Whack-a-Mole

Stuck: How Vaccine Rumours Start – and Why They Don’t Go Away 
by Heidi Larson.
Oxford, 157 pp., £18.99, September 2020, 978 0 19 007724 2

Anti-Vaxxers: How to Challenge a Misinformed Movement 
by Jonathan Berman.
MIT, 277 pp., £25, September 2020, 978 0 262 53932 6

In the late​ 1840s, the Hungarian obstetrician Ignaz Semmelweis oversaw two free maternity clinics in Vienna. The clinics accepted patients on alternate days. At the first clinic the mortality rate was 10 per cent; at the second, it was 4 per cent. The clinic with the low mortality rate trained midwives. The clinic with the high mortality rate trained medical students. Fear of the medical trainees’ clinic was so great that some women chose to give birth in the street – that way they could say they had been on their way to the clinic, and still receive free medical care for their baby. Even the women giving birth in the street had lower mortality rates than those giving birth at the clinic staffed by medical students. Semmelweis set out to discover the reason for this. He concluded that the medical trainees needed to wash their hands, like the midwives did. For this, he was dismissed as a madman.

Or rather, most doctors dismissed him as a madman. At his own clinic, the students adopted the new handwashing regime. Maternal fatality rates dropped dramatically. Semmelweis presented this evidence to the world. Again, his findings were rejected. When his term as clinic director ended, he wasn’t re-hired. He returned to his native Budapest, where he had to ask around even for poorly paid work (he eventually became professor of obstetrics at the University of Pest). He wrote a book on his research, hoping that, with all the data and arguments assembled, others would see what he saw. The book received poor reviews. He was portrayed as a man in the grip of an obsession, a man who wouldn’t stop talking about dying women.

He started drinking heavily. Even his wife began to complain about his obsession. He was often seen with a prostitute. He may have developed neurosyphilis, but this remains unclear. The maddening effects of professional and social rejection can’t have helped his mental state. In the summer of 1865, he was committed to an asylum, where he was beaten by the guards. He died shortly afterwards from infected wounds. Those infections could probably have been prevented if the guards had washed their hands. Mortality rates at the maternity clinics rose again after the handwashing regime was abandoned. Only some years later, in Germany, did it become common practice for doctors to wash their hands (they used chlorine).

In her introduction to Stuck: How Vaccine Rumours Start – and Why They Don’t Go Away, Heidi Larson describes her time as Unicef’s strategy and communications director for new vaccines, which overlapped with the 2003-4 boycott of the organisation’s polio programme in northern Nigeria. Rumours had spread that the vaccines caused sterility in children. During the fourteen months of the boycott, the Nigerian strain of the virus found its way to other African countries and then, via the Hajj, as far afield as Indonesia. Larson recognised the power of the rumours, and she also recognised that the fact they were untrue, and could be proved so, was an insufficient counterweight to that power. Her book, mostly written before the current pandemic, looks at what she calls the ‘ecology of rumours’. She argues that ‘understanding the contagion of not just viruses but also sentiments and beliefs is crucial to the future of vaccines.’