An Elaborate Fraud, Part 8: In Which The British Medical Journal Tries to Debunk a Clear-Cut Case of Regressive Autism
In its attack on Dr. Andrew Wakefield in January, The British Medical Journal said he “manufactured” data to fabricate a link between the measles-mumps-rubella shot and the onset of autism in 12 children, setting off a worldwide vaccine scare.
Author Brian Deer questioned whether the children even had the disorder. If they did not, of course, that would be a devastating blow to Wakefield’s work. “First to crack was ‘regressive autism,’ the bedrock of his allegations,” wrote Deer, based on his seven-year investigation of Wakefield’s 1998 report. Just one child -- Case 2 -- clearly had regressive autism, he asserted.
But that charge is false. Take Child 11, whose circumstances we described in the last article in this series. Child 11 clearly had regressive autism – just as he clearly developed autism after the MMR shot, not before it, as Deer falsely reported in the BMJ (see HERE).
Once again, only Brian Deer claims otherwise.
When I first spoke to Father 11 earlier this year, it was by phone. I had dropped off a copy of my book at the guard’s entrance to his gated enclave in Southern California, with a note on the back of my business card that I was interviewing families of the 12 children described in Wakefield’s Lancet paper, and would like to speak with him while I was in the area.
He called the next morning.
“My son was diagnosed in 1994,” he told me. Until 15 months, “my son was a healthy young baby, and after he was given the MMR he came down with otitis media (an ear infection) and later came down with pneumonia. He was just slowly regressing, after several months. It was almost unnoticeable.”
The father and I arranged to meet about an hour later at a coffee shop nearby. At this point he hadn’t read Deer’s article and wasn’t aware of its contents – he was just unguardedly describing what happened to his son. He showed me a letter he had written to Wakefield at the Royal Free Hospital in London in 1997 that confirmed what he told me.
“My son at age 15 months, was immunized with the Merck MMR vaccine and became ill for the next several months. As his pediatric records indicate he came down with a viral infection, and shortly thereafter viral pneumonia. His condition slowly deteriorated over time, and was diagnosed as being autistic at age 3. The onset of his autistic-like behaviors began around 18 months.”
This was a straightforward chronology, whatever one might think of the cause-and-effect issue: Normal development. A shot. Illnesses. Regression. Autism. And it wasn’t just the father saying so. His letter continued:
“After going to three prominent children’s hospitals for an evaluation of his condition in California, the medical community concurred that his condition was psychological and that the situation was hopeless. He was diagnosed as moderate to severe, with no speech, no eye contact, and cognitive function at 6 months overall.”
In March of 1994, he took his son to a specialist affiliated with a major American university. In this article, I’m not naming the doctor, but I know his identity, and in fact unearthed the text of comments he made a couple of years later to a national autism group.
“One of the striking feature [sic] in all autistic patients that we have studied,” he said, “is a strong association between immunization with MMR and the development of autism (regressive autism).” That parenthetical reference -- regressive autism -- is in the original.
Put aside again the issue of whether the MMR triggered autism. Here is a doctor saying publicly that all – all – the autism patients he studied were characterized by regressive autism. That included Child 11. And that's on top of diagnoses from three prominent children's hospitals. This family had the money to try to help their son, and they used it, creating an unusually detailed record on the nature and timing of his disorder. All of this occurred before the child got anywhere near the Royal Free Hospital.
How, you may ask, did Deer and the BMJ decide this child’s diagnosis was in doubt, that it was part of a questionable pattern in which Wakefield “fixed” the facts in furtherance of “a hoax”? That the children were not even autistic? Well, that requires a little further digging.
The BMJ’s report on Wakefield is constructed like a maze; you can get lost at every turn. The first article, on January 5, starts with Father 11 and uses him to convict – not just indict – Wakefield of what Deer calls "frauds." But for a coherent bill of particulars of each “fraud,” you must read the sidebar titled “How the Link Was Fixed.” The first bullet point states that "only one child clearly had regressive autism."
And what are the details of that blockbuster charge?
Well, a chart with the BMJ article purports to compare the 12 children’s real medical records with those falsified in the Lancet paper. The Lancet reported that Child 11 had a diagnosis of regressive autism, but Deer puts a question mark there.
That’s as far as the printed article goes. But in fine print at the end of the article, there’s this: “The version of this article on BMJ.com contains full footnotes.”
To BMJ.com we go, still in search of evidence that Child 11’s regressive autism diagnosis is questionable. Online, you click on “Web Extra.” There you find the same chart as in the print version, this time with footnotes, including Footnote 87 next to the question mark about Child 11’s diagnosis. It reads, in full:
“Documentation is incomplete. As with other children in the series, child 11 does not appear to have been neuropsychiatrically assessed at the Royal Free, which had no department for child development and no paediatric neurologist. The hospital discharge summary refers to “autism”, and the father recalls a diagnoses [sic] in California that his son was “autistic”. According to the father, the boy never started to talk at an appropriate age. “Speech didn’t come in,” he said. “My wife thought about having another kid, and she said, ‘No I’m going to wait till he starts speaking.’ Even at age 2, no speech.” Child 11 received MMR at 14 months. [sic]
This, then, is the entire case for questioning Child 11’s diagnosis. At least four tactics here are worth noting:
* Misdirection. Whether the Royal Free pediatric gastrointestinal unit is set up to diagnose developmental problems is irrelevant in light of the qualified professional assessments already made.
* Omission. Writing that the father recalls that his son was diagnosed as “autistic” omits the crucial fact that multiple medical professionals said so. The dubious-sounding parental “recall” is not the issue here. The air quotes around “autistic” make it seem like some sort of West Coast diagnosis du jour rather than the confirmed clinical description of a severely disabled child.
* Suppression. Regardless of the child’s language development – which can be quite variable in boys in infancy -- the critical fact is that he lost skills and developed autism after the MMR shot at 15 months (not 14 months.) The quote, "Even at age 2, no speech," is a complete red herring -- since any developmental problem after 15 months could implicate the MMR rather than point to a pre-existing problem.
* Falsehood. There is no factual basis for claiming that “incomplete” records make the diagnosis questionable.
The “Web Extra” itself is unusual. It begins: “This is an author’s background document giving information additional to the peer-reviewed report ‘How the case against the MMR vaccine was fixed’ by Brian Deer, published in the BMJ in January 2011.”
BMJ Editor Fiona Godlee has stated that the BMJ articles were peer-reviewed and carefully fact-checked. Does this wording mean the Web Extra fell outside those parameters? Yet it is the only basis for crucial claims made in the BMJ proper.
Regardless, we have so far shown that Child 11, contrary to assertions made by the British Medical Journal, unquestionably had n diagnosis of regressive autism before his father ever contacted Andrew Wakefield at the Royal Free Hospital, and that those symptoms did in fact begin after the MMR shot was given. Because Child 11 was the initial and most detailed case reviewed in the BMJ article -- and because Father 11 is the only parent actually hostile to Wakefield's work, making him Deer's best and only witness -- one might reasonably inquire whether others among the Lancet children were even more vulnerable to the same pattern of misdirection, omission, suppression and falsehood.
We will dig into that, but first we need to tumble further down the rabbit hole created by the BMJ’s claims about Child 11.
Read Parts 1 - 7 of Elaborate Fraud HERE.
Dan Olmsted is Editor of Age of Autism. He is the co-author, with Mark Blaxill, of The Age of Autism – Mercury, Medicine, and a Man-made Epidemic, published in paperback in September by Thomas Dunne Books.