Respectful Insolence

I just don’t understand it.

I just don’t understand how anyone can take discredited antivaccination loon Andrew Wakefield seriously anymore. In particular, I don’t understand how any reputable newspaper can actually take him seriously anymore, given how thoroughly he and his “work” have been discredited. First came the news in late December that at the time he did his “research” that purported to show a link between the MMR triple vaccination and autism and bowel problems, Dr. Wakefield was in the pay of lawyers looking to sue for “vaccination injury” and failed to disclose his clear conflict of interest. Indeed, for that he is scheduled to appear before Britain’s General Medical Council on July 16 to answer this charge, among many others, including ethical lapses in their research such as doing unnecessary procedures that were not medically indicated.

More recently, his reputation took an even nastier pummeling during the Autism Omnibus hearings in Washington, D.C. Dr. Stephen Bustin, a world expert on the polymerase chain reaction (PCR), particularly quantitative PCR, explained in gory detail how the laboratory that Wakefield used to measure measles virus RNA sequences from the colon biopsies of autistic children used such shoddy technique and failed to use proper controls that it was very clear that the measles virus RNA that Wakefield claimed to have detected in the colon biopsy specimens was in reality due to widespread contamination of the laboratory with plasmid containing measles sequences. Worse for Wakefield, Dr. Nicholas Chadwick testified that in every case in which he detected measles sequences by PCR, sequencing the product revealed that it was the same as the laboratory strain and didn’t match up with any known natural or vaccine strains of measles and that all the specimens that he tested were either negative for measles virus or turned out to be false positives. Worse still, he testified that he informed Dr. Wakefield of his results. If the combination of Wakefield’s conflict of interest, unethical conduct, shoddy science, and reporting of results that one of his underlings had shown to be incorrect aren’t enough to destroy his credibility forever, I don’t know what is.

All of which makes this article in yesterday’s Observer all the more puzzling, emblazoned with the headline, I told the truth all along, says doctor at heart of autism row. In antivaccination land, Wakefield remains a persecuted hero, and he’s now playing the martyr for science role to a nauseating extreme:

To supporters, Wakefield is a hero, a lone crusader for truth and a principled, caring doctor challenging a policy that is harming significant numbers of children. Some scientists, a handful of doctors and parents of sons and daughters they claim have been damaged by the triple vaccine see him as the victim of a Department of Health-led plot to discredit him, and the GMC hearing as a show trial designed to suppress an uncomfortable truth. Wakefield, talking to The Observer in his only interview before the hearing, says he plans to defend himself vigorously against allegations he sees as ill-conceived and malicious. ‘I’ve done what I’ve done because my motivation is the suffering of children I’ve seen and the determination of devoted, articulate, rational parents to find out why part of them has been destroyed, why their child has been ruined. Why would I go through this process of professional isolation if it was simply to do with egomania? My alleged egomania doesn’t explain things very well. There’s been no upside for me in having pursued this issue. It’s been very difficult.

‘As Vaclav Havel once said: “Follow the man who seeks the truth; run from the man who has found it.” I can’t tell you that we know that the MMR vaccine causes autism. But the Department of Health can tell you with 100 per cent certainty that it doesn’t, and they believe that, and that concerns me greatly.’

Václav Havel? The playwright turned political activist in Czechoslovakia who spent several terms in prison for his political activities opposing the Soviet-style Communist government in the 1970s and 1980s, who ultimately played a major role in the Velvet Revolution of 1989 that led to the bloodless overthrow of Communism and then became President of Czechoslovakia and later the first President of the Czech Republic? A man whose nonviolent resistance and frequent imprisonment has led him to be compared to Gandhi and Nelson Mandela? My, Wakefield sure has an inflated opinion of himself, doesn’t he? Continuing with the metaphor, he then follows the script and cries persecution:

Wakefield explains that legal advice and his desire not to turn the GMC panel against him, mean he is unable to respond directly to the allegations. But friends say that he views the GMC hearing as part of a long-running ‘Stalinist’ campaign to ruin his reputation. He and his co-accused deny all the claims.

Wakefield told The Observer that he has no regrets for saying what he did in 1998 nor for continuing to seek to prove his view of MMR as the likeliest explanation for the rise in cases of autism in Britain. Almost every child health expert, though, regards the jab as hugely beneficial to public health and rules out any connection between it and autism.

‘My concern is that it’s biologically plausible that the MMR vaccine causes or contributes to the disease in many children, and that nothing in the science so far dissuades me from the continued need to pursue that question’, Wakefield said. ‘The trend in autism has gone up sharply in many countries. It’s interesting that that increase coincides in many places with the introduction of the MMR vaccine. That doesn’t make it the cause. But it’s an observation that needs to be explained, because there was clearly some environmental change at that time that led to growing numbers of children becoming autistic. It’s a legitimate question if MMR is one of those factors. I fear that it may be.’

“Stalinist campaign”? Nice touch, given his previous Havel analogy.

Despite what Wakefield says, a link is, in 2007, not biologically plausible. Even back in 1998 when Wakefield first published his paper and stirred up hysteria about the MMR, it was only a borderline plausible hypothesis. Subsequent science, including virology and epidemiological studies among others, have failed to find any correlation between MMR and autism in the intervening nine years have rendered the hypothesis even less plausible than it was then. Of course, if you want to invoke the Galileo gambit these days, you want to do it with a more contemporary spin to it, and Wakefield doesn’t disappoint:

As the Havel quote suggests, Wakefield sees himself as a dogged seeker after a disturbing truth. He compares himself to the small band of doctors who, soon after Aids emerged in the Eighties, pinpointed a previously unknown virus (HIV) as the cause, only for their theory to take years to become established.

‘In the Thatcher-Reagan era, Aids was originally seen as something politically unacceptable, as an act of God or a gay plague – as anything but our problem. People were stigmatised,’ he said. ‘We are looking at something with autism which is similarly politically unacceptable. That is, how could one of medicine’s modern miracles possibly be associated with damage to children? Because if it’s shown to be linked, then it becomes less of a miracle and more of a potential scandal.’ He believes that the Department of Health introduced MMR into the UK in 1988 to save money and that he has been persecuted for daring to take on powerful political and drug industry interests.

Yes, indeed, like all good cranks, Wakefield sees dark conspiracies against him because he has The Truth, and, like many good cranks, he vows to fight on, no matter what the cost…for the children, of course:

In the Italian restaurant, Wakefield fires a parting shot before another meeting with his lawyers. ‘I’m determined to continue to do this work, regardless of the personal cost. It has to be done. Because the parents of these children deserve an answer, and their children deserve help and they can be helped’, he says. ‘My colleagues and I won’t be deflected by the interests of public health policymakers and pharmaceuticals. I want to help children with autism; they are my motivation. If the work ultimately exonerates the vaccines, that’s fine. If not, we need to think again.’

Sure, Andy. Anything you say.

Why a newspaper would give an interview to someone like Andrew Wakefield, as pompous and self-serving as he is, is something that I can sort of understand. After all, he’s controversial, and he caused a lot of mischief, not the least of which is the anti-MMR hysteria and fear that gripped the U.K. in the years after his dubious paper was published, which ultimately led to a significant decrease in the vaccination rate, with an increase in the number of measles cases. Indeed, last year, for the first time in 14 years, a boy died of the measles. The boy was not vaccinated. Given that background and Wakefield’s upcoming hearing in front of the GMC, he’s newsworthy, and any reporter worth his or her salt would love to get an interview with him. Of course, any reporter worth his or her salt would not have given such a fawning, sycophantic interview. Any reporter worth his or her salt would have asked some–shall we say?–uncomfortable questions. (Calling Brian Deer!) True, the Observer did trot out the expected voices for “balance” pointing out that there’s nothing to support Wakefield’s allegations, but the overall tone of the interview was very sympathetic to Wakefield and his point of view.

What I can’t explain is the second article that was published in the same edition, New health fears over big surge in autism:

The number of children in Britain with autism is far higher than previously thought, according to dramatic new evidence by the country’s leading experts in the field.

A study, as yet unpublished, shows that as many as one in 58 children may have some form of the condition, a lifelong disability that leads to many sufferers becoming isolated because they have trouble making friends and often display obsessional behaviour.

Seven academics at Cambridge University, six of them from its renowned Autism Research Centre, undertook the research by studying children at local primary schools. Two of the academics, leaders in their field, privately believe that the surprisingly high figure may be linked to the use of the controversial MMR vaccine. That view is rejected by the rest of the team, including its leader, the renowned autism expert, Professor Simon Baron-Cohen.

Let’s parse this a bit. First of all, it’s an unpublished study, which immediately makes me wonder why it was reported to the press. Professor Simon Baron-Cohen is a reputable autism researcher and would presumably have been unlikely to have gone to the press with the story before the results of whatever study he is working on had been accepted for publication. Now, consider that two of the team are reported to think that these results somehow link the MMR to autism.

Gee, I wonder which team members leaked the story to the press. I also wonder about the timing of this particular story, coming so soon before Wakefield’s appearance before the GMC. More importantly, I wonder why the Observer didn’t tell its readers about the two who seem to think this study somehow links autism to the MMR vaccine, Drs Fiona Scott and Carol Stott. For example, Ben Goldacre points out that Dr. Stott has long been a player in the “MMR causes autism” movement, pointing out a very bizarre, profanity-laden, late night e-mail exchange that she had with Brian Deer, the journalist who has done more to reveal the depths of Wakefield’s mendacity than anyone else, behavior that led her to be warned by the British Psychological Society, the UK regulatory body for chartered psychologists. She’s also followed Dr. Wakefield to his Thought House Center for Children. Moreover, as reported by Brian Deer, both Drs. Stott and Scott both collected big bucks in the MMR Autism U.K. litigation, £100,000 to Dr. Stott and just over £27,000 to Dr. Scott.

Arthur Allen recently wrote an excellent article about why the myth that vaccines cause autism just will not die, no matter how much the science argues against it. Basically, confirmation bias and the fallacy of thinking that correlation equals causation combine with two of the most potent emotional forces in existence, a parent’s bond to his or her child plus the desire to raise a child as he or she sees fit, with the resulting resentment of what some see as intrusive government mandates, among which the requirement that children be vaccinated is a huge one. Couple that with the need to blame something or someone for their child’s autism, and for all too many parents of autistic children, the result is a rock solid belief that vaccines, be it the MMR vaccine or thimerosal in vaccines, cause autism, a belief that, for some parents, no amount of scientific evidence countering it will dispel, because any such evidence is attributed to a vast “conspiracy” to hide The Truth. Sadly, that belief still appears to be alive and well in the U.K. to perhaps an even greater extent than in the U.S.

Comments

  1. #1 Kristina
    July 9, 2007

    Sometimes I think each new proponent of the latest, hottest, woo-iest autism treatment and causation theory is angling to be the next Copernicus, all while writing up their De Revolutionibus (and hoping for a six-figure advance).

  2. #2 itsjustanalias
    July 9, 2007

    Thanks for this, I nearly ripped my morning paper in two in rage and frustration yesterday…

    Given that the Saturday Guardian has the fine Bad Science column, and the Observer is the stable-mate, you occasionally expect reasonable reporting. Alas, no. In this case my letter to the Editor will be pointing here.

  3. #3 Rev. BigDumbChimp
    July 9, 2007

    “Stalinist campaign”? Nice touch, given his previous Havel analogy.

    We have the reductio ad Hitlerum… is there a reductio ad Stalinum?

    I think I’ll have to start using it considering how often I hear it used similar to the Hitler version.

  4. #4 Gadgeezer
    July 9, 2007

    There’s a neat comparison of Wakefield as putting up an Edith Piaf routine.

    I don’t fully understand what is going on and some of the material has disappeared from Bad Science but Goldacre had an email exchange with Dr Fiona Scott in which she rejected that interpretation and denied that anyone had made such comments to the Observer. Kevin Leitch still has the email and the Telegraph has a partial retraction.

    She said the one in 58 figure was the highest out of three methods tested, and that the other two did not differ significantly from previous findings.

    “The figure is one of several we researched,” she said. “One of the elements of the research was how different methodologies can affect the result. One of the figures was one in 58. The other figures were lower than that.

  5. #5 Tegumai Bopsulai, FCD
    July 9, 2007

    Nice touch, given his previous Havel analogy.

    This is an overreaction. A quote is not an analogy.

  6. #6 daedalus2u
    July 9, 2007

    I predict that Wakefield will be a no show at the hearing.

    Either he tells the truth under oath, and completely -flushes his kool-aid drinking groupies down the toilet (or loo as they say in the UK), or he lies under oath and is brought up on perjury.

    He is already set up in the US, where he isn’t even “practicing” medicine. He has all the DAN! quacks to do that for him.

    If he doesn’t show, he will just claim he couldn’t get a fair hearing.

  7. #7 Robster, FCD
    July 9, 2007

    Tegumai,

    I suspect that his use of Havel and later references to Stalinism was quite calculated, and intended on suggesting an analogy. It is probably a rehearsed piece for the trial.

    Oddly, I don’t remember anything specific to Stalinism (over any other political constructs) that would suggest a tendency to go after damaging conflicts of interest, especially sloppy research practices, or use of bad research to negatively impact public health.

  8. #8 Steve
    July 9, 2007

    Great post – I recently had a discussion (argument) with a friend who posits that it is not the mercury but the effect of the vaccine on the immune system. She argues that some children simply cannot handle the load of MMR, this leads to the autism. Has anyone heard this argument before? Can anyone direct me to some information on this new “theory”? Thanks.

  9. #9 HCN
    July 9, 2007

    Steve, ask her where she got her information.

    Kids are hit with germs from the moment they are born. In the air, through mother’s milk, the water they bathe in and the floor they play on.

    Also, the first MMR is not until the child is over a year old. By then the child has been exposed to lots and lots of stuff that is beyond the imagination. Their immune system is such that the MMR will not work before a certain age.

    Anyway, a search on http://www.pubmed.gov for “infant immune system” brought up over 23000 hits. One of which I found of interest (only the abstract so far) is:
    http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17457344

    If you add “measles” to the search terms you come to specific studies on immune responses of 6mo, 9mo and 12mo old children to the measles and mumps vaccines. I’d show them but I am at the spam filter’s two link maximum.

  10. #10 HCN
    July 9, 2007

    Oh, great it didn’t count http://www.pubmed.gov as a link.

    Anyway the study I saw is:
    http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12850348

    If you look over to the right, you will see more related studies. People who claim vaccines are not researched are liars.

  11. #11 BigHeathenMike
    July 9, 2007

    Thanks for being a great reference. I have a cousin-in-law who doesn’t want to immunize his daughter because of anti-vac weirdos and books he’s read, plus a massage therapist colleague who is all psyched about anti-vac stuff after reading some crap. It was nice to have your site to bounce off of and link to.

    My latest post is a reply to her note.

  12. #12 Alan Kellogg
    July 9, 2007

    A bit of irony for you. Do a comprehensive study of Galileo Galilei and heliocentrism and you’ll learn that Galileo was as much a crank as Andrew Wakefield is.

    The thing is, Galileo insisted that the planet’s orbits (and this included the Earth’s) had to be circular because God set them up that way. In this he followed the thinking of his inspiration, Nicolai Copernicus. Observations by other astronomers discovered problems with this model of the Solar System, and so heliocentrism got a bad reputation. In short, the Copernican model failed as a scientific idea. Wasn’t until Johannes Kepler determined that the planetary orbits are eliptical that heliocentrism became a better model than geocentrism.

    Which means that when cranks, kooks, and woo-meisters appeal to the memory of Galileo, they are appealing to a fellow crank and woo-meister.

  13. #13 anonimouse
    July 9, 2007

    To use a poker analogy…Wakers is all-in. He’s basically committed everything (including his personal reputation) to this theory. It makes sense that he’s going to bet it to the hilt, even if he’s up against a far better hand.

    At this point, what does have to lose? If he gets punked by the GMC he can always scream conspiracy. If he skates by the GMC he can claim vindication. And the mercury and anti-vax loons will continue to sign his praises either way while he gets to buy million dollar homes in England and set up lucrative practices in the U.S.

  14. #14 Bob O'H
    July 10, 2007

    I suspect there will be a nice article about this in next Saturday’s Guardian. I can’t see Ben passing over such a juicy opportunity.

    Bob

  15. #15 Andrew Dodds
    July 10, 2007

    Aaaaaarrrrrrgggggggghhhhh……

    Is anywhere safe?

    Hope the medical correspondant gets the sack.

  16. #16 Crimson Wife
    July 10, 2007

    Do any of you truly believe that Dr. Wakefield’s critics would be going after him with such a vengeance if his research supported the status quo? He is a threat to the medical establishment, and that’s why he is being subjected to a “witch hunt”.

    I don’t know if there is a link between the combined MMR vaccine and autism, but enough questions have been raised about it to warrant caution.

    Why can’t there be a well-designed, non-corporately funded randomized trial comparing the combined MMR vaccine plus two placebos with the 3 monovalent vax? The studies the medical establishment cite as “proving” the combined MMR is safe have serious conflicts of interest and methodological flaws.

  17. #17 HCN
    July 10, 2007

    Crimson Wife:

    I see you copied that question from Autism Vox.

    Did you not know about Japan’s apparently failed experiment? They stopped using their version of the MMR (it is not the Merck MMR that was introduced in the USA in 1971 and then the UK in 1988)… and the autism rates still went up! Oh, and they continue to have measle epidemics (something that throws the “diseases went away with sanitation” statement out the window).

    Now you said: “Do any of you truly believe that Dr. Wakefield’s critics would be going after him with such a vengeance if his research supported the status quo? He is a threat to the medical establishment, and that’s why he is being subjected to a “witch hunt”. ”

    Now explain a couple of things about that commenet:

    1) Which researcher has replicated Wakefield’s findings?

    2) Why did it turn out that the lab results did not quite show what he wanted them to show, yet he still used them?
    See Chadwick testimony, starting at page 2282 at:
    ftp://autism.uscfc.uscourts.gov/autism/transcripts/day10.pdf

    3) If all research had to go by the “status quo”, then how do you explain this:
    http://nobelprize.org/nobel_prizes/medicine/laureates/2005/index.html (hint… the “status quo” can be toppled with good science).

    4) Which is worse, the MMR or mumps? Or the MMR or measles? Remember, we are seeing more of both of those diseases thank to Wakers.

  18. #18 jo
    July 10, 2007

    why cant there be a trial comparing mmr and placebo? yegads! uh.. because leaving children completley unprotected from extremely dangerous diseases might be a bit, you know, unethical? what are you antivax loons drinking? theres been numerous trial over many years demonstrating the safety of vaccinations. a more interesting question might be.. what would it take to convince the antivaxers that MMr is safe?. what fascinates me is the contradiction between the wakefield militia’s MMR “hypothesis”, and the US mercury militia’s obsession with thimiserol ( or however the hell it’s spelt)must take an amazing level of cognitive dissonance to hold two completely different and contradictory “explanations” for the autism non-epidemic.

  19. #19 HCN
    July 10, 2007

    I have a couple more questions for Crimson Wife:

    1) How many children did Wakefield have in his study?

    2) How did those children become the part of his study?

    3) How does his research compare to this paper:
    http://pediatrics.aappublications.org/cgi/reprint/118/1/e139.pdf

  20. #20 qetzal
    July 11, 2007

    Crimson Wife:

    If you’re going to argue motivations, are you honest enough to admit that it cuts both ways?

    If Wakefield wasn’t going against the status quo and claiming to be a victim of a ‘witch hunt’ do you think you would ever have heard of him? Would he be the center of so much attention if he didn’t claim he was being persecuted for trying to get at ‘the truth?’

    You’re arguing that proponents of the MMR vaccine have a vested interest in claiming that it’s safe. True enough. But Wakefield has a vested interest in claiming that it’s not. Noteriety. Attention. Name recognition. ‘Expert’ testimony fees from attorneys. Money from supporters to help him set up and run his center in Austin.

    Wakefield’s hardly free of vested interests in this matter.

  21. #21 MartinM
    July 11, 2007

    But Wakefield has a vested interest in claiming that it’s not. Noteriety. Attention. Name recognition. ‘Expert’ testimony fees from attorneys. Money from supporters to help him set up and run his center in Austin.

    Not to mention his patented measles vaccine…

  22. #22 HCN
    July 13, 2007

    Crimson Wife, why won’t you answer our questions? Why do you limit comments on your blog? Are you afraid of dissenting opinions?

  23. #23 HCN
    July 13, 2007

    Well, I went to her blog and signed in. Sigh.

    I cut and pasted the questions I asked here, PLUS the fact that the vaccine in question was actually approved for use in the USA in 1971, and then approved in the UK in 1988. So why was it only a problem in the UK? Why only after a personal injury lawyer paid Wakefield to look at specific kids?

    To top it all off, she has to approve my comment. Not only does she not allow “anonymous” comments, she has to approve them!

    To me, this is a sign of someone who is afraid of those who question their beliefs.

  24. #24 HCN
    July 13, 2007

    Just as I thought, Crimson Wife is so afraid of anything challenging her beliefs that she will not post a comment that asks her the questions that were posed to her here.

    Pity.

  25. #25 Sarah
    August 11, 2007

    i find your article biased and to be honest the most unethical and unstructured pointless piece of trash i have ever read.
    i am no scientist, but to see people like you condemning research into something which affects our children when you know nothing about it except what the media and government allow normal people to know, well it disgusts me.
    when i was ten years old my sister had mmr. she said goodnight to me the night before and that was the last time she spoke for five years. DO YOU EVEN HAVE THAT EXPERIENCE? NO. DO YOU EVEN KNOW OF THE THOUSANDS OF IDENTICLE CASES WHERE CHILDREN HAVE HAD THAT VACCINE AND COME HOME AS DIFFERENT CHILDREN, EVEN DIED AS A RESULT OF REACTIONS TO THAT VACCINE AND THEIR OWN PARENTS BLAMED?
    do not dare to tell me or anyone else what to believe. state your uninformed biased and trashy comments however you choose but do not even dare to start picking faults with any scientist or doctor that tries to find the best medical routes for our children until you have the same experience professionally and until you have seen firsthand what mmr does and thanks to the government, still does to our children. it is people like you who try to blind others from the truth. well i will not be blinded.
    answer me this. how can a child with no history of autism, epilepsy or any other neurological disorder, and very sound developmental norms change within the space of 12hours after a vaccine and the two not be linked?
    do not tell me any more lies in your common as muck articles because judging by the style of your hand and the lack of any physical research influencing that article, or research and experiences of real parents, you know less than i do.

  26. #26 Orac
    August 11, 2007

    do not dare to tell me or anyone else what to believe. state your uninformed biased and trashy comments however you choose but do not even dare to start picking faults with any scientist or doctor that tries to find the best medical routes for our children until you have the same experience professionally and until you have seen firsthand what mmr does and thanks to the government, still does to our children.

    There is nothing in my post that is untrue.

    If you want to see where I’ve discussed Wakefield, do a search for “Wakefield” using the search box in the upper left hand corner of this page. Although I provide links to the sources backing up my statements, if you want more, particular, if you want to see how execrably bad Wakefield’s science on the MMR was, read this. The man couldn’t even find a lab to do PCR correctly; moreover, when he was told by one of his underlings that the PCR was picking up false positives, he ignored the warning.

    As for Wakefield’s dishonesty and lack of ethics, read this.

    No one says that there aren’t rare complications from vaccines, the MMR included. That’s not what we’re talking about here. Wakefield made specific claims that MMR was linked to autism and “autistic enterocolitis,” a claim he made based on a very small number of children and very shoddy science. Worse, not only had Wakefield accepted considerable renumeration from trial lawyers suing for “vaccine injury”, but he had a different vaccine that he was patenting. Let me ask you something: If a researcher supporting a pharmaceutical company had been paid by that company and had developed a competing vaccine to the one being attacked, would you brush aside that conflict of interest?

    Finally, because vaccines are given to healthy children as a preventative, the standards for their safety have to be very stringent so that they are not more dangerous than the disease that they are meant to prevent. But nothing in medicine (or life, for that matter) is 100% safe. Vaccines in general and the MMR specifically are incredibly safe. Wakefield started a bogus scare over the MMR based on crappy, careless science, the result of which were plunging vaccination rates, a return of measles, and at least one death.

The site is undergoing maintenance presently. Commenting has been disabled. Please check back later!