Vax Populi: Vaccines, Autism, and RFK, Jr.

Robert F. Kennedy, Jr. accepts the scientific consensus on climate change but rejects the conclusion that vaccines do not cause autism. Why? He has been fooled by fraud

In light of the ascendency of Robert F. Kennedy, Jr. as a viable Democratic candidate challenging Joe Biden for the 2024 Presidential election (Newsweek reports “The Economist and YouGov released a survey that showed Kennedy with the highest favorability rating of all the current 2024 presidential candidates”), and the media coverage focusing on RFK, Jr.’s attitudes about vaccines—most notably his belief that they cause autism—I thought I would re-up my review (originally published in the Wall Street Journal on September 27, 2020) of Brian Deer’s exceptionally well-researched book on The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines.

The book is the story of Andrew Wakefield and the fraudulent science behind the alleged causal connection between vaccines and autism upon which so much of Kennedy’s beliefs depend. Kennedy is wrong and Wakefield has been declared a fraud. This much needs to be acknowledged. Kennedy claims to value scientific truth above ideology or politics—he accepts climate science and its conclusions about anthropogenic global warming entirely, for example. And he has repeatedly said on podcasts with Joe Rogan, Jordan Peterson, and Bari Weiss in recent weeks that he would change his mind on the alleged connection between vaccines and autism if the evidence changed. The evidence for the link is not only nonexistent, it never existed. In light of these facts it would behoove RFK, Jr. and his campaign to abandon this false belief.

Over the past decade it has become apparent that there is a “replication crisis” in science, most notably in the social and medical sciences, in which many noted and important studies fail to replicate and very probably never should have been published in the first place. The factors contributing to this problem include: the pressure to “publish or perish” that leads researchers to cut corners; the file drawer problem where nonsignificant results go unreported; data dredging and p-hacking, in which researchers generate false positives by manipulating statistical techniques to get significant p values and find patterns in data that support their preferred hypotheses; Texas sharpshooting, in which after the fact one draws a bullseye around a random cluster of data arrows; and publication bias, in which journals prefer original research over replication studies (including and especially those that fail to replicate).

These are all soluble problems in research methodologies and social norms, with practical solutions outlined by Stuart Ritchie in his book Science Fictions (Metropolitan Books), but one more is harder to detect and that is outright fraud, in which researchers consciously lie, cheat, and even fake their data. The exposure of that factor often takes courageous whistleblowers or tenacious investigative journalists.

Enter Brian Deer, the award-winning reporter for The Sunday Times of London whose The Doctor Who Fooled the World recounts his exhaustive 14-year investigation of Andrew Wakefield, the now-disgraced physician whose since-retracted article in the British medical journal The Lancet launched the modern anti-vaccination movement with his claim that the three-in-one MMR vaccine (measles, mumps, rubella) causes a bowel syndrome in children that leads to brain damage and autism.

Deer submits the facts to a candid world. In January of 1994 a British woman named Jackie Fletcher claimed that MMR caused her son’s brain damage and announced that she planned to sue the vaccine manufacturers. In February of 1996 Wakefield began work with an attorney named Richard Barr, who was awarded a contract by the British government’s Legal Aid Board to represent litigants in a class action lawsuit over MMR. In 1997 Wakefield registered for a patent on his own single measles vaccine, as well as for treatments for both inflammatory bowel disease and autism. In February of 1998 Wakefield’s co-authored paper in The Lancet staked his claim for the link between the MMR vaccine and autism.

The paper describes the intestinal biopsies Wakefield conducted in 12 children with intestinal symptoms and developmental disorders, 10 of whom were autistic. Nevertheless, the authors concluded: “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described. Virological studies are underway that may help to resolve this issue.”

In fact, virologic studies had already been done in Wakefield’s own lab and were negative. That didn’t stop Wakefield from holding a press conference announcing that MMR probably causes autism and recommending the termination of its use and instead proposed that three individual components of the vaccine be given in intervals of a year. Public panic ensued and immunization rates in the UK plummeted from 93 percent to 75 percent, and confirmed measles cases in England and Wales subsequently leapt from 56 in 1998 to 1,348 in 2008.

As the evidence against Wakefield’s hypothesis mounted, and no labs were able to replicate his study, and the detection of measles virus and the rate of intestinal disease was no greater in autistics, and more details about his personal and financial interests in discrediting the MMR vaccine came to the fore, and after the General Medical Council charged Wakefield with professional misconduct, in February of 2010 The Lancet and 10 of Wakefield’s 12 co-authors retracted the paper.

Thanks to Deer’s relentless efforts, the case against Wakefield grew even graver. It turns out that 11 of the 12 children in original study were litigants in the case against the MMR manufacturer, Wakefield was paid nearly half a million pounds by the attorney (with payments billed through a company owned by Wakefield’s wife), and he didn’t disclose any of this until Deer uncovered the conflict of interest shenanigans. Worst of all, when Deer was able to obtain the medical records of Wakefield’s subjects he discovered that several of them had presented with symptoms of autism before they got the MMR vaccine.

In summing up the findings from over 12,000 documents, 500 video and audio recordings, and more than 2,000 letters, emails, legal documents, business reports, and interview transcripts and recordings, Deer’s Jeremiad against Wakefield reveals that the linking of vaccines to autism was not a matter of unconscious bias, data snooping, Texas sharpshooting, or other replication crisis factors; rather, Deer convincingly shows that it was a matter of outright fraud motivated by money and fame, both of which Wakefield accrued (along with a relationship with the supermodel Elle Macpherson), propped up into guru-hood status—as if he were Galileo facing the inquisition—by parents of autistic children who were understandably distraught over their charges’ cognitive impairment. He remains active to this day in the anti-vaxxer movement and has appeared in public with Robert F. Kennedy, Jr. who uncritically swallowed Wakefield’s fraudulent claims.

Speaking more broadly, part of the problem we face in addressing such claims is that it is not altogether irrational for parents of autistic children to make such a causal connection. It is a case of what the philosopher David Hume called constant conjunction, in which the pairing of A (the MMR vaccine) and B (autism) leads our minds to assume a causal connection. But as Hume also noted in his counterfactual definition of causality, just as the rooster crowing doesn’t cause the sun to rise, as evidenced by the fact that if you silence the rooster the sun nevertheless appears above the morning horizon, autism occurs in non-vaccinated children and it continued to appear in vaccinated children even after the purportedly harmful element of the MMR vaccine—the mercury-based preservative thimerosal—was removed from vaccines.

Nevertheless, science has tools to determine if a constant conjunction represents a real causal connection or if it is a spurious correlation, and there isn’t a shred of evidence linking vaccines to autism. That Wakefield remains a hero of the anti-vaxxer movement is a testimony to the power of belief and the psychology of anecdotal causality.

Meanwhile, thanks to the anti-vaxxer movement, in a number of communities herd immunity has been breached and once-eradicated communicable diseases are making inroads in compromised populations. Ironically, the unvaccinated children of anti-vaxxer parents are themselves protected by the vaccinated children around them, but the problem lies with those who cannot get vaccinated for medical reasons and not enough people surrounding them are vaccinated.

The Doctor Who Fooled the World should put an end to what remains of the anti-vaxxer movement—at least that associated with Andrew Wakefield—but age and experience tells me that, if anything, it will only serve to bolster the status of their martyr. And, throughout the 2020 pandemic, we’ve seen similar arguments being made against the anticipated Covid-19 vaccine(s), with the customary concomitant conspiracy theories fueling paranoia. I’m not at all sure that history and science will be our guide to a rational response, but Brian Deer’s book is a model of how it could.

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Michael Shermer is the Publisher of Skeptic magazine, Executive Director of the Skeptics Society, and the host of The Michael Shermer Show. His many books include Why People Believe Weird Things, The Science of Good and Evil, The Believing Brain, The Moral Arc, and Heavens on Earth. His new book is Conspiracy: Why the Rational Believe the Irrational.

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