In 1962, an anonymous woman had an abortion in Sweden. After the procedure, the fetus was taken, without the woman’s knowledge, to be used for medical research. It was first brought to the Karolinska Institute in Stockholm, where it was dissected. Then, the lungs were sent to the Wistar Institute in Philadelphia, where a young biologist named Leonard Hayflick used them in what became a momentous medical breakthrough. The cell line derived from the issue, WI-38, was used to make the measles, rubella, adenovirus, varicella, and rabies virus vaccines.

In her sweeping new book, The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease, physician and journalist Meredith Wadman tells the story of the early days of vaccinology, while focusing an unflinching eye on the troubled history that gave rise to some of our greatest medical achievements.

Wadman spoke with the New Republic about the development and legacy of vaccines, and their uncertain future under a president who has sympathized with the anti-vaccine movement.

Why do you believe this story needed to be told?

I stumbled on a letter to the editor in Science Magazine. It had been prompted because there had been a lot of attention on the HeLa cells. The book The Immortal Life of Henrietta Lacks involves these cancer cells that were taken without her knowledge from a dying African-American woman in 1951, became a tremendously important tool in medical research.

And so this letter to the editor came in from a scientist named Leonard Hayflick. And he said, “You know, the HeLa cells are getting all this attention around property rights and tissues, and whether people should be compensated when medical researchers use their leftover bits and pieces from surgery and turn them into lucrative inventions or medicine. But guess what, I derived this cell line called WI-38 back in 1962. And it has been used to make vaccines that have protected hundreds of millions of people. And what’s more, it came from an aborted fetus, and those cells became the subject of a big intellectual property fight and lawsuits between myself and the [National Institutes of Health] in the mid 1970s.” And I read this letter and I thought, this is fascinating. How has a book not been written about this?

And Mrs. X, whose aborted fetus gave rise to the WI-38 cells that are at the heart of the book and have been used to make so many vaccines—she never got credit. She was told only when researchers had to tell her that they’d used her fetus, several months after the fact. They went back to get her medical history to make sure that cells were clean and not infected and safe for vaccine making. So that’s how she learned. And she obviously never received a penny, like the Lacks family. Those are important object lessons. We need to make sure that that doesn’t happen.

I want to talk a little bit about changes in patent laws, specifically the 1980 Supreme Court case Diamond v. Chakrabarty that allowed the patenting of living organisms. And then following close after that the Bayh-Dole Act, which gave universities the power to patent their inventions that were funded by the government. How has the biotech industry changed because of those changes in patent laws?

Yeah, well the industry was virtually created by the combination of the Bayh-Dole Act and the Chakrabarty decision, because suddenly university researchers were incentivized to commercialize their inventions because part of Bayh-Dole said, not only can the university have title in this, but as a condition of that they have to direct some of the proceeds back to the individual researcher personally. That was attractive. So researchers were asked to do this 180 degree reorientation: they went from, “you should only work for the greater good in science,” and then they were asked to suddenly become scouts for the next commercial opportunity. Today it’s like sort of a badge of honor if you’re out there spinning off a company based on your “university-funded research.”

I was aware of the much more lax ethical standards in science 50-60 years ago, but I wasn’t aware of some of the horrors that you reveal in your book—I mean, experiments on the disabled, orphans, prisoners, newborns. What were some of the most surprising things you learned?

I can tell you I was just as surprised as you. I knew that there had been Tuskegee, and some human radiation experiments, or even the Guatemala studies that were revealed a few years ago. But I didn’t realize that those were not particularly exceptional. I mean they were heinous examples, but this use of people who were powerless not to consent was common throughout medical research. And not common in the sort of outliers group, but among esteemed scientists, people like Jonas Salk who, largely from WWII to the mid ’60s and even in some cases into the ’70s, were using these populations you describe.

So I learned that the rubella vaccine that has protected US infants since 1979 was developed in an orphanage on 1- and 2-year-old toddlers. They were tested. The first time this vaccine was put in human beings was in these orphans, parentless infants. The NIH funded these experiments. Major hospitals conducted them. Eyebrows were not raised. This was normal.

So it’s terribly sobering and you look back and think, how did this happen? And you wonder in 30, 40, 50 years down the road for us what are people going to be looking back at and saying, how was this allowed?

In the past few years there’s been an uptick in anti-vaccine rhetoric. Where is this coming from? Are you worried about the future of vaccines in America?

Yes, I am. And I think it’s coming from a vocal minority that’s feeling empowered by the current occupant of the White House and the general political atmosphere in the country. And I also think it’s coming because vaccines are a victim of their own success. You do not see the diseases that they protect against precisely because we vaccinate against these diseases. So young parents are not seeing children in iron lungs with polio. They don’t know people who just lost a toddler to diphtheria or to measles when it invaded the toddler’s young lungs and caused pneumonia. The fear factor isn’t there.

And then there is the really false and incredibly damaging paper in 1998 that was retracted by The Lancet that claimed that the measles, mumps, rubella vaccine, in particular, caused autism. It has been roundly debunked. But that has taken root as a sort of alternative fact. It’s terribly problematic, not only because those people’s children are not protected but because that then sets an example for parents who may not be dug in and totally opposed to vaccines. They’re called vaccine-hesitant parents. They see the non-vaxxers’ kids and think, well if they’re not getting sick, then it’s probably safe for my kid. Well, you start dipping below 90 percent—or even 95 percent, with a wildly contagious disease like measles—in terms of vaccination coverage, and you get into serious problems.

I think it’s really, really important to respond, yes with emotion, but primarily with evidence and with education. And I think the most effective venue for that is in a pediatrician’s office. I don’t think sort of water cooler arguments or cocktail party arguments between anti-vaxxers and vaxxers will do anyone any good. It’s sad to think, but I hope it doesn’t take some really horrible outbreak to push the hesitant into the vaccinating camp.

We’ve all but eradicated many of these diseases, but if vaccination rates dip low enough, is a countrywide outbreak still possible?

Yes, it’s definitely possible again if vaccine rates dip low enough. Absolutely. That’s why there’s got to be a really strong response to the anti-vaxxers. Measles in particular, because it’s so contagious. And it’s no joke. A healthy kid might have the rash and be miserable, but for a kid with leukemia or some kind of immune deficiency, measles is often a deadly event for them. That’s the end. Pregnancies too, I mean stillbirths, miscarriages can happen if moms get the measles. I’m informed partly by watching toddlers die in South Africa, when I was in medical school, for lack of a measles vaccine, because when they’re sick it invades their lungs and they die of pneumonia. So I remember those bad old days from having worked in Africa, but I’m sure that elderly people remember the bad old days from this country.

The administration has walked back some of its anti-vaccination comments, but the climate research field hasn’t been so lucky. There have been reports of rogue scientists working night and day to protect precious climate data against Trump. Is there a contingency plan among vaccine scientists?

What they’re trying to protect in terms of climate science is all on EPA and other government servers, and so it’s on government websites, and it’s been accumulated by government research agencies. But the vaccine scene would be a bit different because the trials conducted and the data would all be in the medical literature which is not controlled in the same way that say the National Oceanic and Atmospheric Administration website, that has gathered temperature data for decades, is. So I don’t know that preserving data is going to be a threat to the vaccine community or community of vaccine scientists. I think it’s more a battle for hearts and minds. That’s going to be where this is being fought.