Wakefield's Wake, Part 1: Media should help undo damage from vaccine-autism hoax

Andrew Wakefield - creator of one of the greatest scares in medical history - had many accomplices in misleading the world about a link between vaccines and autism. Many in the media helped him spread his intellectual poison. Celebrities rallied behind his fake cause. And the scientific community helped keep the hoax alive by citing his work as if it were legitimate.

Last week, BMJ published the first part of a series, "Secrets of the MMR scare," on Wakefield's dangerous hoax. Longtime investigative journalist Brian Deer put together a thoroughly reported and carefully annotated account of how Wakefield misled parents of children with autism and manipulated evidence as part of a scheme to try to sue vaccine manufacturers and reap a big pay day in court.

Wakefield was ultimately outed by Deer and others and the journal where his article was published in 1998 retracted his paper in 2010. The world that Wakefield has created, though, is going to be with us for a long time.

As Deer wrote, "the scare took off around the world, unleashing fear, guilt, and infectious diseases - and fuelling suspicion of vaccines in general. In addition to measles outbreaks, other infections are resurgent, with California last summer seeing 10 babies dead from whooping cough, in the worst outbreak since 1958."

Over the next few weeks, Antidote is going to dissect Wakefield's work, Deer's reporting and the role of the media, celebrities and scientists to highlight ways that we, as health journalists, might attempt to undo some of the damage.

First, let's start with some of the evidence Deer used for his report.

It's a rare day that one sees a health investigation that makes use of more than 100 distinct sources, let alone cites them in footnotes. Being a medical journal first and foremost, though, BMJ gave Deer the space and the format to fully display his work. We all should be grateful.

Deer has been pursuing the Wakefield story since 2004, when he published the first of dozens of stories in The Times of London chipping away at the hoax. This latest series makes use of the wealth of documents uncovered through various government investigations into the scandal and through Deer's own gumshoe reporting.

Deer based his reporting on medical records, letters, grant applications, patent applications, reports from government panels, scientific papers and, of course, many interviews.

I want to call out three particularly interesting pieces of evidence uncovered by Deer.

1. An early draft of the 1998 paper. Deer has posted point-by-point comparisons between the early draft and the published paper showing how the findings were changed to make them more dramatic. For example, the August 1997 draft of the paper said that the "Average interval reported between MMR shot and onset of behavioural symptoms" was 14 days. By the time of the paper's publication in February 1998, that interval had been shortened to 6.3 days. Similarly, the range in the interval between the time of the shot and the first reported symptoms shrank from 1 to 56 days down to 1 to 14 days.

2. A patent application for a "safer" vaccine. As that early draft was being altered, Wakefield and his colleagues also began the process of putting together a patent application in 1997 for a measles vaccine they claimed would be safer. Wakefield posted both the application and the final patent approval from 1998. This shows how Wakefield and colleagues weren't just after a legal windfall but were hoping to create a market for their own blockbuster drug. Where would scared parents go running? Right into their arms.

3. A legal newsletter. To help lure patients who would become fodder both for his patent application and for his lawsuit, Wakefield worked with a lawyer, Richard Barr. As Deer wrote, "In the month that Barr engaged him - two years before the paper was published - the lawyer touted the doctor in a confidential newsletter to his MMR clients and contacts. "He has deeply depressing views about the effect of vaccines on the nation's children," Barr said. "He is also anxious to arrange for tests to be carried out on any children who are showing symptoms of possible Crohn's disease. The following are signs to look for. If your child has suffered from all or any of these symptoms could you please contact us, and it may be appropriate to put you in touch with Dr Wakefield.""

These documents and the rest used by Deer are great guideposts for health writers, bloggers and investigators hoping to fix what Wakefield and his colleagues have broken.

Questions or thoughts? Join the conversation in the comments below or email me directly at askantidote@gmail.com.

Next: How Deer shows reporters how to handle patient stories and records

Related Posts:

Wakefield's Wake, Part 2: Passionate parents of autistic children can be tricky sources

Wakefield's Wake, Part 3: Trust parents of autistic kids, but verify stories with health records

Wakefield's Wake, Part 4: Overcome confidentiality rules used to hide shaky science