The case against Dr Andrew Wakefield: Part 1

When the MMR triple vaccine was launched in the UK in 1988, I had no hesitation in making sure both my children got it. I didn’t want them to go through what I’d been through in my own childhood: weeks off school, isolated, miserable and ill in my bedroom. I recovered fully from all the infectious diseases I got. Other children of my generation were left with permanent disabilities. Some died.

Horrified at the large-scale re-emergence of measles and aware that a doctor called Andrew Wakefield was being blamed by some while being hailed as some kind of hero by others, I took it upon myself to read everything I could find on the subject. This is what I found out:

In 1998, the Lancet published the report of a study by Andrew Wakefield and 12 colleagues into what they called ‘autistic enterocolitis’. This paper said,

We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described. Virological studies are underway that may help to resolve this issue. If there is a causal link between measles, mumps, and rubella vaccine and this syndrome, a rising incidence might be anticipated after the introduction of this vaccine in the UK in 1988. Published evidence is inadequate to show whether there is a change in incidence.

Wakefield called a press conference to coincide with publication. I haven’t seen a video or read a transcript of this conference but it was reported that Wakefield went somewhat further than the Lancet paper and asserted he was confident a causal link between the vaccine and the syndrome would be found very soon. He also called on parents to reject the triple vaccine :

I can’t support the continued use of these three vaccines, given in combination, until this issue has been resolved.

His hypothesis, as I understand it, was that the measles virus in the MMR vaccine damaged the intestine, allowing harmful proteins from the gut to enter the bloodstream and travel to the brain, causing autism (or something like that).

In 2004, the Sunday Times published a story by investigative reporter, Brian Deer, exposing Wakefield as a liar. Further stories by Deer have appeared since, none of them favourable to Wakefield who, together with co-authors John Walker-Smith and  Simon Murch, is being tried by the General Medical Council on a charge carrying out unauthorised research on the 12 children

Here — in no particular order — is a list of what has been alleged (by Deer and others) about Wakefield:

Selection of study participants

According to the Lancet paper, the twelve children in the study were ‘consecutively referred’ to the Royal Free Hospital’s pediatric gastroeneterology unit with various bowel complaints. The impression given was that these children — most of whom had been diagnosed with autism spectrum disorders — just happened to turn up, one after the other, to his clinic.

However, Wakefield later admitted that these children didn’t just happen to be consecutively referred. Some of their parents had actively sought him out because they believed their children had been damaged by the MMR jab and they knew about Wakefield’s prior view that measles was somehow linked to bowel disease (a view that had not been found to have any basis in fact).

So the selection was (1) seriously biased and (2) gave the false impression that the supposed link between bowel problems and autism was far more common than it is.

Funding

Wakefield wrote that his study was supported by Special Trustees of the Royal Free NHS Trust and the Children’s Medical Charity.

He omitted to mention the biggest funder was the government’s Legal Aid Board. In June 1996 Wakefield and Barr wrote to the Legal Aid Board requesting funding to “seek evidence which will be acceptable in a court of law of the causative connection between either the mumps, measles and rubella vaccine or the measles/rubella vaccine and certain conditions which have been reported with considerable frequency by families who are seeking compensation.”  Their application was successful. Wakefield only admitted this after Sunday Times reporter, Brian Deer, unearthed the evidence, some of which can be seen here.

This was a clear conflict of interest that he should have declared. It was the unearthing of this fact that caused Richard Horton, editor of the Lancet, to say that if he’d known about it he wouldn’t have published that part of the paper that raised the possibility of a link between MMR and autism. Wakefield’s collaborators in the study also claim not to have known about it and, as a result, ten of the original 13 formally retracted that part of the paper.

Exactly how much did Wakefield get paid to find this link between MMR and autism and promote it vigorously? The figure of £50,000 was clearly documented and exposed by Brian Deer in 2004. Even so, Wakefield initially denied it, claiming it was closer to half this amount and said that, anyway, he had used it all to pay a research assistant.

However, two years later, according to the figures released under the Freedom of Information Act, Wakefield was in fact paid £435,643 in fees, plus £3,910 expenses for a variety of services in the cause of frightening parents away from the MMR jab.

Lab results

The lynchpin of the study was the supposed discovery of the measles virus in the gut of the children he investigated. The gut biopsy and spinal fluid samples were collected from the children and tested by Nicholas Chadwick, a research assistant at the Royal Free’s own lab. Chadwick was later to testify in front of a congressional committee in the US that he had tested the samples and they had proved negative and that he had told Wakefield this. Yet Wakefield claimed in the paper that evidence of the measles virus had been found.

One of the children’s parents, an American, took his son’s biopsies from the Royal Free to the Institute of Cancer Research for a second opinion. He then took it to three different labs in the USA. He asked all the labs to look for the measles virus. No measles virus was found. All four labs sent back negative results.

It was later discovered that, unsatisfied with the negative lab results (which he kept quiet about), Wakefield had sent the samples to the Professor John O’Leary’s Unigenetics lab in Dublin. This lab wasn’t accredited and on being investigated, it was found to be contaminated with DNA, leading to false positive results. Nicholas Chadwick asked for his name to be removed from the study before publication because he “wasn’t comfortable with the quality of the data”. The Unigenetics lab is no longer in business.

Ethics Committee approval

This it the one I understand the least but Deer makes a case that, contrary to what was claimed in the Lancet paper about the research having Ethics Committee approval, approval had in fact been given for a somewhat different study.  Taking account of what I’ve read elsewhere, there seems to be more to this one than meets the eye and the Ethics Committee itself doesn’t come out it too well either.

Invasive procedures

Invasive procedures such as lumbar punctures and bowel scopes were said by Wakefield et al to have been clinically indicated and therefore Ethics Committee approval for them was unnecessary.

In fact they were not clinically indicated and approval should have been sought. According to a Daily Mail report, one five year old child was left in a critical condition after his colon was perforated over 12 times.

£500,000 for boy left fighting for life after being used as MMR guinea pig

Wakefield’s single measles vaccine

Wakefield forgot to tell us that he’d been beavering away developing a rival vaccine of his own: a single measles vaccine and related products, for which his first patent application was filed three months before publication of the study and two further applications were filed some time later. It’s not difficult to find the documentary evidence for these applications on the web. Here’s the link to the measles one.

At the press conference Wakefield called at the time the study was published, he advised parents to reject the MMR vaccine in favour of single vaccines. He didn’t go so far as recommending the vaccine that he himself was planning and hoping to make a fortune from. I can’t think why. 🙄

Correct me if I’m wrong but I believe that single vaccines are no longer available on the NHS and only obtainable from doctors in private practice. Furthermore, Wakefield — who is not, after all, an immunologist or a pediatrician — recommended something like a 12 month interval between each one. This was, in effect, a call to leave children unprotected from potentially serious infectious diseases for far longer than necessary, as well as subjecting them to six injections instead of two.

Was he justified?

It’s now been eleven years since Wakefield reportedly predicted that a link between MMR and ASD would be found. No link has been found. His hypothesis about the vaccine causing a leaky gut etc has been soundly refuted. (Although Wakefield’s supporters are claiming that his research has been replicated, I have not yet been able to find any references to relevant studies). It is said that in some of the children he studied, the symptoms of gastric problems predated their MMR jabs. Furthermore, epidemiological studies involving millions of children have failed to show any link between MMR and autism.

In my next post, I’ll take a look at the most recent allegations about Wakefield falsifying data and at his and his supporters response.

In the meantime, in the interests of fairness, here is Wakefield’s response to Brian Deer’s previous allegations. It’s worth noting that he later sued Deer for libel, only to abandon his claim and end up paying Deer compensation. The  court report reveals that, having filed a suit against Deer, Wakefield then sought a stay of execution of the suit and, while it was on hold, used it as a way of threatening others with similar action.

The judge said,

I am quite satisfied…that the Claimant wished to extract whatever advantage he could from the existence of the proceedings while not wishing to progress them or to give the Defendants an opportunity of meeting the claims.

Finally, anyone who enjoys stories about children being hurt and upset at birthday parties, might like to watch this brief video about this hero of the anti-vax movement’s unconventional approach to blood sampling.

 

1 thought on “The case against Dr Andrew Wakefield: Part 1”

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.