Andrew Wakefield’s Lethal Legacy
Yesterday, The British Journal of Medicine http://www.bmj.com/ published the first of several articles detailing the systematic fraud Andrew Wakefield engaged in to show that the measles-mumps-rubella vaccine triggered autism in 12 children who, Wakefield claimed, were perfectly healthy before being immunized. The Lancet published Wakefield’s original article in 1998. Though the paper’s weaknesses were evident back then, it was also clear – to Wakefield and the law firm who paid him millions to concoct and falsify both the research and conclusions – that it would be enough, once published in a major medical journal, to spread a wildfire of fear about vaccine safety.
And indeed that was one hypothesis that Wakefield did prove correct. It took over a decade for The Lancet to retract the original publication and for Britain’s General Medical Council to strip Wakefield of his medical license. During that time, despite the substantive questions about Wakefield’s research, untested theories, lack of medical training and source of funding, there was no serious challenge to Wakefield. In spite of dozens of large studies showing no correlation – first between MMR and autism, then between thimerasol (a mercury-based vaccine preservative) and autism, and then the between whole array of childhood shots and autism — the myth that vaccines were permanently damaging kid’s brains persisted. Wakefield and the movement he helped spawn, thrived and does so today.
Focusing on Wakefield’s fraud misses the point. He succeeded because he created a narrative people wanted to believe. It goes beyond parents seeking a cause for their child’s autism and finding some comfort in blaming vaccines. Wakefield’s theories were published by mainstream medical journals and championed by major media outlets.
Wakefield was a ‘visionary’ because he realized that by churning out a series of small studies and quickly putting them on the Web he and others in the anti-vaccine movement could have a powerful impact on public perception of risks. Others used the Web to turn him into an ‘instant expert’ and characterize him as lonely crusader against evil drug companies on behalf of children with autism. The scientists who defended the value and safety of vaccines were – and are – discredited for their “conflicts of interest” – that is, helping develop vaccines.
The BMJ editorial’s on Wakefield notes that while he might be exposed: “Meanwhile, the damage to public health continues, fueled by unbalanced media reporting and an ineffective response from government, researchers, journals and the medical profession.”
Sadly, as I point out in my new book, Tabloid Medicine, the health damage is not confined to immunizations and the response is not only ineffective, it is shameful. To be sure, confidence in all manner of vaccines among certain groups of parents is decline. There is a corresponding spike in the number of kids killed and hospitalized by vaccine preventable diseases. But in the past decade other groups and individuals have followed the Wakefield formula of hijacking medical science by spreading flimsy fears through the Web where it is only a matter of time that unbalanced media reporting, biased researchers and publicity seeking medical professionals will spread panic for their own agenda.
Today, anyone willing to pay for newsfeeds that continually distribute and obtain prominent placement in Google searches can have their medical scare stories and their half-baked research virtually circle the globe ten times over before the truth takes its first step.
As a result, Wakefield’s imitators are many and are damaging the public health in equal measure. David Healy, another British physician doctor published a small study matching Wakefield’s 1998 research for shoddiness to spread panic about the link between suicide and a class of antidepressants called SSRIs. It lead to a decline in the use the drugs and an increase in teen suicide. David Graham, a Food and Drug Administration (FDA) researcher circulated an unpublished study through the Web claiming Vioxx was responsible for 100,000 deaths. The rest is history.
In 2007, Steve Nissen rushed a study into online publication through the New England Journal Medicine claiming the oral diabetes drug Avandia was linked to heart attacks (even though a government clinical trial found Avandia managed diabetes well and reduced heart risks). Overall use of oral diabetes drugs has declined. Millions of women are avoiding hormone replacement therapy and mammograms because of misleading claims about the dangers of both. As a result, the risk of breast cancer is higher than it should be. In some of these cases the switch to a ‘natural’ treatment, often promoted by those who foster fear, has done more harm than good.
Wakefield may be discredited. But as long as the Web is manipulated to discourage the use and development of medical innovations – and researchers, journalists and politicians – spread this misperception – his lethal legacy will endure.
