“Combined with the self-reinforcing nature of online communities and a content-starved, cash-poor journalistic culture that gravitates toward neat narratives at the expense of messy truths, this disdain for actualities has led to a world with increasingly porous boundaries between facts and beliefs, a world in which individualized notions of reality, no matter how bizarre or irrational, are repeatedly validated.”

In 2009, there were more than 13,000 cases of pertussis (whooping cough) in Australia. In 2010, the pertussis outbreak in California was so bad that some countries started warning their citizens about the dangers of traveling there. It still kills around 80,000 people a year globally. Most deaths are in Africa, where vaccination efforts are incomplete: increasing number of infections, however, also occur in the developed world, where there is no excuse. The reason, Mnookin argues, is increasing parental anxiety about vaccines.

Having read hundreds of scientific papers and thousands of pages of court transcripts for the book, Mnookin argues the evidence in favour of their use is decisive. Further, when children are not vaccinated it places those who cannot be, either because they are too young or have weak immune systems, at risk. Yet in many ways he is sympathetic to parents: overwhelmed by the flood of false information in the internet, they are understandably nervous about their child’s health. Instead, he places the blame on a media that prefers ‘neat stories at the expense of messy truths’ and the ‘charlatans and hucksters’ like Andrew Wakefield who have taken advantage of the fears of parents.

Scientists and the courts have been unequivocal in their support of vaccination, and Mnookin does a good job staying sympathetic to victims while sticking to the science. As he points out, critics of vaccines have often raised legitimately troubling questions insufficiently addressed by the medical community, but that somehow those critics have also decided they have the right to choose their own answer, instead of believing the science. The book thus reads not just as a discussion of vaccines, though it is comprehensive on that subject, but also as an examination of modernity and relativism in general. For anyone interested in the debate, I think there is no better reference on the issues of autism, a much needed counterweight to Oprah, Jenny McCarthy, and other well-meaning people whose advice puts children – and adults – at risk of serious harm.