Among the very worst scientific fraud cases was one that not only misled scientists and doctors, but also had an enormous impact on the public perception of a vitally important medical treatment. It caused so much fear and confusion that even though it occurred more than two decades ago, we still live with its noxious effects today.
I’m referring, of course, to the infamous 1998 study on vaccines published in The Lancet by the British doctor Andrew Wakefield. On the basis of a sample of twelve children, Wakefield and his coauthors claimed that the combined measles, mumps, and rubella (MMR) vaccine was linked to autism. The theory was that measles virus left in the system from the MMR vaccine was a cause of both gut- and brain-related symptoms (Wakefield called the condition, which he was describing for the first time, “autistic enterocolitis”). In interviews and a press conference after the paper’s publication, Wakefield repeatedly stated that the MMR should be split up into three individual vaccines, because the combination was “too much for the immune system of some children to handle.”
By now, most people know that Wakefield’s findings have been discredited. Since 1998, there have been several large-scale, rigorous studies showing no relation between the MMR vaccine (or any other vaccine) and autism spectrum disorder. It’s also been shown that combination vaccines are just as safe as individual ones. What many aren’t aware of, though, is that the Wakefield paper, far from being an honest mistake or an understandable dead end in a tentative line of research, was fraudulent right from the beginning.
After the study’s publication and the attendant controversy, the investigative journalist Brian Deer began to dig into Wakefield’s data and, crucially, his motivations. In a series of stunning articles in The BMJ (formerly the British Medical Journal), Deer described how Wakefield misrepresented or altered the medical details of every single one of the twelve children included in his paper. He simply invented the “fact” that all the children showed their first autism-related symptoms soon after receiving the MMR whereas in reality, some had records of symptoms beforehand, others only had symptoms many months afterward, and some never even received a diagnosis of autism at all.
The Wakefield paper, far from being an honest mistake or an understandable dead end in a tentative line of research, was fraudulent right from the beginning.
As for the motivation, Deer showed, Wakefield had two major financial interests in the research turning out the way it did. First, he was being retained, on a substantial fee, by a lawyer who had plans to sue the makers of the vaccines on behalf of the parents of children with autism. Indeed, an anti-vaccine pressure group linked to this lawyer was how Wakefield recruited the patients for his study. Second, the year before the study’s publication, he had applied for a patent for his own single measles vaccine and would thus have profited had his research frightened people away from the combined MMR. Inexcusably, neither of these interests were disclosed in the paper: it merely noted that the work was funded by “Special Trustees,” and that the parents of the children “provide[d] the impetus for these studies.”
When Deer first contacted The Lancet with his concerns, in 2004, he encountered fierce resistance from the editors of the journal (which, it is worth noting, foreshadowed the same thing happening at the same journal in the notorious case of surgeon Paolo Macchiarini around a decade later). As a result of Deer’s investigation, Wakefield’s paper was finally retracted in 2010, having by this point been a part of the official scientific literature for twelve years. Wakefield was also struck off the U.K. General Medical Council’s register after the longest hearing in its history, banning him from practicing as a doctor in the United Kingdom. This wasn’t just for falsifying data, but also for subjecting a child to unnecessary medical procedures, including a colonoscopy, without proper approval. The Council described him as acting with “callous disregard.” He has since found fame in the anti-vaccination movement in the United States; for example, before it was pulled due to public outcry, his anti-vaccine film, Vaxxed, almost had a showing at New York City’s 2016 Tribeca Film Festival, having been championed by the festival’s founder, and vaccine sceptic, Robert De Niro.
It’s not too far a leap to say that the world is a substantially more dangerous place—especially for children and other vulnerable people, and for those in developing countries—as a consequence of Wakefield’s scientific fraud.
Wakefield’s fraud ignited a vaccine scare that spread as fast as any virus. Many sections of the U.K. media began to run “just asking questions”–style articles about the MMR, seeding doubts among parents. The Daily Mail was a ringleader, and even Private Eye magazine, which prides itself on not getting carried away on media bandwagons, produced a special issue on MMR in 2002, painting Wakefield as a Galileo-esque figure standing up against the combination-vaccine establishment.
The coverage had just the effect you’d expect. In the late 1990s, the United Kingdom’s MMR acceptance rate had been climbing toward the 95 percent that’s necessary for “herd immunity”—the state where enough people are vaccinated that a disease becomes rare enough so as not to threaten those who, for reasons like allergies to the vaccine’s ingredients, can’t be inoculated against it. Post-1998, however, acceptance plunged as low as 80 percent, and rates of measles correspondingly jumped. Outbreaks began across Europe and the wider world, and countries that had for a time been measles-free began to see new cases. The most recent estimate from the World Health Organization is that over 140,000 people died from measles and its complications in 2018—particularly tragic and frustrating since this is a disease we know how to prevent. It’s not too far a leap to say that the world is a substantially more dangerous place—especially for children and other vulnerable people, and for those in developing countries—as a consequence of Wakefield’s scientific fraud.
The acceptance of Wakefield’s study in as prominent an outlet as The Lancet will go down as one of the worst decisions in the history of scientific publication.
The acceptance of Wakefield’s study in as prominent an outlet as The Lancet will go down as one of the worst decisions in the history of scientific publication. There could hardly be a more concrete example of the importance of reliable science for society’s well-being, and of the failure of the peer-review system to screen out bad research. It brings up the issue of trust—the public’s trust in science. Having your child vaccinated is an act of commission: you’re actively having something done to them, trusting that the medics are right that it’s safe. If a study in a famous journal with the seal of approval of scientific peer review implies that it’s not, it’s only rational to take notice. For years after the publication, people genuinely didn’t know whom to trust about vaccines. Many still don’t.
This betrayal of public trust is perhaps the most pernicious thing about fraud. People have invested a great deal in science, up to and including the health of their children. Fraudsters make a mockery of that trust. Although the fraudsters themselves are obviously to blame, our scientific system also deserves condemnation. Not only do the most glamorous journals encourage people to send only the flashiest findings—more or less guaranteeing that some small fraction of scientists will turn to deception to achieve such flashiness—but journal editors often act with reluctance and recalcitrance when even quite solid evidence of wrongdoing comes to light. Universities, too, shouldn’t escape criticism: not only are their investigations often sluggish, but there are cases like that of Macchiarini, where they defended the indefensible and actively went after the whistleblowers. Naturally, anyone accused of fraud should be considered innocent until proven guilty; there’s no better way to ruin trust than to throw around allegations haphazardly. But the longer those in positions of responsibility drag their feet, and the longer each faked paper exists in the literature, the more our systems and institutions fail science—and by extension, society.
Excerpted from Science Fictions: How Fraud, Bias, Negligence, and Hype Undermine the Search for Truth by Stuart Ritchie. Published by Metropolitan Books July 2020. Copyright © 2020 by Stuart Ritchie. All rights reserved.