BRIAN DEER The Doctor Who Fooled The World: Andrew Wakefield’s war on vaccines. Reviewed by Braham Dabscheck
Investigative journalist Brian Deer reveals how the anti-vax movement began with an elaborate fraud designed to enrich its perpetrator.
One way to view the history of the world is as a struggle between superstition and science. In trying to understand what is happening in relation to a particular issue, should we trust our gut reactions or should we call on experts who devote their lives to studying the subject? A subset of this struggle is a battle between science and pseudo-science. Any scientist or investigator will find themselves spending time taking on pseudo-scientists, persons who have an aura of expertise and spread falsehoods which, if acted upon, could have harmful impacts on individuals and society more generally. This latter, secondary struggle is the basis of sometimes vitriolic disputes between academics which the rest of us are at a loss to understand.
Brian Deer’s The Doctor Who Fooled The World: Andrew Wakefield’s war on vaccines involves an examination of both these struggles. In 1998, Andrew Wakefield was the lead author of a paper published in the highly regarded medical journal The Lancet,which maintained that a triple vaccine shot for measles, mumps and rubella (MMR) ‘was associated’ (the term used in the paper) with autism in children. Deer, an investigative reporter specialising in medical matters, was approached by the editor of the Sunday Times to research these claims and Wakefield’s more general attack on vaccines as endangering public health.
Deer writes:
… such work was life-crushing, to get on top of all the -oligies involved. Vaccines were a hugely multidisciplinary topic, and to go beyond the trivial platforming of experts – he says this; she says that – you’d be quicker becoming fluent in Russian. The temptation with medicine is like reading Shakespeare: you hope the tricky words will make sense from their context. But … I made a pact with myself … I was determined to know what they meant.
Deer spent thirteen years on Wakefield’s case. In February 2010 The Lancet ‘fully retracted’ the 1998 article. An editorial in a 2011 edition of the BMJ (formerly the British Medical Journal) said Wakefield’s ‘paper [in The Lancet in 1998] was in fact an elaborate fraud’.
The Doctor Who Fooled The World provides the background to this fraud, its exposure and subsequent events.
Wakefield’s initial foray into medicine was as a surgeon. He developed an interest in the causes of Crohn’s disease (an inflammatory bowel disease) and decided to become a medical researcher. He began the process of publishing papers, attracting research funds and following the ‘rules’ of medical academe. His interest then morphed into the causes of autism in children, which he linked to the measles component of the MMR vaccine.
Wakefield entered into an agreement with a lawyer and a Dublin-based doctor to conduct research into this supposed association, to publish and publicise a paper demonstrating this association, and to use the publicity to attract the interest of parents with autistic children and then pursue a class action against drug companies who manufactured MMR vaccines. Wakefield would be employed by the lawyer for a consultancy fee in medical discussions with the families concerned. The class action was supported and paid for by legal aid.
Wakefield and others duly prepared a paper, based on a study of twelve children, that asserted a link between measles/MMR and autism. Before the Lancet paper was published,Wakefield’s hospital, the Royal Free Hospital London, held a press conference announcing its results; the story was picked up by different parts of the press (looking for a good story) and the MMR–autism bandwagon was launched.
The first sign of trouble for Wakefield was when his connections with the lawyer were revealed and questions were raised about conflicts of interest. The case against the drug companies was dropped on the advice of independent medical investigators and legal advice that other tests could not find any ‘association’ between autism and MMR. Deer reports that other studies have been unable to replicate the findings of The Lancet paper and the findings of Wakefield’s Dublin-based colleague. Despite the case not going to trial, the lawyer and all concerned ‘prospered’ from the venture with their costs of £26 million being picked up by legal aid.
A flurry of cases and inquiries followed. Deer was sued for libel, but the case never went to trial, with costs being paid by Wakefield’s team. A hearing conducted by the General Medical Council, which regulates doctors in the United Kingdom, banned Wakefield from medical practice in 2010. In these hearings access was obtained to the medical records of the twelve children that formed the basis of The Lancet paper. They did not support the conclusions contained in the paper, which Deer refers to as ‘an elaborate fraud’.
Wakefield had already made some forays into America, where he found other parents with autistic children looking for answers and keen to take on drug companies. After the General Medical Council’s findings he moved to America full-time and mounted attacks on all vaccines. Deer describes how Wakefield used social media and the establishment of anti-vaccine foundations to enhance both his income and profile. He was an invitee to President Trump’s inauguration ball in 2017. Wakefield portrayed himself as a martyr persecuted by state medical agencies who were protecting drug companies. His campaigning and that of others in many nations has led to a reluctance by parents to vaccinate their children with consequent increases in death from diseases that bodies such as the World Health Organisation thought had been eradicated.
Deer, thinking about the parents who jumped aboard the anti-vaccine bandwagon, says:
Ask yourself the question: if you could swindle yourself to millionaire status by stealing from the government, or a pharmaceutical company – and be sure that, if you fail, you won’t even face criticism, let alone go to jail – would you maybe give it a go? … [if you have a developmentally challenged child] would that impact your moral calculation, if it meant misrecalling a few facts? Here was the grim accountancy on the human condition … And would it even be a crime in the balance of injustice if Wakefield had convinced them that on the other side was a conspiracy: by drug companies, corrupt doctors, lying scientists and ‘shill’ journalists … Wouldn’t any parent believe in the link after what they had seen, and couldn’t explain about their child, and heard from the charming Dr Wakefield?
The Doctor Who Fooled The World provides a damning indictment of the processes and procedures against scientific fraud in medical academe. The Lancet, a so-called leading medical journal, and its editorial team at the time, come in for particular criticism. Virtually all of the doctors, scientists and researchers who were involved with Wakefield have had their reputations besmirched. What was needed was a more skeptical, cautious approach with additional testing, rather than a rush to publication chasing research (and other) funds and fame.
The great strength of Deer’s book is how he clearly explains the issues associated with medical and scientific research in the specialised area of vaccinations. His account is readily accessible to persons without such knowledge or training. The Doctor Who Fooled The World should be read by all of us for its explanation of campaigns against vaccination – battles between science and superstition, science and pseudo-science – which, if not put to rest, will have devastating consequences for all of us.
Brian Deer The Doctor Who Fooled The World: Andrew Wakefield’s war on vaccines Scribe Publications 2020 PB 416pp $35.00
Braham Dabscheck is a Senior Fellow at the Melbourne Law School at Melbourne University who writes on industrial relations, sport and other things. He recently completed a review article on employment in America and the introduction of a domestic transfer system in Australian soccer.
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