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Teenager Mackie Doyle has every reason to believe he's different. Iron, especially in blood, makes him sick. He cannot attend the church of his minister father. He also worries about the town whispers of the replacements of healthy infants by sickly ones who die young and fears he may one. Brenna Yovanoff's debut horror fantasy for young adults, The Replacement, follows Mackie's efforts to learn about himself, to survive and gain acceptance from his peers.

Mackie's parents have hidden his differences and try to compensate as best they can. His mother keeps knives well hidden. His father encourages him to emulate normal teenagers like his friends. Mackie has a strong bond with his loving sister Emma who provides care and mothering for him.

Fortunately, Mackie also has loyal supportive friends. His best friend Roswell, popular and accepted, never ridicules him and encourages Mackie to date the teen queen Alice to whom he's attracted. Two other friends, twins Danny and Drew, accept Mackie's quirks as they experiment with weird inventions.

An old coal town in Pennsylvania, Gentry, unlike surrounding towns, has always prospered. Some whisper about the haunted slag heap at the edge of town and mutter about the seven cycles of child deaths. Almost every family has been affected at some time. Yet no one seeks a solution until rebellious Tate, a friend of Mackie's, insists her sister was replaced.

Mackie grows weaker and more lethargic every day. Yet when a creepy local rock musician tells him he will die unless he seeks help from those who live in the slag heap, he rejects that suggestion. He wants no part of that weird world.

Meanwhile, Emma gets a tonic from a friend to save him. It works, but neither she nor Mackie know what the price for it may be. Without more of it, he sickens again. The slag people, source of the tonic, use threats against Emma to coerce him into serving them, which at first seems simple.

Alienation and feeling odd man out appears as common among young people and occurs in many young adult novels. However, Yovanoff's horror twist provides a good use of those themes. Astute readers will recognize the replacements as Changelings and the various myths associated with the seven year cycles of sacrifice and renewal.

Mild horror fans will love Yovanoff's well-crafted novel with its great atmospherics, especially the weird fairies and the living dead who are not vampires. Descriptions of gore and rotting dead may not satisfy those looking for deep horror, but will be acceptable to those who purchase materials for young adult and most readers.