Andrew Wakefield’s film, VAXXED, opened today in a theater in New York. Mr. Wakefield somehow convinced Robert De Niro to break the rules of the Tribeca Film Festival and personally insert the film into the lineup of TFF. When this was discovered, Mr. De Niro first defended his decision and, after getting input from people whose expertise is science, pulled the film. Mr. Wakefield, with no apparent sense of irony about having avoided due process to get into the festival, cried out that he was denied due process in the removal process. But didn’t hesitate to add the tagline to his film poster, “the film they don’t want you to see”.
The opening of VAXXED had about 20 people in the audience by one account. I couldn’t attend, but someone I know did and gave me a lot of feedback. I was preparing to give summarize that feedback here when a review on indewire came out: ‘Vaxxed: From Cover-Up to Catastrophe’ is Designed to Trick You (Review) which concurs with the impressions I was about to relate here. Here’s a paragraph from that review:
In a statement leading up to the film’s release, Wakefield’s co-writer Del Bigtree claimed that “Vaxxed” is “not an anti-vaccine movie,” which is kind of like saying “Triumph of the Will” is anti-Hitler. Strung together in obvious ways to induce a constant sense of dread (look out for the slo-mo shot of a crying child!), “Vaxxed” shamelessly repeats the same non-arguments over and over again, drowning facts in murky proclamations.
VAXXED purports to be the story of a “CDC Whistleblower”, William Thompson, who contacted Brian Hooker, a vocal proponent of the idea that vaccines cause autism. The “about” page for the movie pretty much only talks about Thompson. One thing people going to see VAXXED will find is that the CDC study/William Thompson part is a very small part of the film. Most of it is filler, much of the conversation that goes on all the time online about vaccines.
But what is the Thompson story and why is it supposedly so explosive? Well, William Thompson was researcher who worked on vaccine epidemiology at the CDC. Most of that was many years ago. In fact the research discussed in VAXXED started in 2001. Thompson sought out Brian Hooker, a very vocal proponent of the idea that vaccines cause autism and led Hooker to a finding that was not reported when the paper was published in 2004.
Since this is really the heart of the film, allow me to go into some detail. The main claim was that the CDC team found in their first pass/rough analysis that autism was more common in African American boys who got the MMR vaccine than those who didn’t. Another finding was that for children without other conditions, there also appeared to be a higher autism risk. This group was called at the start of the study “isolated autism”, as in autism isolated from other conditions.
Let’s take that second one first, isolated autism. Here’s the thing–when the CDC team published their study in 2004, they did report on this. Instead of autism isolated from all other conditions, they showed autism without intellectual disability. The CDC reported that the calculated risk for this group was “statistically significant”.
In other words–what did they hide? Nothing. It’s the same result that Wakefield says was hidden. The only question I have– if this result is so important, why didn’t Wakefield or Hooker notice for the 10 years after it was published?
So, what about the other result? Thompson told Hooker that the CDC team another possible result. This result was limited to only African American boys, a fact that is largely glossed over in a film of largely white people. And this Autism/MMR/African American boys result didn’t remain statistically significant under the CDC planned, more complete, analysis. Which is to say, it’s not strong, it’s not really controversial.
But let’s ignore that for the moment. Let’s ask ourselves, if this is the smoking gun, the finding that was so explosive that a CDC researcher reached out to Brian Hooker to tell him about it, why don’t we don’t hear about that that finding until about 1/2 way through the film? And why is so little time spent on it? I’d think this would be a huge part of the film.
Let’s take another step back, a step away from the film. Here’s the thing about this from my perspective as an autism parent–if you believe this represents a real effect (that the MMR causes autism in African American males), you act very differently than Andrew Wakefield. You try to answer the question. Wakefield was at one point running a charity whose stated purpose was autism research (in the end, about half the money went to Wakefield’s salary). He is reported to have raised $400k for this film. Four hundred thousand dollars. I have seen no effort whatsoever by Mr. Wakefield to investigate this claim of a link between MMR and autism in African American boys. Instead we keep hearing about efforts on getting a congressional hearing on the subject. For those outside the autism community: there have been two autism related congressional hearings in recent years. While they have provided much YouTube footage for people pushing the idea that vaccines cause autism, they haven’t done anything to make life better for the autism communities. Nothing.
But one might argue, William Thompson tells us that this shows vaccines cause autism, right? No, he doesn’t. Here’s a public statement (one of only 2 I am aware of) that Mr. Thompson wrote:
The fact that we found a strong statistically significant finding among black males does not mean that there was a true association between the MMR vaccine and autism-like features in this subpopulation
But you won’t find that point emphasized in VAXXED. Instead you will find Wakefield and cowriter Del Bigtree claiming that Thompson says that the CDC “…knew that vaccines were actually causing autism”
There’s a huge difference between “does not mean a true association” and “knew that vaccines were actually causing autism”. I don’t know how big the difference is in film producer land, but in science, it’s night and day.
While we are exploring whether this claim of an MMR/autism link in African American boys, it’s worth noting that just yesterday the CDC came out with their latest autism report (they do this every year at the beginning of April). The CDC autism prevalence numbers show a very different story about the possibility of the MMR causing autism in African American boys. The autism prevalence in African American children is lower than that in whites. If the MMR/Autism link were real and as large as the rough analysis claimed, it would be higher.
And what about the dramatic claim of research fraud by the CDC team? This claim not only doesn’t hold up, but it’s morphed a bit over time. Originally Wakefield and Hooker claimed that the CDC changed their analysis plan after finding the “race effect”. That is–they saw a result they didn’t like and then changed the analysis plan. Let me show you. Here’s a quote from an earlier Wakefield video on the subject
“Over the ensuing months, after the data after the data had been collected and analyzed, and strictly forbidden in the proper conduct of science, the group abandoned the approved analysis plan, introducing a revised analysis plan to help them deal with their problem.”
We also see this claim in the press release that accompanied Brian Hooker’s “reanalysis” of the CDC data:
According to Dr. Thompson’s statement, “Decisions were made regarding which findings to report after the data was collected.” Thompson’s conversations with Hooker confirmed that it was only after the CDC study co-authors observed results indicating a statistical association between MMR timing and autism among African-American boys, that they introduced the Georgia birth certificate criterion as a requirement for participation in the study. This had the effect of reducing the sample size by 41% and eliminating the statistical significance of the finding, which Hooker calls “a direct deviation from the agreed upon final study protocol — a serious violation.”
The problem with that statement was that the final “revised analysis plan” was dated Sept 5, 2001 and the “race effect” wasn’t seen until late October/early November 2001. Two months later. In other words, for this version of the fraud claim to work, the CDC team would have to travel back in time. We know this timeline because the William Thompson documents are now public and we can compare the analysis plans and analysis.
If this seems confusing, it gets worse in VAXXED where we are taken into a discussion of the CDC team switching from using race data from school records to birth certificates and how this reduces the statistical power and hides an effect and all.
Rather than go into details about that, I’ll state this: this argument is a red herring. And wrong, but a red herring. Yes the CDC had data from both school and birth records. But they always planned on using the birth certificate data for their final analysis. From the analysis plan we read:
For the subset of children with Georgia birth records, sub-analyses will be performed in which potential confounding variables from the birth certificate will be used to adjust the estimated association between the MMR vaccine and autism. The variables that will be assessed as potential confounders will be birth weight, APGAR scores, gestational age, birth type, parity, maternal age, maternal race/ethnicity, and maternal education
Or to put it simply, the school records didn’t include things like APGAR scores and so much more that the CDC team planned to use from the start.
So much for “research fraud”.
We can go through the details, but let me just say that a great deal of VAXXED is not really directly the story–the story that is promised in the VAXXED web page. A lot of discussion about and by Andrew Wakefield, for example. We also get parents speaking about their beliefs that vaccines caused their child to be autistic. While very emotional and not something to be dismissed, this doesn’t address the question of whether vaccines cause autism or if there was malfeasance at the CDC.
We a significant amount of filler in the “Big Pharma is bad” sort. The industry insider they get to speak is person who worked in sales for Vioxx. No expertise on vaccines, no experience on the inside for vaccines. And more that I just won’t go into detail about.
Does that mean it won’t be convincing? Well, a large part of the audience for this is already convinced. But will they convince more people with this film? Sadly, the answer is yes. People are not afforded the chance to see the counter arguments. And the appeal to emotion that is much of the film will play. Much better than dry analysis like the above that I have provided. But do I find this movie in the least accurate? No.
By Matt Carey