Tweet

First he got struck off the medical register in the UK, then his favourite paper was retracted from the Lancet, then the anti-vaxers favourite paper got withdrawn (which they still cite BTW*), then he was quietly removed from his job at Thoughtful House. Following his move to Texas in 2010, the phrase going around the internets was he “lost his career and his country”. Not only that, he also lost all respect from the scientific community and the chance to ever publish in the mainstream scientific literature ever again.

If you reap what you sow, then it appears Wakefield’s chickens have come home to roost – and these are not small chickens either. Imagine Brian Deer in a chicken costume, sitting aloft Wakefield’s tower, watching every move with beady eyes (well that was what I imagined anyway). Brian Deer of course being the “UK investigative journalist who exposed Wakefield’s Lancet work for not just “bad science” but for deliberate fraud. Deer has been on Wakefield’s case for some seven years now and was the first guy to blow the whistle on the now infamous paper which kicked-off the worldwide vaccines-cause-autism scare.

I’ve been following this case for a long time, so I knew the background well, but even I was shocked when I read the three part series published by the BMJ last week.

Deer provides evidence that Wakefield fabricated the clinical data for the 12 kids to make it appear they had suffered neurological disorders soon after they received their MMR. Wakefield had a business plan to set-up a company making kits to detect ulcerative colitis which was projected to make 72.5 million pounds a year. Wakefield received almost $AUD700,000 (plus expenses) from lawyers assembling a class action suit against the manufacturers of the MMR. The same lawyers had paid 50,000 pounds to fund the Lancet study. Wakefield had a patent for a single measles vaccine, which was projected to make him a very wealthy man once he had discredited the triple version.

And none of this was revealed to the journal before he published the paper. This constitutes a huge conflict of interest.

Of course, the reaction from the anti-vaxers has been predictable. Even Wakefield himself referred to Deer as hit-man sent by “them”. On Anderson Cooper in the US, Wakefield claimed it was an effort by the medical community to quash valid research into the safety of vaccines.

Which is interesting. Really interesting.

Because what was so revealing to me – out of all the revelations in the papers from the BMJ – was the fact that Wakefield was offered the chance to reproduce the results from the Lancet paper.

From “How the vaccine crisis was meant to make money“

“…UCL volunteered to support his work. It offered him continuation on the staff, or a year’s paid absence, to test his MMR theories. He was promised help for a study of 150 children (to try to replicate his Lancet claims from just 12) and, in return for withdrawing from the January London conference, he would be given the intellectual property free.

“Good scientific practice,” the provost’s letter stressed, “now demands that you and others seek to confirm or refute robustly, reliably, and above all reproducibly, the possible causal relationships between MMR vaccination and autism/“autistic enterocolitis”/inflammatory bowel disease that you have postulated.”

Then this:

“At the time, Wakefield agreed. Then his employer waited. It prompted, waited longer, and prompted again. “Three months have elapsed,” Llewellyn-Smith wrote to him in March 2000, asking for “a progress report on the study proposed” and “not to make any public statements” in the meantime.

But the study did not happen. The 1998 Lancet research had been a sham. Trying to replicate it with greater numbers would have been hopeless.

So Wakefield’s claims of “trying to quash valid vaccine research” are lies. He was given the opportunity to reproduce his work – he never did. And it all becomes clear why. A complex lie based on 12 children when amplified in 150, just becomes a bigger lie.

But it didn’t stop Wakefield from spiralling further down the rabbit hole. I hoped he might have retreated into a corner somewhere, maybe to slap out some more fictional books with forwards by our favourite Mommy warrior, Jenny McCarthy. But given that the man has an ego the size of a buffet in Vegas, sadly, this has not happened.

Instead, yesterday it was revealed on Twitter by @sthmnookin and @doctorblogs that he’s back stomping the pavements trying to recruit patients for his next favourite woo autism therapy. This time, instead of parents recruited by a law firm, he’s targeting the Somalian population of Minnesota who reportedly have a higher than usual occurrence of autism.

On January 18th it was announced that the CDC, the NIH and Autism Speaks National would begin a study to investigate this anomoly among Somali-Americans in Minneapolis. The Minnesota Department of Health released a report in 2009 confirming higher rates of Somali-American kids participating in special education classes for children with autism in Minneapolis. But it’s still unclear whether these data are real or artificially inflated because Somali parents prefer to enroll their children in school-based programs, as opposed to seeking help from autism specialists in the medical community. You can read more about it here.

So Wakefield, given that he is incapable of understanding he is a danger to children, has jumped on the bandwagon, sticking his fraudulent nose where it doesn’t belong and addressing a group of parents at a local restaurant in an effort to recruit patients for his own study.

This screen cap was published on Twitter by @doctorblogs and retweeted by @sethmnookin

So essentially Wakefield wants to use the Somali kids as more guinea pigs – as he did in his Lancet study – with the unproven and potentially dangerous therapy of hyperbaric chamber treatment for autism. According to the newspaper clipping, many parents have already signed up. And why wouldn’t they. There is no cure for autism, we don’t even know yet what combination of factors cause it. So of course desperate and vulnerable parents are only willing to agree to participate, even if it potentially puts their kids’ health at risk and in the knowledge that Wakefield is a fraud.

How much more harm can Wakefield do? Sadly, it seems a lot.

————-
Click to read Part 1, Part 2 and Part 3 of the Lancet’s investigations.

*when a paper is withdrawn or retracted it can be for a number of reasons, including the work has been published elsewhere, something fundamentally wrong with the data has been detected or the data is deemed to be fraudulent. Only under exceptional circumstances will a paper be retracted or withdrawn. When it happens, it means you can no longer refer to it or “cite” it – it has essentially been scratched from the scientific record (even if it is cached on InfoWarriors).

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.”

.

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.”

.

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.”

.

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.

.

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.

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.

The 1998 paper which was published in the Lancet signalled the beginning of the anti-vacc movement and is considered responsible for a 12% decrease in the vaccination rate in the UK. Wakefield is being investigated for serious professional misconduct along with John Walker-Smith and Simon Murch, two professors who contributed to the research. All three have denied any wrongdoing.

Andrew Wakefield attends the hearing in 2008, flanked by his wife and supporters displaying placards.

An investigation, begun in July 2008 by the General Medical Council in the UK accused the three of acting dishonestly and unethically in compiling the research, which suggested there could be a link between the triple jab, bowel disease and autism. However, it has since been revealed that Dr Wakefield allegedly paid children £5 to take their blood at his son’s fifth birthday party.

One of the key claims is that Dr Wakefield accepted £50,000 for research to support parents’ attempts to fight for compensation. Among the 46 allegations, Dr Wakefield was accused of allowing one patient – Child 10 – to be given an experimental drug, “Transfer Factor”, with a view to it becoming a measles vaccine. Further, he admitted being involved in proposals in 1998 to set up a company – Immunospecifics Biotechnologies Ltd – to manufacture the drug, with the intention that the father of Child 10 become its managing director.

He also admitted proposing that the equity in the company would be split between himself, as its research director, the father and other parties.

The Sunday Times investigation by Brian Deer, claims to have confirmed evidence presented to the General Medical Council (GMC), which states that:

“In most of the 12 cases, the children’s ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal”.

Even if it is revealed that Wakefield faked the data, it is unlikely to end the anti-vacc movement. THe case continues. We wait with baited breath to see the outcome.