Dr. Andrew Wakefield, British former surgeon and author of a famous Lancet paper that purported to link autism to MMR vaccines, drew his harshest professional criticism yesterday. The British medical journal BMJ, relying on the latest work by noted investigative journalist Brian Deer, alleged that his autism study “was in fact an elaborate fraud.” Wakefield denied the allegation, decrying the claim an “attempt to crush any attempt to investigate valid vaccine safety concerns.”
This allegation by BMJ is the latest of many calling into question both the study’s science and the doctor’s credibility. The 1998 paper in Lancet linked childhood autism to the MMR vaccine by way of a hypothetical gastrointestinal inflammation that occurred immediately after MMR administration. Wakefield theorized that the inflammation systematically released gut proteins that then attacked the children’s brains.
Growing scientific criticism and Deer’s original investigative report on the study in 2004 resulted in almost all the doctor’s co-authors retracting their conclusions. Deer showed that Wakefield had been in the substantial pay of lawyers with an interest in suing over an alleged vaccine/autism link, a revelation that the editor of Lancet called “fatal conflict of interest.” Wakefield denied that his being paid or that refusing to disclose payments were problematic. No credible, large-scale study has supported Wakefield’s theory of the autism/vaccine link.
Deer’s latest work, which relies upon medical records, alleges that the 12 children Wakefield based his study upon either did not subsequently become autistic, did not have GI inflammation, or had it before the vaccine. In other words, the vaccine –> inflammation –> autism theoretical cascade was a virtual impossibility from the beginning because the 12 cases were wildly different: they didn’t or couldn’t suddenly develop inflammation and autism. The only conclusion is that Wakefield falsified the patient data to make them fit his hypothesis. [via]
How bad was the deception?
First of all, in order for this all to make sense, the children had to have what is known as “regressive autism”. In other words, they had to have been fine — normal, in fact — and then get much worse after the MMR shot, developing autism. Children who obviously weren’t right from the start would have had something wrong already, and not have autism caused by the MMR vaccine. In Wakefield’s paper, he described 9 of the 12 children as having regressive autism. Mr. Deer’s investigation found that three of the 9 children he reported as regressive autism were not. Moreover, an additional 5 of the remaining 6 could not be proven to have regressive autism. So — at best — only 6 of the 12 children in the study had regressive autism; more likely, only one did.
Next, Wakefield’s paper alleged that a colitis brought on by the vaccine is what led the shot to become so damaging. In his paper, he reported that 11 of 12 of the children had a nonspecific colitis. What did the records show? That only 3 of the 12 had nonspecific colitis. The other 6 cases were falsified.
And, of course, the final piece of the puzzle was that symptoms needed to start not long after the vaccine was given. In Wakefield’s paper, 8 of the 12 patients reported symptoms days after the MMR. Mr. Deer’s investigation confirmed that for 10 of the 12 children, this was false. For the other two it was unknown. So — at best — 2 of the 12 children showed symptoms near the vaccine. At worst, none did.
Furthermore, Wakefield has been given ample opportunity either to replicate the paper’s findings, or to say he was mistaken. He has declined to do either. He refused to join 10 of his coauthors in retracting the paper’s interpretation in 2004, and has repeatedly denied doing anything wrong at all. Instead, although now disgraced and stripped of his clinical and academic credentials, he continues to push his views.
Last year, Wakefield was stripped of his ability to practice medicine in Britain, and Lancet took the extraordinary step of retracting the paper, citing falsifications and unethical medical practices. Wakefield now operates an autism-oriented facility in Austin, Texas, called Thoughtful House Center for Children. His currently heroic status as a fighter for autistic children can be directly traced back to the original Lancet study and the immediate and long-lasting press he’s gotten for supposedly establishing the link:
At a press conference held by the Royal Free medical school, London, in conjunction with the publication, Wakefield recommended separating the three components of the injections by at least a year. The paper, press conference, a video news release, and resulting media coverage were linked to a steep decline in vaccination rates in the United Kingdom.
It also led to declines in vaccinations in America, too. The hangover from the fraudulent study is twofold: vaccines are still baselessly viewed with fear, and childhood cases of measles and mumps continue to rise in both countries. Deaths have resulted.
In Britain, immunisation rates collapsed from 92% before the Lancet paper was published, to 80% at the peak of Britain’s alarm. Measles has returned as officially “endemic”.
With less than 95% of the population vaccinated, Britain has lost its herd immunity against the disease. In 1998 there were 56 cases reported; last year there were 1,348, according to figures released last week that showed a 36% increase on 2007. Two British children have died from measles, and others put on ventilators, while many parents of autistic children torture themselves for having let a son or daughter receive the injection.
“There’s not a day go by I don’t cry because of what happened,” said the mother of a severely disabled 12-year-old girl. “I shouldn’t have took her [for the MMR], and you know everyone will say, ‘Don’t blame yourself’, but I do. I blame myself.”