If you want to know where the current ridiculous anti-vaccination scare came from, there's one well known source: Andrew Wakefield. He published a paper in 1998 that claimed there was a link between vaccination and autism that was a popular sensation, and had a dramatic effect.
Despite involving just a dozen children, the 1998 paper's impact was extraordinary. After its publication, rates of inoculation fell from 92% to below 80%. Populations acquire "herd immunity" from measles when more than 95% of people have been vaccinated.
Last week official figures showed that 1,348 confirmed cases of measles in England and Wales were reported last year, compared with 56 in 1998. Two children have died of the disease.
Now for some shocking news — it looks like the data may have been faked.
The research was published in February 1998 in an article in The Lancet medical journal. It claimed that the families of eight out of 12 children attending a routine clinic at the hospital had blamed MMR for their autism, and said that problems came on within days of the jab. The team also claimed to have discovered a new inflammatory bowel disease underlying the children's conditions.
However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children's ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.
Will this revelation matter? Not one bit. The anti-vaxers have ignored all the evidence that they are wrong so far, so one more demonstration that one of the primary promulgators of this nonsense was an outright fraud won't change a thing, I'm afraid. This is still a clear-cut case where delusions can kill.
(via Phil)
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Persecution claims by hordes of non-scientists in 3...2...1....
Why did this take ten years to come out?
A small study with biased single author. Not surprising that it could slip into the literature. The fact that it took ten years to show the fraud doesn't say much about the quality control systems with these studies. Of course, once there, the antivaxers will still proclaim it even if it has been falsified.
I know it won't happen, but I'd love to see Wakefield and other antivaxers be held legally responsible for the deaths they've caused with their fearmongering and lies. Seems like there should be a manslaughter charge in their somewhere.
Err, "in there" even. Even preview can't save me from some mistakes...
Why did this take ten years to come out?
Because it took that long for the anti-vaxer wooheads to stop, take a breath, and let someone else do anything other than be screeched at.
As so many others have said, this won't change the minds of the anti-vaxers. They're true believers, don't confuse them with mere facts. What's more, they'll continue to offer Wakefield's study as proof that they're right.
Two other examples of this anti-vaxer type of group psychopathology that come to mind are Bendectin and
Silicon Breast Implants.
I'd say that's the other shoe now, but really, with Wakefield, it's more like the sixth. And who wears six shoes?
Anyway. My point (and I do have one) is: Brian Deer rocks.
some of us mentioned this a week or so ago, but there was a great "This american life" episode on this. It made me realize that not only are they damaging their own children, they actually fit the definition of sociopathy--they are severely anti-social, looking out only for themselves.
I live in southwestern Ontario and it is amazing how many loving and (supposedly) well-educated parents choose not to have their kids vaccinated. The irony is that the herd of vaccinated children at school makes this kind of decision far safer than might otherwise be the case.
The increase in Measles in the UK is no joke...It's a serious disease...in addition the the deaths, complications are common.
"Complications with measles are relatively common, ranging from relatively mild and less serious diarrhea, to pneumonia and encephalitis (subacute sclerosing panencephalitis), corneal ulceration leading to corneal scarring[3] Complications are usually more severe amongst adults who catch the virus.
The fatality rate from measles for otherwise healthy people in developed countries is 3 deaths per thousand cases. [4] In underdeveloped nations with high rates of malnutrition and poor healthcare, fatality rates have been as high as 28%. [4]In immunocompromised patients, the fatality rate is approximately 30 percent.[5]"
http://en.wikipedia.org/wiki/Measles
The anti-vaccine bullshit is one thing that really gets my blood boiling. I attend a support group for bereaved parents and one of the couples has lost a child to SSPE, a fatal complication of measles that strikes years after infection. Their child was exposed to measles at a daycare before he was old enough to be vaccinated - one of the older children whose parents didn't "believe" in vaccines had measles and spread it around before anyone realized the kid was sick. So this baby got measles, recovered, then, eight years later, came down with subacute sclerosing panencephalitis and died a horrible death as his brain degenerated. All because of some other parents believed that stupid autism story.
This enrages me.
Well it's looks as if it worse that a fake publication, the guy was getting paid by anti-vax lawyers.
"In 2007 Wakefield became the subject of a General Medical Council disciplinary hearing over allegations that his research had received funding related to litigation against MMR-vaccine manufacturers, and had concealed this fact from the editors of The Lancet.[33] It was later revealed that Wakefield received £435,643 [about $780,000] plus expenses for consulting work related to the lawsuit. This funding came from the UK legal aid fund, a fund intended to provide legal services to the poor.[28]
http://en.wikipedia.org/wiki/MMR_vaccine
But Andrew Wakefield is a Good Guy(tm) who dares to reveal The Truth. Of course, the evil pharmaceutical companies will say anything to splash mud on him. The anti-vaxxers will stand firm behind Their Man.
Seeing as we already knew he was essentially bribed to reach that specific conclusion, I can't say that I'm surprised.
Shocked, shocked I tell you.
Anti-vaxxers faking data?
NEVER
Boy this pisses me off like crazy. All the antivax bullshit pisses me off; this just adds on to it.
I was certainly smart enough to get my kids vaccinated, but as for myself, I'm not immune to measles and apparently can't be made immune, if my doctors are correct that is. So when I hear the anti-science kooks spew their antivax bile out their mouths, I take it very, very personally.
How about a lynch mob for Andrew Wakefield?
Oh wait, we are the good guys. We only have truth and integrity to fight with.
As disgusting as Tar and Feathering was, it sure sent a message.
Rev. BDC #20
Tar is going too far, but perhaps we could use some Tanglefoot instead?
Not that it ever made any kind of sense that something wrong with your gut would affect brain processes.
But in my mind, it doesn't matter. The small likelihood that an injection will cause a bad outcome for an individual child (my own included) is part of the trade off of living in society. You live in society. You get clean water to drink, electricity, police officers, sewers etc. In exchange YOU VACCINATE YOUR CHILDREN. You do this for the greater good. Some people can't be made immune, some are too young to get vaccinated, immunity to many diseases fades over time, but doesn't need to be maintained in adults because it is prevented from circulated by vaccinating children (ie. pertussis).
You don't want to vaccinate your kid? Fine, then live in the woods, drink water from a stream, dig pits for toilets and grow your own food.
THE TIMES is probably wrong again, plus others.
PZ “Andrew Wakefield. He published a paper in 1998 that claimed there was a link between vaccination and autism that was a popular sensation, and had a dramatic effect.” This is simply not true and the story becomes a complicated one, beyond the scope of this post for length; so there are two quotes below, one, part of the original LANCET article and second from Ben Goldacre:
The Lancet, Volume 351, Issue 9103, Pages 637 - 641, 28 February 1998
doi:10.1016/S0140-6736(97)11096-0
“We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described. Virological studies are underway that may help to resolve this issue.
If there is a causal link between measles, mumps, and rubella vaccine and this syndrome, a rising incidence might be anticipated after the introduction of this vaccine in the UK in 1988. Published evidence is inadequate to show whether there is a change in incidence22 or a link with measles, mumps, and rubella vaccine.23 A genetic predisposition to autistic-spectrum disorders is suggested by over-representation in boys and a greater concordance rate in monozygotic than in dizygotic twins.15 In the context of susceptibility to infection, a genetic association with autism, linked to a null allele of the complement (C) 4B gene located in the class III region of the major-histocompatibility complex, has been recorded by Warren and colleagues.24C4B-gene products are crucial for the activation of the complement pathway and protection against infection: individuals inheriting one or two C4B null alleles may not handle certain viruses appropriately, possibly including attenuated strains.
Urinary methylmalonic-acid concentrations were raised in most of the children, a finding indicative of a functional vitamin B12 deficiency. Although vitamin B12 concentrations were normal, serum B12 is not a good measure of functional B12 status.25 Urinary methylmalonic-acid excretion is increased in disorders such as Crohn's disease, in which cobalamin excreted in bile is not reabsorbed. A similar problem may have occurred in the children in our study. Vitamin B12 is essential for myelinogenesis in the developing central nervous system, a process that is not complete until around the age of 10 years. B12 deficiency may, therefore, be a contributory factor in the developmental regression.26
We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunisation. Further investigations are needed to examine this syndrome and its possible relation to this vaccine.”
http://www.badscience.net/2008/08/the-medias-mmr-hoax/
The media’s MMR hoax
August 30th, 2008 by Ben Goldacre in MMR, bad science, badscience |
This is an extract from my new book “Bad Science“, in the Guardian today. It’s out on Monday: my recommendation is that you buy it, and give it to someone who disagrees with you.
Ben Goldacre
The Guardian
Saturday August 30 2008
Dr Andrew Wakefield is in front of the General Medical Council on charges of serious professional misconduct, his paper on 12 children with autism and bowel problems is described as “debunked” - although it never supported the conclusions ascribed to it - and journalists have convinced themselves that his £435,643 fee from legal aid proves that his research was flawed.
I will now defend the heretic Dr Andrew Wakefield.
The media are fingering the wrong man, and they know who should really take the blame: in MMR, journalists and editors have constructed their greatest hoax to date, and finally demonstrated that they can pose a serious risk to public health. But there are also many unexpected twists to learn from: the health journalists themselves were not at fault, the scale of the bias in the coverage was greater than anybody realised at the time, Leo Blair was a bigger player than Wakefield, and it all happened much later than you think.
Before we begin, it’s worth taking a moment to look at vaccine scares around the world, because I’m always struck by how circumscribed these panics are. The MMR and autism scare, for example, is practically non-existent outside Britain. But throughout the 1990s France was in the grip of a scare that hepatitis B vaccine caused multiple sclerosis.
In the US, the major vaccine fear has been around the use of a preservative called thiomersal, although somehow this hasn’t caught on here, even though that same preservative was used in Britain. In the 1970s there was a widespread concern in the UK, driven again by a single doctor, that whooping-cough vaccine was causing neurological damage.
What the diversity of these anti-vaccination panics helps to illustrate is the way in which they reflect local political and social concerns more than a genuine appraisal of the risk data, because if the vaccine for hepatitis B, or MMR, is dangerous in one country, it should be equally dangerous everywhere; and if those concerns were genuinely grounded in the evidence, especially in an age of the rapid propagation of information, you would expect the concerns to be expressed by journalists everywhere. They’re not.
In 1998 Wakefield published his paper in the Lancet. It’s surprising to see, if you go back to the original clippings, that the study and the press conference were actually covered in a fairly metered fashion, and also quite sparsely. The Guardian and the Independent reported the story on their front pages, but the Sun ignored it entirely, and the Daily Mail - home of the health scare, and now well known as vigorous campaigners against vaccination - buried their first MMR piece unobtrusively in the middle of the paper. There were only 122 articles mentioning the subject at all, in all publications, that whole year.
This was not unreasonable. The study itself was fairly trivial, a “case series report” of 12 people - essentially a collection of 12 clinical anecdotes - and such a study would only really be interesting and informative if it described a rare possible cause of a rare outcome. If everyone who went into space came back with an extra finger, say, then that would be worth noting. For things as common as MMR and autism, finding 12 people with both is entirely unspectacular.
But things were going to get much worse, and for some very interesting reasons. In 2001 and 2002 the scare began to gain momentum. Wakefield published a review paper in an obscure journal, questioning the safety of the immunisation programme, although with no new evidence. He published two papers on laboratory work using PCR (a technique used in genetic fingerprinting) which claimed to show measles virus in tissue samples from children with bowel problems and autism. These received blanket media coverage.
The coverage rapidly began to deteriorate, in ways which now feel familiar and predictable. Emotive anecdotes from distressed parents were pitted against old men in corduroy with no media training. The Royal College of General Practitioners press office not only failed to speak clearly on the evidence, it also managed to dig up anti-MMR GPs for journalists who rang in asking for quotes. Newspapers and celebrities began to use the vaccine as an opportunity to attack the government and the health service, and of course it was the perfect story, with a charismatic maverick fighting against the system, a Galileo-like figure. There were elements of risk, of awful personal tragedy, and of course, the question of blame: whose fault was autism?
But the biggest public health disaster of all - which everyone misses - was a sweet little baby called Leo. In December 2001 the Blairs were asked if their infant son had been given the MMR vaccine, and refused to answer, on the grounds that this would invade their child’s right to privacy. This stance was not entirely unreasonable, but its validity was somewhat undermined by Cherie Blair when she chose to reveal Leo’s vaccination history, in the process of promoting her autobiography, and also described the specific act of sexual intercourse which conceived him.
And while most other politicians were happy to clarify whether their children had had the vaccine, you could see how people might believe the Blairs were the kind of family not to have their children immunised: essentially, they had surrounded themselves with health cranks. There was Cherie Blair’s closest friend and aide, Carole Caplin, a new age guru and “life coach”. Cherie was reported to visit Carole’s mum, Sylvia Caplin, a spiritual guru who was viciously anti-MMR (”for a tiny child, the MMR is a ridiculous thing to do. It has definitely caused autism,” she told the Mail). They were also prominently associated with a new age healer called Jack Temple, who offered crystal dowsing, homeopathy, neolithic-circle healing in his suburban back garden, and some special breastfeeding technique which he reckoned made vaccines unnecessary.
Whatever you believe about the Blairs’ relationships, this is what the nation was thinking about when they refused to clarify whether they had given their child the MMR vaccine.
The MMR scare has created a small cottage industry of media analysis. In 2003 the Economic and Social Research Council published a paper on the media’s role in the public understanding of science, which sampled all the major science media stories from January to September 2002, the peak of the scare. It found 32% of all the stories written in that period about MMR mentioned Leo Blair, and Wakefield was only mentioned in 25%: Leo Blair was a bigger figure in this story than Wakefield.
And this was not a passing trivial moment in a 10-year-long story. 2002 was in fact the peak of the media coverage, by a very long margin. In 1998 there were only 122 articles on MMR. In 2002 there were 1,257 (from here). MMR was the biggest science story that year, the most likely science topic to be written about in opinion or editorial pieces, it produced the longest stories of any science subject, and was also by far the most likely to generate letters to the press, so people were clearly engaging with the issue. MMR was the biggest and most heavily covered science story for years.
It was also covered extremely badly, and largely by amateurs. Less than a third of broadsheet reports in 2002 referred to the overwhelming evidence that MMR is safe, and only 11% mentioned that it is regarded as safe in the 90 other countries in which it is used.
While stories on GM food, or cloning, stood a good chance of being written by specialist science reporters, with stories on MMR their knowledge was deliberately sidelined, and 80% of the coverage was by generalist reporters. Suddenly we were getting comment and advice on complex matters of immunology and epidemiology from Nigella Lawson, Libby Purves, Suzanne Moore and Carol Vorderman, to name only a few. The anti-MMR lobby, meanwhile, developed a reputation for targeting generalist journalists, feeding them stories, and actively avoiding health or science correspondents.
Journalists are used to listening with a critical ear to briefings from press officers, politicians, PR executives, salespeople, lobbyists, celebrities and gossip-mongers, and they generally display a healthy natural scepticism: but in the case of science, generalists don’t have the skills to critically appraise a piece of scientific evidence on its merits. At best, the evidence of these “experts” will only be examined in terms of who they are as people, or perhaps who they have worked for. In the case of MMR, this meant researchers were simply subjected to elaborate smear campaigns.
The actual scientific content of stories was brushed over and replaced with didactic statements from authority figures on either side of the debate, which contributed to a pervasive sense that scientific advice is somehow arbitrary, and predicated upon a social role - the “expert” - rather than on empirical evidence.
Any member of the public would have had very good reason to believe that MMR caused autism, because the media distorted the scientific evidence, reporting selectively on the evidence suggesting that MMR was risky, and repeatedly ignoring the evidence to the contrary. In the case of the PCR data, the genetic fingerprinting information on whether vaccine-strain measles virus could be found in tissue samples of children with autism and bowel problems, this bias was, until a few months ago, quite simply absolute. You will remember from earlier that Wakefield co-authored two scientific papers - known as the “Kawashima paper” and the “O’Leary paper” - claiming to have found such evidence, and received blanket media coverage for them. But you may never even have heard of the papers showing these to be probable false positives.
In the Journal of Medical Virology May March 2006 there was a paper by Afzal et al, looking for measles RNA in children with regressive autism after MMR vaccination, using tools so powerful they could detect measles RNA down to single-figure copy numbers. It found no evidence of the vaccine-strain measles RNA to implicate MMR. Nobody wrote about this study, anywhere, in the British media (except for me in my column).
This was not an isolated case. Another major paper was published in the leading academic journal Pediatrics a few months later, replicating the earlier experiments very closely, and in some respects more carefully, also tracing out the possible routes by which a false positive could have occurred. For this paper by D’Souza et al, like the Afzal paper before it, the media were united in their silence. It was covered, by my count, in only two places: my column, and a Reuters news agency report. Nowhere else (although there was a post on the lead researcher’s boyfriend’s blog where he talked about how proud he was of his girlfriend). [EDITED to disambiguate]
Journalists like to call for “more research”: here it was, and it was ignored. Did the media neglect to cover these stories because they were bored of the story? Clearly not. Because in 2006, at exactly the same time as they were unanimously refusing even to mention these studies, they were covering an identical claim, using identical experimental methodology: “US scientists back autism link to MMR” said the Telegraph. “Scientists fear MMR link to autism” squealed the Mail.
What was this frightening new data? These scare stories were based on a poster presentation, at a conference yet to occur, on research not yet completed, by a man with a well-documented track record of announcing research that never subsequently appears in an academic journal. This time Dr Arthur Krigsman was claiming he had found genetic material from vaccine-strain measles virus in some gut samples from children with autism and bowel problems. If true, this would have bolstered Wakefield’s theory, which by 2006 was lying in tatters. We might also mention that Wakefield and Krigsman are doctors together at Thoughtful House, a private autism clinic in the US.
Two years after making these claims, the study remains unpublished.
Nobody can read what Krigsman did in his experiment, what he measured, or replicate it. Should anyone be surprised by this? No. Krigsman was claiming in 2002 that he had performed colonoscopy studies on children with autism and found evidence of harm from MMR, to universal jubilation in the media, and this work remains entirely unpublished as well. Until we can see exactly what he did, we can’t see whether there may be flaws in his methods, as there are in all scientific papers, to a greater or lesser extent: maybe he didn’t select the subjects properly, maybe he measured the wrong things. If he doesn’t write it up formally, we can never know, because that is what scientists do: write papers, and pull them apart to see if their findings are robust.
Through reporting as shamelessly biased as this, British journalists have done their job extremely well. People make health decisions based on what they read in the newspapers, and MMR uptake has plummeted from 92% to 73%: there can be no doubt that the appalling state of health reporting is now a serious public health issue. We have already seen a mumps epidemic in 2005, and measles cases are at their highest levels for a decade. But these are not the most chilling consequences of their hoax, because the media are now queueing up to blame one man, Wakefield, for their own crimes.
It is madness to imagine that one single man can create a 10-year scare story. It is also dangerous to imply - even in passing - that academics should be policed not to speak their minds, no matter how poorly evidenced their claims. Individuals like Wakefield must be free to have bad ideas. The media created the MMR hoax, and they maintained it diligently for 10 years. Their failure to recognise that fact demonstrates that they have learned nothing, and until they do, journalists and editors will continue to perpetrate the very same crimes, repeatedly, with increasingly grave consequences.
It is legal to tar and feather an effigy, isn't it? Maybe that would get the message through to some of these deluded fools.
Clever enough to find a way to make money off the vaccine manufacturers. Not clever or perhaps moral enough to worry about the consequences.
You think Measles is bad, consider Polio. ~50% kill rate, a 100% disability rate, low gestation time, incredibly easy to transmit, and present in almost every pool of standing water the world over. I shutter to think of the tragedy awaiting any population which dips below the herd immunity threshold for that damned disease.
One year over 1000 children died from the disease, the next none; why do they refuse to see the connection?
Sorry, Ross, tl;dr.
Somebody medical and British can correct me if I'm wrong, but it is my recollection that The Lancet, though a British medical journal, is not peer-reviewed, in any meaningful sense. Just sayin', and I hate it when people type "just sayin'."
Polio is indeed a fearful disease, but your figures are a bit high. 99% of infections are asymptomatic. Overall, 5–10% of patients with paralytic polio die due to the paralysis of muscles used for breathing. The mortality rate varies by age: 2–5% of children and up to 15–30% of adults die. Source, Wikipedia.
Because then they might have to admit that vaccines aren't all evilevilevil. Of course, the mental contusions that they have to maintain their beliefs can be amazing. The usual claim I've seen for polio is that it was increasing standards of hygiene that wiped out polio, not the vaccine.
I've also heard somebody claim that it was because everyone's emotional state changed (presumably for the better), but this person also explicitly rejected germ theory, claiming that all diseases were caused by emotional trauma---trying to hunt down the Respectful Insolence thread I first encountered this person, I discovered this is apparently the point of view taken by the German New Medicine.
You could probably also find people claiming that not only did the vaccine not help against polio, but prolonged the epidemics, but I don't really feel like sifting through tl;dr amounts of kookery.
I'm working as an ABA therapist until I get my undergraduate degree. Anyway, about a year ago I received a job posting with an eight year old with autism. I went to the interview, and when I got there, I noticed that the child was very high functioning ... very, very high functioning. He wasn't in any special needs classes, was getting As and Bs in regular school, had perfect speech, and seemed to have an idea about social norms. He never obsessed over anything, and was therefore pretty focused (made good eye contact). When I asked one of his siblings if he had any obsessions, she didn't know what I was talking about. The main issue with this kid, was that he was extremely aggressive, and unlike other autistic children that I've worked with, he knew what he was doing. Most autistic children are aggressive because they like to get a reaction out of people; it interests or amuses them, but not this kid. Now, I know that there are different degrees of autism. I've worked with functional kids before, as well as children with aspergers. I'm not saying that this child wasn't autistic, I'm just not sure how ABA or behavioural therapy would help his situation. The child had a history of torturing animals, for crying out loud! I don't know how anyone could expect a bunch of undergraduate students under the age of 25 to really help this kid. Anyway, moving on ...
I talked to his mother, and she seemed very normal. I told her her son was very high functioning, and her response was "Yes, that's because he hasn't always been autistic." When she said this I was expecting her to tell me he had some special, rare case of autism, probably with a long name. Instead she says "He got it from the measles vaccine." Knowing at this point that I wasn't going to accept the job anyway, I responded "I thought that was only a myth." She was appauled by my response, and suffice to say, the interview didn't last much longer after that.
The experience was all very questionable, and weird ... this woman is receiving a lot of funds from the government to provide her son with special needs programs that are offered to autistic children. I do believe her son should receive extra help, but I don't know how ABA therapy is going to help his situation. Her story is very questionable, and her son's symptoms didn't match most of the children that I worked with. My point is that it was all very sketchy.
Another case where delusion trumps the facts, every time. The study is legitimate because they want it to be. The facts are wrong because we think they are.
Sometimes, I despair for humanity.
Mirax: the symptoms you describe resemble one of the related conditions referred to as sociopathy, not autism. It seems to me likely that the mother is aware that he is "different" from other children but in denial about the nature of that difference and has seized on the "vaccines cause autism" hype to buttress her denial, perhaps with the cooperation of an incompetent or inattentive doctor. I doubt there's much you can do, but if you can follow up on this I would advise doing so; this child may eventually become dangerous. (Needless to say, I wouldn't suggest taking the job).
someone gonna spend several years in gaol for this?
jenny maccarty? jenny? anyone?
#5 try peer review instead
Can I recommend Offit's Autism's False Prophets enough?
What often gets forgotten with Wakefield's paper,whether it was a fraud or not,is that a sample size of 12 patients is not in any way,shape or form suitable to draw any conclusions from.
This was never a study,maybe a case report,but surely not a study that would hold up to any scientific or statistical scrutiny.
clinteas,
How are things going over your way? It sounds like, well, hell over there. Is it starting to improve?
Oh wow, a dodgy claim turns out to be false. What a surprise...
Hi Wowbagger,
off night shifts now,was pretty tough last nite,lots of smoke inhalation(and drunk dickheads).We had to take spillover from the Hospitals that were on bypass to just take burns.But my house wasnt threatened,so all good...Lots werent so lucky though,pretty horrific.Its cooled down,still hardly any rain tho.
clinteas,
That's good to know. It's a time of extreme weather all over the damn country. My old stomping ground of northern Queensland is seriously underwater and the rain doesn't look like stopping anytime soon.
Since we're OT here already....
Dawkins on creationism as part of a NatGeo interview :
http://natgeochannel.co.uk/programmes/dawkins-darwin-evolution/videos/d…
Best bit : "To believe the world is less than 10000 years old requires you to be immensely ignorant,or...insane."
Nice.
Glad to hear the Aussie contingent is ok. I'm in Bandung in Indonesia at the moment visiting my sister and the news looks pretty horrific.
Hiya BoSOM,
they reckon 650+ homes destroyed,66+ people dead,and 12 "bad" fires are still burning,with no rain around...
Its going to get worse before it gets better here.
Bride of Shrek,
It's not looking all that good in flooded NQ either - though fatalities aren't an issue; lots of property damage and what looks to even more rain to come.
If the GMC don't erase Wakefield from the register their credibility with UK doctors (which is already pretty low) will vanish, probably beyond retrieval. In a couple of decades the damage done by anti-vax doctors encouraging this insanity is going to make Shipman look like a pussycat.
BTW, the risk of SSPE after measles declines steeply with age, so adults who can't get immunity after vaccination shouldn't have too many sleepless nights. It's the ones who can't get immunity to mumps that need to get some sperm frozen.
I have been wondering whether we will have to routinely check immunity post-vaccination. I don't know about the US, but in the UK/Aus/NZ only rubella testing in early pregnancy is routine. If there's a bad outbreak of measles I'd prefer to know that I needed another vaccine course rather than take the risk. Of course, as an emergency doctor my exposure risk in an epidemic is around 100%.
Not practicable for one.
Also,the protection you get from >95% vaccination rates in the community far outweighs the rate of failed immune response after vaccination.
The biggest risk by far is from parents not vaccinating their kids anymore.I see about one a week here in Australia,and Im always lost for words as to their stupidity.
I had a woman here (Tasmania) tell me her child was homeopathically immunised. I told her quite sharply that there was no such thing and that her child was unimmunised. I know we're supposed to respect 'patient choice' and wondered if she would write a complaint. I would have refused to apologise, I think, had she done so. I simply can't pander to this stupidity.
I meant testing for immunity when immunisation rates fall below safe threshold. I don't want to find out the hard way that my vaccinations didn't work (I did get whooping cough after vaccination). Plus in a serious outbreak the last thing you need is for staff to get sick.
To be fair, the anti-immunisation brigade aren't the only ones to deserve the blame here. The UK media and government have to share this.
The government were right in their response but still gave the appearance of trying to cover it up. They could have silenced the whole thing by just setting up a study to see if the findings were repeatable. But by constantly refusting to do so, they looked like they were trying to hide something. And considering the lack of trust people have in the government, that conclusion was pretty much inevitable.
The media is a nightmare when it comes to reporting science. They push controversy and don't refer to previous studies in their reporting (as it's not 'news). They also overstate conclusions. All they achieve is hysteria with nobody knowing who to trust.
With such reporting it's hardly surprising that people start assuming the original study might have been correct. It appeared a scientist had maybe found a link between MMR and autism. And the government instead of taking the results seriously and looking into it, was just saying to trust them.
I can only hope the UK government (in particular) have learned the lessons from this. It's not just about the science. It's about being believed. If you have to have an additional study to make people trust you, then that's what has to be done.
I'm with Nutmeg @ #22. I firmly believe that everyone should be vaccinated in the absence of a sound medical reason not to, and those so unvaccinated should not receive medical treatment. If you want to spend thousands of pounds of taxpayers' money and tie up doctors, nurses and support staff treating someone for a disease that they never needed to have caught in the first place, I have two words to say to you -- and the second one is "off".
We really need to take a harder line against the unvaccinated; starting with schools and workplaces refusing to take on anyone whose vaccinations are not up-to-date.
Some people do have sound medical reasons why they can't be vaccinated against certain diseases; and for their sake, it's important that everyone else be vaccinated, so as to minimise the probability of exposure. Which part of "giving a disease, against which you could have been vaccinated but weren't, to someone who for genuine medical reasons couldn't have been vaccinated against it" doesn't sound like [attempted] murder?
So it now appears the Dr Wakefield (soon to be plain "Mr", I hope) made up his results. Scientific fraud, no less. Unfortunately, the harm won't stop. The anti-vaxxers will say he's been persecuted, and that Big Pharma is behind it, because for them it's all a conspiracy. Although we know that anecdotes don't make data, for them personal anecdote = universal truth.
Don't be surprised if we don't have one such angry parent turn up here soon.
You're a disgrace Andrew Wakefield. And he'll never admit he was wrong, just continue his lucrative speaking, writing, and other commercial arrangements. Sigh. When scientists go bad...
Didn't Andrew Wakefield continue doing tests on autistic children after his paper was released to try and shore up his results? I recall private eye suggesting that the tests done then were what can only be described as vile, unethical, and indeed assault. At the very least his obsession with inflamed bowels leading to autism is responsible for so many of his former patients now having to grow up with perforated bowels and the complications that ensue.
Given the things that parents of autistic children will put them through to try to 'cure' them I truly wouldn't be surprised if he did repeatedly infect their bowels with measles and harvest the cells.
23*
While I have absolutely no doubt that media interests outweigh National Health concerns repeatedly and rabidly....and not just on MMR...after all a personal bonus in the wage packet is far more preferable to the health of young kids everywhere..apparently...I find the conclusion that Wakefield was the innocent dupe in all this unacceptable...
He knew what he was about...and he made no denial or correction to perceived impression to his original 'study' in the 10 years this debacle ensued and is still ensuing...
In fact he continues to argue the case that MMR is a cause of Autism...
Wikki reports....
"Wakefield called for suspension of the triple MMR vaccine at a press conference and in a video news release issued by the hospital.
He said, "If you give three viruses together, three live viruses, then you potentially increase the risk of an adverse event occurring, particularly when one of those viruses influences the immune system in the way that measles does." He suggested parents should opt for single jabs against measles, mumps and rubella, separated by gaps of one year."
And...
"In February, 2002, Wakefield stated, "What precipitated this crisis was the removal of the single vaccine, the removal of choice, and that is what has caused the furore - because the doctors, the gurus, are treating the public as though they are some kind of moronic mass who cannot make an informed decision for themselves."
"Wakefield has continued conducting clinical research in the US, joining American researcher Jeff Bradstreet to conduct further studies on the possible relationship between the MMR vaccine and autism."
He is not retracting...he was obviously NOT misquoted...and he is not claiming unfair press coverage!
This man does not require defending...he requires to be strung up and left to twist in the breeze by The General medical Council...for lamentable lack of professionalism and shabby research....and the folks that paid him 1/2 a million quid to foist this nonsense into the world have obviously more money then sense!...
He has undoutably fermented a situation where the very real possibility that children will die...is a foregone conclusion
@my last comment at #50
Ignore that, looks like Orac's covering what I was thinking of on his blog.
With some folks one anecdote that supports their prejudices will outweigh any number of facts. For example, helmets rarely injure motorcyclists, prevent vastly more injuries, but guess which side of the question is heeded by a twit who wants the wind in their hair. BTW, my daughter is up to date on vaccinations.
For #26; Sven this was an “Early Report” and not one person in the scientific community ( that I am aware ) because of the sample size ( as noted in 35 ) and musings of the authors thought more of it than as an interesting pointer paper for more research. THE LANCET is peer reviewed for major articles and rates as a top journal.
The report was partially retracted:
The Lancet, Volume 363, Issue 9411, Pages 747 - 749, 6 March 2004
doi:10.1016/S0140-6736(04)15714-0
“This week, The Lancet prints a partial retraction—a retraction of an interpretation1—from the majority of authors of a paper published in February, 1998, by Andrew Wakefield and colleagues.2 Wakefield and one other co-author, Peter Harvey, have not signed this retraction statement. We hope to publish their response very shortly. The original report2 made clear that the authors “did not prove an association” between measles, mumps, and rubella (MMR) vaccine and a newly described syndrome of bowel disease and autism. But the authors did raise the possibility of a link, on the basis of parental and medical histories, and they suggested that “further investigations are needed to examine this syndrome and its possible relation to this vaccine”. This interpretation of their data, together with a suggestion made by Wakefield during a separate press conference held at the Royal Free Hospital that there was a case for splitting the MMR vaccine into its component parts, triggered a collapse in confidence in the UK's MMR vaccination programme. It is the interpretation expressed about a connection between the vaccine and the new syndrome that is now being retracted.”
As noted by Cylux @ 50: This is a perfect example of having to cross check anything the popular press has to say about medicine or the reporting of results of trials. More often than not, there are fundamental errors ( see New England Journal of Medicine, January 1, 2009 editorial ) It is now so bad that some journals now publish a “What patients are reading” section or have patient summaries of the study published.
As to Private Eye, I will let Wakefield speak to that via quotation assuming this is the same material referenced.
The Lancet, Volume 363, Issue 9411, Pages 823 - 824, 6 March 2004
doi:10.1016/S0140-6736(04)15710-3
“Independently, I was commissioned through a solicitor, Richard Barr, to undertake quite separate virological studies on ten children. This is entirely in line with other university-based studies that have been similarly funded by the Legal Services Commission, and reported, for example, in the BMJ.1 The list of children provided to me by Richard Barr was based on his knowledge of an overlap between patients referred to the Royal Free and those whose parents had made contact with Richard Barr. I could not have constructed such a list since I had no knowledge of the litigation cohort or the legal status of children within this cohort. I was specifically concerned with addressing the scientific question in relation to measles virus—a perfectly legitimate question in view of the nature of the intestinal disease and the sequence of events in the children. Measles virus infection of the intestine is a specific interest of mine.”
Note: BMJ is the BRITISH MEDICAL JOURNAL, again, well respected, which is not to say like anything, error free.
As noted in 52, I was going to suggest ORAC,http://scienceblogs.com/insolence/2009/02/why_am_i_not_surprised_it_loo… for his take, some of which I disagree with. Wakefield is certainly borderline, seems to lack any ability to communicate without the press misreporting, and as a result of both he and the press, many have died. Summary judgment: Wakefield should have shut up, does not seem to get it from his academic perch and I cannot deny he started it for whatever reason, but the press are 90% responsible. Reread Goldacre in #23.
Oh man I didn't know this. All their crap is pinned on a study of 12 cases? That alone alleviates any doubt I may have ever had. Unlike others I guess I'm not surprised I didn't know about this study until 10+ years after the fact. And the dramatic increase in Measles cases in the UK seems to be but one hard example of the counter-proof.
Very interesting. Thanks for posting this PZ.
To make this whole MMR autism story even sillier.
We now have a good idea of what causes autism. It is mostly a genetic disease.
This came out of the human genome project. There seems to be a large number of poorly understood genes that predispose children to autism. The actual identities of most of them or how they work is ongoing research.
But that autism and schizophrenia have a strong genetic base is well established.
"Autism is a neurodevelopmental disorder of genetic origins, with a heritability of about 90%." Says it all, review abstract below.
Thing is Wakefield WAS paid by a group to FIND the connection between MMR and Autism...
He knew that and so did the group...several of whom have Autistic children themselves...hence their emotional and therefore financial involvement...
Whatever he found he obviously ignored because according to the quote from ...
23*
'The Lancet, Volume 351, Issue 9103, Pages 637 - 641, 28 February 1998
doi:10.1016/S0140-6736(97)11096-0'
'No link was found' very first sentence...why was it interpreted as a link was found...and that interpretation allowed to fester in media comment...unless the wanted conclusion by the authors and the press was that a link was actually there and the actual research conclusion can be ignored!
If there was no connection why was he advocating single shots and why did the Lancet make a such palava about withdrawing a paper form publication?...
Why was the press barking hysterically about shadows?
Unless of course the author encouraged them to do so!
If there was a connection why was not a larger more inclusive research attempt launched immediately on the back of the paper not induced by a government department that would fear reprisals from families afflicted subsequent to this knowledge being in the public domain?...unless advice from the tame government science committees informed the government that is was all bullshite!
Wakefield wanted the conclusions drawn by the press...it sealed his bargain in accepting the task and the money...it was an implicit deal!...infer a connection and get MMR withdrawn.
And it was based on faulty research and conclusions were drawn that should never have been drawn...but that obviously suited Wakefield...he has never recanted that position...Andrew 'I have done nothing wrong' Wakefield started that research with the answer already fore concluded...it was a dishonest research project and the false results remains his preferred position!
Ego or stupidity...or just plain dishonesty...whatever it was originally a scam to sue the health authorities ...cooked up by a dodgy lawyer and angry confused and grieving parents.
My new baby just did his 2 month vaccinations. I am not sure what will come about, but I am expecting the bill to show up soon. IOW, I don't expect the insurance company to cover it.
Now, I recognize that insurance companies are in it for the money, and don't have a social conscience, but the part that torques me more than anything is that they do cover circumcision.
How does that make sense? They will cover an elective procedure that is not recommended by any medical association in the western world, but won't cover vaccinations that those organizations all insist are important?
I don't know about anyone else, but this will help me. I'm closely associated with an anti-vaxer who is otherwise pro-science and scientifically literate but very leery of vaccines and untrusting of mainstream medicine.
I won't be able to undo all that in one stroke, because within her immediate family there is a case for a correlation between vaccines and autism (however limited the dataset) and the medical industry has been less than kind, but I will at least be able to offer some specifics about why refusing to vaccinate endangers other kids (not just hers) and the beginning of a collection on the (lack of) correlation between autism and vaccines in the population at large.
From my observations, a lot of the sentiment against mainstream (or actually-tested-and-proven, if you prefer) medicine is driven by fear of how medicine is practiced in our society; it seems to me that addressing this fear is the key to solving the problem of bogus "alternative" medicine, as well as a large chunk of the public disregard for science.
The only other alternative I see is trying to legislate it out of existence, and that isn't likely to end well. The fear is too deeply entrenched (and justified!), and alternative medicine fans seem to have a much more trusting relationship with their homeopaths than with their doctors (this is certainly the case with the mother I'm speaking of here).
wakefield: "three live viruses" - well, the vaccines use a very very controlled constructed virus, that have only the parts that are less likely to allow desease manifestation, but simply estimulates the immune system, in order to recognize the virus surface and so attack it. (There dozens of ways to build a vaccine type, mercury or no mercury, full virus or not, lots and lots, i just hope they vaccinate their kids somehow - don't care if they change the recipe, just let the kids get protection)
The media does not even ask a microbiologist to talk about virus and a doctor to talk about the vaccination. Its amazing...R.Kennedy junior appears on tv with no tecnical suport or a science journalist... cbs talks about vaccination and lobys with no tecnical speakers...
Its a trend that i see more often these days in Fox, skynews,... they just put a general journalis talking bias or interviewing a fanatic, and thats news! No opposition...
Virus also do not "live", they are crystal-like-life-forms, still in debate what they are.
Woozle: "alternative medicine fans seem to have a much more trusting relationship with their homeopaths than with their doctors" - this is being adressed in medical schools.
Some think its because the medical schools do not focus the social aspect very well. I mean it does not train the future doctors on how to relate better with people - something very dificult to teach. There's some relation between a more individualistic personnality (close to social interaction) and lack of better social relationships. Medical students have tons of pressure these days, so the time to have more social experience for themselfs earlier in life is difficult. So there might be a more bigger gap in the relation of patient-doctor.
Medical class are also a bit of a bunch of arrogants :P, the medical knowledge is very complex and sometimes trying to explain takes some basic knowledge to have understanding of the explanation. This is a growing problem as the medical practice becomes more vast and the human mind does not.
Homeopaths are a different sort, they just tell people what they want to hear thats why they seem convincing...my hope is that they finaly get a complain of being a fraud in the justice courts, and start taking responsability for the people that they let die because of homeopathy.
I know of a patient (36 years old) that used homeopathy to treat her breast cancer...after 4 years of that she was at the hospital with a 7cm carcinoma, lots of complications...died a bit after i saw her :(
Although the contents of Strangest Brew ( 59 ) post are entirely plausible and creditable, subsequent LANCET publication to his quote (The Lancet, Volume 363, Issue 9411, Pages 823 - 824, 6 March 2004 doi:10.1016/S0140-6736(04)15710-3 { Wakefield
Response } The Lancet, Volume 363, Issue 9411, Pages 820 - 821, 6 March 2004
doi:10.1016/S0140-6736(04)15699-7 { Horton, editor statement } ) and other factors still leads me to believe that Wakefield, from my vantage point, is not all that good at media manipulation, otherwise there would not be all the stink. Wakefield lives in a different world, ( or is a most proficient liar ) but I emphasize this does not excuse the results. Closer to the truth is the last paragraph where the brew is the dodgy lawyer ( by definition ) the parents, add THE LANCET for not recognising the potential devastation in advance, the likes of Cherie Blair and most importantly, the popular press exemplified by Brian Deer at THE TIMES who I suspect is sharpening his sword with the pen.
A science / medicine educated press would address much of what is in posts 61 and 62/3, but I just do not see it happening in the for profit media as it does not sell readership to get advertising revenue with the NEW YORK TIMES being a possible exception. Most studies are pretty boring stuff for the lay public, adding incremental knowledge, not blockbuster breakthroughs, so it gets spiced up. BBC coverage supports this idea, but they often get off track, but less so than FOX et al. CNN does OK because they stick to the fluff and have Dr. Gupta to rein in the nonsense. The only time Wolf Blitzer expresses doubt is when he asks “ What about that Sanjay”
So I was bored today and looking under e-rocks and found this little gem. http://www.myspace.com/forcedanarchy
Perhaps PZ would like to friend this person on the old Myspace?
Anti-vaccination people sure are fun. Sorry, I meant to say, crazy. Sure are crazy.
Have you ever heard of polio?
The CNS and the GI tract are actually quite close from a developmental perspective. Make of that what you will.
Be careful looking under e-rocks. Often you find e-snakes or e-turds
Oh look, ron paul supporter too.
/ducks
I’d like to share a quick story about our experience with this subject. Our middle child is autistic. He has received all of his scheduled vaccinations (as has our oldest). We were aware of the hubbub concerning the supposed vaccination-autism connection when it came time to vaccinate our youngest, and I have to admit, we were a little scared. Our belief was that there was no connection, but when it comes to actually going through with it, it’s a little scary. At any rate, we talked to our GP about it. He mentioned the Wakefield study but very strongly argued that the conclusions were questionable. In particular, he pointed out that it involved only about a dozen children. It put our minds at ease and we went ahead and had our youngest vaccinated.
One other interesting thing that my GP said which I think is a sad consequence of this nonsense – he said that last year they had 2 cases of measles at their clinic that went misdiagnosed. The problem is that occurrences of measles are on the rise while many of the young doctors are inexperienced with diagnosing the symptoms. He believes that because we have been so successful in the past at controlling measles, its really fallen of our radar. Misdiagnoses will only increase the probability that some people are going to be killed by, what should be, a beaten disease…
Ultima thule: I'm glad to hear that they are at least aware of it and are trying to do something about it. That said, I don't think they're really in the right head-space to grasp what needs to change.
I could probably write a page or two exploring some ideas, but I don't have any firm recommendations. The whole industry is a mess; get rid of the corruption (see Lessig for the sort of thing I'm talking about) and you'll have made progress, but that's only part of it.
On the up-side, my friend's homeopath is an MD (constantly worried that his license will be yanked on some pretext) and he does not hesitate to recommend or prescribe actual medicine -- including antibiotics -- for anything more serious than just a winter cold. I don't think he's actually doing any harm; by taking the time to build more of a personal relationship with his patients he often finds out more than a mainstream doctor might, and he certainly seems to put more thought into the diagnosis than I've seen in your average medical clinic.
Sue Blue#13,
"So this baby got measles, recovered, then, eight years later, came down with subacute sclerosing panencephalitis and died a horrible death as his brain degenerated. All because of some other parents believed that stupid autism story."
Connections. This is only one of the connections. It is natural to want to blame others. But the parents of this baby, had it in a day care at a pretty young age. Had the baby not been nursed and provided with its mother's antibodies? Had the parents not checked to see whether the nursery required vaccinations? The parents should have been aware that they lived in a free society where not everyone was forced to be vaccinated. Fraudulent "science" and a litigious society deserve some of the blame, but not all of it.
The protection provided by maternal antibodies is soon lost once the child stops nursing.
June 5 1997 Dr. Wakefield filed for a patent on a novel measles vaccine. He did not disclose his interest in this vaccine when he challenged the safety of the MMR and began to advocate for the measles, mumps, and rubella vaccines to be given seperately.
He is a very, very bad person.
I've done another round-up post -- who is saying what about the Deer articles on Wakefield in the London Times. I've included this post.
11 years on, Wakefield Manufactured Data showing MMR-Autism Link?
You think the data MAY have been faked? I’ve known all along that this was just a scare tactic. We’re seeing an upsurge of Pertussis. Shameful. Be sure that if as an adult you have to have a tetanus booster you get the one that includes a booster for Pertussis. If you get whooping cough, you’ll wish you had.
Oh, please. A child fucking died because of the irresponsibility of some fuckwitted parents, and you're trying to make this another benefit of libertarianism. Give it a rest.
Not even taking their ideology into account I can name at least one reason why libertarianism turns me off.
Many of those who subscribe to it and comment here and are fucking annoying.
Somebody medical and British can correct me if I'm wrong, but it is my recollection that The Lancet, though a British medical journal, is not peer-reviewed, in any meaningful sense.
I'm neither medical nor British, but a quick look at online instructions for authors shows that The Lancet is a peer-reviewed medical journal. Like other prestigious journals (e.g. Nature,) it also contains news and editorial commentary, which are separate from the research articles.
Pablo from #60, I'm pissed on your behalf at your insurer for not covering vaccines. Have they never heard of the value of prevention?
If you're in the US there is funding available for children whose insurance doesn't cover vaccination, but you have to go to certain clinics (federally qualified health centers) - google Section 317.
I stand corrected aboiut The Lancet. According to this review (p4), they instituted a peer-review system some time after 1976.
The unvaccinated older child who spread measles around the daycare was also out in public, spreading it around where ever he went until he got too sick to be out. Why does it matter why the baby who died was at daycare before he was old enough to be vaccinated? He could just as easily have been exposed at the grocery store. The issue is that the parents of the older child chose not to vaccinate their child because they were worried about autism (which isn't fatal), therefore putting at potentially deadly risk every newborn infant in the area. Is this their right? Also, although I personally advocate breastfeeding, not everyone chooses to do so. Should they be punished with the death of their child because mommy didn't pass on her antibodies? Get real. The blame here rests squarely on the idiotic parents who thought their unfounded fears outweighed the rights of the public to be safe from a deadly disease. Their child lived. Another couples' eight-year-old son died in a coma.
sue blue, sorry. Africangenesis is a libertarian and so lives in a different universe than the rest of us. He has a religious faith in the Just World Hypothesis, where anything bad that happens to people is their own fault. That's why in libertarianism, poor people deserve to die in the streets, and your acquaintances deserved to lose their child. There is no arguing with his delusion; his political religion requires a deep faith in the Just World, so he can't give it up and he can't allow for that child's death not to be the parents' fault.
Wakefield just made Keith Olbermann's "Worst Person in the World" tonight (2/10/09)
In great news the courts have ruled against compensation in the autism vaccination link in three cases today.
It turns out journalist Brian Deer made it up:-
"Sunday Times Journalist Made Up Wakefield MMR Data Fixing Allegation":
http://tinyurl.com/djbtzq
And he was helping the US Justice Dept sink 4500 US kids claims for vaccine damage compensation - what kind of normal journalist does that? Ans: none.
"US Federal Court, US Justice Dept & The Sunday Times - More Questions Than Answers"
http://tinyurl.com/ac5xkt
It turns out journalist Brian Deer made it up:-
"Sunday Times Journalist Made Up Wakefield MMR Data Fixing Allegation":
http://tinyurl.com/djbtzq
And he was helping the US Justice Dept sink 4500 US kids claims for vaccine damage compensation - what kind of normal journalist does that? Ans: none.
"US Federal Court, US Justice Dept & The Sunday Times - More Questions Than Answers"
http://tinyurl.com/ac5xkt