“… they would win the Nobel Prize for this …”

Andrew Wakefield in London, January 28, 2010, after the General Medical Council found him guilty of professional misconduct.

Andrew Wakefield, we now know, was one of the great Pied Pipers of our time. Unlike the rat catcher of Hamelin, however, Wakefield’s targets were parents desperately trying to find the cause for their children’s autism and, more importantly, those who were desperate to ensure that their children would not become autistic. Wakefield came up with a simple, readily understood, easily communicated explanation for the seeming epidemic of autism we now experience—vaccinations.

What explanation could be more viscerally satisfying? Vaccinations are scary enough in themselves. We see babies screaming in agony when they are injected. Parents never want to subject their children to it. And now, it seems, they can destroy the baby’s mind!

The sensation began in 1998 when Wakefield and 12 other medical doctors in the UK published A.J. Wakefield, S.H. Murch, A. Anthony, et al. (1998). “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children” 351 Lancet 637–41 (February 28, 1998) (the paper is made available free in various formats but free registration is required; note: Lancet formally retracted first part and then the entire paper). The claim the paper made was that there was an association among a certain form of “gastrointestinal disease,” “developmental regression in a group of previously normal children” and  possible “environmental triggers.” The triggers they suggested were the MMR vaccine in 8 cases and a measles infection in one other. Since the MMR vaccine is a combination the three live, but attenuated, viruses that cause measles, mumps and rubella, the suggestion meant one thing: the vaccinations, or indeed any small amount of a the measles virus, caused autism! The paper itself denied that it was drawing any such conclusions, but the chief author, Andrew Wakefield was promoted in a video press release, dated February 4, 1998 (before the formal release of the Lancet paper), issued by the Royal Free Hospital NHS Trust, and said that the 3-in-1 vaccine MMR should be suspended until further research was done.

This method—using a guarded (and frankly soporific) paper in a peer-reviewed journal—followed by public releases and interviews that go well beyond what the paper says—is a frequent technique of researchers who seek publicity with sweeping claims unsupported by evidence. Needless to say the video release as well as interviews that Wakefield gave proved sensational. The claim filled a void in understanding (what causes autism?) that parents needed. (Nature is not the only thing that abhors a vacuum.) Thus began the internet industry in equating vaccines with autism whether based on Wakefield’s original claim or others. (Mercury contamination is often used as the reasons vaccines are toxic in many internet scenarios.) In the wake of the report immunizations dropped substantially in the UK and the US. There was even a press row over whether Prime Minister Tony Blair had his son vaccinated.

It turns out, however, that Wakefield had overplayed his hand. The widespread scare prompted other tests which failed to replicate what Wakefield was claiming. In 2001 he was asked to leave Royal Free Hospital and eventually ended up in a research center in Austin, Texas. In January 2010, after an extensive hearing the General Medical Council of the UK struck Wakefield and fellow researcher John Walker-Smith off the list of authorized doctors in the UK but exonerated co-author Simon Murch. The decision was based on narrow procedural grounds—the failure to obtain informed consent and the undisclosed conflict of interest of Wakefield. This has allowed Wakefield to cavil at the findings and continue to follow his demons in the US. His chief supporter now is former Playboy model Jenny McCarthy, an actress whose resumé includes performing in the films “The Stupids” and “Witless Protection,” who even provided the Forward to a book by Wakefield. McCarthy’s sad bewilderment at the condition of her own child (who she called a “crystal child,” thus evidently not predisposed to development disorders) and her willingness to latch onto whatever answer she could (whether she understood it or not) is the perfect illustration of how Wakefield was able to create such a world-wide following. In response to the recent medical journal finding that Wakefield was guilty of deliberate fraud (not just malfeasance), McCarthy’s autism organization, Generation Rescue, issued a press release that the recent “media circus” was “Much Ado About Nothing.”

Brian Deer has a long history of award-winning investigations of the drug industry

Wakefield’s downfall was largely engineered by the highly respected investigative journalist Brian Deer in a series of articles in the Sunday Times. You can read the history of this “take down” (as Wakefield has called it, evidently thinking the term was pejorative to Deer’s efforts) in Deer’s own collection of reports, hosted here. It was the dogged pursuit of the conflict of interest that led Deer to unravel the fraud. Wakefield tried to stop Deer with a libel suit, but Wakefield was forced to withdraw it paying all of Deer’s costs.

On January 6 of this year the British medical journal BMJ began a series by Deer on the financial scheme that Wakefield planned. It shows that Wakefield was not simply shoddy or unethical. It paints the picture, as BMJ editor Fiona Godlee says, in no uncertain terms, of good, old-fashioned, money-grubbing “fraud.” The first article (but particularly the covering summary by Godlee) received a great deal of publicity. But it is part two of Deer’s series, published yesterday, “How the vaccine crisis was meant to make money” (in full here), that I highly recommend you read. It is in the first place one of the increasingly rare instances of meticulous investigative journalism. While all the attention in the reports of last week was on Wakefield, we should take a moment to admire something that we so rarely see. The internet has allowed, and indeed promoted, the kind of unthinking, self-important, “opinionating,” such as the ridiculous blogspot, evidently designed to run-down Deer himself, replete with juvenile cartoons and folksy attacks on Deer. While big-money “journalists” are constantly decrying the fact that their income, for repeating the same thoughts peddled by their peers, is threatened by the internet, there remain (at least for now) real journalists like Deer, who actually do the hard work to uncover information of public interest. In the second place, you should read the article because it is well written. And it is a story of greed that will warm the hearts of all those interested in understanding what motivates the great men of our time.

Deer shows that Wakefield planned the entire scheme while still in medical school, before he met any child claimed to have been affected by vaccines. It shows how he engineered the hiring by London’s Royal Free Hospital of pediatric gastroenterologist John Walker-Smith, while Wakefield was merely a researcher at the hospital. Wakefield was a man on a mission. He wanted Wakefield to prove his own theory—that Crohn’s disease was caused by infections from the measles virus, mainly from injections of the vaccine. Walker-Smith became a missionary. Wakefield’s quest was grand:

“You used to hear Wakefield’s people talking about how they would win the Nobel Prize for this,” remembers Brent Taylor, the Royal Free’s head of community child health, who frequently clashed with the pair. “The atmosphere here was extraordinary.”

It is a story of unethical “fishing” for patients, of preconceived “conclusions,” of hubris, of a scheme to rake in a fortune from a medical scare, and behind it all a lawyer, a home closing lawyer looking to bring a lawsuit against vaccination manufacturers. Plus the inevitable coverup. The whole thing is Dickensian in the breadth of its utter disregard for morality. It proves that Wakefield was not a deluded, but good-hearted, researcher, but rather one of the great Scientific Fraudsters of historic proportions. Up there with Lysenko and the perpetrator of the Piltdown hoax. The public health consequences of Wakefield’s fraud are sufficiently serious, however, that criminal prosecution should be considered, even if you don’t consider the financial fraud perpetrated on people like Jenny McCarthy, who financially supported Wakefield.

I urge you to read the piece and come to your own conclusion. Even Keith Olbermann might have to re-think his own knee-jerk reaction. Incidentally, in that regard, it might be time, especially after this week-end, for Olbermann to retire altogether his “Worst” in the world segment. The world really is a bit more nuanced than hit pieces allow for. (Since Olbermann causes one to think only in black and white, one can’t help wondering if Olbermann himself was affected by Murdoch disaffection syndrome: the Sunday Times is published by a subsidiary of New Corporation, owned by Murdoch.)

  1. I’m keeping a list of positive responses to the BMJ (Yes Wakefield is a fraud, and here are the implications…) and negative responses (Wakefield’s research IS TOO valid and vaccines cause autism anyway) at A roundup of responses to the BJM & Wakefield’s research was motivated by fraud.

    I’m updating the list to include reaction’s to today’s BMJ piece.

    Some observations
    1. The positive responses come from a broad range of sites — politically left and right; people who are skeptics/ people who have heretofore (to my knowledge) never commented on vaccines or autism before, and so on. The negative responses are from a predictable set of sites and people.
    2. The news coverage in the US has (perhaps inadvertently) perpetrated the idea that all parents of children with autism believe in the vaccine causation myth. It is a complete falsehood. Many parents of children with autism and adults with autism robustly reject the myth.
    3. Kev Leitch, whose daughter has intense autism, has a moving post on how Wakefield’s actions have damaged everyone affected by autism

  1. July 15th, 2013

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