Brian Deer, the investigative journalist who first broke the story about the fraudulent research activities of Andrew Wakefield, was interviewed by CNN UK.
I am glad that CNN gave Mr. Deer the chance to take on the claim that Mr. Wakefield’s research has been replicated. It hasn’t (see our discussion here). Mr. Deer states that criminal charges should be brought against Mr. Wakefield and that his immigration status should be checked.
I’ll get the transcript up as soon as I can find it.
First of all, here’s the transcript of Handley on CNN, courtesy of Liz Ditz:
Parker: Now joining us from Portland, Oregon I J.B. Handley. JB is the father of an eight-year old with autism, and he is a founder of Generation Rescue, a group that believes that there is a connection between autism and vaccination. Welcome JB
JB Handley (JBH): Thanks for having me.
Parker: Thank you Did today’s report cause you to reconsider your position on vaccines at all?
JBH: No, not one bit.
Parker: So, explain that. Why doesn’t this affect the way you think?
JBH: You know the original Wakefield study looked at 12 children. All 12 had autism. The only conclusion of the study was that the 12 were suffering from a new form of bowel disease. Andy Wakefield also reported that 8 of the parents said that their children regressed after the MMR vaccine. So the notion that his study ever incriminated MMR as causing autism is false. and the vaccine industry continues to beat this dead horse.
Parker: so you think that um when you talk about regression you are saying not so much that uhm the vaccine causes autism but that it causes a regression? And what does that mean to you?
JBH: No. What you hear from many parents, and my son is one of these, is that the children are developing typically, and my son’s case up to 14 months he was normal, and then then they gave a regression, they start to lose skills, they start to lose milestones. I have personally talked to about a thousand parents who all report that their children where that regression took place immediately following a vaccine appointment.
It’s important for parents to understand that children are given 36 vaccines in the US by the time they are the age five. The MMR only accounts for two of those 36 vaccines. Typically the shots are given simultaneously so the average child will get six vaccines in a single appointment, yet we don’t have a single piece of research to understand the potential risk of all those vaccines at once. So when someone tries to tell me that MMR alone doesn’t cause autism, but I take my child in for a vaccine appointment, and they are getting six shots in 10 minutes, how am I supposed to feel reassured?
Spitzer: I say this with overwhelming sympathy for you and for your son, but just listening to you I’ve got to ask the question: there isn’t a single study, and we’ve looked at all the science, that says there’s any causal link between these vaccines and autism. And I know you are saying there is
JBH: But that’s not true
Spitzer: there isn’t a study that disproves it, but there’s no affirmative causal link there. And so don’t don’t you think it would make more sense to look at other potential potential causative factors?
JBH: What you are saying is simply false. There is a study out of SUNY Stonybrook within the last six months that compared a group of children who got the entire round of HepB vaccine, and a group of children who didn’t, and found autism was three times more likely in one group. There’s a new study out of the University of Pittsburgh that took primates and vaccinated a group of them and didn’t vaccinate the another and found dramatic differences between the two sides. So to represent that somehow the science has been done is simply false. More importantly the science that has been done is what we like to call “tobacco science”. You take a group of kids who all got vaccines but got a little less mercury and compare them to a group of kids who all got vaccines but a little more mercury and find there’s no difference in autism and then claim that vaccines don’t cause autism. The only appropriate study to do would be to look at a group of children who never got vaccines and a group of children who got all of them, and see if there’s a difference in autism rates and that study has never been done despite many people trying to call for it.
So to represent that the science has been done on this is simply untrue. The vaccine makers are highly effective at PR and which is why I am here talking to you.
Parker: Well JB you obviously feel passionately about this and we can certainly understand that. How do you feel specifically about, when you find out that this particular doctor was when Wakefield was actually deliberately fraudulent in advancing the claim that there was a connection?
JBH: What is interesting is that there are 12 children in the original study in the Lancet, OK? The parents of the 12 children have all written letters, time and again, in support of Andy Wakefield. The study’s conclusion was that the children were all suffering from bowel disease, and Andy went on to mention eight of the parents claimed that the regression took place after the MMR. So the notion that the data is somehow new, what’s new? They didn’t suffer from bowel disease, even though all the parents have represented that they did? People need to look at the details not at the headlines. This an attempt to whitewash, once and for all, the notion that vaccines cause autism. They are not just beating a dead horse, they are beating a horse that never existed in the first place. That’s not what Wakefield’s study said. It’s a seven page page study, it is on the Generation Rescue website. Anybody can read it for themselves and verify what I am saying is true.
Spitzer: JB, again with all sympathy, and as somebody who has been a harsh critic of
JBH: I don’t need any sympathy!
Spitzer: Well, OK but what I am trying to say is
JBH: [talking over] I don’t need any sympathy! I don’t need your sympathy What I need is the facts and for someone to look at the details.
Spitzer: Well what you yourself have said is that what you glean from your anecdotal conversations is hugely compelling to you but unfortunately in terms of the scientific data and the analysis that sort of anecdotal database simply doesn’t establish the causal link what we are looking for in terms of really understanding this and I think that what validates today
JBH: [talking over] Look at the Suny Stonybrook study, look at the university of Pittsburg study
Spitzer: [continuing over JB] this study that we examined today was fraudulent. And I think that’s really where we are.
JBH: [talking over] Look at the Suny Stonybrook study, look at the university of Pittsburg study. You haven’t done all your research. You are reaching false conclusions. Parents do your own work.
[pleasantries to close]
Now lets isolate Handley’s main talking points and decide if they are true or false:
1) You know the original Wakefield study looked at 12 children. All 12 had autism.
Not accurate. According to material from the British Medical Journal three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism.
2) Andy Wakefield also reported that 8 of the parents said that their children regressed after the MMR vaccine.
Not accurate. According to the same source five had documented pre-existing developmental concerns.
3) So the notion that his study ever incriminated MMR as causing autism is false.
Semi-accurate. Although the paper itself may not have mentioned it, the video conference Wakefield gave _about_ the study certainly did:
…you would not get consensus from all members of the group on this, but that is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR…
4) …we don’t have a single piece of research to understand the potential risk of all those vaccines at once.
Not accurate. Any vaccine in the US has to undergo something called a ‘concomitant use study’. These are to establish that vaccines work OK together. Searching Pubmed for the phrase ‘concomitant vaccine’ returns over 700 results.
5) There is a study out of SUNY Stonybrook within the last six months that compared a group of children who got the entire round of HepB vaccine, and a group of children who didn’t, and found autism was three times more likely in one group
Not accurate. This study is flawed on an number of levels. Firstly, they are comparing kids born as early as 1980 to kids born during “the epidemic”. Anything that happened past 1991 would be an autism risk. Secondly and very worryingly, they pick datasets that have children born before the introduction of the Hep B vaccine. Thirdly, this whole thing is essentially a survey. It’s based on parental recall.
6) There’s a new study out of the University of Pittsburgh that took primates and vaccinated a group of them and didn’t vaccinate the another and found dramatic differences between the two sides.
Not accurate. Again, lots of issues with this study. So many so in fact that Sullivan wrote a devastating takedown of the paper in July last year.
I think that’s all the statements of attempted fact from Handley. All in all it shows that Generation Rescue cannot be trusted to present the most pertinent or up to date information.
Brian Deer is the investigative reporter who broke the story of the research fraud that Andrew Wakefield conducted in his autism/MMR studies. Andrew Wakefield made some serious charges against Mr. Deer yesterday, claiming ” He is a hit man. He’s been brought in to take me down because they are very, very concerned about the adverse reactions to vaccines that are occurring to children. Who brought this man in, who is paying this man, I don’t know.”
Mr. Deer was interviewed on CNN today. Here is that segment:
here is the transcript
CHETRY: Yes. And so, this is certainly a bombshell of a story this morning. The study that linked the MMR vaccine to autism caused shock waves when he it was published back in 1988 in the medical journal “Lancet.” But by 2004, most of the paper’s co-authors had withdrawn their support. Then last February, “Lancet” retracted that report saying the research was, quote, “unethical.” Last summer, Dr. Wakefield was then barred from practicing medicine in Britain.
And Brian Deer is the investigative journalist who really blew the lid off of this story. And he joins us live from London this morning.
Brian, good morning.
BRIAN DEER, INVESTIGATIVE JOURNALIST, SUNDAY TIMES OF LONDON: Good morning.
CHETRY: One of the things I want to ask is: what is the — what was the most motivation then for Dr. Wakefield to falsely link autism to the MMR vaccine in that initial study?
DEER: Well, I believe that his motivation was essentially to make money. Initially to make money from litigation, he was retained as an expert in a lawsuit for which we know he was paid three quarters of a million U.S. dollars. But he also had all kinds of business interests which he thought would make considerably more money through promoting the scare and promoting public anxiety through over the MMR vaccine.
CHETRY: And then the question seems to be: why would there be all of these other co-authors? And why would it make its way into a prestigious journal like “Lancet” and really shape the discussion and the fears about autism linked to vaccine?
DEER: Well, that’s one of the great weaknesses of medicine and medical publishing, is that people can publish things that are false. People talk about peer review and such like. And they imagine they’re some kind of safety system. But, in fact, the whole system works on trust. His co-authors didn’t know which child was which in the study that he published.
And so, it is actually possible for determined cheat to get away with the kind of behavior that Dr. Wakefield has been involved in.
CHETRY: Well, Dr. Wakefield is still continuing to stand by his study and his findings. Anderson Cooper actually talked to him last night. He went after you. He accused you of being part of a conspiracy to discredit him.
Let’s just listen to a bit of what he said. Also, he claimed that you were getting paid to do this — to do this investigation. Let’s listen.
(BEGIN VIDEO CLIP, CNN’S ANDERSON COOPER 360) DR. ANDREW WAKEFIELD, ACCUSED OF FAKING AUTISM RESEARCH: I have read his multiple allegations on many occasions. He is a hit man. He’s been brought in to take me down because they are very, very concerned about the adverse reactions to vaccines that are occurring to children. Who brought this man in, who is paying this man, I don’t know.
(END VIDEO CLIP)
CHETRY: Did you have a financial interest in doing this investigation, Brian?
DEER: I’ve been an investigative journalist working for “The Sunday Times of London” since the early 1980s.
The point you have to remember about this whole issue is, firstly, that it’s not me saying this. It’s the editors of the “BMJ,” a very prestigious medical journal who peer reviewed and checked of the facts which we put forward in our investigation this week. So, it’s not me saying it. It’s the editors of that journal who are behind this.
But secondly, this material has been published in the United Kingdom in extraordinary detail. If it is true that Andrew Wakefield is not guilty as charged, he has the remedy of bringing a liable action against myself, against “The Sunday Times of London,” against the “British Medical Journal,” against television networks here — and he would be the richest man in America.
(CROSSTALK)
CHETRY: But he’s alleging that you were being paid to do this article. I mean, you were paid, right, because you were a journalist?
DEER: I was commissioned by the “British Medical Journal” to write the piece, yes. That’s what the journalists do.
CHETRY: What about “The Sunday Times of London” and Channel 4 in Britain?
DEER: I work for them. Right. Yes, of course, they pay, I’m a journalist. I was hired to do a job, like you are.
CHETRY: Right.
DEER: You are being paid to your job and I’m being paid to do my job.
CHETRY: Thank goodness.
The bottom line, though, is he’s questioning your motivations for going after him? Clearly, what are your motivations for going after Dr. Wakefield and his study?
DEER: It was simply a journalist assignment given to me late in 2003. A simple journalistic assignment which I expected would last a week or two weeks. And it just completely opened up when Dr. Wakefield began what we know has established a campaign of lies. When you’re a journalist and you see somebody you’re dealing is lying to you, then you pursue it. He then sued me. He was then required to may my costs. So, I received a check on his behalf, the previous false lawsuit that he began.
And now, what he’s trying to do, cloud the picture by — in the same way as he used to cloud the picture by saying some doctors say the vaccine is safe. Some doctors say it isn’t safe.
Now, what he’s trying to do is to say, well, some people say that he’s a liar and he says that I’m a liar.
CHETRY: Right.
DEER: So, what he’s trying to basically do is to split the difference. On that basis, he can work a nice living which he’s got going. You should see him in Jamaica this weekend, which he’s having a marvelous sometime on the expense of parents of autistic children.
CHETRY: Well, I want to ask you about that. What has been the impact of this safety on calling into question the safety worldwide of certain vaccines?
DEER: Oh, it’s been absolutely devastating because he and a little clique of lawyers and activists around, anti-vaccine activists around him, have been able to spread anxiety, to export it from the United Kingdom, bring it across the Atlantic, the United States, with the result, we’re now seeing parents anxious about vaccination. We’ve seen just the worst outbreak of whooping cough in California since the 1950s.
CHETRY: Are we going to understand autism and what causes it, though? Because we have seen this rise, 50 percent from 2002 to 2006 in children identified with autism spectrum disorder? I mean, why is it increasing like this?
DEER: Well, I’m a journalist, I’m not a doctor. And I don’t give medical advice. I can say from what I understand talking to doctors and scientists is that the (INAUDIBLE) conditions which cause autism, autisms, neurological problems in children, are very complex issues. And science just doesn’t have the answer.
So when someone like Dr. Wakefield comes along that gives a simple answer that blames other people, blames drug companies, now blames me, it’s all my fault, a very small number of parents become misled by that and cling to this. Because their choice is basically blame somebody else or suffer the possibility that they’re left with the guilt of thinking it was their fault that they vaccinated their child. So, it’s a very vulnerable group that Dr. Wakefield preys on.
CHETRY: Well, your reporting certainly is getting attention this morning. All of it is going to be out there along with the editorial as well. We look forward to seeing all of this.
Brian Deer, thanks for joining us this morning.
DEER: Thank you.
Seth Mnookin is the author of the upcoming (next week) book “The Panic Virus“. As someone who spent 2 years researching the issue of the vaccine/autism hypothesis, he was chosen to respond to Andrew Wakefield on CNN.
They note this in the story, but I will point it out again here: Andrew Wakefield would not appear together with Mr. Mnookin. This isn’t new. Last year the program “The Doctors” had a program with Jenny McCarthy, J.B. Handley, Dr. Jerry Kartzinel and others–where they only agreed to go on air if the there were no people with opposing views present.
Mr. Mnookin points out that Mr. Wakefield tried to frame the story as a single reporter (Brian Deer) “out to get him”.
He has framed this consistently as this one renegade journalist who’s out to get him. In fact, there was a British — the Medical Research Council, which licenses doctors in the U.K., spent two-and-a- half years looking into his work. It was the longest investigation they had ever done.
On the subject of Mr. Wakefield’s scientific credibility:
GUPTA: No, I think that — I think this is a pretty big deal, what’s happened today.
But, you know, he didn’t — he hasn’t had really credibility within the scientific world for some time. I mean, as you pointed out, he’s been stripped of his medical license. The paper has been retracted. His co-authors all essentially left the paper.
The problem is that Mr. Wakefield’s audience is not the scientific community. The damage he does is not within or to the science community. The damage is to public health and to the autism communities. I am hopeful that this paper in the BMJ will reduce what credibility Mr. Wakefield still has and the damage he is causing.
Mr. Mnookin has a blog post of his own on the BMJ article and editorial: The problems with the BMJ’s Wakefield-fraud story
Here is the transcript:
COOPER: Also joining us right now is Seth Mnookin, author of “Panic Virus.”
Andrew Wakefield would not go on the program with you.
SETH MNOOKIN, AUTHOR, “THE PANIC VIRUS: A TRUE STORY OF MEDICINE, SCIENCE, AND FEAR”: Right.
COOPER: He would only go on if Sanjay and I were — were asking the questions.
What do you make of what he said?
MNOOKIN: I find it — I find it upsetting and — and disturbing.
He has framed this consistently as this one renegade journalist who’s out to get him. In fact, there was a British — the Medical Research Council, which licenses doctors in the U.K., spent two-and-a- half years looking into his work. It was the longest investigation they had ever done.
And that was the group that stripped him of his right to practice medicine and — and said that he had displayed a callous disregard for children.
There have been dozens of studies.
COOPER: They said a callous disregard for children?
MNOOKIN: Callous disregard for children.
COOPER: That’s why — and that’s — in stripping him of his — of his license?
MNOOKIN: Well, the — the — there were several reasons they listed. The callous disregard had to do with performing unnecessary tests on children who had been brought to him to support this point, including spinal taps, invasive examinations, colonoscopies on very, very young children.
They also found that there was — his evidence couldn’t be backed up. His — his data couldn’t be backed up. So, for it to be portrayed by — by — by Andy Wakefield as this being one person out to get him, you know, I think what he’s banking on is that people won’t actually look and see — look and see what the reality of the situation is.
(CROSSTALK)
COOPER: When you read this report by — by Deer…
MNOOKIN: Right.
COOPER: And I don’t know this guy Deer at all, but, I mean, I have read his entire report. It’s — it’s — it’s pretty exhaustive.
MNOOKIN: Not only is it exhaustive, but, if you took out everything that Brian Deer had ever written, there would be exhaustive evidence that — that this was not trustworthy.
Dozens of researchers in dozens of countries have studied literally millions of children around the world. And this notion that there’s some sort of conspiracy between public health officials, doctors, journalists, drug companies, researchers around the world, you know, it — it would be the most brilliant conspiracy that had ever been hatched.
And — and — and Andrew Wakefield’s setting himself up as this one renegade or this band of renegades, you know, sort of fighting against this is — is, I think, laughable.
COOPER: Sanjay, does he have any credibility?
GUPTA: No, I think that — I think this is a pretty big deal, what’s happened today.
But, you know, he didn’t — he hasn’t had really credibility within the scientific world for some time. I mean, as you pointed out, he’s been stripped of his medical license. The paper has been retracted. His co-authors all essentially left the paper.
COOPER: But, you know, let me just say one thing. Because there — there is so much distrust of big pharmaceutical companies, there are going to be a lot of people watching this who say…
GUPTA: Well, that…
COOPER: … you know, we’re all in the pockets of big pharma, or, you know, that — that there is this conspiracy.
GUPTA: That’s what I was going to say. I don’t know that it’s going to change people who are still going to be very concerned about vaccines.
And the reality is that, if we had a great answer as to what causes autism, I think that would — that would change this debate altogether. But we don’t. So, you — it’s trying to prove a negative, obviously, an impossible thing to do.
But, in his case, I — I don’t think that it — while as big a deal as this is in science today, I don’t know how much this changes the debate overall, because his — his — his science has been discredited in the scientific community for some time.
COOPER: But — but, I mean, it’s understandable. Look, parents — look, we don’t know about — a lot about autism, and — and the numbers are growing. And that is — is of concern. And it’s understandable parents would latch on to anything.
But — but in terms of just facts, and we do — you know, I believe in facts a lot on this program — I mean, Seth, are there peer-reviewed scientific reports that — that indicate a link between…
MNOOKIN: No.
COOPER: … between vaccines and — and autism?
MNOOKIN: No. And not only is there not peer-reviewed work, this is probably the most studied public health issue involving children over the last 20 years.
COOPER: Would public health officials have an interest in — in hiding a link, if there was?
MNOOKIN: Public health officials, I think, would have an interest in keeping children safe.
Even if there — if there was a link and it was discovered, I think public health officials would — would have an interest in doing whatever they could to protect children. This notion that everyone’s trying to — to — to cover their butts and — because they have already been — been perpetrating this scam, is — to distrust the motives of that many people around the world, you know, you would need to assume that — that everything going on is in some ways out to get you.
I think Sanjay’s point about our not knowing what causes autism is really in some ways the crucial one, because it’s so frightening to parents. The numbers are rising. And here’s something that you can point to. And because it occurs at the same time, you always get vaccinated when you’re a child, and autism is diagnosed when you’re a child, so it’s easy to understand why patients would latch on to that as a connection.
But it has no more validity than — than if I said microwave popcorn causes autism. The numbers have gone up since we have started eating microwave popcorn. There’s just — there’s absolutely no evidence supporting a link.
COOPER: Do — do you agree with that?
GUPTA: Yes. I mean, and I think…
(CROSSTALK)
COOPER: And, as a parent, what do you tell other parents?
GUPTA: Well, I — I have three children. I got my kids vaccinated on schedule, on time. So, you know, I mean, that’s — I think the proof’s in the pudding in my case, because I had to make that decision.
But I think, also, you know, that I — you could get a sense of where the debate goes from here. Wakefield’s paper may be discredited, but we still don’t know. We give more vaccines now. We give them in different schedules. Could there be something new that’s possibly causing this uptick in autism?
And — and — and I think the question is going to remain out there, despite what’s happened today. You know, the smallpox vaccine, when it was given, it causes an immune response to the body. It was a — a really profound immune response, more powerful than all the vaccines that we give today, and yet the autism rates are higher now.
So, if it’s the vaccine itself, why wasn’t it happening when we gave these really, really powerful vaccines so many years ago?
COOPER: And, Seth, the report that is out today by this journalist Deer, it indicates that he had a financial — that Wakefield had a financial motive.
MNOOKIN: Right.
COOPER: What was the financial motive?
(CROSSTALK)
MNOOKIN: Well, there were a couple of things.
One, he had filed a patent application for an alternate measles vaccine several months before the paper came out, which he did not disclose at the time. It was precisely the vaccine that you would have wanted if you stopped using the three-in-one MMR vaccine. It was just for measles.
So, that’s one very obvious thing. He also was — his work was being funded by a law firm that was involved in potential vaccine litigation. And a number of the children in this study were also involved with that law firm.
So, the — for — for him to say, you know, “I had no financial connection, and, to prove it, you should read my book,” you know, it — it’s — it’s sort of like saying, no, no, I swear I’m a good guy, and, to prove it, listen to me.
It — you know, it just doesn’t hold up.
COOPER: I read — I read in “Newsweek” this week in an article you wrote about kids who have died because they haven’t been vaccinated…
MNOOKIN: Yes.
COOPER: … died — died from things that they shouldn’t have died of. MNOOKIN: Yes.
COOPER: Whooping cough.
MNOOKIN: In 2010 alone, 10 infants died of whooping cough in California, which is astounding that that is happening today.
There are children that have died of Hib, diseases that I have always assumed were definitely in the past in this country. There was a measles epidemic several years ago in California, in San Diego, that cost $10 million to contain, and resulted in a quarantine of dozens of children.
That meant that those parents then had to find some way to take care of those kids, either not go to work or pay for day care. So, even when you have a case like with that measles epidemic, where it’s true that children didn’t die, you had one infant that was hospitalized for a serious amount of time, and dozens of families that had to pay an enormous amount of money because of this.
COOPER: This is maybe an unfair and an impossible question to answer, is, do you believe Wakefield believes what he’s saying?
MNOOKIN: I talked to him several times over the past several years. Mostly in the context of these conferences that he was referring to where he’s surrounded by people who adulate him.
I think that it’s certainly possible that, at this point, he’s been living in this for so long that he thinks it’s true. I have talked to other people involved in that community who have told me candidly that they wish the conversation could move on from that, because they understood that the science is not…
COOPER: Has the media played a role in perpetuating this? Because you see in a lot of TV shows, you know, on this subject, several sides represented. You have the people who believe the vaccines cause autism and the people who don’t. And it seems to give equal credence, you know.
Or you have a famous person, you know, like Jenny McCarthy, and nothing against her personally, but you know, who is going to get a lot of attention. Has that made the problem worse? Has that given the — this side more credence?
MNOOKIN: I think absolutely. And an example I use is there are people who believe the earth is flat. Most people obviously do not, but if you had one person who believed the earth is flat and one person who said, “No, it’s actually round,” and they were discussing the issue together, it would seem that the consensus was split 50/50.
So here you have a situation in which you have millions of doctors, public health officials, all coming down on one side, and then Andrew Wakefield and a very small number of people who are associated with him, a miniscule number of people, saying, “No, this is what’s actually going on.” But because we can’t present millions of points of view or millions of people, it ends up sounding — there’s this false equivalency. It ends up sounding on the one hand, on the other hand, when there really is only one hand in this case.
COOPER: Do you agree with that, there is only one hand in this?
GUPTA: Yes, and I mean, the one thing I would say with the earth, flat earth, round thing, is we know the answer to that now.
One of the things that again has made this discussion so difficult is that, at the end of the discussion, no matter how much you disagree with the other person, if they come back to you and say, “So what does cause it?” We still don’t have that great answer. It could be some environmental unknown with a genetic predisposition. Who knows? But that, in part, has made this difficult.
Also, you know, just as a parent, I can tell you, it’s so deeply personal. And that also, despite what’s happened today, I think many parents who are dealing with this right now are still believing this, despite all the evidence to the contrary.
COOPER: It’s a fascinating topic. I appreciate both you guys being here with your expertise. Thank you. Dr. Sanjay Gupta, Seth Mnookin.
Of the groups pushing the vaccines-caused-an-epidemic-of-autism idea, the National Autism Association stands out. In a good way. They are the one group that actually has a non-vaccine segment to their agenda. They presented recently at the IACC on issues of safety. Unfortunately, they are stuck in the vaccine-causation debates of 10 years ago. Case in point: coincident with the lifting of the embargo on the BMJ’s pieces on Andrew Wakefield (e.g. How the case against the MMR vaccine was fixed) the NAA put out a statement defending Mr. Wakefield. (National Autism Association Says BMJ Article is Yet Another Attempt to Thwart Vaccine Safety Research)
As a part of this defense, they claim that Mr. Wakefield’s research has been replicated. The claim has been made before and upon scrutiny shown to be false. They use 5 references:
(1) Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic Spectrum Disorder and Chronic Gastrointestinal Symptoms, Arthur Krigsman, MD, et al, New York University School of Medicine, Autism Insights, 27 Jan 2010
(2) Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms. Gonzalez L, et al. ArchVenez Pueric Pediatr, 2005;69:19-25.
(3) Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsulenteroscopy: Another piece in the jig-saw of the gut-brain syndrome? Balzola F, et al. American Journal of Gastroenterology. 2005. 100(4):979-981.
(4) Childhood autism and eosinophilic colitis. Chen B, Girgis S, El-Matary W.. Digestion. 2010;81:127-9. Epub 2010 Jan 9].
(5) Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report, Timothy Buie, MD, et al, Department of Pediatrics, Harvard Medical School Pediatrics, Vol. 125 Supplement January 2010
Taking a lead from Catherina at JustTheVax, who showed last year that the “replication” of Mr. Wakefield’s results was not independent nor a replication, I will take a look at the 4 papers which are purported to “confirm” and association between autism and bowel disease.
1) A paper by Arthur Krigsman in Autism Insights. Arthur Krigsman was one of Andrew Wakefield’s partners at Thoughtful House when he wrote this. Both have since left. Autism Insights is an online journal whose editors include Dr. Krigsman himself. At the time Dr. Krigsman’s paper was published, the editorial board also included Andrew Wakefield. (strangely, Mr. Wakefield is no longer listed on the editorial board). Hardly independent. Right now, Autism Insights has 18 editors. They also have 8 published papers. Yes, they have twice the number of editors as papers. One has to question if this is a real journal. The Krigsman paper was timed to come out to support Andrew Wakefield at a time when his press was quite poor. Not a replication.
2) Gonzalez, et al.. From JustTheVax:
Gonzales et al, number 2, has been published in “Arch Venez Pueric Pediatr” which stands for Archivos Venezolanos de Puericultura y Pediatría. It was a bit tricky to get my hands on the paper, especially since the citation was not quite right, but I did manage and was not surprised to find that indeed the authors cannot replicate Wakefield’s 1998 “findings” of a distinct autistic enterocolitis, although they do report a higher incidence of gastrointestinal problems in their autistic group.
3) Balzola, et al.. Again, from Catherina:
Balzola et al, number 3, is a case report of one adult autistic patient with inflammed bowel.
4) Chen, et al.. Here’s the abstract, which spells out a rare association in 2 children, with possible mechanisms that may connect the two.
BACKGROUND/AIMS: The significance of the association between many gastrointestinal pathologies and autism is yet to be discovered. The aim of this report is to highlight an association between autism and microscopic eosinophilic colitis in 2 children. The possible mechanisms that may connect these two conditions are discussed.
METHODS AND RESULTS: A rare association between autism and microscopic eosinophilic colitis in 2 children is reported through retrospective chart review. Common causes of secondary eosinophilic colitis were excluded.
CONCLUSION: This report suggests the possibility of either impaired intestinal barrier function or an aberrant immune system that predisposes autistic children to sensitization to environmental antigens. Large controlled studies are needed to examine this hypothesis.
5) Bui, et al.. Here is the paragraph in that paper discussing Mr. Wakefield’s work:
In 1998, Wakefield et al. reported an association between ileocolitis and developmental regression in 12 children and coined the term “autistic enterocolitis.” From the same uncontrolled study they reported NLH of the ileum and colon as an abnormal finding in most children with ASDs. However, similar findings are known to be present in children with typical development, as well as children with food allergies and immunodeficiencies. The significance of these findings, therefore, is unclear. Wakefield et al. also proposed a causal relation between measles, mumps, and rubella (MMR) vaccination and autism, a suggestion that was later retracted by many of the original authors.
None of these papers is a replication of Mr. Wakefield’s work. And this is the best that the NAA can do to support Mr. Wakefield’s work, given 12 years of research since his paper in the Lancet. It also avoids the very clear problem with trying to “replicate” or “confirm” work that was fraudulent to begin with.
What is even more strange is that the NAA goes on in their piece to discuss the hypothesized link between autism and vaccines. Strange because Mr. Wakefield has been strenuously distancing himself from the impression that his paper “proved” a link between autism and vaccines.
Mr. Wakefield’s work was fraudulent. The BMJ says so in clearly and conclusively. It is time for some autism parent organizations to distance themselves from this man and his work. They are doing themselves and the autism communities as a whole any good by further association with him.
In a recent post here on LeftBrainRightBrain we discussed the first in a series of articles by investigative journalist Brian Deer in the BMJ. There is also an editorial by the BMJ, “Wakefield’s article linking MMR vaccine and autism was fraudulent“. The Lancet’s retraction of the Wakefield paper was fairly mild, citing only that the patients were not consecutively referred and the study did not have ethical approval. The BMJ’s statement is much more clear, and with a reason. From the editorial:
The Lancet paper has of course been retracted, but for far narrower misconduct than is now apparent. The retraction statement cites the GMC’s findings that the patients were not consecutively referred and the study did not have ethical approval, leaving the door open for those who want to continue to believe that the science, flawed though it always was, still stands. We hope that declaring the paper a fraud will close that door for good.
Perhaps wishful thinking on their part, as there will always be people who believe Mr. Wakefield.
The BMJ goes further. They are calling for a review of other papers by Mr. Wakefield with the question of whether more retractions are warranted.
What of Wakefield’s other publications? In light of this new information their veracity must be questioned. Past experience tells us that research misconduct is rarely isolated behaviour. Over the years, the BMJ and its sister journals Gut and Archives of Disease in Childhood have published a number of articles, including letters and abstracts, by Wakefield and colleagues. We have written to the vice provost of UCL, John Tooke, who now has responsibility for Wakefield’s former institution, to ask for an investigation into all of his work to decide whether any more papers should be retracted.
This parent of an autistic child welcomes this move by the BMJ. I am grateful to the editors for their action.
Here is the press release for the series in the BMJ on Andrew Wakefield.
Today, the BMJ declares the 1998 Lancet paper that implied a link between the MMR vaccine and autism “an elaborate fraud.”
Dr Fiona Godlee, BMJ Editor in Chief says “the MMR scare was based not on bad science but on a deliberate fraud” and that such “clear evidence of falsification of data should now close the door on this damaging vaccine scare.”
She is struck by a comparison between researcher Andrew Wakefield’s fraud and Piltdown man, that great paleontological hoax that led people to believe for 40 years that the missing link between man and ape had been found.
She also questions the veracity of Wakefield’s other publications and calls for an investigation “to decide whether any others should be retracted.”
A series of three articles starting this week reveal the true extent of the scam behind the scare. The series is based on interviews, documents and data, collected during seven years of inquiries by award-winning investigative journalist Brian Deer.
Thanks to the recent publication of the General Medical Council’s six million word transcript, the BMJ was able to peer-review and check Deer’s findings and confirm extensive falsification in the Lancet paper.
In an editorial, Dr Godlee, together with deputy BMJ editor Jane Smith, and leading paediatrician and associate BMJ editor Harvey Marcovitch, conclude that there is “no doubt” that it was Wakefield who perpetrated this fraud. They say: “A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.”
Yet he has repeatedly denied doing anything wrong at all, they add. “Instead, although now disgraced and stripped of his clinical and academic credentials, he continues to push his views. Meanwhile the damage to public health continues.”
“Science is based on trust,” concludes Dr Godlee. “Such a breach of trust is deeply shocking. And even though almost certainly rare on this scale, it raises important questions about how this could happen, what could have been done to uncover it earlier, what further inquiry is now needed, and what can be done to prevent something like this happening again.”
The BMJ will explore these and other questions over the next two weeks.
Brian Deer, the investigative journalist who broke the story of the misdeeds of Andrew Wakefield, has a new article in the BMJ, How the case against the MMR vaccine was fixed. The article is prefaced:
In the first part of a special BMJ series, Brian Deer exposes the bogus data behind claims that launched a worldwide scare over the measles, mumps, and rubella vaccine, and reveals how the appearance of a link with autism was manufactured at a London medical school
This article is damning enough, but as a series this may lay out clearly, in one place, the cases behind the multiple ethical breaches which cost Andrew Wakefield his license to practice medicine in the UK.
Some may ask “why?” There is so much information out there about Mr. Wakefield and his misdeeds. Do we really need it again? I would say yes. In this BMJ series we have the research (and other) ethical lapses laid out in a medical journal. No lengthy GMC transcripts. No news stories with false balance. No “Callous Disregard” book.
The full article is worth the read. Here is the summary from today’s article.
How the link was fixed
The Lancet paper was a case series of 12 child patients; it reported a proposed “new syndrome” of enterocolitis and regressive autism and associated this with MMR as an “apparent precipitating event.” But in fact:
• Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism
• Despite the paper claiming that all 12 children were “previously normal,” five had documented pre-existing developmental concerns
• Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination
• In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school “research review” to “non-specific colitis”
• The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations—all giving times to onset of problems in months—helped to create the appearance of a 14 day temporal link
• Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation
In multiple ways, the story of the Lancet article was crafted to support the conclusion Mr. Wakefield had–a conclusion he came to before starting on the research project.
Yes, before.
In his research proposal to the legal aid board, Mr. Wakefield made the following statement (quoted in Mr. Deer’s article):
““In contrast with the IBD cases [those set out in paragraph 2] which have a prima facie gastrointestinal pathology, children with enteritis/disintegrative disorder form part of a new syndrome. Nonetheless, the evidence is undeniably in favour of a specific vaccine induced pathology. ”
Mr. Deer presents a table comparing how the Lancet article reported the 12 children and how the records really show their cases. He compares regressive autism (only 1 patient’s records clearly show it), non-specific colitis (only 3 children showed it) and whether symptoms occured in the days following MMR (10 clearly did not, 2 are unclear). In all, none of the Lancet 12 children had all three features.
So that is the Lancet 12: the foundation of the vaccine scare. No case was free of misreporting or alteration. Taken together, NHS records cannot be reconciled with what was published, to such devastating effect, in the journal.
Mr. Deer opens his piece with a discussion he had with the father of child 11. Mr. 11 did not agree with the way his son was represented in the Lancet article. Mr. 11 states:
“Please let me know if Andrew W has his doctor’s license revoked,” wrote Mr 11, who is convinced that many vaccines and environmental pollutants may be responsible for childhood brain disorders. “His misrepresentation of my son in his research paper is inexcusable. His motives for this I may never know.”
We may never know the motives. In the end, I don’t care. It is the damage that this fraudulent research has caused to the autism communities and to public health that matter. Countless families have believed Mr. Wakefield, with parents blaming themselves for causing their child’s disability. As to public health, Mr. Wakefield is responsible for a drop in vaccine uptake in the UK, which led to disease and death.
Further reading on the subject can be found at Action For Autism with Wakefield and the MMR Autism Hoax
Over at Age of Autism today, financial whizz Mark Blaxill subjected Paul Offit’s finances to his usual searing intellect. I can’t quote from his post because its just to smart for me to understand!
Anyway, his conclusion has drawn the following response from Paul Offit in an email:
Just for the record: I no longer financially benefit from the sales of RotaTeq. My financial interests in that vaccine have been sold out by either The Wistar Institute, The Children’s Hospital of Philadelphia, or me. I will, however, continue to stand up for the science of vaccines because unfounded fears about vaccines have hurt children. That is why I do what I do and why I have always done it. And I will continue to closely follow the distribution of rotavirus vaccines because these vaccines have the potential to save as many as 2,000 children a day, which is why I joined the research team at Children’s Hospital.
Seems pretty clear to me 🙂
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