The Wakefield investigation was the longest in the history of the GMC, with the disciplinary panel sitting for a total of 148 days over a period of 2 and a half years at an estimated cost of one million pounds. The results of the investigation were revealed in a 143 page report on 28th January 2010, and found that Wakefield showed a “callous disregard” for childrens’ suffering and “abused his position of trust.”

The GMC “..determined that Dr Wakefield’s name should be erased from the medical register…”.

The decision follows an investigation into Wakefield’s behaviour surrounding the 1998 publication of a scientific paper in The Lancet journal, linking the triple MMR vaccine with gastrointestinal disorders and autism. Although the study itself did not demonstrate the MMR vaccine caused autism, Dr Wakefield urged caution and advised parents to get single injections against measles, mumps and rubella at a subsequent press conference.

Wakefield’s statements resonated world wide, scaring many parents away from vaccinating their children and firmly cementing the anti-vaccination movement. The resulting drop in vaccine compliance, spurred on by a complicit media, continues to contribute to outbreaks of vaccine preventable diseases such as measles, mumps and whooping cough.

Wakefield was found to have brought the medical profession “into disrepute” after he took blood samples for the study from children attending his son’s birthday party in return for 5 pounds “reward”. He later laughed and joked at a conference about the children fainting and vomiting.

(It’s unbelievable that Wakefield would expect this method of collecting samples for a study to be ethical and above board. He is either completely clueless when it comes to the strict procedures instructed by ethics committees or he’s a completely incompetent researcher. Or perhaps his ego got in the way).

In addition Wakefield conducted unnecessary, painful and intrusive diagnostic treatments on children, including colonoscopies and spinal taps, procedures for which he did not have ethics approval to undertake.

In further investigations, Sunday Times journalist Brian Deer revealed that Wakefield did not disclose serious financial conflicts of interest. Deer provided evidence that Wakefield was paid thousands of pounds by lawyers seeking a link between the MMR vaccine and autism. Wakefield also had a patent pending on his own single measles vaccine, similar to the one he urged parents to seek out at the press conference following the publishing of the paper.

In 2004, ten of the thirteen authors on the Lancet paper withdrew their names from the publication stating; “We wish to make it clear that in this paper no causal link established between MMR vaccine and autism as the data were insufficient. However the possibility of such a link was raised and consequent events have had major implications for public health.”

It took a further six years before the editor of the Lancet, Richard Horton, retracted the paper, which effectively means it is now scratched from the scientific record. Another Wakefield paper which was accepted for publication in the journal NeuroToxicology was also subsequently withdrawn.  This study attempted to show a link between thimerosal and impaired neurological development and was nick-named “14 monkeys”.

Wakefield relocated to the US in 2005, where he established and was director of the alternative medicine clinic for children with autism spectrum disorders, known as Thoughtful House. The clinic has come under fire for using questionable treatments such a chelation, a scientifically unproven therapy for autism. He was pressured into resigning his position following the GMC findings in January. (Interestingly, the “Founders” tab on their website is broken, and there is no mention of Wakefield anywhere that I can find. Wakefield has been effectively erased from their records).

Despite recent events, the anti-vaccination movement continue to rally around their “poster boy”. Wakefields’ supporters called the findings “unjust”, a “smear campaign” and “a sad day for our children.” Generation Rescue, a zealous anti-vaccination group in the US, (publicly represented by Jenny McCarthy), issued a statement of support following the GMC findings in January;

“Dr. Andrew Wakefield is perhaps this debate’s greatest hero. He’s a doctor who has held onto the truth, unbowed, through pressure that would break most mortals. Dr. Wakefield’s influence in saving other children from the fate that befell so many children is incalculable.”

Comments left on the Age of Autism website were supporting calls for Wakefield to be knighted. How people can support such a fraudulent and discredited man is completely beyond me.

So let’s summarise the chain of events that led to Wakefield getting struck off

• Wakefield was getting paid by lawyers putting together a class action suit against the manufacturers of MMR for 2 years prior to the publication of the Lancet paper.

• He called for parents to seek out a single vaccine for measles – he had a patent on his own single measles virus.

• The PCR data was found to have come from contaminated samples and could not be independently confirmed.

• Pathology results were fabricated

• No conflicts of interest were declared when the paper was submitted.

• He did not have ethics approval for some of the studies on children.

For such a small study (12 children) that did not even examine a vaccines/autism link, it is incredible to think that it had such a large impact on public health. But of course the blame does not solely lie with Wakefield. The media were highly complicit in spreading the fear about the MMR vaccine. And the result of their misinformation was MMR vaccination rates in the UK fell from over 90% to below 80%. And although the anti-vaccine movement  was well and truly active at this stage, it must be acknowledged that this boosted their cause.

Even after 10 of the 12 authors removed their names from the paper in 2004 for “public health” reasons, Brian Deer exposed the conflicts of interest and fraudulent practices, the Lancet retracted the paper completely in 2010, rapidly followed by NeuroToxicology doing the same, the GMC called Wakefield dishonest and irresponsible, he got shafted from the woo-fest that is Thoughtful House, he was stripped of his license, people continue to rally around him.

No respectable medical journals are gonna touch him again. Although he is on the editorial board of the quack-fest that is Medical Veritas, The Journal of Medical Truth, along with other prestigious anti-vaxers such as Veira Shreibner. Actually itr seems quite a shame really. If you search PubMed for AJ Wakefield, you get 15 reviews and 112 other papers. He was a prolific publisher, especially for a clinician, but it matters not anymore.

Recently he sat down to be interviewed by Mercola in a five part series on YouTube.

Although clearly Wakefield knew what was coming – I mean he wrote it in his book, which was published weeks ago, and entitled “Callous disregard”, that he lost his medical license. Harriet Hall has had the stomach to read the book, you can read her blog about it here.

Speaking prior to the GMC hearing on May 24, Wakefield told the BBC he was not responsible for the resurgence in measles. He has also said he categorically denies suggestions that he had acted dishonestly, or against the best interests of children.

He did not attend the GMC hearing in London, rather choosing to appear on the Today Show in New York City where he was interviewed by Matt Lauer. The interview is a clear illustration of him now believing the rheteoric, as he repeatedly insists that his Lancet findings been repeated in five different countries and that there is a link between vaccines and autism. He also tells Lauer the GMC decision is a PR exercise designed to ruin him.

Despite a flurry of research spurred on by Wakefield’s 1998 study, no link between vaccines and autism has been found and Wakefield’s original findings have not been reliably replicated.

Speaking at an anti-vaccine rally in Washington on Wednesday, Wakefield said he plans to set up a virtual university where he will design studies and recruit researchers to carry out the work.

Wakefield’s colleague, Professor Walker Smith, a senior author on the study has also been struck off the UK medical register. The other doctor under investigation, Professor Simon Murch was found not guilty of professional misconduct.

Smith and Wakefield have 28 days to appeal the decision. Wakefield has indicated that he planned to do so.

Apologies for not blogging this properly. I have just written an article for someone else, and can’t post the same text here. I will endeavour to do so in the next few days.

In the meantime, here are the findings on Wakefield from the GMC.

SPOILER ALERT:

Accordingly the Panel has determined that Dr Wakefield’s name should be erased from the medical register. The Panel concluded that it is the only sanction that is appropriate to protect patients and is in the wider public interest, including the maintenance of public trust and confidence in the profession and is proportionate to the serious and wide-ranging findings made against him.

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The effect of the foregoing direction is that, unless Dr Wakefield exercises his right of appeal, his name will be erased from the Medical Register 28 days from when formal notice has been deemed to be served upon him by letter to his registered address.

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Date: 24 May 2010

Dr Andrew Jeremy WAKEFIELD

Determination on Serious Professional Misconduct (SPM) and sanction:

The Panel has already given its findings on the facts and its reasons for determining that the facts as found proved could amount to serious professional misconduct.

It then went on to consider and determine whether, under Rule 29(1) of the General Medical Council Preliminary Proceedings Committee and Professional Conduct Committee (Procedure) Rules Order of Council 1988, the facts as admitted or found proved do amount to serious professional misconduct and if so, what, if any sanction it should impose. It has accepted the Legal Assessor’s advice in full as to the approach to be taken in this case, and has looked at each doctors’ case separately but, when considering whether Dr Wakefield is guilty of serious professional misconduct, has looked at the heads of charge found proved against him as a whole. It has not confined its consideration to the heads of charge; it has also had regard to the evidence that has been adduced and the submissions made by Ms Smith on behalf of the General Medical Council. On behalf of Dr Wakefield, no evidence has been adduced and no arguments or pleas in mitigation have been addressed to the Panel at this stage of the proceedings. In fact Mr Coonan specifically submitted:

“……we call no evidence and we make no substantive submissions on behalf of Dr Wakefield at this stage.” “…I am instructed to make no further observations in this case”.

Nevertheless, the Panel considered the totality of the evidence in Dr Wakefield’s case including the reference dated 27 October 1995, from Professor Leon Fine, the then Head of the Department of Medicine at the Royal Free Hospital, when reaching its decision at this stage, having been asked to consider that as part of Mr Coonan’s submissions at Stage 1.

Serious professional misconduct has no specific definition but in Roylance v General Medical Council [1999] Lloyd’s Rep. Med. 139 at 149 Lord Clyde, in giving the reasons of the Privy Council, said:

“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required by a medical practitioner in the particular circumstances…”

Lord Clyde went on to say:

“The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the misconduct to the profession of medicine. Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.”

The Panel has acted as an independent and impartial tribunal and exercised its own judgement on these matters. It has borne in mind the relevant GMC guidance at the time, namely the 1995 Good Medical Practice and, in so far as the findings relate to events after 1998, the 1998 Good Medical Practice. It has considered what has been adduced and submitted on behalf of the doctors about the standards and procedures which were prevalent at that time.

In considering Dr Wakefield’s case, the Panel has also taken into account the passage of time before these matters were brought before it and the length of time this case has taken. It noted that the multiple sittings were for a variety of reasons including professional commitments of the Panel and requests from Counsel for reasons such as illnesses, accidents, unavailability of witnesses and preparation time.

The Panel has noted Dr Wakefield’s previous good character and taken into account everything it has heard including his qualifications, experience and standing within the profession, with patients and the parents of patients.

The Panel considered the conduct of Dr Wakefield whilst he was registered as a medical practitioner and employed by the Royal Free Hospital Medical School in 1996 and 1997, initially as a Senior Lecturer in the Departments of Medicine and Histopathology. Later, from 1 May 1997 he was a Reader in Experimental Gastroenterology and an Honorary Consultant in Experimental Gastroenterology at the Royal Free Hospital.

The Panel has already found proved that Dr Wakefield’s Honorary Consultant appointment was subject to a stipulation that he would not have any involvement in the clinical management of patients. On five occasions (child 2, 4, 5, 12 and 7) he ordered investigations on children, when he had no paediatric qualifications, and in contravention of the limitations on his appointment. The Panel considered this alone constituted a breach of trust of patients and employers alike.

In February 1996 Dr Wakefield agreed to act as an expert in respect of MMR litigation. In relation to the Legal Aid Board (LAB), the Panel found that Dr Wakefield accepted monies totalling £50,000 procured through Mr Barr, the Claimants’ solicitor to pursue research. A costing proposal had been submitted by Mr Barr to the LAB containing detailed information provided by Dr Wakefield, and Dr Wakefield ought to have realised that Mr Barr would submit it to the LAB.

The costing proposal set out costs in respect of the investigation of five children. It covered each child’s four-night stay in hospital with colonoscopy, MRI and evoked potential studies. Dr Wakefield admitted that the funding subsequently provided by the Legal Aid Board had not been needed for these items because these costs were borne by the National Health Service as the patients were being admitted as NHS patients.

The Panel found that Dr Wakefield had a duty to disclose this information to the Legal Aid Board via Mr Barr. It was dishonest and misleading of him not to have done so. The Panel concluded that his intention to mislead the Legal Aid Board was sufficient on its own to amount to serious professional misconduct.

The Panel also found that in respect of £25,000 of LAB monies, Dr Wakefield caused or permitted it to be used for purposes other than those for which he said it was needed and for which it had been granted. In doing so he was in breach of his duties in relation to the managing of, and accounting for, funds.

In September 1996 Dr Wakefield made an application to the Ethical Practices Sub-Committee of the Royal Free Hospital (Ethics Committee) seeking approval for a research project involving 25 children. This was approved by the sub-Committee as Project 172-96. He named himself as one of the three Responsible Consultants, thereby taking on the shared responsibility for the information given in support of his application; for ensuring that only children meeting the inclusion criteria would be admitted to the study; that conditions attached to the Ethics Committee approval would be complied with; and that children would be treated in accordance with the terms of the approval given.

In respect of Research and Ethics Committee approval, the Panel had regard to the particular ethical guiding principles with regard to conducting research on children. It rejected Dr Wakefield’s overall contention that Project 172-96 was never undertaken; that all the investigations carried out on the children were clinically indicated and that the research elements of the project were covered by another Ethics Committee approval.

The Panel concluded that the programme of investigations that these children were subjected to was part of Project 172-96. It further determined that the conditions for approval and the inclusion criteria for that project were not complied with. The Ethics Committee’s reliance on the probity of Dr Wakefield as a Responsible Consultant was not met.

With regard to nine of the eleven children (2,1, 3, 4, 6, 9, 5,12 and considered by the Panel, it determined that Dr Wakefield caused research to be undertaken on them without Ethics Committee approval and thus without the ethical constraints that safeguard research. Ethical constraints are there for the protection both of research subjects and for the reassurance of the public and are crucial to public trust in research medicine. It was in the context of this research project that the Panel found that Dr Wakefield caused three of these young and vulnerable children, (nos. 3, 9 and 12) to undergo the invasive procedure of lumbar puncture when such investigation was for research purposes and was not clinically indicated. This action was contrary to his representation to the Ethics Committee that all the procedures were clinically indicated. In nine of the eleven children (2,1, 3, 4, 9, 5,12, 8 and 7) the Panel has found that Dr Wakefield acted contrary to the clinical interests of each child. The Panel is profoundly concerned that Dr Wakefield repeatedly breached fundamental principles of research medicine. It concluded that his actions in this area alone were sufficient to amount to serious professional misconduct.

The results of the research project were written up as an early report in the Lancet in February 1998. Dr Wakefield as a senior author undertook the drafting of the Lancet paper and wrote its final version. The reporting in that paper of a temporal link between gastrointestinal disease, developmental regression and the MMR vaccination had major public health implications and Dr Wakefield admitted that he knew it would attract intense public and media interest. The potential implications were therefore clear to him, as demonstrated in his correspondence with the Chief Medical Officer of Health and reports which had already appeared in the medical press. In the circumstances, Dr Wakefield had a clear and compelling duty to ensure that the factual information contained in the paper was true and accurate and he failed in this duty.

The children described in the Lancet paper were admitted for research purposes under a programme of investigations for Project 172-96 and the purpose of the project was to investigate the postulated new syndrome following vaccination. In the paper, Dr Wakefield failed to state that this was the case and the Panel concluded that this was dishonest, in that his failure was intentional and that it was irresponsible. His conduct resulted in a misleading description of the patient population. This was a matter which was fundamental to the understanding of the study and the terms under which it was conducted.

In addition to the failure to state that the children were part of a project to investigate the new syndrome, the Lancet paper also stated that the children had been consecutively referred to the Department of Paediatric Gastroenterology with a history of a pervasive developmental disorder and intestinal symptoms. This description implied that the children had been referred to the gastroenterology department with gastrointestinal symptoms and that the investigators had played no active part in that referral process. In fact, the Panel has found that some of the children were not routine referrals to the gastroenterology department in that either they lacked a reported history of gastrointestinal symptoms and/or that Dr Wakefield had been actively involved in the process of referral. In those circumstances the Panel concluded that the description of the referral process was irresponsible, misleading and in breach of Dr Wakefield’s duty as a senior author.

The statement in the Lancet paper that investigations reported in it were approved by the Royal Free Hospital Ethics Committee when they were not, was irresponsible.

Subsequent to the paper’s publication, Dr Wakefield had two occasions on which he could have corrected the content of the Lancet paper yet both times he compounded his misconduct.

First, in a published letter in response to correspondents who had suggested that there had been biased selection of the Lancet children, Dr Wakefield stated that the children had been referred through the normal channels, a response which was dishonest and irresponsible. He provided an inaccurate statement which omitted relevant information when he knew that the description of the population in the study was being questioned by the scientific community.

Second, at a meeting of the Medical Research Council, the Chair, Professor Sir John Pattison referred to the seriousness and importance of the implications of Dr Wakefield’s research and its major public health implications. At that meeting and on the issue of bias in generating the series of cases, Dr Wakefield stated that the children had come by “the standard route”, a response which was dishonest and irresponsible.

Regarding the issues of conflicts of interest, Dr Wakefield did not disclose matters which could legitimately give rise to a perception of a conflict of interest. He failed to disclose to the Ethics Committee and to the Editor of the Lancet his involvement in the MMR litigation and his receipt of funding from the Legal Aid Board. He also failed to disclose to the Editor of the Lancet his involvement as the inventor of a patent relating to a new vaccine for the elimination of the measles virus (Transfer Factor) which he also claimed in the patent application, would be a treatment for inflammatory bowel disease (IBD).

Even before the publication of the Lancet Paper, eminent professionals had expressed concerns about the LAB funding to Dr Wakefield and potential conflicts of interest. Dr Wakefield rejected these views. With regard to non-disclosure to the Ethics Committee, Dr Wakefield did in evidence accept that the Legal Aid Board funding should have been disclosed, but said that his involvement in the litigation need not, especially because of his interpretation of the questions in the application form. He said no question was asked which related to that matter and therefore felt no need to disclose. In evidence to the panel he stated:

“The form is set out expecting certain answers to specific questions and no such question exists. Therefore, since it was not asked, it was not answered.”

However, given the importance of an Ethics Committee’s reliance on the probity of an applicant, the Panel determined that this was a failure by Dr Wakefield and his actions amounted to serious professional misconduct.

With regard to the non-disclosure to the Lancet the Panel accepted evidence from the Editor of the Lancet, as to the importance of this issue. The Lancet published clear guidance in relation to the conflict of interest test that the applicant should apply and the need to discuss any issues arising from it with the Editor. The Lancet test was: “Is there anything that would embarrass you if it were to emerge after publication and you had not declared it?” Dr Wakefield chose not to declare or discuss any conflict of interest with the Editor. He stated that he was able to reconcile his position, was not embarrassed by it, and was quite proud of the position he had taken on behalf of the Lancet children.

Dr Wakefield was insistent that his involvement with the new patent had not given rise to any prior need to disclose. Despite the clear terms of the patent, he did not accept that the invention was envisaged as an alternative vaccine to MMR. He acknowledged that he had envisaged the use of transfer factor for at least a proportion of the population and that he had a financial and career interest in its success, but he said that it did not cross his mind to disclose it, and even with hindsight he insisted that there was a reasonable argument, as he put it, for non-disclosure. The Panel considered that his actions and his persistent lack of insight as to the gravity of his conduct amounted to serious professional misconduct.

In relation to the administration of Transfer Factor to Child 10, the Panel noted the admitted background of Dr Wakefield’s involvement in a company set up with Child 10’s father as Managing Director, to produce and sell Transfer Factor. Around the same time, Dr Wakefield inappropriately caused Child 10 to be administered transfer factor. The Panel accepted that information as to its safety had been obtained and that the approval to administer Transfer Factor to one child was granted in the form of “Chairman’s approval”, “on a named patient basis” in a letter from Dr Geoffrey Lloyd, Chairman of the Medical Advisory Committee at the Royal Free Hospital. Nonetheless the Panel found that Dr Wakefield was at fault because the substance was given for experimental reasons, he did not cause the details to be recorded in the child’s records, or cause the general practitioner to be informed, and he did not have the requisite paediatric qualifications.

Dr Wakefield’s actions were contrary to the clinical interests of Child 10 and an abuse of his position of trust as a medical practitioner. The Panel considered these to be serious departures from the standards of a registered medical practitioner and concluded that these amounted individually and collectively to serious professional misconduct.

Dr Wakefield caused blood to be taken from a group of children for research purposes at a birthday party, which the Panel found to be an inappropriate social setting. He behaved unethically in failing to seek Ethics Committee approval; he showed callous disregard for any distress or pain the children might suffer, and he paid the children £5 reward for giving their blood. He then described the episode in humorous terms at a public presentation and expressed an intention to repeat his conduct. When giving evidence to the Panel, Dr Wakefield expressed some regret regarding his remarks. The Panel was concerned at Dr Wakefield’s apparent lack of serious consideration to the relevant ethical issues and the abuse of his position of trust as a medical practitioner with regard to his conduct in causing the blood to be taken. The Panel concluded that his conduct brought the medical profession into disrepute.

Dr Wakefield defended the ethical basis for the taking of blood at a birthday party contrary to the experts who gave evidence to the Panel and who strongly condemned this action. The Panel determined that his conduct fell seriously short of the standards expected of a doctor and was a breach of the trust which the public is entitled to have in members of the medical profession. It concluded that this behaviour amounted to serious professional misconduct.

The Panel has borne in mind the principles guiding a doctor as set out in the relevant paragraphs of 1995 Good Medical Practice which relate to providing a good standard of practice and care, good clinical care, keeping up-to-date, abuse of professional position, probity in professional practice, financial and commercial dealings, and the general principles of conflict of interest, followed by particular provisions as to the way in which research must be conducted. The 1998 Good Medical Practice, relevant to Dr Wakefield’s conduct at the birthday party, lists the duties of a doctor in providing a good standard of practice and care, keeping up-to-date and the issue of research and the absolute duty to conduct all research with honesty and integrity.

In all the circumstances and taking into account the standard which might be expected of a doctor practising in the same field of medicine in similar circumstances in or around 1996-1998, the Panel concluded that Dr Wakefield’s misconduct not only collectively amounts to serious professional misconduct, over a timeframe from 1996 to 1999, but also, when considered individually, constitutes multiple separate instances of serious professional misconduct.

Accordingly the Panel finds Dr Wakefield guilty of serious professional misconduct.

In considering what, if any, sanction to apply, the Panel was mindful at all times of the need for proportionality and the public interest which includes not only the protection of patients and the public at large, but also setting and maintaining standards within the medical profession, as well as safeguarding its reputation and maintaining public confidence in the profession. It bore in mind that the purpose of sanctions is not punitive, although that might be their effect.

The Panel noted the submissions of GMC Counsel that the appropriate and proportionate sanction would be erasure in light of his serious and wide-ranging misconduct. However the Panel accepted the Legal Assessor’s advice that this was only a submission on behalf of the GMC and it was for the Panel to make up its own mind. Dr Wakefield’s counsel did not make any substantive submissions on his behalf.

The Panel went on to consider whether it should, pursuant to Rule 30(1), postpone the case. It received no submissions in this regard and so went on to determine whether it was sufficient to conclude the case without making a direction or with an admonition.

The Panel made findings of transgressions in many aspects of Dr Wakefield’s research. It made findings of dishonesty in regard to his writing of a scientific paper that had major implications for public health, and with regard to his subsequent representations to a scientific body and to colleagues. He was dishonest in respect of the LAB funds secured for research as well as being misleading. Furthermore he was in breach of his duty to manage finances as well as to account for funds that he did not need to the donor of those funds. In causing blood samples to be taken from children at a birthday party, he callously disregarded the pain and distress young children might suffer and behaved in a way which brought the profession into disrepute.

In view of the nature, number and seriousness of the findings the Panel concluded it would be wholly inappropriate to conclude the case without making a direction or

with a reprimand.

It next considered under rule 31 whether it was sufficient to direct that the registration of Dr Wakefield be conditional on his compliance during a period not exceeding three years with such requirements as the (Panel) may think fit to impose for the protection of members of the public or in his interests. Conditions have to be practicable, workable, measurable and verifiable and directed at the particular shortcomings identified. The Panel concluded that Dr Wakefield’s shortcomings and the aggravating factors in this case including in broad terms the wide-ranging transgressions relating to every aspect of his research; his disregard for the clinical interests of vulnerable patients; his failure to heed the warnings he received in relation to the potential conflicts of interest associated with his Legal Aid Board funding; his failure to disclose the patent; his dishonesty and the compounding of that dishonesty in relation to the drafting of the Lancet paper; and his subsequent representations about it, all played out against a background of research involving such major public health implications, could not be addressed by any conditions on his registration. In addition, the Panel considered that his actions relating to the taking of blood at the party exemplifies a fundamental failure in the ethical standards expected of a medical practitioner. It concluded that conditional registration would not mark the seriousness of such fundamental failings in his duty as a doctor.

The Panel next went on to consider whether it would be sufficient to suspend Dr Wakefield’s registration for a period not exceeding twelve months. Dr Wakefield has demonstrated a persistent lack of insight and has insisted in many instances on his ethical propriety: in the context of the referral process and the treatment of the children in the research project in which he was engaged; in the context of the funding of the project; with regard to the terminology of the Lancet paper; with regard to his non-declaration of interests; with regard to not acting in the best clinical interests of the Lancet children and with regard to obtaining blood from children at a birthday party.

The Panel noted that the sanction of suspension may be appropriate for conduct that falls short of being fundamentally incompatible with continued registration; where there is no evidence of harmful deep-seated or attitudinal problems; and where there is insight and no significant risk of repeating behaviour. Although these points have been set out in the GMC’s Indicative Sanctions Guidance which was published subsequent to these events, the Panel considered that the guidance outlines the type of sanction appropriate to the gravity of misconduct and that the same principles are applicable to Dr Wakefield’s actions at the material times. The Panel considers that Dr Wakefield’s conduct in relation to the facts found falls seriously short of the relevant standards and that suspension would not be sufficient or appropriate against a background of several aggravating factors and in the absence of any mitigating submissions made on his behalf. Dr Wakefield’s continued lack of insight as to his misconduct serve only to satisfy the Panel that suspension is not sufficient and that his actions are incompatible with his continued registration as a medical practitioner.

Accordingly the Panel has determined that Dr Wakefield’s name should be erased from the medical register. The Panel concluded that it is the only sanction that is appropriate to protect patients and is in the wider public interest, including the maintenance of public trust and confidence in the profession and is proportionate to the serious and wide-ranging findings made against him.

The effect of the foregoing direction is that, unless Dr Wakefield exercises his right of appeal, his name will be erased from the Medical Register 28 days from when formal notice has been deemed to be served upon him by letter to his registered address.

Dr Wakefield is presently not subject to any interim order on his registration. The Panel will hear submissions on whether an immediate order of suspension should be imposed upon him pending the outcome of any appeal, first from Ms Smith on behalf of the General Medical Council and then from Mr Coonan on behalf of the doctor but will do that at the conclusion of the reading of all three determinations.

Earlier this year, he was forced to resign from the US-located autism clinic Thoughtful House, which he established after leaving the UK in 2005. In the longest investigation in the history of the General Medical Council, surrounding his behaviour during research for his notorious “Lancet” paper he was found to be unethical, callous and irresponsible.

Following this, The Lancet made a complete retraction of the paper, six years after the majority of the authors had already disassociated themselves from it in 2004. Another paper, accepted and due to be published in NeuroToxicology, showing that thimerosal caused impaired neurological development in baby macaques, was withdrawn.

These days he can be seen hanging out with the likes of Dr. Joseph Mercola, the anti-vaxer, anti-pharmaceuticals and lover of all things woo.

Yet, because of the publicity at the time (and subsequently) surrounding the Lancet paper, it is often forgotten that what Wakefield and colleagues actually claimed was not MMR causes autism, but that autism was linked to a new form of gut pathology, dubbed “autistic enterocolitis” (essentially ulceritive colitis in autistic children).

But like much of the data in the now retracted paper, it appears the pathology results purporting to demonstrate this are under suspicion. According to a recent feature in the British Medical Journal from investigative journalist, Brian Deer;

“Two years before the paper was published he (Wakefield) was hired by a solicitor to help launch a speculative lawsuit against drug companies that manufactured MMR vaccine. And the instrument of their attack was to find what he called at the time “a new syndrome” of bowel and brain disease caused by vaccines.”

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Notably, Wakefield was also paid in excess of four hundred thousand pounds of legal aid money by the lawyers to find this link. Some pretty hefty vested interests involved there.

But, despite Wakefield being completely disgraced, his believers have clung on even tighter to his findings in the face of consistently damning evidence.

The comments on the piece from Brian Deer already contain claims that other papers have “vindicated” Wakefield’s 1998 study. What they mean is that the findings of ulceritive colitis in autistic children has since been repeated.

(Interestingly, one piece of supporting evidence they are citing is an abstract which was presented at a conference as a poster on Sunday, May 2, 2010. It’s not indicated if it has been published in the conference proceedings).

I haven’t read the studies cited in the comments, which apparently prove Wakefield was right after all, as there are many. But I have no immediate reason to doubt their validity. As a body of work, they may indeed support the hypothesis that ulceritive colitis exists in autistic children.

But why bring in the discredited and retracted (= scratched from the scientific record) Wakefield study into the mix? Why not let the new work stand on it’s own? Particularly when the pathology slides from the Wakefield study are now lost and the conclusions under suspicion.

From Brian Deer:

“The biopsy slides are no longer available, according to one of the paper’s authors, Professor Amar Dhillon, but the GMC obtained all but one of the hospital pathology reports, and for the missing case I obtained the discharge summary. I passed the summary and reports to specialists for their reaction. They concluded that most of the 11 children reported as having non-specific colitis in the Lancet paper had been reported by the Royal Free as having normal pathology.”

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So how was the diagnosis of non-specific colitis obtained in the paper if the pathology slides were normal? Well it’s not entirely clear but it is known that Wakefield apparently wrote them into the paper.

And recall;

“Two years before the paper was published he (Wakefield) was hired by a solicitor to help launch a speculative lawsuit against drug companies that manufactured MMR vaccine. And the instrument of their attack was to find what he called at the time “a new syndrome” of bowel and brain disease caused by vaccines.”

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Even the editor of the Lancet, Richard Horton, who withdrew the paper, was circumspect about the condition;

“I do believe there was, and remains, validity to the connection between bowel disease and autism, which does need further investigation,” Richard Horton told the BBC in February 2004.

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Wakefield has fallen, hoisted by his own petard. He will not be published in scientific journals again. His latest work is “Callous Disregard“, an account of the GMC enquiry in his own words, with a forward by the poster child of anti-vax, Jenny McCarthy. Any one not wanting to tarnish their reputation or their science, would be advised to stay well away.

Congress set up the special judicial forum, sometimes called the “vaccine court,” in 1986 to address claims over vaccine safety, following pressure from parents and anti-vaccine lobbies who insisted there was a link.

Three test cases brought before the court were to pave the way for a class action by thousands of parents of children affected by autism spectrum disorder (ASD), but after reviewing the cases it was deemed there was no convincing evidence.

The vaccines and autism theory was popularised by Dr Andrew Wakefield following the publishing of his 1998 Lancet paper, which has subsequently been retracted. Wakefield was the subject of the longest investigation in the history of the UK General Medical Council for misconduct surrounding research for this paper. The GMC found he had been “callous” irresponsible” and “dishonest”, was paid by lawyers to prove a link between vaccines and autism, had a patent submitted for his own single measles vaccine and conducted unnecessary and painful invasive procedures on children without the correct ethics approvals.

Another blow to his reputation came when his ‘monkey study’ paper, due to be published any day, was withdrawn from Neurotoxicology. This paper was lauded by the anti-vax movement, since it presented evidence for impaired neurological development in baby macaques given vaccines containing thimerosal – the mercury containing component.

It is expected that Wakefield’s work will never again be accepted for publication in any reputable scientific journal. A decision about his status as a doctor in the UK is expected to be made soon, but it is predicted he will be be struck off. He was recently pressured into resigning from his position as director of the alternative medicine clinic Thoughtful House in Texas.

The current status of Wakefield is unknown but his career is in tatters.

In the U.S. Court of Federal Claims, Special masters released more than 600 pages of findings none of which could find a convincing link between vaccination and autism.

Special Master Patricia Campbell-Smith said in her conclusion of test case one, William P. Mead, that the “Petitioners’ theory of vaccine-related causation is scientifically unsupportable.”

“In the absence of a sound medical theory causally connecting William’s received vaccines to his autistic condition, the undersigned cannot find the proposed sequence of cause and effect to be logical or temporally appropriate. Having failed to satisfy their burden of proof under the articulated legal standard, petitioners cannot prevail on their claim of vaccine-related causation.”

In the second test case, Special Master George L. Hastings Jr. wrote,

“After studying the extensive evidence in this case for many months, I am convinced that the opinions provided by the petitioners’ experts in this case, advising the King family that there is a causal connection between thimerosal-containing vaccines and Jordan’s autism, have been quite wrong.”

In the final test case, Special Master Denise K. Vowell wrote of Colin R. Dwyer, a minor, that his parents, Timothy and Maria Dwyer,

“have not demonstrated by a preponderance of the evidence that Colin’s condition was either caused or significantly aggravated by his vaccinations. Thus, they have failed to establish entitlement to compensation and the petition for compensation is therefore denied.”

As predicted, anti-vaccine lobbies are up in arms, claiming government conspiracy to protect the national vaccine programme.

Thimerosal was removed from all childhood vaccines, purely as a precautionary measure, in 1999.

The source for the news was an email circulated on the Thoughtful House Yahoo! list which was given legitimacy with comments left by Brian Deer confirming the story:

Yes, I heard this was coming some days ago. Apparently, Jane Johnson, Krigsman and Anissa Ryland are among those behind it.

Who is Jane Johnson?

This comment was left by @lizditz

The co-managing director of Thoughtful House’s board is Jane Johnson of New York, part of the family of the Johnson & Johnson health care products and services company. Johnson (who co-authored Jepson’s book, Changing the Course of Autism) and her husband, Chris, donated $1 million to lay the groundwork for Thoughtful House in 2004.

Ah, so Jane Johnson is apparently an heir to the fortune of Johnson and Johnson, a big pharmaceutical company.

That’s right folks, Thoughtful House was seemingly established with funds connected to a BIG PHARMA.

Oh the irony! Or hypocrisy.

Anyway, the news was also reported in the media today, with stories from the Times Online and The Guardian in the UK. Thoughtful House have yet to issue a statement, but it appears that Wakefield’s name has been removed from the staff list, however, his publications are still listed.

The reaction from the Australian anti-vaxers has been to cling even tighter to their poster boy, as one commentator said of the headline “Disgraced MMR doctor..”;

He is NOT disgraced – they should be ashamed….. ……… ……… . (1)

But as Brian Deer said on Orac’s post;

What he did to autistic children is just shocking. And what he’s been saying to people around him over the last few years is now seen for what it was: beyond belief.

One wonders what will become of Andrew Wakefield now. It’s looking very likely that he will get struck off the medical register in the UK and with no journal editors wanting to touch his tainted research, it looks like his career as a research scientist is over too.

Brian Deer said;

I always wondered what the reaction to the GMC verdict would be. As the Neurotoxicology withdrawal (taking with it a big chunk of Liz Birt’s hard-raised money, which Wakefield still controls) shows, no reputable journal editor will now accept his data.

Some people facetiously suggested he relocate to Ecuador and hook up with Mike Adams

(Oh, that was me).

Meanwhile on the home front, the deadline for the closure of the AVN is rapidly approaching (eight days to go). They seem to be getting more and more rattled at the moment, going into chaotic spins and devising conspiracy theories about the “septics” left right and centre.

Emails emerged today where they accused one male blogger of being a front woman for a drug company that runs a number of bullying blogs attacking anybody who want honest information on vaccination.

Even I was included at one stage, being accused of getting material that showed me in a bad light removed from a website, of which I have nothing to do with. Actually I left a comment on a post there last year, which now cannot be accessed due to a server problem. I know so much about I.T., I barely even know what this means, let alone how to remove material.

Also, in desperation and no doubt encouraged by the approaching deadline, the AVN sent another pledge email today offering a case of wine as an incentive to the next person who pledges $1000 (2). One wonders how far $1000 will get them, when they were asking for “..a benefactor or series of benefactors come forward to establish a fund that would guarantee the AVN’s existence for at least the next 2-3 years”, but who said there was method in their madness.

A colleague decided to utilise the powers of Sidewiki to inform people considering purchasing products from the winery who donated the loot, describing why “I cannot in good conscience buy Rosnay products”.

Take a look at the post if you have Sidewiki activated in your browser. Suffice it to say, Jason hit the nail on the head. Here’s an excerpt;

It has come to my attention that Sam Statham of Rosnay Wines is a financial supporter of a group called the Australian Vaccination Network. Sam’s most recent offering was a case of Rosnay Wines to the first donator of $1000 in the AVN’s most recent cash drive. The offer was made seemingly not as a personal donation, but as direct corporate endorsement.

.

The Australian Vaccination Network (AVN) is Australia’s largest anti-vaccination organisation. They have been running a campaign of misinformation and fear-mongering since 1994. Many people who now refuse to vaccinate cite the information that they received from the AVN as being partly, or wholly, responsible for their decision not to vaccinate.

I will leave the last word to Brian Deer, who reflected on the downfall of Wakefield on Orac’s post;

Part of me isn’t surprised by this apparent new development. The simple math of Thoughtful House’s board suggests that there will be at least one or two people of calibre and integrity, who know that all the cranksite stuff about a witchhunt, sinister forces and all that shit, are just that: shit. Wakefield has been nailed, absolutely fairly, properly, but belatedly, with no hidden agendas or vested interests.

Apart, that is, from the public interest.

Good riddance to bad rubbish.

–
(1) AVN Yahoo!Group message #42270, sent 12.31 am, February 19, 2010.
(2) AVN Yahoo! Group message #42275, sent 5.47 am, February 19, 2010.

This paper was originally published in October 2009 to the acclaim of the anti-vaxers who commented;

“Neurotoxicology, a highly-respected medical journal, deserves great credit for courageously publishing the first phase of this vaccinated monkey study.”

The study, in macaques reported impaired neurological development in young monkeys following vaccination with a thimerosal containing vaccine.

I commented about this paper on Skeptically Speaking recently, citing, amongst other things, the conflicts of interest statement by the authors as a source of concern. It says;

Prior to 2005, CS and AJW acted as paid experts in MMR-related litigation on behalf of the court retained by plaintiff lawyers. LH has a child who is a petitioner in the National Vaccine Injury Compensation Program. For this reason, LH was not involved in any data collection or statistical analyses to preclude the possibility of a perceived conflict of interest.

As a working scientist, I participate in the peer review process. To me, these conflicts of interests are serious enough to enquire of the editor if the paper should be rejected on these grounds alone. I also can’t help but wonder if the reviewers did any background searches for Wakefield. If they had, my suspicions are this paper would never have been published in the first place.

I certainly hope this means that the studies he is about to publish, as referred to by Generation Rescue below, never see the light of day in a peer reviewed, respectable journal.

Whilst Neurotoxicology is indeed a respectable journal, it is albeit, small fry. With an impact factor of 2.409, it is certainly not a big hitter in the journal stakes. By comparison, The Lancet, which last week, retracted Wakefield’s notorious 1998 paper, has an impact factor of 28.

This Neurotoxicology paper is the one described by Jenny McCarthy and Jim Carrey in a statement following the Lancet retraction. They said;

“There is no question that the publication of the monkey study will lend substantial credibility to the theory that over-vaccination of young children is leading to neurological damage, including autism.”

According to the statement,

Dr. Wakefield and his scientific colleagues are on the brink of publishing their entire study, which followed the monkeys through the U.S. childhood vaccine schedule over a multi-year period. It is our understanding that the difference in outcome for the vaccinated monkeys versus the unvaccinated controls is both stark and devastating.

And

The fallout from the study for vaccine makers and public health officials could be severe. Having denied the possibility of the vaccine-autism connection for so long while profiting immensely from a recent boom in vaccine sales around the world, it’s no surprise that they would seek to repress this important work.

Although the editors of Neurotoxicology do not explain why they withdrew the paper, it seems likely that the GMC findings describing Wakefield as not only being wrong about the science in the Lancet paper, but also acting unethically with respect to using unnecessary and invasive procedures on children, are likely to have influenced their decision. He was also described as “unethical”, “callous” and “dishonest”.

With this third blow to Wakefield’s reputation in a week, the anti-vaxers have finally conceded that he was wrong about vaccine safety, accepted that he had multiple conflicts of interest which he did not declare and disassociated themselves from him.

Just kidding!

Instead they made a BIG FLOW CHART detailing the conspiracy designed to quash “one of the world’s most respected and well-published gastroenterologists.” Click for a high resolution image.

And they’ve also announced that they will republish the Lancet paper in the online quack-fest that is Medical Veritas. As yet, I have not seen any statements from Jen and Jim but, rest assured, it won’t be long before they start screaming conspiracy.

Sigh.

The General Medical Council (GMC) in the UK has handed down their findings on Dr Andrew Wakefield and two colleagues who are credited with catalysing the Measles, Mumps Rubella (MMR) vaccine scare in 1998.

Thousands of parents opted out of having their children vaccinated following the publishing of a paper in the journal ‘The Lancet’ linking MMR with gastrointestinal disorders and autism.

Wakefield’s findings resonated world wide firmly establishing the anti-vaccination movement and resulting in outbreaks of vaccine preventable disease.

The enquiry sat for 148 days and was estimated to have cost one million pounds. The GMC’s disciplinary panel of experts ruled Dr Wakefield showed a ‘callous disregard’ for children’s suffering and abused his position of trust.

His conduct brought the medical profession ‘into disrepute’ after he took blood samples from youngsters at his son’s birthday party in return for payment. He also acted dishonestly and was misleading and irresponsible in the way he described research later published in The Lancet medical journal. More seriously, he was charged with causing pain to sick children by unnecessary painful, intrusive diagnostic treatments

Dr Wakefield faces being struck off the medical register after the panel decided the allegations against him could amount to serious professional misconduct, which will be decided at a later date.

Although The Lancet study did not demonstrate the MMR vaccine as dangerous, Dr Wakefield warned parents to have single injections against measles, mumps and rubella. The claim has been widely discredited. Subsequent studies into the safety of vaccines have demonstrated no link between vaccination, the mercury based preservative thimerosal and autism.

But the anti-vaccination movement calls the findings “unjust”, a “smear campaign” and “a sad day for our children.” Generation Rescue, a militant anti-vaccination group in the US, issued a statement of support saying;

“Dr. Andrew Wakefield is perhaps this debate’s greatest hero. He’s a doctor who has held onto the truth, unbowed, through pressure that would break most mortals. Dr. Wakefield’s influence in saving other children from the fate that befell so many children is incalculable.”

Already petitions have sprung up in support of the Dr who they call “a man of integrity, courage and proven commitment to children and public health.”

But sadly, the facts surrounding this case do not reflect this belief. Wakefield defends his decision to use children at the birthday party as a control group for his study. He continues to believe it was not unethical.

“I had fully informed parent and child consent. The ethics committee is there to protect NHS patients, and these weren’t NHS patients.”

Investigations by Sunday Times journalist Brian Deer revealed that Wakefield had not revealed serious conflicts of interest when submitting his paper for publication. Deer claims he was paid four hundred thousands pounds by lawyers seeking a link between the vaccine and autism. Further, Wakefield had a patent pending on a single measles vaccine, just like the one he urged parents to seek out the press conference following the publishing of the paper.

In 2004, ten of the twelve authors on the paper withdrew their names from the paper.

“We wish to make it clear that in this paper no causal link established between MMR vaccine and autism as the data were insufficient. However the possibility of such a link was raised and consequent events have had major implications for public health.”

The decision as to whether Wakefield is struck off the medical register in the UK is expected to be handed down in the next few months. He currently resides in Texas where he is the director of a alternative medicine clinic, Thoughtful House, which has also been accused of using dubious treatments such a chelation.

Regular readers of my blog would know that that the anti-vaxers are prone to a little hysteria and exaggeration from time to time.

Whether this involves large leaps of logic when extrapolating scientific data or claiming that a car crash death following a vaccine was a direct result of the vaccine, nothing is too ridiculous for them.

What appears to be a stock photo (c) Adrian Brooks at Imagewise may not be what it appears..

Whilst I may have made the latter up, I predict it will be so in the near future. The former however, is true and refers to the recently published Wakefield study, which reported impaired neural development in baby macaques (monkeys) following an injection with low concentrations of thimerosal, lower than what is normally found in vaccines. This was all the evidence the anti-vaxers required to prove that thimerosal is the cause of autism. The scientists amongst you would know this is a preposterous leap where the most you could really say about a causal link with autism is that the data is interesting and may warrant further investigation. Howe er you may even hesitate to do this before very closely analysing the study, since Wakefield does not have a good reputation for publishing accurate data.

You may recall that the Lancet publication which started the whole autism/MMR controversy has since been retracted by the journal, and 10 of the 12 authors also stated unequivocally in a publication in 2004 (1);

“(we) wish to make it clear, that in this paper no causal link was established between the MMR vaccine and autism as the data were insufficient. However the possibility of such a link was raised and subsequent events have had a major implications for public health. In view of this we consider now is the appropriate time that we together formally retract the interpretation placed upon those findings in the paper, according to precedent”.

It has also since been revealed that the PCR data which reported measles RNA in the gut of the children, and this data was critical for the conclusions of the study, cannot be replicated and is now suspected to be fabricated. Other damning evidence which bring the paper into disrepute is information that Wakefield was paid 400,000 pounds by lawyers looking for a link between autism and MMR and also that he himself was involved with the development of a single measles vaccine.

Now all of this taken together would make any intelligent critical thinking person ever after suspicious of Wakefield’s work.

I review papers as part of the peer review process and had I seen the macaque manuscript, I would have been very careful to thoroughly scrutinize it before approving it for publication (assuming I did), particularly after I read the conflict of interest statement herein;

“Prior to 2005 CS (Carol Stott, third author) and AJW (Wakefield) acted as paid experts in MMR-related litigation on behalf of the court retained by plaintiff lawyers. LH (Laura Hewitson, first author) has a child who is a petitioner in the National Vaccine Injury Compensation Program. For this reason, LH was not involved in any data collection or statistical analyses to preclude the possibility of conflict of interest”.

..it's proof that Tamiflu is really really DANGEROUS

I’m not sure this gets the authors off the hook in my opinion. This is a pretty serious conflict of interest, for all of them. Wakefield runs a woo clinic charging large amounts of money to administer quack, very expensive and dangerous autism treatments. The lead author on the paper is attempting to sue the government for vaccine damage to her daughter and both Wakefield and third author Carol Scott get paid to say MMR is bad. I would have to leave this to the discretion of the editor but this seems like a too serious breach of conflict of interest to me to let it go unquestioned. And perhaps it wasn’t – I am not privvy to the review process on this paper, but I would certainly love to know.  (As an aside, I have selected “alternative medicine” as one of my areas of speciality, but as yet I have not received such a manuscript to review).

In any case, it now seems that hysteria, cherry picking and jumping to conclusions is not limited to published data. It now includes photographs.

So behold readers, now the anti-vaxers are claiming that the photo to the right is photographic evidence that the drug used in the treatment of H1N1, Tamiflu is so dangerous that you can only handle it wearing a mask, EVEN WHEN IT IS SEALED!

This is a stock photo, made to look sciencey by the presence of the mask. If Tamiflu were that TOXIC then why would the scientist not be wearing gloves? Or a HAZCHEM suit? I DON’T KNOW BUT I’M NOT HANGING AROUND TO FIND OUT, ARGHHH. TOXIC! WASTE! STUPID! BURNS!

(1) Lancet, 2004 Mar 6;363(9411):750.

“Defiant mummies, whom one pictures at the helm of their 4×4s, trailing clouds of particulates and rubella, declare that they don’t care what anyone thinks about their lifestyle choice. It’s not their fault if their unvaccinated children should chance to infect babies, pregnant women or anyone with a weakened immune system”.

She goes on to say that if they can’t be convinced by science and evidence then “…I can only suggest that vaccine-dodgers have their principles fully tested, but in a really non-authoritarian way” by giving schools the power to rule whether they will accept unvaccinated kids.

“…most schools would probably support the MMR as a condition of enrolment, leaving dodgers to send their children to schools tolerant of the unjabbed, where their diverse immune systems can be challenged in a truly diseased environment. Admittedly, these MMR-free academies may be unfair on the children. But so, when they could have been eradicated, are measles epidemics”.

Hear, hear.

Considering the recent resurgence of this debate, sparked by the ramblings of LBCs 97.3FM’s Jeni Barnett last week, I thought it appropriate to make you aware of the “retraction of interpretation” published in the Lancet in 2004 and written by 10 of the 12 authors of the original paper. This includes Murch and Walker-Smith who, along with Wakefield, are currently being investigated by the General Medical Council of the UK for serious professional misconduct relating to the Lancet publication. Conspicuous by his absence from this retraction is Dr Wakefield. The authors explain that they

“wish to make it clear, that in this paper no causal link was established between the MMR vaccine and autism as the data were insufficient”

The entire retraction is reproduced below, please click on the image to see it in high resolution.

Lancet, 2004 Mar 6;363(9411):750.

I want to emphasise this was published in 2004. Almost FIVE years ago. Yet the anti-vaccers, including the likes of the toxic Jeni Barnett still insist there is a link between MMR and autism. Just to make sure I didn’t get it wrong, here is the important part, enlarged.

This seems pretty clear to me.

So why is this debate still on-going? If the authors have admitted they may have got the interpretation of their own data wrong, why is it the anti-vacc crowd think they know better?
And when will they realise the Wakefield paper was never a definitive finding on MMR and autism?
Especially when you look at the conflict of interest issues also clouding this publication which constitutes part of the reason why Wakefield is currently being investigated for serious professional misconduct.

For the anti-vacc crowd it seems like this might be a case of Saunders’* law in action;

The more bizzare the premise, the more entrenched the belief.

*Richard E. Saunders

You can read the entire 1998 Lancet paper, for free reproduced here on Brian Deer’s blog.