There cannot be many doctors as thoroughly discredited and ostracised as Andrew Wakefield has been in the UK who are subsequently seen smiling at the inauguration ball of a US president and later discovered to be dating the Australian model Elle Macpherson.
But there he is. Wakefield was all but drummed out of Britain. The gastroenterologist lost his job, had his scientific paper linking the MMR vaccine and autism retracted by medical journal the Lancet and, in 2010, was struck off the medical register. He disappeared to the US and it was assumed he had gone to ground, having lost all credibility. He was a spent force, even though his name was often in the air as the anti-MMR views he seeded around the world led to many parents shunning the vaccine and outbreaks of measles wherever anyone had heard Wakefield’s creed.
It was known he was in Texas with those who shared his views on vaccines and conspiracy. But he was not a public figure. Until Donald Trump was elected US president of the United States.
Under an anti-establishment presidency, the anti-vaccine crusader, whose views appear to have become all the more entrenched by his drubbing at the hands of eminent scientists around the world, is back in the limelight and his new visibility could give his arguments even more currency. At one of President Trump’s inaugural balls in January last year, he was quoted as contemplating the overthrow of the (pro-vaccine) US medical establishment in words that brought to mind Trump himself. “What we need now is a huge shakeup at the Centers for Disease Control and Prevention (CDC) – a huge shakeup. We need that to change dramatically.”
That same month, vaccine sceptic Robert F Kennedy Jnr announced that he would be heading up a new federal panel on vaccine safety convened by Trump. It didn’t happen, but the possibility sent shivers through the medical world.
This week, it became clear that Wakefield has been accepted by celebrity-smitten US society. Separated from Carmel, the wife who was staunchly at his side throughout the UK debacle, he is now dating Elle Macpherson, a supermodel with her own nutrition brand. He was photographed this week kissing her on an organic farm in Miami.
In fact, Wakefield never did run and hide. From the very beginning, he had supporters who hailed him as a hero victimised by the medical establishment in the UK which, they believed, was in hock to big pharma. The perpetual cry of the anti-vaxxers is that you can’t trust the drug industry – which is only interested in profits and not people – to tell you the truth.
If Wakefield ever had the normal uncertainties of a scientist embarking on research, wondering what their investigations will prove, that must have been pulverised by the avalanche of criticism over the Lancet study. He and those around him now believe there is a massive conspiracy to force vaccines upon our children, driven and funded by the wealthy pharmaceutical companies and those who take their shilling.
It is 20 years since the crucial paper was published by the Lancet, one of the world’s best-respected medical journals, in February 1998. Even at the press conference to launch the paper, the dean of the Royal Free hospital in London where Wakefield worked was trying to dampen down any speculation about the implications. The paper featured just eight children – a case series, not a trial. But it purported to find a connection between the measles, mumps and rubella vaccine (MMR), gut problems and autism in children. Little was known about the causes of autism. The paper was dynamite. Parents recalled that their autistic children had been developing normally until they had the MMR – in fact, it is at about that age that the symptoms often first show themselves, regardless of immunisation.
Wakefield could have taken the medical establishment’s criticism on the chin, accepted that he might be wrong and continued with a promising career. But he refused to back down. In March, the Medical Research Council, which had been quickly tasked by the government with finding out whether there could possibly be a problem with MMR, said there was no evidence. Wakefield battled on, offering scientific papers by himself and collaborators to try to prove the thesis. Their arguments were dismissed. In 2001, he left his job at the Royal Free. In 2004, allegations were published in the Sunday Times that Wakefield had been funded by the Legal Aid Board while looking for evidence for parents of autistic children suing vaccine manufacturers for compensation. In 2010, he was struck off the medical register and forbidden from practising – the ultimate disgrace for a doctor.
By then, he was in New York, reviling the British establishment and insisting he was right. The General Medical Council’s decision was predictable, he told me by phone. “It seemed to me that they had come to this decision a long time ago, long before the evidence was fairly heard. This is the way the system deals with dissent. You isolate, discredit and provide an example to other doctors and scientists not to get involved in this kind of thing. That is examining questions of vaccine safety,” he said.
There are plenty of vaccine sceptics in the US and, as everywhere, parents of autistic children looking for answers. Wakefield went to Texas, working with autism-related charities and businesses. In 2005, while still a registered medical practitioner, he became director of the Thoughtful House Center for Children, an autism treatment and education centre in Austin (now known as Johnson Center for Child Health and Development), but resigned after losing his licence.
He then founded the Strategic Autism Initiative the same year, and ran it with Polly Tommey, a British mother with an autistic son, who has been a major collaborator and ally. Wakefield also founded the Autism Media Channel in Austin, which makes videos asserting a link between autism and the MMR vaccine.
Its most famous film was Vaxxed, directed by Wakefield, which was put forward to premiere at the 2016 Tribeca film festival by Robert De Niro, the father of an autistic child. It alleges a cover-up of the alleged link between MMR and autism by the CDC – the institute Wakefield said needed a shake-up at the Trump inaugural ball. After the furore that broke out and discussions with scientists, De Niro eventually withdrew the film.
Many worried parents in the US and Europe continue to shun the MMR vaccine, fearful that it could precipitate autism in their child in spite of all the reassurances of the World Health Organization and public health authorities around the world. An outbreak of measles in Minnesota in the spring of last year was caused by doubts about the MMR vaccine in the local American-Somali community, who had seen the incidence of autism rise. Wakefield had been a visitor to the community six or seven years earlier, talking to them about the risk of autism.
Worldwide last year, measles cases soared in Europe, according to the WHO. There was a four-fold increase during 2017 with large outbreaks in one in four countries. Festivalgoers were urged to get the jab, after infection rates in England tripled in a year. “Over 20,000 cases of measles, and 35 lives lost in 2017 alone, are a tragedy we simply cannot accept,” said Dr Zsuzsanna Jakab, the WHO regional director for Europe, at the time. Romania, Italy and the Ukraine were worst hit.
Loss of confidence in the MMR vaccine, which is very effective, was blamed. There are ambitions to wipe out measles from the planet, but that will not be possible while confidence in the immunisation programmes is undermined. Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance says vaccination in developed countries has never fully recovered since Wakefield’s initial claims, and that “the anti-vaccination campaigners he continues to spearhead” are “endangering the health of children across the world”.
The internet and social media have spread vaccine doubts and conspiracy theories around the world. Wakefield has said so himself. Social media has provided an alternative to the “failings of mainstream media”, he has said – another phrase that could have come from a tweet by the US president himself. “In this country, it’s become so polarised now … No one knows quite what to believe,” Wakefield said. “So, people are turning increasingly to social media.”
The scientific establishment has its work cut out. Wakefield and his supporters insist mainstream science is wrong and will not be persuaded otherwise. The conspiracy theories of the anti-vax movement are all over the internet. The apparent acceptance of Wakefield into the upper echelons of American society can only boost them further.