The Doctor Who Killed

At this writing (December 2021), the headlines are filled with stories of bad behavior. Elizabeth Holmes’ fraud trial arising from the Theranos scandal is ongoing.  As is Ghislaine Maxwell’s sex trafficking trial. Jussie Smollett was just convicted of faking a homophobic attack upon himself, presumably to drum up sympathy and publicity. Josh Duggar was just convicted on child pornography charges. Chris Cuomo was just sacked by CNN for inappropriately helping his brother (former governor Andrew Cuomo) and lying about it. The former dean of the Temple University business school was recently convicted of fraud for fudging numbers to improve the school’s rankings. We could go on, but this list is depressing enough.

This post is prompted by the bad behavior of Dr. Andrew Wakefield, which arguably caused more harm than all the wrongdoers listed in the previous paragraph combined. And the harm continues today, because of its contribution to the anti-vaccine movement that is causing tens of thousands of needless deaths around the world and is pointlessly extending the pandemic.

We write often about the fact that good people sometimes do bad things and report on the behavioral ethics research that explores this phenomenon and looks for ways to minimize it. But there are some folks out there who appear to be just bad folks, and Brian Deer’s 2020 book The Doctor Who Fooled the World: Science, Deception, and the War on Vaccine certainly makes the case that Dr. Andrew Wakefield is one of those baddies.

Wakefield has a decades-long record of lying, defrauding, self-promoting, baselessly accusing others of wrongdoing that he himself was clearly guilty of, and generally attempting to line his own pockets at others’ expense. He has profited mightily from being the darling of the anti-vax set and the damage he has done is extensive.

Most seriously, in 1999 he published an article in the British medical journal The Lancet that purported to report a study based on twelve children that proved the measles, mumps, and rubella (MMR) vaccination was linked to “regressive” autism (where children who had been “normal” suddenly developed autism) and colitis, a disease of the gut. This “finding” caused more than a spot of bother in the UK and much trouble in the U.S. and elsewhere. Parents whose children suffered autism suddenly had lawsuits to file. Parents who worried about autism stopped vaccinating their children and measles made a comeback after being nearly eradicated. Wakefield boosted the anti-vaccine movement well beyond MMR.

Deer is an award-winning investigative reporter whose relentless reporting helped expose Wakefield’s wrongdoing. It would take a longer blog post than you haven time to read to detail it all, so let’s just focus on the study underlying the Lancet article which claimed to show that the measles virus in the MMR vaccine caused both autism and colitis (a condition Wakefield called “autistic enterocolitis”). Among other points to keep in mind:

  • Before the study ever commenced, Wakefield was already hired to be an expert witness for and being paid by an attorney intent upon suing MMR vaccine manufacturers and claiming that the vaccine caused autism. Wakefield never disclosed this whopping conflict of interest.
  • The research was essentially paid for by the law firm (though this was hidden), and Wakefield and the lawyer had drawn up a list of things they needed the study to conclude before the study was ever commenced.
  • Nor did Wakefield disclose that he was intent upon creating and patenting his own competing vaccine that would be quite a money maker if the existing MMR vaccines were put out of business.
  • Most of the twelve children who became part of the Lancet study were, contrary to representations, brought to Wakefield by parents already intent upon suing MMR manufacturers. Many of these parents had ties to the attorney paying Wakefield.
  • The Lancet article misdescribed the backgrounds, symptoms, diagnoses, or other aspects of the case histories of every one of the twelve children. Commonly, the article would represent that a child had manifested symptoms of autism within two weeks after receiving the MMR vaccine when, in fact, they had manifested such symptoms either before receiving the vaccine or many months after being vaccinated, or had, in fact, never been diagnosed with autism. Others subjects were misrepresented as having colitis, when they did not. Not one of the twelve subjects’ cases was accurately described in the Lancet
  • Wakefield did not disclose that his own lab had failed to find the measles virus genomes critical to his theory.
  • When other researchers could not replicate the article’s findings, the University College of London asked Wakefield to perform a “gold standard” study to replicate the findings of his 12-subject study and offered to fund it. He quickly agreed, but then never even started the study, despite repeated requests.
  • Although Wakefield listed several co-authors on the Lancet article, he was the sole true author. When the facts began to come to light, the other authors sought to retract the article. Wakefield refused.
  • When the facts came out, Wakefield continued to lie relentlessly in his attempts to deflect responsibility for his wrongs.

Like some people have difficulty accepting that they have lost elections, Wakefield has had difficulty accepting that he has lost his medical license and been erased from the medical register in England because of all the fraud underlying the Lancet article. He has continued to attend anti-vaccine rallies around the world, endlessly repeating his own “Big Lie,” reveling in the adoration of anti-vaccine protestors, and supporting himself with grants from wealthy anti-vaxxers. And still producing zero credible evidence to support his Lancet claims.

Is Wakefield a “good” person who did bad things? Or a “bad” person who did bad things? We will reserve judgment, but The Lancet’s editorial board seemed to think the latter:

Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.

Deer may be biased, because for more than a decade Wakefield played Moriarity to Deer’s journalistic Holmes, but his experience with Wakefield convinces him that The Lancet was correct in evaluating Wakefield’s character. Deer finds Wakefield “incapable of embarrassment” and possessing “no conscience.”

There can be no question that Wakefield’s article and subsequent false pronouncements have increased vaccine skepticism regarding the MMR vaccine and others, including the COVID-19 vaccine, although the true magnitude of the impact is difficult to quantify.

 

 

Sources:

Julia Belluz, “The Research Linking Autism to Vaccines Is Even More Bogus than You Think,” Vox, Jan. 10, 2017, at https://www.vox.com/2015/2/2/7965885/vaccine-autism-link-false-evidence-wakefield.

Brian Deer, “How the Case against the MMR Vaccine Was Fixed,” BMJ, 342:c5347 (Jan.6, 2011).

Brian Deer, The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines (2020).

James Fanelli, “Ghislaine Maxwell Accuser Describes Meeting Socialite at Epstein’s Ranch,” Wall Street Journal, Dec. 10, 2021, at https://www.wsj.com/articles/ghislaine-maxwell-accuser-describes-meeting-socialite-at-epsteins-ranch-11639168358.

Fiona Godlee, “Wakefield’s Article Linking MMR Vaccine and Autism Was Fraudulent,” BMJ , 342: c7452 (Jan. 6, 2011).

Scott Jaschik, “Ex-Dean at Temple Convicted,” Inside Higher Ed, Dec. 6, 2021, at https://www.insidehighered.com/admissions/article/2021/12/06/former-dean-temple-convicted-rankings-scandal

Julie Leask, “MMR, Wakefield and The Lancet: What Can We Learn?” Medical Journal of Australia, 193(1): 5-7 (2010).

Doha Madani & Diana Dasrath, “Josh Duggar Found Guilty in Child Sex Abuse Image Trial,” NBC News, Dec. 9, 2021, at https://www.nbcnews.com/news/us-news/josh-duggar-found-guilty-child-sex-abuse-image-trial-rcna7788.

Julia Marsh et al., “Chris Cuomo Fired from CNN over Involvement with Brother Andrew’s Scandal,” New York Post, Dec. 4, 2021, at https://nypost.com/2021/12/04/chris-cuomo-fired-from-cnn-over-involvement-with-brother-andrews-scandals/.

Matthew Motta & Dominik Stecula, “Quantifying the Effect of Wakefield et al. (1998) on Skepticism about MMR Vaccine Safety in the U.S.,” PLOS ONE, Aug. 19, 2021, at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256395.

Jonathan D. Quick & Heidi Larson, “The Vaccine Autism Myth Started 20 Years Ago. Here’s Why It Endures Today,” Tine Magazine, Feb. 28, 2018, at https://time.com/5175704/andrew-wakefield-vaccine-autism/.

Jeetendr Sehdev, “Jussie Smollet Is Guilty. Here’s What We Can All Learn,” Forbes, Dec. 9, 2021, at https://www.forbes.com/sites/jeetendrsehdev/2021/12/09/jussie-smollett-is-guilty-heres-what-we-can-all-learn/?sh=50a6143f498f.

Heather Somerville & Sara Randazzo, “The Elizabeth Holmes Trial: The Defense Rests Its Case,” Wall Street Journal, Dec. 8, 2021, at https://www.wsj.com/articles/elizabeth-holmess-lawyers-rest-their-case-in-criminal-fraud-trial-11638991035

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