One of the 12 children on a doctor visit not long after the BMJ articles were published in January.
By Dan Olmsted
The British Medical Journal began its attack on Dr. Andrew Wakefield last January by telling the story of Child 11, one of the case histories Wakefield allegedly altered to manufacture "the appearance of a link" between the MMR shot and autism.
Contrary to Wakefield's claims, Child 11’s autism symptoms began before he got the shot, author Brian Deer wrote. The father, he said, was outraged by Wakefield’s "fraud.” Even the child’s autism diagnosis was questionable, Deer wrote, because it was solely based on parental “recall.”
As we’ve shown in earlier articles, the BMJ was dead wrong on both counts – the shot did come before the symptoms, and the autistic regression that followed was all too real. Both facts were described and documented multiple times by outside doctors before the family got anywhere near Wakefield or the Royal Free Hospital in London, where he worked. They do not provide any basis to allege fraud or question Wakefield’s version of the child’s medical history.
There are three more critical facts about Child 11 – facts that contradict this “fraud” scenario -- that the BMJ suppressed:
The father did believe the MMR shot caused his son’s regression.
The child was treated accordingly.
And, according to the father, the child recovered.
“Our dedicated effort to save our son's life has been fruitful,” the father wrote Wakefield on January 7, 1997, when he first sought to have him evaluated at the Royal Free. “As a small child unable to communicate, he has now entered a normal kindergarten class with assistance of a tutor. He is quite intelligent and continues to progress, but is still fighting the [bowel] disease which we believe is viral, from the vaccine.”
Yes, from the vaccine. After the father saw how he had been portrayed in the BMJ, he said: "Mr. Deer’s article makes me appear irrational for continuing to believe that the MMR caused difficulties which predated its administration."
And how, exactly, did the child recover from what the father believed was a vaccine injury? The letter reports: “In March of 1994, we met with Dr. [name omitted] and his immunological panel of tests indicated an underlying immunodeficiency as you can see by his report. His suspicions of the MMR vaccine in my son's case are mentioned in his letter. He was immediately put on 400 mg/kg of IVIG every four weeks at [clinic name omitted], and he responded quite well to the treatment.”
IVIG is intravenous immunoglobulin, administered to boost antibody levels in immune deficient patients and, at high doses, to regulate autoimmune conditions.
The father took his son to another leading immunologist, who reported that his measles virus titer was above measurable limits. Workups by a third doctor revealed his son “was suffering from indeterminant inflammatory bowel disease.”
This was the apparent new syndrome the Royal Free doctors were treating and that Wakefield was investigating – indeterminate or non-specific inflammatory bowel disease and autistic regression, in most instances associated in time by parents or doctors with the MMR shot. The father learned of the work at the Royal Free from his American doctors and was the first to fly his child across the Atlantic because he believed his son was showing the same pattern. The first case series, on 12 such children including Child 11, was published in The Lancet in 1998.
But this clear sequence – vaccination, illness, regression, chronic bowel inflammation, treatment, recovery – is nowhere to be found in the BMJ account of Child 11, even though Deer met with the father twice, in California and London, and also communicated with him via e-mail.
Absent, too, is the fact that Child 11 is now in college in California after graduating from high school with a 3.75 academic average.
The treatment the father cited, and the rationale for it, has been described in detail by the U.S. doctor who administered it. “A number of immunological abnormalities have been observed in patients with autism,” according to the text of comments he subsequently made at a meeting of an autism group. He said all the children he treated, which included child 11, had regressed after the MMR shot.
“Natural killer cells … that appear to play an important role in defense against virus infected cells and tumor cells are decreased both in numbers and functions in patients with autism. This deficiency may play a role in increased susceptibility to various infections that may in turn play a role in the pathogenesis of autism.”
He goes on to describe the use of IVIG in this context, at the 400 mg/kg dose the father cited. “IVIG has been used in a number of primiary immunodeficiency syndromes, and autoimmune and immunoinflammatory disorders including demyelinating polyneuropathy, multiple sclerosis, Guillain-Barre syndrome."
In his autistic patients, "The results of IVIG treatment show that a noticeable improvement, although to a variable degree, was observed in reciprocal social interaction, verbal and non-verbal communication, and repertoire of activity and interest in all children. One of these patients has been 'completely cured' and is attending regular school."
Deer had every opportunity to gather and report these crucial facts yet chose not to. Why? This more complete narrative would have contradicted his claims of fraud in the BMJ. You simply can’t have a child being treated for a presumed vaccine injury, and according to the father, recovering, if you’re trying to make the case that the shot came after the onset of regressive autism, that the sequence was manipulated by Wakefield, and that the father is outraged about the deception.
Instead, Deer spun a story using only fragments of the truth and, exploiting a typographical error in a discharge document, claimed that Wakefield faked the data on autistic regression and bowel disease.
Amazingly, multiplied by 12, such sleight-of-hand lies behind the entirety of the BMJ’s fraud claim. Speaking at the U.S. National Institutes of Health, BMJ Editor Fiona Godlee cited “multiple discrepancies” by Wakefield in the description of "inflammatory bowel problems, regressive autism, and the parental claim that MMR was the underlying cause. What these articles [in the BMJ] also say [is] that when those three things didn't come up trumps on the twelve children included, and the subsequent series of children, Andrew Wakefield altered the data to make those three things emerge."
Actually, in its treatment of Case 11, it was the BMJ that “altered the data to make those three things” disappear.