What specific evidence did Brian Deer present to support claims of data falsification in the Wakefield paper?
Executive summary
Brian Deer’s multi-year investigation presented a constellation of documentary mismatches, medical-record contradictions, undisclosed financial ties, and recruitment irregularities that he argued amounted to deliberate falsification in Andrew Wakefield’s 1998 Lancet paper; Deer laid out case-by-case discrepancies between the published histories and confidential hospital and legal records, and linked the research to paid legal work and commercial ambitions [1] [2] [3]. While Deer and the BMJ concluded the paper was fraudulent and these findings helped prompt The Lancet’s retraction and the GMC’s disciplinary action, critics and Wakefield denied deliberate fraud and later disputes over some pathology documents were publicly noted [1] [4] [5].
1. Documentary mismatches: published case histories versus NHS and hospital records
Deer produced detailed side‑by‑side comparisons showing that none of the twelve children described in the Lancet case series could be reconciled fully with their NHS and hospital records—dates of symptom onset, timings of behavioral regression relative to MMR vaccination, and clinical diagnoses in the records often differed from the paper’s published accounts—evidence Deer presented as clear falsification of the study’s core clinical data [6] [1] [2].
2. Specific examples: altered ages, invented cases, and numerology problems
Among the anomalies Deer identified were simple but telling inconsistencies—parents told Deer Wakefield had claimed a different case count and sequence (for instance, a claimed “13th child” when the paper listed twelve), and individual case narratives in the Lancet contained signs of retrospective editing that did not match clinicians’ notes or biopsy reports, which Deer documented in his BMJ series and on his archive [2] [7].
3. Pathology and biopsy records that contradicted reported enterocolitis
Deer highlighted confidential pathology forms and reports that undercut Wakefield’s claim of a novel “autistic enterocolitis”: independent pathology and later expert review found bowel biopsies were largely normal or did not support the specific inflammatory diagnoses asserted in the paper, a discrepancy central to Deer’s charge that findings were misreported or manufactured [5] [2].
4. Undeclared conflicts of interest and motives to create evidence
Deer unearthed contractual and payment records showing Wakefield had been paid by a lawyer preparing litigation against vaccine manufacturers and had commercial interests in single‑component measles vaccines and patents—information absent from the Lancet disclosure that Deer argued amounted to a motive and context for fabricating or selecting data to support a legal and commercial case [3] [2] [7].
5. Recruitment and ethical breaches that altered the sample frame
Deer traced the recruitment of many study families to anti‑MMR groups and to the solicitor’s client list rather than to an unbiased clinical cohort, demonstrating that the sample was neither random nor independent and raising the likelihood that histories and tests were shaped to fit a preordained narrative—again a pattern Deer used to argue intentional data manipulation rather than honest error [3] [7].
6. How Deer framed these fragments into an allegation of falsification—and the limits and contestations
Deer assembled these discrete findings—mismatched clinical timelines, pathology contradictions, undisclosed payments, and selective recruitment—into the argument that Wakefield had manipulated and misreported data to create the appearance of a vaccine‑linked syndrome; the BMJ endorsed this framing, calling the paper fraudulent and citing Deer’s documentation [1] [2]. That said, contemporaneous and subsequent critics noted legal and interpretive disputes—Deer’s reporting initially raised the possibility of fraud and later editorial language escalated to a fraud label, while others have contested specific documents such as some pathology sheets, so not every claim has been free from challenge [5] [8].
7. Institutional outcomes that followed Deer’s evidence
Deer’s published evidence and reporting were integral to the cascade of institutional responses: The Lancet first partially, then fully, retracted the paper following GMC findings of dishonesty, and the GMC concluded Wakefield acted dishonestly and irresponsibly—outcomes that track with the central elements Deer documented about data misrepresentation and conflicts of interest [1] [4].