8 Feb 2009

Wakefield falsified data to link MMR to autism

One of the major sources of suffering for autistic people and their parents over the past 10 years, has been the continued association in the media and in the public's consciousness between the MMR vaccine and autism. Andrew Wakefield was a gut surgeon, a maverick doctor with a hunch and in the pay of lawyers. He held the patent on a rival measles vaccine and stood to benefit if somehow he could sully the MMR vaccine approved of by the health department and have it replaced with his own measles vaccine. For a while he tried to link the MMR with Crohn's disease to no avail, so he must have been delighted when he heard whisperings of parents blaming the MMR for causing their children's autism. He managed to recruit a bunch of these parents, most of whom were suing the government for causing their children's neurological condition, and though he wasn't a paediatrician, he got a mate to scope their guts, had the samples analysed at a badly run lab and concocted the results he needed to make out there was a strong association.

Yes, it seems he falsified the data.

Brian Deer writes on today's Sunday Times about the many ways in which Wakefield's Lancet paper of 1998, the article that set this whole confusing and damaging mess in motion, changed many important details about the 12 children studied. 11 of them were described as having a brand new condition invented by the authors, "regressive autism."

According to Deer's investigation:
"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."

(Dear Brian Deer, your work here is excellent, but please, no more of the "sufferers of autism" thing.)

Another child was written about in the Lancet paper as developing "regressive autism" two weeks after his jab, but Deer explains that:
"...this child’s medical records, backed by numerous specialist assessments, said his problems began three to five months later."
So Wakefield blithely ignored the truth when it didn't support his theory. There is much more, the only girl in Wakefield's cohort was described in the Lancet as, "having suffered a brain injury “two weeks” after MMR" but "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”."

There is more:
"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."

The MMR debacle, started by one arrogant, dishonest doctor with scant regard for scientific accuracy or even for ethics in how he treated the children, has been extrapolated by the media with years of inaccurate, awful reporting on vaccines and autism. Even last week, one radio presenter, former actress Jeni Barnett, spewed her ignorant and rather deranged views on vaccination over the airways for an hour. She of course spoke of her notion that vaccines made her child autistic.

Dr Ben Goldacre played a long excert from her LBC show so people could hear for themselves just how befuddled and mistaken the woman was, just how it is that media personalities fuel the lies that have resulted in the low uptake of a life saving vaccine, the continued misrepresentation of autism as something that happens to previously "normal" children and the high rise in measles cases. The show is now available on Wiki Leaks and there are loads more links on Holford Watch.

Her response, send the lawyers after him. Typically, this has only served to spread the recognition of her stupidity world wide as transcripts of the show pop up all over the blogosphere. Hurrah for the internet.

But enough!

There have been so very many biomedical and epidemiological studies done into that supposed association. It just doesn't exist. It is a fairytale.

The time and money spent attempting to reassure the public of the MMR's safety could have been used to do make actual progress in health and science. If the smallest fraction of that effort had focused instead on helping autistic people live and thrive, the benefits would be immense.

We are fed up hearing our children described as toxic and poisoned. Surely even Wakefield's most ardent supporters, those who wave placards outside the GMC when he turns up for his disciplinary hearings and who gaze adoringly at him as if they're 10 and he's Zac Efron, will rethink and realise he's no hero.


Unknown said...

"There have been so very many biomedical and epidemiological studies done into that supposed association. It just doesn't exist. It is a fairytale."


What are the biomedical studies that have been done?

Sharon McDaid said...

It amazes me that despite the post's content, you ask about what you doubtless already know. Are you not shocked that this man, a doctor with a responsibility to do his best by his patients, used a bunch of autistic children to further his floundering career, that he lied, that he pushed the emphasis away from education and living standards to reassuring the public of vaccine's safety?

You know that every single study attempting to reproduce Wakefield's results couldn't do so. A meta-analysis of mmr studies concluded, "Exposure to MMR was unlikely to be associated with Crohn's disease, ulcerative colitis, autism or aseptic meningitis (mumps)."

Anonymous said...

I can't find that Jeni Barnett clip, despite repeated clicks on highlighted text here and on Goldacre.

Sharon McDaid said...

Sorry K, I didn't give the correct link. The show can be heard on wiki leaks.

I'll edit the post.

Anonymous said...

Thanks. I found it interesting she didn't know the difference between a cold and influenza.

Anonymous said...

I'm quite speechless.
Thanks for researching all these things and shedding light on them.

Alyric said...

Isn't that typical of the truly despicable Harold Doherty? No depths too low to plummet in support of what exactly?

The Biologista said...

Mr. Doherty,


What are the biomedical studies that have been done?"

A selection:

Madsen KM et al. (2002). N Engl J Med 347 (19): 1477–82 - No correlation

Jefferson T et al. (2003). Vaccine 21 (25-26): 3954–60. - *Meta analysis* correlation is "unlikely"

DeStefano F et al. (2004). Pediatrics 113 (2): 259–66. - No correlation

Smeeth L et al. (2004). Lancet 364 (9438): 963–9. - Non significant negative correlation (ie MMR shown protective)

Barbaresi WJ et al. (2005). Arch Pediatr Adolesc Med 159 (1): 37–44. - Autism reporting rates are up but do not correlate with MMR.

Honda H et al. (2005). J Child Psychol Psychiatry 46 (6): 572–9. - withdrawl of MMR in Japan results in no change to autism rates. (n=30,000)

Demicheli V et al.(2005). Cochrane Database Syst Rev 19 (4). -Cochrane Library meta analysis of 31 studies. No correlation.

Fombonne E et al. (2006). Pediatrics 118 (1): e139–50. -no correlation (n=27,749)

Taylor B (2006). Child Care Health Dev 32 (5): 511–9.

D'Souza Y, Fombonne E, Ward BJ (2006). Pediatrics 118 (4): 1664–75.

Richler J, Luyster R, Risi S et al. (2006). J Autism Dev Disord 36 (3): 299–316.

Uchiyama T, Kurosawa M, Inaba Y (2007). J Autism Dev Disord 37 (2): 210–7. - An update of the situation in Japan. Still no correlation.

Cox AR, Kirkham H (2007). Drug Saf 30 (10): 831–6. PMID 17867721.

DeStefano F (2007).Clin Pharmacol Ther 82 (6): 756–9.

Hornig M, Briese T, Buie T et al. (2008). PLoS ONE 3 (9): e3140

On the opposing side I think the publication count is three. Two written by Wakefield. The first now considered at least partially falsified, the other shown to have been compromised contamination of a PCR experiment.

Sharon McDaid said...

@Gonzo, it's hard to believe isn't it. I can only hope this man, who does not deserve the title doctor or scientist, is ashamed of what he has done some day.
For some reason the last scene of Harry Potter 7 came to mind!

@Alyric, Mr Doherty (autism reality) has an agenda and he must never let up. Like you, I'm not quite sure what it is beyond his seeming inability to understand that neurodiversity means human rights for all including those with atypical neurologies.

@Biologista, well done there.
It's a bit shameful that Trinity College and a professor there played such a large and damaging part in this whole debacle.

Alyric said...

I.ve always thought with Wakefield it was the lure of fame. First it was the Crohn's connection he wanted to be known for. That didn't work.. Then it was the regressive autism with leaky gut and colitis. Now we've seen just how dreadful the data was in not supporting his conclusions. But it gets much worse. Wakefield is medically qualified but the leaky gut theory is the most biologically implausible theory anyone could possibly have dreamt up. It's totally inconsistent with life as we know it at any rate. Anyone with a compromised gut that must allw free range to any and all bacteria is not going to live for very long. So you have this egomaniacal liar who would do anything to be rich and famous.

Ah well, at least |jeni Barnett got the full Barbra Streisand effect and as far as I know that's the first time that the media has had a severe knockdown for their stupidity. Maybe things are changing.

Jean said...

Ths post has given me great reassurance...I KNOW the mmr didn't "give" my little boy autism, and despite a background in public health, I find myself a little nervous as he is due his mmr booster. This demonstrates the fear that Wakefield has instilled in parents. My head knows that all he achieved was deluded scaremongering, but the seed of fear has been planted.
Of course I will have my son vaccinated. It's just hard to apply science to your own kids.
A very well timed post for me!

Anonymous said...

Ah, but there is always a grain of truth in these kinds of false studies. There isn't just one autism, any more than there is one Asperger Syndrome or one ADHD. There are many different kinds of each one, likely with many different causes. We know so little about the causation that we lump things together according to what we see.

Many years ago, I worked with a mentally challenged woman who had been damaged by a vaccination. It happens, but it's very rare. She was not autistic.

As for autistic regression, I know too many Asperger kids who were very neurotypical as babies and toddlers, then "developed" autistic symptoms later. Not my kid -- he was wired different from day one -- but so many others.

Sure, maybe MMR is the wrong answer. But the truth is that so far, there are no answers. With all the millions spent on research, we still have the same questions. This is why the MMR urban legend lives on.

Manuel said...

saw that on the news earlier........ my god this is such a hard battle to fight without this sort of carry on.....you must be quite angry a lot of the time eh?

Liz Ditz said...

I've done another round-up post -- who is saying what about the Deer articles on Wakefield in the London Times. I've included your post.

11 years on, Wakefield Manufactured Data showing MMR-Autism Link?

Sharon McDaid said...

@Alyric, if Wakefield hadn't been a gut specialist, would we now have a different theory of autism circulating the internet crank sites? Might they be saying it's leaky pancreas or lungs? I remember asking Gordon about the leaky gut stuff years back and he explained exactly why it was such a load of nonsense.

And yes, Wakey-baby does seem to relish the fame, he should have given up on medical school and tried RADA or a rock band instead.

@Jean, this MMR rubbish has hit hard. I have spoken to so many smart people that worry about vaccines, that feel guilty in case they failed to protect their children when they had them vaccinated. I really hope it will now end; vaccinations are sod all to do with autism. They are just a really good, safe way of guarding your children's health. Thanks for writing here.

@Nancy, there is no truth in a false story. Wakefield submitted a shoddy, error laden and fraudulent paper and subsequently the world went silly, autistic children were described as toxic and many were subjected to horrible quack treatments to "clear the toxins," and the rates of infectious diseases shot up. Children have died from measles simply because not enough people are getting vaccinated. It's disgusting and reprehensible.

Every person who is autistic is unique, but I reject the claim that there are many kinds of autism and we do know a great deal about it's causation from genetic studies.

It is well established that there have been cases of vaccine induced injury. But the risk of suffering a bad reaction to a vaccine, even a minor one, is much lower than the risk of serious reaction to the infectious diseases.

The data clearly shows now that the MMR is definitely the wrong answer. I see no reason why this legend should have any more credibility than the existence of Atlantis.

@Manuel, at times I want to get medieval on someone. But, it's easier and keeps me the right side of the law to just write a grumpy blog post.

@Liz, thanks for that. It's an impressive list! Wakers must be so proud of all the attention. Perhaps he's thinking, as in the Carry On film, "infamy, infamy, they've all got it in for me!"

AnnB said...

Well done Sharon on another brilliant blog that pulls no punches. My own personal theory, (for what it's worth) for the unbalanced media coverage is that the MMR myth sells, as it feeds into the middle class modern parent guilt trip, which is a hugely lucrative market. Induce enough guilt into this target group and you could sell them anything at any cost. This, of course, makes it really difficult for responsible people to be well informed. Having worked in the media for a very long time, I always follow one cardinal rule: Always ask yourself what the source has to gain from the story being broadcast. I'm always on the look out for vested interests. We have to be responsible about how we consume information. Keep up the great work but make sure you get enough rest!

Sharon McDaid said...

Anne B, I think your assessment of the media's major role in promoting this fiasco is spot on.

Anonymous said...

If you are doing anything for Darwin Day this year, let us know so we can get the word out. http://www.scientificblogging.com/darwin_day_2009

Anonymous said...

It turns out journalist Brian Deer made it up:-
Sunday Times Journalist Made Up Wakefield MMR Data Fixing Allegation:

And he was helping the US Justice Dept sink 4500 US kids claims for vaccine damage compensation - what kind of normal journalist does that? Ans: none.
US Federal Court, US Justice Dept & The Sunday Times - More Questions Than Answers

Unknown said...

Dr. Wakefield's formal complaint to the UK Press Complaint's Commission against journalist Brian Deer.