I want to thank all of those who have commented on this blog for their thoughtfulness and reason. In answer to some of your questions:
Regarding the scope of the book: One commenter asked if I had considered including material in the book that was not directly related to the vaccine-autism debate. Yes. The one area that I didn’t address was the history, scope, and impact of the anti-vaccine movement in the United States. There is probably no more powerful influence on how many parents make decisions about vaccines than that of the cynically named National Vaccine Information Center. This group, using a variety of scare tactics, consistently puts out misinformation about vaccines on their website. I would have liked to have spent some time in the book describing the origins of this group, their ties to personal-injury lawyers, and their influence on Congress.
Regarding the child on the cover of the book: One commenter asked why I had chosen to put an unclothed child on the cover, viewed from the back. This wasn’t my choice, but rather the choice of the art director at Columbia University Press. The drama of the picture owes to the fact that the child is viewed from the back (remember the picture of Babe Ruth viewed from behind, kneeling in the on-deck circle in his later years) and is exposed from the waist up. My concern with the picture is that one could argue that this child is too young to be reasonably given the diagnosis of autism spectrum disorder.
Regarding the recent ruling by the Georgia Supreme Court: On October 6th, 2008, the Georgia Supreme Court ruled in favor of a couple who wanted to directly sue vaccine makers on behalf of their autistic child, claiming that thimerosal in vaccines had been the cause. This ruling appears to be in direct contradiction to the National Childhood Vaccine Injury Act (NCVIA) of 1986, which protected vaccine makers from initial lawsuits against vaccines by creating a Vaccine Injury Compensation Program managed through a federal claims court. Previous appeals to state supreme courts in New York and Pennsylvania have failed to circumvent this Act. What some may not realize is that despite the NCVIA, a parent can still sue vaccine makers directly; they just have to wait until their case has failed both in this federal vaccine court and the court of appeals. The goal of the lawyers appealing to the state Supreme Court in Georgia was simply to skip a step. Historically, claims that have failed in the federal vaccine court and the federal court of appeals have fared poorly in state courts, so lawyers have been reluctant to take these cases. However, if lawyers can make their initial claims directly to juries in state courts, instead of first having to make them in front of federally appointed judges in federal vaccine court, they are more likely to win. All of this is very bad news for children. Vaccines are not big moneymakers for pharmaceutical companies. If this Georgia ruling stands–and parents directly sue vaccine makers without first going through the Vaccine Injury Compensation Program–we might end up right back where we were before the Program was created and manufacturers were on the verge of completely abandoning vaccines for American children. Again, the perceived rights of the individual will trump the rights of society.