Flawed research and its enduring repercussions
On 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. Sitting at the front of the room was the senior author, Andrew Wakefield, who explained that the combination measles-mumps-rubella (MMR) vaccine could cause developmental delays, including autism. Wakefield argued that the MMR vaccine suppressed the immune system in some children, freeing 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.
Wakefield became an international hero. A biopic starring British actor Hugh Bonneville 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 investigative reporter working for The Sunday Times. Deer would become the first to expose the clinician's undisclosed financial associations and unearth troubling 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…
As a consequence of these and other revelations, 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 developmental delays than those who do not receive it.
Nonetheless, the damage was done. The Wakefield 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 details. Curious lay readers and vaccine experts alike are sure to learn something worthwhile from Deer's well-chronicled account.
From San Francisco to Shanghai, from Vancouver to Venice, controversy over vaccines is erupting around the globe. Fear is spreading. Banished diseases have returned. And a militant "anti-vax" movement has surfaced to campaign against children's shots.But why?
In The Doctor Who Fooled the World, award-winning investigative reporter Brian Deer exposes the truth behind the crisis. Writing with the page-turning tension of a detective story, he unmasks the players and unearths the facts. Where it began. Who was responsible. How they pulled it off. Who paid.
At the heart of this dark narrative is the rise of the so-called "father of the anti-vaccine movement": a British-born doctor, Andrew Wakefield. Banned from medicine, thanks to Deer's discoveries, he fled to the United States to pursue his ambitions, and now claims to be winning a "war."
In an epic investigation spread across fifteen years, Deer battles medical secrecy and insider cover-ups, smear campaigns and gagging lawsuits, to uncover rigged research and moneymaking schemes, the heartbreaking plight of families struggling with disability, and the scientific scandal of our time.
PROLOGUE: Resurrection
On the first night of the Donald Trump presidency, a video went up on the World Wide Web that sent a shudder through medicine and science. It featured a sixty-year-old man in a black tie and tuxedo, grinning into his phone under blue and white lights from a ballroom in Washington, DC.
“Sorry about that, guys,” he says, in a mellow British accent that would suit James Bond or a Harry Potter wizard. “I don’t know whether people are back on. Yeah?”
Then he repeats himself. “Sorry about that.”
Below medium-brown hair, his face glistens with sweat. White light flashes on gray eyes. As he talks, he walks: first in brightness, then shadow, pursing full lips as if searching for a thought. Then raising a fist to cough. “Just looking round to see if there’s anyone important here,” he says, unzipping a smirk at his proximity to power. “If I can prevail upon them.”
The picture is shaky and doesn’t last long: two-and-a-half minutes of sideways-turned images, streamed live on Periscope, a self-broadcasting app, from that night’s most exclusive event. A muffled beat thumps. Spotlights blaze. Secret Service agents take up positions.
To some of us watching—as I was, from London—he looked like the perfect party guest. People once said he was “handsome,” even “hot,” with a sportsman’s physique, a charismatic charm, and a confidence that led others to trust him. That night, in a winged collar and pretied bow, he might have passed for a diplomat, a knighted stage actor, or a retired major league baseball star.
But to others around the world, his appearance provoked gasps. You’d think the Prince of Darkness had stepped onto the dance floor. For this was Andrew Wakefield, a disgraced former doctor who’d been booted from his profession on charges of fraud, dishonesty, and a “callous disregard” for children’s suffering.
“Too much to comprehend,” sneered a Texas gastroenterologist, in a flurry of Twitter posts fired that night. “I need anti-nausea meds,” moaned a chemist in Los Angeles. A Dutch autism researcher: “Scary times indeed.” A Brazilian biologist: “An administration for charlatans.” And from a PhD student on the North Island of New Zealand: “I hoped he’d just crawled under a rock.”
No chance of that. This man reveled in infamy. His nature and predicament required it. Not since the 1990s and the arrest of one Harold Shipman—who serially murdered two hundred of his patients—had a British medical practitioner been so scorned. The New York Times described Wakefield as “one of the most reviled doctors of his generation.” Time magazine listed him among history’s “great science frauds.” And the Daily News spat that he’d been “shamed before the world,” under the headline:
Hippocrates would puke
His fall wasn’t recent, or easily missed by Trump’s team tasked to check the night’s guest list. By now, his disrepute was both acute and chronic, absorbed into popular culture. He’d been drawn as the villain in a cartoon strip (“The Facts in the Case of Dr. Andrew Wakefield”), sweated over by students in high school exams (“Was Dr. Wakefield’s report based on reliable scientific evidence?”), and his name embraced in public conversation as shorthand for one not to be believed.
The Andrew Wakefield of biology
The Andrew Wakefield of politics
The Andrew Wakefield of transportation and planning
Yet here he was at the Liberty Ball, on Friday, January 20, 2017, at a little after seven in the evening. Behind him, on Level 2 of the Walter E. Washington Convention Center, the first of the night’s revelers to pass through security rustled in their finery toward fluorescent-fronted bars. And Trump would later shuffle here with the first lady, Melania, to Frank Sinatra’s 1960s classic “My Way.”
“So, uh, yeah, very, very exciting times,” Wakefield gushed. “I wish you could all be here with us.”
Me too…
Deer, Brian (2020-09-28T23:58:59). The Doctor Who Fooled the World. Johns Hopkins University Press. Kindle Edition.
Struck-off former UK doctor among those spearheading efforts
It is becoming increasingly clear that amyloids are not necessarily the smoking gun of neuronal dysfunction and cognitive decline in neurodegenerative diseases. This is displayed in centenarians who have both apparently good cognitive health and brains populated with amyloids (1). Epidemiological data also point to the concept of cognitive reserve, where certain individuals appear more resilient to pathological changes in their brains (2). Hence, a challenge in neurodegeneration is to understand how certain aging brains successfully maintain proper neuronal function despite chronic amyloid buildup, whereas others do not. Several genetic studies have suggested that microglia, the primary tissue-resident macrophages of the brain, may be key in determining this success (3, 4). Emerging data in developing, adult, and diseased brains collectively suggest that microglia are critical to neuronal homeostasis and health. These observations raise the question of whether, and which, microglia-neuron interactions may be impaired in Alzheimer’s disease (AD) and Parkinson’s disease (PD) to confer neurodegeneration. Insight into this question will enable the development of methods to assess and modulate microglia-neuron interactions in the aging brain and allow for a desperately needed expansion of focus from clearing amyloids alone to monitoring neuronal health in biomarker and target engagement efforts…
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