The overlooked red flag of Wakefield (1998)

Andrew Wakefield (note: no longer Dr.) is almost entirely responsible for the spurious connection between vaccines and autism. This was reported extensively at the time by Brian Deer, a journalist who chased down leads, spoke to scientists involved, spoke to scientists cited, and tried (and mostly failed) to speak with Wakefield himself. Deer had both excellent written reporting, along with a television documentary. The Wakefield article in question was later retracted. The whole affair was summarized in 2021 by youtuber Hbomberguy in what remains an entertaining and informative watch. 

The article itself is capably criticized by Deer and Hbomberguy, who note several red flags, including:

• Connections between onset of behavioral symptoms and exposure to vaccines were noted by parents – that is, it’s just what the parents happened to believe

• Onset of symptoms after vaccination reported by parents from 24 hours to 1-2 months

• Citations include a reference to a “study” by a former doctor who believes he can cure autism with a pill he invented using his own biological material

• A truly bizarre theory of autism that asserts that problems in the gut lead to “opiods” from food freely entering the bloodstream (???)

• Speculation that monovalent vaccines are safer than combined vaccines, without clear reasoning as to why (see below for the reason why)

Beyond what could be seen by readers at the time of publication, Deer reported:

• Falsification of patient records

• Wakefield was contacted by a lawyer who wanted evidence to form a class-action suit, and explicitly asked for (and paid) Wakefield to manufacture such evidence, prior to the study

• A patent, filed by Wakefield, for a monovalent vaccine, which he had baselessly asserted would be safer than the combined MMR vaccine

There you have it! On its face, the article has issues. And behind the scenes, reporting found worse issues, including what appears to be a financial motivation for writing the article. 

But what if something stands out, even beyond these points?

The “Early Report” switcheroo

Anyone reading the article at the time could see that the article is filed as an “Early Report.”

An early report or “brief report” is, according to the Mayo Clinic, designed to spark interest in a more rigorous study. That is to say, this is an observation and the lowest level of evidence, not intended to suggest control over the variables.

This also (presumably) leads to a lower level of scientific scrutiny. After all, Wakefield is saying: we haven't proven anything. Journal reviewers understand that the early report is just a prelude to something more.

And then, after the article concludes:

The gigantic “RETRACTED” across each page makes it a chore to read, but here is the text:

Addendum:

Up to Jan 28, a further 40 patients have been assessed; 39 with the syndrome.

Oh this? It’s just a widdle early report, nothing serious! (P.S. 98% of referrals have this)

The addendum is designed to grant undue gravitas to a paper that was deliberately undersold to avoid scrutiny. Earlier we alluded to the fact that readers could not have known that data was faked or that the author had a conflict of interest, but reviewers should not have allowed the egregious addendum to be included.

A similar trick by Wakefield was to hold a press conference about the paper, which is incredibly atypical and was the initial spark for the vaccine panic in the UK. His early report, not regarded as strong evidence, presented to the media without context in order to legitimize the illegitimate. 

…What is your point?

The article is found to be scientifically invalid. Later studies show that MMR viruses and/or antibodies do not show up in the intestinal tissue of autistic kids. Later reporting shows that Wakefield did it for the money. Later reporting shows that Wakefield altered data. This is all important to know. But at the moment it was published, readers wouldn’t have been able to know all these facts. 

Nevertheless the article is clearly a fraud merely on face value. You can read it critically and recognize the trick without knowing the data is altered, etc. 

It’s true that science should be criticized from the perspective of scientists. However, that is not always a convincing perspective for the layperson. Frankly I’m not capable of evaluating ileal tissue samples after all. But I am capable of evaluating the rhetorical tricks of a grifter. Perhaps anti-vaxers should read the article, and do their own research.