The air around me was thick with not-quite-boos. The sound was more like a rising tide of disapproval, a hornet swarm rising above the two dozen or so people staring daggers at me, twisted around in their seats.
“Fake news,” someone mumbled.
“Just put the facts down,” another hissed, gesturing at my notebook. “Just put down what he said.”
“Sit down,” someone urged, from elsewhere in the darkened room.
This was unpleasant, but it was not a huge surprise. My interactions with the anti-vaccine crowd have always gone badly, and our latest run-in, during a screening of the film Vaxxed, was proceeding with only slightly more hostility than I expected. I had questions about this extremely popular anti-vaccine documentary we had just watched, and the audience had questions about who the hell I thought I was.
In the past few years, medical conspiracies have undergone a resurgence like few other alternative beliefs, and they have a unique power to do harm. Anti-vaccine activists have had a direct hand in creating serious outbreaks of the measles, which they have then argued are hoaxes ginned up by the government to sell more vaccines. There’s also evidence that this form of suspicion is being manipulated by malicious outside actors. A 2018 study by researchers at George Washington University found evidence that Russian bot accounts that had been dedicated to sowing various kinds of division during the 2016 election were, two years later, tweeting both pro- and anti-vaccine content, seeking to widen and exploit that divide, too.
Medical conspiracy theories are big, profitable business: an uptick in the belief that the government is hiding a cure for cancer has led people back to buying laetrile, a discredited fake drug popular in the 1970s. Fake medicines for cancer and other grave diseases are peddled by players of all sizes, from large importers to individual retailers on websites like Etsy—in spite of the platform’s policy of removing products that are illegal or claim to cure or treat serious diseases. People like Alex Jones—but not just Alex Jones—are doing multimillion-dollar sales in supplements and quack cures. According to people I have interviewed who work for his main supplier and other organizations’ reporting, some of those supplements are harmless and some of them are capable of turning you permanently blue or causing serious kidney and vision problems.
At the same time, medical conspiracies aren’t irrational. They are based on frustration with what is seen as the opacity of the medical and pharmaceutical systems. They have taken root in a country with profoundly expensive and dysfunctional healthcare—some adherents take untested cures because they can’t afford the real thing. And there is a long history both in the United States and worldwide of doctors giving their approval to innovations—cigarettes, certain levels of radiation, thalidomide, mercury—that turn out to be anything but safe.
Medical conspiracy theories are startlingly widespread. In a study published in 2014, University of Chicago political scientists Eric Oliver and Thomas Wood surveyed 1,351 American adults and found that 37 percent believe the Food and Drug Administration is “intentionally suppressing natural cures for cancer because of drug company pressure.” Meanwhile, 20 percent agreed that corporations are preventing public health officials from releasing data linking cell phones to cancer, and another 20 percent that doctors still want to vaccinate children “even though they know such vaccines to be dangerous.” (Though the study didn’t get into this, many people who feel that way assume doctors do it because they’re in the pockets of Big Vaccine, though vaccines are actually less profitable than many other kinds of medical procedures.) When it came to lesser-known medical conspiracies (the CIA deliberately infecting black people with AIDS, for example) people tended to disagree with them or remain neutral. But the findings were still striking, Wood and Oliver wrote, with 49 percent of Americans believing in at least one medical conspiracy and 18 percent believing in three or more.
Subscribing to those conspiracy theories is linked to specific health behaviors: believers are less likely to get flu shots or wear sunscreen and more likely to seek alternative treatments. (In a more harmless vein, they’re also more likely to buy organic vegetables and avoid GMOs.) They are also less inclined to consult a family doctor, relying instead on friends, family, the Internet, or such celebrity television doctors as Dr. Oz or Andrew Weil for health advice.
Statistics give us a broad view, but to understand the profound chaos that medical conspiracy theories can wreak, we need only to look at the long and eventful career of Andrew Wakefield.
Wakefield is tall, with heavy-lidded eyes, a haircut somewhere between a mid-’90s Hugh Grant and an ungainly bowl, an aristocratic British murmur, and an implacable belief that many powerful people are actively working toward his destruction. He’s made what some estimates put at millions of dollars and built a following among parents who compare him to Nelson Mandela and Jesus Christ—but that all came later.
The story of Wakefield’s public infamy and subcultural rebirth begins in 1998, when he was working as a gastroenterologist and medical researcher at the Royal Free Hospital in London. That year, Wakefield was the lead author on a paper published in the Lancet that suggested a link between the measles, mumps, and rubella vaccine (MMR) and the onset of regressive autism. That thin sheaf of paper unleashed a parental panic, and the medical decisions of millions have never been the same.
As it happened, this wasn’t Wakefield’s first paper proposing a link between vaccines and a serious disease: in 1993 and 1995, he published papers positing that the measles vaccination could be a risk factor for inflammatory bowel disease in general and Crohn’s disease specifically. Subsequent research by other scientists failed to confirm his hypothesis, and those papers met with little fanfare. However—and this would become significant—Wakefield filed for two patents, one for a method of diagnosing Crohn’s by first detecting the measles virus, and the second for an alternative, “safer” measles vaccine. Wakefield expected that the test for diagnosing Crohn’s could bring in €28 million in revenue, according to a prospectus he created for potential investors, much of that income coming from “litigation-driven testing” of patients in the United States and Britain.
The 1998 paper linking the MMR vaccine to autism was based on a study of only twelve children; it noted that eight of them developed what the paper called “behavioral symptoms” after receiving the vaccine. The article itself was cautious, pointing out that there wasn’t a definite link, but elsewhere Wakefield didn’t hold back. In a press conference, he told journalists that as a “moral issue” he could no longer support the use of the MMR vaccine. “Urgent further research is needed to determine whether MMR may give rise to this complication in a small number of people,” he said. What happened next was dubbed a “hysteria”: vaccination rates in the United Kingdom plummeted. According to the BBC, parts of England where some 90 percent of toddlers had previously been vaccinated dropped to below 70 percent.
The British media’s coverage of the study peaked between 2001 and 2003, and by 2008, the scare had spread to the United States. Actress Jenny McCarthy became the most public face of the American vaccination skeptics. Her son, Evan, has autism, and that year, she and her then-partner Jim Carrey published an editorial on CNN’s website blaming a number of factors for his condition, including vaccines. “We believe autism is an environmental illness,” the two wrote. “Vaccines are not the only environmental trigger, but we do think they play a major role. If we are going to solve this problem and finally start to reverse the rate of autism, we need to consider changing the vaccine schedule, reducing the number of shots given and removing certain ingredients that could be toxic to some children.” McCarthy and Carrey also claimed that a gluten-free, casein-free diet, a “detox of metals,” and antifungal medicines were helping Evan “recover.”
The effect of parents choosing not to vaccinate was measurable: in 1998, there were just 56 cases of measles in England and Wales. By 2008, there were 1,370. In 2006, the first child in England in more than a decade died from the disease. In 2008, the United States reported 131 cases of measles in the first half of that year alone, more than had been seen at any time in over a decade.
No other research ever succeeded in replicating the link between autism onset and MMR that Wakefield claimed. The British investigative journalist Brian Deer raised even more disturbing concerns in his reporting in the Sunday Times beginning in 2004. Deer wrote that some of the costs for Wakefield’s research had been paid by lawyers on behalf of parents who wished to sue vaccine makers for damages. (Dr. Paul Offit, a pediatrician and vaccine advocate, has referred to this as “essentially laundering legal claims through a medical journal.”) Deer also unearthed the so-called safer measles vaccine Wakefield had patented.
Memorably, Deer found footage of Wakefield joking at a 1999 talk that he had paid children at his son’s birthday party five pounds each to give blood samples for research. “Two children fainted, one threw up over his mother,” he is seen in the clip telling his audience, who giggled in response. “People said to me, ‘you can’t do that—children won’t come back to your birthday parties.’ I said, ‘We live in a market economy; next year they’ll want ten pounds.’” Wakefield later said he had fabricated the birthday party incident for humor, and he himself launched a series of libel lawsuits against Deer. He claimed that the payments he received from lawyers were for a different study entirely, one that looked for evidence of measles in the intestines of children with autism symptoms.
Still, Wakefield eventually left his job at the Royal Free Hospital after being unable to replicate his 1998 findings. “I have been asked to go because my research results are unpopular,” he told the Telegraph at the time, in a statement that displayed the particular tone of martyrdom Wakefield tends to affect. “I did not wish to leave, but I have agreed to stand down in the hope that my going will take the political pressure off my colleagues and allow them to get on with the job of looking after the many sick children we have seen.”
In 2004 ten of Wakefield’s coauthors formally retracted the study that carried their names. Two years later, the British General Medical Council launched an inquiry into Wakefield’s alleged misconduct. And finally, four years after that, in February 2010, the Lancet article was retracted. Eventually the GMC stripped Wakefield of his medical license.
By then, though, Wakefield was long gone, having moved to Austin, Texas, to set up a center called Thoughtful House to study childhood developmental disorders, although he wasn’t licensed to practice medicine in the state. He had also developed a fervent, near-religious following among parents who believed he was the only person with answers to what had caused autism in their children, and he was making a lot of money, earning $270,000 a year and buying a $1.2 million house, the Austin American-Statesman reported. He and his wife, Carmel, also purchased three other properties, worth a combined $1 million.
Wakefield subsequently left Thoughtful House and became involved with a series of autism-related foundations and media companies. In some of them, Wakefield’s salary made up a huge proportion of the budget. He also regularly spoke to paying audiences, who greeted him with what I can safely characterize as rapture. “To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one,” the New York Times quoted J. B. Handley, cofounder of Generation Rescue, one of many anti-vaccination parent groups. “He’s a symbol of how all of us feel.”
The parental fervor did not wane, even after the tides of medicine, law, and the media turned against Wakefield. Between 2010 and 2017, vaccine rates in England and the United States started to tick back up, in response to a sustained public health campaign, though they remained lower than average, several studies showed, in wealthy, white communities, particularly in Southern California. One California study found that vaccine refusal due to personal beliefs doubled from 2007 to 2013, hitting 3.06 percent. In the same time period, more than seventeen thousand children attending more than six thousand schools in California opted for delayed vaccination schedules, which are not recommended by pediatricians and are based in an erroneous belief that “too many” vaccines at once can be harmful.
In 2017, Wakefield scored an enormous public relations coup when he managed to get Robert De Niro interested in Vaxxed, an anti-vaccine documentary he had just made. (Its working title was the higher-pitched Injecting Lies.) De Niro has a son with autism, and Wakefield somehow managed to persuade him that there were open questions about vaccine safety. The Tribeca Film Festival, which De Niro cofounded, quietly added the film to its schedule, and it became clear in a series of eye-popping TV interviews that De Niro was a vaccine skeptic himself, and one of Wakefield’s biggest fans.
“There’s a lot of information about things that are happening with the CDC, the pharmaceutical companies, there’s a lot of things that are not said,” De Niro stated on the Today show. “I, as a parent of a child who has autism, I’m concerned. And I want to know the truth. I’m not anti-vaccine. I want safe vaccines.” That became the new line for anti-vaccine groups: they merely want the safest possible vaccines, even though decades of rigorous testing have found existing vaccines to be extremely safe. The environmental activist Robert F. Kennedy, Jr., similarly claimed, falsely, that vaccines are full of the kind of mercury that’s hazardous to human health, suggesting that appropriate safety studies have not been carried out.
In the case of Vaxxed, after an enormous backlash, it was pulled from the Tribeca Film Festival without ever airing. But borne along on a tide of donations, Wakefield and the other filmmaker, a former CBS producer named Del Bigtree, set about airing the film in independent movie theaters across the United States, Canada, Europe, New Zealand, and Australia. The film has been shown at on-demand screenings for years at independent theaters, supported by two different Facebook groups, each with more than eighty-five thousand members. Beyond appearing at Vaxxed screenings, however, Wakefield largely receded from the public eye. Meanwhile, Del Bigtree began pledging to push for big legislative changes relating to vaccine safety.
Anti-vaccination activists habitually suggest that there are powerful supporters in the shadows, waiting for the right time to reveal themselves at some future date. Implicit in the promise is a reluctant admission: anti-vaccination beliefs are still radioactive enough that it is wise to avoid admitting to them publicly. Robert F. Kennedy, Jr.’s decades of environmental activism have been overshadowed by his erroneous claims that vaccines contain deadly amounts of mercury and aluminum. Jenny McCarthy’s star faded as her name became synonymous with “public health crisis.”
The anti-vaccine movement is the most successful medical conspiracy—persistent, lucrative, perpetually able to net new believers in spite of scientific evidence. It is also emblematic of all such conspiracy theories: people get caught up in them through either grief or desperation, exacerbated by the absence of hard answers and suspicion about whether a large and often coldly impersonal medical system is looking out for their best interests. And an army of hucksters stands ready to catch them and make a buck.
The opposition to vaccines is almost as old as their invention. Early forms of inoculation began in the late 1700s, when an English physician, Edward Jenner, built on the recognition that a mild infection with cowpox, a nonlethal disease in humans, could prevent the contraction of smallpox. He tested the safest, most effective way to transmit cowpox, and in 1796 successfully infected an eight-year-old boy. Jenner was able to subsequently expose the child to smallpox without him becoming ill.
With that discovery, widespread, mandatory smallpox vaccinations became common in the early 1800s in England. But even as rates of the disease began to fall, public distrust in vaccinations grew. Vaccine objectors’ leagues sprang up, motivated by a mix of forces: suspicions that vaccination went against God’s will, distrust of a “cure” that came from an animal, and a lack of understanding of how the disease actually spread. The protest was effective, however: the Vaccination Act of 1898 allowed a provision for conscientious objectors to avoid inoculating their children.
The same process repeated itself in the United States: the two countries have a curious twinship when it comes to vaccine controversies, and what happens across the pond tends to come here not long after. The Anti-Vaccination Society of America was founded in 1879, and in this instance the British influence was clear. The group was created after a visit by a Manchester businessman named William Tebb, who argued in prolific writings and public speeches that mandatory vaccinations were a violation of citizens’ rights to bodily autonomy. (Tebb was an unusual guy: a pacifist, he built a monument to the horses killed in the Boer War, and he campaigned against premature burial, which worried him so much that he insisted he be buried only a week after his death, just to be on the safe side.)