the Rise in Autism: Vaccine Safety Doubt, Conditions of Inquiry, and the Shape of Freedom,” Ethos: Journal of the Society for Psychological Anthropology 38, no. 1 (2010): 22.

84. Ibid.

85. Some scholars have criticized Beck’s limited construal of the mass media and its role in the risk society. See, for instance, Simon Cottle, “Ulrich Beck, ‘Risk Society’ and the Media: A Catastrophic View?” European Journal of Communication 13, no. 1 (1998): 5–32.

86. “Summary of Notifiable Diseases—United States, 2010,” Morbidity and Mortality Weekly Report 59, no. 53 (2012): 1–111. On the decline of vaccine-preventable infections by this time generally, see S. W. Roush and T. V. Murphy, “Historical Comparisons of Morbidity and Mortality for Vaccine-Preventable Diseases in the United States,” Journal of the American Medical Association 298, no. 18 (2007): 2155–63; and Kate Yandell, “Vital Signs | Prevention: Chickenpox Down 80 Percent since 2000,” New York Times, August 21, 2012, D6.

87. The term “elimination” was chosen as an admittedly imperfect term by a panel of infectious disease specialists who debated about how to characterize this achievement. S. L. Katz and A. R. Hinman, “Summary and Conclusions: Measles Elimination Meeting, 16–17 March 2000,” Journal of Infectious Diseases 189, no. S1 (2004): S43–S47; W. A. Orenstein, M. J. Papania, and M. E. Wharton, “Measles Elimination in the United States,” Journal of Infectious Diseases 189, no. S1 (2004): S1–S3.

88. “Announcements: National Infant Immunization Week—April 21–28, 2012,” Morbidity and Mortality Weekly Report 61, no. 15 (2012): 278; CDC, “National, State, and Local Area Vaccination Coverage among Children Aged 19–35 Months—United States, 2009,” Morbidity and Mortality Weekly Report 59, no. 36 (2010): 1171–77.

89. A. E. Barskey, J. W. Glasser, and C. W. LeBaron, “Mumps Resurgences in the United States: A Historical Perspective on Unexpected Elements,” Vaccine 27, no. 44 (2009): 6186–95; “Mumps Outbreak—New York, New Jersey, Quebec, 2009,” Morbidity and Mortality Weekly Report 58, no. 45 (2009): 1270–74.

90. “Measles—United States, 2011,” Morbidity and Mortality Weekly Report 61, no. 15 (2012): 253–57; “Measles Outbreak Associated with an Arriving Refugee—Los Angeles County, California, August–September 2011,” Morbidity and Mortality Weekly Report 61, no. 21 (2012): 385–89; “Notes from the Field: Measles Outbreak—Indiana, June–July 2011,” Morbidity and Mortality Weekly Report 60, no. 34 (2011): 1169; “Notes from the Field: Measles Outbreak—Hennepin County, Minnesota, February–March 2011,” Morbidity and Mortality Weekly Report 60, no. 13 (2011): 421.

91. “Summary of Notifiable Diseases—United States, 2010.”

92. K. Winter et al., “California Pertussis Epidemic, 2010,” Journal of Pediatrics (2012).

93. “Pertussis Epidemic—Washington, 2012,” Morbidity and Mortality Weekly Report 61, no. 28 (2012): 517–22.

94. “Summary of Notifiable Diseases—United States, 2010”; P. A. Hall-Baker et al., “Summary of Notifiable Diseases—United States, 2008,” Morbidity and Mortality Weekly Report 57, no. 54 (2010): 1–92.

95. Barskey, Glasser, and LeBaron, “Mumps Resurgences in the United States”; “Update: Mumps Outbreak—New York and New Jersey, June 2009–January 2010,” Morbidity and Mortality Weekly Report 59, no. 5 (2010): 125–29.

96. P. Rohani and J. M. Drake, “The Decline and Resurgence of Pertussis in the U.S.,” Epidemics 3, nos. 3–4 (2011): 183–88; B. M. Kuehn, “Reports Highlight New Cause of Pertussis, Tickborne Illness, and Better Food Safety,” Journal of the American Medical Association 307, no. 17 (2012): 1785, 1787; C. R. Capili et al., “Increased Risk of Pertussis in Patients with Asthma,” Journal of Allergy and Clinical Immunology 129, no. 4 (2012): 957–63.

97. January Payne, “What Parents Need to Know about the Latest Vaccine News,” U.S. News & World Report, January 26, 2009, http://health.usnews.com/health-news/family-health/articles/2009/01/26/what-parents-need-to-know-about-the-latest-vaccine-news (accessed August 2012).

98. “Doctors Report Cases of Whooping Cough on the Rise,” Click on Detroit / MSNBC, January 19, 2009, http://www.msnbc.msn.com/id/20090128684205/ (accessed July 2012).

99. Campbell Brown, “Commentary: Get Your Children Vaccinated for Measles,” CNN Health, February 13, 2009, http://www.cnn.com/2009/HEALTH/02/12/campbell.brown.vaccine/ (accessed August 2012).

100. Editorial, “The Solution to the Rising Incidence of Pertussis: Vaccination,” Seattle Times, July 29, 2012, http://seattletimes.nwsource.com/html/editorials/2018791162_edit30pertussis.html (accessed July 2012); Kent Sepkowitz, “The Hack Is Back,” Newsweek, August 6, 2012, 11.

101. Reuters, “Most U.S. Kindergartners Getting Vaccines, Risks Remain,” August 23, 2012, http://www.reuters.com/article/2012/08/23/us-usa-health-vaccines-idUSBRE87M16820120823 (accessed August 2012).

102. Gary L. Freed et al., “Parental Vaccine Safety Concerns in 2009,” Pediatrics 125, no. 4 (2010): 654–59.

103. Liz Szabo, “Refusing Kid’s Vaccine More Common among Parents,” USA Today, May 3, 2010, http://usatoday30.usatoday.com/news/health/2010-05-04-vaccines04_ST_N.htm (accessed July 2012).

104. CDC, “Vaccination Coverage among Children in Kindergarten—United States, 2011–12 School Year,” Morbidity and Mortality Weekly Report 61, no. 33 (2012): 647–52.

105. Karin Klein, “Making It a Little Harder to Say No to Vaccination,” Los Angeles Times, August 24, 2012, http://www.latimes.com/news/opinion/opinion-la/la-ol-vaccine-bill-california-20120824,0,5816567.story (accessed August 2012).

106. Liz Szabo, “Childhood Diseases Return as Parents Refuse Vaccines,” USA Today, June 14, 2011, http://usatoday30.usatoday.com/news/health/medical/health/medical/story/2011/06/Childhood-diseases-return-as-parents-refuse-vaccines/48414234/1 (accessed July 2012).

107. Associated Press, “1 in 4 U.S. Parents Buys Unproven Vaccine-Autism Link,” FoxNews.com, March 1, 2010, http://www.foxnews.com/story/2010/03/01/1-in-4-us-parents-buys-unproven-vaccine-autism-link/ (accessed August 2012).

108. Paul Starr, Remedy and Reaction: The Peculiar American Struggle over Health Care Reform (New Haven, CT: Yale University Press, 2011).

109. Jill S. Quadagno, One Nation, Uninsured: Why the U.S. Has No National Health Insurance (New York: Oxford University Press, 2005); T. R. Reid, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care (New York: Penguin, 2009).

110. Mnookin, The Panic Virus.

111. “Why the Myth that Vaccines Cause Autism Survives,” On the Media, WNYC, May 11, 2012, http://www.onthemedia.org/people/seth-mnookin/ (accessed July 2012).

112. In May 2013, Mother Jones offered a rare corrective to the view that autism-fearing parents were solely to blame for rampant under-vaccination. Kiera Butler, “The Real Reason Kids Aren’t Getting Vaccines,” Mother Jones, May 2013, http://m.motherjones.com/environment/2013/05/vaccines-whooping-cough (accessed May 2013).

CHAPTER TEN

1. Lena Dunham, “All Adventurous Women Do,” Girls, season 1, episode 3 (HBO, 2012).

2. Cori Rosen, “‘Girls’ Fan to Get a Tattoo in Lena Dunham’s Handwriting,” Hollywood.com, June 10, 2013.

3. Not all HPV infections are pre-cancerous, and “scraping out” the cervix is not a treatment for HPV infection. See, for example, Roni Caryn Rabin, “TV Show ‘Girls’ Adds to the Muddle on HPV Testing,” New York Times, May 14, 2012, http://well.blogs.nytimes.com/2012/05/14/tv-show-girls-adds-to-the-muddle-on-hpv-testing/?_r=0 (accessed June 2013).

4. The streamlined process is reserved for drugs that represent a major new advance in treatment or that serve an unmet need. Priority review requests are typically made by drug companies. See Food and Drug Administration, “Fast Track, Accelerated Approval and Priority Review,” http://www.fda.gov/forconsumers/byaudience/forpatientadvocates/speedingaccesstoimportantnewtherapies/ucm128291.htm (accessed March 2011).

5. Committee on Adolescent Health Care and the ACOG Working Group, “Committee Opinion: Human Papillomavirus Vaccination,” Obstetrics and Gynecology 108, no. 3 (2006): 699–703.

6. Associated Press, “Panel Urges Approval of Vaccine for Cancer,” New York Times, May 19, 2006, 21.

7. CDC, “STD Prevention Counseling Practices and Human Papillomavirus Opinions among Clinicians with Adolescent Patients—United States, 2004,” Morbidity and Mortality Weekly Report 55, no. 41 (2006): 1117–20. In the committee’s first formal recommendations, they added that the “vaccine can be administered as young as age 9 years.” The committee also ruled that the vaccine should be made available to indigent and uninsured girls through Vaccines for Children. CDC, “Vaccines Included in the VFC Program,” June 29, 2006, http://www.cdc.gov/vaccines/programs/vfc/downloads/resolutions/0606vaccines.pdf (accessed March 2011); CDC, “Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP),” Morbidity and Mortality Weekly Report 56, no. RR02 (2007): 1–24.

8. Gardiner Harris, “Panel Unanimously Recommends Cervical Cancer Vaccine for Girls 11 and Up,” New York Times, June 30, 2006, 12.

9. Cynthia Dailard, “The Public Health Promise and Potential Pitfalls of the World’s First Cervical Cancer Vaccine,” Guttmacher Policy Review 9, no. 1 (2006): 6–9.

10. CDC, Eliminate Disparities in Cancer Screening & Management, http://www.cdc.gov/omhd/AMH/factsheets/cancer.htm (accessed December 2007).

11. National Conference of State Legislatures (NCSL), “HPV Vaccine: State Legislation and Statutes,” http://www.ncsl.org/default.aspx?tabid=14381 (accessed December 2007, January 2009, April 2011, and August 2012).

12. Virginia lawmakers made several subsequent attempts to repeal the mandate; none were successful. NCSL, “HPV Vaccine.”

13. Harris Interactive, “Seventy Percent of U.S. Adults Support Use of the Human Papillomavirus (HPV) Vaccine,” Wall Street Journal Online Health-Care Poll 5, no. 18 (2006): 1–8.

14. A smaller debate followed the announcement that the Department of Homeland Security would require the shot for all immigrant women between the ages of eleven and twenty-six, because immigration law required immigrants to get all immunizations recommended by the ACIP. The requirement was ultimately abandoned. See Associated Press, “Green Card Applicants Mandated to Get HPV Vaccine,” New York Daily News, October 3, 2008, http://www.nydailynews.com/latino/green-card-applicants-mandated-hpv-vaccine-article-1.299017 (accessed June 2013); and Associated Press, “Immigrant Seekers Won’t Have to Get HPV Vaccine,” USA Today, November 16, 2009, http://usatoday30.usatoday.com/news/health/2009-11-16-immigration-hpv-vaccine_N.htm (accessed June 2013).

15. Barbara Loe Fisher, “Speech Given at the March 8, 2007, Rally Sponsored by the Parents and Citizens Committee to Stop Medical Experimentation in D.C.,” National Vaccine Information Center, 2007, http://www.nvic.org/vaccines-and-diseases/HPV/fisherhpv.aspx (accessed April 2013).

16. Sigrid Fry-Revere, “Mandatory Vaccines Help Drug Firms, Not Necessarily Consumers,” Tampa Tribune, March 20, 2007; Sigrid Fry-Revere, “The Rush to Vaccinate,” New York Times, March 25, 2007, 9.

17. See, for instance, “Focus on the Family Position Statement: Human Papillomavirus Vaccines,” www.family.org/socialissues/A000000357.cfm (accessed December 14, 2007).

18. Laura Schlessinger, “Mandatory Testing for Cervical Cancer for Pre-Teen Girls? I Don’t Think So!,” February 9, 2007, www.drlaurablog.com/2007/02/09/mandatory-testing-for-cervical-cancer-for-pre-teen-girls-i-dont-think-so/ (accessed June 2013).

19. Gregory Lopes, “CDC Doctor Opposes Law for Vaccine; Cancer-Causing Virus Not Contagious Disease,” Washington Times, February 27, 2007, A1.

20. See, for example, Allan M. Brandt, No Magic Bullet: A Social History of Venereal Disease in the United States since 1880 (New York: Oxford University Press, 1985); and Dorothy Porter and Roy Porter, “The Enforcement of Health: The British Debate,” in AIDS: The Burdens of History, ed. Elizabeth Fee and Daniel Fox (Berkeley: University of California Press, 1988), 97–120.

21. See chapter 8.

22. On the history of struggles to define blame for cancer prevalence in the U.S. population, see James T. Patterson, The Dread Disease: Cancer and Modern American Culture (Cambridge, MA: Harvard University Press, 1987); Robert Proctor, Cancer Wars: How Politics Shapes What We Know and Don’t Know about Cancer (New York: Basic Books, 1995); Gerald Markowitz and David Rosner, Deceit and Denial: The Deadly Politics of Industrial Pollution (Berkeley: University of California Press, 2002); and Devra Lee Davis, The Secret History of the War on Cancer (New York: Basic Books, 2007).

23. On the rise of the anti-globalization movement, see Luke Martell, The Sociology of Globalization (Cambridge: Polity Press, 2010); and Saskia Sassen, Cities in a World Economy, 3rd ed. (Thousand Oaks, CA: Pine Forge Press, 2006).

24. Terrance Neilan, “Merck Pulls Vioxx Painkiller from Market, and Stock Plunges,” New York Times, September 30, 2004, http://www.nytimes.com/2004/09/30/business/30CND-MERCK.html (accessed June 2013); Marc Kaufman, “Merck Found Liable in Vioxx Case,” Washington Post, August 20, 2005, A1.

25. Fernando Meirelles, dir., The Constant Gardener (Focus Features, 2005).

26. John Le Carré, The Constant Gardener (New York: Scribner, 2001), 490.

27. Marcia Angell, The Truth about the Drug Companies: How They Deceive Us and What to Do about It (New York: Random House, 2004).

28. Greg Critser, Generation Rx: How Prescription Drugs Are Altering American Lives, Minds, and Bodies (Boston: Houghton Mifflin, 2005); John Abramson, Overdosed America: The Broken Promise of American Medicine (New York: HarperCollins, 2004); Ray Moynihan and Alan Cassels, Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All into Patients (New York: Nation Books, 2005); Jerry Avorn, Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs (New York: Knopf, 2004).

29. Stephen S. Hall, “‘The Truth about the Drug Companies’ and ‘Powerful Medicines’: The Drug Lords,” New York Times, November 14, 2004, Sunday Book Review, 1.

30. Jenny McCarthy, Louder than Words: A Mother’s Journey in Healing Autism (New York: Dutton, 2007). Data taken from the New York Times Bestseller List Archive at http://www.hawes.com/pastlist.htm.

31. Sigrid Fry-Revere, “Mandatory HPV Vaccines: Who Benefits?,” Cato Institute, December 14, 2007, http://www.cato.org/blog/mandatory-hpv-vaccines-who-benefits (accessed December 2007).

32. Fisher, “Speech Given at the March 8, 2007, Rally.”

33. MaryAnna Clemons, “So Why Does the State Want to Require HPV Vaccinations?,” San Francisco Chronicle, March 12, 2007, 7.

34. Steve Lawrence, “Vote Delayed on Bill Requiring Girls to Be Vaccinated against HPV,” San Francisco Chronicle, March 13, 2007, 1.

35. Schlessinger, “Mandatory Testing for Cervical Cancer for Pre-Teen Girls?”; U.S. Cancer Statistics Working Group, United States Cancer Statistics: 1999–2009 (Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute, 2013).

36. Courtland Milloy, “District’s HPV Proposal Tinged with Ugly Assumptions,” Washington Post, January 10, 2007, 1.

37. Elisabeth Rosenthal, “Cervical Cancer Vaccine Is Popular, but Fails to Cure Doubts,” New York Times, August 19, 2008, http://www.nytimes.com/2008/08/19/world/americas/19iht-vaccine.4.15437772.html?pagewanted=all (accessed December 2008).

38. Deborah Kamali, “Requiring a Vaccine for Young Girls,” New York Times, February 10, 2007, 14.

39. Bradford King, “The HPV Vaccine Debate—Gardasil: Beyond the Scope of Public Health,” Free Lance-Star (Fredericksburg, VA), April 22, 2007; Victoria Cobb, “HPV Legislation: A Train Wreck Waiting to Happen,” Richmond (VA) Times-Dispatch, March 23, 2007, A15; Rita Rubin, “Vaccines: Mandate or Choice?,” USA Today, February 8, 2007, 6D.

40. Cobb, “HPV Legislation.”

41. See, for example, Laura Smitherman, “Drug Firm Pushes Vaccine Mandate,” Baltimore Sun, January 29, 2007, http://articles.baltimoresun.com/2007-01-29/news/0701290104_1_vaccine-cervical-cancer-hpv (accessed December 2008); Elisabeth Rosenthal, “Drug Makers’ Push Leads to Cancer Vaccines’ Rise,” New York Times, August 20, 2008, A1; Lianne Hart, “Texas HPV Vaccine Mandate Meets Swift Resistance,” Los Angeles Times, February 27, 2007, A25; and Amanda Terkel and Ryan Grim, “Michele Bachmann Defends HPV Vaccine Comments, Goes after Rick Perry,” Huffington Post, September 22, 2011, http://www.huffingtonpost.com/2011/09/22/michele-bachmann-rick-perry-hpv-vaccine_n_977139.html (accessed June 2013).

42. Rosenthal, “Drug Makers’ Push Leads to Cancer Vaccines’ Rise.”

43. Merck, “Driving Growth with our Commitment to Vaccines,” 2007 Annual Review (Whitehouse Station, NJ: Merck & Co., 2007), http://www.merck.com/finance/annualreport/ar2007/home.html (accessed April 2011). In 2008 the company swept the Phame Awards, the Academy Awards of the pharmaceutical industry, based on the “creative excellence” behind its Gardasil campaign. Matthew Arnold, “Gardasil Tops at Annual Phame Awards,” Medical Marketing and Media 43, no. 6 (2008), http://www.mmm-online.com/issue/june/01/2008/823/ (accessed March 2011).

44. FDA guidelines issued in 1997 permitted direct-to-consumer advertising of prescription drugs through electronic media, including television for the first time. Meredith Rosenthal et al., “Promotion of Prescription Drugs to Consumers,” New England Journal of Medicine 346, no. 7 (2002): 498–505; Julie Donohue, Marisa Cevasco, and Meredith Rosenthal, “A Decade of Direct-to-Consumer Advertising of Prescription Drugs,” New England Journal of Medicine 357, no. 7 (2007): 673–81.

45. Michael Applebaum, “Life Gard,” Brandweek 48, no. 36 (2007): 1–7.

46. Deconstructions of Merck’s ads and its presentation of “risky girlhood” appear in Laura Mamo, Amber Nelson, and Aleia Clark, “Producing and Protecting Risky Girlhoods,” in Three Shots at Prevention: The HPV Vaccine and the Politics of Medicine’s Simple Solutions, ed. Keith Wailoo et al. (Baltimore: Johns Hopkins University Press, 2010), 121–45; Giovanna Chesler and Bree Kessler, “Re-Presenting Choice: Tune in HPV,” in ibid., 146–64.

47. Mary Engel, “Cervical Cancer Vaccine Gains Acceptance in California,” Los Angeles Times, February 18, 2009, http://articles.latimes.com/2009/feb/18/local/me-hpv18 (accessed April 2013).

48. J. A. Tiro et al., “What Do Women in the U.S. Know about Human Papillomavirus and Cervical Cancer?,” Cancer Epidemiology Biomarkers and Prevention 16, no. 2 (2007): 288–94.

49. “Merck & Co: The Marketing Machine Behind Gardasil,” PharmaWatch: Cancer 5, no. 7 (2006): 4.

50. “Gardasil Ads Remain Platonic . . . for Now,” Medical Market & Media 41, no. 7 (2006): 11.

51. Sheila M. Rothman and David J. Rothman, “Marketing HPV Vaccine: Implications for Adolescent Health and Medical Professionalism,” Journal of the American Medical Association 302, no. 7 (2009): 781–86.

52. Rosenthal, “Drug Makers’ Push Leads to Cancer Vaccines’ Rise.”

53. John Simons, “From Scandal to Stardom: How Merck Healed Itself,” Fortune, February 18, 2008, 94–98.

54. Arlene Weintraub, “Making Her Mark at Merck,” BusinessWeek, January 8, 2007, 64–65.

55. Beth Herskovits, “Brand of the Year: Gardasil,” Pharmaceutical Executive, February 2007, 58–70. Merck’s marketing efforts won widespread recognition; see also Arnold, “Gardasil Tops at Annual Phame Awards.”

56. See, for example, David Healy, The Antidepressant Era (Cambridge, MA: Harvard University Press, 1997); Jeremy Greene, Prescribing by Numbers: Drugs and the Definitions of Diseases (Baltimore: Johns Hopkins University Press, 2007); and Moynihan and Cassels, Selling Sickness.

57. Robert Aronowitz, “Gardasil: A Vaccine against Cancer and a Drug to Reduce Risk,” in Wailoo et al., Three Shots at Prevention, 21–38.

58. FDA guidelines issued in 1997 permitted direct-to-consumer advertising of prescription drugs through electronic media, including television for the first time. Rosenthal et al., “Promotion of Prescription Drugs to Consumers”; Donohue, Cevasco, and Rosenthal, “A Decade of Direct-to-Consumer Advertising of Prescription Drugs.”

59. Applebaum, “Life Gard”; Herskovits, “Brand of the Year: Gardasil.”

60. Sue Abercrombie, “Requiring a Vaccine for Young Girls,” New York Times, February 10, 2007, 14.

61. Ajantha Jayabarathan, “What about the Boys?,” Canadian Family Physician 54, no. 10 (2008): 1375. For a discussion of consumer-led demands to bring attention to HPV’s role in anal cancer, see Steven Epstein, “The Great Undiscussable: Anal Cancer, HPV, and Gay Men’s Health,” in Wailoo et al., Three Shots at Prevention.

62. CDC, “Recommended Immunization Schedules for Persons Aged 0 through 18 Years—United States, 2012,” Morbidity and Mortality Weekly Report 61, no. 5 (2012): 1–4. Gardasil had been licensed for females only, and not until 2009 was an HPV vaccine licensed for use in boys. Moreover, between the ACIP’s 2006 decision and its 2011 decision, evidence had accumulated to implicate HPV not only in cervical cancer, but also in vaginal cancer, penile cancer, and, in both sexes, anal cancer and head and neck cancers. Minutes from October 2011 Meeting, Advisory Committee on Immunization Practices, Department of Health and Human Services and Centers for Disease Control and Prevention, http://www.cdc.gov.proxy.library.emory.edu/vaccines/acip/meetings/meetings-info.html (accessed June 2013).

63. Heather Munro Prescott, “‘I Was a Teenage Dwarf’: The Social Construction of ‘Normal’ Adolescent Growth and Development in the United States,” in Formative Years: Children’s Health in the United States, 1880–2000, ed. Alexandra Minna Stern and Howard Markel (Ann Arbor: University of Michigan Press, 2005), 170; Heather Munro Prescott, A Doctor of Their Own: The History of Adolescent Medicine (Cambridge, MA: Harvard University Press, 1998).

64. Quotes collected from www.myspace.com; www.facebook.com; www.youtube.com, using search terms “gardasil,” “cervical cancer,” and “HPV,” December 2007.

65. Mollysevilfather, “You Could Be One Less,” http://www.youtube.com/watch?v=Yj7aSivwgvM (accessed September 2008).

66. wowTHATSfunny954, “A parody commercial for gardasil called shymali,” http://www.youtube.com/watch?v=fa6IEARWpiM (accessed September 2008).

67. logomojo529, “Guard Yourself Commercial,” http://www.youtube.com/watch?v=9YkAhd0xWzU (accessed September 2008).

68. The poster’s profile information is no longer available, but her comments can still be viewed at http://www.youtube.com/user/ThinkOneMore/feed (accessed June 2013).

69. Mary Jane Horton, “A Shot against Cervical Cancer,” Ms., Summer 2005, 65–66.

70. Cindy Wright, “Lifesaving Politics,” Ms., Spring 2007, 12–13.

71. Adina Nack, “Why Men’s Health Is a Feminist Issue,” Ms., Winter 2010, 32–35.

72. Approval Letter—Gardasil, October 16, 2009, BL 125126/1297, http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm186991.htm (accessed June 2013).

73. Meeting Minutes, Advisory Committee on Immunization Practices (ACIP) Summary Report, October 21–22, 2009, http://www.cdc.gov/vaccines/acip/meetings/minutes-archive.html (accessed June 2013).

74. J. J. Kim and S. J. Goldie, “Cost Effectiveness Analysis of Including Boys in a Human Papillomavirus Vaccination Programme in the United States,” British Medical Journal 339 (2009): b3884, doi: http://dx.doi.org/10.1136/bmj.b3884 (accessed October 2013). Specifically, male vaccination was not cost-effective when female vaccination levels were 80 percent or higher; below 80 percent, studies produced varying predictions of the cost-effectiveness of vaccinating males. See also “FDA Licensure of Quadrivalent Human Papillomavirus Vaccine (HPV4, Gardasil) for Use in Males and Guidance from the Advisory Committee on Immunization Practices (ACIP),” Morbidity and Mortality Weekly Report 59, no. 20 (2010): 630–32.

75. Jacob Goldstein, “Routine Gardasil Vaccination for Boys: Not Recommended,” Wall Street Journal Health Blog, October 21, 2009, http://blogs.wsj.com/health/2009/10/21/routine-gardasil-vaccination-for-boys-not-recommended/ (accessed June 2013); quote under “Comments.”

76. Jim Edwards, “Girls as Guinea Pigs: What the CDC’s ‘Gardasil for Boys’ Issue Says about Sexism in Medicine,” CBS MoneyWatch, November 1, 2010, http://www.cbsnews.com/8301-505123_162-42846288/girls-as-guinea-pigs-what-the-cdcs-gardasil-for-boys-issue-says-about-sexism-in-medicine/ (accessed June 2013).

77. William Saletan, “Sexually Transmitted Injection,” Slate, October 15, 2009, http://www.slate.com/articles/health_and_science/human_nature/2009/10/sexually_transmitted_injection.html (accessed June 2013).

78. Amanda Hess, “The Feminist Implications of Male Reproductive Health,” Washington City Paper, February 24, 2010, http://www.washingtoncitypaper.com/blogs/sexist/2010/02/24/the-feminist-implications-of-male-reproductive-health/ (accessed December 2010).

79. Saletan, “Sexually Transmitted Injection.” See also Epstein, “The Great Undiscussable.”

80. Epstein, “The Great Undiscussable.”

81. Meeting Minutes, Advisory Committee on Immunization Practices (ACIP) Summary Report.

82. A. B. Moscicki et al., “Chapter 5: Updating the Natural History of HPV and Anogenital Cancer,” Vaccine 24, no. S3 (2006): S42–S51.

83. A. B. Moscicki et al., “Updating the Natural History of Human Papillomavirus and Anogenital Cancers,” Vaccine 30, no. S5 (2012): F24–F33.

84. A. Jemal et al., “Annual Report to the Nation on the Status of Cancer, 1975–2009, Featuring the Burden and Trends in Human Papillomavirus (HPV)-Associated Cancers and HPV Vaccination Coverage Levels,” Journal of the National Cancer Institute 105, no. 3 (2013): 175–201. Liver, kidney, and thyroid cancers also increased.

85. Recurrent respiratory papillomatosis is characterized by benign growths in the respiratory tract; it affects men and women.

86. Meeting Minutes, Advisory Committee on Immunization Practices (ACIP) Summary Report. GlaxoSmithKline’s Cervarix was approved for use in October 2009. See Food and Drug Administration, “Approval Letter—Cervarix,” October 16, 2009, http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm186959.htm (accessed December 2009).

87. The research was conducted in collaboration with researchers from the CDC, the National Cancer Institute, and the North American Association of Central Cancer Registries. Jemal et al., “Annual Report to the Nation on the Status of Cancer.”

88. H. Mehanna et al., “Oropharyngeal Carcinoma Related to Human Papillomavirus,” British Medical Journal 340 (2010): c1439, doi: http://dx.doi.org/10.1136/bmj (accessed June 2013).

89. On the history of such collaborations, see, for example, John Patrick Swann, Academic Scientists and the Pharmaceutical Industry: Cooperative Research in Twentieth-Century America (Baltimore: Johns Hopkins University Press, 1988).

90. Dan Childs and Radha Chitale, “Farrah Fawcett’s Anal Cancer: Fighting the Stigma,” ABC News, June 27, 2009, http://abcnews.go.com/Health/story?id=7939402 (accessed April 2013).

91. “Farrah Fawcett’s Struggle with Anal Cancer,” FoxNews.com, June 25, 2009, http://www.foxnews.com/story/2009/06/25/farrah-fawcett-struggle-with-anal-cancer/ (accessed April 2013).

92. Val Willingham, “Oral Cancers in Women Rising, HPV Sometimes a Factor,” CNN Health, November 30, 2009, http://www.cnn.com/2009/HEALTH/11/30/oral.cancer.women/ (accessed April 2013).

93. Xan Brooks, “Michael Douglas on Liberace, Cannes, Cancer and Cunnilingus,” Guardian, June 2, 2013, http://www.theguardian.com/film/2013/jun/02/michael-douglas-liberace-cancer-cunnilingus; Deborah Kotz, “Throat Cancer and Oral Sex,” Boston Globe, June 10, 2013, http://www.bostonglobe.com/lifestyle/health-wellness/2013/06/09/michael-douglas-blames-throat-cancer-oral-sex-what-are-risks/Akb38cr5CCvj2HUKXJ5SCP/comments.html (accessed June 2013).

94. Matthew Herper, “At Our Throats,” Forbes.com, October 15, 2009, http://www.forbes.com/forbes/2009/1102/health-cancer-tonsils-virus-hpv-at-our-throats.html (accessed June 2013).

95. D. Forman et al., “Global Burden of Human Papillomavirus and Related Diseases,” Vaccine 30, no. S5 (2012): F12–F23.

96. “Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males—Advisory Committee on Immunization Practices (ACIP), 2011,” Morbidity and Mortality Weekly Report 60, no. 50 (2011): 1705–8.

97. Jemal et al., “Annual Report to the Nation on the Status of Cancer.”

98. In 2010, 32 percent of girls ages thirteen to seventeen were fully vaccinated against HPV; 48.7 percent had received at least one dose of vaccine. “Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males.”

99. Richard Knox, “Why HPV Vaccination of Boys May Be Easier,” Shots—NPR Health Blog, November 7, 2011, http://www.npr.org/blogs/health/2011/11/07/142030282/why-hpv-vaccination-of-boys-may-be-easier (accessed June 2013).

100. L. E. Markowitz et al., “Reduction in Human Papillomavirus (HPV) Prevalence among Young Women Following HPV Vaccine Introduction in the United States, National Health and Nutrition Examination Surveys, 2003–2010,” Journal of Infectious Diseases (2013), doi: 10.1093/infdis/jit192.

101. Press Briefing Transcript, CDC Telebriefing on HPV Prevalence among Young Women Following HPV Vaccination Introduction in the United States, NHANES, 2003–2010, June 19, 2012, http://www.cdc.gov/media/releases/2013/t0619-hpv-vaccinations.html (accessed June 2013).

CONCLUSION

1. A comprehensive and up-to-date overview of laws is available at http://www.immunize.org/laws/.

2. “Remarks by the President on Senate Passage of Health Insurance Reform,” White House Office of the Press Secretary, December 24, 2009, http://www.whitehouse.gov/the-press-office/remarks-president-senate-passage-health-insurance-reform (accessed June 2013).

3. “The Affordable Care Act: Secure Health Coverage for the Middle Class,” White House Office of the Press Secretary, June 28, 2012, http://www.whitehouse.gov/the-press-office/2012/06/28/fact-sheet-affordable-care-act-secure-health-coverage-middle-class (accessed June 2013). “Grandfathered” health plans are exempt from the requirement to provide all ACIP-endorsed vaccines at no cost. Non-grandfathered plans must provide the vaccines no later than one year after they become recommended by ACIP. Vaccines for Children remains in place under the law, as does Section 317, funding for which increased to $620 million in 2012. 317 Coalition, “FY 2013 Senate Labor HHS Appropriations Bill—Centers for Disease Control and Prevention—Immunization,” http://www.317coalition.org/update.html (accessed May 2013). For a complete discussion of the Affordable Care Act’s potential impact on immunization, see Alexandra M. Stewart et al., The Affordable Care Act: U.S. Vaccine Policy and Practice (Washington, DC: Department of Health Policy, School of Public Health and Health Services, George Washington University Medical Center, 2010).

4. CDC, “National, State, and Local Area Vaccination Coverage among Children Aged 19–35 Months—United States, 2009,” Morbidity and Mortality Weekly Report 59, no. 36 (2010): 1171–77.

5. Saad Omer et al., “Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases,” New England Journal of Medicine 360, no. 19 (2009): 1981–88.

6. Tara Parker-Pope, “Vaccination Is Steady, but Pertussis Is Surging,” New York Times, August 17, 2010, D1; Anemona Hartocollis, “Jewish Youths Are at Center of Outbreak of Mumps,” New York Times, February 12, 2010, http://www.nytimes.com/2010/02/12/nyregion/12mumps.html (accessed October 2011); Jennie Lavine, Aaron King, and Ottar Bjornstad, “Natural Immune Boosting in Pertussis Dynamics and the Potential for Long-Term Vaccine Failure,” Proceedings of the National Academy of Science 108, no. 17 (2011): 7259–64. Outbreaks of measles and mumps that occurred in the 1980s, by contrast, were attributed to falling immunization rates due to federal and state budget cuts for vaccine programs, or to vaccines that proved less effective in practice than they had in vaccine trials. See Melinda Wharton et al., “A Large Outbreak of Mumps in the Postvaccine Era,” Journal of Infectious Diseases 158, no. 6 (1988): 1253–60.

APPENDIX

1. The rotavirus vaccine, for example, is made from weakened cow rotavirus that contains segments of human rotavirus. Stanley Plotkin and Susan Plotkin, “A Short History of Vaccination,” in Vaccines, ed. Stanley Plotkin, Walter Orenstein, and Paul Offit (Philadelphia: Elsevier, 2008), 1–16.

2. Ibid.

3. Dorothy Porter and Roy Porter, “The Enforcement of Health: The British Debate,” in AIDS: The Burdens of History, ed. Elizabeth Fee and Daniel Fox (Berkeley: University of California Press, 1988), 97–120; Donald Hopkins, The Greatest Killer: Smallpox in History (Chicago: University of Chicago Press, 1983).

4. Norman Baylor and Karen Midthun, “Regulation and Testing of Vaccines,” in Vaccines, ed. Plotkin, Orenstein, and Offit, 1611–28.

5. Baylor and Midthun, “Regulation and Testing of Vaccines.”

6. Ibid.