Andrew Wakefield's Lethal Legacy

Andrew Wakefield's Lethal Legacy
By Robert M. Goldberg on 1.7.11 @ 6:07AM

On Wednesday, the British Journal of Medicine published the first of several articles detailing the systematic fraud Andrew Wakefield engaged in writing a study in 1998 claiming measles-mumps-rubella vaccine triggered autism in 12 children. News outlets have posted accounts of the fraud as 'breaking news." They also note Wakefield's false research led to fear of vaccines and to kids dying from lack of shots.

Wakefield's fraud is beside the point. He was able to do so much damage for so long because the media, the scientific community, politicians and trial lawyers found it in their interest to believe and lionize him. We ate our young. Wakefield just gave us the recipe.

The Lancet published Wakefield's original article in 1998. Though the study's weaknesses were evident back then, it was also clear -- to Wakefield and the law firm that paid him millions to concoct the research and falsify his conclusions -- that it would be enough, once published in a major medical journal, to spread a wildfire of fear about vaccine safety.

It took over a decade for the Lancet to retract the original publication and for Britain's General Medical Council to strip Wakefield of his medical license. During that time, despite the substantive questions about Wakefield's research, untested theories, lack of medical training and source of funding, there was no serious challenge to Wakefield. Dozens of large studies showing no correlation -- first between MMR and autism, then between thimerasol (a mercury-based vaccine preservative) and autism, and then between all childhood shots and autism -- were undermined because the media allowed Wakefield and his followers to discredit the findings just by saying so.

His theories were published by mainstream medical journals, championed by major media outlets, given legitimacy by other scientists and politicians. He didn't fool us. He was given a platform. He created a narrative people wanted to believe and profited from.

The BMJ accompanying editorial on Wakefield notes that while he might be exposed, "the damage to public health continues, fueled by unbalanced media reporting and an ineffective response from government, researchers, journals and the medical profession."

Sadly, the harm is not limited to immunization rates, To be sure, confidence in all manner of vaccines among certain groups of parents is in decline. There is a corresponding spike in the number of kids killed and hospitalized by vaccine-preventable diseases.

Wakefield and the movement he helped spawn live on. Wakefield wannabes now overrun scientific discourse and dominant medical journals and shape public perception of the value of medical innovation. Wakefield was one of the first to realize that churning out a series of small studies and spreading them over the Internet was more powerful than genuine science.

The Wakefield formula of hijacking medical science by spreading flimsy fears through the Web is now mainstream. Today, anyone willing to pay for newsfeeds that continually distribute and obtain prominent placement in Google searches can have their medical scare stories and half-baked research virtually circle the globe ten times over before the truth takes its first step. Rest assured, unbalanced media reporting, biased researchers and publicity-seeking medical professionals will spread panic for their own gain.

Hence, Wakefield's imitators are many and are damaging the public health in equal measure. David Healy, another British physician, published a small study matching Wakefield's 1998 research for shoddiness to spread panic about the link between suicide and a class of antidepressants called SSRIs. It led to a decline in the use the drugs and an increase in teen suicide. David Graham, a Food and Drug Administration (FDA) researcher, circulated an unpublished study through the Internet claiming Vioxx was responsible for 100,000 deaths. The rest is history.

In 2007, cardiologist Steve Nissen in the online version of the New England Journal Medicine claimed the oral diabetes drug Avandia was linked to heart attacks (though a NIH clinical trial found Avandia managed diabetes well and reduced heart risks). Overall use of oral diabetes drugs has declined. Millions of women are avoiding hormone replacement therapy and mammograms because of misleading claims about the dangers of both. As a result, the risk of breast cancer is higher than it should be. And government health czars like Medicare director Donald Berwick invoke the pseudo-science of comparative effectiveness to switch patients to alternatives promoted by the fear mongers, compounding harm and undermining innovation. You see, medical progress is not only too risky, it's too expensive.

Wakefield may be discredited. But as long as the Internet is manipulated to inspire fear about using and developing medical innovations -- and as long as researchers, journalists, and politicians spread these misperceptions -- people will die and Wakefield's lethal legacy will endure.