Yesterday, the news broke that the British Medical Journal was running a series of stories that labeled Andrew Wakefield’s infamous 1998 Lancet study that posited a link between the MMR vaccine and autism an “elaborate fraud.” Dr. Fiona Godlee, the BMJ‘s editor-in-chief, compared the MMR scare to the Piltdown man hoax, in which a series of fossilized remains found near East Sussex, England were claimed to be a previously unrecognized early ancestor of humankind. (I’m hoping that has more resonance in the UK than it does in the US, because when I first read that I had absolutely no recollection of the whole Piltdown mess.)
As someone who has spent two years doing nothing but looking into various vaccine scares, I found the way these latest revelations, which were based on reporting by Brian Deer, were packaged to be problematic.
First off, if there is one reporter responsible for bringing the truth to light about Wakefield’s work, it’s Deer. He had the tenacity and spent the time and energy to do the digging that the rest of the media failed to do, and it was his articles, which first began appearing in 2004, that blew the lid off of this whole fiasco.
Unfortunately, Deer’s single-mindedness has become a sticking point that Wakefield and his allies have seized onto anytime new information is brought to light. When NBC did an hour-long special on Wakefield in the summer of 2009, Wakefield kept insisting that it was Deer, and Deer alone, who was pursuing him, as if Deer was some sort of deranged psycho bent on…well, who knows what. But bent on something.
And sure enough, that’s the angle that Wakefield is taking again: Last night, he was interviewed via Skype^ on Anderson Cooper’s CNN show (video is here, transcript here), and Wakefield’s talking points could pretty much be summed up as follows:
1. Brian Deer is a hit man hired to track me down and (metaphorically) kill me. (This is not an exaggeration: Wakefield actually said “He is a hit man. He’s been brought in to take me down.”
2. The world would know the truth if everyone only bought Wakefield’s book.*
Anyone who has been following the story closely knows that both of these are ridiculous points to make: Brian Deer is not a hit man and, as Anderson Cooper said to Wakefield on air, “But, sir, if you’re lying, then your book is also a lie. If your study is a lie, your book is a lie.” (Cooper also served up this smackdown: “Sir, I’m not here to let you pitch your book. I’m here to have you answer questions.”)
HOWEVER…most people have not been following the story closely. Most people just hear about it from their friends or in online chat rooms or at the playground — and then they see it on TV or read about in the news when the story flares up for one reason or another. And to some of those people, I’m sure this sounds like a he-said, he-said scenario, with Andrew Wakefield telling the world that Brian Deer is a deranged journo-assassin and Deer telling the world that Wakefield’s research was dishonest and can’t be trusted.
Another fallout from this is that it only reinforces the the conviction on the part of Wakefield’s allies that this is all a one-man crusade (although judging from the emails I’ve been getting, I’ve recently joined this crusade).
After Wakefield finished his Skypeterview with Cooper and CNN medical correspondent Dr. Sanjay Gupta, I appeared on CNN for a brief segment. (Wakefield actually refused to go on air with me.+) When Cooper asked me what I thought of Wakefield’s protestations, I tried to address what I found to be the problem with on-the-one-hand, on-the-other-hand reporting on issues about which there is only one-hand:
MNOOKIN: I find it — I find it upsetting and — and disturbing. He has framed this consistently as this one renegade journalist who’s out to get him. In fact, there was a British — the Medical Research Council, which licenses doctors in the U.K., spent two-and-a- half years looking into his work. It was the longest investigation they had ever done. And that was the group that stripped him of his right to practice medicine. …
They also found that there was — his evidence couldn’t be backed up. His data couldn’t be backed up. So, for it to be portrayed by–by–by Andy Wakefield as this being one person out to get him, you know, I think what he’s banking on is that people won’t actually look and see — look and see what the reality of the situation is. … And not only is there not peer-reviewed work [that supports Wakefield's contentions], this is probably the most studied public health issue involving children over the last 20 years.
COOPER: Would public health officials have an interest in — in hiding a link, if there was?
MNOOKIN: Public health officials, I think, would have an interest in keeping children safe.
Even if there — if there was a link and it was discovered, I think public health officials would — would have an interest in doing whatever they could to protect children. This notion that everyone’s trying to — to — to cover their butts and — because they have already been — been perpetrating this scam, is — to distrust the motives of that many people around the world, you know, you would need to assume that — that everything going on is in some ways out to get you.
I think Sanjay’s point about our not knowing what causes autism is really in some ways the crucial one, because it’s so frightening to parents. The numbers are rising. And here’s something that you can point to. And because it occurs at the same time, you always get vaccinated when you’re a child, and autism is diagnosed when you’re a child, so it’s easy to understand why patients would latch on to that as a connection.
But it has no more validity than — than if I said microwave popcorn causes autism. The numbers have gone up since we have started eating microwave popcorn. There’s just — there’s absolutely no evidence supporting a link. …
If you took out everything that Brian Deer had ever written, there would be exhaustive evidence that — that this was not trustworthy. Dozens of researchers in dozens of countries have studied literally millions of children around the world. And this notion that there’s some sort of conspiracy between public health officials, doctors, journalists, drug companies, researchers around the world, you know, it — it would be the most brilliant conspiracy that had ever been hatched.
The other point I want to make — and I find this difficult to say — is that I think the BMJ was guilty of over-hyping their story in a way that ended up creating a misrepresentation of the story as a whole. By sending out breathless press releases and prepping the worldwide media for a series of bombshell stories,# the BMJ created the impression that this was fundamentally new news — and it wasn’t. We knew that Wakefield’s work wasn’t reliable or accurate on January 3 — and we still know that today. The stories that are currently running are not really all that different in tone or content than the stories that ran almost exactly a year ago, when a UK medical panel found there was sufficient evidence to justify stripping Wakefield of his right to practice medicine.
In fact, in some ways the way these new pieces have been presented actually confuses the issue unnecessarily. The lead in the main BMJ story quotes the father of the one of the initial 12 children in Wakefield’s 1998 study as saying that Wakefield misrepresented his son’s medical history. If there’s one thing we’ve learned from the past twenty years of vaccine scares, it’s that memory is immensely fallible — especially when it comes to emotionally charged situations. (At one point I had a whole chapter in my book about false memories…but, like about 200 hundred other pages, it ended up getting cut.) From the day it was published, one of the major problems with Wakefield’s original work that researchers pointed to was that it relied on parents’ post-facto recollections to determine what had or had not actually happened. Those memories weren’t a suitable substitution for actual data then…and they’re not now, either.
^ This did not help Wakefield’s case any: His face was covered in shadow and his movements looked jerky.
* The single oddest part of my work on The Panic Virus occurred when Wakefield asked me if I might be interested in translating his book into Hebrew. I still have no idea what he was possibly thinking.
+ I’m guessing he no longer is interested in my services as a translator.
# I tweeted about this after the BMJ’s press release was emailed to me and was worried that I had inadvertently broken the magazine’s embargo as a result. I emailed the BMJ’s press officer and she assured me it was all good. For a fascinating discussion of this, check out Ivan Oransky’s take on his blog, Embargo Watch.