I often feel like there is a production line somewhere (possibly Florida) where anti-vaccine propaganda documentaries are quickly assembled and released on social media to garner millions of views. The recipe is fairly simple: weave in interviews of the same handful of prominent anti-vaccine activists with emotional appeals from parents whose children were “never the same” after receiving their shots. But I would be hard pressed to name many pro-vaccine documentaries.
The movie Virulent: The Vaccine War, written, directed and edited by Tjardus Greidanus, had almost wrapped when COVID-19 happened. Greidanus is no stranger to medical documentaries, having directed a film about the first successful liver transplantation and another one about Jonas Salk’s polio vaccine. Virulent is about vaccine hesitancy, and while many of us thought this fear had died down substantially in recent years, our current pandemic showed us otherwise. The embers of vaccine hesitancy never die out. New life can easily be breathed into them by the loud proclamations of anti-vaccine activists.
Virulent paints an accurate portrait of the modern anti-vaccine movement—vociferous, hot-blooded, and blinded by selfishness—while addressing the biggest problem vaccines have: their success has turned the fiends of polio and measles into mythical creatures many modern parents do not take seriously.
Not my problem
The documentary relies on physicians, journalists, mothers, and vaccine advocates to illustrate the characteristics of anti-vaxxers in the post-Wakefield era. Pushback against vaccination has existed as long as vaccines have been around: ethicist Arthur Caplan reminds us that when cowpox was used to develop immunity against the much more dangerous smallpox, some people rebelled, worrying that the vaccine would turn them into a cow. But it was Andrew Wakefield’s now-discredited 1998 study that solidified the anti-vaccine movement into its modern incarnation. And what a terrible and fraudulent study it was, with some of the children’s parents having been recruited by a lawyer who wanted to find something wrong with the combined measles-mumps-rubella vaccine in order to sue vaccine makers. Dr. Paul Offit, who helped develop the rotavirus vaccine, makes the following remark in Virulent: “There were 13 authors on that paper and eight study subjects. Just as a tip to future epidemiologists: you should always have more study subjects than authors.”
Wakefield’s shoddy work was then given a face in actress and model Jenny McCarthy, who infamously told Oprah Winfrey that her autistic son Evan was “her science,” blaming childhood vaccinations on his condition. This personal story opened the floodgates for a movement now bathed in parental anecdotes. The dual urges for purity and liberty, meanwhile, give sustenance to its activists, who use the appeal to nature to decry the unnaturalness of vaccines and who gleefully tear down their social contract. As Cori Gentry, a birth instructor, summarizes in the movie, some parents think, “Well, I’m not going to expose my child to something that I perceive as harmful because your child has a compromised immune system. That’s your responsibility to limit any kind of exposure.” As warm of an embrace as vaccine hesitant parents can feel in the arms of an anti-vaccine movement that validates their anxieties, the ultimate callousness of a community that sees the vulnerabilities of some children as “not my problem” is becoming hard to ignore.
Virulent also spends time at the top of the pyramid, pointing out the de facto leaders of the movement who seem to be making a lot of money on the anti-vaxx circuit. There’s Dr. Bob Sears, whose unscientific vaccine schedule has caused parents to postpone life-saving vaccines out of fear that too many shots would overwhelm their infant’s immune system. There’s Del Bigtree, a filmmaker who famously adopted the yellow Star of David to appropriate persecution from the real victims of the Holocaust. There’s Larry Cook, whose “Stop Mandatory Vaccination” Facebook group trained new anti-vaccine activists. And finally, there is Robert F. Kennedy, Jr., whom the director interviews for the movie. Kennedy says the word “anti-vaccine” is pejorative and is used to discredit or silence his people. Meanwhile, he openly calls Dr. Offit “a charlatan and a crook” in front of the camera, saying “he is Big Pharma, he’s their chief spokesman.” I’m not sure what interviewing him achieves. The movie thankfully does not promote false balance. Kennedy’s few seconds on screen, though, seem unnecessary.
I already know how Virulent will be denounced by the very movement it criticizes. Its adherents will say that Kennedy’s important points were cut out in the editing, that he was made to look like a fool on screen. They will blast the editors for giving Dr. Offit too much time to speak and will condemn Offit’s role as medical advisor in the movie. The presence of journalists from “the mainstream media,” like Brandy Zadrozny and Kevin Roose, will likewise be a reason for some to dismiss the film. And the fact that the Jewish Healthcare Foundation generously supported the making of the documentary will raise an anti-Semitic eyebrow or two. These grand conspiracy theories are alive and well, unfortunately. Julie Broida appears on screen as a woman who opposes California vaccination laws. She talks of families who, long ago, figured out a way to control the United States. She clarifies, “a section of Jews, maybe they would fall more into, like, [a] cabal. I don’t think ‘all Jews.’”
Virulent is not going to change the minds of people like Broida and Kennedy. Rather, it was made for the vaccine hesitant, and it uses an anti-vaccine trick against that same movement.
The power of storytelling
Those who oppose vaccines rely almost exclusively on personal testimonials that confuse one thing happening after another—a diagnosis of autism after a childhood vaccine, for example—for evidence of causation. Because vaccines are victims of their own success, Virulent invites parents to tell the stories of their child who died of a vaccine-preventable illness.
Jessica Rowlette’s son, Joey, spiked a fever while attending school. His paediatrician said it was just the flu, so Jessica took Joey home to rest and get hydrated. He started projectile-vomiting, then became ice cold. An ambulance arrived in the morning. On the way to the hospital, Joey had a heart attack. He flatlined in the emergency room and died. A title card reminds us that in 2019-2020, a total of 52,000 children were hospitalized with the flu. The vaccine against influenza is not mandated for school attendance. Jessica Rowlette and her children now volunteer at their local flu shot clinic to listen to people and to share Joey’s story with them.
Children have died needlessly from diseases against which we already have good protection, while other kids were harmed and died in the attempt to show that those protections were safe and effective. Dr. Offit reminds us in the movie that there is a price for knowledge. Jonas Salk’s polio vaccine was tested in a randomized controlled trial. 420,000 children were to receive the vaccine, while 200,000 were set to get a placebo. We remember the outcome of this trial—that the vaccine was “safe, potent and effective,” as Dr. Thomas Francis, the trial’s director, proclaimed—but we easily forget what happened to the children in the placebo group. Sixteen of them died from polio and 36 were left permanently paralyzed after catching the virus, all in the placebo group. We know the vaccine works because these children did not receive it.
It is phenomenally frustrating to still see so many people hesitant in the face of one of the most effective public health measures ever developed. Hopefully, Virulent can assuage some misplaced anxieties and counteract the anecdotal fearmongering of the anti-vaccine movement with affecting stories of its own.
Virulent: The Vaccine War is not currently available for rental. The website Science-Based Medicine recently held an eleven-day virtual screening. Screenings can be requested for conferences, hospital grand rounds, and school courses. I look forward to this science education tool being more widely available. People need to see it.
P.S.: The documentary spends some time going over an unprecedented digital attack by anti-vaccine activists on a children’s hospital, overwhelming them with accusations and mass-downvoting their online rating. The hospital put together a toolkit on how to prepare for, defend against, and clean up after this kind of organized warfare. It is available here.