How Not to Make a Documentary About Vaccines

By Ellie Shechet | September 29, 2017 | 6:55pm

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A new documentary about Andrew Wakefield, the former gastroenterologist and floppy-haired mascot of vaccine skepticism, draws its title from a phrase Wakefield used to describe himself. The film does not get much more critical from here.

Andrew Wakefield is the lead author of a discredited 1998 study that kicked off the modern anti-vaccine movement. The study suggested a connection between the MMR (measles-mumps-rubella) vaccine and autism, which he made explicit in a press conference on the study’s findings, announcing that “I cannot support the continued use of the three vaccines given together.”

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A 2004 investigation by the journalist Brian Deer in the Sunday Times made the claim that Wakefield had undisclosed conflicts of interest, and the study was eventually retracted. After an investigation by the General Medical Council in Britain, he was accused of “multiple separate instances of professional misconduct” and exhibiting a “callous disregard” for the suffering of the children involved in his research, resulting in over 30 charges. In 2010, the General Medical Council stripped Wakefield of his medical license. Wakefield’s position is that this imbroglio was a conspiracy to discredit him, and continues to share his belief—despite an enormous body of research demonstrating otherwise—that the MMR vaccine causes autism. He has been blamed for an uptick in measles infections in the U.K. and United States, where the disease had previously been eliminated. Earlier this year, a Somali immigrant community in Minnesota which Wakefield and other anti-vaccine activists visited was the site of a measles outbreak.

The Pathological Optimist, directed by Miranda Bailey, follows Wakefield and his family from 2011 to 2016 during his attempts to sue the British Medical Journal, its editor Fiona Godlee, and the journalist Brian Deer; they’d published a 2011 investigation that claimed that the 1998 Lancet study Wakefield co-authored was fraudulent, featuring distorted data. Press materials for The Pathological Optimist, which premieres today, frame the film as a character study that “takes no sides, instead letting Wakefield and the battles he fought speak for themselves.”

“I said ‘listen, I’m not out there to prove that you’re right, and I’m not out there to prove that you’re wrong,’” Bailey told Jezebel in a phone interview, referencing an early conversation she had with Wakefield. “‘I just want to watch, and see what happens.’ And he was like ‘yeah, that’s fine.’”

Bailey, a film producer whose credits include The Diary of a Teenage Girl, Lake Bell’s latest directorial effort I Do… Until I Don’t, and the Oscar-nominated The Squid and the Whale, has not historically been silent about vaccine safety. My colleague Anna Merlan included Bailey in a 2015 list of “anti-vaccination celebrities” because Bailey tweeted in opposition to SB 277, a California law that removed personal belief exemptions to vaccination requirements. SB 277 was a point of contention for vaccine skeptics, many of whom rigorously object, without evidence to back up their position, to the concept of mandatory vaccination. Anti-vaccine sentiment isn’t limited to Hollywood (Brooklyn veterinarians recently noticed that some people are refusing to vaccinate their pets, for example), but a Pediatrics study found that parents skeptical of vaccines are typically white and well-off.

Bailey told me that her tweets were “taken out of context,” and that she believes the Hepatitis B vaccine should be administered when children are older, not never at all. (The Center for Disease Control disagrees.)

“I think that vaccines are an incredible, valuable tool; I want them available for me and my children,” she told Jezebel. She also says she thinks it would have been proven by now if the MMR vaccine caused autism. “I would say I’m pro-vaccine, but I think everybody’s pro-vaccine, because I mean, what, are people pro-disease? No,” she said. In general, Bailey says she objects to the label “anti-vaccine activist,” which she believes paints with too broad a brush; she told me “vaccine hesitant” is a better way to describe those individuals.

But back to the documentary. A character study on someone like Andrew Wakefield might have made for a good one, but that’s not really what The Pathological Optimist turned out to be. Nearly everything Wakefield says or does in the film seems constructed to convince viewers that he has been—as his wife Carmel Wakefield puts it at one point—“gravely defamed.” Although clips of Wakefield being criticized on TV appear throughout the documentary, and notes flashed on the screen provide counterpoints to certain claims, no one speaks directly to the camera or appears to have been interviewed at all who might give any sort of conflicting or complicating observation about Wakefield’s scientific career or his treatment by the press.

The only people who do speak directly to the camera are Wakefield, his wife, one of his children, his brother, two of his lawyers, a few fans at his book signing, and a supporter of Wakefield’s who believes her son became autistic immediately after receiving the MMR vaccine. Several of them take this opportunity to question the integrity of the press, which seems like it could undercut the authority of the aforementioned critical press clips—particularly in an era when the media is consistently held up as a singular and sinister establishment force. Wakefield’s argument, after all, is that the media, the medical establishment, the CDC—they’re one big, amorphous “them,” all out to hide an inconvenient truth. (Here are the members of the FDA’s Vaccines and Related Biological Products Advisory Committee; the majority of them do not work for drug companies.)

The film acknowledges that a huge amount of research has shown no link between vaccines and autism, which begs the question: why is the author of a debunked study being given a 90-minute opportunity to tell his side of the story, using a unique strain of jargon-cluttered British persuasiveness? It’s disingenuous to claim objectivity when one side lacks a viable argument; to do so is to encourage a sense of mystery and controversy around vaccine safety, which belies the fact that among public health experts and clinicians alike, this is not a topic of disagreement.

Vaxxed, an anti-vaccine film by Wakefield that premiered while The Pathological Optimist was filming, did just this to try to convince viewers that vaccines are controversial and disputed—which they are, though not amongst those who actually study them. Among Bailey’s many vaccine-related tweets is a full-throated endorsement of the 2011 documentary The Greater Good, which the New York Times described as an “emotionally manipulative, heavily partial look at the purported link between autism and childhood immunization” that benefits from “appearing to present both sides of the debate.” And as we see in the Hollywood Reporter review of The Pathological Optimist, it’s quite an effective way to sow doubt, if that is something one wanted to do:

If you have any doubt that reviewing a documentary about Andrew Wakefield, the British doctor who became the public face of the anti-vaccination movement, is a difficult proposition, scroll down. You’re bound to see a jampacked comments section featuring incendiary remarks from readers both pro and con on the subject. So, let me stipulate up front that this reviewer is not taking a stand on the controversial issue. Please forgo the invective, folks.

The film’s main antagonist, the British journalist Brian Deer, was not interviewed for the film, even though his name is mentioned throughout (at one point, a “Down with Deer!” cheers takes place). Clips of him on TV appear instead, and it’s noted at the end that Deer declined to participate in the documentary, which Deer claims is not true.

(Wakefield previously sued Deer for libel in the U.K. in 2005; he dropped the suit and paid the defendants’ legal expenses shortly after the judge wrote an opinion concluding that Wakefield “wished to extract whatever advantage he could from the existence of the proceedings while not wishing to progress them or to give the Defendants an opportunity of meeting the claims.”)

When I initially reached out to Deer, he said he knew a documentary was in the works, but didn’t know that it was about a legal effort against him. According to his email exchange with Marc Lesser, a producer on the documentary, Deer was asked multiple times in 2012 to participate in a documentary about the “MMR scandal”; at that point, Bailey’s team had already been filming Wakefield for a year. The exchange ended after Deer accused the filmmakers of being funded by anti-vaccine activists, a charge they denied.

Bailey claimed that Deer’s accusations made her question his reliability, and that her team didn’t know yet exactly what the film was going to be about beyond the “MMR scandal” when she contacted Deer. They did not reach out to Deer again.

Deer contacted Bailey and Gravitas Ventures, the distributor of the documentary, last week, writing in a lengthy letter:“It appears to me that collectively you have, with this project, lied, lied, and lied again.” Bailey published the entirety of Deer’s letter on her website, along with the production team’s entire correspondence with Deer, after speaking with Jezebel.

“At a time when ‘fake news’ and a rising culture of deception are matters of intense debate, it may be that you provide a case study of how the public can be effortlessly tricked,” Deer wrote. “In this instance, of course, your victims include parents of children with disabilities who, thanks to your hero Wakefield, blame themselves for vaccinating a son or daughter.”

In a second letter to Gravitas Ventures, Deer suggested he might pursue legal action, and claimed that he was concerned for his safety. Gravitas has not responded to multiple requests for comment from Jezebel.

When I asked if they’d reached out to anyone else who could provide a counter-argument to various things Wakefield and others say throughout the film, Bailey argued that the style of the documentary, which she compared in an email to cinéma vérité, would make that difficult to weave in.

“Once the style of the film found itself, which was not the style of, you know, a news show—once it was clear that it was a character study about this figure in history, then it felt like, when you’d have those things, they weren’t attached to the character study and it seemed like a messy concept,” Bailey told me.

“I’m not a newsperson, I’m not there to show a balanced—I’m not Fox News, I don’t need to do interviews. Interviews are boring, also.”

In the email, she added:

“I gather that your question to me is really wanting me to answer why I didn’t show interviews of other people who can tell me that Wakefield is a fraud, and a charlatan etc. Well, that information is already out there. It’s in every piece of news we read about him. If you are familiar with the story you already know all of that. I wanted to show you what you haven’t seen which is inside his life living with these charges.”

The expectation that a viewer would come to the documentary with extensive foreknowledge isn’t really a fair one, or one likely to result in clarity. But clarity isn’t the goal of this film. An inaccurate statement by Carmel Wakefield, for example—that her husband was listed last on the Lancet paper, that he simply “collated” the findings—was only quietly refuted several frames later, when his name (listed first) is underlined on the paper as his lawyer speaks about something else. Wakefield’s lawyer—rather than a scientist, for example—explains the Lancet paper’s conclusions to viewers. Wakefield’s brother provides us with commentary on a trial.

A mournful, occasionally stirring violin soundtrack plays through the film as we spin through scenes of Wakefield sitting on bleachers, doing yoga, worrying about his children, Wakefield giving a toast to a group of generous chiropractors, Carmel Wakefield telling her daughter they can’t afford their house anymore as legal bills mount, Wakefield’s mother telling him she hopes he is “cleared in the eyes of your peers before anything happens” to his father, Wakefield chopping wood in a tank top.

You can refute some of his statements, and question him about his discrepancies, and show news footage of Anderson Cooper reaming him on CNN, but the decision to physically focus this documentary entirely within Andrew Wakefield’s perspective, giving him and his family an opportunity to repaint himself as wronged and his research as ethical when there is quite a lot of evidence to the contrary, is an odd one, given the stakes of the subject matter. Is it artful to project ambiguity onto a subject that is, at this point, pretty unambiguous? When the topic of a documentary involves a basic health decision that could put a viewer’s kid, or someone else’s kid, in the hospital, is it responsible to let viewers walk out in a state of confusion?

Correction: A previous version of this post said that measles had been eradicated in the US and UK. The correct term is ‘eliminated.’