Until recently, it was easy to scoff at parents who refused to vaccinate their kids. Paranoid, we would say. Most of us were raised on the notion that vaccines represent one of the greatest medical advances of modern times, sparing our families from crippling and often fatal diseases. Cast against that background, claims that vaccines cause everything from asthma to autism have been easy to counter.

But several recent reports promise to give the anti-vaccine movement a boost by pointing out that official immunization policies often have as much to do with politics as they do with science.

The nearly 20-year history of the hepatitis B vaccine is a case in point. Congress appropriated money to vaccinate low-risk infants against the disease but could not muster enough support to provide shots for the people who really needed them—IV drug users and inmates—according to Joshua Sharfstein, writing in The American Prospect (May 8, 2000).

Hepatitis B is a disease that, like AIDS, is caused by a blood-borne virus, but the hepatitis B virus is much more infectious than AIDS. Most people who get it—usually IV drug users and their sexual partners—recover after a nasty bout of jaundice and vomiting. But about 6 to 10 percent can’t shake the virus, which eventually destroys the liver.

In the 1980s, scientists developed a vaccine, and while it was popular with at-risk health care workers, they represent only a small portion of cases. "Other than advise physicians on whom to vaccinate, public health officials in the Reagan era did little to bring the hepatitis B vaccine to those most likely to contract the disease," Sharfstein writes.

In an attempt to address the problem, a Centers for Disease Control committee in 1991 considered a plan to immunize all children at birth and offer the shot to everyone treated for a sexually transmitted disease, according to Sharfstein. Only the shot for babies won approval that year.

Ironically, it was the anti-vaccine movement that brought the issue to light. Most vaccines do cause a small number of severe reactions. And many of the parents testifying before Congress last year blamed the hepatitis B vaccine for problems unlikely to be linked to it, Sharfstein notes. But the session raised questions about vaccination priorities. Eventually, universal infant vaccines will protect the entire country, but targeting high-risk groups as well would have worked much more quickly.