SCIENCE sciencemag.org 2 OCTOBER 2020 • VOL 370 ISSUE 6512 43PHOTO: SHAUN CURRY/AFP/GETTY IMAGES
O
n 26 February 1998, the Royal Free
Hospital in London held a press
conference to announce that a study
conducted by one of the hospital’s
clinicians would be published in
The Lancet, one of the world’s oldest
and most prestigious medical journals. Sit-
ting at the front of the room was the senior
author, Andrew Wakefield, who explained
that the combination measles-mumps-
rubella (MMR) vaccine could cause develop-
mental delays, including autism. Wakefield
argued that the MMR vaccine suppressed
the immune system in some children, free-
ing the measles vaccine virus to damage the
intestine, which allowed encephalopathic
proteins to enter the circulation, cross the
blood-brain barrier, and destroy brain cells.
He called for MMR vaccinations to cease
until more research could be conducted.PUBLIC HEALTHBOOKS et al.
Wakefield became an international hero.
A biopic starring British actor Hugh Bonn-
eville portrayed him as a courageous man
willing to speak truth to power. In the
United States, Wakefield testified before the
Congressional Committee on Government
Reform and appeared on 60
Minutes with Ed Bradley. Then
along came Brian Deer, an in-
vestigative reporter working for
The Sunday Times. Deer would
become the first to expose the
clinician’s undisclosed financial
associations and unearth trou-
bling problems with the Lancet
paper. In The Doctor Who Fooled
the World, Deer recounts in vivid
detail how he came to learn that
Wakefield and his study were
not what they appeared to be.
Deer reveals that children admitted to the
Royal Free Hospital with developmental de-
lays in the 1990s were subjected to a regime
known as the Wakefield protocol, which
entailed magnetic resonance imaging, elec-
troencephalography, spinal taps, abdominal
x-rays, blood tests, and intestinal biopsies—procedures often not indicated by the chil-
dren’s symptoms. “The Royal Free would
become the Mecca, or Lourdes,” he writes,
“for the desperately questing families of de-
velopmentally challenged children.”
Wakefield, we learn, had received £435,643
(the equivalent of $846,000 today) to con-
duct studies that would help build a legal
case against MMR vaccine producers 2 years
prior to the Lancet publication. And although
he reported that the children in his study
were referred to his hospital through routine
channels, many came from an antivaccine
group called JABS and the lawyer preparing
to sue vaccine makers. In June 1997, further
undermining the sentiment the physician
would convey at the 1998 press conference
(“It’s a moral issue for me”), Wakefield sub-
mitted a patent for a product that claimed to
treat so-called “autistic enterocolitis,” rid the
body of harmful toxins, and immunize safely
against measles.
Deer reveals that Wakefield also misrep-
resented clinical, biological, and molecular
data. Although the 12 children in his paper
were described as having suffered develop-
mental problems within 2 weeks of vaccina-
tion, for example, Deer discovered that some
had begun displaying symptoms before re-
ceiving the MMR vaccine whereas others did
not begin exhibiting symptoms until months
afterward. Moreover, there were instances in
which normal intestinal biopsy specimens
were mischaracterized as colitis, and Wake-
field’s claim that the measles vaccine virus
genome was present in intestinal epithelial
cells of children with autistic enterocolitis
was inconsistent and irreproducible.
As a consequence of these and other rev-
elations, The Lancet retracted the paper,
and Wakefield lost his license to
practice medicine. Subsequent
studies have shown that children
who receive the MMR vaccine
are at no greater risk of develop-
mental delays than those who do
not receive it. Nonetheless, the
damage was done. The Wake-
field study helped to accelerate
the antivaccination movement
that has imperiled children and
led to the resurgence of once-
controlled diseases.
Although many people think
they know this now-infamous story, it is
likely they are unaware of all its dramatic de-
tails. Curious lay readers and vaccine experts
alike are sure to learn something worthwhile
from Deer’s well-chronicled account. j10.1126/science.abb3587Andrew Wakefield addresses the media outside
the General Medical Council on 28 January 2010.The Doctor Who
Fooled the World
Brian Deer
Johns Hopkins University
Press, 2020. 408 pp.The reviewer is director of the Vaccine Education Center
and an attending physician in the Division of Infectious
Diseases at Children’s Hospital of Philadelphia, Philadelphia,
PA 19104, USA. Email: [email protected]A journalist recounts how he exposed problems
with a study linking vaccines and autism
By Paul A. OffitFlawed research and
its enduring repercussions