Feb 09 2009
In 1998 Andrew Wakefield and others published a small study of only 12 subjects in the Lancet. This small study sparked a huge controversy – Wakefield used it to claim that the MMR (mumps measles and rubella) vaccine caused autism. As a result compliance with the MMR dropped from 92% in the UK down to 85%, and measles cases soared from only 58 cases in 1998 to 1,348 cases in 2008.
Despite the fact that Wakefields paper has been thoroughly discredited, and subsequent studies showed convincingly that there is a lack of association between MMR or vaccines in general and autism, the controversy sparked by Wakefield continues. It has spread to the US as well, where measles cases are also starting to jump. The existing anti-vaccine movement latched onto Wakefield’s study and have been running with the vaccines-cause-autism fear-mongering ever since. While not letting go of MMR, they did shift over to thimerosal (which was never in the MMR vaccine), which has also been cleared from any association with autism (but was removed from vaccines in the US and most countries anyway).
The real story of MMR, thimerosal, vaccines, and autism is a scientific one, and the science has spoken. While further research is always welcome (as long as it is ethical) the question is essentially settled – vaccines do not cause autism. The scientific evidence does not care for the personal saga of Andrew Wakefield, but he has never-the-less become a central figure in this story. He has now been elevated to the status of folk-hero by the antivaccinationists. So while I consider Wakefield a footnote, his story is interesting and instructive.
Investigative journalist Brian Deer has been almost single-handedly responsible for digging up and exposing the sordid details of Wakefields dubious behavior. Over the weekend Deer published yet another expose on Wakefield in the TimesOnline – this time presenting evidence that Wakefield actually faked some of his data. He reports:
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.
If true this is extremely damning. What it would mean is that Wakefield either deliberately faked data, or he is such a sloppy researcher that he manipulated data to suit his biases. Confirmation bias, cherry picking, and creative interpretation can occur to manipulate data without being conscious that one is out-and-out lying. The difference hardly matters as far as scientific ethics are concerned – a researcher is responsible for the integrity of their data, and in supposed to take care that data is not fake, whether it was deliberate or not.
Wakefield, of course, denies the allegations – which does not tell us if he believes he is guilty or not.
Brian Deer documents many other damning allegations on his website. For example, Wakefiled applied to patents on a supposedly improved and safer MMR vaccine the year before he published his fateful study. Therefore he had a vested interest in calling the safety of the MMR vaccine into question.
Wakefield’s “theory” of autism was that the MMR vaccine caused inflammatory bowel disease which allowed proteins from the vaccine to gain access to the nervous system, causing autism. He therefore argued that by treating measles infection autism could be helped or even cured. He and the Royal Free Hospital with which he partnered stood to profit from their treatment regimen for autism which targeted measles infection.
Further, it is alleged that the hospital’s lab used improper PCR technique in detecting measles RNA in autistic children. A later study failed to replicate their results.
Most of Wakefield’s co-authors withdrew their names from the paper and the Lancet has issued a retraction. However, the damage to public perception had already been done.
There’s more – check out Deer’s site for more information.
There are several things that are clear at this point. All of this is irrelevant to the scientific evidence, which confidently points to the conclusion that vaccines do not cause autism. Every aspect of Wakefield’s research has been thoroughly discredited. The study was terrible science, faked or not. Wakefield himself is a very dubious character, and in fact in under investigation for professional misconduct.
It is also clear from past history that this new revelation will not change the minds of the hard-core antivaccinationists. To them all evidence against Wakefield or his research is just part of the Big Pharma and government conspiracy against him, further elevating his status as a folk-hero and possibly martyr.
But hopefully each new such revelation, and each new piece of scientific evidence supporting vaccine safety, can futher marginalize the very dangerous antivaccinationist quackery.
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