The Doctor Who Fooled the World
Andrew Wakefield’s War on Vaccines
By Brian Deer
(An edited version of these book reviews was published in The Skeptic magazine, September 2020, Vol 40 No 3)
This is an important book. Whether it’s really about “the scientific deception of our time”, as the blurb on the back cover describes it, or the result of “the most extensive investigation by a reporter into an aspect of medicine ever undertaken”, as the author describes it, history will decide. But it has to be said that the subject of the book has caused immeasurable damage to the lives of many thousands, and possibly millions, of people.
Therefore we deemed it appropriate to run two reviews – the first by your editor, and the second by noted anti-anti-vaccination campaigner Peter Bowditch, who adds a personal perspective.
Brian Deer is an experienced journalist with a list of exposes of medical fraud and mispractice in his CV. But Wakefield is probably his magnum opus. He has spent 16 years following the saga of Andrew Wakefield, “the doctor without patients”. He wrote a number of revelatory articles on Wakefield’s progress for the Sunday Times, the publication that supported him throughout, both financially and legally, as well as many TV, radio and public appearances, and a significant expose in the British Medical Journal.
Readers of this publication will be aware of Andrew Wakefield’s role in the anti-vaccination movement – the search for autistic kids who could be linked to the measles/MMR vaccine, publication in The Lancet, Wakefield’s promotion of the ‘link’ which lead to a major decline in MMR vaccinations across the world and consequent increases in cases of measles and the damage that has caused.
Deer came to this story during the anti-vaccination campaign, with Wakefield a high-profile figure riding a wave of publicity and, frankly, adulation. From 2002 until the writing of this book in 2019, Deer has followed the vicissitudes of his subject, and played a key role in exposing a range of misconduct and duplicity that eventually led to the longest-ever inquiry by the UK General Medical Council (GMC). In January 2010, the GMC judged Wakefield to be “dishonest”, “unethical” and “callous”, and on 24 May 2010, Wakefield was struck off the UK medical register. Responding to Deer’s findings, The Lancet partially retracted Wakefield’s research in February 2004 and fully retracted it in February 2010 following the GMC findings. In 2011, Deer published his findings in the BMJ with an endorsement by the editors.
Wakefield, of course, became a tragic hero of the anti-vaccination movement, a martyr to the cause, now living in the US and still promoting the supposed autism link, despite the masses of evidence against him and his claims.
Needless to say, Wakefield does not come out of it looking rosy. In fact, Deer portrays Wakefield as an opportunist, a mediocre researcher who used his personal charisma as a tool to promote himself, and who cottoned on to a ‘good thing’ and milked it – and continues to milk it – for everything it’s got.
But Deer makes clear that, despite the book’s title, there were many others contributing to the failed theory and whose involvement made them just as guilty as Wakefield; it is just that Wakefield had the charisma and drive – if not the medical knowledge and skill – to push the case to a broader public. These others include scientific and medical associates, adulatory followers, politicians, parents, learned journals, lawyers (importantly) and, of course, a complicit media. Some of these have paid the price of their association with Wakefield.
But Deer’s coverage of the media is a bit surprising. This reviewer’s background is journalism, and seeing how the media promoted and boosted Wakefield’s scare tactics was always disappointing, to say the least! There would not have been a vaccine scare without some media putting the case in hyperbolic terms. Their role in the growth of the anti-vaccination movement is considerable and intrinsic to spreading misinformation and paranoia.
Therefore, it is interesting that Deer doesn’t spend more time on the media’s involvement. Certainly, he makes reference to a number of specific and highly partisan journalists, such as Lorraine Fraser of the Mail on Sunday, Jeremy Paxman and Susan Watts on the BBC’s Newsnight, and Matt Lauer of the NBC’s Today program, but his coverage of the media is as much about their attacks on him as it is their support for Wakefield, and in some cases, once Deer’s work had been publicised, trying to gazump him with a scoop.
With that in mind, Deer’s book covers a lot of his investigation in addition to what he is investigating. This adds an element akin to a detective thriller, which takes the book along at a very readable pace. Overall, media coverage notwithstanding, this is an excellent book. The depth and detail are spot on, from well-explained scientific and medical protocols and procedures to well-told human interest elements (the parents’ responses ranging from suspect support to desperate self-blame).
It is highly likely that this is the definitive version of the Wakefield and Co saga. Now for one on the evolution of the anti-vaccination movement to complement it.
PS: The story is bookended by a couple of Australians. In the beginning was John Walker-Smith, a gastroenterologist who was instrumental in testing the children who would eventually become the basis of The Lancet paper (and who only just missed out on suffering the same professional fate as Wakefield), and at the tail end we have Elle ‘the Body’ Macpherson, super-model and consort of the superstar Wakefield. One wonders whether everyone got their just desserts.
– Reviewed by Tim Mendham
In 1996 I was commissioned to write a book about the Internet. It was to explain to people who didn’t know anything about it or the technology behind it or what it could be good and bad for. There was some hysteria about the possibility of a flood of pornography filling our lounge rooms so I actually had to research porn (it was boring!) to answer the inevitable questions in interviews. I also looked for other forms of bad information because it was obvious even then that there would be dubious information coming down the tubes. One of the bad things I found was a group of websites spreading fear about vaccinations. I commented at the time that none of the pornography I was forced to watch was as offensive as some of these sites.
In 1999 I started paying more attention to the anti-vaccination sites and it wasn’t long before I was sneeringly told that a paper by a Dr Andrew Wakefield had been published in The Lancet (the world’s second-most prestigious and influential medical journal) which proved that the MMR vaccine caused autism. As I had experience of people citing unlikely research results in the hope that nobody would check, I read the paper for myself (I had access to the medical library at Westmead Hospital) and it proved no such thing – it only suggested there might be a link. There were several red flags on the paper, one of which was that the editors of The Lancet felt the need to include an editorial statement implying the clichés “further research is needed” and “the science is not settled”.
The biggest red flag for me came from something I had been taught about research methodology at university – the sample of subjects looked too good to be true. It seemed highly unlikely that the parents of the children had independently and randomly sought out a doctor (who didn’t see patients!) at a small and relatively unknown London hospital. I mentioned my concerns in a conference presentation in 2001. The most charitable view was that there had been some cherry-picking going on mixed with some confirmation bias. The peer review process can’t always detect outright fraud, so this was a case of “the benefit of the doubt”.
But fraud it certainly was.
Journalist Brian Deer had been investigating suspicious matters around the pharmaceutical industry for some years, and in 2003 he was approached by an editor at the Sunday Times and asked to apply his investigative skills to the Wakefield story, which by then had started to have a serious effect on vaccination levels and public health. There was enough information and doubt from within the medical profession itself to suggest that the public didn’t know all the things it should have known, and it wasn’t long before the facts started coming out – that Wakefield was paid a large amount of money to find what he wanted to find, that he had applied for a patent on a measles vaccine that would have made him very wealthy if it replaced the current vaccine, that the subjects of the study had not been randomly chosen but had been supplied by a lawyer, Roger Barr, who intended taking legal action against vaccine manufacturers, that Barr had used a loophole in the regulations to stripmine the Legal Aid system for tens of millions of pounds (shared with Wakefield), that Wakefield and Barr both had close associations with prominent anti-vaccination campaigners, that the laboratory doing the tests for measles DNA had less credibility than a school science project … the list went on.
In 2010 Wakefield’s registration as a medical practitioner was cancelled and The Lancet retracted the 1998 paper. It took too many years, but we thought that at last it might all be over. We were wrong.
Brian Deer (described as “a lying dog of a journalist” by a leading anti-vaccination campaigner) has now written a complete history of the Wakefield saga. The book goes back some years before the notorious 1998 paper to reveal the involvement of lawyer Barr and vociferous anti-vaccination organisations, through the almost unbelievable litany of lies, corruption and fraud that surrounded Wakefield and the coordinated attempts to use his fraudulent “research” to damage the public’s perception of the safety and efficacy of vaccines, to his elevation to hero status in the anti-vaccination movement and his current incarnation as the director and producer of anti-vaccination films liked the execrable “Vaxxed: From Cover-Up to Catastrophe”. (The use of the word “cover-up” in the title caused irony meters across the world to shatter, given the way that Wakefield et al had covered up his deceit. Also, when the film first came out in 2016 someone commented about the propaganda: “Leni Riefenstahl would have baulked at making something this dishonest”.)
I could summarise the book into something like those old Reader’s Digest condensed novels, but I wouldn’t know what to leave out and this review would be about 300 pages long. The book is an essential read for anyone who has followed Wakefield over the years (and even I, who have followed him very closely, found many new things to wonder and grimace at). It is essential reading for anyone who thinks that scientific and medical research can’t be corrupted by greed and self-interest or to support an agenda. And it is essential reading for anyone who thinks for a nanosecond that the anti-vaccination movement is based on any philosophy that includes honesty, ethics or morality. Strangely, the book also reinforces the claim by anti-vaccinators that all medical research is corrupt and driven by money, although they will make an exception in this case.
You need this book. Buy it! Highly recommended.
– Reviewed by Peter Bowditch