Last week, as I reported here, journalist Brian Deer published a detailed investigative article in the BMJ about how former British surgeon and medical researcher Andrew Wakefield manipulated the data of his now-notorious (and retracted) 1998 Lancet paper to suggest a link between the measles, mumps and rubella (MMR) vaccine and autism.

As BMJ editor Fiona Godlee noted in an accompanying editorial, Wakefield’s paper “was in fact an elaborate fraud.”

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This week, in a second BMJ article, Deer provides evidence of a strong motivation for that fraud: money. Big money. For although Wakefield failed to disclose it when his Lancet paper was published, he was actively involved at the time in establishing several potentially lucrative autism-related medical businesses.

He and his investors wouldn’t make a dime, however, unless the MMR vaccine could be shown to be linked to what Wakefield declared was a new syndrome of brain and bowel disease — “autistic entercolitis.” (The existence of this syndrome is now considered highly dubious.)

For one of his business ventures, Wakefield planned to develop his own “replacement” vaccine for MMR. For another, he intended to develop and sell testing kits that would let doctors diagnose autistic entercolitis. In a business prospectus for investors, Wakefield said the testing kits alone would generate $44 million in annual revenues.

He also said the initial market for the kits would be the “litigation driven testing of patients with AE [autistic entercolitis] from both the UK and USA.”

Wakefield knew something about the big money that could be earned from vaccine litigation. Before he published his Lancet paper, he had received the British pound equivalent of hundreds of thousands of dollars from a law firm involved in product liability suits against vaccine makers — another fact he failed to make public at the time.

Some of Wakefield’s business efforts were put into motion long before he knew the results of his research for the Lancet paper — even before the first child in the study had been fully medically investigated, Deer reports.

For Wakefield, therefore, a lot of money rode on whether or not his research findings supported a connection between the MMR vaccine and autism.

Within months of the publication of the 1998 paper, officials at University College London, where Wakefield worked and conducted his research, became concerned about possible conflicts of interest and about the scientific strength of the methodology behind his research. They offered to give Wakefield funding to confirm his findings with a larger group of children. (The original paper had included only 12 children.) At first he agreed, but then he declined, claiming, strangely, that his academic freedom would be somehow jeopardized.

Wakefield left UCL in 2001. Deer quotes Wakefield’s former boss as saying that they paid him to “go away.”

As Deer also reports, Wakefield’s original findings have never been duplicated by independent researchers.

The details reported by Deer (from documents he obtained under Britain’s Freedom of Information Act) are quite damning. You’ll have to read his entire article to get the full weight of them. I’d like to add one more detail to my summary, however. Wakefield’s supporters often claim that the pharmaceutical industry is conspiring to ruin Wakefield because his research poses a threat to their multi-billion-dollar vaccine sales. Well, Deer has uncovered evidence showing that until questions arose about the validity of his research, Wakefield actually had support from such drug-industry giants as Johnson & Johnson, Merck and SmithKline Beecham. And, on at least one occasion, Axcan Pharma Inc. paid for his first-class trans-Atlantic airfare.

Not that those facts will change Wakefield’s pedestal-status among his supporters.

On Thursday, Dr. Gregory A. Poland and Dr. Robert M. Jacobson of the Mayo Clinic in Rochester published a brief but illuminating history of anti-vaccinationists in the New England Journal of Medicine. In it they write that “even though more than a dozen studies have demonstrated an absence of harm from MMR vaccination, Wakefield and his supporters continue to steer the public away from the vaccine. As a result, a generation of parents and their children have grown up afraid of vaccines, and the resulting outbreaks of measles and mumps have damaged and destroyed young lives.”

You’ll find Deer’s latest investigative article here and the NEJM commentary here.