Why am I not surprised? It looks as though Andrew Wakefield probably falsified his data

Pity Andrew Wakefield.

Actually, on second thought, Wakefield deserves no pity. After all, he is the man who almost single-handedly launched the scare over the MMR vaccine in Britain when he published his infamous Lancet paper in 1998 in which he claimed to have linked the MMR vaccine to regressive autism and inflammation of the colon, a study that was followed up four years later with a paper that claimed to have found the strain of attenuated measles virus in the MMR in the colons of autistic children by polymerase chain reaction (PCR). It would be one thing if these studies were sound science. If that were the case, then Wakefield's work would have been very important and would have correctly cast doubt on the safety of the MMR. Unfortunately, they were not, and, indeed, most of the authors of the 1998 Lancet paper later withdrew their names from it.

Over the next decade, aided and abetted by useful idiots in the media, by British newspapers and other media that sensationalized the story, and the antivaccine movement, which hailed Wakefield as a hero, Wakefield managed to drive MMR vaccination rates in the U.K. below the level of herd immunity, from 93% to 75% (and as low as 50% in some parts of London). As a result, I "thanked" Andrew Wakefield for his leadership role in bringing the measles back to the U.K. to the point where, fourteen years after measles had been declared under control in the U.K., it was in 2008 declared endemic again.

Worse, this fear was based on the worst science. First, no scientist not associated with Andrew Wakefield has ever been able to replicate his work. Second, as was exposed by U.K. reporter Brian Deer, not only was Wakefield paid big bucks by trial lawyers seeking to sue vaccine manufacturers for "vaccine injury" to do his studies on autistic children, a conflict of interest he never revealed and that had to be exposed through Deer's investigations, but months before he published his Lancet paper Wakefield had applied for a patent on a an allegedly safer single measles vaccine that could succeed best if the safety of the MMR were called into doubt. Even after all of this came to light, leading to Wakefield's correctly being dragged in front of the General Medical Council for charges of scientific misconduct. Even after this, he still enjoys a cult of personality that I can't figure out, and is often portrayed as being "persecuted" by the British medical establishment. Third, was revealed at the Autism Omnibus proceedings when PCR expert Stephen Bustin testified about the shoddy methods at the laboratory used to do the PCR on the colon biopsies. In brief, the laboratory used was set up such that cross contamination between the plasmids used to maintain the measles virus sequences and the area where the PCR was done. PCR is very sensitive; if there is contaminating plasmid sequence, it is very easy to amplify and detect it even when there is nothing in your samples. Indeed, I've experienced this very problem on occasion in my own lab. Unfortunately, in the case of Wakefield's research, no controls were done to make sure that contamination was detected in the negative controls. Finally, Wakefield's results were roundly refuted in an attempt to replicate his work that was published last year. As you can see, Wakefield's work and ethics are about as bad as it gets.

Or so I thought, until readers started sending me this article published in The Times, again by Wakefield's nemesis Brian Deer. Holy crap. If only a fraction of the allegations in this article are true, not only is Wakefield an unscrupulous and incompetent scientist but he's a scientific fraud as well:

The doctor who sparked the scare over the safety of the MMR vaccine for children changed and misreported results in his research, creating the appearance of a possible link with autism, a Sunday Times investigation has found.

Confidential medical documents and interviews with witnesses have established that Andrew Wakefield manipulated patients' data, which triggered fears that the MMR triple vaccine to protect against measles, mumps and rubella was linked to the condition.

The research was published in February 1998 in an article in The Lancet medical journal. It claimed that the families of eight out of 12 children attending a routine clinic at the hospital had blamed MMR for their autism, and said that problems came on within days of the jab. The team also claimed to have discovered a new inflammatory bowel disease underlying the children's conditions.

However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children's ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.

The complete story reveals behavior on the part of Wakefield that leaves me just shaking my head in disbelief. It's simply unbelievable.

Let's step back a minute. The original Lancet paper examined the cases of twelve children with autism and other neurodevelopmental disorders. In the paper, it was reported that in 8 of the 12 children with regressive autism the onset of developmental changes closely followed MMR vaccination and in one of the 12 it followed measles infection. Moreover, colonoscopy showed colon abnormalities "ranging from lymphoid nodular hyperplasia to aphthoid ulceration." In 11 children, biopsy histology showed patchy chronic inflammation in the colon. The conclusion was that there was an apparent association between MMR vaccination and a syndrome of regressive autism and inflammatory bowel changes. Even though the paper's tone was more tentative than one would have thought given the furor it launched and even though it stated that the authors "did not prove an association between measles, mumps, and rubella vaccine and the syndrome described," Wakefield promoted his results to the media as though he had definitely found a link between the MMR vaccine and a syndrome consisting of regressive autism and inflammatory bowel disease. Thus was launched the scare that caused a thousand cases of measles (in 2008) that could have been avoided and caused many autistic children to be subjected to invasive procedures they didn't need, sometimes at the cost of serious complications.

If the latest information is true, however, Wakefield is guilty of more than shoddy science and unreported conflicts of interest. He is guilty of scientific fraud and falsifying the medical reports of these children. For example, take Child 11, whose father requested a second set of testing on his child's biopsy specimens:

MR ELEVEN'S taxi dash was a small ride in his desperate quest to find an answer for his son's condition. Today, Child Eleven is much improved: at 17, he is a terrific scholar, although too nervous to drive.

The extra tests on his biopsies produced striking results. His father asked the cancer institute to look for the measles virus, which lay at the heart of Wakefield's concerns over the vaccine. According to a theory that underpinned the project, this virus in MMR was the cause of bowel disease, which then did damage to children's brains.

"It took a big fight to get the information," said Mr Eleven. "They told me there was no measles virus. I had the tests repeated three times at different labs in the US, and they all came back negative."

This struck a different note from what Wakefield suggested when describing his research to the world.

"We would not have presented this paper to The Lancet had we not undertaken extensive virological studies already," he told the 1998 press conference.

Of course, this anomaly could simply have been due to the aforementioned incompetence of the lab that Wakefield used to test his specimens for MMR strain measles virus, with its procedures guaranteed to produce false positives. Unfortunately, there's more. A lot more. Take Child One:

In the paper this claim would be adopted, with Wakefield and his team reporting that Child One's parents said "behavioural symptoms" started "one week" after he received the MMR.

The boy's medical records reveal a subtly different story, one familiar to mothers and fathers of autistic children. At the age of 9½ months, 10 weeks before his jab, his mother had become worried that he did not hear properly: the classic first symptom presented by sufferers of autism.

This is an incredibly common story among parents who believe that vaccines caused their child's autism. Many vaccines are scheduled to be given during the same time that children often show the first behavioral alterations associated with autism, and it is not uncommon either for such changes to occur within a few weeks of a vaccination by random chance alone, nor is it uncommon for parents to remember incorrectly that the child's symptoms started soon after a vaccine when they did not. Indeed, it is not uncommon at all for experts to be able to detect the subtler signs of autism on videotapes of babies before the parents noticed and before the child received the vaccinations for which parents blame the condition. Unfortunately, human memory is fallable, and it easily relates events that are not closely related, particularly in response to other information or preexisting beliefs. This happens all the time with vaccines and autism, where numerous epidemiological studies have failed to find an association between either mercury in thimerosal-containing vaccines and autism, between MMR and autism, and between vaccines in general and autism.

Next, we have Child Two:

This was Child Two, an eight-year-old boy from Peter-borough, Cambridgeshire, diagnosed with regressive autism, which, according to the Lancet paper, started "two weeks" after his jab.

However, this child's medical records, backed by numerous specialist assessments, said his problems began three to five months later.

And the list goes on:

Only one was a girl, Child Eight, aged 3, from Whitley Bay, Tyne & Wear. She was reported in the journal as having suffered a brain injury "two weeks" after MMR.

Her medical records did not support this. Before she was admitted, she had been seen by local specialists, and her GP told the Royal Free of "significant concerns about her development some months before she had her MMR".

Child Six, aged 5, and Child Seven, aged 3, were said to have been diagnosed with regressive autism, with an onset of symptoms "one week" and "24 hours" after the jab respectively.

But medical records show that neither boy was "previously normal", as the Lancet article described all the children, and that both had already been hospitalised with brain problems before their MMR.

Child Six received his vaccine at the age of 14 months, but had twice previously been admitted with fits.

Child Seven was given his at the age of 20 months but, again, problems already showed.

In other words, one of two things happened, neither of which is flattering to Wakefield. Either he took the history from parents, for whom confirmation bias could easily have led to remembering incorrectly that their child's behavioral changes were noted shortly after the MMR rather than before it or months later, in which case Wakefield was incompetent for not having examined the medical records. Alternatively, Wakefield did examine the medical records and lied about them in the Lancet paper. Take your pick.

In fact, I might have been willing to give Wakefield somewhat of the benefit of the doubt, viewing the discrepancies between the medical records and what he reported in the Lancet paper as being yet more evidence of his incompetence and his resultant shoddy research methodology rather than dishonesty, were it not for the major discrepancies between what Wakefield said about the histology of the biopsy specimens in the paper. The Lancet paper described a uniform pattern of patchy inflammation, but apparently what Wakefield reported does not jibe with what the pathologists saw:

"The uniformity of the intestinal pathological changes and the fact that previous studies have found intestinal dysfunc-tion in children with autistic-spectrum disorders, suggests that the connection is real and reflects a unique disease process, " the Lancet Paper explained of the "syndrome".

Yet pathology records of samples taken from the children show apparent problems with this evidence. The hospital's consultants who took biopsies from the children's colons concluded that they were not uniform but varied and unexceptional.

For Child Eight, the pathology report said: "No abnormality detected", while the Lancet paper said: "Nonspecific colitis". This pattern was repeated for two of the other children, Nine and Ten.

The most striking change of opinion came in the case of Child Three, a six-year-old from Huyton, Merseyside. He was reported in the journal to be suffering from regressive autism and bowel disease: specifically "acute and chronic nonspecific colitis". The boy's hospital discharge summary, however, said there was nothing untoward in his biopsy.

Not happy with the readings of the pathologists, apparently Wakefield's research team met for a "research review" of the biopsy specimens. This in and of itself is not unusual. However, it is unusual that the research team overturned the original readings of so many of the specimens. As Brian Deer put it:

It was not an unusual move for a group of specialists to reconsider the evidence upon which their research was relying. It was nevertheless striking that their conclusion was that 11 of the children's bowels were in fact diseased when their colleagues had found no abnormalities in at least seven of the cases.

Quite frankly, such conduct beggars the imagination. It's about as unethical as it gets. But it's all of a piece with Andrew Wakefield's behavior. After all, as I pointed out before, he was in the pocket of a lawyer named Richard Barr seeking to sue vaccine manufacturers for "vaccine-induced" autism before he undertook his research. Not only that, but Barr was affiliated with the antivaccine group Jabs and had arguably concocted his new "syndrome" with at least some consultation with Barr. But perhaps the most unethical, at least from a human research standpoint, was that the patients recruited to his study were not anything resembling a random or neutral sample. As pointed out by Brian Deer, the parents of these children heard through word of mouth about Wakefield. Moreover, Wakefield subjected these children to unnecessary invasive medical procedures, and then incompetently analyzed the specimens obtained from them for measles virus in order, it seems, to come to a preordained conclusion, even if it required "tidying up" the data beyond recognition to do so. Given such a level of ideological blindness that seems to think his cause so just that good science and ethics are optional in pursuit of it, a lack of concern over blatant conflicts of interest, and an appallingly inflated opinion of himself that he is seems to believe that he is actually a persecuted Galileo, is it any surprise that Wakefield may have stooped so far as to falsify research results in his campaign?

Not to me, it isn't.

Sadly, none of this will matter to antivaccinationists, who view Wakefield as exactly that--a persecuted scientific hero. Although I have yet to see any response from antivaccine blogs like like Age of Autism, I'm sure that they'll wax ridiculous about what a great doctor and man Wakefield is and how it's big pharma and its minions who, frightened by the implications of Wakefield's work, are working hard to demonize him and suppress his "science." Unfortunately for their reality-challenged world view, sometimes things are as they appear, sometimes there really is no conspiracy, and sometimes a rat is a rat.

And Wakefield is most definitely a rat. A rat who caused thousands of cases of measles and at least one death.

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Unlike Wakefield, Galileo had the quality of being right.
He should be discredited. He deserves worse.

Wow - it doesn't surprise me that much though. This might just be the nail in the coffin of MMR causes autism the British press hate the thought that they've been made fools of and if they think Wakefield did that to them they'll turn on him like a gang of weasels.

A little off-topic perhaps, but there has been a recent media whirl around a British 'autiste' (yes- the French have a word for it) by the name of Daniel Tammet.

He speaks 11 languages fluently, has outstanding arithmetic skill but, perhaps best of all, is able to relate to other people and interact fairly normally. The parents of 'autistes' should maybe consider their children as potentially gifted, rather than desperately ill.

Had he been born in Iran, he would have been strangled to death by the state for being gay. Realising this reminded me of how much I despise theocratic god-bollocks. Just wanted to share that with you.
http://en.wikipedia.org/wiki/Daniel_Tammet

Tiny correction: the solicitor was Richard Barr. He has a rather folksy website: http://richardbarr.org - which you may find charming or emetic, according to taste.

It just gets murkier and murkier doesn't it? There was a time when I was willing to believe that Wakefield was just another doctor who held an honestly misguided viewpoint on autism...it's safe to say that time is long since past!

Hmmm...I wonder what Age of Autism will say:
"Blah, blah, persecution, blah blah, Big Pharma, blah, blah, lies, blah blah, it's the money stupid, support him, blah blah this changes nothing, our struggle for our children continues!
My hope is that the story will be spread in the media and linked to the new measles epidemic (?) in Britain right now. Somehow, I fear it won't.
Let's just hope that that (insert rudest term of abuse) Andrew Wakefield is suitably and publically disgraced.

From the extended Times article:

"In June 1996 â the month before Child Oneâs arrival at the hospital â Wakefield and Barr filed a confidential document with the governmentâs Legal Aid Board, appearing already to know of a 'new syndrome'"

This is just depressing. Why do people believe in grand conspiracies involving impossibly large numbers of people, based on nothing more than inference and speculation, when the real dirty dealings are plain for all to see?

Hopefully, the mainstream media here in the UK will see this is a (final!) nail in the MMR 'controversy' coffin. I think that the rise in measles cases might have chastened them bit. Having said that, there's now this barmy scuffle happening with LBC Radio, and one must never underestimate the depths to which the Daily Hate is willing to plunge.

By ananamide (not verified) on 08 Feb 2009 #permalink

Very informative.

Wasn't the Lancet paper referred? I am not trying to blame it on the journal, but vow...even the referees, supposedly experts in the field, were fooled and recommended acceptance of the paper.

There is still some water to flow under this particular bridge. Our political classes have been running these "show trials" since the mid-90's with the Bristol Heart Inquiry. Truth is an early casualty. It is the profession of medicine that is under attack from elements in the left wing of the Labour party. Let's hear the other side of the story.

I predict the woo crowd will make him a martyr--deliberately destroyed by big pharma for daring to expose them. Total BS, I realize, but believing in BS is the at the core of the woo faithful.

Sadly, it doesn't matter. The anti-vax dipshits will just claim elaborate persecution by Big Pharma. According to them, this is all just an elaborate scheme to shut him him. He could have a press conference and say he made it all up, with detailed notes and payments, and they still wouldn't believe it. There is no end to the lengths they will go to in order to believe in their beloved conspiracy theory.

I'm just wondering how they justify their valiant hero had had applied for that patent on the other Measles vaccine. It undermines their whole position that vaccines are bad and Measles is a harmless childhood disease.

If Wakefield is proven to have falsified these results and to have had an undisclosed conflict of interests, shouldn't he go to prison? People like him have the potential to cause public health disasters, and they should be held fully accountable.

You know, in a sense, it would be a good thing for the Age of Autism to follow the money. In this case, it would show that their conspiracy theories are founded: in the person of Wakefield and Barr.

I wonder if they couls assimilate it.

The very fact that Wakefield hasn't immediately hit Deer and the Times with a libel suit is quite telling. Yes, libel law is generally very plaintiff-friendly in the UK -- BUT the plaintiffs have to endure a rather rigorous bit of discovery themselves. If Wakefield had no reason to fear the discovery process, he'd have filed suit right away.

It is the profession of medicine that is under attack from elements in the left wing of the Labour party. OK Fred, how about naming some names? Just who are these "elements" and why do they hate bad doctors?

It's time to push back on the Big Pharma canard. Antivaxxers work for Big Legal.

Compliments of an MDC poster:

"So it doesn't disturb you highly ethical thinkers that Brian Deer is using illegally obtained confidential medical records here?

It also doesn't disturb you that the long GMC case doesn't seem to be demonstrating unethical behavior? How do I know? Well, I've been reading Martin Walker's accounts, but you could dismiss those as biased. But the best evidence is the silence in the U.K. press on the course of the trial. If there were lots of solid evidence of wrongdoing on the part of Andrew Wakefield it would be all over the press in the U.K. The silence indicates that the case stinks.

This is a last minute attempt to prejudice what is already a prejudiced process.

http://childhealthsafety.wordpress.c...nk-journalism/

Am I claiming that Wakefield never, ever made any errors in any of his work? No. He doesn't walk on water. But the majority of the accusations against him are nonsense.

For example, Horton knew about Wakefield's legal work before the paper was published in the Lancet. This has been shown, thoroughly, before the GMC with letters from the Lancet files. So Horton perjured himself.

There is a lot of misinformation floating around."

And so the denialism continues.

A 12 year old French girl died in Geneva recently (January 29th) of measles encephalitis. She was not vaccinated.

Tell me again how this disease is a "mild childhood illness".

By Tsu Dho Nimh (not verified) on 08 Feb 2009 #permalink

A 12 year old French girl died in Geneva recently (January 29th) of measles encephalitis. She was not vaccinated. She had previously been in good health.

Tell me again how this disease is a "mild childhood illness".

*********
http://www.lenouvelliste.ch/fr/news/flash_info/index.php?idIndex=468&id…

Une jeune fille de 12 ans, jusquâalors en bonne santé, est décédée le 29 janvier dernier aux Hôpitaux Universitaires de Genève dâune encéphalite due à la rougeole. La jeune fille habitait en France, à proximité de la frontière Suisse. Elle nâétait pas vaccinée. Ce cas tragique confirme que la rougeole est une maladie dangereuse, souligne lâOFSP.

By Tsu Dho Nimh (not verified) on 08 Feb 2009 #permalink

@Fred Smith:

Let's hear the other side of the story.

What other side? This seemed to be a pretty objective presentation of facts.

Oh, right. Reality is biased. I forgot. Sorry about that.

My open letter to anti-vaccine groups:

Dear Anti-Vaxer,

Back away from Andrew Wakefield. Slowly.

Seriously, if you want to have any mainstream credibility, you need to disavow the research and the attention these publicity whores are gaining (in a negative way) for what you believe in. You have to. There's only so many times you can go to the "Big Pharma Conspiracy" card before you truly become the guy on the street corner declaring the end of the world is nigh.

If you honestly think that vaccines are dangerous and harmful, then you need to stick to research that is - at the very least - not fradulent and riddled with conflicts of interest. You have no moral high ground otherwise. You have to be just as angry and pissed off at Andrew Wakefield as you are at Paul Offit.

But you won't be, will you?

You'll be content to portray Wakefield as some victim of a wide-ranging Illuminati-esque conspiracy, portraying him as the fall guy for "natural increases in the prevalance of measles" or the "failure of the MMR vaccine to protect kids". I know where this is going, you know where this is going, so get your crappy talking points out there now so we can all have a good laugh at them.

xxxooo,
anonimouse

By anonimouse (not verified) on 08 Feb 2009 #permalink

js, referees aren't expected to look in detail for falsified data. That's not their job nor should it be their job. Don't blame the referees on the paper.

Phoenix Woman said "The very fact that Wakefield hasn't immediately hit Deer and the Times with a libel suit is quite telling."

He has done that already, and it was dismissed. Wakefield had to pay the costs:
http://briandeer.com/wakefield/lawsuit-discontinues.htm

Some interesting comments from the judge about the way the litigation was conducted. See in particular paragraph 2, and paragraphs 30 to 37.

I have to admit in all this saga, I'm still curious about the initial media reports and who they were from and precissely what they said. What paper, what journalist, etc. It always feels to me that they have a part to play too, but their names never seem to get mentioned.

js: Have to agree with Joshua. Referees look mainly for errors of logic in the argument, conflicts with previous knowledge, previous work the authors seem unaware of, etc. They don't have the time or the means or the mandate to cross-check data. (How would they get the medical records? How much time would that take? Wouldn't this turn referring a paper into a research project in it's own right?)

By Heraclides (not verified) on 08 Feb 2009 #permalink

I notice that Age of Autism (which has already linked to this) is sponsored by "Lee Silsby compouding pharmacy - the leader in quality compounded medications for autism".
Hmmm. Obviously not part of the Big Pharma conspiracy that they claim sponsors us.
And how nice that there is medication for autism! Tell the doctors quick! Oh, wait....
Their initial take is that Brian Deer, the journalist behind this story has been stalking and harrassing the saintly "Dr", while there is a genuine issue behind his getting hold of confidential patient records, which are in any case false. No need for them to worry then, eh?

Mojo, that was a previous suit by Wakers, I believe Phoenix Woman is referring to this latest expose by Brian Deer.

Estellea said "Mojo, that was a previous suit by Wakers, I believe Phoenix Woman is referring to this latest expose by Brian Deer."

Well, it is Sunday... I doubt that there are any courts open in either the UK or Texas today. So I assumed she meant at any time since Deer has been writing about Wakefield for years.

Isn't it cool when real journalists uncover real wrongdoing?

A natural extension of this would be for Thoughtful House to be investigated, assuming US authorities are on top of things. One can only hope that all autism charlatans face justice eventually.

"Hmmm...I wonder what Age of Autism will say."

Well, they'd have a hard time topping the "open letter" just released on the AoA website, castigating the medical disciplinary panel hearing charges against Wakefield:

http://www.ageofautism.com/2009/02/the-wakefield-affair-and-meadow-synd…

"...the central charges (against Wakefield) are âtrumped-upâ fabrications which should never have been brought. I would particularly like to highlight the horrific manipulation of the truth, which has a vile ideological tinge to it."

I would have warned you beforehand about the dangers to your irony meters, but this sort of thing goes well beyond irony into some construct not measurable by mortal man.

Note also that AoA's Galileo Award winner for 2008 is none other than...Andrew Wakefield.

http://www.whale.to/vaccines/blaxill4.html

By Dangerous Bacon (not verified) on 08 Feb 2009 #permalink

While I'm at it, here's some of the blogsopheric reaction:

http://scienceblogs.com/authority/2009/02/scientific_misconduct_and_the…
http://skepticdad.wordpress.com/2009/02/08/discredited-dr-wakefield-fur…
http://www.sciencebasedmedicine.org/?p=370
http://blogs.discovermagazine.com/badastronomy/2009/02/07/did-the-found…
http://scienceblogs.com/insolence/2009/02/why_am_i_not_surprised_it_loo…
http://scienceblogs.com/whitecoatunderground/2009/02/dishonest.php
http://scienceblogs.com/aetiology/2009/02/vaccines_and_autism--can_we_s…
http://genefinding.blogspot.com/2009/02/autism-vaccines-and-andrew-wake…
http://pajamasmedia.com/instapundit/69088/
http://igetpissed.net/?p=571
http://holfordwatch.info/2009/02/08/brian-deer-discusses-andrew-wakefie…
http://gmapalumni.org/chapomatic/?p=3572
http://theglitteringeye.com/?p=5968
http://foo.ca/wp/2009/02/08/jeni-has-a-blog-andrew-is-a-liar/
http://volokh.com/posts/1234107891.shtml
http://lawhawk.blogspot.com/2009/02/mmr-vaccine-link-study-with-autism…
http://scienceblogs.com/pharyngula/2009/02/anti-vax_study_a_case_of_sci…
http://scienceblogs.com/clock/2009/02/a_quick_note_to_huffington_pos.php
http://www.blacktriangle.org/blog/?p=1899
http://minx.cc/?post=282574
http://crowhill.net/blog/?p=5265
http://weblog.sinteur.com/2009/02/mmr-doctor-andrew-wakefield-fixed-dat…
http://daisymayfattypants.blogspot.com/2009/02/it-defies-description.ht…
http://community.livejournal.com/parenting101/4128658.html
http://www.medmarg.com/2009/02/somebody-give-andrew-wakefield-mmr-and.h…
http://polonius.wordpress.com/2009/02/08/andrew-wakefield-made-it-all-u…
http://buttle.wordpress.com/2009/02/08/there-goes-whats-left-of-the-lan…
http://www.canspice.org/2009/02/08/paper-linking-mmr-vaccine-to-autism-…
http://www.lesjones.com/2009/02/08/original-researchers-retract-claimed…
http://knightindragonland.blogpeoria.com/2009/02/08/hero-of-the-anti-va…
http://www.novascotiascott.com/2009/02/08/mmr-doctor-doctored-his-data/
http://scibite.blogspot.com/2009/02/mmr-and-autism-how-media-endangered…
http://dannyb1022.wordpress.com/2009/02/08/the-mmr-and-autism-link-shou…

Oh my, that AoA letter just takes the biscuit.

to paraphrase:
"Gut disorders in autism occurs because the NAS has told parents not to put off getting treatment when thier doctors think they are just scared by the Wakefield saga"

So, a statement encouraging parents to be wary of diagnostic overshadowing by GP's - when the GP's are only concerned because the scare caused by Wakefield means they are seeing a rush of parents coming in with "Well I read something somewhere about something like this Doc - could you run expensive and invasive tests for us just in case?" - is then taken as evidence that the correlation is there?

How utterly, utterly devious and/or stupid. I think I need to lay down for bit.

I have no idea how you people manage to deal with this level of utter tripe and not end up doing yourselves a mischief.

I'm less interested in what the rank-and-file have to say as I do the leaders of the "movement". Are they going to continue to associate themselves with someone who has violated just about every ethical scientific and medical standard there is?

Do they really think they can get away with that and maintain any sort of public credibility?

By anonimouse (not verified) on 08 Feb 2009 #permalink

Chris, Mojo et al -- I'd forgot about Wakefield's 2005 attempt to go after Channel Four and Brian Deer. Sounds like the spanking Wakefield got then (and you're right, Mojo: It is a thing of beauty) has pretty much warned him off from trying to muzzle Deer ever again. He's pretty much reduced to flinging verbal poo at Deer while his acolytes fan his fevered brow.

Hi, Orac, hi all,

this is to inform you about the latest developments in the UK: Ben Goldacre is sued by a radio station.

Here is a part and a lot of links into the story:

http://www.transgallaxys.com/~kanzlerzwo/showtopic.php?threadid=5147

Jeni Barnett is a radio journalist (hard to believe, really) who manipulates parents into not vaccinating their children.

Before going into the details of Ben Goldacre's new bloggonia let me tell you one thing: in the end of january a 12 year old girl died in Switzerland.

http://www.transgallaxys.com/~kanzlerzwo/showtopic.php?threadid=5147

The girl died from measles. She was not vaccinated.

Please, do support Ben Goldacre and take part in the net-wide support of texts and pieces of proof against insane "journalists".

Thank you
ama

It would be fair to describe Wakefield's groupies at Jabs, Jackie Fletcher, John Stone, Gus, Cybertiger et al, as his most serious victims (after anyone suffering measles complications). So completely have they unquestioningly swallowed the bullshit (in fact Jackie Fletcher was one of Wakefield's original co-conspirators) their on-line behaviour is unrecognisable from the worst religious cult fanatics.
I doubt it will happen but Wakefield should be behind bars, along with many of the newspaper editors who have promoted his, shall we say, lies.

Orac, if you wish to put the blame on Wakefield for the outbreaks in the UK (rather than on him in concert with a gormless media everready to seize on any scare story), there are more than just a thousand cases of measles to consider. Over the last 10 years, since the MMR scare Wakefield invoked in 1998 (at which time there were as few as 56 confirmed cases per year in the UK) there have been 4362 cases (laboratory confirmed).
http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733833790
http://www.hpa.org.uk/hpr/news/default.htm#msls

A chart displaying the cases including the 2008 notifications can be found here:
http://news.bbc.co.uk/1/hi/health/7872541.stm

However, UK cases have not confined themselves to the UK, and have been the source of outbreaks abroad, most notably this one in the Piemonte region of Italy in 2007/8 which caused 966 cases and one death. The index case had caught measles in the UK. The epidemic spread to the rest of Italy, with 2000 cases being notified within 6 months alone.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18928

So who knows just how far the Wakefield-inspired plague has spread? Are these cases just the tip of the iceberg?

There was also another death in the UK last year, bringing to 2 the UK death toll since the MMR scare (and the death toll to 3 if you include the Italy death as being related)

But that is not even the whole story. These are laboratory confirmed cases only, so there may be considerably more. And wherever you get measles, you will get other complications that cause permanent neurological damage from illness such as acute encephalitis, and you will also get SSPE (subacute sclerosing panencephalitis) in around 1 in every 10,000 cases. This is a lingering, chronic and universally fatal encephalitis. We can expect some of these kids who are now getting measles to get this illness in the years ahead.

Sometimes I wonder how the antivaxers can actually sleep at night.

Deer hates Wakefield with a passion, along with most of you here.

Genuine question:

How do you know Deer is being honest?

By Brian Deer (not verified) on 09 Feb 2009 #permalink

Some idiot who signed in as "Brian Deer" said "How do you know Deer is being honest?"

Because the information was from hearings on Wakefield's ethics in the UK, along with testimony from the Autism Omnibus hearings in the USA. It might help if you actually read the articles.

From what I have seen the anti-vaxers are just using this as justification that their "movement" is seen as a "threat" to "Big Pharma". All it is doing is reinforcing their paranoia. No matter what news comes out, it gets put in the spin machine and reported as proof.

I've seen one exceptionally deluded anti-vaxer using the old Gandhi saying (the ignore, laugh, fight, win thing) as her signature on forums. I am truly amazed and shocked that they would draw that comparison. They really, truly believe they are fighting "oppression".

Is there anything short of an outbreak of a vaccine preventable disease and some real injuries/deaths that will wake people up? Everytime another young Mom quotes some AoA drivel as if it is medical fact I want to scream.

How do you know Deer is being honest?

I don't know that, but it's a very reasonable assumption, for two reasons:

1. UK libel laws are extremely plaintiff-friendly.

2. Precedent: Brian Deer was sued by Andrew Wakefield before. Brian Deer prevailed after producing documentation of his findings. Wakefield backed down.

How do you know Brian Deer is being honest?

We don't. However, first this does chime in with what doctors like Orac do know about autism and MMR and Wakefields fraudulent/biased/inaccurate study; and second if Deer's report is wrong, he can expect to be sued over it.

Yes, I hate Wakefield with a passion. He gave traction to a lunatic fringe group all for the purpose of collecting some lawsuit money and royalties from a new Measles vaccine.

He sought to profit at the risk of the lives of children. Is that not why anti-vaxers hate "Big Pharma"? I would think that this would be the one thing the anti-vaxers might be able to comprehend.

Anti-vaxers despise Offit for having the nerve to patent a new vaccine and it is used to impune his integrity at every chance they get. Why is this same logic not applied to Wakefield? Or for that matter the Geiers who patent "treatments"? Or Jenny who is making a ton off of her books. Or David Kirby who's whole livelihood is provided by this farce.

They never ask what the people that support them have to gain from this. People who make a very good living and would lose everything if vaccines are proven safe. "Big Pharma" won't disappear if vaccines go away. Who has more to lose?

Good grief. It had already been established that he ignored evidence against his results (which by itself would constitute scientific fraud), but this is a whole new level. Proof that he knew what the results were going to be before the study was started, AND that the actual data was fabricated? I can't say I'm surprised he went that far, but it's a bit scary that it took this long for the truth to come out.

How do you know Deer is being honest?

Well he could be lying, but that would be at great personal risk, and I am sure the Sunday Times' lawyers have been over this one with a fine-tooth comb.

To put this into its historical perspective, the case of the GMC against Wakefield for misconduct has just ended. During the course of the case, the Wakefield supporters and websites were producing their own versions of "transcripts" which purported to show how Saint Andrew was whiter than white. They constantly heaped derision upon Brian Deer, asking why he was reporting nothing about the case, and taking his silence as an admission there was nothing adverse to report about their hero.

The reasons for that are now clear. The case is over, so Deer is presumably only now free to reveal evidence that was presented during it. No doubt we will find out in the fullness of time what went on, but this serves as a taster of what Deer has discovered.

I've seen it stated that the Brian Deer article came out when it did as part of a massive conspiracy to make anti-vaxers look bad, just before the Omnibus decision was released.

Here's a link to Wakefield's response.

http://www.rescuepost.com/files/deer-response.pdf

By Broken Link (not verified) on 09 Feb 2009 #permalink

Part of a massive conspiracy to make anti-vaxers look bad

There is just such a conspiracy. Age of Autism and JABS is behind it, and Andrew Wakefield is its phrophet - or, in his case, profit.

Let us also not forget: this is a multivalent vaccine. The data of the "fallout" from not vaccinating with MMR should include the rubella and mumps statistics, too, both of which are more virulent in adults. Measles and rubella can kill, and mumps orchitis is no joke. Parents refusing MMR are more likely to refuse other vaccines, too, like chicken pox, DTP, hepatitis...

Mothers who don't get their kids vaccinated with MMR are not only risking that child's health but also that of any younger sibling in utero if a rubella or measles epidemic gets started due to lack of herd immunity. Yes, the mothers were probably vaccinated...but vaccine immunity wanes with time, faster than natural. Many women of childbearing age have not gotten booster shots in years, and because this is a "live virus" vaccine, we have to wait until after delivery to give it.

Unfortunately, in the case of Wakefield's research, no controls were done to make sure that contamination was detected in the negative controls.

Wince! A PCR without proper negative controls has about as much validity as a seance. Wakefield might as well have declared that vengful ghosts were causing autism. It'd've had at least as much scientific validity. It's just painful that this got published in Lancet.

Well, rubella won't kill a child, but it can cause a baby exposed in utero to be born with severe birth defects and/or mental retardation...with features of autism, even. How ironic.

Sorry, I see someone already gave a link to Wakefield's response.

I love this bit from Wakefield:

"Finally, I did not âcreateâ a scare but rather, I responded to a scare that parents brought to my attention. To have ignored their concerns would have been professional negligence."

Oh the delicious irony......

Shorter Wakefield: "It would be irresponsible not to speculate...."

Wakers is really, really playing the victim card.

By anonimouse (not verified) on 09 Feb 2009 #permalink

Anybody want to comment on this passage from Wakefield's letter (referred to by others) - my italics:

Deer has completely missed the point; the âsyndromeâ that we have accurately and reproducibly described is the combination of autistic regression, swelling of the lymph glands in the last part of the small
intestine (ileum) and inflammation of the colon. Any association of this syndrome with MMR vaccine remains to be confirmed and, in contrast with Deerâs claim, the syndrome does not require any temporal link to MMR vaccination at all. This has been made clear to the GMC.

By Robin Levett (not verified) on 09 Feb 2009 #permalink

As a journalist I'm totally undone by AOL's 'five years pouring over' comment. Is this Dan Olmstead guy supposed to be a professional?

By NZ Sceptic (not verified) on 09 Feb 2009 #permalink

Sorry - that's 'AOA' but the idiocy remains the same!

By NZ Skeptic (not verified) on 09 Feb 2009 #permalink

It's interesting that Wakefield suggests use of a single measles vaccine rather than MMR at the end, especially because of his conflict of interest there. If he knows the data are forged to create a problem with MMR, then he can safely recommend a single measles vaccine because, like MMR, it will not actually be linked to disease. That is, unless someone else gets away with similar (alleged) distortions of the science.

I'm not totally surprised that Wakefield is suggesting the use of a monovalent measles vaccine...just as idle curiosity, is the measles vaccine he supposedly holds the patent for a monovalent one? /sarcasm

The Wakefield/antivax position is quite untenable and filled with inconsistencies regarding MMR/monovalent single vaccines/measles causing autism. They shift position almost daily dependent upon whichever way the wind blows.

Of course measles in theory could do exactly what they say MMR does. Even one of the "Wakefield 12" suffered neurological problems and bowel problems after catching measles. Did he make anything of that fact? Did he jump to the conclusion measles infection itself might cause a leaky gut? Did the finding that these kids had measles virus in their bowel indicate to him that this might be a site tropic for measles virus infection, and would occur in natural measles infection? He should have, but the answer in all cases was NO! He was too blinkered into incriminating MMR into his little syndrome to consider any other possibilities.
(PS They actually didn't have measles virus in their gut, and Wakefield knew it, but he still said they did just to support his own silly hypothesis).

Single vaccines are promoted as being a "safer" option on the presumption that it is the combination that is harmful. There is no evidence for this. Measles vaccine itself could be the culprit by antivaxers' own standards of evidence. They even had the stupidity to misrepresent the Japan data (MMR was stopped, but autism continued to rise) by suggesting the reason autism continued to rise was because kids still received singles measles jabs.
Illogical or what?

They also fail to grasp that by arguing "too many shots" or "too many toxins", yet advocating splitting the MMR into 3 individual components they are recommending 3 times the number of injections and 3 times the amount of preservatives, stabilisers, plutonium, aborted fetuses, monkey brains, eye of newt and everything else they say makes up a vaccine. How could 6 shots of toxic soup cocktail possibly be safer than 2 shots if their argument holds true?

Deer has completely missed the point; the âsyndromeâ that we have accurately and reproducibly described is the combination of autistic regression, swelling of the lymph glands in the last part of the small intestine (ileum) and inflammation of the colon.

So is Wakers suggesting that this syndrome happens without the MMR? Why hasn't he ever said that before?

Oh wait, he wasn't fighting for his right to practice medicine and wasn't being hounded by all comers for his fantastically stupid hypothesis.

By anonimouse (not verified) on 10 Feb 2009 #permalink

Unfortunately this blog comes through regularly on a Google alert to me on some other topic, so I often read it just to get my blood boiling. I enjoy its arrogance and self righteousness!

I have never posted before and might never again, but on the Wakefield issue - and I am neither pro him nor against him - he has ALWAYS asserted single vaccines - and yet you 'knowledgeable' lot don't seem to know that!

By Elizabeth (not verified) on 12 Feb 2009 #permalink

Unfortunately this blog comes through regularly on a Google alert to me on some other topic, so I often read it just to get my blood boiling. I enjoy its arrogance and self righteousness!

I have never posted before and might never again, but on the Wakefield issue - and I am neither for him nor against him - he has ALWAYS suggested single vaccines - and yet you 'knowledgeable' lot don't seem to know that!

By Elizabeth (not verified) on 12 Feb 2009 #permalink

Yes he does recommend single vaccines, preferably ones he holds the patent on.

Did your boiling blood make you too blind to actually read the post, Elizabeth? I could understand if this was stated in a different post or page - but it was stated in this exact same post directly above ... Press Ctrl-F and search for "single". Oops!

Child Six, aged 5, and Child Seven, aged 3, were said to have been diagnosed with regressive autism, with an onset of symptoms "one week" and "24 hours" after the jab respectively.

Minor point since it turns out that the whole thing was made up, but it takes something like 2 weeks to form a specific immune response to a pathogen in a naive host. So the most the vaccine could have done one day or even one week after exposure is cause a non-specific inflammatory response. Any pathogen (or non-pathogenic moiety that the immune system mistakes for a pathogen) will cause essentially the same non-specific reaction. If the problem is specifically with the MMR, then it wouldn't show up for at least 2 weeks after injection. And probably not for long after that, given that it's going to take some time for immune mediated damage to the central nervous system to occur.

Shorter comment: I can't think of a biologically plausible way in which the injection of a small amount of weakened virus could cause autism within 24 hours of the injection.

Orac,

This is in reply to a comment you left on my blog at http://www.patsullivan.com/blog/2009/02/tide-turning-regarding-possible… --

Orac,

I was able to track down your post even though I had problems with the link above.

Notice that I do not mention Wakefield, nor does the Huffington Post. I have never been a big fan of Wakefield. I note you don't comment on any of the many scientists listed who now have growing concerns about vaccines. Perhaps you are behind the times? Wakefield has pretty much been discounted long ago.

You state in your post here:

"numerous epidemiological studies have failed to find an association between either mercury in thimerosal-containing vaccines and autism, between MMR and autism, and between vaccines in general and autism."

With your oft stated need for double blind, placebo controlled studies to prove a substances efficacy and safety, why are you not crying out for these kinds of studies? Thimerosol has never had these studies. Most vaccines have not had these studies. Nor has the practice of giving babies many simultaneous vaccines whose immune systems and brains are still developing been tested. Why? With babies being our future, why would we not take the same caution or care as we would with say, Prozac or Lipitor?

How hard would it be to take 100 guinea pigs (lab animals, not babies!) and shoot them with all the thimerosol ladened, multiple vaccines when they are babies? Take another 100 and shoot them with water. Also, make sure the pigs have a mix of APOe genes that include ones with the 4,4 allele. Track what happens. To my knowledge a basic study like this has never been done.

Instead you and others rely totally on epidemiological studies which have merit, but are not the gold standard and usually can be done to show most anything the researcher (and the funders of the study) wants to show.

Where is the real science? The gold standard? You know Thimerosol has never been actually studied for safety. If it has, please site the study. I would love to see it. Why don't vaccines get the same treatment as any drug would?

Pat

Pat Sullivan said "With your oft stated need for double blind, placebo controlled studies to prove a substances efficacy and safety, why are you not crying out for these kinds of studies?"

Because it is not ethical, and in some cases not practical (like for surgery). The MMR has been around since 1971, and it was tested per the standards then, and has been shown to be safe and effective in reducing disability and death due to measles, mumps and rubella.

You continued with "Why don't vaccines get the same treatment as any drug would?"

Actually, vaccines are initially tested with placebo groups. That is what the literature shows if you bother to look it up.

For a more complete explanation read this blog input:
http://photoninthedarkness.com/?p=154

Read the part near the end that says "Another suggestion made was to have a study where children are placed into âno vaccinationâ and âvaccinationâ groups. This, of course, would be rejected out of hand by any Institutional Review Board because the risks of not vaccinating are well known and quite serious. On the other hand, the connection between vaccines and autism is tenuous at best. It would be unethical to expose adults to a known serious risk in order to test a weakly-supported (again, at best!) possible risk. In children, it would be unthinkable."

You should also read the chapter in Paul Offit's book "Autism's False Prophets" where the value of epidemiological studies are discussed (like in the case of smoking and cancer).

I always find it interesting that anti-vaxers take the ethical argument and usually respond "Well why don't you just study children that aren't vaccinated, there are lots of them out there?"

The main problem with this is obviously it would not be blind at all. In other words, the placebo group would know exactly who they are. The ethical part is you cannot give a child a saline shot instead of a vaccine (or vice versa) without their parent's knowledge. You would have to have test subjects that agree to randomly receive or not receive the vaccine(s). I doubt many of the anti-vaxers would agree to let their children be vaccinated nor would others allow their children to not be, particularly without being made aware of it.

If you know you are in the placebo group then your results may be biased by personal perception - therefore they are useless.

And lets face it, even if this kind of study were possible I doubt very seriously they would accept the results if it supported vaccines being safe. Otherwise every other study to date would have gotten a better reception from them, even if they did believe them to be somehow flawed.

I remember the radio show Offitt was on with that loony mother who basically said "I don't trust the government" followed by "I want the government to do a neutral study". She admitted that there was nothing that would convince her of vaccine safety. You just can't debate that, you just have to limit the impact of that stupidity on more reasonable parents.

To get some idea of what a poorly thought-out study looking at completely unvaccinated children and "fully vaccinated" children might show, you only have to look as far as the Generation Rescue telephone "survey" on vaccines and autism done in 2007.

Their results were so bizarre that they had to resort to water-boarding the data to get them to show what they wanted.

Prior to "coercive measures", the GR "data" showed that "partially" vaccinated boys were more likely to have autism than either "fully" vaccinated or unvaccinated boys.

[Note: in order to make the data support their pre-determined conclusion, GR had to lump ADD/ADHD with autism. In addition, their prevalence numbers for both autism and ADD/ADHD were about ten times the current prevalence in the general population.]

My question is this: if we do manage to perform an ethical study of unvaccinated vs vaccinated children - or even just boys - what will the vaccines-cause-autism crowd do if (when?) the data show that unvaccinated children have a higher prevalence of autism? [Note: there are good reasons to suspect that such a study would show exactly that.]

I suspect that there is no outcome - apart from "vaccines cause autism" - that will be accepted by the people currently crying for such a study. If not, they would have already realized that the currently available data shows pretty convincingly that vaccines don't cause autism.

"Doing" another study or two (thousand) to hammer the confidence interval closer to zero won't change minds that are not receptive to new information.

Prometheus

With your oft stated need for double blind, placebo controlled studies to prove a substances efficacy and safety, why are you not crying out for these kinds of studies? Thimerosol has never had these studies. Most vaccines have not had these studies.

Do you actually read what you type? Or do you find that you just drift in and out?

Are you really suggesting that vaccines, injections given to nearly all children, are not rigorously tested?

By Joseph C. (not verified) on 17 Feb 2009 #permalink

How hard would it be to take 100 guinea pigs (lab animals, not babies!) and shoot them with all the thimerosol ladened, multiple vaccines when they are babies? Take another 100 and shoot them with water. Also, make sure the pigs have a mix of APOe genes that include ones with the 4,4 allele. Track what happens. To my knowledge a basic study like this has never been done.

This is easily one of the stupidest things ever posted to this blog.

By Joseph C. (not verified) on 17 Feb 2009 #permalink

The parents of 'autistes' should maybe consider their children as potentially gifted, rather than desperately ill.

As a parent of an 'autiste,' may I suggest that you should take your patronizing advice and put it in the same, lightless hellhole where Wakefield's studies belong.

Children with autism and ASDs are still people, which means they can be clever, learn languages and have aptitudes for language or math, just like everyone else. This doesn't mean that they are adorable wind-up toys whose affliction makes them have special talents.

Looks to me like Wakefield in particular and/or anti-vaxers in general are just buying time with that complaint. The writing is on the wall.

@ mythago

"Children with autism and ASDs are still people, which means they can be clever, learn languages and have aptitudes for language or math, just like everyone else. This doesn't mean that they are adorable wind-up toys whose affliction makes them have special talents."

Is this supposed to imply someting about the way parents of autistic children view their children? Or is it perhaps some form of projection of your own views on autism?

I see now at LB/RB that Brian Deer has responded to the complaint. He provides documentation that shows Wakefield is simply lying.

How hard would it be to take 100 guinea pigs (lab animals, not babies!) and shoot them with all the thimerosol ladened, multiple vaccines when they are babies? Take another 100 and shoot them with water. Also, make sure the pigs have a mix of APOe genes that include ones with the 4,4 allele. Track what happens. To my knowledge a basic study like this has never been done.

film izle, you might be interested in reading here and here about the Hewitson monkey studies, which are not too different from the experiment you describe. Of course, the Hewitson monkey studies are severely limited in usefulness (usefulness to science, anyways) by the conflicts of interest of the lead author, but you might find them interesting.

You might want to consider carefully something Orac noted, namely, "The first thing I always look at whenever reading any study is a simple question: What is the hypothesis being tested?"

By Antaeus Feldspar (not verified) on 03 Dec 2009 #permalink

Of course testing thimerosal would be silly for several reasons:

1) The MMR never contained thimerosal.

2) Thimerosal was removed from all but one pediatric vaccine almost a decade ago.

3) And several large epidemiological studies done over several countries shows no casual association between vaccines and autism. And just recently a small study from Poland showed that kids who got the MMR were less likely to be autistic. See this discussion.

film izle, you might be interested in reading here and here about the Hewitson monkey studies, which are not too different from the experiment you describe. Of course, the Hewitson monkey studies are severely limited in usefulness (usefulness to science, anyways) by the conflicts of interest of the lead author, but you might find them interesting.

You might want to consider carefully something Orac noted, namely, "The first thing I always look at whenever reading any study is a simple question: What is the hypothesis being tested?"

@Fred Smith:
| Let's hear the other side of the story.

Wasn't "the other side" the paper? What more do we need to hear fom that "side"?

film izle, you might be interested in reading here and here about the Hewitson monkey studies, which are not too different from the experiment you describe. Of course, the Hewitson monkey studies are severely limited in usefulness (usefulness to science, anyways) by the conflicts of interest of the lead author, but you might find them interesting.

You might want to consider carefully something Orac noted, namely, "The first thing I always look at whenever reading any study is a simple question: What is the hypothesis being tested?

Another good thread to shut down, Orac. Post #87 is being bizarrely and intermittently reposted under other pseudonyms. Some kind of way that a bot gets a website link on to blogpages?

By Orange Lantern (not verified) on 04 Sep 2010 #permalink