Dr. Wakefield, MMR & the GMC Hearing – Calling the British Media’s Bluff
By John Stone
With the General Medical Council hearing against Drs Wakefield, Walker-Smith and Murch due to announce its preliminary findings in less than a week there is little doubt that the UK media will play the line that whatever happens the science is over – yet they have every reason to believe that this is not true and continue to blank the specific criticisms with ad hominems against supporters of Andrew Wakefield. They have had it demonstrated:
1) The persistence of measles of virus in the gut (the most controversial part of Wakefield’s hypothesis) is an established reality
2) The epidemiological evidence base for the safety of MMR vaccine (and particularly in relation to autism) is non-existent
3) Autism incidence has spun out of control despite denials
Until they answer the criticisms their journalism will remain vacuous opinionising: no better than propaganda. Above all, they can scarcely counter that they are unaware of the problems, because I for one have assiduously placed them back under their noses, year after year – notably with such opinion leaders as Jeremy Laurance, medical editor of the Independent, and Ben Goldacre, author of the Guardian’s Bad Science column.
In the case of Laurance (although Goldacre is deeply implicated to) I placed a challenge for him in BMJ Rapid Responses recently (BMJ HERE), and then when he did not reply, placed the link in an editorial he wrote in his own newspaper (Independent HERE ).
Laurance set the scene with his comment on the MMR affair in his review of the decade in British Medical Journal:
No vaccine in recent history has provoked so much anger, fear, and ill informed speculation. It started in 1998 with the publication of the now infamous Lancet paper linking MMR vaccine with bowel disease and autism. Vaccination rates with MMR stood at 91% in 1997-8 but had slipped to 80% in 2003-4 and as low as 60% in parts of London. Although the rates have since recovered to 85%, hundreds of thousands of children remain unprotected from the diseases and cases of measles have soared.
One of the greatest puzzles of the saga is what has sustained this level of mistrust in the medical authority. Unlike most scientific controversies, which flare up and die away, this one has simmered for a decade. And it looks set to be fired up again by the conclusion of the General Medical Council case against the chief author of the Lancet paper, Andrew Wakefield, which is expected to conclude early in 2010.
To which I responded:
Laurance [1] writes:
"One of the greatest puzzles of the saga is what has sustained this level of mistrust in the medical authority."
It may seem like this to a newspaper journalist, not paying enough attention to the small print, but it does not seem like this to many autism parents. One of the features of this episode is the reverse spin given to studies which actually support further concern.
For instance, a widely reported study by Hornig et al 'Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study' actually immeasurably enhanced the plausibility of the Wakefield hypothesis by showing the persistance of measles virus in the ileum of two patients (one autistic, one control, but both with bowel disease and having had MMR) confirmed in 3 laboratories. To cap it all in the discussion the authors stated:
"Our results differ with reports noting MV RNA in ileal biopsies of 75% of ASD vs. 6% of control children... Discrepancies are unlikely to represent differences in experimental technique because similar primer and probe sequences, cycling conditions and instruments were employed in this and earlier reports; furthermore, one of the three laboratories participating in this study performed the assays described in earlier reports. Other factors to consider include differences in patient age, sex, origin (Europe vs. North America), GI disease, recency of MMR vaccine administration at time of biopsy, and methods for confirming neuropsychiatric status in cases and controls." thus, quietly endorsing the results of the Uhlmann (O'Leary/Wakefield) study [2,3]. These anomalies were not picked up or reported by mainstream journalists.
Another key case is the Cochrane review of MMR 2005 [4], which actually gave a poor review to the six autism studies included, and found little evidence for the vaccines safety - indeed, had found the safety studies to be "largely inadequate" - against which the claim that it had not found any evidence that MMR causes autism and bowel disease has to be assesed for its relevance [5].
Meanwhile, a Cambridgeshire study of autism in children detected an incidence of ~1 in 60 [6], a result which the Observer newspaper was pilloried for reporting by Ben Goldacre and the lead author Simon Baron Cohen, ahead of the GMC hearing against Wakefield and colleagues [7], but which later turned out to be well-founded.
Whatever happens at the GMC, I suggest, the greatest gap in credibilty lies with a scientific profession which has failed to explain what is happening to our children.
[1] Jeremy Laurance, 'Health stories of the decade'
[2] Hornig et al, 'Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study'
[3] Uhlmann et al, 'Potential viral pathogenic mechanism for new variant inflammatory bowel disease'
[4] Demicheli et al, 'Vaccines for measles, mumps and rubella in children'
[5] John Stone, 'Re: Evidence is not bullying'
[6] Baron-Cohen et al, 'Prevalence of autism-spectrum conditions: UK school-based population study', Br J Psychiatry. 2009 Jun;194(6):500- 9,
[7] Ben Goldacre, 'MMR: the scare stories ar back',
Competing interests: Autistic son
Equally, these issues have been repeatedly placed before Goldacre, both on his Guardian Blog and BMJ Rapid Responses.
So far they have absolutely no answer except the arrogance of their own silence, and the act is wearing a pretty thin. The time has come for the truth: how can they be censorious about Wakefield when they behave like this?
John Stone is UK Editor for Age of Autism.
I am not an expert on the law here but the probability is that panel will reach a collective view, and they are presumably under oath, like the witnesses. A jury oath in the UK reads:
‘I do solemnly, sincerely and truly declare and affirm that I will faithfully try the defendant(s) and give a true verdict (true verdicts) according to the evidence.’
I don't know whether the text is identical but the defence in this instance can appeal to the High Court if they think the findings are defective. Perhaps,on this occasion - if it comes to it - Sir Nigel Davis will not be so absent minded as to sit on the case by accident, though as Brian Deer reminds us "The ruling elite [in the UK] remains surprisingly small".
http://www.ageofautism.com/2009/03/brian-deer-and-the-davis-brothers.html
Posted by: John Stone | January 24, 2010 at 03:44 PM
I've been wondering... What happens of the members of the GMC don't agree with each other? How does the decision making process work? Is it majority rules?
Posted by: Twyla | January 24, 2010 at 01:34 PM
Thank you, John. It took a few days for me to process this because of anxiety about outcomes next week.
I was watching one of the various films about the hearings on Viddler: a UK mom describes what her colleagues at work have been led to believe about Dr. Wakefield from the press: that he performed grotesque and unethical medical experiments on the twelve subjects of the Lancet paper-- a perfect example of the press creating the direct reverse of the truth.
I'm very afraid the GMC will somehow be trapped into throwing good money after bad in service to the whole machinery of bs that's been generated to this point. I hope they're constrained by things I don't understand about British law.
Posted by: Gatogorra | January 24, 2010 at 12:42 PM
I do believe that it is peculiarly telling when you get ill-suppressed results of the kind I highlighted in my letter - the fact that the authors are backed into a corner covering up their own results shows exactly how frightened they are of them.
Posted by: John Stone | January 23, 2010 at 04:58 PM
An excellent article I hope the outcome of the hearing supports Dr Wakefield's research.
My perspective is from someone who has been suffering with Lyme disease another illness that seems to have been triggered for some people following a vaccine.
Lyme Disease Action http://www.lymediseaseaction.org.uk/
2008 conference Dr Robert Bransfield presented
http://www.lymediseaseaction.org.uk/conf2008/index.htm
Dr Bransfield's research found 20-30% of autistic children had Borrelia Lyme Disease amongst their infections and with appropriate treatment their Autistic symptoms improved. Currently their is research that shows that blood tests can miss 50% of Lyme Disease cases. Bransfield theorieses that as many as 90% of Autistic children could actually have Lyme Disease.
See this charity
http://www.lymeinducedautism.com/
One thing is certain that with HPA sticking rigidly to IDSA 2006 guidelines which are currently under review details on ILADS website http://www.ilads.org/
there is not one paediatric doctor in the NHS who is properly assessing children with Autism for Lyme Disease.
Posted by: Joanne Drayson | January 23, 2010 at 08:28 AM
Thank you so much for continuing to speak out about this so eloquently. It's just incredible how distorted the news coverage of this story has been.
Newspapers tell us that Dr. Wakefield started the MMR scare, when he was actually reacting to parents. And his Lancet story would not have had "legs" were there not so many parents telling about their children's life-changing adverse reactions. Why are all these people marching?
http://www.ageofautism.com/2009/04/watch-the-london-open-your-eyes-to-autism-rally.html
What are these parents saying? Are they all enthralled in some kind of mass hysteria caused by Andrew Wakefield?
"One of the greatest puzzles of the saga is what has sustained this level of mistrust in the medical authority." Like, duh! Get to know the affected families, and this would no longer be a mystery to you, Mr. Laurance!
http://www.ageofautism.com/2009/05/new-uk-film-selective-hearing-brian-deer-and-the-gmc.html
Such a good point about that Hornig study. This study found chronic measles infection in the bowels of a boy with autism & IBD, and another boy with IBD though no autism. The lab reports from the lab Dr. Wakefield had used were consistent with those from the other labs. This provided supportive evidence for Dr. Wakefield's work! But instead it was said to contradict his work because of the percentages of kids w. measles in the gut -- in a study of a couple dozen kids! Too small for percentages to mean anything!! And of course the percentages would be different because Dr. Wakefield was studying a group of kids whose parents had brought them in for treatment of GI issues which for most of them began after the MMR!
Posted by: Twyla | January 22, 2010 at 11:34 PM
How many of us have had our autistic children, who are in constant and chronic GI stress, turned away by GI doctors and refused examination? My family has experienced this ourselves and so have the tens of thousands of others and not just here in the US. What is the problem? Are these people afraid to look inside? Is everyone afraid of ending up the next Dr. Wakefield?
Posted by: AnaB | January 22, 2010 at 01:54 PM
Craig W
I’m hoping that having been so severely stung by the drug companies over the swine flu debacle, perhaps the government will rethink the very close relationship it has with big pharma?
http://bit.ly/7ML443
Posted by: Seonaid | January 22, 2010 at 10:42 AM
Goldacre is not only a corporate lobbyist disguised as a journalist, he is also an idiot.
Posted by: Natasa | January 22, 2010 at 10:20 AM
I think that what all of us have realise is that there is a clear and distinct possibility that the autism/vaccine connection will continue to be swept under the rug. Especially now that the government has become so dependant upon the Pharmaceutical industry (the new Medical bill, anyone?) that anything that questions pharmaceutical doctrine will be seen as a threat. And let's face it; if an unvaccinated population shows fewer cases of neurological health problems, then it's safe to say that vaccines are implicated in autism. And if that is the case, the Pharmaceutical giants WILL fall. You are looking at billions upon billions of dollars in liability claims.
Sadly, I fear that the Pharmaceutical Giants have become too big to fail.
Posted by: Craig Willoughby | January 22, 2010 at 09:39 AM
Thank you John - excellent as always
Posted by: Theresa Cedillo | January 22, 2010 at 09:22 AM
What has always gotten to me is that the powers that be say Dr. Wakefield's work has never been replicated. That is patently untrue. Wake Forest University and New York University Medical Center both found live measles virus in the intestines of Autistic children: http://www.dailymail.co.uk/news/article-388887/Another-study-raises-questions-MMR.html
If you notice only UK papers seemed to report on this study and US news outlets treated the study like it never happened. Why? Yet, when the CDC, who is hardly without conflict of interest when it comes to vaccines, does a study on Autism they splash the results all over the news. Yet, the media ignores peer review studies that do not jive with the vaccines are safe for all people party line, leaving the public with the impression that the case is closed. Why? Why does the American media self-censor like this?
I have completely lost faith in the mainstream media. It is a joke to me because it seems to me like they self-censor stories journalist think might be bad for their careers. Such journalists would do well to remember that history shames such "journalism" in the end.
Posted by: AnaB | January 22, 2010 at 09:10 AM
Very well said John.
The anger and fear and so called ‘ill informed’ speculation over MMR started long before 1988. In fact it started not long after the introduction of the vaccine [1988] when parents began to suspect that their children were being damaged by it. Dr Wakefield’s paper cannot be blamed for that! As far back as 1993, Jackie Fletcher, founder of the JABS forum, persuaded her local Community Health Council to place an ad in their local newspaper to find out if any other parents suspected vaccine damage after MMR. No less than thirty families responded.
http://bit.ly/7qWY3A
From there, public awareness and demands for information have snowballed to the point where not just the safety of MMR vaccine is questioned, but also the whole area of vaccination – including the continued use of thimerosal - and squalene [supposedly illegal in this country!] It may be of interest to note, that after 17 years fighting, the indomitable Mrs Fletcher has finally succeeded in being granted a form of legal aid and so continue her battle for justice.
http://www.wigantoday.net/wigannews/MMR-mum-makes-legal-history.5952381.jp
This ‘saga’, and growing ‘mistrust in medical authority’ will continue and will grow so long as no scientific research takes place into the possible biomedical side effects of vaccination. Numerous epidemiological studies have been produced but figures can be manipulated. Examination and testing of damaged children does not happen within mainstream medicine. Why not? Well we just have to look at how Dr Wakefield has been treated to understand why not. What he has been subjected to is enough to scare away anyone who values their professional reputation and career within mainstream medicine!
Vaccine damage happens. About nine hundred Families in UK have been quietly compensated, but this is estimated to be only 10% of the actual total who have been vaccine-damaged. Recently though I note a subtle progression towards recognition of the fact that vaccines CAN damage. Perhaps thanks I believe, to undeniable adverse events of Swine Flu vaccine and Tamiflu, the normally coy press, seem now happy to now publish statements such as “All drugs have side effects.” A tiny step towards openness?
Points to ponder – [March 2006]
“A former Government medical officer responsible for deciding whether medicines are safe has accused the Government of "utterly inexplicable complacency" over the MMR triple vaccine for children.
Dr Peter Fletcher, who was Chief Scientific Officer at the Department of Health, said if it is proven that the jab causes autism, "the refusal by governments to evaluate the risks properly will make this one of the greatest scandals in medical history.
He added that after agreeing to be an expert witness on drug-safety trials for parents' lawyers, he had received and studied thousands of documents relating to the case which he believed the public had a right to see.
He said he has seen a "steady accumulation of evidence" from scientists worldwide that the measles, mumps and rubella jab is causing brain damage in certain children.
But he added: "There are very powerful people in positions of great authority in Britain and elsewhere who have staked their reputations and careers on the safety of MMR and they are willing to do almost anything to protect themselves."
http://www.dailymail.co.uk/health/article-376203/Former-science-chief-MMR-fears-coming-true.html#ixzz0c2VDz8V7
Case Study: Autism and Vaccines. Hannah Poling
http://www.time.com/time/health/article/0,8599,1721109,00.html
Posted by: Seonaid | January 22, 2010 at 09:07 AM
about Ben Goldacre
take a look at this revealing news story on How science journalism really works http://www.theregister.co.uk/2007/11/27/guardian_use_me_as_a_mouthpiece/
it contains this interesting quote.
"incidentally, before you assume that i'm a lazy journo, i dont write like this with anyone else, but in fact i am offering ORG the chance to use me as a mouthpiece for your righteous rightness.
think of it as a "pull" model for lobbying, rather than the usual push"
Posted by: Just Another Dad | January 22, 2010 at 07:42 AM