At first glance, many people would not know who Andrew Wakefield is, but they have probably heard of the scandal tied to his name. Andrew Wakefield is the former British physician who, with 12 other authors, published the infamous 1998 study in The Lancet that associated the MMR (measles, mumps, and rubella) vaccine with autism and gastrointestinal issues. This study, which has long been discredited, is partially responsible for the reduced vaccination rates and the increased prevalence of preventable diseases in the past two decades. Despite an overwhelming amount of scientific research that has shown no causation between vaccines and autism, Wakefield’s study did significant damage to the public’s trust in vaccines that still continues to this day. And although early critics quickly pointed out obvious shortcomings of the paper — such as the low sample number, lack of controls, and reliance on parental recall — it took much longer for the scientific community to discover the full depth of the fraud in Wakefield’s work.
Wakefield’s study was not a controlled experiment, but a study of 12 children who were, according to Wakefield, “referred to a paediatric gastroenterology unit with a history of normal development followed by loss of acquired skills, including language, together with diarrhoea and abdominal pain” (637). There is no mention of how the 12 children were chosen beyond this description. According to investigative journalist Brian Deer, the children were recruited to Wakefield’s study directly or indirectly through anti-MMR groups such as JABS (Justice, Awareness, and Basic Support) (Fixed 78). In addition, a significant amount of the data was manipulated. For example, several children were reported to have symptoms within days of the MMR vaccine, but medical records contradicted these claims. Also, the paper claims that all 12 children were previously “normal,” but some had documented pre-existing conditions (Fixed 79). Clearly Wakefield cherry-picked or altered data. He ignored relevant medical histories, and likely depended on the (influenced?) testimonies of parents who are already biased by their anti-vaccine sentiments. As we will see, several parents were also litigants in law suits against vaccine-producing companies and have a vested interest in establishing a strong connection between the MMR vaccine and autism in this “scientific study.”
Deer also found significant conflicts of interest that Wakefield failed to make public. In 1996, a JABS lawyer named Richard Barr retained Wakefield to assist in a legal suit against MMR vaccine manufacturers, and therefore partially funded his research (Money 137). Many of the children in Wakefield’s study were litigants in this same suit (Money 138). In 1997, Wakefield filed for a patent on a “safer” single measles vaccine, also not disclosed (Money 140). After his paper is published in 1998, Wakefield urged the use of single vaccines instead of the 3-in-1 MMR vaccine at a press conference (Money 139). He also established a company intended to test patients for “autistic enterocolitis,” which would initially market to litigants in suits against MMR vaccine manufacturers (Money 140). So not only was Wakefield paid by the legal team of the plaintiffs against MMR vaccine manufacturers, but he had even more self-interest in the results of his study due to his own investments to sell “safer” alternatives to the traditional MMR vaccine. When combined with the extent of dishonesty found in his study, it is clear that Wakefield manipulated his study in his own self-interest, and there was never a legitimate basis for his claims about vaccines and autism.
It is disappointing that it took 12 years to completely redact this study, and almost worse that it was allowed to publish in the first place. Even when disregarding the severe conflicts of interest and fudged data, the study itself is rather weak. There is no control, and the very small sample prevents the data from being statistically significant. The data was also collected in a sloppy fashion, with such a strong dependence on parental recall. This strongly reminds me of witness testimony, which we know now to be one of the worst kinds of evidence in court due to the unreliability of human memory.
Measles, mumps, rubella, and varicella have all been drastically reduced by the introduction of vaccines, but are still common in many developing countries. Before the introduction and use of the measles vaccine, there were about 2.6 million deaths per year from measles alone. There were still 140,000 measles-related deaths in 2018, but that is significantly less than before. Measles is no longer endemic in the United States and many other countries. The U.S. was considered “measles-free” in 2000, and all of the Americas were declared free of endemic measles in 2016. However, there are still outbreaks in these countries, usually due to travel from out of the country, and where it then spreads to unvaccinated people in the population.
It is unlikely that there will never be “anti-vaxxers,” because it is difficult to “un-ring the bell,” so to speak. Once an idea has been put out and proliferated by the media, it has gained enough momentum to reach an audience that will be hard to dissuade. Even once told “Oh never mind, that was incorrect,” it may always be a “what if?” in the back of people’s minds. After all, how could something so wrong get so much traction? And still others will simply jump on the bandwagon of conspiracy out of distrust of “Big Government” and “Big Pharma,” regardless of the underlying science. Others claim religious reasons. This is very frustrating because unvaccinated people put others at risk, including young children and the immunocompromised. No one’s choices exist in a vacuum, and they can irreversibly affect other people. Hopefully, with the spread of vaccines to more developing areas and other countries, which generally do not have the same anti-vaccine population, we can continue to reduce the effects of these diseases worldwide.
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