Comment on: Wrong About Vaccine Safety: A Review of Andrew Wakefield’s “Callous Disregard”

23 Jan

Andrew Wakefield has been discussed here and elsewhere a great deal. Thankfully his presence in the autism communities seems to have retreated to a small core of supporters and the occasional parent convention where he can, yet again, defend himself. Yes, his supporters are vocal. And, yes, he continues to cause harm. But his heyday is long past.

Mr. Wakfield was stripped of his medical license after an extremely lengthy hearing. Mr. Wakefield chose to not present evidence at the hearing, chose not to appeal the decision and has, instead, offered up his defense in a book: “Callous Disregard”. Callous Disregard has been discussed online multiple times.

Mr. Wakefield and his supporters tend to make sciency appearing defenses of him. For example, there are claims that his work has multiple independent replications in various countries. If one checks the references used to make that claim, one finds the claim is, well, false. Citations in “Callous Disregard” often do not support the arguments Mr. Wakefield is making. But few people have the time to go through his prose, much less his references.

One gentleman has taken on that task. Joel A. Harrison, PhD, MPH, has published a paper: Wrong About Vaccine Safety: A Review of Andrew Wakefield’s “Callous Disregard” in which he debunks the main claims in “Callous Disregard”. Here is the abstract:

Abstract: On February 28, 1998, Dr. Andrew Wakefield published an article in the Lancet on 12 children “with a history of pervasive developmental disorder and intestinal symptoms. Onset of behavioral symptoms was associated, by the parents, with measles, mumps, and rubella vaccination in eight of the 12 children.” Though not claiming the MMR vaccine caused the symptoms, adding what parents thought certainly raised the possibility. Statements and articles by Wakefield suggested he believed such a link probable. Vaccination rates plummeted in the UK and outbreaks of vaccine preventable diseases followed. Investigative journalist Brian Deer uncovered dishonest and unethical medical practices by Wakefield, resulting in Wakefield losing his medical license. Rather than appeal the decision, Wakefield wrote a book, “Callous Disregard: Autism and Vaccines – The Truth Behind a Tragedy,” wherein he claims loss of his license was a political attempt to silence his criticism of vaccine safety. This paper examines the validity of Wakefield’s claims. A careful review of publicly available information makes it clear that Wakefield’s claims regarding vaccine safety are wrong. It is hoped that this review will be used by doctors and public health personnel to encourage parents hesitating to have their children vaccinated to question anti-vaccination claims in general, given that many proponents often refer to Wakefield as an authority and display in their own writings and pronouncements similar erroneous claims.

The paper is 17 pages as published and includes 142 references. His conclusion is quite strong, and includes this paragraph:

I have shown that every major claim Wakefield makes in his book concerning vaccine safety is wrong. I have given accurate quotes from both Wakefield’s book and sources that contradict his claims, including those he misquotes. Based on the old adage, “trust but verify,” where possible I have given the URLs to many of the documents and articles referred to in this paper. My hope is that those who take the time to check will realize that Wakefield’s claims regarding vaccine safety are not only wrong but also harmful, and that once this is realized, people will read Deer’s articles [3] and the British Medical Council’s findings [1,2] with an open mind.

How does he back up such a strong conclusion? Consider this point he makes in his summary (which is discussed at length in the paper)

Wakefield claims that a leading Swedish vaccine researcher, Dr. Christenson, told him that vaccine safety studies had not been carried out in Sweden; yet, gives references to two Swedish papers that extensively report on vaccine safety studies in Sweden, one of them coauthored by Dr. Christenson.

Yes, once again, we see Mr. Wakefield claiming something which the very references he uses show the opposite.

Consider Mr. Wakefield’s stance on the Urabe-strain containing mumps vaccine (a component of the MMR used for some time in the UK). Mr. Wakefield ignored the Urabe vaccine during his time as an expert for the MMR litigation in the UK but has more recently taken the story up as some sort of defense of himself. If that sounds confusing, it really isn’t. Mr. Wakefield thinks we all will just forget that he pushed his own pet theory 15 years ago and just listen to the fearful message he gives now.

Dr. Harrison states:

“Wakefield claims that the Urabe mumps strain contained in the MMR vaccine used in the UK starting in 1988 had been approved after the Canadians withdrew it. Not True.”

Yes, the UK didn’t approve the Urabe Strain vaccine after Canada withdrew it.

Canada licensed Trivirix in May 1986 [57]. The starting date for the UK for MMR vaccinations was October 1, 1988 [58,59]. The license for Trivirix was withdrawn in Canada in May 1990 stating: “Recent laboratory findings from the United Kingdom, Canada and Japan have provided sound evidence. . . In addition, the report states: “The infection follows the course of benign aseptic meningitis” [60]. The UK withdrew the Urabe-containing vaccine on September 14, 1992 [61].

Dr. Harrison also goes to great length to discuss how Mr. Wakefield’s characterization of the Urabe strain vaccine is inaccurate–painting a story of a dangerous vaccine where the evidence does not support this argument.

So Wakefield carried out an incorrect statistical analysis, claimed the authors combined the data when they did not, and incorrectly gave a shorter follow-up time. All of these inaccuracies move evidence from showing safety to showing possible harm.

Dr. Harrison concludes the paper with:

The only conclusion that can be reached from this review is that the title of Wakefield’s book is incomplete. It should read: “Andrew Wakefield’s Callous Disregard for the Facts.”

A rather bold statement given Mr. Wakefield’s litigious nature, having brought suit against the BMJ and Brian Deer and threatening an autism charity with legal action.

Mr. Wakefield’s supporters will likely ignore this lengthy takedown. Mr. Wakefield is dishonest. He lies. And the sad thing is that people believe him.


By Matt Carey

note: minor edits were made after this article was published

27 Responses to “Comment on: Wrong About Vaccine Safety: A Review of Andrew Wakefield’s “Callous Disregard””

  1. lilady January 23, 2014 at 21:51 #

    Excellent analysis of Joel A. Harrison’s brilliant paper.

    I had the pleasure of reading Harrison’s paper earlier today and I am impressed with its meticulous detail and its citations.

    “Mr. Wakefield’s supporters will likely ignore this lengthy takedown. Mr. Wakefield is dishonest. He lies. And the sad thing is that people believe him.”

    That’s a major understatement, Matt. You could bet the farm that it will be ignored by Wakefield’s supporters, because…

    – Dr. Joel Harrison, who is a retired epidemiologist is a private citizen who received no funding from any government sources or any *ebil Big Pharma* sources.

    – None of their *journalists* and none of their hack quack doctors have the skill set to understand this scientific paper.

    • Sullivan (Matt Carey) January 23, 2014 at 23:53 #

      We are down to the hard core of his [Wakefield’s] support network.

      Those supporters of Mr. Wakefield who would look critically at his many transgressions are no longer supporters of Mr. Wakefield.

  2. AnObservingParty January 24, 2014 at 13:19 #

    I was finally able to get through the paper last night. First, a standing ovation to Dr. Harrison for having the fortitude to sit through that book, which in addition to being full of lies, is just terribly written. I’ve read Sherlock slash fiction written by a 17-year-old and posted on Tumblr with better structure.

    Dr. Harrison is the exact source the Cult of St. Andy has been clamouring for: independent. He doesn’t even work anymore. Now, what will the response be? I think, Lilady, it will be completely ignored, they will stick their fingers in their ears and cover their eyes, because they can’t point and shriek about how Dr. Harrison is nothing but a paid player in Big Pharma’s character assasination.

    Like so many other minions who saw it on RI, I want to spread this far and wide.

  3. Joel A. Harrison, PhD, MPH January 25, 2014 at 15:26 #

    Hi:

    Thanks for writing about my paper. I spent a lot of time and effort putting it together and hope that anyone who takes the time to carefully read it, including checking out the references, will have a hard time still believing anything Wakefield says. In addition, anyone among the anti-vaccine groups who support Wakefield and quote him should also lose their credibility. Just one small point, though retired, I worked hard to earn my degrees, PhD, MPH, and would appreciate it if you could change “Mr. Harrison” to “Dr. Harrison.” Maybe I’m being petty; but Wakefield supporters certainly don’t write “Mr. Wakefield.”

    Thanks

    • Sullivan (Matt Carey) January 25, 2014 at 17:55 #

      First off–I greatly appreciate your efforts. That was a lot of work and, let’s face it, with Andrew Wakefield’s tactic of silencing criticism with threats of legal action, it took guts to publish that.

      I’ve changed the above. I hope I got all instances of “Mr.”

      I usually reserve “Dr.” for treating physicians. I chose this route after being fooled into thinking someone who had a “treatment” trust was a treating physician but was instead a Ph.D.. One exception I make is with someone who has had online discussions about the use of “Dr.” and how and why many people don’t use it in regard to her.

      As someone with more letters after my name than Mr. Wakefield was ever entitled to (he has since lost his society fellowships), I mean no disrespect by the honorific Mr.. I chose it for myself over Ph.D.. I do not ask you to do the same.

      However, if Mr. Wakefield were to make a similar request, I would not honor it. Having placed himself as a self-pronounced expert in the medical management of autism, I think it is important to note that he is not a treating physician.

      • Sullivan (Matt Carey) January 25, 2014 at 17:57 #

        To complete the thought: the above is almost certainly more information than you wanted. But the topic comes up occasionally as to why I use “Mr.” or “Ms.”. I took the opportunity to clarify.

      • Joel A. Harrison, PhD, MPH January 25, 2014 at 20:38 #

        Hi:

        Thanks for making the changes. While I have no respect for Wakefield, his MD is legitimate. He did earn it. The Dr. refers to his degree, not whether he is a clinician or “researcher.” I had several profs who went through medical school, never practiced medicine, and then got PhDs in biostatistics. They still were called Dr. and wrote “MD, PhD” after their names.

        One other reason I don’t like being called Mr. Harrison is that was what people called my later father and every time I hear or read it, I still miss him though he has been gone many years.

        Wakefield is a disgrace to the medical profession. Perhaps, someday, the history books will call him the Bernie Madoff of vaccine science.

        Feel free to ignore the above. I’m old and just being persnickety.

        A suggestion: if you don’t want to give Wakefield the Dr., rather than Mr. just use his name “Wakefield.” Just a suggestion, though I think it sounds better.

        Also, where you write: “checks the refefences used to make that.” Typo “refefences”. Old eyes still working?

      • Sullivan (Matt Carey) January 26, 2014 at 00:33 #

        I appreciate the input. I don’t have any problem with other people calling him “Dr.” I realize it gives people the impression that I am being petty. It would be easier to either drop using “Mr.” and “Dr.” (and as I’ve gotten more lazy I have been). But I’m getting old and I’m already persnickity ;)

        From what I can see, the New York Times takes the same approach to the use of “Dr.” I’m certainly not comparing myself to the Times, but if they can take that approach, I’m good with it.

        Thanks for catching the typo. And, again, thanks for taking on this project.

  4. Joel A. Harrison, PhD, MPH January 26, 2014 at 21:32 #

    Hi:

    You are an expert on computers so maybe you can help. How do I get Yahoo and Google to include my paper in searches, e.g. words from title, author’s name, and the keywords. It would be nice if anyone who searches for e.g. Andrew Wakefield or Callous Disregard or vaccine safety would find my article? So far I can only find my paper if I type “Wrong About Vaccine Safety.” By the way, you have my e-mail. I really don’t think your blog is the best place to exchange questions, etc. not directly related to posted OpEd? ? ?

    • Chris January 26, 2014 at 23:16 #

      I think that Tim Farley had some ideas on his site:

      http://skeptools.com/

      Personally, I think a version of your article needs to be published on Science Based Medicine.

    • BA January 27, 2014 at 03:09 #

      Dr. Harrison,

      Finally got a chance to read the entire paper (and not just the abstract) and I must say you have done a very professional job of analyzing the assertions in Wakefield’s book. I will be using parts of this paper to refute anti-vaccine talking points in my interactions with parents. Appreciate the effort and thank you.

      BA

  5. CcOoBb January 28, 2014 at 16:39 #

    Can someone aware of the ins and outs of the Wakefield situation please have a look at this and advise me on it’s veracity:

    http://www.boards.ie/vbulletin/showpost.php?p=88697136&postcount=442

    Sorry for pasting it in the wrong comments section earlier.

    Thanks for the help!

    • Chris January 28, 2014 at 17:08 #

      So you want us to believe a guy who just says stuff without any actual evidence? One who calls himself “Bounty Hunter Dad.” Why?

      Here is the basic answer: even if Wakefield was truly honest and did everything above board, he was wrong.

      It was a tiny study of a dozen kids. So the only response should have been: “Okay, that is interesting. But it does not mean much, gather more kids and do it again.” Which is exactly what happened, the Royal Free offered him the chance to expand the study, but he refused. That task was taken up by Dr. Brent Taylor, who found nothing like what Wakefield reported (go to PubMed and search for Taylor, Royal Free and autism).

      If it was supposed to be on the effect of “the” MMR vaccine, he would have mentioned which MMR vaccine. Between 1988 and 1992 the UK had three different MMR vaccines from three manufacturers. There are different vaccine strains from measles, mumps and rubella. The different mumps strains were known, but Wakefield never noted the different kinds of measles vaccine strains. That is just sloppy.

      It was also sloppy in that PCR results were contaminated, as per testimony during the Autism Omnibus hearing by Dr. Chadwick.

      So the best thing you can say about Wakefield is that he was incompetent. He was doing research on subjects way outside his training. He had no expertise in virology nor in autism. So he was just wrong.

      This is why attempts to independently replicate his study turned out negative:

      PLoS ONE 2008; 3(9): e3140 doi:10.1371/journal.pone.0003140
      Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study.

      BMJ 2002; 324(7334):393-6
      Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: Population Study.

      Lancet 1999;353 (9169):2026-9
      Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association.

      (the last two are from Royal Free researcher Dr. Brent Taylor)

      • Sullivan (Matt Carey) January 28, 2014 at 18:29 #

        Let’s see, the guy starts by dismissing anything negative about Andrew Wakefield because it all (in his assertion) derives from Brian Deer who (again in his assertion) has been caught lying multiple times. He does not provide substantive evidence that Brian Deer has lied but he ignores the fact that Andrew Wakefield has been caught on numerous lies.

        The GMC based their case on records from the Royal Free and the litigation.

        As I recall he went to one home of one of the Lancet 12 families. The home of the woman who was the driving force behind the litigation. Seems like a good idea to me. He’s investigating the story, what should he do, ignore them? He used the pseudonym Brian Lawrence (using his middle name and dropping his last). He did this after clearing it with his editor. This method was within the ethics rules for journalists. In fact, Dan Olmsted’s partner in journalism (pre Age of Autism) did the same thing on a series of stories and was lauded for the results.

        Wakefield was a doctor. A researcher. He was not allowed clinical responsibility for a patient. Not then, not now, not before the Lancet 12 children were seen by him. The first charge for which he was found guilty by the GMC was that of taking clinical actions with patients (disabled children) when his contract expressly forbade him from doing so. Given that by definition this means that Prof. Walker-Smith was not involved, Prof. Walker-Smith’s appeal would not exhonerate Mr. Wakefield.

        Mr. Wakefield did not declare his conflicts of interest to his colleagues. They were shocked when they found out the extent of his COI and this is a big reason why they retracted the interpretation of the Lancet paper.

        The fees from the litigation went directly to Andrew Wakefield. He has since claimed that he later donated the money to the Royal Free but there is no record of it actually happening

        When asked about his COI in a letter to the Lancet, he dodged the question through misleading language, making it seem like it was only after the paper that he started working as an expert. He did not disclose his multiple business interests until they were exposed by Mr. Deer.

        Wakefield made a lot of money. He was being paid by the legal aid fund (~$750k) and he was a business partner in the lab created to test his samples (Unigenetics, with Prof. O’Leary). He had a buisness prospective to get venture capital funding for lab tests, a vaccine and therapies.

        Of the 50k pounds given to Dr. Wakefield for his initial stages of research, 25k were not used and were not returned to the Legal Aid Fund. They were, instead, used for other projects. I.e. he syphoned money to another project.

        Wakefield’s paper did not explicitly state that MMR causes autism. He, however, has used his work to make that statement.

        Prof. Walker-Smith, through his attorney, made it clear that Mr. Wakefield’s hypothesis has been disproved.

        I can go on. The author claims that “the truth will come out” or something like that. The truth did come out. Wakefield was wrong. Wakefield lied.

      • Chris January 28, 2014 at 18:50 #

        Yeah, it was pretty well determined that Wakefield was just flat out wrong before 2004. Dr. Brent Taylor effectively did that by doing the studies that Wakefield refused to do. Plus there were studies in California, Finland, and elsewhere that showed no association between MMR and autism dated before 2004.

        What Brian Deer do is answer the question of why Wakefield was wrong: fraud.

        Dr. Harrison’s very thorough paper outlines the many many errors and cherry picked quotes in Wakefield’s book. It took me a while to read, not only for its length but because the pdf took so long to load. “Bounty Hunter Dad” and CcOoBb really need to read it carefully. Especially the bits of the research on the MMR vaccines done in the 1970s and 1980s.

      • Sullivan (Matt Carey) January 28, 2014 at 19:42 #

        I doubt they would take the time to really read the paper. Consider this statement by “Bounty Hunter Dad”

        “So, further research in this area would be most welcome now. Seems to be sadly lacking”

        People who have already cherry picked the data to present–ignoring, for example, the Hornig paper you cited above for example–are not going to be convinced by new results. Andrew Wakefield has lied on so many occasions, but his followers just won’t see it.

      • Chris January 28, 2014 at 21:34 #

        You may be right. Neither would bother to read the article. I just noticed “Bounty Hunter Dad” first posted the silly list that was addressed in the third paragraph of your blog article (with the link to the Just The Vax article going through each of the articles). He even cut and pasted the citing of an entire year of a journal.

      • Chris January 28, 2014 at 21:41 #

        As I go through the forum comments, I see why he wandered over here. This blog was referenced, and in one comment this particle article.

        I still wonder why CcOoBb decided to comment on this subject on the DSM-V article.

  6. Lawrence January 28, 2014 at 17:02 #

    I would link to the paper provided – it actually covers a number of issues cited, with all of the background evidence necessary.

  7. William Marchant February 23, 2014 at 12:17 #

    We have had our issue regarding vaccine damage examined and we have had legal funding restored by an LSCappointed Committee. It is easy to condemn Dr Wakefield having hidden the evidence which totally supports his findings. It is also strange that an unqualified moron is used to supply false evidence . One must assume that Brian Deer was the only choice available, The statistics of autism increaes match completely with the introduction of the MMR VACCINE. Strangely Deer actually told me that DOCTOR WAKEFIELD was correct but he was not the doctor and the timing was too early. He has also never admitted that I gave him a record of my daughter’s which totally backed the bowel problemsas described by Dr Wakefield. This diagnosis was made by Southampton General Hospital. W Marchant

    • Chris February 23, 2014 at 17:51 #

      Mr. Marchant: “The statistics of autism increaes match completely with the introduction of the MMR VACCINE.”

      Yes, do provide that data. The MMR vaccine using the Jeryl Lynn mumps strain was introduced in the USA in 1971, and was the preferred vaccine for the 1978 Measles Elimination Program.

      Please provide verifiable documentation dated before 1990 that there was a steep increase in autism in the USA during the 1970s and 1980s.

      And who are you referring when you say “unqualified moron”? Would it also include Dr. Taylor who took over the research the Royal Free wanted Wakefield to do but he refused? Like:

      BMJ 2002; 324(7334):393-6
      Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: Population Study.

      Lancet 1999;353 (9169):2026-9
      Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association.

      Notice how the dates are before 2004.

      Or do you mean Joel A. Harrison, PhD, MPH? I suggest you read his article, since it contains more earlier citations that Wakefield ignored.

    • Sullivan (Matt Carey) February 23, 2014 at 21:50 #

      Perhaps I could ask you to step back a moment and consider the use of their pejorative “moron”. In general it’s not a good thing but consider that this is a disability focused site. When you use intellectual disability as an insult you reinforce the notion that individuals like my son are somehow less than those graced with average and above intelligence. That its OK to make fun of him. Maybe not to his face, but this is what you are doing.

      Think about it a bit.

  8. lilady February 27, 2014 at 21:38 #

    Apologies for linking to this crank website. I do so, because this website describes the supposed circumstances surrounding William Marchant’s child being injured by the MMR vaccine. I leave it up to to the reader to determine the veracity of the statements Mr. Marchant has posted here; “Silenced Witnesses Vol. 2: The Parents’ Story: The Denial of Vaccine Damage by Government, Corporations and the Media”

    http://www.naturalmedicine.net.nz/product-reviews/silenced-witnesses-vol-2-the-parents%E2%80%99-story-the-denial-of-vaccine-damage-by-government-corporations-and-the-media/

    • Chris February 28, 2014 at 00:12 #

      From that link: “Unknown to them at the time, Jodie had not only been injected with the MMR (with their written consent) but with two other vaccines – the DPT and polio vaccine, all drawn up into the one syringe.”

      Really?

      • lilady February 28, 2014 at 01:49 #

        That’s his story…and he’s sticking to it.

        He’s all over the internet on some other “choice” blogs.

Trackbacks/Pingbacks

  1. The Science of Vaccines | theautisticperspective - September 11, 2014

    […] sample sizes. Second of all, that study has been refuted a thousand times. I’ll just leave some links right here.(TL;DR: Wakefield was an honest to gods shill. I’m not being offensive, […]

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