Paul Offit : The Cutter Incident
Paul Offit, MD: Review of his book “The Cutter Incident”
Vaccines do so much good in the world, how come we don’t like them more? This question is answered in this book by Dr. Paul OffitDr. Paul Offit, an infectious disease specialist and vaccine expert. Dr. Offt traces the origin of today’s antipathy to vaccines to a horrendous incident during the 1950s in which thousands of people received polio vaccine containing live poliovirus.
Offit describes the development of polio vaccine, from trials of early vaccines through to the appearance on the scene of Jonas Salk. In 1951 Dr. Jonas Salk’s vaccine was licensed quickly thanks to political pressure, and during the next two weeks, five companies distributed about five million doses. Then came the problem: Thirteen days after the first doses were administered, there were reports of cases of polio in immunized children. All of these initial cases had received vaccine manufactured by one company-Cutter Laboratories). In the end, at least 220 000 people were infected with live poliovirus in Cutter’s vaccine (including 100 000 contacts of immunized children), 70 000 developed muscle weakness, 164 were severely paralyzed, and 10 died.
How did live viruses get into the vaccine?
Dr. Offit exlains in detail. The reasons included the use of a highly virulent strain (Mahoney), deficiencies in the inactivation of vaccine virus, inadequate safety tests, and poor communication with other scientists and the government. However, Cutter Laboratories was not negligent. It was doing all that the licensing authority required of it. Sixty lawsuits were subsequently filed. The first resulted in a verdict that “affected all pharmaceutical companies for the next fifty years.” The jury found that Cutter was not negligent in producing the vaccine, but had breached an implied warranty that their product was safe. The concept of liability without fault was born. In other words, companies were responsible for the effects of their products even when they were not negligent in their design or manufacture. Paul Offit goes on to reveal the large number of successful lawsuits that arose from this precedent. These led to the 1986 National Vaccine Injury Compensation Program, designed to protect companies from lawsuits not supported by scientific evidence. But the damage was already done. Despite the government program, pharmaceutical companies are abandoning vaccines. In 1957, 26 companies made five vaccines in the United States. By 2004 four companies made 12 vaccines. As a result vaccines costs more and development of new vaccines is slowed. In addition to being an acclaimed scientist and physician, Paul Offit is a good writer and The Cutter Incident is an enjoyable read, at times like a detective thriller, at others like a courtroom drama. The Cutter Incident tells and important story and tell its well. There can be no argument that vaccines have been a great benefit to humankind. This book shows how close we have come to putting one of our most effective public health tools in jeopardy.
