A pediatrician and prominent critic of the anti-vaccine movement reviews the science behind a controversial new documentary about vaccines and autism.
On March 26, Robert De Niro reversed his decision to premiere the movie Vaxxed at the Tribeca Film Festival. Andrew Wakefield, the film’s director, claimed that Vaxxed had been the victim of censorship. Almost every major news outlet carried the story. What happened?
In 1998, Wakefield, a British physician and researcher, published a paper claiming that the combination measles-mumps-rubella (MMR) vaccine caused autism. The publication ignited an international firestorm; thousands of parents in Europe and the U.S. chose not to vaccinate their children. Outbreaks of measles followed; hundreds were hospitalized and at least four children died.
During the next 12 years, disturbing facts about Wakefield and his study came to light. First, and most important, more than a dozen studies performed in several countries involving hundreds of thousands of children and costing tens of millions of dollars showed that the MMR vaccine didn’t cause autism. Wakefield had been wrong. Worse, he was found to have falsified biological and clinical data, drawn blood from children who had attended his son’s birthday party, and neglected to mention to his colleagues that he had been paid more than $800,000 on behalf of several children in his study whose parents were in the midst of suing vaccine makers, essentially laundering legal claims through a medical journal. In 2010, Wakefield’s paper was retracted, but not before he had lost his license to practice medicine.
Wakefield moved to Florida, then Texas, where his career went into free fall. Ignored by the media and marginalized by the scientific community, he became a pariah, supported only by a small group of parents who saw him as a countercultural hero. But in Vaxxed: From Cover-Up to Catastrophe, Wakefield is back, resurrected as a documentary filmmaker.
In his film debut, Wakefield has cast himself as the victim of a massive conspiracy to hide the truth. In Vaxxed, we learn that a 1994 study performed by the Centers for Disease Control and Prevention (CDC) apparently buried the fact that MMR had caused autism in a small subset of African-American boys — a fact that, according to Wakefield, should now exonerate him. How do we learn about this cover-up? One of the CDC researchers involved in that study has now stepped forward to blow the whistle on his colleagues.
Well, not exactly stepped forward. We never actually see this man in the movie. We just hear his voice, leaving open the question of whether the tapes were fairly edited or whether he was recorded without his knowledge. But to Wakefield this was the smoking gun — evidence that he had been right all along.
If MMR really does cause autism, why hadn’t the link been found in 15 other studies, many of which included African-Americans and almost all of which didn’t involve the CDC? Are there other whistleblowers who just haven’t come forward yet? The real explanation for Vaxxed‘s “revelation” isn’t conspiracy or hidden data; it’s something else. When compared with their Caucasian counterparts, African-American boys in Atlanta in 1994 were under-vaccinated. In order to qualify for autism-support programs, this subset of under-vaccinated children with autism had to get vaccinated. In other words, it wasn’t that MMR had caused autism; it was that the diagnosis of autism had caused them to get MMR. Not surprisingly, this is never explained in the film.
Whistleblowers are supposed to blow the whistle on malfeasance that has resulted in harm. In this case, there was no malfeasance and there was no harm. Which is probably why the whistleblower never really blows the whistle. Others in the movie try to blow it for him but without much sound.
The real crime of Vaxxed — apart from the fact that Wakefield will again scare some parents unnecessarily — is that it misses the real story. What drove Wakefield from being a respected researcher to a conspiracy theorist? What caused him to go from being a consultant physician at one of London’s most renowned hospitals to making a film about autism that doesn’t include a single, well-respected autism expert? Because the movie fails to answer these questions, Wakefield remains an enigmatic figure.
Also, just for the record, Vaxxed contains several statements that are painfully inaccurate. For example:
• Children who receive the single measles vaccine instead of MMR don’t develop autism. Amazing, given that unvaccinated children can develop autism. Does this mean that the single measles vaccine prevents autism?
• Vaccines are not tested prospectively in placebo-controlled trials or with other vaccines that are given at the same time. In fact, all vaccines submitted to the Food and Drug Administration (FDA) for licensure are subjected to this kind of testing.
• Rates of autism are rising exponentially; it is now estimated that by 2032 about 80 percent of boys will be on the autism spectrum, essentially creating a new normal. On the contrary, the latest evidence shows that rates of autism in the U.S. have plateaued.
For people who believe that President Barack Obama is not a U.S. citizen, that the moon landing was filmed on a Hollywood soundstage and that an intergalactic board of elves and fairies are trying to get the IRS out of Puerto Rico, this movie is for you. For the rest, I would recommend waiting for a film that explains what internal demons drive a man from a field that demands logic and reason into a world where logic and reason are the enemy.
Paul A. Offit, M.D., is a professor of pediatrics in the division of infectious diseases at the Children’s Hospital of Philadelphia. His book, Autism’s False Prophets: Bad Science, Risky Medicine and the Search for a Cure (2008), has made him one of the most prominent critics of anti-vaccine rhe