Covering Vaccines

Around 8 p.m. on the evening of Dec. 23, 2009, my 12-year-old son and I were puttering around the house when there was a sudden, loud banging at the front door.

"I have legal papers for Amy Wallace," a brusque woman's voice said from the other side of the door when I asked who was there. I was startled. The voice sounded unpleasant. It was dark out. It was the night before Christmas Eve. I didn't feel like welcoming the voice in. Can you leave the papers outside, I asked? "Are you Amy Wallace?" barked the voice. "Uh," I said, hesitating, my head muddy. Who was sending me legal papers?

"I'm going to take that as a yes!" the voice said, and not in a friendly way. "I saw you through the window. Consider yourself served!"

A little more than two months before, the November issue of Wired magazine had hit newsstands. The cover story was "An Epidemic of Fear: One Man's Battle Against the Anti-vaccine Movement," and I had written it. In part, the story was a profile of Dr. Paul Offit, the co-inventor of the rotavirus vaccine and a leading proponent of vaccines for children. But the story also painted a portrait of a passionate movement led by people who believe vaccines injure and kill children. And on Dec. 23, one of those people sued me, Dr. Offit and Conde Nast, the company that publishes Wired, for one million dollars.

We'll get to the allegations of the suit in a second. But since I'm writing this for journalists, let me say this: getting sued for libel is just as big a bummer as you've always feared.

I've been a journalist for more than half my life. I have written for newspapers and magazines, I have been a reporter, an editor, a staff writer, an editor-at-large. Never before have I been a defendant. I am careful. I am meticulous. Above all, I work hard to be not just factual, but fair - to put bits of information in their proper context.

But here's the simple truth: If someone wants to sue you, they can. Easily, too. And Barbara Loe Fisher, the cofounder and president of the National Vaccine Information Center in Vienna, Virginia, the largest, oldest, and most influential of the watchdog groups that oppose universal vaccination, wanted to sue me. So she did.

Challenge your assumptions

I've been asked to offer advice in this essay to those thinking of writing about vaccines. My basic advice is the same as I'd offer to people interested in covering public schools or Congress or the environment. Learn everything you can about the topic. (The resource guide posted on USC's Center for Health Journalism Digital website is excellent in this regard). Challenge your own assumptions and be open to all points of view. Talk to lots of people and be willing to ask dumb questions. Then, take care to get every detail - big or small - right in print. And when I say right, I mean it in both the micro and macro sense. Context is everything.

But even as I ask you to bring the same rigor to every topic you choose, it must be acknowledged that writing about an emotionally charged issue like vaccines brings with it special challenges and is something to think carefully about. Like writing about abortion or animal rights, writing about vaccines inevitably raises the ire of certain readers. It is not for the timid. I'm not saying you have to be a fiery advocate. On the contrary. But you should go into the job with eyes open.

Autism's False Prophets, Dr. Offit's 2008 book, opened my eyes to the risks of reporting on vaccines. Before I began working on my Wired story I read it, focusing at first on his straightforward description of what being a vaccine advocate had cost him. He'd been vilified on the Internet as a profiteer, a prostitute who serviced Big Pharma, and worse. He'd been physically accosted. His life had been threatened. Once, an anonymous caller had even implied they might go after Offit's two children.

Shooting the messenger

What I experienced in the wake of my Wired story was similar in tone (although my child was spared). Like Offit, the vast majority of the feedback I received was positive, but the negative stuff would make your hair stand on end. As I blogged at the time, "Here are some of the questions I've been asked: ‘Do you believe in anything?' ‘Do you have children?' ‘You went to Yale?'

I've been called stupid, greedy, a whore. (You can read reader comments here.) I've been called the author of "heinous tripe." J.B. Handley, the founder of Generation Rescue, the anti-vaccine group that actress Jenny McCarthy helps promote, sent me an essay titled, "Paul Offit Rapes (intellectually) Amy Wallace and Wired Magazine." In it, he implied that Offit had slipped me a date rape drug. Later, he sent me a revised version that omitted rape and replaced it with the image of me drinking Offit's Kool-Aid. That one was later posted at the anti-vaccine blog Age of Autism.

On Thanksgiving of last year, as the furor seemed to be dying down a bit, the website Age of Autism - the same site that published Handley's "Kool-Aid" screed - posted a Photo-shopped portrait of me, Dr. Offit and several others who have written or reported on the vaccine issue (and not blamed vaccines for autism or numerous other maladies) sitting around a table, about to dig in to a holiday feast. The greeting on the card said, "Happy Thanksgiving from The Hotel California." Instead of a turkey, the main course we were about to dine on was a baby.

Still, until Dec. 23, I had this to be thankful for: no one had sued me. Then came the rapping at the door. Here is what Barbara Loe Fisher, who I'd described in my story as "the brain" of the anti-vaccine movement and as "a skilled debater who often faces down articulate, well-informed scientists on live TV," alleged in her suit: That a two-word quotation (Dr. Offit says of Fisher, "She lies.") constituted a false statement of fact about her that would cause people to conclude that she is not a person of honesty or integrity.  In this way, she alleged, I (along with Dr. Offit, and Conde Nast) had defamed her and caused her to appear "odious, infamous and ridiculous."

Here was the context within which the quote she objected to was placed:

Paul Offit has a slightly nasal voice and a forceful delivery that conspire to make him sound remarkably like Hawkeye Pierce, the cantankerous doctor played by Alan Alda on the TV series M*A*S*H. As a young man, Offit was a big fan of the show (though he felt then, and does now, that Hawkeye was "much cooler than me"). Offit is quick-witted, funny, and - despite a generally mild-mannered mien - sometimes so assertive as to seem brash. "Scientists, bound only by reason, are society's true anarchists," he has written - and he clearly sees himself as one. "Kaflooey theories" make him crazy, especially if they catch on. Fisher, who has long been the media's go-to interview for what some in the autism arena call "parents' rights," makes him particularly nuts, as in "You just want to scream." The reason? "She lies," he says flatly.

"Barbara Loe Fisher inflames people against me. And wrongly. I'm in this for the same reason she is. I care about kids. Does she think Merck is paying me to speak about vaccines? Is that the logic?" he asks, exasperated. (Merck is doing no such thing). But when it comes to mandating vaccinations, Offit says, Fisher is right about him: He is an adamant supporter.

On March 10, 2010, Fisher's lawsuit was dismissed on its merits. United States District Judge Claude M. Hilton issued a Memorandum Opinion that is better reading material than anything I will type here. Basically, he concluded that Dr. Offit's quote about Fisher was illustrative of the rough-and-tumble nature of the controversy over vaccines – and therefore worthy of mention in an article about that controversy.

So, we won. But not before thousands of hours (and countless dollars) were spent proving how fair the story was. This is the nature of the beast. And the beast doesn't tire, it seems, of taking whacks at those who dare to describe it.

A few weeks ago, Age of Autism caught wind of the fact that my Wired article is going to be included in the next edition of the annual compilation Best American Science Writing. The site promptly published a post. "Remember Amy Wallace? I sure wish I didn't," the writer began, adding: "For those lucky enough not to, I apologize for ruining your day."

The post then asserted that the inclusion of my Wired piece in the book was simply payback from the pharmaceutical industry. How, you may wonder, did they make that leap? Well, this year's collection is being edited by Dr. Jerome Groopman, the Harvard professor, scientist and writer. And according to Age of Autism, "Drug companies Immunex and Hoffman-La Roche have funded Groopman's research. He has authored a chapter on viral infection in a symposia published by Novartis, and has served on the speaker's bureau of Ortho Biotech, a subsidiary of Johnson and Johnson..."

They keep going in their list of supposed conflicts, but you get the idea. The point is this: When you enter the vaccine-thicket, one thing you can rely upon is that experts will be vilified. To the extent you attempt, with thorough reporting, independent research and cogent analysis, to become something of an expert yourself, you likely will be labeled a villain, too.

Do I regret my trip into the thicket? On the contrary. My Wired piece was a chance to contribute in a meaningful way to a discussion that must be had. The other day, a friend told me she'd heard about a mumps outbreak at a Los Angeles high school. Then, the morning that I finished writing this, the Los Angeles Times had a story about health officials' worries that an East Coast mumps outbreak was spreading to L.A.

Need I say any more?

Story Ideas

Here are some ideas to jump-start your reporting on vaccines:

1. The state of California has just declared whooping cough an epidemic, with 910 cases that have left five babies dead - a case load that is 400 percent higher this year than last. The state is on track to break a 50-year record. This bleak fact (which is true in an alarming number of other states as well) could be the jumping off point for a whole series of articles, from the history of the disease to how to spot pertussis in your children to explanatory pieces about herd immunity and why it's necessary to protect individual health by behaving responsibly as a community.

2. Canvass the research universities in your area for scientists who were interested in doing autism-related or vaccine-related research, but backed off because of the surrounding furor. (Paul Offit writes about this phenomenon in his book Autism's False Prophets.)

3. A recent study showed that more children suffered still-rare fever-related seizures when they received a combination vaccine for measles, mumps, rubella and chicken pox, rather than separating the vaccine into two doses. Find a pediatrician in your area who can talk anecdotally about this occurrence in his/her practice. It's the perfect way in to a story about the growing movement to space vaccines out instead of delivering them all at once.

4. Track down a Patient Zero in your community who was the start of an outbreak of a vaccine-preventable disease. This a very difficult assignment, given patient confidentiality, but potentially riveting and important.

5. The whole issue of research grants creating conflicts or the appearance of conflicts for scientists is a fascinating one. Here's a good primer on the issues.

Amy Wallace is a Los Angeles-based writer whose work has appeared in The New Yorker, Vanity Fair, GQ, Esquire, Wired, Elle, More, Men's Journal, the New York Times Magazine, The Nation and Conde Nast Portfolio, the business magazine where she was on staff as a senior writer from 2006 to 2009. Previously, she spent 14 years at the Los Angeles Times, first as a reporter and later as a Deputy Business Editor over entertainment and technology coverage. Her 2009 Wired magazine piece on vaccine panic, "An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All," will soon be published in The Best American Science Writing 2010.