Andrew Wakefield’s “do not re-vaccinate” letter

20 Jan

I keep thinking I’ve left the Wakefield story behind. Believe me, I want to. It isn’t easy being repeatedly reminded of a man who subjected disabled children to invasive tests, many of which were not in the clinical best interests of the children, in order to collect data for a litigation driven study. The letter below keeps sticking in my mind. It was blogged by others years back, but I keep thinking that it is worth putting out in the public’s eye once more.

Why? Two reasons.

First it addresses Mr. Wakefield’s defense that his concerns about the MMR vaccine were based on a 200 plus page report he generated. I’ve never seen this report and would welcome a link if someone could provide it. The letter below is from September 1996. To put this in perspective, the first of the Lancet 12 children was seen at the Royal Free in July of that year. So this goes to the state of mind at the time of the Lancet 12 study.

Second, this letter addresses one of Mr. Wakefield’s current methods of deflecting criticism: by claiming he never told people to not vaccinate. Well, he told a senior health official in the UK to stop a vaccination program. Does that count? He even emphasized it. At the bottom of the letter below, he tells the Chief Medical Officer to abandon the plan to re-vaccinate children before entrance to preschool. “Do not re-vaccinate”

As to his state of mind at the time, it is clear from the letter below that in Mr. Wakefield’s mind, the key issue at hand was his hypothesis that the MMR vaccine caused a persistent measles infection, resulting in bowel disease. Strangely, he wrote this just as his own group had just published a paper showing no evidence for measles virus in blood or tissue samples from patients with IBD. Yet he doesn’t appear to cite his most recent work and, instead, states “Persistent infection following vaccination is, therefore, not only biologically plausible but likely.”

Based on this letter, I’d be willing to bet that a substantial portion of Mr. Wakefield’s 200+ page analysis of measles vaccine safety is an attempt to bolster support for his own ideas of persistent measles infections, comparing single measles vaccines to the combined MMR. It is an idea which failed (e.g. here and here)

The discussion below is from day 26 of the GMC hearing, where the letter was read into evidence (one of a few times). GMC comments are in bold. The letter is in regular text.

Thereafter, I want to take you on to the next correspondence from Dr Wakefield which was in September 1996 and is at page 193. This is a letter from Dr Wakefield directly to Dr Calman, the Chief Medical Officer, and there is a manuscript note at the top indicating that it was handed on to you. I do not propose to read again the whole of it and others may wish to take you to other parts, professor, but may we run through it.

“Dear Dr Calman,

I am writing to you in order to express formally my anxieties over your intention to re-vaccinate all pre-school children prior to school entry. I will not go over the history of our exchanges on this subject; this will emerge at the appropriate time.

I feel sure that your independent expert advisers will have alerted you to the detection of vaccine-strain measles virus in children with autoimmune hepatitis, a disease in which measles has been implicated previously on evidence far, far more tenuous than our own for measles and Crohn’s disease.

Doubtless they have also informed you …”

and he then goes into the characteristics of the measles vaccine that he suggests are relevant.

“Persistent infection following vaccination is, therefore, not only biologically plausible but likely.

You will also have seen our recent paper in the Lancet which provides what many consider to be compelling evidence of a causal association between measles and Crohn’s disease following exposure in utero. No doubt your experts will be able to reassure you on this particular issue.

In the future you may have cause to reflect on the ‘independence’ of your appointed experts. Certainly, Dr Miller from the PHLS and Professor Minor of NIBSC cannot be considered independent. If I and my colleagues are right, then they are wrong. Their scientific and professional standing and credibility is inextricably linked to the success of measles vaccination. You may also wish to consider the value of their advice with respect to the depth of their knowledge about measles virus. I refer specifically to comments made by Dr Miler and yourself in letters to the Lancet following the ’94 revaccination campaign (following which paediatric IBD cases have increased dramatically).

In your letters you quote from a letter to the Lancet provided by Professor Herman-Taylor …”

and we have heard his name of course in relation to his theory about Crohn’s Disease.

“Hermon-Taylor illustrates that the emergence of Crohn’s disease in the 1940-50s in the UK took place before either the disappearance of measles epidemics, or the introduction of measles vaccination. Hermon-Taylor puts this forward as categorical evidence that neither measles nor measles vaccine can possibly be the cause of Crohn’s disease, which you and your experts endorse. This is a superficial and naïve perspective that reflects a profound lack of understanding of either the changing pattern of morbidity and mortality from measles in the UK leading up to the emergence of IBD, or the risk factors for persistent infection and delayed disease that are associated with measles virus infection.”

He then sets out his arguments in relation to the rising incidence of Crohn’s disease in three UK centres plotted against measles notifications in England and Wales with graphs indicating that or purporting to do so and he then says,

“It is my concern that the expert advice that you have received has been deficient, and far from independent. If and when the dam bursts it will be you and your department that is standing in the way. We, for our part, have tried to help, only to have our work denigrated and misrepresented. We went into this with our eyes open and will continue to generate peer-reviewed, published data in the true scientific spirit: there is a vast gulf between this and opinion. You may wish to ask your experts what are the longest prospective safety trials of measles vaccine, MMR, and measles re-vaccination at any time, anywhere in the world. The result may surprise you.

Do not re-vaccinate.”

The emphasis in “Do not re-vaccinate” was his, not mine. He chose to underline (which for some reason doesn’t work for me on this blog).

Again, my guess is that the 200+ page report he created critiquing MMR vaccine safety relied heavily on the now disproven link between IBD and measles infection.

6 Responses to “Andrew Wakefield’s “do not re-vaccinate” letter”

  1. autiemum January 20, 2011 at 08:58 #

    heady stuff. It gives a sense of how powerful he felt. With hindsight his claims/delusions are extraordinary.

  2. sharon January 20, 2011 at 09:38 #

    F#$*ing sociopath.

  3. autiemum January 20, 2011 at 10:28 #

    Yes, quite. That’s another way of putting it.

    I find the double life fascinating. In one life you are crossing out question marks, altering research results (putting in measles findings when it is not there), fiddling timings etc. In another you are aggressively and self-righteously attacking people who query your “findings”.

    Totally weird. I can’t understand why anyone would bother.

  4. Aaron January 20, 2011 at 17:28 #

    The guy clearly has a firm belief in the lack of safety of MMR; which I don’t judge him for. He is entitled to his opinion. But he should have had enough sense to keep his mouth shut until he had enough proof to back his theories. I think it was naive of him to start “campaigning to save the children” before he had unequivocal evidence.

    Most people who support his arguments will now quote his “safety first” argument. But as a scientist, he should not have allowed his emotions to get in the way of his thinking; realizing that without the proper evidence, his campaign to stop MMR was in vain.

  5. autiemum January 20, 2011 at 17:51 #

    If someone has a strong, irrational point of view which is not susceptible to the evidence we call them mad, Aaron. You are right we do not judge them.

    You seem to feel that AW “firm belief in the lack of safety of MMR” is an irrational belief like fairies at the bottom of the garden. We mustn’t judge etc.

    But he was/is a doctor who fiddled the scientific evidence for money and conducted unethical experiments on children. Why can’t we judge (and condemn) him for this?

  6. sharon January 20, 2011 at 22:38 #

    Aaron I am not convinced that Wakefield does believe there is a link. I suspect more as time goes on that he is operating out of self interest. He benefits from fear mongering and the spread of misinformation. I find that incredibly offensive. That’s why I condemn him.

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