Andrew Wakefield: In it for the money all along?

One of the favorite attacks favored by advocates of pseudoscience, particularly advocates of the sort of pseudoscience favored by proponents of "alternative" medicine, particularly the more militant ones who really, really detest conventional, science-based medicine, is to poison the well with a pre-emptive ad hominem attack that implies that defenders of science-based medicine are somehow interested in nothing but money. The first favored attack is to point out that the pharmaceutical industry is interested in nothing but money. That's partially true (they are, after all, for profit companies), but it doesn't change the fact that most pharmaceutical company products are extensively tested and have to be shown to be efficacious and safe before they can merit FDA approval.

Those of us who criticize pseudoscience, particularly that favored by quacks and the anti-vaccine movement, frequently encounter a special variety of ad hominem attack. So common is this tactic that I even coined a term for it--yes, as far as I can tell, I coined it--namely, the pharma shill gambit. Defend vaccines? Well, obviously you must be a minion of big pharma, hopelessly in its thrall, accepting big checks for sitting there in your underwear and doing battle with anti-vaccine trolls. Either that, or your very connection with a medical school, some of whose researchers accept pharma money to perform clinical trials, must also mean that you are hopelessly in the thrall of big pharma. Yes, I personally have been subject to that sort of attack. For the anti-vaccine movement in general, and the anti-vaccine crank blog Age of Autism in particular (particularly a particularly dim young man named Jake Crosby), no connection to the hated pharma is too tenuous or filtered through too many degrees of separation to permanently taint your reputation.

That's why I can't help but experience a warm, fuzzy feeling of schadenfreude when I part two of Brian Deer's report on anti-vaccine guru Andrew Wakefield. I think you'll quickly get a good idea why just by looking at its title: How the vaccine crisis was meant to make money. What becomes very obvious reading this expose is that to a large extent it was about money from the beginning. When Andrew Wakefield first started his "research" (if it can be called that anymore), it wasn't just about discovering something new. It was with an eye to make money. Lots and lots of money. Millions of pounds. Millions and millions of pounds. Now, being a capitalist myself for the most part, I don't begrudge a man a chance to make a buck (or a pound). The problem is that Wakefield is being represented as this selfless, tireless crusader for "vaccine safety" when in the beginning, when it comes to profit motive, he rivaled (and appears to continue to rival) anyone working for big pharma. Worse, the evidence is very strong that he committed scientific fraud to do it, as I discussed last week.

It all began with Wakefield's relationship with one British solicitor named Richard Barr. This story is relatively well known, but it's worth reviewing again:

Since February 1996, seven months before child 2's admission, Wakefield had been engaged by a lawyer named Richard Barr, who hoped to bring a lawsuit against vaccine manufacturers. Barr was a high street solicitor, and an expert in home conveyancing, but also acted for an anti-vaccine group, JABS. And, through this connection, the man nowadays popularly dubbed the "MMR doctor" had found a supply of research patients for Walker-Smith.

"The following are signs to look for," Barr wrote in a newsletter to his vaccine claim clients, mostly media enlisted parents of children with brain disorders, giving a list of common Crohn's disease symptoms. "If your child has suffered from all or any of these symptoms could you please contact us, and it may be appropriate to put you in touch with Dr Wakefield."

These are the sort of children that were being encouraged to contact Dr. Wakefield, who, as we know was ultimately paid £435,643 in fees, plus £3,910 expenses by Barr. But that was chump change compared to the amount of money that Wakefield and his cronies envisioned based on the work they were doing at the Royal Free Hospital. Even while Child 2 was still in the hospital undergoing a grueling workup including an MRI of his brain (which, for children that young usually requires general anesthesia), electroencephalography and evoked potentials, a radioactive Schilling test, blood and urine tests, and a lumbar puncture, all of which had been specified in an agreement with Barr. Then, while the child was still in hospital (as the British say), having just undergone an ileocolonoscopy two days before that 14 years later the British General Medical Council would conclude had not been medically indicated, this happened:

And on Wednesday, with the news that the boy--still on the ward--might have Crohn's disease, the doctor produced a remarkable document. It was an 11 page draft of a scheme behind the vaccine scare, now revealed for the first time in full.

The document was headed "Inventor/school/investor meeting 1."15 Based on a patent Wakefield had filed in March 1995 claiming that "Crohn's disease or ulcerative colitis may be diagnosed by detecting measles virus in bowel tissue, bowel products or body fluids,"16 it proposed starting a company that could reap huge returns from molecular viral diagnostic tests. It predicted a turnover from Britain and America of up to £72.5m a year.

"In view of the unique services offered by the Company and its technology, particularly for the molecular diagnostic," the document noted, "the assays can command premium prices."

To help finance the scheme, Wakefield looked to the government's legal aid fund--meant to give poorer people access to justice. For the previous seven months, child 2 had been enrolled with Barr's firm,17 which since February 1996-- two years before the paper's publication-- had been paying the researcher undisclosed fees of £150 an hour, plus expenses.8

Wow. £72.5 million a year. That's a lot of cash that Wakefield was planning on trying to make using his patent claiming that detecting measles virus in the gut is diagnostic for Crohn's disease. Indeed, where other researchers saw suffering children they wanted to try to help, Wakefield apparently saw an amazing profit opportunity. Indeed, he even cranked out the prospectus for this amazing profit opportunity while investigating children referred to him by trial lawyers. This is a massive undisclosed conflict of interest (COI) that beggars imagination. It's huge compared to most COIs that individual investigators who seek to commercialize their products have, because most such investigators don't envision making anywhere near as much money as Wakefield apparently thought he could make from developing a diagnostic test. He even wrote that "the ability of the Company to commercialise its candidate products depends upon the extent to which reimbursement for the cost of such products will be available from government health administration authorities, private health providers and, in the context of the molecular diagnostic, the Legal Aid Board." In other words, Wakefield was already thinking of ways to obtain reimbursement from third party payers for his device, recognizing quite correctly that the success of any such test is utterly dependent upon this.

What was particularly disturbing and depressing about these new revelations was that they reveal just how deeply the Royal Free Hospital was involved in Wakefield's research, profit-seeking, and outrageous self-promotion. Nowhere is this better demonstrated than in how the hospital helped Andrew Wakefield put together his publicity machine to capitalize on the fraudulent findings that Wakefield published in The Lancet almost exactly 13 years ago. In fairness, at the time the Royal Free Hospital administration didn't know that Wakefield's results were fraudulent, but it clearly knew that they were explosive. Remember how I discussed just yesterday how Wakefield produced a video interview around the time his Lancet paper was released, an interview in which he asserted that he doubted the safety of the MMR vaccine and claimed that separating the MMR into its component parts is safer than the MMR? Well, not only did the Royal Free Hospital produce the video, but it was ready for the expected fallout:

Neither school nor hospital stood on the sidelines. They threw their weight behind Wakefield. In the build-up to the press conference, they installed extra phone lines and answering machines to field the expected panic, and distributed to broadcasters a 23 minute video news release showcasing Wakefield's claims. "There is sufficient anxiety in my own mind for the long term safety of the polyvalent vaccine--that is, the MMR vaccination in combination--that I think it should be suspended in favour of the single vaccines," he said, in one of four similar formulations on the videotape.28

The press conference and video boosted the commercial plans, which were moving forward behind the scenes. The following week, Wakefield brought two associates to the school for an already scheduled meeting with the finance officer Tarhan. One was the father of child 10 in the paper. The other was a venture capitalist. And two days after the meeting, they submitted a 13 page proposal to launch a joint business with the school. It would be focused on a new company, Immunospecifics Biotechnologies Ltd, aiming not only to produce a diagnostic test, as proposed 18 months earlier, but also "immunotherapeutics and vaccines."29

From my perspective, if this is true, if the Royal Free Hospital and the UCL were so heavily in bed with Andrew Wakefield and participated so actively in generating publicity for his research in the wake of his Lancet paper, then they were just as guilty as Wakefield in promoting the MMR scare that followed and just as guilty as Wakefield. Not only did they aid and abet Wakefield's self-promotion, helping him to gain a platform to promote fear mongering about the MMR, but they continued to negotiate with him to partner with him in bringing what can best be described as quackery, up to and including Hugh Fudenberg's transfer factor quackery, to market as a product. In case you don't know who Hugh Fudenberg is, we've met him before; he's the source of some of Bill Maher's anti-vaccine claims. Fudenberg also lost his license to practice medicine years ago. Sadly, by giving Wakefield a platform to promote his execrable science and run a campaign against the MMR and by continuing to try to help him find funding for his dubious "product," the Royal Free Hospital and UCL both failed miserably in their obligations as science-based institutions of medical academia.

Fortunately, in 1999 a new sheriff arrived in town, so to speak, in the form of a new head of medicine: Mark Pepys. He was a fellow of the Royal Society and a well-respected researcher with expertise in amyloid diseases; in addition, Pepys brought big grants to UCL. He was also appalled at what was going on under Wakefield's supervision at the Royal Free Hospital. Just as Wakefield's scheme, which involved Carmel Healthcare Ltd. and another business of which Wakefield would become a director, Unigenetics Ltd. in Dublin, the same business that was later found to have been so incompetent at performing PCR assays for Wakefield looking for measles sequences, was nearing fruition, Pepys brought the hammer down:

Wakefield was summoned from the hospital's Hampstead campus to the college's central London headquarters. He was challenged over the scheme, then on the verge of fruition, and was given a two page letter.

"We remain concerned about a possible serious conflict of interest between your academic employment by UCL, and your involvement with Carmel," it said, in part. "This concern arose originally because the company's business plan appears to depend on premature, scientifically unjustified publication of results, which do not conform to the rigorous academic and scientific standards that are generally expected."50

Indeed.

Ultimately, Wakefield was ousted from his job at Royal Free Hospital. Since then, he has claimed on numerous occasions that his firing came about because his research was so"unpopular," but the Provost's letter and the paperwork Brian Deer has unearthed for his BMJ articles provide new revelations that directly contradict that claim. In fact, UCL volunteered to support Wakefield's work. It offered a chance for him to continue on Royal Free's staff or even to a year's paid leave in order try to replicate the results reported in his Lancet paper. He was even offered help to carry out a study of 150 children to try to confirm his previous results under more rigorous conditions. From Deer's report, it appears that UCL and Royal Free Hospital bent over backwards to try to help Wakefield do a study to try to replicate his results. Wakefield, not surprisingly, reacted by turning passive aggressive:

At the time, Wakefield agreed. Then his employer waited. It prompted, waited longer, and prompted again. "Three months have elapsed," Llewellyn-Smith wrote to him in March 2000, asking for "a progress report on the study proposed" and "not to make any public statements" in the meantime.54

But the study did not happen. The 1998 Lancet research had been a sham.10 Trying to replicate it with greater numbers would have been hopeless.

Wakefield, however, shrugged off his non-compliance as arising from some fault of the school's. "It is clear that academic freedom is essential, and cannot be traded," he eventually responded in September 2000. "It is the unanimous decision of my collaborators and co-workers that it is only appropriate that we define our research objectives, we enact the studies as appropriately reviewed and approved, and we decide as and when we deem the work suitable for submission for peer review."55

This was a step too far, and in October 2001 Wakefield was shown the door.

Even then, Wakefield apparently received two years' severance pay and a statement clearing him of misconduct. He even got a gag on Royal Free commenting on the whole affair. As Pepys put it, "We paid him to go away." Would that it were possible to pay to reverse the damage Wakefield did. Meanwhile, Wakefield painted himself as a martyr to the cause of academic freedom.

The truly ironic thing about the Wakefield affair is that, when it all comes down to it, it appears to have been largely about the money right from the very beginning. There might have been some genuine scientific curiosity early on, but it's obvious that it was rapidly corrupted by Richard Barr and then by the lure of making lots of money selling tests whose results would fuel Barr's lawsuits against vaccine manufacturers. From very early on, Wakefield showed an entrepreneur's aggressiveness in pursuing deals to make money off of his fraudulent research, and after he left Royal Free Hospital he rapidly found a nice, cushy spot at Thoughtful House in Texas, a position he occupied at a generous salary until about a year ago, when he was kicked out by the Thoughtful House board of directors in the wake of the GMC's ruling finding him guilty of research misconduct and ethical breaches, which led to the retraction of his Lancet paper. Meanwhile, his defenders have been deploying and will continue to deploy the pharma shill gambit against those who criticize Wakefield for his fraudulent research and his stoking the fires of an anti-vaccine scare that has done real harm in the U.K. by leading to a massive resurgence in measles cases. To them, it's all a conspiracy by big pharma and the government to "suppress" Wakefield's "truth" and protect their profits. That Wakefield was in it for the money doesn't affect their world view on bit. He's still their patron saint.

You can see why it's hard not to feel a bit of schadenfreude here, but it will only be brief. Wakefield has a disturbing tendency to be able to reinvent himself in order to continue to promote his pseudoscience and, above all, himself. Even having his license to practice medicine stripped, his papers retracted, and his position as scientific director of Thoughtful House taken away didn't keep him from finding a way to keep promoting the scientifically discredited idea that the MMR vaccine causes autism and enterocolitis. I'm under no illusion that he won't be able to do it again.

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I must disagree very strongly with this. It's my long-standing observation that, in cases of fraud by a legitimately credentialed researcher, financial gain is NOT a satisfactory explanation of motive. As a rule, any possible personal gain is small (sometimes non-existent) compared to the effort, resources and especially the risks of a hoax. Also, of course, people who JUST want to make money fast can always make up credentials rather than earning them.

I believe that, at least as a rule, the roots of fraud are psychological. In Wakefield's case, as I have already argued more than once, I think it comes down to pure narcissism. Prior to starting the scare, he had something like twenty years of experience, without distinguishing himself legitimately. Joining the MMR litigation and especially feeding a vaccine scare immediately made him "important". As long as he has even a small group of committed followers, he can receive a supply of reinforcement that even legitimate success might never have given him.

I know this story very well, having researched it for a comic strip story (one that's about to be published in the student version of the British Medical Journal), but the naked greed on show here never fails to shock me. I find it incredible that anyone would behave this way.

This should, by rights, be the final nail in his coffin, but it won't be.

Wakefield could stand on his rooftop shouting "yes, I'm a total fraud" and his disciples would not believe him.

At this point the public anti-vaxxers are so fully invested in their rhetoric that they cannot see that continuing is (to use a financial saying) throwing good money after bad. They keep frantically tearing up and moving the goalposts - so much so, their game cannot be won.

That makes me angry and sad.

By CanadianChick (not verified) on 11 Jan 2011 #permalink

I'm rolling in schadenfreude here, and the only way it could get better is when they arrest him on various charges of fraud.

And about Jake, he's a poor little monkey whose entire life was ruined by his mother's fillings (according to him). Tch!

I did a post a few days back about one of the core issues here; arguments that rely on attacking links between money and science( http://autismandoughtisms.wordpress.com/2011/01/07/ought-to-vaccine-or-… ).

I agree that it's nice to be able to turn the tables, and you do have a lot of interesting and revealing points here about Wakefield's fingers-in-pie and potential motivations. I can foresee this preditably just turning into a slug-fest about who stands to earn more and who is more dodgy, which is (almost) always going to end up being a subjective issue.

As long as the discussion always returns to finding the truth in amongst the mud slung, it's fine. Will be interesting to see what direction the comments take on this one.

It's like reading the biography of Darth Vader had he taken up medicine rather than Jedi. In this analogy, Walker-Smith is Obi-Wan. Jenny McCarthy is Jar Jar Binks.
"Me-sa no understand science".

My sister has come up with what has to be the single finest explanation for human behavior ever devised: everyone is retarded. Since I started to subscribe to this notion, the world has made a lot more sense. Not to be cynical, but that said, since lovers of all things woo will rarely be swayed (and yes, I'm including all anti-vaxers in this description), would someone really be so wrong if they were to sell woo devices even as they tried to educate people that woo never works?

Obviously this vaccine controversy is in an entirely different realm of fetid, but if one were to sell blood of a mythical genetic hybrid creature that was supposed to increase your balance, flexibility and sexual performance, would that be so wrong?

I ask because a...friend of mine is working on something so obviously silly there's no way "he" thinks that anyone could conceivably buy into it.

Wakefield could stand on his rooftop shouting "yes, I'm a total fraud" and his disciples would not believe him.

Let's hope he never does that. Their cognitive dissonance would approach infinate density creating a dim hole (also formed when black holes marry their cousins) that would destroy the earth!

Would the Richard Barr who was in cahoots with Wakefield be this Richard Barr, a "Co-Opted" Director of the British Society of Homeopaths and a member of The Society's Professional Standards Committee.

http://www.homeopathy-soh.org/about-the-society/Bod.aspx

Second from the bottom.

He has been a solicitor since 1971 and now works with a âvirtual law firmâ (Scott Moncrieff Harbour and Sinclair) and runs his legal practice from his home in North Norfolk where he handles mainly medical cases.

I assume the Professional Standards of the Society of Homeopaths are "homeopathic".

By Militant Agnostic (not verified) on 11 Jan 2011 #permalink

"That's why I can't help but experience a warm, fuzzy feeling of schadenfreude when I part two of Brian Deer's report on anti-vaccine guru Andrew Wakefield."

Here you are claiming that Andrew Wakefield is an anti-vaccine guru.

"Wakefield was going after money from the very beginning, money from trial lawyers suing vaccine manufacturers, money from a patent for a vaccine designed to compete with the MMR, money from pretty much everything."

Here you are claiming that his scheme to get rich was to patent a vaccine.

Why would an anti-vaccine guru attempt to get rich from making a vaccine? It simply doesn't add up. Either he's anti-vaccine, or he's not, correct? It seems a complete contradiction.

By schadenfreudeless (not verified) on 11 Jan 2011 #permalink

@11

Why would an anti-vaccine guru attempt to get rich from making a vaccine? It simply doesn't add up. Either he's anti-vaccine, or he's not, correct? It seems a complete contradiction.

He became an anti-vaccine guru (Plan B) after "Plan A" (getting rich from making a vaccine) failed. Logic would indicate that even attempting Plan A would would make Plan B difficult, but when has logic ever been a feature of the anti-vaccination movement? If it turned out that Wakefield was investing all his ill-gotten gains in Big Pharma stock his supporters at AOA wouldn't bat an eye.

By Militant Agnostic (not verified) on 11 Jan 2011 #permalink

Why would an anti-vaccine guru attempt to get rich from making a vaccine?

From what I remember Wakefield was just anti-MMR (at least before joining Thoughtful House), and it was the anti-vax movement who turned him into their guru. Of course, since Wakefield is largely responsible for measles becoming endemic again in the UK, being anti-MMR is bad enough.

By Matthew Cline (not verified) on 11 Jan 2011 #permalink

Has anyone attempted to quantify how many children may have fallen ill, been injured or died because of the fall in vaccinations? I expect it would prove to be damning indictment of this man and his followers.

"It's like reading the biography of Darth Vader had he taken up medicine rather than Jedi. In this analogy, Walker-Smith is Obi-Wan. Jenny McCarthy is Jar Jar Binks.'Me-sa no understand science'."

No, Jack.

John Stone is the Jar Jar Binks one: 'Me-sa fucking idiot!'

Which is true. Because that's what he is.

By David N. Andre… (not verified) on 12 Jan 2011 #permalink

I'd like to make a prediction. When John Stone at AoA gets around to discussing this BMJ piece by Deer, he's not going to focus on the money. Instead he will ask:

"How can Mark Pepys be commenting on this? There is a signed agreement of confidentiality between Dr. Wakefield and the Royal Free. Deer could not have obtained this information. Thus, this entire article is false."

By Broken Link (not verified) on 12 Jan 2011 #permalink

Besides the money and the adulation, another possible motivation for Wakefield is the groupies. Here's recent post to his Facebook wall:

Dr W., are you married? I just watched this clip...wanna go on a date? ;) You're one awesome man-you're cool, collected, and HONEST. The passion you have in your statements...if your ever free for a date or to figure out my son's bowel i...ssues LOL please let me know :)

By Broken Link (not verified) on 12 Jan 2011 #permalink

Why would an anti-vaccine guru attempt to get rich from making a vaccine? It simply doesn't add up. Either he's anti-vaccine, or he's not, correct? It seems a complete contradiction.

That's like saying "Why would a talk-radio host who's constantly sneering about liberals coddling useless drug addicts be procuring and using drugs illegally himself?" Or "Why would a televangelist who preaches against the sexual immorality of the modern world cheat on his wife?" Just because it would represent a contradiction (or to be more blunt, hypocrisy) doesn't mean a person won't do it.

It especially doesn't mean that in this case, where Wakefield's disciples are so brainwashed that they'll deny Wakefield was even preparing a rival vaccine -- even after they've seen the patent application where Wakefield states outright that his new invention is a vaccine. It's that much harder to resist temptation (not that I think Wakefield necessarily tried) if you know that you have a core audience of fanatics who will forgive/deny/applaud even your worst actions.

By Antaeus Feldspar (not verified) on 12 Jan 2011 #permalink

I experienced schadenfreude for about 20 minutes a week ago -- then I moved on to thinking about the hundreds (if not thousands, who knows?) of children who have been subjected to voodoo "science" to rid their bodies of imaginary persistent measles virus.

That's like saying "Why would a talk-radio host who's constantly sneering about liberals coddling useless drug addicts be procuring and using drugs illegally himself?" Or "Why would a televangelist who preaches against the sexual immorality of the modern world cheat on his wife?" Just because it would represent a contradiction (or to be more blunt, hypocrisy) doesn't mean a person won't do it.

This is a good point, Antaeus. I also like Militant Agnostic's depiction of the situation as Wakefield switching to Plan B (suing vaccine manufacturers) after Plan A (making a new vaccine) failed. But I think it's not quite as straightforward as that.

First, making a new vaccine while attacking an existing one (and profiting handsomely off of those legal attacks) is not really a contradiction. In fact, it fits right in with what the AoA crowd have shifted to in recent years -- "Green Our Vaccines". They're not *anti* vaccine, they're pro-vaccine-safety, or so they say. And wonder of wonders, here Wakefield was working on a safe vaccine! Except it's not as simple as that either, because what he was working on wasn't a vaccine in any conventional sense, and was only marginally less ridiculous than homeopathy. The straight-up fraud I can sort of understand. But his "measles transfer factor" thingie makes my brain hurt. I suspect he either abandoned it because the litigation and autism treatment angle was turning out to be stupendously profitable for far less effort, or he was keeping it on the back burner in case he needed some more income later on. But that ship has definitely sailed now.

By Calli Arcale (not verified) on 12 Jan 2011 #permalink

@Broken Link: Well, yes. You don't last as long as Wakefield has in the fraud business unless you've got a fair amount of charisma.

Someone needs to check the bookies whether he took out a bet on "how many measles cases in the UK in 2003?". I think that would be the only avenue of potential revenue generation he missed.

And has Richard Barr been hauled up before the Law Society to have his part in this investigated?

By Lancelot Gobbo (not verified) on 12 Jan 2011 #permalink

When John Stone at AoA gets around to discussing this BMJ piece by Deer, he's not going to focus on the money. Instead...

He's already made some comments in some of the previous posts here. Among other things he has (as far as I can tell) argued that the clinicians who performed the tests for Wakefield and wrote up reports could have put erroneous copies of the reports in the medical records of the children but sent correct copies to Wakefield, so the fact that Wakefield's paper disagrees with the medical records isn't indicative of fraud.

By Matthew Cline (not verified) on 12 Jan 2011 #permalink

Callie @21 - Up until a day or so ago I was unaware that Wakefield's vaccine was quackery. Is there a short explanation of what it was and why it was implausible. It seems this thing gets worse and worse the more we look at it. The lawyer who funded Wakefield appears to be a director to the British Society of Homeopaths. See my link @ post #10.

By Militant Agnostic (not verified) on 12 Jan 2011 #permalink

I think David Brown has a good point. Wakefield has got to be completely mental--doesn't void his guilt in all the rotten science, but goes a ways to explain his continuing participation in the anti-vax landscape. He is so convinced by now of his "rightness", that he appears on very obscure radio shows and such--any sane person would be working on revamping his image, not dragging it further down a rathole.

By knotfreak (not verified) on 12 Jan 2011 #permalink

"Jenny McCarthy is Jar Jar Binks."

Jack:
If Jar Jar Binks ends up being a Centerfold . . .

. . .

. . .

I will track you down.

poison the well with a pre-emptive ad hominem attack that implies that defenders of science-based medicine are somehow interested in nothing but money.

But of course; we often project onto our enemies motives driven by our own basest sins. Deeply-closeted homophobes, corrupt law-and-order politicians, hedonistic fire-and-brimstone preachers... anti-vaxxers deploying the "shill" gambit are just another sample set of the overall set of people with the same condition.

If someone accuses you of doing something out of greed, you have to ask yourself how greedy the accuser is.

-- Steve

As continuing revelations uncover the impressive depths to which Mr. Wakefield had sunk in his pursuit of the almighty pound (or dollar, depending on location) and confirm the suspicions that many of us have had for quite a while, we wonder if someone cries loudly about "profiteering" by his critics perhaps *his* first thoughts rest on the assumption that his critics' motivations mirror his own. It's possible that the ex-doctor ( and many of our all-too-familiar woo-providers-social critics) don't have the ability ( person perception, "taking the role of the other", non-solipcistic thought) to comprehend others' *raison d'etre* if it is *not* based on lucre. Thus, perhaps crying ,"Pharma shill!" is not entirely a choice, but the only reaction possible. Somehow though, in light of their business decisions' consequences, I can't really summon up much sympathy for their limitations. Or them.

By Denice Walter (not verified) on 12 Jan 2011 #permalink

@27 It may be a case of having nowhere else to go. If his reputation is irredeemably damaged in the rational world, then pandering to the nut-jobs is the only paying gig he can get. It may be the rational choice for someone with no morals. However, I think sometimes con men end up believing their bullshit because they repeat it so often. L Ron Hubbard comes to mind.

By Militant Agnostic (not verified) on 12 Jan 2011 #permalink

Good grief ... he has ONE patient, the child is still in the hospital, and he writes up a "how to profit from the thing I'm going to prove"?

That pretty well disproves the claims that he was in it for the children. It was all about the money he could make.

By Tsu Dho Nimh (not verified) on 12 Jan 2011 #permalink

Militant Agnostic @ 26:

Up until a day or so ago I was unaware that Wakefield's vaccine was quackery. Is there a short explanation of what it was and why it was implausible.

I'm hazy on the details, but I'll see if I can find where I saw it explained. I think it's something made from the blood of a person infected with measles, but not the same sort of thing as the immunoglobulins used in, for instance, antivenin or tetanus antitoxin. I did find this link:
http://leftbrainrightbrain.co.uk/2010/01/wakefiel-vaccine-alternatives/ This one discusses Wakefield's rather disingenuous claim that it wasn't intended as a vaccine. It was intended, in part, as a preventative, which of course would benefit from slandering MMR. This link mentioned something else which is interesting -- the transfer factor wouldn't just be to prevent measles (a la vaccination) but to treat it. In other words, it presents *two* ways Wakefield would stand to gain from a reduction in vaccine uptake -- one, he could market this as an MMR alternative, and two, there would be more measles cases which he'd propose treating with the measles transfer factor.

This is, of course, exactly how Big Pharma stands to profit from a modest reduction in vaccine uptake -- measles treatment is profitable, but rare with the current herd immunity. Being slightly under herd immunity would seem to be a profitability sweet spot, and anyone who offers both a vaccine and a treatment would stand to gain from not *quite* reaching herd immunity. (I do not believe Big Pharma tends to consider that; the product lines aren't close enough together to influence one another, and in any case, big business has a bad habit of thinking in terms of short-term returns only.)

By Calli Arcale (not verified) on 12 Jan 2011 #permalink

anyone who offers both a vaccine and a treatment would stand to gain from not *quite* reaching herd immunity.

Especially if the vaccine was ineffective eh.

By Militant Agnostic (not verified) on 12 Jan 2011 #permalink

@31:
One of my observations with research fraud is that there usually does seem to be some element of sincere belief in what a hoax was supposed to "prove". I think it's probably a matter of the researcher being emotionally overinvested in a theory.

On the issue of self-deception, I have come up with a line I have never found a good occasion to use: "Believing your own hype is about as dangerous as being a drug dealer and using your own product."

"Then, while the child was still in hospital (as the British say),"

How do the Yanks say it?

Nice post. I'm inclined to agree with the first comment about Wakefield's motivation. Nevertheless, the irony of the anti-vax loonies accusations about us all being big pharma shills, is truly exquisite given how Wakefield lined his pockets out of all this.

â¢Prometheus at A Photon In The Darkness has found something interesting. See Idée fixe, January 11th, 2011,
http://photoninthedarkness.com/?p=209#respond

Doing a check of MedLine, he found that prior to the Lancet article, Wakefield was an author of 30 of 98 articles that reported a possible link between Crohnâs disease and measles. However, since the Lancet article, Wakefield has been an author on only one published study reporting a possible link between Crohnâs disease and measles, which article may have been undergoing pre-publication review when the Lancet article was published.

Curious that a researcher with a level of specialized knowledge in one area, would simply abandon it.

However, a man with a patent on a measles vaccine competing with the measles vaccine in the MMR would stand to profit handsomely if the safety of the measles portion of the MMR was brought into question for any reason. Further, the incidence of ASD diagnoses has gone from about 1 in 150 children to 1 in about 110, which is much higher than Crohn's disease, and so there is a much larger scare factor.

Accordingly, it is possible to conclude that, together with what else is known, well before the Lancet article was published in 1998, Wakefield was looking for something to call in to question the safety of the measles portion of the MMR, so that his competing measles vaccine could be substituted into the MMR.

@37

It was Wakefieldâs mistaken ideas about a relationship between measles virus (MMR!) and Crohnâs disease that brought him to the attention of the lawyers who subsequently employed him to implicate MMR in ASD. Just as in Wakefieldâs work with ASD, his earlier work was skewed by false-positive reactions: while the PCR reaction Wakefield used in the ASD-related work gave false-positive reactions to human DNA (as shown in DâSouzaâs work) that could only be differentiated from any true positives (DâSouza found none) by the sort of rigorous follow-up experiments (such as sequencing the reaction products) that Wakefield did NOT do, Wakefield's ulcerative colitis and Crohn's mistakes were due to a monoclonal antibody that turned out to react not only to measles but also to a human protein. [Iizuka M et al. Immunohistochemical analysis of measles related IBD. Gut 2001;48:136-137] That brought an end to the measles-causes-Crohns work.

We usually say "hospitalized."

By dedicated lurker (not verified) on 12 Jan 2011 #permalink

BTW, I'm still waiting to hear from Jay Gordon if he continues his unwavering support for Wakefield.

You may remember that Gordon wrote: "I spent Saturday at an incredible conference in Chicago. Any thoughts I ever had about wavering in my support of Andrew Wakefield have dissolved." Perhaps he's waiting to see what the third installment of the BMJ expose will bring, since the first two discussed allege only fraud and greed.

Dr. Jay?

@Skepticat UK: ""Then, while the child was still in hospital (as the British say),"How do the Yanks say it?"

Here in the US We put an extra "the" in there...so ...child was still in the hospital...

We're like that, you know. We drop u's from words like color/colour, but put unnecessary periods (stops, to you) after words like Mr and Mrs. 2 nations separated by a common language, indeed (my Aussie friend just amused me by complaining that the day was going by like a week of rainy Mondays...never had heard that before!)

By Triskelethecat (not verified) on 12 Jan 2011 #permalink

Matthew Cline @25: So if I may rephrase, John Stone is saying that the experimental evidence should be ignored in favor of Wakefield's story? How... creationist of him.

Jack @7, David @15: Actually, the account reminded me more of "Jekyll and Hyde" - the musical version, not Stevenson's story. Researcher with his own theory, rejected by colleagues, sets out on his own to prove it, etc. etc. And it even involves the death of innocents! Really, a great parallel; we should contact Sondheim immediately.

@36: We say "in THE hospital" - a difference that sounds odd on my ears and took some getting used to studying medicine in Australia.

"So I went to go visit my grandmother who was in hospital"

vs

"So I went to go visit my grandmother who was in the hospital"

@36, Skepticat. We say "in the hospital." Thirty years ago I spent three weeks with some British mates at the Marine Biological Research Station on Bermuda; so I am bilingual.

We also pronounce the "h" in hospital, generally.

By Mephistopheles… (not verified) on 12 Jan 2011 #permalink

MI Jen, nybgrus: It's interesting that we say "in the hospital" but "in school" or "in jail".

IIRC, the added "u" in "colour" or "flavour" was introduced to British English after the primary divergence between British and American English.

@38
Brian, you should post that info as a comment to Prometheus' article. He frequently responds to comments, and would likely appreciate your input.

Thanks, wfjag, I did as you suggested. Prometheus did provide a nice summary.

@Ken:

So if I may rephrase, John Stone is saying that the experimental evidence should be ignored in favor of Wakefield's story? How... creationist of him.

No, he's saying (as far as I can tell) that the experimental evidence does agree with Wakefield, but that everyone but Wakefield made errors in recording the evidence, which is why the medical records for the children disagree with Wakefield.

By Matthew Cline (not verified) on 12 Jan 2011 #permalink

@Canadian chick: "they keep frantically moving the goalposts." That would be because no one has actually studied the vaccine schedule well enough to disprove anything. What about some aluminum studies or p80 etc? What about a primate study that compares vaccinated primates to unvaccinated and studying them. If the study done was not to J. of Toxicology's liking then surely someone will do something that is to the "scientist's" liking. Or is it really just too threatening to compare vaccinated vs unvaccinated primates and study the differences in brain size etc.?

@11

Why would an anti-vaccine guru attempt to get rich from making a vaccine? It simply doesn't add up. Either he's anti-vaccine, or he's not, correct? It seems a complete contradiction.

Look out! It's the Wookie Defense!

By SnowDayStuckIn (not verified) on 12 Jan 2011 #permalink

Anon @50, really?

On pubmed.com, searching for:

"vaccine aluminum adjuvant" 1347 hits

"vaccine p80" 22 hits & a pointer to genetic research

vaccinated vs. -un- primates : Uh, autism is a social developmental delay strongly characterized by language. Are you suggesting we teach other primates to talk? If they were capable, then it'd probably as unethical to experiment on them with vac-vs-un as with humans.

What Canadian Chick was talking about was "Mercury! No, Aluminum! No, aborted fetal tissue! No, too many too soon! No, diseases were already disappearing!" Just FYI.

By HomeOnSnowDay (not verified) on 12 Jan 2011 #permalink

I'm not shocked by Wakefield anymore. At this point, they could write stories about him cavorting with Lady Gaga and a herd of cows in a cornfield in Iowa and I'd think "yeah, I can see that."

@ Ken:
"Matthew Cline @25: So if I may rephrase, John Stone is saying that the experimental evidence should be ignored in favor of Wakefield's story? How... creationist of him."

Well put!

My assessment of John Stone over the past few weeks is this:

He is a complete tosser!

By David N. Andre… (not verified) on 12 Jan 2011 #permalink

#55 - Please don't insult cows. They have more common sense than to cavort with Wakefield.

Pulling on the Daddy Humor Hoodie - "And since he's a quack wouldn't be cavort with ducks?"

Uh-huh. I went there.

I loike the Title. In it for the money eh? Possibly.

I'm just glad that Pfizer and Glaxo do it for the benefit of mankind. It would break my little heart to find out that they are just in it for the money too.

Idiots.

What do you think BUSINESS is all about. Somehow, I get the feeling that Science Blobs is anti-capitalism and pro-marxism. Correct me if I'm wrong. Oh, and tell PZ he hasn't fornicated a poll in a long time. I miss telling pollsters about his scheme.

By Captain Patriot (not verified) on 12 Jan 2011 #permalink

Captain Patriot @ #58.

I missed where your comment addresses the issue of conflict-of-interest, which is what Orac's post is about.

Perhaps you'd be so kind to point that out to me.

Cheers.

By Jeff Keogh (not verified) on 12 Jan 2011 #permalink

I miss telling pollsters about his scheme.

LOL, I know this guy. He thinks he's somehow fighting "for great justice!" because he sends emails to websites hosting polls that get crashed to inform them... that their entirely open internet polls are being crashed.

he's a laugh riot, I tell ya.

c'mon captain...

Your ideas are intriguing to me and I wish to subscribe to your newsletter.

Please don't insult cows. They have more common sense than to cavort with Wakefield.

After all, if anyone understands the concept of herd immunity
it would be cows. That and an appreciation for the extinction of rinderpest due to vaccination. Not to mention the role of cows in developing the smallpox vaccination. Even Wakefield would be cowed by their refusal to accept his bull.

By Militant Agnostic (not verified) on 12 Jan 2011 #permalink

What do you think BUSINESS is all about.

When conducted ethically, it is about transactions where everyone receives value from the transaction or at least is not harmed by it. Wakefield's "business" does not qualify, since hundreds of thousands of parents were terrified into making bad medical decisions for their children thanks to Wakefield's fraud.

By Antaeus Feldspar (not verified) on 12 Jan 2011 #permalink

@Ichthyic

You may know my counterpart as Guardian of the Poll. Happy to be of service to pollsters. Even happier when posslters repsond an the fornicators at pharyngula get their feelings hurt. Happy monkey!

I used to have fun over at Ed Brayton's until his intolerance censored me. His brother comes on here all the time. He refuses to tell his brother that captain Patriot sends his regards. Oh well. What can I expect from someone intolerant?

@Antaeus

On the contrary, I bet nonoe of those parents who witheld your miracle vaccine got autism did they? Not only that, i bet they didn;t even get sick at all. I have never had the flu vaccine. I have had the flu in the past when I was a kid. I survived without the vaccine. Others can too. It's parents choice. Wakefield was only trying to help parents make a decsion as to wether to get their kid vaccinated. We already know the dangers of gardasil. It does more harm than good and besides, keeping out of bed until marriage will solve the majority of your gardasil vaccine cravings.
truthaboutgardasil.org

By Captain Patriot (not verified) on 12 Jan 2011 #permalink

Captain Patriot:

On the contrary, I bet nonoe of those parents who witheld your miracle vaccine got autism did they?

You mean like Kim Stagliano's youngest daughter with autism, who has never been vaccinated? There are several more, and they posted here and at LeftBrainRightBrain (usually responding to the inane comments of Tony Bateson).

Wakefield was in it for the money.

I'm watching to see if, in response to the BMJ series, whether Wakefield makes a single public statement that doesn't start and end with "buy my book for the real story."

"He became an anti-vaccine guru (Plan B) after "Plan A" (getting rich from making a vaccine) failed. Logic would indicate that even attempting Plan A would would make Plan B difficult, but when has logic ever been a feature of the anti-vaccination movement? If it turned out that Wakefield was investing all his ill-gotten gains in Big Pharma stock his supporters at AOA wouldn't bat an eye. "

So you are claiming that Wakefield was pro-vaccine when he patented his vaccine, which then must have been before the whole MMR controversy, and only switched to being anti-vaccine after his vaccine failed? I read that his vaccine was an attempt to improve upon the existing MMR vaccine that he suspected may have something to do with bowel disease, and was patented after MMR vaccine was suspected of being an issue.

In that case he was anti-vaccine prior to development of his vaccine contrary to your claim. But that doesn't really make any sense either because someone who is anti-vaccine is highly unlikely to be successful creating a vaccine that they have spent years railing against. Regardless of whether logic is a part of the anti-vaccine movement, if you are going to take away someone's medical license and eviscerate them in the media, your reasons why have to make sense. From what I can tell, Wakefield is no idiot.

From the reading I have done, it isn't really adding up and this blog entry contains many unexplained contradictions. Wakefield has maintained he isn't anti-vaccine which makes more sense since he had patented one. As well, the Lancet article in question said they found no link between autism and the MMR vaccine but all the antagonists keep claiming he did, and blame him for parents reluctance to vaccinate. I don't know any autistic people, and already have my vaccinations so I don't see this as that big a deal, but it simply doesn't add up.

By schadenfreudeless (not verified) on 12 Jan 2011 #permalink

It makes me sad in a sense, I read such educated commentary here along with wonderful blog posts by Orac. I find this to be one of the best blogs on science blogs in terms of what one can learn and you always get some uneducated idiot who couldn't be taught even if you had a Captain-Patriot-Teaching-Machine (Patent Pending)
I especially love the "I survived without the vaccine" chestnut. Want to know why I will vaccinate my son, beside the wealth of scientific information for it? My mother in law described to me losing friends to polio. Her friends losing little brothers and sisters to pertussis. This was in the fifties and sixties, is it so possible hygiene has gotten THAT much better since then to wipe out these diseases? I know the anti vaxxer crowd is rebranding themselves constantly but shouldn't we take point and rebrand them the "Pro Dead Child" coalition?

By Irreverent (not verified) on 12 Jan 2011 #permalink

I loike the Title. In it for the money eh? Possibly.

I'm just glad that Pfizer and Glaxo do it for the benefit of mankind. It would break my little heart to find out that they are just in it for the money too

To my knowledge, you are the first person to have suggested (albeit jokingly) that Pfizer, GlaxoSmithKline, et al are in it for the benefit of mankind rather than because it can make them some money.

*Everyone* is in it for the money. The question is whether or not they allow that to supercede ethical concerns. There is a world of difference between being a shopkeeper and being a fence, after all, yet both are essentially in it for the income.

By Calli Arcale (not verified) on 12 Jan 2011 #permalink

There is a world of difference between being a shopkeeper and being a fence, after all, yet both are essentially in it for the income.

I think Captain Patriot is more qualified to be a fence post.

By Militant Agnostic (not verified) on 12 Jan 2011 #permalink

@69 Militant Agnostic
You insult many a solid minded fencepost.

By Irreverent (not verified) on 12 Jan 2011 #permalink

Callie Arcale

To my knowledge, you are the first person to have suggested (albeit jokingly) that Pfizer, GlaxoSmithKline, et al are in it for the benefit of mankind rather than because it can make them some money.

You jest, but without Pfizer, GSK, et al what can the avg. Orac to do? Twiddle their thumbs? They take the goodies, the CEU's, their biased professor's nudges, and the perks, but also pretend to be objective and unbiased. I say they are not. They can not continue to whore themselves to the money that drives them and also continue to claim objectivity. That includes pharmaceutical grants. NIH included.

Don't claim to be a champion of science yet be a whore to industry, then clutch your pearls when the very industry that drives you is found out to be dishonest and fraudulent.

By augustine (not verified) on 12 Jan 2011 #permalink

MESSAGE BEGINS--------------------

By the Venerated Battle Claw of the Great Viagrus, you have given your Glaxxon Overlords a great victory my shills and minions! The PharmaRiches shall flow! Expect a little something extra in your envelopes this week.

"In it for the money all along" . . . I love it!

Take the rest off the week of Shills and Minions, you have earned it.

Oh, and one more thing. After last week's Shills vs. Obsidian Maintenance Crew shuffleboard tournament, one of you lost a "Chapstick" here on the station and today one of the older hatchlings ended up eating it. While surprisingly nourishing, she had a deuce of a time passing the case, and really, the hatchlings are irritable enough without that kind of drama. Kindly mind your personal objects while in orbit.

Lord Draconis Zeneca, VC, iH7L
PharmaCOM Orbital HQ
0010101101001

-----------------------------MESSAGE ENDS

By Glaxo PharmaBa… (not verified) on 12 Jan 2011 #permalink

@72
I heartily agree with your description of craptain patriot, but using that story is a little ironic- seeing as she was not regarded as being at risk and therefore qualifying for the vaccination.

Sorry symball should have made my self clear the point is Captain seems to think the flu is harmless. This story shows it isn't.

The cynic in me can't help but wonder if the UK media would be quite so much in favour of vaccination against the flu if the current shortage of the vaccine didn't embarrass an unpopular government, though.

Calli said "The question is whether or not they allow that to supercede ethical concerns."

NAH! A thing like that would never happen to doctors or hospitals or pharmaceutical companies. That thing only happens to insurance companies. Pharmaceutical companies vaccinated themselves against greed with the greedy man vaccine that only government agents and media matters know about.

Of course Pfizer i in it for the money. The goal of a business is to serve customers in order to benefit the collective will of the people. Right? WRONG! The goal is to serve customers, but also make, GASP!, a profit. Ooops. I said that ugly P word. Sorry. That's life.

Idiots. anti-capitalists suck.

Don;t worry about me. When Hussein Obama and the Federal Cunt Commission gets their Internet ID (Revelation 13:16-17) I will not be able to return here. I refuse to get that mark.

By Captain Patriot (not verified) on 13 Jan 2011 #permalink

Don;t worry about me. When Hussein Obama and the Federal Cunt Commission gets their Internet ID (Revelation 13:16-17) I will not be able to return here. I refuse to get that mark.

Fucking moron. Your brain cell is showing.

Your Imperial Reptilian Awesomeness,

Your humble minion requests that you please see fit to dispatch an Obsidian unit filled with hungry hatchlings to Craptain Patriot's trailer at once. Don't worry about backup however, he's certain to be alone.

By Pareidolius (not verified) on 13 Jan 2011 #permalink

While I am always glad to hear from Lord Draconis Zeneca, the revelation that Wakefield was always in it for self-enrichment leaves me feeling...both sad and mucky.

The sad part is about the hundreds and perhaps thousands children who have been subjected to arduous and painful regimens of "treatment" to remove the alleged persistent measles virus from their bodies. What side effects do years-long regimens of unnecessary anti-viral medications have on developing minds and bodies?

The mucky part is (a) well, I've known for years that there are people who exploit others' suffering for their own profit, but seeing it again is disturbing; and (b) observing the mental gyrations of Wakefield's acolytes is also...disturbing.

augustine:

Don't claim to be a champion of science yet be a whore to industry, then clutch your pearls when the very industry that drives you is found out to be dishonest and fraudulent.

Augustine, Orac has criticized the industry, multiple times. Don't make assumptions about other people's motives.

Captain Patriot:

Of course Pfizer i in it for the money. The goal of a business is to serve customers in order to benefit the collective will of the people. Right? WRONG! The goal is to serve customers, but also make, GASP!, a profit. Ooops. I said that ugly P word. Sorry. That's life.

So, if we allow a drug company to do whatever it wants, we're evil for letting them make killer vaccines. If we try to regulate them in any way, we're evil for being socialists. So what do you believe in?

By Gray Falcon (not verified) on 13 Jan 2011 #permalink

@ anthonyk

Sorry. thought I had it covered up. Wouldn't want HAARP signal to interfere with my thinking capacity. Also, those pesky microwave towers are worth worrying about too.
I realize I only have the one brain cell. Sorry. The government confiscated the rest. Guess those taxes really are too high.

By Captain Patriot (not verified) on 14 Jan 2011 #permalink

@84
Captain patriot, you had 20 hours to to think of a response to @83, and look at you, you can't argue your way out of the meth bag you got yourself into. How do you not know you are a reptile?