The legacy of Andrew Wakefield continues

Actions have consequences. No matter how much the person might want to try to hide from the consequences of one’s actions, they frequently have a way of coming back, grabbing you by the neck, and letting you know they’re there. We see it happening now in the U.K.

Fifteen years ago, British doctor Andrew Wakefield published a case series in The Lancet in which he described gastrointestinal symptoms in 12 autistic children who were treated at the Royal Free Hospital. His conclusion was that he had identified associated gastrointestinal disease and developmental regression in a group of previously normal children that appeared to be associated with the MMR vaccine. The paper causes a sensation (a panic, actually), leading British parent to refuse to vaccinate their children with the MMR for fear that it was associated with autism. Meanwhile, with a “wink, wink, nudge, nudge,” charisma, and skill at self-promotion, Wakefield promoted the idea that the MMR vaccine causes autism. True, his Lancet paper didn’t exactly say that, whether through the enforcement of caution on its statements by the reviewers who accepted it or through plausible deniability is not clear, but Wakefield himself wasn’t so shy. Nor was the British tabloid press, with its notoriously insatiable appetite for scandal and sensationalism, which eagerly glommed onto the story and promoted it with nearly the same intensity that Wakefield did. Ultimately, MMR uptake rates plummeted and the measles, vanquished in the U.K. in the 1990s, came roaring back to endemic levels within a decade.

These are consequences that persist to today, as a recent story in the Washington Post tells us, Measles outbreaks flourish in UK years after discredited research tied measles shot to autism:

More than a decade ago, British parents refused to give measles shots to at least a million children because of now discredited research that linked the vaccine to autism. Now, health officials are scrambling to catch up and stop a growing epidemic of the contagious disease.

This year, the U.K. has had more than 1,200 cases of measles, after a record number of nearly 2,000 cases last year. The country once recorded only several dozen cases every year. It now ranks second in Europe, behind only Romania.

Last month, emergency vaccination clinics were held every weekend in Wales, the epicenter of the outbreak. Immunization drives have also started elsewhere in the country, with officials aiming to reach 1 million children aged 10 to 16.

“This is the legacy of the Wakefield scare,” said Dr. David Elliman, spokesman for the Royal College of Paediatrics and Child Health, referring to a paper published in 1998 by Andrew Wakefield and colleagues that is widely rejected by scientists.

Indeed it is. This is Andrew Wakefield’s legacy, the resurgence of a disease that, thanks to vaccination, was once under control. Even though 15 years is a long time, the effects of Wakefield’s perfidy live on in the suffering of children who hadn’t even been born yet at the time but who are victims of Wakefield every bit as much as the children whose care he oversaw as part of his clinical study at the Royal Free Hospital. It doesn’t matter to them that, thanks to the dogged investigation and intrepid reporting of investigative journalist Brian Deer, we now know that Andrew Wakefield was in the pocket of trial lawyers who were interested in suing vaccine manufacturers and wanted research to cite in lawsuits. Nor does it matter to them that, as a result of research misconduct, Andrew Wakefield was stripped of his U.K. medical license (or, as the Brits like to call it, “struck off”). It doesn’t matter that two years ago it was revealed that Wakefield had almost certainly committed research fraud in gathering the data he later published in The Lancet, so much so that Deer labeled it “Piltdown medicine” and “inventing autistic enterocolitis.” Nor does it matter that The Lancet, in an apparent effort to atone for the massive mistake it had made in even publishing Wakefield’s case series in the first place, retracted the paper and that ultimately even the quack clinic that Wakefield had helped found decided to give him the boot. Wakefield has fallen into about as much disrepute as it’s possible to fall, short of becoming a Nazi or a pedophile, and deservedly so. Meanwhile, the science consistently fails to support Wakefield’s hypothesis that the MMR vaccine is somehow associated with autism and “autistic enterocolitis.”

So here it is, 15 years later. MMR uptake rates have improved in the U.K., but, thanks to at least a decade’s worth of low MMR uptake rates, there is a generation of children who are not protected against the measles, with sadly predictable results:

Across the U.K., about 90 percent of children under 5 are vaccinated against measles and have received the necessary two doses of the vaccine. But among children now aged 10 to 16, the vaccination rate is slightly below 50 percent in some regions.

To stop measles outbreaks, more than 95 percent of children need to be fully immunized. In some parts of the U.K., the rate is still below 80 percent.

It is these unvaccinated children who are bearing the brunt of the measles outbreaks, but vaccinated children are not completely safe. Because it takes an MMR uptake of 90-95% to produce adequate herd immunity to prevent outbreaks and because the vaccine, although very effective, is not 100% effective, all children are being endangered by low vaccine uptake rates. That is the legacy of Andrew Wakefield.

Even after how utterly he’s been discredited, Wakefield still has acolytes who still believe that he is a hero when he is about as far from a hero as you can imagine. If you examine the comments, you’ll see that Anne Dachel, the “media editor” of the antivaccine crank blog that we all know and don’t love so much, Age of Autism, has sent her flying monkeys fling their poo of antivaccine pseudoscience into the comments of the Washington Post article. All the familiar names are there: Anne Dachel, John Stone, Maurine Meleck, and others. The old familiar tropes are there, too: Whinging that Brian Deer is corrupt and evil; that he is being “defamed”; that the Hannah Poling case shows that Wakefield was right; that there is a conspiracy to “suppress” Wakefield’s “inconvenient truth”; and more, such as links to long discredited “studies” (many of which I’ve deconstructed in detail right here on this very blog).

Wakefield’s antivaccine acolytes, spreading misinformation, pseudoscience, quackery, and lies hither, thither, and yon are also his legacy. They are also the reason that I fear that dangerous pseudoscience like antivaccinationism will never quite go away. It might be driven to low levels, such as now in the U.K., where the resurgence of measles is leading parents to stop fearing the MMR jab and to start fearing vaccine-preventable diseases again. But it will never go away.

That, too, is part of Wakefield’s legacy.