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5:54 p.m. - 2021-10-27
ANDREW WAKEFIELD
In 1998 Andrew Wakefield, a British surgeon turned researcher, published a paper in The Lancet which was to have a profound and deleterious impact on healthcare worldwide, specifically by spawning the anti-vaccine movement. In it Wakefield claimed to have discovered a link between MMR vaccine, bowel disease, and autism. The general mechanism in Wakefield's hypothesis involved vaccine-induced damage to the bowel and subsequent leakage of opioid-like substances into the circulation, leading to brain injury. The heart of Wakefield's claim was the second table in his paper: two columns linking the occurrence of autism in time to parents' recollection of exposure to the vaccine in eight of twelve autistic children.

Several problems with the science should have been immediately apparent. Wakefield's reasoning involved a post hoc fallacy: temporal association of autism and vaccination does not prove a cause-effect relationship. Children typically begin developing language skills (or not, in the case of autism) at about the same time they get the MMR shot. Memory bias was another potential criticism since the alleged correlation was based solely on the recollection of the parents. The study used a small sample size, and there was no control group. The reputed presence of measles virus in the bowel tissues was supported only by immunochemical staining but without substantiation from the far more sensitive molecular assays that were available, nor were the histopathology studies blinded. Other laboratories were unable to replicate Wakefield's findings, and it should have been a red flag to other scientists when Wakefield announced his "findings" via press conference.

More serious problems were eventually uncovered by investigative journalist Brian Deer, the author of the book. Wakefield had a financial interest in destroying the public faith in the MMR vaccine. He was accepting large funds from a legal team suing the pharmaceutical company for $100 million for alleged damages to autistic children. He was working on his own single dose vaccine, which would presumably compete with MMR. The children used in Wakefield's study were in fact recruited from families that were litigants in the same lawsuit, and the parental "recollection" of the relationship between vaccination and the onset of symptoms was, to say the least, flawed. In fact, the alleged association was a criterion for selection, rather than a discovery of the study.
In some cases Wakefield--neither a psychiatrist nor a pediatrician--changed the diagnosis of other doctors to fit better with his narrative. When Wakefield was offered funding to perform a better-designed, gold standard version of his flawed study, he declined. These flaws, along with ethical concerns about the treatment of the children in the study led to Wakefield losing his medical license, as well as the retraction of the Lancet paper.

Unfortunately, the problems with Wakefield's findings were not hashed out solely within the scientific community. The early involvement of a credulous and sympathetic British press, along with Wakefield's own natural charisma and love of the spotlight, guaranteed a less thoughtful public forum for his claims. In the US, a supportive story on 60 Minutes, a softball interview by Matt Lauer, and support from celebrities like Jenny McCarthy and Robert DeNiro served to enhance Wakefield's reputation and support his posture as the victim of a broad medical conspiracy. Congressman Dan Burton held public hearings sympathetic to Wakefield and his supporters, and social media played a huge role--still does!-- in disseminating his false claims.

Vaccines have saved millions of lives since Edward Jenner vaccinated for smallpox in the late 18th century, but today we have new outbreaks of the once-eradicated measles, skepticism about Covid vaccines, and "vaccine hesitancy" becoming one of the World Health Organization's top ten dangers to human life. Wakefield did indeed fool the world, but not without help from other medical professionals and the media. (less)

 

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