Questioning Offit. Part 12. Wakefield

When a true genius appears in the world, you may know him by this sign, that the dunces are all in confederacy against him.
Jonathan Swift

Chapter 6 (continued)

Over the past 15 years, most discussions about vaccines have, in one way or another, revolved around the story of Andrew Wakefield. Allegedly, there was a doctor who, in 1998, published a study linking vaccination to autism. But it later turned out that he had been paid, and the study itself was falsified. As a result, the article was retracted, and Wakefield’s medical license was revoked. Subsequent studies supposedly proved once and for all that there is no link between vaccination and autism, and that all vaccines are safe and effective.

Although this story is often used as the main argument to dismiss any doubts about vaccines, not a single claim in it holds up to scrutiny.

In this part, we will examine the story of Andrew Wakefield. In the next ones, we will try to understand whether the studies that followed truly proved the absence of a link between vaccination and autism.

***

After complaining about judges who awarded compensation to people allegedly injured by vaccines — injuries that, in his view, were not caused by the vaccines — Offit moves on to the topic of vaccination and autism. He writes about the Wakefield’s study:

In his paper, Wakefield proposed a series of events: measles vaccine entered the intestines causing inflammation; once inflamed, the intestines became leaky, allowing harmful proteins to enter the blood, travel to the brain, and cause autism.

That’s not true. Wakefield’s paper makes no such claim. The topic of the measles vaccine is not central to the article — it’s mentioned only in passing. The paper puts forward no hypotheses about a mechanism linking the measles vaccine to autism. It merely notes that eight out of twelve parents reported such a connection, and suggests that further research should be done to determine whether the link actually exists.

Autism and Intestinal Inflammation

Offit:

The worldwide panic following Wakefield’s paper caused researchers to take a closer look. Investigators found that children with autism were not more likely to have measles vaccine virus in their intestines; and they were not more likely to have intestinal inflammation.

Let’s start with the claim that children with autism are no more likely to experience intestinal inflammation. To support this, Offit cites three studies conducted between 1998 and 2002. However, more recent research has actually confirmed Wakefield’s hypothesis.

A 2014 meta-analysis that included 15 studies found that gastrointestinal symptoms occur four times more frequently in children with autism. These findings were confirmed by a systematic review and meta-analysis in 2022, and again in another meta-analysis published in 2023. Moreover, a 2020 systematic review and meta-analysis — followed by another in 2024 — demonstrated that children with autism are significantly more likely to exhibit increased intestinal permeability.

The link between autism and gastrointestinal dysfunction — for which Wakefield was harshly criticized by virtually everyone — is now widely recognized in the medical literature.

In short, Wakefield’s hypothesis that children with autism are significantly more likely to have intestinal inflammation and increased gut permeability has been fully confirmed. And in fact, Wakefield was far from the first to propose this idea.

The link between psychiatric disorders — such as schizophrenia — and increased intestinal permeability was already being discussed back in the 1980s. And the fact that children with autism frequently suffer from digestive issues was noted as early as 1943 by Leo Kanner, the very person who introduced the term autism, in his seminal paper. Connections between autism and celiac disease, as well as the potential benefits of a gluten-free diet in such cases, were being discussed in the 1960s. The association between autism and nutrient malabsorption was already present in the scientific literature in 1971. In 1972, this link was also mentioned by John Walker-Smith, Wakefield’s co-author in the 1998 study. Increased gut permeability in autistic children was reported, for instance, in an Italian study from 1996, two years before Wakefield’s publication.

And yet — no one outside the scientific community paid attention to those articles, no one retracted them, and no one accused the authors of fraud.

So how is it that, immediately after Wakefield’s famous study, researchers rushed to investigate the gut–autism link and somehow couldn’t find any connection — only for it to suddenly resurface 10 to 15 years later? Did autistic children simply stop having gastrointestinal inflammation between 1998 and 2010, only for it to return afterward?

Or is it more reasonable to suppose that, at the time, the scientific community was under intense political pressure aimed at discrediting Wakefield? That researchers chose not to investigate the topic — or avoided publishing their findings — fully aware that doing so might mean the end of their careers?

In fact, even after Wakefield’s 1998 study and up until 2010, several articles were published that described a connection between autism and intestinal inflammation. Offit, however — as usual — engages in cherry-picking, citing only those studies that support his position. Meanwhile, Wakefield had nothing to do with these other publications: Horvath, 2002, Bazola, 2005, Galiatsatos, 2009, Krigsman, 2010, Chen, 2010.

It’s important to note that all of these papers are clinical observations — descriptions of individual cases or case series — that follow the same format as Wakefield’s original article. And here we come to a crucial point: while several epidemiological studies failed to detect a real association between autism and intestinal inflammation, clinicians repeatedly observed and described the phenomenon in practice. Then epidemiologists came in, ran a few studies, found no association, and for the next 15 years the phenomenon was dismissed. Only a quarter of a century later, with new studies, systematic reviews, and meta-analyses, was this association finally and definitively confirmed.

This same pattern repeats itself with nearly all serious adverse effects linked to vaccination. Physicians repeatedly report case series where, for example, the DTP vaccine appears to cause encephalopathy or epilepsy in children. Then the epidemiologists step in, conduct case-control or cohort studies, and find no association. After that, organizations like the Institute of Medicine review only the epidemiological data, discard all the case reports as mere coincidences, and conclude that according to science, there is no link between DTP and encephalopathy.
Numerous case reports of hepatitis B vaccines triggering multiple sclerosis, or pertussis vaccines linked to sudden infant death syndrome (SIDS)? The script is always the same: conduct epidemiological studies, find no association, dismiss the case reports as anecdotal, and close the topic.

The autism–gut inflammation link followed this exact pattern. The only difference was that the topic couldn’t be buried — because the prevalence of autism rose exponentially. There were simply too many autistic children. And unlike infants who died of SIDS and could be quietly forgotten, the growing number of autistic children with serious gastrointestinal problems could no longer be ignored or waved away.

You’d think science would have learned something from this. That it would recognize the limitations of epidemiological studies as the sole basis for establishing or rejecting causality.

But no — that lesson still hasn’t been learned. At least, not yet.

Autism and Measles in the Gut

Let’s now return to Offit’s first claim — that the measles virus is no more likely to be found in the intestines of autistic children than in other children. This claim, too, has nothing to do with Wakefield’s retracted paper. It emerged later, in the early 2000s, based on a number of studies by other researchers — none of which were ever retracted.

In the late 1990s, when Wakefield’s study was published, it was generally believed that the measles virus disappears from the body within two weeks after vaccination and cannot persist for long periods, as Wakefield and some others claimed. But newer findings have challenged that assumption. A 2008 study detected vaccine-derived measles virus in the intestinal biopsies of two children more than six months after vaccination. An Australian study in 2019 found the vaccine-strain measles virus in the respiratory tracts of 11 children more than 100 days post-vaccination — and in some cases, up to a year or even two years after vaccination.

The first study to detect measles virus RNA in the blood of autistic children was conducted in Japan in 2000. Then in 2002, a British study reported measles virus in the intestines of 75 out of 91 children with intestinal inflammation. Wakefield was a co-author on both. Later, U.S. studies in 2002 and 2003 found unusual measles-related antibodies, as well as elevated measles antibody titers in autistic children. A 2004 study detected measles virus in the cerebrospinal fluid of children with autism.

In 2006, Stephen Walker of North Carolina conducted a similar study among autistic children with intestinal inflammation and found vaccine-strain measles virus in the intestines of 85% of them. His findings were presented at a conference in Montreal, made headlines, and caused a scandal. After that, the study was never published.

Then, between 2006 and 2008, a number of studies emerged that contradicted the earlier ones — failing to detect measles virus in the guts of autistic children. Offit cites one of these, but there were a couple of others as well [1] [2], after which the entire topic faded away. Notably, one of the first studies not to find measles virus in autistic children was published back in 1998 by Wakefield himself, co-authored with his graduate student Nicholas Chadwick [1].

I don’t claim to know where the truth lies. It’s entirely possible that Wakefield was wrong in this case. He certainly couldn’t have fabricated all those studies: he was involved in only some of them, and only as merely as of the co-authors. Perhaps there was contamination, or the testing methods lacked specificity.

Or perhaps — just like with his other hypothesis about autism and gut inflammation — the studies that refuted the measles virus connection were no better in quality than the early ones that dismissed the gut-autism link. The final word on this issue has yet to be spoken.

The effort to discredit Wakefield resulted in the gut–autism connection being buried for nearly two decades. Even now — almost 30 years after his study — the topic remains largely avoided, even though the connection itself is no longer seriously questioned in the medical literature.

But while the link between the gut and autism eventually became undeniable, especially as autism went from a relatively rare condition to a widespread epidemic, the idea of a possible connection with the measles virus remains something the scientific community can still afford to ignore — even if it does exist.

Gastrointestinal symptoms in autistic children are visible to the naked eye. Any pediatrician can begin to notice the pattern simply by listening to patient histories. But research into viruses requires colonoscopies, biopsies, laboratory equipment, high-specificity assays, and ethics committee approvals. It’s a complex, expensive, and high-risk endeavor — both scientifically and reputationally. In the last 15 years, no one has seriously pursued this line of investigation. No one wants to become the next Wakefield.

In any case, it’s worth emphasizing once more: the claim that the measles virus enters the intestines has nothing to do with the retracted Wakefield paper. That claim was made in other studies, none of which have ever been retracted.

Ostracism

Offit:

Scientists and public health officials didn’t marginalize Wakefield because he had challenged the belief that vaccines are absolutely safe; they did it because he was wrong—clearly and inescapably wrong.

Many scientists publish studies that are later disproven. That’s part of the scientific process, and in a healthy academic environment, no one is ostracized for it. Being wrong is normal. Even if Wakefield had turned out to be wrong, ostracism has no place in science. He was not ostracized because he was wrong — he was ostracized to send a message to other physicians and researchers.

Ostracism is used when there’s nothing to rebut on the merits. Throughout the history of science, there have been many cases where those who were cast out later turned out to be right. Galileo Galilei, who proposed that the Earth revolves around the Sun; Giordano Bruno, who suggested that the universe is infinite; Ludwig Boltzmann, who theorized that matter is made of atoms; Ignaz Semmelweis, who advised doctors to wash their hands after dissecting corpses. Even Andreas Vesalius, the founder of modern anatomy, faced rejection by the medical establishment.

In the 1970s, Linus Pauling was ostracized after publishing the first study suggesting that vitamin C could be effective in cancer treatment. A series of follow-up studies by the prestigious Mayo Clinic failed to replicate his results — but they had used oral administration, whereas Pauling had used intravenous vitamin C. The research was dismissed, and Pauling — a two-time Nobel Prize winner — became a pariah in the scientific community. Only now, half a century later, are new studies beginning to confirm Pauling’s original conclusions.
Wakefield’s 1998 paper was formally retracted in 2010. In the 15 years since, much of the core content of that study — and of his subsequent research — has been confirmed. Whether the rest will be confirmed remains to be seen. But in any case, to claim that “science is settled” or that “science has reached a final conclusion” contradicts the very nature of scientific inquiry.

As Max Planck famously said, “Science advances one funeral at a time.” What was unthinkable 50 years ago is now scientific orthodoxy — and treatments once thought safe and effective just a few decades ago are now seen as dangerously misguided.

The Allegations of Brian Deer

Offit:

Because no one could confirm his work, Wakefield lost credibility among his colleagues. Then he suffered further disgrace. Brian Deer, a journalist working for the Sunday Times of London, found that the parents of five of the eight children described in Wakefield’s paper were suing pharmaceutical companies, claiming that MMR had caused autism. Deer also found that the personal-injury lawyer who represented these children, Richard Barr, had given Wakefield £440,000 (about $800,000) to perform his study, essentially laundering legal claims through a medical journal.

The whole story is reminiscent of an old Soviet joke:

— Is it true that Rabinovich won a Volga car in the lottery?
— Yes, absolutely true. Except it wasn’t Rabinovich, it was Ivanov. And it wasn’t a Volga, it was a hundred rubles. And it wasn’t a lottery, it was a card game. And he didn’t win — he lost.

Same pattern here. First of all, according to the very source Offit cites, Richard Barr didn’t pay £440,000 — he paid £55,000. Second, the money didn’t go to Wakefield personally, but to the hospital where he worked. Third, it wasn’t Richard Barr who paid, but the Legal Aid Board (LAB) — a government legal agency. Fourth, the payment wasn’t for the 1998 study, but for a different study completed in 1999. Fifth, Wakefield is a gastroenterologist, not a psychiatrist. Barr — or rather, the LAB — was not funding a search for a link between the MMR vaccine and autism, but an investigation into a possible connection between the vaccine and inflammatory bowel disease.
But other than that — sure, everything checks out.

Now let’s take a closer look.

Andrew Wakefield is a gastroenterologist specializing in Crohn’s disease and inflammatory bowel disease. His first paper on a possible link between persistent measles virus and Crohn’s disease was published in 1993, together with several co-authors. In 1995, he co-authored a study titled "Is measles vaccination a risk factor for inflammatory bowel disease?" — published in The Lancet. Only after this, in 1996, when he was already published more than 100 papers and was a recognized specialist in his field, Richard Barr approached him — inviting him to testify in court as an expert witness and offering to fund research into whether the measles virus could persist after infection or vaccination, and whether it could lead to complications like Crohn’s disease or autism.

Any clinical study requires funding. Usually, such funding comes from pharmaceutical companies. They approach clinics, provide financial support, and physicians working at those clinics conduct the studies. But in this case, the sponsor was not a pharmaceutical company, but a legal organization — specifically, the Legal Aid Board (LAB), a government-funded agency that supports class-action lawsuits. So the money came not from a commercial interest, but from the state.

In August 1996, the Legal Aid Board sent a check to the hospital. However, unlike the routine flow of pharmaceutical funding, this payment caused confusion — the administration simply didn’t know what to do with it. In the end, the check was left hanging — and as it turned out later, it had been held up by Arie Zuckerman, the Dean of the Medical School. (p. 102)

Arie Zuckerman and Conflicts of Interest

It turned out that several months before this incident — in early 1996 — Sir David Hull, head of the UK’s Joint Committee on Vaccination and Immunisation, along with representatives from the Department of Health, had contacted the leadership of the medical school where Wakefield worked. They demanded that pressure be put on him to halt his research.

Professor Arie Zuckerman, the school’s dean, spoke with Wakefield and told him that participating in such a study constituted a conflict of interest. To which Wakefield replied:

I do not think that there is any conflict between duty of care to patients or the provision of independent expert advice to lawyers. However, it is a different matter when lawyers fund a particular piece of research where a specific action is contemplated. This surely suggests that some preliminary legal discussions have taken place and that a specific action is contemplated. If so, then the interpretation must surely be that a conflict of interest may well exist. The School must, therefore, seek expert advice, but in the meantime you should know of my concern. (p. 98)

When clinical trials of vaccines or medications are funded by pharmaceutical companies — whose primary goal is profit — no one seems bothered. No one raises questions about potential conflicts of interest or ethical concerns.

But the moment lawyers fund a study that might suggest some children were harmed by adverse effects of vaccination, it is immediately declared an unacceptable conflict of interest.

Professor Arie Zuckerman reached out to Dr. Mac Armstrong, chair of the British Medical Association’s ethics committee. In October 1996, he wrote him the following letter:

A senior member of the School’s clinical academic staff is engaged in work that has become somewhat controversial in that he is suggesting a causal link between the measles virus and in particular vaccination against measles and the onset of Crohn’s disease and inflammatory bowel disorders. Arising from recent widespread publicity given to this research, the Legal Aid Board has provided funding through a firm of solicitors representing Crohn’s disease sufferers and we have been asked to make an appointment to the staff of the Medical School specifically to undertake a pilot study of selected patients. Clearly this could lead to a case against the Government for damages. (p. 100)

Mac Armstrong replied only six months later, in March 1997, writing:

funding of research by special interest groups is commonplace and as long as the findings, or uses to which the data is put, are not influenced by the wishes of the funders, this should not be problematic.
…to delay or decline to conduct research which appears to be in the public interest on the grounds that it may embarrass the government or a particular health facility does not appear to be a sound moral argument. (p.107)

The chair of the British Medical Association’s ethics committee made his position clear: not conducting this research would itself be unethical. Reluctantly, Arie Zuckerman signed the check only in May 1997.

By that time, the very 12 children later described in the retracted 1998 paper had already been examined. The funding in question, once again, was not for that study, but for a different one, completed in 1999, which aimed to determine whether the measles virus persists in the intestines of affected children.

Incidentally, that same year — 1997 — while expressing concern over potential conflicts of interest regarding the Legal Aid Board’s funding of vaccine-related research, Zuckerman published an editorial in the New England Journal of Medicine (NEJM), in which he strongly advocated for universal infant hepatitis B vaccination.

What he failed to mention was that he was listed as an inventor on a patent related to the hepatitis B vaccine — and could therefore have personally benefited from the very public health policy he was endorsing. At the time, however, the NEJM had strict rules prohibiting editorial contributions from authors with undisclosed patent-related conflicts of interest.

The Press Conference

It wasn’t Andrew Wakefield, but Arie Zuckerman who was truly responsible for the scandal that followed the publication of the study. It was Zuckerman’s decision to hold a press conference ahead of the paper’s release, hoping it would bring positive publicity to the hospital. During the press event, when a journalist asked a question about the safety of the MMR vaccine, it was Zuckerman who passed the question to Wakefield — fully aware of his views on the subject — even though several other co-authors of the paper were also present. What’s more, after Wakefield gave his now-famous response, Zuckerman publicly supported him. He added that it was entirely plausible that the MMR vaccine, which contains three live viruses, might be more likely to cause adverse reactions than monovalent vaccines.

Thousands of scientific articles are published every day, and the vast majority of them go unnoticed. Wakefield’s study was merely a case series describing twelve children. Without the press conference, it’s very likely that no one outside a narrow circle of specialists would have ever heard of it. It would have passed quietly, just like thousands of other studies documenting vaccine side effects.

In fact, Wakefield’s paper wasn’t even the first to mention a possible link between vaccination and autism.

The first known case of regressive autism following smallpox vaccination was described in Leo Kanner’s 1943 paper, although he himself didn’t draw any connection between the two. In 1976, a study was published describing a 15-month-old child who developed autism after a smallpox vaccination. The authors considered a causal link unlikely, but acknowledged that the vaccine might have triggered the regression.

In 1994, Michael Rutter — widely known as the “father of child psychiatry” — described a case of autism that began after vaccination. (Ironically, it was Rutter who later played a key role in the revocation of Wakefield’s medical license.)

Wakefield wasn’t even the first to suggest a link between MMR and autism. A 1996 study reported that in 15 out of 22 cases, autism symptoms began within a week after MMR vaccination. No one retracted that paper. And no one would have noticed Wakefield’s paper either — just as no one noticed those studies and many others — had it not been for the press conference.

The Retraction of Interpretation

Offit:

When Wakefield’s coauthors found out about the money, ten of thirteen formally withdrew their names from the paper, distancing themselves from the MMR-causes-autism hypothesis.

This is a lie. First of all, Wakefield’s co-authors were fully aware of the funding — which, once again, went to the hospital, not to Wakefield personally. Second, they never withdrew their authorship. The only thing they did was retract the interpretation.

Ninety percent of the study focused on a possible link between autism and gastrointestinal inflammation. The remainder mentioned a possible association with vaccination. In their 2004 statement, 10 of Wakefield’s 13 co-authors wrote:

We wish to make it clear that in this paper no causal link was established between MMR vaccine and autism as the data were insufficient. However, the possibility of such a link was raised and consequent events have had major implications for public health. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon these findings in the paper, according to precedent.

It was already clearly stated in the 1998 paper itself that no association had been established. The authors wrote, plainly: "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described."

The so-called “retraction of interpretation” was essentially a public relations move, proposed by Richard Horton, the editor-in-chief of The Lancet. Before this, such a retraction had been published only once, just a few months earlier (this is the precedent mentioned in the quote above). The third instance of a “retraction of interpretation” appeared in 2007. There have been no other examples of this type of retraction in the scientific literature. But even those other two cases involved authors retracting an interpretation they had actually made — in light of new data. The Wakefield case was entirely different: the co-authors withdrew an interpretation that the paper itself never actually made.

In a letter to The Lancet, Wakefield and two of his co-authors explained why they did not participate in the retraction. They wrote that they were not entirely sure what their colleagues had even retracted, basically stating that an interpretation is a possibility — and a possibility cannot be retracted.

John Walker-Smith and the Revocation of Medical License

Offit:

In January 2010, after England’s General Medical Council ruled that Wakefield had acted with “callous disregard” for children when he had subjected them to spinal taps, endoscopies, and intestinal biopsies; had brought the medical profession “into disrepute” when he had paid children £5 for their blood at his son’s birthday party; and had “failed in his duties as a responsible consultant” in not getting approval for his studies from an ethics review board, Barbara Loe Fisher continued to stand by him.

What Offit fails to mention is that in addition to Wakefield, the UK’s General Medical Council (GMC) issued a nearly identical ruling against Professor John Walker-Smith, the senior author of the Lancet paper. Both men were given 28 days to file an appeal. Walker-Smith did, as did Wakefield — but Wakefield was later forced to withdraw his appeal, after his insurance company refused to cover the legal costs.

In 2012, the High Court in London fully exonerated Walker-Smith and reinstated his medical license. The judge ruled: "the panel's overall conclusion that Professor Walker-Smith was guilty of serious professional misconduct was flawed, in two respects: inadequate and superficial reasoning and, in a number of instances, a wrong conclusion."

The GMC’s investigation of Wakefield and Walker-Smith had lasted 217 hearing days over three years — making it the longest case in the council’s history. Yet despite this massive effort, the country’s highest court ultimately found the GMC’s ruling superficial and inadequate, and overturned it.

The only difference between Wakefield’s case and Walker-Smith’s was that Wakefield, during his son’s birthday party, paid the child’s friends £5 each to allow him to draw blood samples for research. Although he obtained consent from both the children and their parents, he did not request formal ethics committee approval for this procedure.

One can debate whether that constituted a serious violation — and whether it justified the loss of a medical license — but it had no relevance whatsoever to the Lancet paper, nor to the possible MMR-autism connection.

Wakefield was targeted and ostracized for political reasons alone. He wasn’t even the lead figure in the Lancet study. He did not conduct the procedures on the children — that was Walker-Smith’s role. He did not make the diagnoses — those were made by pathologists. His role was to analyze the data and draft the paper. There were 12 other authors besides him. Wakefield wasn’t even the lead author — that, again, was Walker-Smith. Each co-author revised and approved the final version of the manuscript. None of them retracted the contents of the study. Six years later, under pressure from The Lancet editor Richard Horton, ten of them formally withdrew “the interpretation of the findings” — simply to quell the ongoing controversy. And yet, as noted already, the paper explicitly states: "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described." In other words, they weren’t just saying they hadn’t proven causation — they weren’t even attempting to prove correlation between MMR and autism.

This article, once again, was not extraordinary in any way. There are hundreds, perhaps thousands, of similar case reports that describe temporal associations between vaccinations and subsequent illnesses. I’ve barely referenced such studies in my book — there are simply too many of them. What turned this paper into a global scandal was not its content, but the press conference, the media response, and Wakefield’s charisma. A major role was also played by Prime Minister Tony Blair’s refusal to answer whether his son had received the MMR vaccine.

Before the 1998 publication, Wakefield reviewed the literature on MMR safety and concluded that existing studies did not demonstrate that injecting three live viruses into children at once was safe. Later, in 2005, a Cochrane review confirmed his concerns, stating: “The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate.”

Parents — most of whom had never heard of Wakefield before the press conference, and would never have heard of him otherwise — believed him. And yet, Wakefield was not opposed to vaccination. He did not call for children to remain unvaccinated. Answering a journalist’s question, he simply recommended giving measles, mumps and rubella vaccines separately, instead of as the combined MMR.

However, just six months later, in August 1998, the UK Department of Health removed single-antigen vaccines from the market, leaving only the combined MMR. Thus, the decline in vaccination coverage following the controversy was not Wakefield’s fault — he had proposed an existing alternative. Rather, it was the Department of Health that eliminated that alternative.

Michael Rutter and Conflicts of Interest

Wakefield was condemned under the principle of “give me the man, and I’ll find the crime.” Ironically, one of the main prosecution witnesses at the GMC hearings was Professor Sir Michael Rutter, who himself had described a case of autism following vaccination back in 1994 — four years before Wakefield’s publication.

On the one hand, Rutter claimed that the 12 children described in the paper had undergone unnecessary invasive procedures, such as lumbar punctures or intestinal biopsies. These accusations were fully dismissed during Walker-Smith’s 2012 appeal, since the procedures were performed not by Wakefield, but by Walker-Smith.

On the other hand, Rutter accused Wakefield of an undeclared conflict of interest — namely, that by participating as an expert witness in a legal case and not disclosing this in the Lancet publication, Wakefield had violated ethical standards.

However, Rutter himself regularly served as an expert witness in court cases involving vaccines, though unlike Wakefield, who testified on behalf of affected families, Rutter represented pharmaceutical companies.

In 1998, under The Lancet’s conflict of interest policies at the time, authors were required to disclose only active conflicts directly related to the subject of the published paper. These policies became much stricter in the early 2000s, when authors were expected to disclose not just active conflicts, but also perceived conflicts — those that readers might interpret as conflicts, even if they weren’t real. After this change, the percentage of Lancet articles including a conflict-of-interest declaration increased a hundredfold, from 0.5% to over 50%.

Wakefield, however, was tried between 2007 and 2010 under these stricter retrospective standards — even though his paper had been published in 1998, when such rules were not yet in place. It was precisely this retroactive application of the new guidelines that allowed The Lancet to retract the paper.

Michael Rutter, a member of ethics committees and a self-declared “expert on conflicts of interest,” published at least five papers between 2005 and 2008 asserting that vaccines were not linked to autism. In none of these publications did he disclose the fact that he regularly served as a legal expert on behalf of vaccine manufacturers — a clear and ongoing conflict of interest. Yet none of his articles were retracted, and no formal proceedings were ever launched against him. On the contrary, he became one of the key prosecution witnesses in the GMC case against Wakefield.

Richard Horton

However, it was not Rutter, but Richard Horton, the editor-in-chief of The Lancet, who played the leading role in the campaign against Wakefield. Horton was the one who initiated the entire process of discrediting Wakefield by making public statements that Wakefield’s paper “should never have been published” due to a conflict of interest. That statement prompted The Sunday Times to begin publishing allegations brought forward by journalist Brian Deer.

In 2004, Horton openly declared: “The career assassination of Wakefield cleansed science of an unwise agent provocateur.”
In his book, titled Second Opinion, published in 2003, Horton admitted experiencing a severe personal crisis following the publication of Wakefield’s paper. He recounted that the former president of the UK Academy of Medical Sciences called him furious over the article, which raised doubts about MMR. He described a terrible experience at a formal dinner where he was asked whether he would ever be forgiven for that publication and its aftermath. Horton spoke of “very personal” attacks — unusual for scientific discourse. And he confessed that, despite the editorial team’s best efforts, public concern about vaccine safety “spiraled into a snowball effect.”

In another book of his, titled MMR: Science and Fiction, published in 2004, Horton writes:

"In truth, they (the GMC) had not a clue where to begin. At a dinner I attended on 23 February (2004), one medical regulator and I discussed the Wakefield case. He seemed unsure of how the Council could play a useful part in resolving the confusion. As we talked over coffee while the other dinner guests were departing, he scribbled down some possible lines of investigation, and passed me his card, suggesting that I contact him directly if anything sprang to mind. He seemed keen to pursue Wakefield, especially given ministerial interest. Here was professionally led regulation of doctors in action - notes exchanged over liqueurs in a beautifully panelled room of one of medicine's most venerable institutions (p7-8)"

In other words, Horton is almost explicitly stating that the General Medical Council didn’t know how to get rid of Wakefield and turned to him for help — which he then provided.

This is the same Richard Horton who, in a 2015 article, wrote:

[M]uch of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.

Conclusion
This article has addressed only those aspects of the Wakefield story that Paul Offit discusses. Beyond these, there are other absurd accusations against Wakefield.

For example, he is often accused of opposing the MMR vaccine because he supposedly held a patent for his own measles vaccine. While there was indeed a patent involved, it was neither for a vaccine nor in Wakefield’s name. The patent concerned a method for producing transfer factor, and the primary beneficiary was the hospital where Wakefield worked—not Wakefield himself. Moreover, even if Wakefield had held a patent for an alternative measles vaccine, we’re talking about the late 1990s—a time when it took decades to move from patent to licensed product, not the nine months we see today.

Another widely repeated accusation, promoted by Brian Deer, is that some of the children featured in the study showed signs of autism prior to vaccination, or only developed symptoms much later. However, even the General Medical Council (GMC) did not support this claim in its 2010 ruling. Wakefield thoroughly analyzes each of the 12 cases in his book. Furthermore, it was later revealed that in the case of one of the study participants (child no. 9), the mother associated the onset of regressive autism with the administration of the MMR vaccine. However, this information was not included in the published paper, because the child’s father forbade the mother from mentioning any possible link to the vaccine—since whenever it was brought up, doctors reacted with hostility, which negatively affected the parents’ ability to get help for their child.

Far more intriguing questions—ones that, curiously, no one seems to be asking—are: how did journalist Brian Deer gain access to the confidential medical records of these children? Who leaked this legally protected personal information to him? Why did the British Medical Journal publish his accusations without properly verifying them? And why, after the GMC made every effort to find any possible fault with Wakefield but ultimately found no issue with how the children's medical histories were presented, have Deer’s articles still not been retracted?

The Lancet retracted the Wakefield’s paper in 2010, immediately following the GMC’s decision. The official grounds for retraction were the article’s claim that the children were “consecutively referred,” which the GMC found to be inaccurate. However, in 2012, the High Court in London, ruling on John Walker-Smith’s appeal, completely overturned that conclusion, stating that the GMC had misinterpreted the phrase.
The second reason for the retraction was the GMC’s finding that the research had not been approved by an ethics committee. This claim too was fully rejected by the High Court. The judge concluded that the procedures in question were part of clinical diagnostics, not research, and thus did not require separate ethical approval. Therefore, The Lancet should have reconsidered its decision and reinstated the paper—but it never did. And no one is asking why.

Andrew Wakefield will undoubtedly be vindicated sooner or later—maybe in five years, maybe in fifty. And it does not even matter whether Wakefield was ultimately right or wrong. The mere fact of his ostracism, the double standards, and the fabricated accusations are, in and of themselves, a death sentence for the scientific method. Science will either vindicate Wakefield, or it will complete its descent into dogma.