As a UK doctor, I was profoundly disappointed by Godlee’s appearance at the Fogarty International Center last week. One disappointment (out of many) was Godlee’s flatfooted trip over … the failures of the government, the media and even the (piously hypocritical) medical establishment … in getting across the message that all vaccines, particularly the MMR, are safe for all people, at all times.

Godlee says (39m 33),

… “As for looking back … why the message didn’t get across … there’s a whole host of.. um …reasons one might look to …this is thinking about the early days of the scare, why the government didn’t make a better case in the UK to .. kind of … contain things .. um .. I think one has to say that negative studies are not good news … stutter … are not news … so in the place of this single twelve children case series, which seemed to suggest something positive but dreadful .. nervous titter ... negative studies would suggest … barely audible tsk … strongly confirm something negative but positive .. um … sorry … negative but good for health … are not such, such important news. It’s also, I think it’s fair to say, a very complex story” …

Indeed, Dr Godlee!

Of course, I think it’s fair to recall, at this stage, the flatfooted case of Professor Sir* David Salisbury, UK director of immunisation and bulwark of the British medical establishment, who acted as an expert witness for the prosecution of Andrew Wakefield, in the longest and most expensive trial in UK medical history. In front of the GMC, the professor declared that the MMR had an “exemplary safety record” … despite the fact that the vaccine had been withdrawn from UK use, in 1992, because the vaccine was unsafe.

I also think it would be fair to suggest that Dr Godlee should now take the opportunity to trip - flat-footedly - off the UK and international stage.

* although not yet awarded, a knighthood for services to vaccine safety, is a racing certainty

Sickening! Godlee’s performance was shocking!

Towards the end of the performance Godlee was heard to say …

… “you’re absolutely right, Andrew Wakefield is a very good communicator … umm … and I think that where you put him up against officials with less skill in that way, they appear very flatfooted …. but he is very …. he’s a very clever man …”

It seems unlikely that Andrew Wakefield will have ever have come up against a more flatfooted establishment official than this.

Competing interests: GMC registered practitioner appalled at the flatfooted state of the medical establishment in the UK.

Hi, Nick,

As Jake Crosby pointed out in his questions to Godleee, certain items about the children's health (whether the children with Asperger's had a pre-existing condition, or regressed; whether bowel pathology was found) are verifiable, and as Jake pointed out, Deer is the one who is factually incorrect.

The rest of it ("paid by a lawyer to influence his results and had blatantly manipulated the study data") is pure mudslinging. Did a lawyer confide to Deer that he had handed Wakefield a check in order to influence some aspect of his research? Did anyone dummy up pathology reports? Not to my knowledge--and this would be the sort of verification one would hope the *BMJ* would have tried to find, before running with the Deer allegations.

I think you and I are both trying to see this one through the lens of how things are *supposed* to operate--not how (unfortunately) they end up happening in the real world.

@Nick,

That's the thing: the GMC didn't make any of these statements about fraud, being paid by a lawyer, or manipulating data. Brian Deer made these statements, and now Fiona Godlee (I keep typing "Godless," haha) is repeating them. The GMC's problems with Wakefield had nothing to do with the quality of his data; they had to do with his treatment of patients. Although many of us disagree with its findings, the GMC has been somewhat transparent about its proceedings, and has made what I believe to be errors in judgment, rather than outright libel.

The GMC said, for example, that lumbar punctures weren't warranted. No one disputes that spinal taps were performed on some of Wakefield's patients; however, the GMC is choosing to believe that they weren't warranted, rather than accepting the opinion of Wakefield, Walker-Smith, and Murch that they were part of a valid diagnostic inquiry. Brian Deer's allegations, on the other hand, are different *in fact* from what Wakefield and his colleagues have said, and since Deer's reports were not part of a legal proceeding, no rules of evidence have been applied to Deer's statements.

It's all pretty shady, and I find it extremely bothersome that the *BMJ* is just taking the word of a journalist (who may have a financial conflict of interest), rather than doing an investigation of its own into the facts of the *Lancet* case series, if the BMJ had any actual doubt as to the veracity of the facts published in the *Lancet.*

So, now that Dr Wakefield is in the US, and Dr Godlee's presentation was in the US, does Wakefield have a case for slander/libel in an American court, given that Godlee was unable to back up anything she said?

Theresa,
I was wondering exactly the same thing as I read these lies on the NIH's videocast website:

Please join BMJ Editor Fiona Godlee for a discussion of the stunning investigation she published earlier this year that revealed the MMR scare was based not on bad science but on deliberate fraud. The three-part series was produced by journalist Brian Deer, who spent seven years investigating Andrew Wakefield’s infamous study linking the MMR vaccine with autism, discovering Wakefield had been paid by a lawyer to influence his results and had blatantly manipulated the study data.

Fundamentally, if you are going to make allegations you need to be on top of your subject and Godlee isn't. There is also an echo here of Richard Horton who made allegations against Wakefield in 2004 which were just plain wrong, and were repeated by by him under oath in 2007:
http://www.bmj.com/content/328/7438/528.full/reply#bmj_el_232455

But actually we seem to have the reverse of justice where the people making the allegations are perpetually given the benefit of the doubt and the people on the receiving end are always denied it: indeed in the case of many of the allegations there is somewhat more than doubt.

Martin

So many points where she didn't seem to have a basic grasp of factual detail - she also claimed that the case collapsed some time in the late 90s? Has she never heard of Judge Davis?

Jenny

Yes she also spoke as if Deer's claims in BMJ were completely new - a revelation - when it was just re-cycled garbage from the Sunday Times. If she bought it as a whole new package she really was incompetent, but is it remotely credible? Truth is that the Sunday Times launch of 2009 had nil impact outside News International, so presumably had to be done again with pseudo rubber stamp of peer review. Even then it made little progress in the UK before the BBC's trashy, commercially surrendered science department got hold of it.

I don't get this bit about senior British medical journal editors suffering from vagueness (Horton seems to have the same difficulties).

John Stone asks:-
'So, who is trying to be misleading?'

Did anyone else notice that projected picture of the British Medical Journal COVER and the headline, 'How the case against the MMR was BUILT.' This design incorporated the words into bricks. The edition was the one containing the first Brian Deer article from the series 'Secrets of the MMR scare.'

The title of this article was actually, 'How the case against the MMR vaccine was FIXED.' This title and the content was almost identical to the 2009 Murdoch Sunday Times Brian Deer article:-

http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece
'MMR doctor Andrew Wakefield fixed data on autism.'

This seems to be a classic case of a 'smoke and mirrors' presentation by the BMJ and Godlee in particular.
'Building' a case and 'fixing' a case are at opposite ends of a very misleading spectrum.

Off topic but had to get it out of my system. Vons grocery stores are advertising 20% discount off total orders for anyone getting a flu shot. Guess FOOD INC is in bed with BIG PHARMA.

http://www.fic.nih.gov/News/Events/Pages/fiona-godlee-mrr.aspx

The link to the recorded Godlee lecture at Bethesda can be accessed from here.

Why so much fear why no honesty , i can smell the dishonesty from here he,s very quiet isnt he are we all getting to close for comfort ,excellent pieces John you always get to the core , no answer because you make such a good point always

Thanks John my bad, regret the error.

University of California Research presented in Australia

http://www.abc.net.au/news/2011-09-08/am-autism-study/2876128/?site=melbourne

Study moves towards unlocking autism mystery
A new study has discovered there are different biological types of autism, with genetics, the immune system and the environment all thought to be factors in causing the varied forms.

A study of 350 children in the US found two biologically different types of brain development in autism and concluded that there are likely to be more.

"One worry is that anything from pesticides to other kinds of agents that we introduce into the environment may actually be causing or at least may be exacerbating the causes of autism - 55 per cent of the risk for having autism in this study was attributed to shared environmental factors," he said.

"I think that in the United States, and worldwide, people are taking more seriously the idea that the environment may be contributing the rise in autism."

----------------------------------------------------

What triggers underlying gene expression, has an effect directly on the immune system and is environmental ?

----------------------------------------------------

http://latino.foxnews.com/latino/health/2011/09/08/us-researchers-identify-two-different-strains-autism/

Researchers from the University of California Davis's MIND Institute in Sacramento began the Autism Phenome Project in 2006. They have been studying the brain growth, environmental exposure and genetic make-up of 350 children aged between two and 3.5 years, and have so far found two biologically distinct subtypes of autistic brain development.

One group of children -- all boys -- had enlarged brains and most had regressed into autism after 18 months of age; another group appeared to have immune systems that were not functioning properly.

Psychiatry professor David Amaral, who led the MIND Institute's longitudinal study, said the findings could lead to more individualized treatment. "The ultimate goal is when a child comes into the clinic, rather than saying you just have autism, to be able to say you have autism type A, or type B, or type C," Amaral said.

"And then based on that description, we would know whether there is a different treatment profile that we should recommend to the families.

"As an example, if a child has an immune form of autism, it may be that what we want to do is manipulate their immune system rather than trying something else that may be related to synaptic functions in the brain."

Families were currently presented with a vast array of treatments without necessarily knowing which worked, he said.

Amaral predicted there would be many more biological subtypes of autism identified just as there were many forms of cancer. "If we were trying to cure all cancer at the same time, it would be hopeless," he said. "Well, the same is true for autism. My guess is that there just isn't going to be a single diagnostic marker for autism -- there's going to be a whole panel."

Under the heading of maybe not a coincidence, Johns Hopkins is the center of important vaccine safety discussions. The Advisory Committee on Vaccine Practices meets at the Bloomberg School of Public Health. Also under aegis of Hopkins is the Kennedy Kreiger Institute, highly regarded for brain injury treatment and research.

Two individuals at Hopkins have been at the exact epicenter of the theorized association between vaccines and permanent brain damage. Leo Kanner from 1930 to 1959 was Director and Chief of Child Psychiatry. He identified and described autism in 1943 as a "novel , new disorder." Dr Andrew Zimmerman is currently Director of Medical Neuroscience, Center for Autism and Related Disorders at Kennedy Kreiger, and a Yale man to boot. He testified in two highly publicized vaccine/autism claims; at Cedillo v HHS, he testified that vaccines were not implicated in autism; interestingly, later, he testified in Poling v HHS that vaccines caused a pre-existing condition to deteriorate to autism as a result of the childhood shots.

Bloomberg School on August 19, 2011 hosted Brian Deer's presentation "An Elaborate Fraud: Vaccines and Autism" at Sommer Hall to an adoring, fawning reception. Deer was assigned by the Murdoch owned Sunday London Times in 2004 to, in his own words, "get something big" on the MMR shot. One can only imagine the means by which he went about his task.

Fast forward to 9-6-2011. Fiona Godlee, editor of the British Medical Journal, gives a presentation at the Bethesda main campus of National Institutes of Health entitled "The Fraud Behind the MMR Scare". Godlee was discussing BMJ's recent three part editorial, actually written by Deer, alleging that Andrew Wakefield committed deliberate fraud by manipulating and falsifying data reported in the retracted 1998 Lancet article Ileal-lymphoid-nodular hyperlasia non specific colitis and pervasive development disorder.

The Godlee NIH event is as shameful as the Deer Bloomberg School event. Bernadine Healy, past director of NIH, passed away only in October of this year. Although she was not qualified as a Murdoch Journalist, she did say on CBS Nightly News that a vaccine brain damage association is not ruled out. The Merck Manual lists encephalitis as the most common vaccine adverse reaction. This is a replay of the NIH lead paint/gasoline fiasco. Dr. Herbert Needleman describes his experience in a special article in Pediatrics Vol 90 No. 6 entitled Salem Comes to the National Institutes of Health: Notes from Inside the Crucible of Scientific Integrity. Needleman saved his reputation, despite the efforts of NIH, and now kids are not exposed to lead in paint and gasoline.

Fiona Godlee considers Murdoch journalism to be an acceptable standard for BMJ, and what a sad day indeed for that august publication.She did not explain how Deer got access to private medical records (hacking? Blagging?). She did not reveal Deer filed the original complaint against Wakefield with the General Medical Council in England, and then proceeded to report on the complaint that had been filed with the General Medical Council in England. The tail wagging the dog in in the most literal sense. Professor John Walker-Smith, described by Journal of Pediatric Gastroenterology and Nutrition as "the premier, if not the premier, pediatric gastroenterologist in the world…"was disgraced along side Wakefield, and both Hopkins and NIH are complicit in their professional destruction. Anyone at Bloomberg and NIH who is uncritically accepting Deer's shameless self promoting nonsense, and even gloating about it, should remember one thing: publish the wrong little tidbit, and it could happen to you.

NIH and CDC maintain the searchable site Vaccine Adverse Reporting System or VAERS. VAERS currently lists 58,367 reportable adverse effects linked to MMR. Since VAERS is under reported by a factor between 1 and 100, the actual number of adverse reactions to the MMR shot is somewhere between 580,000 and 5,800,000. Perhaps Wakefield, like Needleman before him, was onto something after all.

CHS

Just to be clear, Deer has never posted in response to criticisms anything that would have stood scrutiny in an academic journal, which was perhaps too implicitly part of my point. If Deer had posted in BMJ what he posted on the blogs of Gorski and Leitch the charade would have immediately been exposed. On the other hand he has never responded to the serious criticisms posted on CHS and AoA. For a start:-

http://childhealthsafety.wordpress.com/2011/07/29/british-medical-journal-fraud/

http://www.ageofautism.com/2011/04/brian-deer-allowed-to-bluff-his-way-out-of-trouble-on-bbc-radio4.html

http://www.ageofautism.com/2011/04/time-to-revisit-deers-claims-that-wakefield-fabricated-his-findings.html

http://www.ageofautism.com/2011/05/time-to-revisit-deers-claims-that-wakefield-fabricated-his-findings-part-2.html

http://www.ageofautism.com/2011/07/time-to-revisit-deer-3.html

Of course, this material in one form or another has been submitted to BMJ over and over.

Dear Fiona Godlee,

I endorse the comments made by John Stone (reproduced below), regarding the refusal by the BMJ to allow proper debate with the BMJ pages regarding the Brian Deer fraud allegations made against Dr Andrew Wakefield within the published articles 'Secrets of the MMR scare' Janurary/February 2011. The GMC manifestly DID NOT find Dr Wakefield guilty of fraud.

I am also extremely concerned about the recent US lectures by yourself and Brian Deer, which further publicised these unproven allegations against Dr Wakefield. The Brian Deer Powerpoint lecture on 19-04-11 at the Johns Hopkins University, is alleged to have contained a great deal of outrageous and possibly slanderous 'showman type' content, including depictions of playing cards and 'Jackpots of money'. This referred to what Deer insists on calling a Wakefield competing MMR vaccine, but was actually a measles damage ameliorating substance developed by Dr Wakefield during his research. The patent was held by the Royal Free Hospital NOT Dr Wakefield and any 'jackpots of money' could have helped those thousands of children, all affected by the devastating gut condition which the non medical, non histopathology trained Brian Deer claims to be non existent, if only.

There have been no published transcripts of any of these US Deer lectures or your own. The lack of open public debate on these issues tells its own story. Can I remind you of your own comments made to the UK Science and Technology Select Committee in May this year? This seems incompatible with your claiming, during your Bethesda lecture, to have been ignorant of the huge BMJ funding received from MMR manufacturers GSK and Merck.
“We have to acknowledge that the publishing industry has a number of different revenue streams, one of which is the pharmaceutical industry.”

“It has been said that journals are the marketing arm of the pharma industry and that is not untrue; to a large extent that is true,”

You are a mother too. How can you live with yourself? What will you tell your own children?
This is an open letter.
Jennifer Helen Allan

Competing interest
Autistic Grandson with the bowel condition as described by Dr Andrew Wakefield in the 1998 Lancet paper.