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Vaccinated: One Man’s Quest to Defeat the World’s Deadliest Diseases
By Paul A. Offit, 256 pp, $26.95.
New York, NY, Smithsonian Books, 2007.
ISBN-13 978-0-0612-2795-0.
JAMA. 2007;298:1946-1947.
Maurice Hilleman has saved the lives of hundreds of thousands of children, and yet most people do not even know his name. Hilleman saved lives through the power of vaccination, having played a pivotal role in the development of many of the major vaccines currently in use. In Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases, Dr Paul Offit gives the reader a window into the key scientific advances that have led to the modern age of vaccines. Through a series of interviews with Hilleman himself, Offit shows a man of unique talent, drive, and perspective who was able to effectively translate basic scientific discoveries into livesaving vaccines, improving the lives of millions of individuals around the world.
The story begins on the eastern plains of Montana. Maurice Hilleman was born on August 30, 1919—but there were complications. His twin sister was stillborn, and his mother succumbed to eclampsia within 2 days after giving birth. Raised by his uncle just down the road from his father and other siblings, Hilleman developed the drive and unmistakably strong work ethic that propelled him forward for the rest of his life. As a budding scientist, Hilleman could have easily pursued a profession in academia, but in his own words, his desire to produce something of practical use drove him toward a career in the biopharmaceutical industry. As Hilleman put it, "I came off a farm. We had to do marketing. We had to do sales. I wanted to do something. I wanted to make things!" This drive to produce something of practical value would be the hallmark of Hilleman's career.
In his first position at Squibb, Hilleman learned the mechanics of vaccine production, specifically focusing on influenza. Later, at Walter Reed Army Medical Research Institute, he used that knowledge to create an influenza vaccine for the 1957 flu pandemic (the occurrence of which he had correctly predicted), saving thousands of lives. From Walter Reed, Hilleman moved on to become director of virus and cell biology at Merck Research Laboratories. From this position, he was able to achieve remarkable advances in both basic and applied vaccinology. In 1963, Hilleman isolated a strain of mumps from his daughter, Jeryl Lynn, which he used as the starting material for a vaccine (the Jeryl Lynn strain) that was licensed in 1967. More than 150 million doses of the Jeryl Lynn vaccine have been distributed in the United States, preventing nearly 1 million cases of mumps every year. As one reporter once wrote, "Jeryl recovered from mumps virus, but mumps virus never recovered from infecting Jeryl." Hilleman also partnered with other scientists to develop a measles vaccine, bringing this product to market in 1968. Interestingly, his farming background and Montana connections proved instrumental in the development of the first measles vaccine derived from avian leukemia virus–free chicken eggs. A vaccine against rubella, a leading cause of birth defects, came in 1969. Vaccines against hepatitis B and hepatitis A followed in 1981 and 1995. During this period, he also pushed for mass production of vaccines against pneumococcal bacteria, Haemophilus influenzae type b (Hib), and chickenpox. Hilleman was even the one who came up with the idea of combining the measles, mumps, and rubella vaccines into a single injection (ie, the current MMR vaccine) to reduce the number of injections faced by young children. In all, Hilleman was involved in the basic science or mass production of 9 major vaccines.
Even with his success, Hilleman's career and the emerging field of vaccinology as a whole were not without controversy. Many initial vaccine trials were performed in mentally retarded, institutionalized children, raising concerns about exploitation of vulnerable populations. Vaccines such as those for rubella and hepatitis A were prepared using human fetal cells, bringing condemnation from opponents of abortion. More recently, unfounded concerns over the MMR vaccine and the use of mercury-containing preservatives have fueled a fiercely debated controversy over childhood vaccines and their suspected links to autism. Although these potential associations have been refuted by several large and statistically valid studies, conspiracy theories continue to circulate on the Internet, and parents continue to worry—and, in some cases, refuse to vaccinate their children because of these unsubstantiated fears.
Hilleman was totally dedicated to his profession and expected the same devotion from those around him. Despite his gruff exterior, Hilleman earned the trust and devotion of his employees. At his core, Hilleman was only concerned about developing the best vaccines and did not particularly care about personal glory. In one instance, Hilleman became convinced that a rubella vaccine developed by a well-known vaccine researcher, Stanley Plotkin, was superior to his own. Plotkin recalled, "Maurice said . . . that it would be a good idea to replace his vaccine with mine. After recovering my faculty of speech, I readily agreed." Hilleman's willingness to sacrifice prestige in pursuit of the greater good earned him respect and recognition by the scientific community. Over the course of his career he earned numerous honors and awards, including election to the National Academy of Sciences and the Special Lifetime Achievement Award presented by the World Health Organization. Sadly, the Nobel Prize remained out of reach despite the lobbying efforts of many researchers. Although there are few scientists who have saved so many lives, one key member of the committee pointed out that the Nobel Prize in medicine would not be given to anyone who worked for a company.
Vaccinated is a compelling story, providing more than just a simple history lesson in vaccines. Offit brings interesting perspective to the characters of the time. In places, the story takes large detours that are only distantly related to Maurice Hilleman. However, these deviations (including stories about Edward Jenner, Louis Pasteur, and others) are intriguing and enjoyable to read. Offit ends by emphasizing the power of preventive medicine and hopes that the great strides in vaccinology, in large part due to Maurice Hilleman, will not fall to complacency and ignorance.
Financial Disclosures: None reported.
Mark K. Slifka, PhD, Reviewer;
Ian J. Amanna, PhD, Reviewer
Vaccine & Gene Therapy Institute
Oregon Health & Science University
Beaverton
slifkam{at}ohsu.edu
Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Contributing Editor.
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