Andrew Wakefield - The Skeptic's Dictionary

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<div class="logo"> <img src="_images/logo_01.png" alt="The Skeptic's Dictionary" width="270" height="60" border="0" />           by <a href="http://skepdic.com/refuge/bio.html">Robert Todd Carroll</a> * est. 1994 </div> <div class="slogan"> <img src="_images/slogan_01.gif" alt="A Collection of Strange Beliefs, Amusing Deceptions, and Dangerous Delusions" width="362" height="30" /> </div> </div> <div class="menu"> <ul> <li></li><li><a href="http://skepdic.com/">Home</a></li> <li><a href="http://skepdic.com/news/">Newsletter</a></li> <li><a href="http://skepdic.com/feedback.html">Feedback</a></li> <li><a href="http://skepdic.com/faq.html">FAQ & Interviews</a></li> <li><a href="http://skepdic.com/tour.html">Site Map</a></li> </ul> </div> <div class="middle"> <div class="left"> <h2>Topical Indexes</h2> <ul class="nav_1"> <li><a href="http://skepdic.com/tialtmed.html">Alternatives to Medicine</a></li> <li> <a href="ticriticalthinking.html">Critical Thinking</a></li> <li><a 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href="http://skepdic.com/contents.html#K">k</a></li> <li><a href="http://skepdic.com/contents.html#L">l</a></li> <li><a href="http://skepdic.com/contents.html#M">m</a></li> <li><a href="http://skepdic.com/contents.html#N">n</a></li> <li><a href="http://skepdic.com/contents.html#O">o</a></li> <li><a href="http://skepdic.com/contents.html#P">p</a></li> <li><a href="http://skepdic.com/contents.html#Q">q</a></li> <li><a href="http://skepdic.com/contents.html#R">r</a></li> <li><a href="http://skepdic.com/contents.html#S">s</a></li> <li><a href="http://skepdic.com/contents.html#T">t</a></li> <li><a href="http://skepdic.com/contents.html#U">u</a></li> <li><a href="http://skepdic.com/contents.html#V">v</a></li> <li><a href="http://skepdic.com/contents.html#W">w</a></li> <li><a href="http://skepdic.com/contents.html#X">x</a></li> <li><a href="http://skepdic.com/contents.html#Y">y</a></li> <li><a href="http://skepdic.com/contents.html#Z">z</a></li> </ul> <webContent><h1>Andrew Wakefield, M.D.</h1> <blockquote> Fewer youngsters worldwide are dying of childhood diseases now than at any other time in history. About 80% of children today are vaccinated against such deadly illnesses as measles and polio, compared with 20% in the early 1980s.<a href="http://www.time.com/time/magazine/article/0,9171,1125860,00.html?iid=sphere-inline-sidebar">*</a> There were an estimated 30 to 40 million cases of measles in 2000, causing some 777,000 deaths.<a href="http://www.who.int/mip/2003/other_documents/immunization/en/">*</a> ...immunization can be credited with saving approximately 9 million lives a year worldwide. A further 16 million deaths a year could be prevented if effective vaccines were deployed against all potentially vaccine-preventable diseases.<a href="http://www.unicef.org/pon96/hevaccin.htm">*</a> "Health officials say aggressive efforts to vaccinate young children against measles have resulted in a 74 percent global decline in the number of deaths due to the illness [between 2000 and 2007]. Experts say the biggest decline, 90 percent, occurred in the Eastern Mediterranean region."<a href="http://www.voanews.com/english/archive/2008-12/2008-12-04-voa48.cfm?CFID=136764874&CFTOKEN=49223763&jsessionid=6630d3ca972e32db8702e78b156f46226301">*</a> In England and Wales, measles cases increased 36% in 2008.<a href="http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1233822584984?p=1231252394302">*</a> Measles cases more than doubled from the year before during the first half of 2008 in the United States.<a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5733a1.htm">*</a> "To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one," says J. B. Handley, co-founder of Generation Rescue.<a href="http://www.nytimes.com/2011/04/24/magazine/mag-24Autism-t.html?_r=0">*</a> </blockquote> Dr. Andrew Wakefield, a gastroenterologist once associated<img border="0" src="graphics/wakefield.jpg" style="float: right" alt="Andrew Wakefield" width="106" height="153"> with the Royal Free Hospital of London, sounded the alarm about a possible connection between the MMR vaccine, autism, and bowel disease in children in a report published by The Lancet in 1998. <a href="http://www.bmj.com/content/342/bmj.c7452.full">Wakefield's "study" has been called fraudulent by the BMJ</a>, but that charge has been <a href="http://www.prnewswire.com/news-releases/ongoing-investigations-by-dr-david-lewis-refute-fraud-findings-in-dr-andrew-wakefield-case-133649563.html">challenged by Dr. David Lewis</a>. The report has the imposing title of "<a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673697110960/fulltext">Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children</a>." Most scientists have dismissed Wakefield's work, including an earlier report published in 1993, as <a href="http://www.mja.com.au/public/issues/175_03_060801/macintyre/macintyre.html"> inadequate</a> and <a href="http://news.bbc.co.uk/hi/english/health/newsid_1100000/1100174.stm"> dangerous</a>. The 1998 report involved only 12 children. Both "studies" were: <blockquote> conducted on highly selected patients referred for gastrointestinal ailments. The studies had <a href="control.html">no controls, were unblinded</a> and were not designed to test aetiology or harm. There were multiple potential sources of bias. For example, the association between vaccination and autism was based primarily on parental recall — parents are likely to link changes in behaviour with memorable events such as vaccination, thereby introducing "recall" bias. Such a case-series analysis is unable to determine causal links. Moreover, the onset of autism and MMR vaccination may appear to be associated in time because the average age at which parents report concerns about child development is 18-19 months and most children receive MMR vaccine before their second birthday.<a href="http://www.mja.com.au/public/issues/175_03_060801/macintyre/macintyre.html">*</a> </blockquote> An investigation by journalist Brian Deer uncovered the fact that two years before the 1998 Wakefield group report was published, Wakefield had begun receiving money from lawyers, led by <a href="http://briandeer.com/mmr/lancet-summary.htm#fivefaces"> Richard Barr</a>, wanting to file lawsuits against vaccine manufacturers. Of £3.4m distributed to doctors and scientists recruited to help build their case, Wakefield received £435,643 in fees, plus £3,910 expenses.<a href="http://briandeer.com/mmr/st-dec-2006.htm">*</a> Deer also discovered that in 1997 Wakefield had applied for <a href="http://briandeer.com/wakefield/wakefield-patents.htm">a patent for a measles vaccine</a> on behalf of the Royal Free hospital medical school and the Neuroimmuno Therapeutics Research Foundation, a private company of unconventional immunologist <a href="http://briandeer.com/wakefield/hugh-fudenberg.htm"> Professor H. Hugh Fudenberg</a> of Spartanburg, South Carolina. (Fudenberg claimed in a 2004 interview with Deer that he cured autistic children with his own bone marrow.) Wakefield's vaccine would be a potential competitor to the MMR and single-shot measles vaccines. The final blow to whatever credibility Wakefield had left was delivered in 2009 when it was discovered that he had <a href="https://web.archive.org/web/20100525134829/http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece"> fixed his data</a>. In 2004, a <a href="http://www.vaccinesafety.edu/Lancet-MMR-03-2004.htm"> statement was issued </a>by 10 of the 12 authors of the 1998 Wakefield report (John Linnell, the 11th author, could not be reached). It reads: <blockquote> We wish to make it clear that in [the 1998] paper no causal link was 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. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon [the] findings in the (1998) paper, according to precedent. </blockquote> Two years before Wakefield was rebuffed by his former colleagues, he testified before a U.S. congressional hearing, chaired by <a href="https://web.archive.org/web/20081226213117/http://www.house.gov/burton/autism.htm">Rep. Dan Burton</a>, on the link between vaccines and autism. Wakefield testified that he had studied scores more children since the 1998 paper, "identifying almost 150 in whom MMR had triggered autism."<a href="http://www.newsweek.com/id/185853/page/2">*</a> Irish pathologist John O'Leary also testified. Wakefield had been citing O'Leary's work, in which he claimed to find many cases of the measles virus present in children with gut disorders. O'Leary testified that "Wakefield's hypothesis is correct." <a href="http://briandeer.com/mmr/oleary-pcr.htm"> After a court in Ireland ordered him to turn over his raw data</a> so experts could evaluate it, O'Leary issued this statement: "At no time have I set out to prove that MMR causes autism. Instead, I have sought to investigate a novel bowel pathology in children with autism. In our <a href="http://www.ncbi.nlm.nih.gov/pubmed/11950955?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum&log$=freejrpmc">Molecular Pathology</a> paper we have described an association between the presence of measles virus and new variant inflammatory bowel disease. We have never claimed that this is causal and indeed I have been forthright in transmitting this information to the public at large in the form of press statements. I have and continue to urge people to vaccinate their children. My advices and findings were consistently and persistently to vaccinate children and to use MMR."<a href="http://briandeer.com/mmr/oleary-statement.htm">*</a> Serious questions were raised about the reliability of O'Leary's work when even some of the controls tested positive for the measles virus. mercury and the U.S. scare Across the pond in the U.S. a different scare was being perpetrated: fear that mercury was poisoning our children and causing many kinds of neurological disorders, including autism. On July 7, 1999, the American Academy of Pediatrics (AAP) and the U.S. Public Health Service issue a warning about the preservative thimerosal (which contains ethylmercury) in many vaccines. In a joint statement they noted that there are "no data or evidence of any harm" from thimerosal. Nevertheless, the AAP warned that children's cumulative exposure to mercury from vaccines "exceeds one of the federal safety guidelines" for mercury. Infants who received all of their vaccinations could be exposed to a cumulative dose of ethylmercury as high as 187.5 µg (or 0.00000661 ounces, i.e., less than 7 millionths of an ounce) by 6 months of age. This value exceeded guidelines recommended by the Environmental Protection Agency (EPA), but did not exceed those recommended by the Agency for Toxic Substances Disease Registry (ATSDR) or the FDA. It should be noted that "guidelines from the EPA were based in part on data from pregnant women in rural Iraq who were exposed to large quantities of methylmercury."<a href="http://pediatrics.aappublications.org/cgi/content/full/112/6/1394">*</a> In the U.S., fear of vaccines because of the preservative thimerosal was part of a larger fear of mercury ingestion, including the fear of eating fish that contain methylmercury. The FDA, which regulates commercially caught fish, sets an "action level" of 1 part methylmercury per million parts. That's "about 480 micrograms (0.000017 ounces, less than 200 thousandths of an ounce) of methylmercury in one pound of fish."<a href="http://www.eurocbc.org/page462.html">*</a> The EPA, which does not regulate commercial fish, has a "reference dose" that says people can be exposed to 0.1 microgram per kilogram of body weight per day, which is roughly “5 to 7 micrograms (0.00000018 to 0.00000025 ounces) per day for someone who weighs 100 to 154 pounds.”<a href="http://www.eurocbc.org/page462.html">*</a> The AAP statement did not mention autism.<a href="http://www.newsweek.com/id/185853/page/1">*</a> Nor did it note that thimerosal contains ethylmercury and the federal safety guidelines are for methylmercury.<a href="http://www.slate.com/id/2123647/">*</a> Methylmercury is absorbed more quickly and retained much longer than ethylmercury, and is thus significantly more dangerous.<a href="https://web.archive.org/web/20090615224524/http://www.ehponline.org/docs/2005/7712/abstract.html">*</a> Neither the media nor the general public, however, noted the difference and the anti-vaccination movement got a large boost from the AAP. Thimerosal was removed from most childhood vaccines by 2001 "as a precautionary measure."<a href="http://pediatrics.aappublications.org/cgi/content/full/112/6/1394">*</a> Thimerosal has never been used in the MMR vaccine.<a href="http://www.cdc.gov/vaccinesafety/Concerns/thimerosal/thimerosal_faqs.html#11">*</a> Wakefield and measles epidemics  Wakefield, as far as I know, never got on the thimerosal bandwagon. His work is considered dangerous because it has been blamed for the hysterical <a href="antivaccination.html">anti-vaccination movement</a> that was partly responsible for a measles epidemic in <a href="http://web.archive.org/web/20040620230351/http:/www.educationmatters.ie/news/New020204.htm"> Ireland</a>: over 1600 cases reported and three associated deaths in 2000, most in the Dublin area. The vaccination rate had fallen to 63 percent in parts of Dublin and 72 percent nationally.<a href="http://query.nytimes.com/gst/fullpage.html?res=9E01EFDF123BF93BA35751C0A9659C8B63">*</a> Not all of the failures to vaccinate were due to conscious rejection of the MMR due to fears raised by Wakefield, however. Compliance has been a persistent problem in parts of Ireland, but public health officials blamed a sudden surge in cases of measles (from 30 to 100 in a six-week period) to fears fueled by media reports of the potential dangers from the MMR. Other epidemics have been attributed to the anti-vaccination movement that Wakefield and his colleagues fueled by the claims they made and the way those claims were presented by the press to the general public. Fear of getting autism or inflamed bowels from the MMR vaccine became a rallying cry in the UK. The fear of inflamed bowels, as far as I know, has never been a central feature of the anti-vaccination movement in the US, where the fear focused first on mercury and then, since mercury has been removed, on some unknown danger from the quantity of shots given to children, though this fear has no scientific basis. <a href="http://www.cdc.gov/vaccinesafety/Vaccines/multiplevaccines.html#2"> According to the CDC</a>: <blockquote> The available scientific data show that simultaneous vaccination with multiple vaccines has no adverse effect on the normal childhood immune system.... No evidence suggests that the recommended childhood vaccines can "overload" the immune system. In contrast, from the moment babies are born, they are exposed to numerous bacteria and viruses on a daily basis. Eating food introduces new bacteria into the body; numerous bacteria live in the mouth and nose; and an infant places his or her hands or other objects in his or her mouth hundreds of times every hour, exposing the immune system to still more antigens. An upper respiratory viral infection exposes a child to 4 to 10 antigens, and a case of "strep throat" to 25 to 50. </blockquote> Despite the fact that there have been numerous scientific studies that have found no connection between vaccines and autism or any other disorder, there have been several outbreaks of measles, polio, and pertussis in several industrial nations that have been attributed to failure to vaccinate children.<a href="autismtimeline.html">*</a> On the other hand, as the number of children who are not vaccinated increases so does the number of children who are diagnosed with autism. Yet, nobody is arguing that not getting vaccinated is causing autism. In fairness to Wakefield and the anti-vaccination supporters, it should be noted that even before Wakefield published his paper, vaccination rates had been declining. The case of Ireland has already been mentioned. In the U.S., there has always been a contingent of folks who have avoided vaccinations because of their religious beliefs. In 2009, Dr. Dora Mills, director of the Maine Center for Disease and Prevention, said that Maine has seen a large increase the last few years of parents signing forms that exempt their children from vaccination requirements for philosophical or religious reasons.<a href="https://web.archive.org/web/20100209075420/http://ellsworthmaine.com/site/index.php/2009021219278/Latest/Whooping-Cough-Raises-Concern.html">*</a> Several states in the U.S. allow exemption from vaccination for religious groups who claim vaccinations go against their religious beliefs. In Australia in 1997, there was a major push to lift immunization rates. The Federal Government began giving Maternity Allowance payments to those completing immunization at 18 months of age, as well as linking Child Care Assistance and the home child care allowance to immunization status.<a href="https://web.archive.org/web/20130421075652/http://www.foodsecretariat.health.gov.au/internet/main/publishing.nsf/Content/health-archive-mediarel-1997-mw1697.htm">*</a> While 97 per cent of parents favored immunization, only 53 per cent of Australian children were fully immunized for their age. vaccination-rate drop blamed on Wakefield In any case, there is now a widespread belief in the UK, the U.S., and other industrial nations that childhood vaccines are harmful. This belief is partly due to the fear generated by media reports on Wakefield's work and to the proselytizing of parents' advocacy groups who argue that the MMR vaccine causes autism. Both Wakefield and the parents' advocacy groups have taken their case directly to the media and to the courtroom, ignoring, for the most part, the growing body of scientific evidence that there is no connection between vaccines and autism or any other neurological disorder. The media has more than obliged them. As a result, many more parents are not having their children vaccinated and MMR vaccines no longer have mercury in them. This is so even though the evidence is overwhelming that there is <a href="http://skepdic.com/skeptimedia/autismthimerosal.html"> no causal link between autism and vaccines, with or without thimerosal</a>. Many children are not being protected from preventable diseases. No vaccination is 100% effective, so even vaccinated children are at increased risk when they get no protection from the <a href="http://en.wikipedia.org/wiki/Herd_immunity">"herd effect."</a> After The Lancet report was published, rates of inoculation in the UK fell from 92% to below 80%. (The internationally accepted level for controlling measles is 95 percent.<a href="http://query.nytimes.com/gst/fullpage.html?res=9E01EFDF123BF93BA35751C0A9659C8B63">*</a>) In 2008, there were 1,348 confirmed cases of measles in England and Wales, compared with 56 in 1998. Two children have died of the disease.<a href="http://sciencelearn.org.nz/News-Events/Latest-News/News-Archive/2010-News-archive/MMR-vaccine-controversy">*</a> In London, <a href="http://news.bbc.co.uk/1/hi/england/london/7633399.stm"> National Health Service records show</a> only 49% of children had received the first and second dose of the MMR vaccine by their fifth birthday. In 2002, <a href="http://news.scotsman.com/mmrvaccine/Expert-says-MMR-autism-link.2311033.jp"> Wakefield told the press</a>: "Despite the re-emergence of measles in England and Scotland, my original study is justified." Wakefield was asked to leave his post at London’s Royal Free Hospital and became a trustee of Visceral, the only charity in Europe dedicated to raising funds to investigate possible links between childhood vaccines, autism, and bowel disease. Wakefield was adamant and warned of lawsuits against health officials from parents: <blockquote> If there is a measles epidemic and single vaccines are not made available and that decision turns out to be wrong because an unvaccinated child dies, there is going to be legal liability on behalf of individual members of that committee. </blockquote> Wakefield's defiance As noted above, Wakefield was paid more than £400,000 by lawyers trying to prove that the MMR vaccine was unsafe. The payments were part of £3.4m distributed from a legal aid fund for doctors and scientists who had been recruited to support a now-failed lawsuit against vaccine manufacturers.<a href="http://scienceblogs.com/insolence/2007/01/surprise_surprise_andrew_wakefield_was_p.php">*</a> At the time he published his 1998 report in The Lancet, he had already been paid  £55,000 to look for links between the vaccine and disorders. He did not disclose that he was being paid to discredit the MMR or that he had applied for a patent for an alternative vaccine when he submitted his work for publication to The Lancet. Richard Horton, editor of The Lancet, says that he would not have published Wakefield’s paper had he known of the conflict of interest. Wakefield was unrepentant. He <a href="http://www.telegraph.co.uk/news/uknews/1455603/Doctor-demands-apology-for-MMR-claims-in-Lancet.html"> hired a lawyer </a>and demanded an apology from The Lancet. He didn't get one. In 2004, the British General Medical Council (GMC) began an inquiry into allegations of professional misconduct against Wakefield and two former colleagues. Three years later Wakefield was working in Texas at <a href="https://web.archive.org/web/20090213120850/http://thoughtfulhouse.org/bio_awakefield.htm">an autism clinic</a> and was still waiting for the GMC hearing to begin. In the meantime, he sued Channel 4, 20-20 Productions, and Sunday Times reporter <a href="http://briandeer.com/wakefield-deer.htm">Brian Deer</a> for libel. He dropped the suit, claiming he had to concentrate on the upcoming GMC inquiry. Deer's investigation had found that Wakefield didn't reveal to The Lancet that some of the children who took part in his research were also subjects in another study funded by legal aid to find out whether they had a possible compensation claim against vaccine manufacturers. As noted above, in 2009 it was discovered that Wakefield had faked some of his data. The Sunday Times reported on Wakefield's 1998 report: <blockquote> ...our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals 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. </blockquote> While being investigated by the GMC, Wakefield was hired as a researcher at a Texas autism clinic with the swell-sounding name of <a href="https://web.archive.org/web/20090228231206/http://thoughtfulhouse.org/index.html">Thoughtful House</a>. He's not licensed to practice medicine in Texas, but <a href="http://www.casewatch.org/990/thoughtful_house_2008.pdf"> tax records show</a> that Wakefield was paid $270,000 for his work at Thoughtful House in 2008 and that Thoughtful House received about $2.4 million in grants and contributions. The GMC finally issued a ruling on Wakefield and two colleagues in January 2010: Wakefield, the Council said, had acted "dishonestly and irresponsibly" in doing his research.  <a href="http://news.bbc.co.uk/2/hi/health/8483865.stm">According to the BBC</a>: <blockquote> The verdict, read out by panel chairman Dr. Surendra Kumar, criticized Dr. Wakefield for the invasive tests, such as spinal taps, that were carried out on children and which were found to be against their best clinical interests.... The GMC also took exception with the way he gathered blood samples. Dr Wakefield paid children £5 for the samples at his son's birthday party. Dr. Kumar said he had acted with "callous disregard for the distress and pain the children might suffer." He also said Dr. Wakefield should have disclosed the fact that he had been paid to advise solicitors acting for parents who believed their children had been harmed by the MMR. </blockquote> </div> The GMC still has to decide whether the behavior of Wakefield, professor John Walker-Smith and Dr. Simon Murch amounted to serious professional misconduct and whether any sanctions should be imposed. Walker-Smith and Murch were reprimanded for acting dishonestly, but not unethically. [update: In February 2010, <a href="http://www.guardian.co.uk/society/2010/feb/19/wakefield-quits-texas-autism-centre"> Wakefield resigned from Thoughtful House</a>.  In May 2010 <a href="http://www.nytimes.com/2010/05/25/health/policy/25autism.html"> Wakefield and Walker-Smith were found guilty and had their medical licenses revoked</a>. Murch was found not guilty.] After the GMC's initial ruling was announced, Dr. Shona Hilton of the Medical Research Council said the MMR scare had undermined parents' trust in the MMR vaccination. "Thankfully confidence is returning and the uptake of MMR vaccine is increasing," she said. "We need to continue rebuilding trust with parents that MMR vaccination is safe and ensure that those parents caring for children with autism do not blame themselves."<a href="http://www.guardian.co.uk/society/2010/jan/28/andrew-wakefield-mmr-vaccine">*</a> Also, one should not forget that thanks to the vaccine scare, parents of children of autism now have one more thing to dread: that their child will contract some preventable disease because other parents are afraid to have their children vaccinated. <div class="it"> the role of the media in the scare How could a blatantly flawed study (forget the fraud) have such a powerful effect? <a href="http://www.badscience.net/2008/08/the-medias-mmr-hoax/"> Dr. Ben Goldacre</a> thinks he knows: <blockquote> ...in MMR, journalists and editors have constructed their greatest hoax to date, and finally demonstrated that they can pose a serious risk to public health. But there are also many unexpected twists to learn from: the health journalists themselves were not at fault, the scale of the bias in the coverage was greater than anybody realised at the time, Leo Blair was a bigger player than Wakefield, and it all happened much later than you think. </blockquote> Goldacre argues that different countries have different anti-vaccination concerns. The diversity of anti-vaccination panics illustrates how they reflect "local political and social concerns more than a genuine appraisal of the risk data." When Wakefield began pushing his claims in 2001 and 2002, he was arguing that his work on tissue samples showed that children with bowel problems and autism had the measles virus. He got "blanket media coverage" in which "emotive anecdotes from distressed parents were pitted against old men in corduroy with no media training." <blockquote> The Royal College of General Practitioners press office not only failed to speak clearly on the evidence, it also managed to dig up anti-MMR GPs for journalists who rang in asking for quotes. Newspapers and celebrities began to use the vaccine as an opportunity to attack the government and the health service, and of course it was the perfect story, with a charismatic maverick fighting against the system.... </blockquote> The prime minister and his wife, Tony and Cherie Blair, were asked by journalists if their son Leo had been vaccinated. The Blairs refused to say, thereby giving up an opportunity to set the record straight for the general public about the safety and necessity of childhood vaccinations. Their silence was not golden, nor was it seen as a proper response of a public couple trying to protect the privacy of their children. Rather, the Blair's refusal to say whether their son had been vaccinated was taken by some to mean that maybe this Wakefield guy was right. Then there was the fact that Cherie Blair wore crystals to keep evil rays from harming her. Her best friend's mother, Sylvia Caplin, was "a spiritual guru who was viciously anti-MMR ('for a tiny child, the MMR is a ridiculous thing to do. It has definitely caused autism,' she told the Mail)." The Blairs were also associated with new age healer Jack Temple, "who offered crystal dowsing, homeopathy, neolithic-circle healing in his suburban back garden, and some special breastfeeding technique which he reckoned made vaccines unnecessary." <blockquote> In 2003 the Economic and Social Research Council published a paper on the media’s role in the public understanding of science, which sampled all the major science media stories from January to September 2002, the peak of the scare. It found 32% of all the stories written in that period about MMR mentioned Leo Blair, and Wakefield was only mentioned in 25%: Leo Blair was a bigger figure in this story than Wakefield. </blockquote> According to Goldacre, the UK media "distorted the scientific evidence, reporting selectively on the evidence suggesting that MMR was risky, and repeatedly ignoring the evidence to the contrary." celebrities contribute to the scare in the U.S. In the U.S., things were even messier because of the claim repeatedly made in the media by parents, <a href="http://skepdic.com/refuge/harm8.html">celebrities like Jenny McCarthy (given a bully pulpit by Oprah Winfrey)</a>, and famous names like <a href="http://skepdic.com/skeptimedia/autismthimerosal.html#rfkjr"> Robert F. Kennedy Jr.</a> that the MMR vaccine was the cause of autism. After thimerosal was removed from vaccines, the focus shifted from mercury poisoning to the quantity of jabs children receive or the the speculation that some children, impossible to identify before vaccinations are given, are "especially sensitive" to vaccines. Some people think that the immune systems of children are being weakened by vaccines, making them vulnerable to illnesses later on in life. Quackwatch calls this <a href="http://www.quackwatch.org/03HealthPromotion/immu/immu07.html"> misconception #7</a>. For example, some think that their child's asthma or respiratory problems may be due to "vaccine overload" on their immature immune systems. <blockquote> In fact babies have an ability, right from birth, to cope with lots of different germs. The body is constantly surrounded by germs and has to react to them in different ways. The advantage of being immunized rather than catching the disease is that the vaccine uses only part of the germ, or, if the whole germ, it is either killed or toned down (“attenuated”). In this way, the challenge to the immune system is less than that from the disease, but it is enough to produce protection. In 2002, the Immunization Safety Review Committee of the American Institute of Medicine made a detailed examination of all the evidence about the effects of multiple immunizations on a baby’s immune system. They concluded that there was no evidence to support the suggestion that multiple immunizations overwhelm the immune system. They strongly supported the continuing use of vaccines against multiple diseases.... If immunizations are delayed, a baby will remain unprotected for longer than necessary. This could be particularly dangerous for whooping cough and Hib. Very young babies, if they catch whooping cough, are likely to be much more seriously ill than older children and are more likely to need hospital care. Babies under a year old are more likely to catch Hib than older children Studies have shown that when the vaccines are given at the younger age, babies have fewer reactions such as fever, sore injection sites etc, while at the same time they are still protected.<a href="http://www.ich.ucl.ac.uk/immunisation/faqs.html">*</a> </blockquote> There have been many well-designed studies that have examined claims that vaccines cause chronic diseases such as asthma, <a href="http://www.quackwatch.org/03HealthPromotion/immu/immu10.html">multiple sclerosis</a>, chronic arthritis, <a href="http://www.quackwatch.org/03HealthPromotion/immu/immu05.html"> sudden infant death syndrome</a>, and diabetes. The studies have not found compelling evidence for any such links.<a href="http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=12612250">*</a> the media & politicians in the U.S. scare Journalists are rarely medically trained and the common practice is <a href="http://skepdic.com/pseudosymmetry.html"> pseudosymmetry</a>: to present minority and <a href="contrarian.html">contrarian</a> positions as if they are equal to consensus views backed by an overwhelming preponderance of the evidence. This practice is defended as a matter of fairness, though it is probably more a matter of ignorance, laziness, or a desire to be popular by not offending the majority. After all, you never read of a journalist presenting the "other side" of gravity or feeling obligated to report on the accused child molester's point of view. U.S. politicians, most of whom weren't following the thimerosal debacle, generally played it safe when asked about it. In America, politicians never say: "I don't know; I haven't studied that issue." When in doubt most invoke the <a href="http://skepdic.com/skeptimedia/skeptimedia20.html"> precautionary principle</a>, which generally leaves the public with the feeling that maybe there is something to worry about here. <a href="http://www.msnbc.msn.com/id/7992200/">Senator John Kerry</a> is a prime example. In 2006, he told media host Don Imus an anecdote he heard from a UPS driver about how the driver's child, a twin, got autism after getting vaccinated, while the other twin didn't get vaccinated and didn't get autism. The driver blames thimerosal and Kerry says "yet, we still have mercury in vaccinations around the country. It's absurd. I don't get it. We ought to stop...." Imus asserts that "we know that thimerosal is a neurotoxin, and that it's ethyl mercury, and it's 50 times stronger than the mercury we'd find in fish...." The mercury in fish is methylmercury and is usually given in terms of parts per million, so it is hard to compare the two. At the time Kerry and Imus were making their scary claims, however, thimerosal had been absent from most vaccines for five years, but people were still eating fish.<a href="http://pediatrics.aappublications.org/cgi/content/full/112/6/1394">*</a> In the U.S., an even more popular tactic with politicians is to justify backing off an issue because it is before the courts. There were so many cases (about 5,000) before the courts involving parents blaming vaccines for autism in their children that a special federal court with "special masters" (judges) was created to hear them. In 2007, the first test case was decided. The special master ruled in favor of the parents, even though the child had never been diagnosed with autism. In February 2009, however, <a href="http://www.washingtonpost.com/wp-dyn/content/article/2009/02/12/AR2009021201391.html"> the court ruled</a> on another test case and asserted that vaccines do not cause autism. The special masters, it seems, looked at <a href="http://www.cdc.gov/ncbddd/autism/documents/vaccine_studies.pdf"> the evidence</a>. The totality of the evidence points to the conclusion that Wakefield and the parents' groups blaming vaccines for autism were wrong. Wakefield, journalists, celebrities like Jenny McCarthy and Robert F. Kennedy, and politicians who continue to blame vaccines for autism are misleading many parents. Those parents in turn may be doing irreparable harm to those they love the most by following the advice of people who systematically ignore the clear implications of the sum of the evidence. See also <a href="antivaccination.html">anti-vaccination movement</a>, <a href="http://skepdic.com/skeptimedia/skeptimedia122.html">Wakefield Warriors</a>, <a href="http://skepdic.com/news/newsletter1402.html#rights">Rights and Vaccines</a>, and <a href="skeptimedia/skeptimedia93.html">The Wakefield Propaganda Machine</a>. further reading <a href="http://tallguywrites.livejournal.com/148012.html" name="new2"> </a> <a href="http://tallguywrites.livejournal.com/148012.html">The Facts In The Case Of Dr. Andrew Wakefield: A fifteen page story in comic book form about the MMR vaccination controversy</a> <a href="autismtimeline.html">Timeline of the autism scare</a> <a href="skeptimedia/autismthimerosal.html">All posts on autism and thimerosal in vaccines</a> books and articles <a href="http://www.amazon.com/exec/obidos/ISBN=0415321794/roberttoddcarrolA/"> Fitzpatrick, Michael. (2004). MMR and Autism. Routledge.</a> (A <a href="http://www.amazon.com/exec/obidos/ISBN=B000OT83A6/roberttoddcarrolA/"> Kindle edition</a> is also available. For more on Kindle click <a href="http://www.amazon.com/exec/obidos/ISBN=B000FI73MA/roberttoddcarrolA/"> here</a>.) Judelsohn, Richard G. (2007). "Vaccine Safety: Vaccines Are One of Public Health's Great Accomplishments." Skeptical Inquirer. November/December. Norman, Matthew and Jesse Dallery. (2007). "Mercury Rising: Exploring the Vaccine-Autism Myth." Skeptic. vol. 13 num 3. Novella, Steven. (2007). "The Anti-Vaccination Movement." Skeptical Inquirer. November/December. <a href="http://www.amazon.com/exec/obidos/ISBN=0061227951/roberttoddcarrolA/"> Offit, Paul A. (2007). Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases. HarperCollins. </a> <a href="http://www.amazon.com/exec/obidos/ISBN=0231146361/roberttoddcarrolA/"> Offit, Paul A. (2008). Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. Columbia University Press. </a> websites <a href="http://briandeer.com/mmr/lancet-summary.htm">The MMR-autism crisis - our story so far - An investigation by Brian Deer</a> <a href="http://www.cdc.gov/ncbddd/autism/documents/vaccine_studies.pdf"> CDC Studies on Vaccines and Autism Spectrum Disorders</a> <a href="http://www.wrongplanet.net/article361.html">Ten Myths about Autism - Debunked</a> "<a href="http://www.csicop.org/si/show/anti-vaccination_movement">The Anti-Vaccination Movement" by Steven Novella</a> <a href="http://www.freerepublic.com/focus/f-news/1138318/posts"> Panel Finds No Evidence to Tie Autism to Vaccines by Sandra Blakeslee, NY Times, May 19, 2004</a> <a href="http://skeptico.blogs.com/skeptico/2005/06/robert_f_kenned.html"> Robert F. Kennedy Junior’s completely dishonest thimerosal article</a> bl<a name="blogs"></a>ogs <a href="http://www.sciencebasedmedicine.org/?p=5343" rel="bookmark">Andrew Wakefield Fights Back</a> by Harriet Hall His career was in shreds and there was only one way left for him to fight back: to write a book. Callous Disregard: Autism and Vaccines — The Truth Behind a Tragedy has just been published....In my opinion the book does nothing to scientifically validate his beliefs or to excuse his behavior, but rather boils down to self-serving apologetics and misleading rhetoric. It also undermines his claim that he is a good scientist by showing that he values anecdotal evidence (“listening to the parents”) over experimental evidence. <a href="http://www.sciencebasedmedicine.org/?p=370">Antivaccine hero Andrew Wakefield: Scientific fraud?</a> <a name="news">news</a> 25 April 2011.For his outstanding perseverance, stamina and revelation on a story of major importance, <a href="http://briandeer.com/award.htm">Brian Deer</a> was awarded <a href="http://www.pressawards.org.uk/page-view.php?page_id=741&parent_page_id=0&news_id=40&numbertoprintfrom=1">Specialist Journalist of the Year at The Press Awards</a>. His tireless investigation into Andrew Wakefield’s claim of the supposed link between autism and the MMR vaccine culminated in January 2010, when Wakefield was found guilty of misconduct by the General Medical Council and struck off as a doctor. It was ‘a tremendous righting of a wrong.’ 3 Feb 2011. The real lessons of the MMR debacle by Dr Michael Fitzpatrick It is unfortunate that [journalist Brian] Deer has allowed himself to be dragged into the disputatious mire into which this sorry saga has festered for many years. He was, for example, ill-advised in getting drawn into a slanging match with parent campaigners in the course of the GMC hearings. He has also made ill-judged criticisms of others who have been involved in challenging the campaign against MMR – including US paediatrician Paul Offit, Guardian columnist Ben Goldacre, and, heaven forbid, myself....We must, however, allow Deer some slack in all this. He has been much abused by the pro-Wakefield lobby, and it is unsurprising that he feels more than a little beleaguered. He has done a marvellously tenacious job in digging out the damning detail of the case when other journalists were looking the other way. The medical, scientific and wider community have now a full account from which to draw their own conclusions. 6 Jan 2011. The British Medical Journal calls the Wakefield study that started the vaccine/autism scare <a href="http://www.bmj.com/content/342/bmj.c7452.full">"fraudulent."</a> In a series of articles starting this week, seven years after first looking into the MMR scare, journalist Brian Deer shows the extent of Wakefield’s fraud and how it was perpetrated. 3 June 2010. Another published paper by the disgraced Wakefield et al. has been retracted, this time by the <a href="http://www.nature.com/ajg/journal/v105/n5/full/ajg2010149a.html"> American Journal of Gastroenterology</a>. <blockquote> On 28 January 2010, the UK General Medical Council's Fitness to Practice Panel raised concerns about a paper published in the Lancet by Dr Wakefield et al. The main issues were that the patient sample collected was likely to be biased and that the statement in the paper, that the study had local ethics committee approval, was false. There was also the possibility of a serious conflict of interest in the interpretation of the data. The Lancet has now retracted this paper. This paper in the American Journal of Gastroenterology (AJG) also includes the 12 patients in the original Lancet article and therefore we retract this AJG paper from the public record. </blockquote> 23 May 2010. Weeping wounds of the MMR scare: Tomorrow the doctor who started a panic may be struck off, but for some the pain will never end Tomorrow ... Andrew Wakefield — known as “the MMR doctor” — is likely to be struck off the medical register for what the five-member tribunal [of the General Medical Council] has already labelled “dishonest”, “unethical” and “callous” research. In withdrawing his licence to practise, the council will be laying to rest a huge scare that spread rapidly among parents, causing a massive slump in the number of children who were vaccinated against measles, mumps and rubella in Britain. Two children subsequently died of measles and many others became seriously ill. <a href="http://www.guardian.co.uk/society/2010/may/24/mmr-doctor-andrew-wakefield-struck-off"> MMR row doctor Andrew Wakefield struck off register</a> Andrew Wakefield, the doctor at the centre of the MMR scare, has been struck off the medical register after being found guilty of serious professional misconduct. He was not at the General Medical Council (GMC) hearing to receive the verdict on his role in a public health debacle which saw vaccination of young children against measles, mumps and rubella plummet. The GMC said he acted in a way that was dishonest, misleading and irresponsible while carrying out research into a possible link between the measles, mumps and rubella (MMR) vaccine, bowel disease and autism. He had "abused his position of trust" and "brought the medical profession into disrepute" in studies he carried out on children. The GMC said there had been "multiple separate instances of serious professional misconduct". further reading <a href="http://www.badscience.net/2010/05/a-staggeringly-weak-interview-of-andrew-wakefield-on-the-today-programme/"> A staggeringly weak interview of Andrew Wakefield on the Today programme</a> by Ben Goldacre <a href="http://www.badscience.net/2010/01/the-wakefield-mmr-verdict/"> The Wakefield MMR Verdict by Ben Goldacre</a> Dr Andrew Wakefield struck off medical register The Royal College of Paediatrics and Child Health said that the false suggestion of a link between autism and the MMR vaccine had done “untold damage to the UK vaccination programme”. “We cannot stress too strongly that all children and young people should have the MMR vaccine. Overwhelming scientific evidence shows that it is safe,” it said. A Department of Health spokesperson added: “The GMC has given its conclusions on Dr Wakefield’s fitness to practice. The safety of MMR has been endorsed through numerous studies in many countries. Thankfully, more parents are having their children vaccinated with MMR and they see it as being as safe as other childhood vaccines.” (TimesOnline) <a name="book">4 May 2010</a>. In a major fit of hubris and rationalization, Andrew Wakefield has written <a href="http://www.amazon.com/exec/obidos/ISBN=1616081694/roberttoddcarrolA/"> a book</a> that he describes as "dispatches from the battlefront in a major confrontation—a struggle against compromise in medicine, corruption of science, and a real and present threat to children in the interests of policy and profit. It is a story of how ‘the system’ deals with dissent among its doctors and scientists." The true story is quite different. Wakefield is the one who has compromised medicine, corrupted science, and posed a major threat to the health of children and others around the world, all for money and fame. Over the years since his 1998 report on finding a link between the MMR vaccine, autism, and bowel disease in children—a study of 12 children that used no controls—Wakefield has apparently deceived himself into believing he is a pioneer scientist besieged by enemies as he works to "help" children with autism. The 'system' allowed him to push his phony agenda on the slimmest thread of evidence for many years until he was finally brought before a medical board for his unethical practices. He didn't lose his jobs because of his scientific pursuits; he lost his jobs because of his unethical behavior. Wakefield says he was maligned when a recent General Medical Council ruling stated he was "dishonest, irresponsible and showed callous disregard for the distress and pain of children." The evidence indicates that the GMC's opinion is justified. Wakefield also claims that the media has maligned him, even though it was the media that gave him a bully pulpit to pursue his own economic and personal interests on the basis of a tiny study that was never replicated with proper numbers, controls, or randomization. Callous Disregard: Autism and Vaccines—The Truth<img border="0" src="graphics/callous.jpg" width="131" height="132"> Behind a Tragedy is a desperate attempt by the callous Wakefield to continue the charade that he is the protector of children at war with mighty self-interested forces that keep producing all this scientific evidence that vaccines are not the cause of autism, evidence he and his followers choose to disregard. To provide authenticity, the book has a foreword by <a href="http://skepdic.com/skeptimedia/skeptimedia78.html"> Playmate turned pseudoscientist Jenny McCarthy</a>. A detailed and thorough review of every claim made in Wakefield's book about vaccinations concludes: "I have shown that every major claim Wakefield makes in his book concerning vaccine safety is wrong." See "<a href="http://benthamopen.com/contents/pdf/TOVACJ/TOVACJ-6-9.pdf">Wrong About Vaccine Safety: A Review of Andrew Wakefield’s “Callous Disregard</a>”" by Joel A. Harrison, PhD, MPH in The Open Vaccine Journal, Vol 6, 2013, pp 9 – 25. <a href="http://www.bmj.com/cgi/content/full/340/apr15_2/c1127"> Wakefield’s "autistic enterocolitis" under the microscope</a> by Brian Deer, journalist, British Medical Journal Two years before the paper was published he 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. More evidence of Wakefield's incompetence or fraud. Commentary: We came to an overwhelming and uniform opinion that these reports do not show colitis There are no grounds to believe that any new inflammatory bowel disease was discovered by Wakefield et al. by Ingvar Bjarnason professor of digestive diseases, consultant physician and gastroenterologist King’s College Hospital, London SE5 9RS, UK Wakefield's Lancet paper retracted On 2 Feb 2010 the editors of Lancet posted the following notice online: "Following the judgment of the UK General Medical Council’s Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al1 are incorrect, contrary to the findings of an earlier investigation.2 In particular, the claims in the original paper that children were “consecutively referred” and that investigations were “approved” by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record. 12 Feb 2010. <a href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W81-4XC57CT-1&_user=10&_coverDate=10/02/2009&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=8559005de9beb85139671132c489f355"> Another paper co-authored by Andrew Wakefield has been withdrawn, this time by Neurotoxicology.</a> <a href="http://news.bbc.co.uk/2/hi/health/8483865.stm">MMR scare doctor 'acted unethically', panel finds </a>Dr. Andrew Wakefield's 1998 Lancet study caused vaccination rates to plummet, resulting in a rise in measles - but the findings were later discredited.<a href="http://news.bbc.co.uk/2/hi/health/8483865.stm"> </a> <a href="http://www.time.com/time/health/article/0,8599,1957656,00.html"> Doctor in MMR-Autism Scare Ruled Unethical</a> Wakefield's study has since been discredited, and the MMR vaccine deemed to be safe....Vaccination rates among toddlers plummeted from over 90% in the mid-1990s to below 70% in some places by 2003. Following this drop, Britain saw an increase in measles cases at a time when the disease had been all but eradicated in many developed countries. In 1998, there were just 56 cases of the disease in England and Wales; by 2008 there were 1,370. <a href="http://www.guardian.co.uk/society/2010/jan/28/andrew-wakefield-mmr-vaccine"> Andrew Wakefield found 'irresponsible' by GMC over MMR vaccine scare</a> Branding him a dishonest, irresponsible doctor, the GMC disciplinary panel, which has sat and heard evidence for 148 days over two and a half years, finally found a long array of charges against him proven. 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