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How a zealot’s word led us astray on autism

Wed Feb 3, 2010 12:49 PM EST
business, health, only-on-msnbc-com, breaking-bioethics, autism, vaccine, vaccination, lancet, mmr, wakefield, andrew-wakefield
msnbc.com News — Arthur Caplan, Ph.D., msnbc.com - Only on msnbc.com
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— A dozen years ago, a British physician named Dr. Andrew Wakefield published a paper in the prestigious medical journal The Lancet that did immeasurable harm to children.

Wakefield, who back in 1998 was working at London’s Royal Free Hospital, claimed in the article that the vaccination of 12 children with measles/mumps/rubella (MMR) vaccine had caused a reaction in their bowels that caused autism.

At a press conference shortly after the paper came out, Wakefield urged parents not to give their children the combination vaccine.

The British press went crazy over the report. The word and the fear quickly spread around the world.

Since the controversial paper was published, British parents abandoned the vaccine in droves, leading to a resurgence of measles. Vaccination rates for measles have never recovered, and there are outbreaks of the disease in the U.K. every year.

And across the globe, millions of parents who choose to follow their own doctors' advice and vaccinate their children have had to face the anxiety of an alleged link to a dread disease.

All this despite the fact that no scientists were ever able to replicate Wakefield's findings.

Yesterday, The Lancet, after years of investigations, lawsuits, press complaints and accusations, took the unprecedented step of withdrawing this 12-year-old article as misleading and false.

Why did The Lancet finally act? Because the British board that licenses doctors recently concluded that Wakefield had “shown callous disregard” for the children in his study and had “abused his position of trust” in doing his research. In language I have almost never seen from a disciplinary body, the General Medical Council added that Wakefield acted "dishonestly," was "misleading" and "irresponsible" in the way he described the findings of his tiny study about the danger of MMR vaccine in The Lancet.

As it turns out, for the study Wakefield took blood samples from children at his son's birthday party, paying them 5 pounds each.

The language was probably not strong enough. The Wakefield paper killed children and left others deaf and disabled from preventable diseases as their parents, in an effort to avoid autism, left them unvaccinated.

Vaccination has always had its critics. Using needles to put things into children’s bodies has always left some parents uneasy. And the epidemic of autism has left other parents searching for some cause, some agent, some substance that might be to blame.

Vaccination became a prime suspect because it occurs so close to the time at which autism used to be first diagnosed. And Wakefield’s paper was all the ammunition anti-vaccinators needed.

Wakefield’s study was both tiny and flawed. Nearly all of his 13 other co-authors eventually bailed out on the article. Still, the press could not resist from spreading the scary news over and over again, even though no one could get the same findings as Wakefield did. And Wakefield himself, supported by a fanatical anti-vaccine lobby that to this day cannot let go of the vaccine-autism connection, continued to spread fear of vaccines right up to the time of his disciplinary hearing.

Some will try to portray Wakefield as a martyr, sacrificed for the profits pharmaceutical companies make from vaccines. But the profit from childhood vaccination has always been a very small part of Big Pharma’s big profits. The companies still in the childhood vaccine business generally stay there from a sense of duty to the public health not greed.

Wakefield is no martyr. He is a scientist who would not give up on his theory no matter how much evidence accumulated that vaccines are not linked to autism. And that makes him guilty of letting his zealotry blind him to the harm avoiding effective vaccines did to many vulnerable children.

The bitter lessons of the decision to expunge the Wakefield paper from medical history are clear. No single, small study should ever be taken as the basis for a massive change in anyone’s behavior when it comes to your health and that of your family. And the desire to find some reason, any reason, for the plague of autism should not blind us to the fact that the evidence clearly shows that vaccination is not the culprit.

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GOZO-unlimited

(Austin, Texas) – The Press Complaints Commission (PCC) of London, an independent body that oversees journalism fairness in the UK, has issued an interim order calling for the Sunday Times to remove stories written by Brian Deer about Dr. Andrew Wakefield from its web site. Dr. Wakefield had filed an extensive complaint with the PCC regarding errors of fact in Deer’s reportage on the MMR vaccine and its possible relationship to autism. The General Medical Council (GMC) in the UK is presently hearing evidence involving Dr. Wakefield and two of his colleagues following a complaint to the GMC by Deer himself. The PCC decision today appears to indicate there are questions about the accuracy of the Deer stories.

The PCC complaint by Dr. Wakefield provides clear evidence that Deer’s allegations of “data fixing” by him are false. The complaint also accused Deer of an undisclosed conflict of interest since Deer also failed to disclose in his articles that he was the person who made the original complaint to the GMC, misleading the newspaper’s readers over the accuracy of his reporting.

“Given the ongoing nature of the dispute,” Stephen Abell of the PCC wrote, “the articles should be removed from the newspaper’s website until this matter has been concluded. This would not be an admission of any liability on the part of the newspaper.”

Although media are expected to respond promptly to complaints through an informal process, the Sunday Times took more than three months to answer detailed issues raised by Dr. Wakefield, and called upon legal representation to write the paper’s response. Despite this they have failed to produce any evidence of “data fixing” by Dr. Wakefield. In its letter to Dr. Wakefield, the PCC “expressed concern at the initial slowness of the newspaper’s response.” The PCC said it delayed a complete ruling until it has a fuller accounting of all information submitted to the GMC, but that the outcome of the GMC hearing is not relevant to a final decision by the PCC.

http://thoughtfulhouse.org/pr/sunday-times-ordered-to-remove-brian-deer-MMR-stories.php

  • 2 votes
Reply#1 - Wed Feb 3, 2010 1:47 PM EST
GOZO-unlimited

Formal Complaint Filed Against Journalist Covering Autism and MMR Jab Controversy

Dr. Andrew Wakefield Submits Detailed Document to PCC Showing Examples of Erroneous Published Information

Read Complaint: Submission to the UK Press Complaints Commission
Read Complaint Addendum: Submission addendum to the UK Press Complaints Commission

A formal complaint against journalist Brian Deer was delivered to the Press Complaints Commission (PCC) today on behalf of Dr. Andrew Wakefield, the physician whose autism research has been the subject of several articles in the Sunday Times. Deer is accused in the PCC document of publishing incorrect information and also of having a conflict of interest caused by his involvement in the General Medical Committee's (GMC) investigation of Wakefield.

"Journalists clearly have a right and responsibility to report on matters of public interest", Wakefield said. "But they also have an obligation to make certain their information is accurate--especially when someone's livelihood and professional reputation are at stake. Mr. Deer has failed miserably as a reporter and has done great harm to me and many others conducting autism research."

Information contained in the PCC filing listed numerous instances of Deer's failure to obtain and report accurate information for a story in the February 9, 2009 Sunday Times that wrongly accused Wakefield of distorting data. As an example, Deer wrote that no doctors have been able to replicate Wakefield's 1998 Lancet study that showed intestinal inflammation in children with autism. However, in the past four years three separate studies have all shown a similar association between autism and intestinal inflammation in children.

"Time and again, Mr. Deer cherry-picks information and ignores data that contradict his premise," Wakefield added. "Further, he shouldn't even be writing about my case since he is on record as having filed the original complaint with the GMC and has become complicit in the agency's investigation by supplying documents and evidence from children's medical records. This is hardly impartial journalism."

Although Deer has consistently denied he is the source of the first complaint that launched the GMC"s investigation on Feb. 24, 2004, three days after he wrote his first article on Wakefield Deer contacted the GMC caseworker Tim Cox-Brown via email: "I write to ask your permission to lay before you an outline of evidence that you may consider worthy of evaluation with respect of the possibility of serious professional misconduct...".

Deer, writing for a major publication under the pretense of objectivity, has also made numerous slurs on his website against Dr. Wakefield and his supporters. The biases, conflicts of interest, and inaccurate information used by Deer are all detailed in the complaint delivered to the PCC.

Wakefield, who now lives in Austin, Texas, is continuing his research at Thoughtful House Center for Children dedicated to serving children with autism and other developmental disorders. Wakefield and his colleague from Thoughtful House, Dr. Bryan Jepson, are speaking at the Treating Autism 2nd International Biomedical Conference and Exhibition at the Bournemouth International Centre, Mar. 12-14.

About Thoughtful House: Thoughtful House takes a multi-disciplinary approach to treating autism and supports a 'safety-first' vaccination policy that gives parents the option of choosing a stand-alone measles vaccine for their children. The research program at Thoughtful House is dedicated to understanding the biological origins of childhood developmental disorders and establishing best practices in treating children affected by these disorders.

  • 2 votes
#1.1 - Wed Feb 3, 2010 1:55 PM EST
Catch22

The ongoing dispute between Dr. Wakefield and how he was described in the press does not change the fact that Wakefield's study was fundamentally flawed.

By all means that complaint process on journalistic coverage should be worked out - it does not change the fact that the study he published was scientifically invalid.  The only issue was whether the coverage was entirely accurate.

Whether or not Deer engaged in slurs is not relevant to the science.

FACT:  Lancet Retracted the controversial 1998 paper.

FACT:  The British Medical Counsel issued a ruling on the conduct of Dr. Wakefield.

The conduct of wakefield and the science regarding causation are seperate issue.  Even if you assume that Dr. Wakefield has been slurred and slandered, it does not change that the study was not valid.

About Thoughtful House: Thoughtful House takes a multi-disciplinary approach to treating autism and supports a 'safety-first' vaccination policy that gives parents the option of choosing a stand-alone measles vaccine for their children.

People can have different opinions but the scienfific evidence supports the conclusion that safety-first means ensuring that you actually get vaccinated and not allow fears of autism to allow fear to trump safety. For all I know this organization does an excellent job - others do not.

  • 1 vote
#1.2 - Fri Feb 5, 2010 11:39 AM EST
Reply
Robert-1126350

Speaking of unethical and unsubstantiated, DR. Kaplan

The Wakefield paper killed children and left others deaf and disabled from preventable diseases as their parents, in an effort to avoid autism, left them unvaccinated.

You should have the proof that you require of out of Dr. Wakefield. But you don't. You could put together this rate or that. You could show temporal associations that you would dismiss if they were in reverse.

How many children died or became deaf from measles during this time period? How many were vaccinated? How many of the unvaccinated cited they chose to not vaccinate because of Dr. Wakefields article or indirectly from it?

You don't have the answers to any of those question yet you throw around accusations. You should be sued for slander.

And you're a bioethicist?

    Reply#2 - Wed Feb 3, 2010 4:29 PM EST
    MarkD-555

    Update: Measles --- United States, January--July 2008

    Sporadic importations of measles into the United States have occurred since the disease was declared eliminated from the United States in 2000 (1). During January--July 2008, 131 measles cases were reported to CDC, compared with an average of 63 cases per year during 2000--2007.* This report updates an earlier report on measles in the United States during 2008 (2) and summarizes two recent U.S outbreaks among unvaccinated school-aged children. Among those measles cases reported during the first 7 months of 2008, 76% were in persons aged <20 years, and 91% were in persons who were unvaccinated or of unknown vaccination status.

    During the first half of 2009, a large number of measles cases were reported in the United Kingdom, specifically in England and Wales. Since June 2009, cases of measles seem to be declining. During July through September 2009, there were 81 laboratory-confirmed cases of measles in England and Wales, compared with 660 confirmed during the previous 3 months.

    (from the CDC)

    I couldn't find the 2009 figures for the US.

    I wonder why so many children are suffering in 2008? Double the normal? Anti-vax insanity would be the reason. You have another reason? Share it. I'd love to hear it.

    Damn straight Wakefield is to blame. When you are a professional health care professional you don't spout off causing people to fear things irrationally, and you are responsible for your actions.

    Total:

    • Zero cases of Autism prevented. ZERO.
    • Large outbreaks of measles in the US and the UK in 2008-2009
    • Who knows how many other parents avoided other vaccinations because of this causing more suffering of their children and others around them.

    Great job doc.

    ---

    Now then, Autism is a terrible affliction, lets get together and find the real reason for it without this tinfoil hat nonsense.

    When you give health advice when you don't know what you are talking about, think about the results.

    • 2 votes
    Reply#3 - Wed Feb 3, 2010 4:50 PM EST
    Robert-1126350

    I wonder why so many children are suffering in 2008? Double the normal? Anti-vax insanity would be the reason. You have another reason? Share it. I'd love to hear it.

    What's ironic is the ignorance. Yet you sound so confident because of your ignorance. We're talking about measles not Ebola.

    Measles is a mild self limiting viral disease of childhood. - Merck Manual.

    Context is very important.

    Damn straight Wakefield is to blame.

    "From 1998-2008 (the year of the study, to last year of stats) there have been 11 deaths from measles in the UK, which is the highest vaccine-refusal nation. In the 10 years prior to that publication by Wakefield, (1987-1997) there were 37 deaths from measles in the UK. (Best estimates for 2009 are 1 death. Adding 1 more year would raise the total to 47 deaths prior to Wakefield's study.)

    That does not square with the idea that Dr. Wakefield's study created measles deaths. He may be wrong, but it appears to be far more wrong to blame him for any deaths in children from measles"#10.3 John Toradze

    Mild Measles and Secondary Vaccine Failure During a Sustained Outbreak in a Highly Vaccinated Population

    http://jama.ama-assn.org/cgi/content/abstract/263/18/2467

      #3.1 - Wed Feb 3, 2010 10:49 PM EST
      Reply
      lah9999

      It's hard to know whom to trust. In our world, no one knows who has the well-being of the public as their primary concern. People worry about their children, of course they do. The jury is still out on the questions of autism.

      http://graciouslivingdaybyday.com/

        Reply#4 - Fri Feb 5, 2010 11:16 AM EST
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