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Helpful Information for Parents, Patients, Partners, and Providers

Helpful Information for Parents, Patients, Partners, and Providers

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Books About Vaccines and the Anti-vaccine Movement

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There are so many rumors flying around the world about vaccines, especially these days as the world anxiously awaits the development of a vaccine that will prevent COVID-19. How do these get started, and why is it so difficult to make them go away? That’s the subject of Stuck: How Vaccine Rumors Start and Why They Don't Go Away, by Heidi J. Larson (2020). The author is not an epidemiologist or a public health expert. She is a cultural anthropologist and Director of The Vaccine Confidence Project (VCP) at the London School of Hygiene and Tropical Medicine as well as a Clinical Professor, Department of Global Health, University of Washington,Seattle, WA. Professor Larson’s research focuses on the analysis of social and political factors that can affect uptake of health interventions and influence policies. Her particular interest is on risk and rumor management of vaccine development from clinical trials to marketing. She studies the various geopolitical, cultural, and religious factors that cause people to have doubts about vaccines, and explains how these lead to rumors that can spread very widely in a short period of time. Her background as an anthropologist sets this book apart from other books that explore the anti-vaccine movement. She acknowledges that misinformation and disinformation are a real problem, but her focus is on a lack of trust in institutions that lead to the rumors being started in the first place. Social media amplifies the spread of these rumors, but she argues that simply removing posts will not resolve the problem. It will only drive these rumors into other distribution systems. Emotions and decision making play key roles in why people develop a mistrust in vaccines, and science education alone will not solve this problem. The bottom line: it’s important to engage people and communities that have vaccine doubts, and not simply dismiss them.
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For another look at dealing with those who are opposed to vaccines, consider reading Jonathan M. Berman’s Anti-Vaxxers: How to Challenge a Misinformed Movement (2020). This book takes a historical approach, looking at the development of vaccinations and the opposition to the procedure that have sprung up again and again. He discusses the Britain's Vaccination Act of 1853 which showed that people are wary of Government mandates. The author focuses on how using social and behavioral research to craft messaging. This approach can be used to combat the onslaught of misinformation that many people are exposed to every day. Privilege enters the story as well. Many people don’t vaccinate their kids not because they opposed vaccines, but because they simply don’t have access or can’t afford them. The COVID-19 pandemic is clearly having a significant worldwide impact on vaccinations for multiple reasons: parents are afraid to take their kids into a doctor’s office; they’ve lost their jobs and can’t afford vaccines; doctors are afraid of taking vaccines into remote area because they are afraid of bringing the pandemic along with them. Also covered in the book are Andrew Wakefield’s movie Vaxxed; Robert F. Kennedy Jr.’s campaign against thimerosal in vaccines, promotion of alternative “more kid friendly” vaccination schedules, and how religious exemptions are used to avoid vaccination even though none of the world’s major religions have any prohibitions from using them.
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Although the anti-vaccine movement has been around since the start of vaccines, one paper alone is often attributed as the primary source of the anti-vaccine movement. That paper, and the man who wrote it, is the subject of The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines by Brian Deer (2020). The doctor was British physician Andrew Wakefield, and the paper was an article published in 1998 in the journal The Lancet that claimed that there was a link between the measles virus and the development of autism in children. The study was quite small and only included twelve children. Even though the paper made no causal claim of the vaccine and autism, Wakefield suggested at press conferences that giving the vaccine should be halted until more research on the project was done. What wasn’t known at the time was that Wakefield had ties to, and received money from, lawyers who were planning on suing the vaccine maker, and was planning on making money by developing a diagnostic test for this new type of “autistic enterocolotis” that he had supposedly discovered. He eventually was charged with fraud amid conflict of interest allegations. His paper was retracted by The Lancet in 2010, the same year he lost his license to practice medicine in the UK in 2010. The book details this story in great depth, and was written the investigative reporter who spent years exposing this fraud. This story has been well covered in the news, but Deer brings the entire story together and outlines the damages that arose from this single paper.
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Some people are beyond teaching and reaching because they’ve developed a mindset that won’t even allow them to reconsider their viewpoints. How and why does this happen? That’s the subject of Denying to the Grave: Why We Ignore the Facts That Will Save Us by Sara E. Gorman and Jack M. Gorman (2016). This book takes a deep dive into a very popular current subject: the rejection of facts and the marginalization of expertise. The primary focus of the book is in examining the psychological factors that control whether or not people choose to believe particular types of information. Included is a discussion of how the scientific method works for those who don’t have training in this process. The book is not a quick read, as there are a number of scenarios to ponder and reflect on. The authors fully admit that while understanding the reasons that people turn away from science (issues of health care are prominently featured in the book) is helpful, knowing this does not ensure that you can turn their thinking around. The book ends with a series of seven guiding principles explaining why people act this way, followed by six proposed solutions that may help us minimize this phenomenon. Consider reading if you’ve gotten tired of arguing about why climate change is real, or how vaccines save lives, with your Uncle Charlie or next door neighbor. It’s harder than sticking your fingers in your ears, but more useful if you hope to change some peoples minds.
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Want to know why you shouldn’t be getting your healthcare advice from Gwyneth Paltrow and her ilk? Are you planning on getting in front of the public to debate vaccines with anti-vaxxers in order to refute their messaging? That would likely be a very bad idea, as outlined in Paul Offit’s latest book Bad Advice: Or Why Celebrities, Politicians, and Activists Aren’t Your Best Source of Health Information (2018). Dr. Offit is a vaccine expert who led a successful effort to develop a vaccine against rotavirus (which can cause fatal diarrhea). This vaccine is saving the lives of hundreds of children across the world every day. This short book is a fast read and covers two basic ideas. About half of the book explains why the information coming from people with no training in medicine or science is at best mostly worthless, and at worst sometimes dangerous. He also shares very good advice for scientists who plan on engaging with the press to challenge this bad information. Offit’s advice is based on his (few) professional career missteps and is meant to guide you to effectively handle (or avoid) lawsuits, death threats, biased debate moderators, and ineffective arguments from those you engage with. It’s not just about arguing on social media. Engaging with vaccine (and public health) opponents has led to physical attacks in addition to online vitriol; some public health leaders have been driven from office during the COVID-19 pandemic. Bad Advice is an excellent source of good advice for navigating these dangerous waters.
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If you are looking for a detailed history of the anti-vaccine movement, a great place to start would be with Paul Offit’s detailed Deady Choices: How the Anti-vaccine Movement Threatens Us All (2011). The author is a well known vaccine expert who is credited with creating a safe and effective rotavirus vaccine that save the lives of hundreds of (mostly third world) kids every day. Vaccines discovered mostly in the 50’s, 60s, and 70s have brought most childhood illnesses under control. However, the viruses and bacteria that cause these diseases have not been eliminated (except for smallpox); they are hiding out in a variety of places, waiting for a chance to strike again. All that’s needed to start a viral firestorm is a group of unvaccinated children, and a single infected individual who acts as the match to set off an epidemic.It’s an excellent, fact filled resource that carefully refutes many of the false claims that vaccine opponents make. The book details a number of stories about the serious damage done to children who encountered viruses that they weren’t immune to, including measles, whooping cough (pertussis), and polio. Dr. Offit is careful to point out that even thought vaccines are safe, there are ways to make them even safer that should be undertaken. Parents who are considering not vaccinating their kids would do well to read this, and it provides many examples of the harms caused by infectious viruses and bacteria that doctors and other health care professionals can share with them.
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If you are looking for a more personal and philosophical take on the question whether or not you should immunize your children, take a look at On Immunity: An Inoculation by Eula Biss (2014). The book is essentially the author’s thoughts and mediations on the subject of vaccination. The book is not as science focused on the other ones on this page. If you’re looking for a factual resource there are better choices to be found. The attraction here is her ruminations on a variety of topics. She delves into her own thought process as she considers the consequences of vaccinating her child. How do we interact with the world? What are we afraid of, and why, and how can we overcome these fears? Fear is an especially important topic, given the increasing association of anti-vaxxers with groups that try to capitalize on this basic emotion. Be afraid of vaccines. Masks. Government mandates. Political leaders. 5G. World domination plots. Why people will accept as fact information that normally they might reject, except that it conforms to their world view and therefore has more credibility. Cultural issues of parenting decisions, our personal views of health, and how we envision ourselves in the world all enter into the mix. What responsibilities do we have to not share communicable diseases with each other? The author, who is not a scientist, makes clear that she is pro-vaccination and explains how she came to that decision. Very well written.
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Here’s a guide for doctors that was written to teach them about vaccines, and to advise them on current best practices to convince parents who are hesitant to vaccinate their kids to actually do so. Written by a family doctor, Let’s Talk Vaccines: A Clinician’s Guide to Addressing Vaccine Hesitancy and Saving Lives by Gretchen LaSalle (2020) strives to accomplish a number of tasks. The primary goal is to educate clinicians about the anti-vaccine movement, and to provide them with tools that can be used to convince parents that vaccines really are safe, effective, and will protect their children from dangerous diseases. It features a number of point:counterpoint arguments that can be employed to ease the concerns of hesitant parents who have been influenced by the anti-vaccine movement. The book also features sections about vaccine safety, how this is monitored by a number of different agencies, and a description of the various ingredients that go into vaccines. With so much vaccine misinformation circulating these days, this book should enable healthcare providers to provide counterarguments and give their patients the straight scoop about vaccines. The book also includes a number of useful appendices about vaccine preventable diseases, details about vaccines currently being used, and understanding graphical data. Though not specifically written for parents, this book would also be a good resource for parents seeking more information than is often found in office handouts.

Books About The Development of the Polio and Other Vaccines

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If you watched Ken’s Burns’s excellent PBS series The Roosevelts, and you want to know more about polio, check out Polio: An American Story by David M. Oshinsky. In the 1950s polio was the most feared disease across America. Parents would keep their children home in the summers when the virus struck most often, affecting mostly children and leaving some paralyzed and others dead. The virus would come and go in unpredictable waves. This book details the rivalry between two leading polio vaccine researchers, Jonas Salk and Albert Sabin, whose competition led them to despise each other for the remainder of their lives. Money to combat this disease was raised by asking all Americans to contribute just ten cents to help fund research into this terrifying disease. This was done under the auspices of the National Foundation for Infantile Paralysis, which was founded in the 1930s by Franklin Delano Roosevelt and Basil O'Connor. This organization revolutionized disease fundraising in the United States and was the first group to use “poster children” to rally Americans to participate in finding cure. The March of Dimes program was unique at the time, counting on a huge number of small contributions from everyday people rather than large checks written by wealthy benefactors. Also woven into the story is a portrait of Isabel Morgan, at talented polio researcher who might have beaten Salk to the an effective vaccine if she had not retired to raise a family. An engrossing story of science’s triumph over a terrible disease.
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In the early days of the polio vaccination effort problems cropped up that threatened to derail this hugely important public health breakthrough. Details about what went wrong and how this led to 200,000 people being injected with live polio virus are clearly recounted in The Cutter Incident: How America’s First Polio Vaccine Led to the Growing Vaccine Crisis by Paul A. Offit (2005). America was celebrating the discovery by Jonas Salk of an effective vaccine against polio, which was a parent’s worst nightmare in the 1950’s. However, this joy turned to sorrow when a batch of polio vaccine made by Cutter Laboratories wound up not being properly inactivated, resulting in the release of a number of doses that actually caused the disease. A number of different problems led to the failure to inactivate the vaccine. These included a change in the type of filters used in the inactivation step, and a lack of sensitivity in the analysis process that was designed to measure whether or not the virus had been killed properly. The Cutter company was sued in court, and the jury did not find Cutter negligent in the manufacture of the vaccine. However, Cutter was found to have violated the implied warranty for its product, and was forced to pay damages. This legal case set a precedent for liability without negligence, and that nearly destroyed the vaccine industry in the United States. This eventually led to the creation of the Vaccine Injury Compensation Program, in which claims against vaccine manufacturers are first arbitrated in “vaccine court.” This legislation allowed the industry to survive and thrive. This discussion is also tied into a legislation that can be used to protect manufacturers of potential pandemic vaccines against product liability claims, which of course is highly relevant as the United States, and the rest of the world, battle the COVID-19 coronavirus pandemic.
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Vaccines are in the news a lot lately, and The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease by Meredith Wadman (2017) gives you an inside look at how some of the early (1960s era) ones were created. The primary focus of the book is the creation of the rubella vaccine, with side trips to polio and rabies. Making vaccines (especially live ones) is really hard. You need to inactivate the viruses enough so that they’re not harmful, but not so much that they no longer can generate an effective immune response in the recipient. The star of the story is Leonard Hayflick, a scientist at the Wistar Institute in Philadelphia who created a cell line that has been used over the years to create a number of vaccines. He also figured out that normal cells, grown outside of the body, have a limited lifespan. Even with that limitation, an initial culture of WI-38 cells that he developed back in the 60s is still being used to make vaccines today. The book introduces us to giants of the vaccine field, including Maurice Hilleman, Stanley Plotkin, and Hilary Koprowski. You will enjoy this story if you want to learn how vaccines used to be made back in the day. The process was messy, and the book doesn’t shy away from reporting on serious ethical issues, such as doctors freely using orphans, poor babies, the disabled, and the incarcerated for many of the early vaccine test and trials. Such stories contributed to a lack of trust among many groups that continues through to today.
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Maurice Hilleman is a legend in the field of vaccines. Among the many accomplishments during his career was the development of not one, not two, but nine vaccines that are given to nearly every child. Most of this work was accomplished during a long career at Merck. Hilleman is credited with saving more lives than any other medical scientist of the 20th century, a remarkable accomplishment. These include the three vaccines that go into the modern MMR vaccine: mumps, measles, and rubella. Hilleman’s story is nicely recounted in Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases by Paul A. Offit (2008). Hilleman started his quest after his daughter, Jeryl, got the mumps as a child. Unlike most parents, he had the technical skills to try and develop a vaccine to make sure other parents would not have to watch their children go through the same thing. During World War II he worked with the military to help develop vaccines, including Japanese B encephalitis, to keep troops safe and on the battle field instead of the infirmary. Hilleman also played a role in the discovery of adenoviruses (that cause colds), the hepatitis viruses, and the potentially cancer-causing virus SV40.Overall, the book provides a good look at the history of modern vaccines. Paul Offit is also a vaccine researcher (he developed a life-saving rotavirus vaccine), and he has the ability to clearly explain to a lay audience what’s involved in the process of creating vaccines, and then testing them to make sure they are safe and effective.
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If you are looking for a basic book that covers the history of vaccines, a good choice would be Vaccines: What Everyone Needs to Know by Kristen A. Feemster (2017). The book, written for a lay audience, covers the following topics: a straightforward explanation of how vaccines work; a look back at the history of vaccines; and issues related to vaccine policy. How is it decided if a vaccine is needed, who it should be given to, and what is the appropriate age to do this? Feemster discusses the complicated process by which vaccines are manufactured.There are many different types of vaccines, including attenuated live virus vaccines, and those that are made against viral subunits. The book acknowledges that vaccine injuries do occur, and explains how these are tracked, what they are, and how infrequently they occur. It covers the alleged link that was found between the MMR vaccine and autism, and explains why that work turned out to be fraudulent and how it led to the doctor who had done it to lose his medical license. There’s a discussion about why some parents are hesitant to vaccinate their kids. It also takes a look at future vaccines, because there are still plenty of known viruses out there against which we still have no community immunity to (e.g. Zika, Chikungunya, and HIV). The author is is a pediatric infectious diseases physician and health policy researcher; her research focuses on how immunization recommendations are implemented, and the epidemiology of vaccine-preventable diseases.

Books About Pandemics and the Risks Posed by New Viruses

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If you want to read the most comprehensive book on the “Spanish Flu” pandemic, read The Great Influenza: The Epic Story of the Deadliest Plague in History by John M. Barry (2004). It’s also a key resource for understanding what people went through back then, and how that compares with what the world is experiencing COVID-19. The Great Influenza pandemic began in 1918 and ended in 1920. Worldwide, the virus approximately 20 to 100 million deaths in about a year. In the U.S., with about 105 million people at the time, the virus killed approximately 675,000 people. In contrast to COVID-19 and other viral disease such as the common flu, the 1918 pandemic was highly unusual because about half of the casualties were young men and women in their 20’s and 30’s. As many as eight to10 percent of all young adults may have died of influenza. The book exhaustively documents what live was like during the pandemic, and how different cities mounted different responses to it. Science and medicine were not nearly as advanced back then as they are now, which no doubt contributed to the high death toll. Written by a historian, the book details how politics and the military were involved with efforts to combat the disease since it occurred near the end of World War I. This is widely considered the most authoritative look at how a pandemic spreads and impacts society. The pandemic highlighted the need for a more rigorous public health system to be established in the U.S. Mask wearing and “social distancing” were widely adopted to combat the raging pandemic, and yes, there were folks who refused to wear masks back then as well.
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Do you like reading scary books? Put aside those Stephen King novels, which are so yesterday. You’ve got more important things to worry about than rabid St. Bernards or prom queens that have mastered psychokinesis. David Quammen’s Spillover: Animal Infections and the Next Human Pandemic (2012) is focused on explaining how how animal viruses have made there way into humans. For those who claim that there was no way to predict the COVID-19 pandemic, this book illustrates why the pandemic was not only predictable, it was pretty much inevitable. There are various routes that the viruses take to get into humans or other species. These include being infected by bat droppings, by eating or processing bush meat (animals killed in the wild for food), spread via wet markets (places where these animals are kept alive for sale and later consumption), and even by being bitten by a mosquito. Examples include viruses such as ebola, chikungunya, nipah, hendra, HIV, and coronaviruses, including the one responsible for causing COVID-19. The author goes out into the field with researchers to learn how they capture wild bats for testing to see what viruses they might carry. The book is well organized and very well researched and written. It covers the spread of HIV, SARS, Ebola, and a number of other infectious viruses, and is a modern detective story where scientists are looking for the smallest killers on the planet. Indeed, it is the scientists who come off as the heroes in this engrossing collection of viral tales.
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Pandemics are deadly serious disease outbreaks, and governments are forced to deal with them in a variety of ways. What exactly, are governments empowered to do to try and quell an outbreak? That’s the subject of John Fabian Witt’s American Contagion: Epidemics and the Law from Smallpox to COVID-19 (2020). Epidemics force governments to act, less the contagion overwhelm their borders and wreak havoc on their populace. This is done both by suggestions (e.g. wear a mask) to enacting laws that enable authorities to take steps to keep the population safe. Individual liberties must be balanced against the need to protect people from those among them who show no interest in stopping the spread of disease. The book is an historical look back at the different approaches employed to combat past pandemics. Two major strategies emerged: sanitation efforts to improve public health, and quarantines to separate those who have been, or are believed to be, infected. Minority and underprivileged groups were exploited by politicians in response to disease outbreaks. This included deliberately spreading disease to Native Americans, and by forcing Blacks to bury the dead during a yellow fever outbreak under the guise that they were immune to the disease. Specific minority groups (e.g. Chinese immigrants during a bubonic plague outbreak in San Francisco) have been quarantined while whites were allowed to travel freely in the city. Throughout history efforts have been directed to protect the elite or ruling class at the expense of the underprivileged. A very timely read.

Books That Explain Why Vaccines DON’T Cause Autism

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Want to read the true story about how the MMR vaccine is NOT associated with the development of autism? Pick up a copy of The Panic Virus: The True Story Behind the Vaccine-Autism Controversy (formerly titled The Panic Virus: A True Story of Medicine, Science, and Fear by Seth Mnookin (2011)). This was the first detailed look at the controversy that resulted from the publication of British doctor Andrew Wakefield’s paper in The Lancet in 1998 that suggested there could be some linkage between the MMR vaccine and the development of a new disorder in children he termed “autistic enterocolitis.” This paper, which was eventually retracted in 2010 as fraudulent, has led to a large number of studies that showed there is no association between ANY vaccine and the development of autism. The scandal around this paper led to Wakefield having his medical license stripped in the UK. He moved to the U.S. and became a darling of the anti-vaccine movement. Mnookin’s book takes a deep dive into the paper, it’s publication, and the ramifications that flowed out from that single seriously flawed study. It’s a gripping and cautionary story about how a single piece of flawed information was adopted by those in the anti-vaccine movement as a rallying point for their cause. It also helped spur the removal of the preservative mercury from vaccines, which was done not for scientific reasons, but to placate parents who were hesitating to vaccinate their kids. A well written and gripping story.
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I’ll also recommend Dr. Peter Hotez’s newest book Vaccines Did Not Cause Rachel’s Autism (2018). Hotez is a well established vaccine expert as well as the father of a 26-year-old woman with autism. This combination gives him some unique insights into debunking the “vaccines cause autism” viewpoint that arose following the publication of a badly flawed (and later retracted) paper by Dr. Andrew Wakefield. The book nicely weaves together two different narratives: one is the challenges (and there are many of them) of raising an autistic daughter (now an adult) who still requires a great deal of help from her parents. The other details a look at his Dr. Hotez’s academic career in vaccine development, along with a clear explanation for why vaccines don’t cause autism, full stop. Well-written by an authoritative source, this book serves as a guide for deconstructing the arguments of vaccine opponents by explaining why their various theories are simply not supported by facts. The book is an easy read, and even if you’re not interested in the science. It gives a heartbreaking view of the struggles he and his wife Ann endure in dealing with Rachel’s many problems, and their efforts to help her build a good life for herself.