Autism, vaccines, and Andrew Wakefield’s fraudulent claims

A new article in the Sunday Times of London by investigative reporter Brian Deer reveals new details about the original study claiming that the MMR vaccine causes autism. This now-infamous study, published in The Lancent by Andrew Wakefield and colleagues in 1998, involved just 12 children, all of whom were autistic. It turned out that the children were all recruited to the study – not a random sample, despite the paper’s claims – by Wakefield and a lawyer whom he partnered with, as part of an effort by Wakefield to build a legal case allowing him to make pots of money by suing vaccine manufacturers. And Wakefield also had filed for a patent on a “safer” vaccine that he was ready to offer as soon as he “proved” that MMR wasn’t safe.

The latest article reveals that Wakefield “changed and misreported results in his research, creating the appearance of a possible link with autism, a Sunday Times investigation has found.” Some of this data was revealed earlier, but Brian Deer has dug deeper and found even more troubling information. Not only were the patients recruited to the study by a lawyer seeking to sue vaccine makers, but the data were manipulated (see the details in this extended article) in ways that seriously altered the findings. Several of the children, for example, showed signs of autism before receiving the vaccine, as was revealed in their medical records. The Lancet study reported that all the children showed the first signs of autism after getting the vaccine. Another example: Wakefield reported on biopsies of the colon for all the children, saying that the biopsies were abnormal. This indicated what he claimed was a new syndrome, where measles particles in the vaccine inflamed the colon, causing a “leaky gut”, through which “toxins” somehow made their way to the brain. Subsequent research has shown no evidence of this, and Wakefield has never identified any specific toxins (nor has anyone else).

Well, it turns out that Wakefield altered the biopsy data too. The paper concluded that 11 of the 12 children had “uniform” intestinal changes that they called “nonspecific colitis”. The hospital pathologists, however, “concluded that they were not uniform but varied and unexceptional.” Wakefield’s team met and reviewed the reports, and decided to stick with their original findings anyway.

Wakefield sees himself as a persecuted hero, or at least that’s what he says. Last summer he compared himself to Vaclav Havel, the playwright and political activist who later became President of the Czech Republic. Orac calls this “the Galileo Gambit” – a tactic where you invoke the name of a famous scientist whose theories were initially rejected, only later to be confirmed, as a defense of your own beliefs. The implication is that you’re just like them – in this case, Wakefield is suggesting that he’s just like Vaclav Havel, who stood up to Communism and repression in his native country.

Sorry, Andrew, you’re no Vaclav Havel – not even close. Havel wasn’t trying to file lawsuits to pad his own pockets. One of the most damning pieces of evidence is a document uncovered by Brian Deer that reveals that in 1996 – two years before the infamous MMR-vaccine paper, Wakefield and his lawyer associated filed documents seeking funds from the UK Legal Aid board for this:

“to seek evidence which will be acceptable in a court of law of the causative connection between either the mumps, measles and rubella vaccine or the measles/rubella vaccine and certain conditions which have been reported with considerable frequency by families who are seeking compensation.”

In other words, Wakefield was looking for evidence that he could use to sue vaccine makers. This is one of the most elementary errors one can make in a scientific study, the confirmation bias problem: you decide in advance what you want to find, and then you interpret all the evidence in a way that supports your pre-conceived notions. In Wakefield’s case, this also conveniently profited his own bank accounts: he earned £435,643 (as reported by Brian Deer) through his work with lawyers.

For 10 years now, scientists and the media have treated Andrew Wakefield with respect. He’s done countless interviews and presented himself in the media as he likes to be seen, and meanwhile scientists have spent millions of dollars and years of effort trying to replicate his findings. All the scientific results have shown the same thing: that there is no link between the MMR vaccine and autism. These years of research could have been devoted to productive research on autism, trying to find the real causes, rather than chasing false hypotheses.

There are only two explanations I can think of for Wakefield’s continuing insistence that he’s right: either he’s incompetent or he’s a fraud. ( Orac calls him an "antivaccination loon" - a bit strong, but justified. David Gorski at Science-based medicine calls him a scientific fraud.) I’ve seen his interviews and he really seems to believe what he’s saying, so my conclusion is that he’s incompetent. Rather than treat Wakefield with respect, we all (journalists included!) show be showing outrage over the damage he’s causing to public health. Because there’s no mistake about that: vaccination rates have fallen, many children have gotten sick as a result, and some children have died. That’s a very real cost, and a tragic one.