The ugly truth of the man behind the anti-vaxxer movement

People measure time on a line, but history often acts like an hourglass. Epochs upend and end up in themselves like a snake eating its own tail. Such is the tale of vaccination, a practice spearheaded at the tail end of the 18th century by English doctor Edward Jenner. Per Harvard University, Jenner observed that exposure to a weaker variant of smallpox –- namely, cowpox –- provided better protection from smallpox than smallpox-based inoculation. This notion of making people stronger by giving them weak diseases became the basis for modern vaccinations.

Skip ahead to the tail end of the 20th century. In the wake of worrisome assertions by Dr. Andrew Wakefield, some worried parents concluded that vaccinating children for measles, mumps, and rubella (MMR) caused autism. These concerns created an anti-vaccination epidemic in which people who largely lacked scientific credentials attempted to discredit the science Jenner helped generate. This is the tale of how Wakefield turned medical history on its head.

Birth of a notion

According to an article in the Journal of The Royal Society of Medicine, Edward Jenner's first paper proffered "a rambling hypothesis that many human diseases were derived from animals." He wrongly reasoned that a horse disease called "grease" caused cowpox. Furthermore, his support for the cowpox-based smallpox vaccine relied on one test subject, a sample size smaller than the smallest pocks. The Royal Society of Medicine (understandably) rejected his unfounded findings. However, stronger studies subsequently showed that many of Jenner's views on vaccination weren't horsepucky.

Andrew Wakefield is the anti-Jenner, a scientific foil who foiled science with progressively faulty research. Like his anti-antecedent, Wakefield was a British physician who harbored half-baked ideas about the origins of a virus. A gastrointestinal surgeon by training, he migrated to medical research during the late 1980s, according to Slate. He would soon set out to prove that measles, the measles vaccine, and the MMR vaccine caused Crohn's disease and other intestinal issues. However, both the scientific and medical communities deemed his work "methodologically flawed and in some instances factually erroneous."

As explained in the book Vaccine: The Debate in Modern America, Wakefield couldn't explain why or how measles and measles-related vaccines could cause intestinal disorders. He also couldn't elucidate why they didn't in many cases. Although his research failed the smell test, the bowel expert pooped out papers pushing his narrative. Eventually, the purported (poo-ported?) intestinal threat posed by vaccines would be associated with autism.

A gutted feeling

In a way, Wakefield's work was always excretory. Even his infamous autism study was grounded in baseless beliefs about bowels. Published in 1998 and retracted 12 years later, his study sought to suss out the connection between the MMR vaccine, multiple digestive maladies, and developmental disorders like autism. Wakefield, who led the research, conducted multiple medical tests on 12 children. Based on those results and symptoms described by the subjects' parents, Wakefield and his coauthors found that all 12 children suffered from "intestinal abnormalities" and that nine ended up with autism.

Absent from the findings is any discernible evidence that the MMR vaccine causes autism. And the researchers knew it! They wrote: "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described." They also acknowledged (albeit indirectly) that there was no indication that MMR vaccinations in the U.K. altered autism rates. Rather, a "genetic predisposition to autistic-spectrum disorders is suggested by over-representation in boys and a greater concordance rate in monozygotic than in dizygotic twins." 

Despite their own admissions, the authors made a leap that would impress Evel Knievel. Specifically, they speculated that individuals with autism-related genes "may not handle certain viruses appropriately, possibly including attenuated strains." Noting that autism symptoms occurred sometime after their subjects received MMR vaccinations (i.e., exposure to "attenuated strains" of viruses), the researchers called for additional studies to unpack whether vaccines packed a developmental punch. 

Rebel without a causation

Relying on a tiny sample and a tiny bit of circumstantial evidence, Wakefield and his colleagues concluded that they couldn't conclude anything regarding vaccines and autism. The most they could muster was a conjecture premised on untested assumptions. Hypotheses and hypotheticals are a far cry from crying "vaccines cause autism," so why all the hype?

Taken at face value, Wakefield's work was arguably unimpressive, but the questions he raised would undoubtedly seem pressing to the press. This created pressure to preempt an impending "media frenzy," according to the Independent. Peer-reviewed journal The Lancet, which published the MMR-autism study, commissioned a critique of its shortcomings. London's Royal Free Hospital, however, convened a press conference.

Held in February 1998, the gathering featured Wakefield and four prominent doctors from relevant fields. The group agreed not to disagree in front of the press. When pressed about the safety of the MMR vaccine, they were to advocate using it unless research revealed people shouldn't. In theory, the plan was plainer than unbuttered toast in a Nebraska wheat field. In practice, it imploded.

Each doctor offered a different opinion. Wakefield's proved the most impactful. As The Daily Beast detailed, the ex-surgeon undercut support for vaccinations, declaring, "with the debate over MMR that has started, I cannot support the continued use of the three vaccines given together. We need to know what the role of gut inflammation is in autism." Ah, of course!

A pox of lips now

During that press conference a dubious bowel doctor pooh-poohed a vaccine and inflamed a peer. As the Independent described, "By the end Wakefield was coolly urging parents to give their children single vaccines at annual intervals" and virologist Arie Zuckerman "was on his feet, banging the lectern in frustration as he insisted that the MMR vaccine had been given to millions of children around the world and was safe." The public would have to choose between competing opinions.

Normally, medical diagnoses reduce doubt. But Wakefield treated doubt like a diagnosis, and the press seconded his opinion. Some outlets simply echoed his concerns, but a number of outlets outright maligned the MMR vaccine. The (very tabloid) Daily Mail, for instance, ran a years-long marathon of harrowing headlines, including "MMR Killed My Daughter," and "MMR safe? Baloney. This is one scandal that's getting worse." According to Guardian contributor Roy Greenslade, such sensationalist headlines were politically driven jabs at the U.K. government, which supported using the MMR vaccine.

That would explain how Tony Blair got dragged into the debate. During the early 2000s newspapers needled the then-Prime Minister about whether his son received an MMR shot. (He had, but Blair weirdly wanted to keep his child's medical history private.) Per The Telegraph, two papers reported that Blair's wife had a relative with autism. While alarmist stories spread, immunization rates dropped.

Hollywood babble on

After rocking the U.K. like a kidney stone, Wakefield took his research on the road. Per The Guardian, in 2000 he presented findings from a second autism study to the U.S. Department of Health. But because there's no road from Great Britain to America, he couldn't make inroads. Or maybe he just couldn't make a convincing case.

The nonexistent inroads didn't remain rocky (or nonexistent) forever. In 2007 Wakefield got an enormous assist from sorta-celebrity and professional non-scientist Jenny McCarthy. In an interview with Oprah Winfrey, McCarthy blamed the MMR vaccine for her young son's autism diagnosis. Newsweek recounted her account of events: "I said to the doctor, I have a very bad feeling about this shot. This is the autism shot, isn't it? And he said no, that is ridiculous; it is a mother's desperate attempt to blame something on autism. And he swore at me." She swore that after the immunization, everything changed: "Boom, soul gone from his eyes."

McCarthy became the soul of America's anti-vaccine movement. And like America itself, she didn't forget her British roots. According to The Telegraph, in 2015 she joined forces with Wakefield, who by then had moved to Texas. McCarthy hailed him as "the symbol of someone who stood up for truth."

Measly, mum, and rubbish

While Wakefield was spreading the gospel of gut germs, an Everest of evidence was mounting against him. Other researchers couldn't replicate his findings or find any vaccine-autism link. Experts who read his research saw red flags. Pathology professor Karel Geboes poked holes in Wakefield's whole approach to research. The bowel doctor assumed seeing bowel measles in kids with bowel problems suggested a causal relationship. He also applied that reasoning to MMR immunizations and autism. That's like claiming trees cause babies because sitting in one precedes marriage and a carriage.

Lazy logic was the least of Wakefield's weaknesses. In 2004 journalist Brian Deer eviscerated the controversial 1998 autism study. Per The BMJ, Deer determined that "not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal." The doctor had doctored his data and was now caught in Deer's headlights.

An article published in the Indian Journal of Psychiatry further illuminated the shadiness. Deer discovered that Wakefield omitted important information. He was conspicuously silent about the fact that his vaccine research had been bankrolled by lawyers who were suing vaccine manufacturers. He also improperly performed tests on children without securing consent. Wakefield's work wasn't groundbreaking; it was broken. In 2010 the study was retracted, and his medical license was rescinded.

Saying is believing

Discrediting and disowning Wakefield didn't dissuade his disciples. The strength of his research didn't lie in the lies or maddening methods. Rather, his ability to nurture uncertainty and project selflessness shifted the burden of belief. The New York Times noted that Wakefield positioned himself as a martyr who suffered for questioning the status quo. In 2004, he relocated from the U.K. to Texas, where he amassed a small group of devotees who would heap praise on him as he described how his incendiary theories set the medical world ablaze and burned his own career to ashes.

In his version of events, he was a vilified hero trying to protect defenseless children from a germ-born juggernaut. Peer review became persecution, and critics became conspirators. To a degree, this has immunized Wakefield from criticism. Anti-vaxx activist J.B. Handley described him as "Nelson Mandela and Jesus Christ rolled up into one." Presumably, that means Morgan Freeman and Jim Caviezel will take turns playing him in biopics. It also means merely questioning vaccine safety has become a kind of virtue.

As the New York Times observed, Wakefield's vaccine doubts give reassurance to many parents of autistic children. Some have had to watch their children struggle with severe verbal, emotional, and motor skill impairments. Uncertain about the origins of autism, the mainstream medical and scientific communities have offered few comforting answers. Wakefield provided something concrete to blame, even if his evidence wasn't solid. 

A ploy named sue

Wakefield's efforts to rebrand and rehabilitate his image have required some revisionism. While 10 of his co-authors disavowed the debunked autism study, per The Guardian, the gutted gastroenterologist responded with gall. As the New York Times described, after refusing to replicate his own research, Wakefield resigned from the Royal Free Hospital (which had hosted his pivotal press conference), relocated to America, and portrayed himself as an honest man among scientific charlatans. In 2012 he pursued courtroom redemption.

The Guardian reported that Wakefield sued BMJ medical journal for defamation. The lawsuit also targeted BMJ editor-in-chief Fiona Godlee and Brian Deer, the journalist who filleted Wakefield's fishy findings in 2004. Wakefield's lawyer alleged that those two took fraudulent shots at his vaccine research. From the get-go this was a losing effort. In 2010 the U.K. General Medical Council had "found Wakefield guilty of serious professional misconduct." Moreover, as judges would rule and reaffirm, Texas lacked the legal authority to prosecute the British journal and journalists.

It was a win-win for Wakefield. Winning the case would undermine attempts to dismiss his research. But dismissing his case would simply feed into the narrative that the powers that be were attacking him like a stomach bug (or stomach measles). A cynical mind might even suggest that losing was the goal. If so, he won big.

Eyes wide shot

The ex-doctor didn't get his day in court, but he still put his accusers on trial. Already condemned by a jury of peer reviewers, Wakefield shared his convictions with the public in film form. In 2016 he unveiled Vaxxed: From Cover-up to Conspiracy, which accused the U.S. Centers for Disease Control and Prevention of deception. The former doc's doc focuses on biologist Brian Hooker and supposed CDC whistleblower Bill Thompson. Per the Vaxxed website, in 2013 Thompson made a mortifying confession to Hooker: In 2004 the CDC allegedly uncovered a causal connection between the MMR vaccine and autism and then covered it up.

The documentary claims the CDC donned its best handlebar mustache and went into full-on villain mode. Instead of sharing a biological bombshell with the public, the agency purportedly altered the data to present a more suitable narrative. The film also features interviews with physicians, pharmacists, and parents of children with autism, fueling ire and drawing fire.

Pediatrician Phillip LaRussa laid into Wakefield's selective storytelling, telling The Guardian, "Wakefield really conducted fraudulent research, and he did nothing in the film to address any of the concerns about all the discrepancies in his research. It's as if that didn't exist." Perhaps that was the point. 2004, the year the CDC supposedly proved the MMR-autism link, was the same year Brian Deer derided Wakefield's fraudulent autism study. Wakefield had essentially accused the CDC of committing his sins, cinematically absolving himself in the process.

Hooker, lie, and stinker

Vaxxed may have attempted to rewrite history, but in the end, it ended up repeating history in reverse. Just as Wakefield was the anti-Edward Jenner, Brian Hooker was the anti-Brian Deer. Deer had exposed deceit data manipulation in 2004. Hooker claimed to have done the same regarding a 2004 study by the CDC. Only this time, the facts purportedly pointed in Wakefield's favor. But as ABC pointed out, Hooker had reversed the facts.

Hooker, who analyzed the allegedly altered CDC data, "played fast and loose with statistics." Pediatrician Margaret Moon told ABC the biologist "manipulated the data and manipulated the media in a very savvy and sophisticated way." Hooker denied intentional wrongdoing, touting a track record of non-retracted articles. Challenging the charges against him, he asked, "Why would I go to the effort and risk in terms of my career?"

That's a good question. Unfortunately for him, there are also good answers. Hooker has an autistic son, whom he described as "vaccine-injured." In 2016 he also served as science adviser for Focus for Health, a group whose objectives include "reducing the incidence of autism and chronic illness." But what about whistleblower Bill Thompson? Surely, he could provide clarity! In 2016 Thompson clarified that he didn't discover a causal link between the MMR vaccine and autism. Based on his reanalysis of the CDC data, Thompson determined that "the MMR vaccine is not linked to autism." Hooker was still on the hook.

Anti-facts-in-nation

Hooker's claim that the CDC cherry-picked data was in turn picked apart by experts. Nevertheless, his participation in the Vaxxed injected momentum into the anti-vaxxer movement. ABC reported that Hooker's bogus number-crunching went viral, misleading an already misinformed public. These anti-facts have also penetrated American politics.

The same year Vaxxed was released Wakefield met with soon-to-be-president Donald Trump, per The Guardian. He also attended the president's inaugural ball, after which the commander-in-chief commanded the government to form a "vaccine safety commission." That never came to fruition, but the statement proved politically fruitful for Wakefield.

Texas, Wakefield's home away from humiliation, has forged a way for hokum to prosper. Anti-vaccine voters have waged a political war against politicians who trust vaccines. Wakefield has happily ridden this wave. In 2018 he called an upcoming Republican primary in Houston an "extremely important time" for the anti-vaxxer movement. Far from alone in the Lone Star State, the star of the anti-vaxxer movement has risen like a phoenix from the ashes of inflammatory bowel research. 

The ought-ism pandemic

In 2014 NPR revealed that the vaccination angst Wakefield propagated resulted in the resurgence of measles, mumps, rubella, polio, and whooping cough. In 2017 the Philadelphia Inquirer reported that pet owners have become increasingly hesitant to vaccinate animals for fear of zoological autism. The forward march of time has seen society recede from progress.

It's easy to view Wakefield as a malignant mole metastasizing on the skin of science. But science is sometimes bowel-like in its movements. The Journal of the Royal Society of Medicine pointed out that Edward Jenner's pro-vaccine research was highly controversial in his day. Contemporaries contemptuously criticized his claims. His initial investigation of smallpox vaccination was deeply dubious and steeped in stupid assertions. His attempts at replication yielded "weak evidence at best." And in the early days of vaccine research, patients at London's Smallpox Hospital were unethically injected with cowpox in order to prove the potency of vaccination.

Both Wakefield and Jenner look loony under a certain light. But individual men aren't the measure of correctness. When confronted with uncertainty, no society or scientist should cling blindly to a theory or a theorizer. Rather, they should flock to the facts and fact-check constantly. The willingness to admit error and adjust accordingly is the difference between better research and a bitter researcher. It's a lesson that must be learned and relearned as history coils and recoils from itself.