Action For Autism

Hornig, MMR and absent friends.

The press release issued by the Columbia University Mailman School of Public Health that announced the results of their recent study into MMR and autism ended with this remarkable statement from  W. Ian Lipkin, John Snow Professor of Epidemiology and director of the Mailman School’s Center for Infection and Immunity.

“The study design process was a critical piece for us, as there is still so much public concern over the safety of the MMR vaccine. For this reason, we involved the autism parent/advocacy community as we designed the study to ensure that all issues were being addressed. We are hopeful that this process of community engagement will build important partnerships among members of the autism community, physicians, public health agencies, and clinical researchers; serve as a paradigm for the conduct of future studies to understand the causes of this disorder; and facilitate the rapid communication of clinically relevant scientific findings to the broader community.”

I understand this to mean that the research team consulted with those sections of the parent/advocacy community who have voiced concerns about a possible connection between MMR and autism. The obvious candidates are SafeMinds, the National Autism Association (NAA), Generation Rescue and Talk About Curing Autism (TACA)

I visited TACA first. They make a big deal out of having Jenny McCarthy as their spokesperson and she blamed MMR for her son’s autism when she appeared on Oprah. But there was no mention of this latest research on their website.

Then I went to Generation Rescue. They have Jenny McCarthy as a board member and just like TACA they feature her prominently on their website. And just like TACA they do not mention this new research either.

Next stop SafeMinds. Nothing there either, which is strange. Because there is a press release that purports to come from SafeMinds circulating on the internet. Kev has commented on it over at Left Brain Right Brain and I have no reason to doubt its authenticity. It first appeared on EOHARM, one of those anti vaccination, autism parent/advocacy email lists. It begins:

A scientific study released today examined the hypothesis that measles virus persisting in the intestinal tract from the MMR vaccine causes or exacerbates autism. The study refuted this hypothesis for the majority of autism cases…

That is stretching the truth slightly. According to Columbia University the lead researcher actually said,

“Our results are inconsistent with a causal role for MMR vaccine as a trigger or exacerbator of either GI difficulties or autism [...] The work reported here eliminates the remaining support for the hypothesis that autism with GI complaints is related to MMR vaccine exposure. We found no relationship between the timing of MMR vaccine and the onset of either GI complaints or autism.”

That sounds to me as if they are saying the study refutes the MMR hypothesis in ALL cases, not just the majority.

…while validating the link between gastrointestinal (GI) disease, inflammation and autistic regression. The study design precluded assessment of a role for acute measles infection from MMR in a subset of children with autism…

More spin. The study was designed to test Wakefield’s hypothesis that persistent measles virus infection in the gut was associated with GI disorders and autism. Is there anything anywhere in the literature to suggest that anybody has developed autism as a result of an “acute measles infection from MMR? Never mind autism. What is the prevalence of acute measles infection from the vaccine?

…and did not examine the role of other vaccines, vaccine components such as thimerosal, or other environmental exposures which can trigger gastrointestinal and immunological problems…

And what about everything else that it did not examine? Science does not work by examining everything at once. You isolate the variable that interests you and try to control for other factors that might confound your results. Did Wakefield examine the role of other vaccines etc. in his original study?

…The topic is of public health interest due to the increasing autism epidemic and parent and scientific reports connecting mercury and vaccines, including MMR, with autism onset.

Not exactly. This topic is of public health interest because anti-vaccine scares have led to an increase in cases of measles in Europe and America.  The autism epidemic is a canard. And despite what SafeMinds thinks, most of the science reports a disconnect between mercury and vaccines and autism. The press release continues in similar vein. It is obvious that even if SafeMinds were one of the parent/advocacy groups consulted on the design of the study they are not happy with it.

NAA at least did publish their press release on their website. Orac has done an excellent job of analysing it over at ScienceBlogs, so I don’t have to. Suffice to say that NAA are not enamoured of Mady Hornig’s latest offering and there is no evidence that they were involved in the design of the study.

It must be remembered that until a short while ago Mady Hornig was a hero in these circles. Her mouse study was lauded as proof of the thiomersal/autism connection and printed on their websites. She was a keynote speaker at their conferences and a key figure in the whole vaccine/autism movement. One “bad” study and they have turned on her.

So who else is there to consult in the autism parents/advocacy community? It occurs to me that probably the aforementioned groups were consulted about their concerns and the scientists went away and incorporated those concerns in their study. But the data came back negative. This happens all the time in science. You think you know something. You test it and you learn that you were wrong. So you think again.

The problem with TACA, NAA, Generation Rescue and SafeMinds is that they have convinced themselves that they already have the answer. If the science does not validate their beliefs they do not think again. Instead they reject the science and often malign the motives of the scientists.

On a recent US talk show a caller came out and said there was nothing that science could say or do to persuade her to alter her beliefs about vaccines and autism. She is another of Jenny McCarthy’s acolytes. McCarthy is not to blame for all this. She came late to a party that was already well established. They lionize her because of her celebrity and celebrity endorsements are all they have left.

Unfortunately celebrity seems to count for a lot more than science in a lot of the media. McCarthy is due to launch another book with another apearance on Oprah. Her endorsement prolongs the life of a movement that no longer commands any scientific support. Doubtless her presence will recruit a few more parents to the cause and further threaten vaccination rates. When vaccine preventable diseases then make an inevitable comeback she will attract an equally inevitable opprobrium.

But she is just a mum like most of the foot soldiers in this charade. Jenny McCarthy may be foolish and misguided, but misguided by whom? The doctors and scientists who have abandoned all professional standards in order to perpetuate the vaccine-autism hoax are the culpable ones. Who will call them to account?

September 6th, 2008 Posted by Mike | Andrew Wakefield, MMR, science, vaccines | 6 comments

MMR and Autism - No connection

10 years go a remarkable press conference took place to mark the publication of a new study in the Lancet. It was remarkable because this was a preliminary report, based on a series of only twelve case studies - not the normal stuff of press conferences. It suggested a new disorder, autistic enterocolitis. There had been suspicions about a link between gut disorders and autism for years. While this study was far too small to settle the issue it did suggest that a large scale study was called for. But why a press conference?

Richard Horton, editor of the Lancet, explains

“In the week of the paper’s publication, some of the Royal Free research team decided to hold a press conference to announce their findings. This gave them an opportunity to express the benefits of the MMR vaccine and the inconclusive nature of their results in respect to the link between the syndrome and the vaccine.” (MMR Science and Fiction by Richard Horton. Granta Books 2004)

So why did they issue this scaremongering press release, which Horton quotes in his book?

“The majority opinion among the researchers involved in this study supports the continuation of MMR vaccination. Dr Wakefield feels that vaccination against the measles, mumps and rubella infections should undoubtedly continue but until this issue is resolved by further research there is a case for separating the three vaccines into measles, mumps and rubella components and giving them individually spaced by at least 1 year.”

The answer, implicit in Horton’s account, is that Wakefield was a dynamic researcher who was shaking up a moribund department of medicine that had been resting on its laurels. He was their star player and was granted more leeway than normal in the hope that he would deliver glittering prizes. Wakefield was pursuing his own glittering prize. He was convinced that there was a connection between measles virus and inflammatory bowel diseases like Crohn’s syndrome. He suspected that measles vaccine might also be involved. He was developing his own single vaccine for measles that would bypass these difficulties and had issued a patent application in the name of the Royal Free Hospital in 1997. He was also employed by solicitors to demonstrate a link between MMR and autism, particularly where it involved symptoms of inflammatory bowel disease.

How much of this was known to his colleagues at the Royal Free? Did it influence their better judgement and allow Wakefield to hijack the press conference? Would there even have been a press conference without Wakefield? Did Wakefield’s ambition and personal conviction lead him to breach the ethics of his profession? All this is still the subject of conjecture and debate and, with regard to ethics, ongoing disciplinary hearings at the GMC. What is beyond conjecture is that, despite no credible evidence to support it, the idea that MMR causes autism became firmly implanted in the public consciousness. Vaccination rates declined and measles is once more endemic in the UK. It is widespread in Europe and spreading in America where concerns about the safety of a mercury preservative in vaccines coalesced with concerns about MMR to create vaccine resistant hotspots, primarily in affluent areas where people can afford the privilege of being the “worried well.”

All this comes at a time when deaths from measles are declining rapidly in the developing world thanks to a vigorous campaign of vaccination. To place this in context, deaths from measles are still statistically insignificant in Europe and North America. Success for the vaccination campaign in Africa, Asia and South America means that “only” around 250,000 children died from measles related causes last year compared to the 750,000 that was commonplace a decade ago.

Given the propensity of wealthy Americans and Europeans for foreign travel to exotic places it would be a tragic irony if the fragile success of the vaccination programme in the developing countries was compromised by western tourists carrying the virus into unvaccinated parts of the third world. It would be even more tragic if the anti-vaccine movements in the USA and Europe gained a foothold in those countries that desperately need vaccines and undermined the efforts led by the World Health Organization, with equally devastating consequences.

So one would hope that a definitive study that effectively disproves any link between MMR and autism would be trumpeted from the rooftops and receive coverage that was commensurate with the thouands of scare stories about MMR that have been in circulation for at least a decade since Wakefield’s inglorious announcement.

We shall soon have an opportunity to judge. Less than an hour ago Forbes Magazine reported on a new study which found no relation between MMR and autism. Of course there have been numerous studies before. These have singularly failed to persuade the Wakefield acolytes and their media friends. As Ben Goldacre noted last week:

“In the Journal of Medical Virology March 2006 there was a paper by Afzal et al, looking for measles RNA in children with regressive autism after MMR vaccination, using tools so powerful they could detect measles RNA down to single-figure copy numbers. It found no evidence of the vaccine-strain measles RNA to implicate MMR. Nobody wrote about this study, anywhere, in the British media (except for me in my column).

This was not an isolated case. Another major paper was published in the leading academic journal Pediatrics a few months later, replicating the earlier experiments very closely, and in some respects more carefully, also tracing out the possible routes by which a false positive could have occurred. For this paper by D’Souza et al, like the Afzal paper before it, the media were united in their silence. It was covered, by my count, in only two places: my column, and a Reuters news agency report

[...]

Journalists like to call for “more research”: here it was, and it was ignored. Did the media neglect to cover these stories because they were bored of the story? Clearly not. Because in 2006, at exactly the same time as they were unanimously refusing even to mention these studies, they were covering an identical claim, using identical experimental methodology: “US scientists back autism link to MMR” said the Telegraph. “Scientists fear MMR link to autism” squealed the Mail.

What was this frightening new data? These scare stories were based on a poster presentation, at a conference yet to occur, on research not yet completed, by a man with a well-documented track record of announcing research that never subsequently appears in an academic journal. This time Dr Arthur Krigsman was claiming he had found genetic material from vaccine-strain measles virus in some gut samples from children with autism and bowel problems. If true, this would have bolstered Wakefield’s theory, which by 2006 was lying in tatters. We might also mention that Wakefield and Krigsman are doctors together at Thoughtful House, a private autism clinic in the US.

Two years after making these claims, the study remains unpublished.”

It will not be so easy to ignore this report.

1. The study is a deliberate attempt to replicate Wakefield’s original study. It looks for measles in the gut of autistic children with bowel disorders. Furthermore it includes a control group of non-autistic children with bowel disorder.
2. It uses three different laboratories to test its results, including the original laboratory that Wakefield used. This lab, run by Professor O’Leary, had its results in the Wakefield study dismissed by world expert Stephen Bustin, because of cross-contamination that made them meaningless. Now that it has literally cleaned up its act its results concur with the other two labs: no evidence of measles in the intestines of autistic children with bowel disorder.
   • “We found no difference in children who had GI complaints and no autism and children who had autism but no GI complaints,” Dr. Ian Lipkin of Columbia University told reporters in a telephone briefing.
3. There was no temporal association between MMR vaccination and onset of GI symptoms.
   • “We found no relationship between the timing of MMR vaccine and the onset of either GI complaints or autism,” Dr. Mady Hornig, also of Columbia, said in a statement.

Look at those names. Mady Hornig was the author of a controversial study that suggested a link between the mercury in some vaccines and autism. Ian Lipkin is her long time collaborator. Rick Rollens, a Californian politician who has been a powerful advocate for a vaccine induced autism epidemic and used to believe that the MMR vaccine was the final straw in his own child’s autism is quoted by Forbes commenting favourably on this study.

Not even the most diehard anti-vaccine activist could claim that this is just another big pharma/big government sponsored cover up. Or could they? What they are claiming, judging by some of the anti-vaccine contributors to the Environment of Harm email list is even more bizarre. Because O’Leary’s lab has produced bone fide results that contradict Wakefield they are arguing that the results he produced supporting Wakefield must be equally valid. I kid you not. It is as if someone watching Gordon Ramsay’s Hells Kitchen were to argue that, because the eventual winner delivered a perfect service in the final, their undercooked disaster in the opening round that very nearly got them eliminated also had to be cookery of the highest order.

I suspect that the true believers will never be persuaded. [Update: I was right. Kev has just blogged the NAA response. They call this a CDC study throughout to avoid admitting that "one of their own" Mady Hornig authored this study. NB for new readers: CDC in the NAA demonology equates to big pharma/government cover-up.] But I am encouraged when open minded scientists can pursue a hypothesis, believing it to be correct, and publish results that prove themselves wrong. So full marks to Lipkin and Hornig for upholding scientific values.

More blogging here

http://www.blacktriangle.org/blog/?p=1833

http://leftbrainrightbrain.co.uk/?p=1252

http://www.autismvox.com/mmr-vaccine-does-not-cause-autism-not-that-you-didnt-know-that-already/

http://blogs.discovermagazine.com/badastronomy/2008/09/03/antivax-new-evidence-shows-again-no-link-to-autism/

http://onedadsopinion.blogspot.com/2008/09/now-is-it-over.html

UPDATE

Now Orac joins the fray.

September 4th, 2008 Posted by Mike | Andrew Wakefield, MMR, Uncategorized, science, vaccines | 5 comments

Another Measles Death

People sometimes ask why this blog is all about vaccines when it is supposed to be about autism. Of course it is not all about vaccines. But it must seem like that because a lot of the time I am responding to the argument that vaccines are a cause of autism. Why do I bother when there is no scientific basis for any of the supposed pathways?

MMR was only ever supported by the work of one team of researchers grouped around Wakefield and working for the lawyers pursuing claims for compensation against the vaccine manufacturers. The testimony of Bustin and Chadwick at the Omnibus Autism Proceedings demonstrated the flawed nature of much of that research. Other scientists have failed to replicate Wakefield’s findings and epidemiological studies have shown no connection between autism and MMR.

Thiomersal, a mercury based preservative that used to be found in minute quantities in some childhood vaccines, has also been blamed. A speculative paper suggested similarities between the symptoms of mercury poisoning and autism. This idea was thoroughly debunked but the idea persisted because the growth in reported prevalence of autism in the USA coincided with an increase in the number of vaccines containing thiomersal. Advocates for this theory never adequately explained why autism numbers in the UK were growing at least as fast as those in the USA while the number of thiomersal containing vaccines [TCVs] in the UK never increased. And when TCVS were eliminated from the recommended childhood vaccine schedule in the USA in 2002 the numbers continued to rise.

The latest “theory” that we give our children “too many too soon” and overwhelm their natural defenses ignores the simple fact that advances in vaccine development mean that the entire vaccine schedule contains less active ingredients than ever before.  A single dose of smallpox vaccine with 200 antigens contained more antigens on its own than all today’s vaccines put together. And in 1960 smallpox plus polio plus diptheria, tetanus and pertussis vaccines delivered 3,200 antigens!

“Too much too soon” is part of the “Green Our Vaccines” campaign. It is coupled with a spurious argument about toxins in vaccines. The Green Our Vaccines list of alleged toxic ingredients has been thoroughly dismissed. There are some potentially toxic chemicals used in vaccine production. These have all been tested for safety and are necessary to prevent contamination during production, storage and delivery of vaccines. I wonder how many of us use equally potent ”toxins” to cleanse work surfaces on which we prepare food for our children.

Their “science” is non-existent. But the anti-vaccine element have proved impossible to ignore because the media continue to give them publicity. And this publicity has contributed to the decline in vaccine uptake, paticularly the MMR. For example last month the Daily Telegraph published a ridiculous story entitled “MMR; the debate that will not go away.” Yesterday the Telegraph, with no apparent sense of shame, carried another story, “Teenager dies of Measles as cases continue to rise, Government officials say.”

This young man did have problems with his immune ystem which made it difficult for him to have vaccinations. Instead he relied on the “herd immunity” conferred on society when sufficient people are vaccinated to prevent a disease taking hold. 95% is usually held out as the threshold figure. But thanks to previous scare stories in papers like the Telegraph coverage is much lower. 84% of two year old have had the MMR. But only 75% of 5 year olds have had their second shot. In London the situation is worse with figures of 71% and 50% respectively according to the Independent. Measles is once again becoming endemic in the UK with 461 cases so far this year.

Most cases are thankfully not fatal. But they can still cause terrible illness. A woman in Blackpool nearly lost her daughter to the complications of measles.

Leah, who picked up the disease from her brother, was rushed into Blackpool Victoria Hospital on June 4 and kept on a drip for four harrowing days.

Mrs Hartley explained: “She had an horrendous sounding cough, a sky-high temperature, an upset stomach, conjunctivitis and she couldn’t stay awake.

“At one point she woke up and was hallucinating so she started screaming and crying, it really was terrifying.

“My mind was racing and I didn’t think she was going to pull through it – I never would have believed measles could make anyone so ill.”

Out of curiosity I visited the JABS forum. JABS claims to be neither pro nor anti vaccine. But it comes across as anti-vaccine and a supporter of the mmr-autism connection. Both the Telegraph report on the death from measles and the Independent report on the rise of measles were posted there on Saturday afternoon. Thus far at 1.00am on Sunday morning the young man’s death has been read 29 times with no comments. But the Independent report on the endemic has attracted 88 readers and comments like these.

Natural measles exposure is the best immunity you can get so I would imagine many parents will welcome this news with open arms.

One case of measles [in which a young man dies] makes the front page thousands of cases of autism unmentioned…agenda or what???

MMR RIP

if they can now justify mentioning individual measles cases, [He means a measles death]when normally they dismiss them in favour of epidemiology, then this must give the green light to discussing adverse reaction individual cases??

I will continue to post stories about vaccines in order to remind myself of what happens when quackery combines with conspiracy theory to drive out reason and compassion. Let us hope that the need to post such stories will diminish as the link between vaccines and autism is finally severed.

June 22nd, 2008 Posted by Mike | Andrew Wakefield, MMR, journalism, mercury, vaccines | 10 comments

Melanie Phillips is wrong again.

“The Wakefield Witchhunt” - Melanie Phillips - The Spectator - Friday, 21st March 2008

A couple of days ago, yet another story appeared claiming that fresh research had shown that there was no link between the MMR vaccination and autism. This new research was said to have shown that, contrary to the claims made by Dr Andrew Wakefield, the surgeon at the centre of the MMR scare, there was no relationship between gut problems and autism, the core of his concerns. It also claimed that the discovery furthermore damaged the related theory that a gluten-free diet could help children with autism.

This must be a first, even when judged by the standards of accuracy previously set by newspaper columnist, Melanie Phillips. Every statement of fact in her opening paragraph is wrong! The ”fresh research” makes no mention of MMR apart from acknowledging a potential conflict of interest because one of the authors, John March “has previously acted as an expert witness for the litigants in the MMR litigation case conducted by Alexander Harris against three MMR vaccine manufacturers, which involved urinary analysis of both litigants and non-litigant controls using MALDI-TOF mass spectrometry. He has an autistic child who was not part of this legal case.”

The next sentence is very telling, “was said to have shown that…” Was said by whom? Has Ms Phillips actually read the research in question or is she relying on her feed from LexisNexis? If she had read the research paper she would know that it makes no claims regarding the purported link between gut issues and autism. Neither does it question the efficacy of the gluten and casein free diet. The authors are careful not to dismiss the diet. Instead they call for more research into it. NHS Choices gets it right.

Despite the newspaper headlines and coverage, the study did not look at the effects of the MMR jab and autism. Instead, it tested and compared the urine of autistic boys with the urine of boys without autism. The researchers conclude that there were no differences between the levels of peptides in the groups and say they have effectively disproved the ’leaky gut theory‘. However, further research is needed to establish whether a casein and gluten-free diet has other effects on autism.The researchers call for more studies into special diet as a treatment for autism, but they do not suggest that their research has any implication for the discredited MMR vaccine/autism theory.

Ms Phillips is on firmer ground when quoting directly from the press release

“Dr Hilary Cass, from Great Ormond Street, said: ‘It is very distressing to have a diagnosis of autism, a lifelong condition. Many families are driven to try out interventions which currently have no scientific basis. For example, advocates of the leaky gut hypothesis offer children a casein and gluten-free diet which as yet lacks an evidence base.’

But then she puts her foot in it by adding her own commentary 

This particular observation is a telling indication that this study bears little relation to reality. For there are countless families whose autistic children’s suffering from gut problems has only been eased, and their autistic symptoms improved, by the introduction of precisely such a diet. ‘No evidence base’? Tell that to those families. It is their lived experience.

All together now, for the benefit of Ms Phillips: The plural of anecdote is not data! Testimonials from parents need to be backed up by solid data from properly conducted research. We are awaiting the outcome of a couple of studies that may provide that evidence base.

Second, despite the way this was presented in the media this is not a new piece of research at all. It is instead a recycled version of a study by Baird G. et al, published in the Archive of Diseases in Childhood on February 5 and reported in the press around that time.

Oh dear! Where on earth did she get that idea? Baird G. et al did take advantage of an earlier study [Baird G, Simonoff E, Pickles A, et al. "Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP)" Lancet 2006; 368:210–15.] for their study of “Measles vaccination and antibody response in autism spectrum disorders.” But this has nothing to do with Dr Cass.

Dr Cass recruited children “from two tertiary referral centres specialising in autistic spectrum disorders whilst controls were recruited from and mainstream primary and secondary schools in the same geographical area. 65 boys with autism mean age 7:4 years (5-11) and 158 control boys mean age 7:8 years (4:2-11)”

Dr Baird used “A community sample of vaccinated children aged 10–12 years in the UK with ASD (n=98) and two control groups of similar age, one with special educational needs but no ASD (n=52) and one typically developing group (n=90), were tested for measles virus and antibody response to measles in the serum.”

So Dr Cass “recycled” this study using different researchers, different children, different research aims and methods, and different funding bodies. The two studies are totally unrelated. Nevertheless Ms Phillips goes on to cite Wakefield’s response to Baird et al and a letter by John Stone in response to Baird et al as if they apply to Cass et al! Not that this mattters to Ms Phillips. Nowhere does she discuss the content of either Baird’s or Cass’s research or evaluate the hefty quotations from Wakefield and Stone. (They total 1100 words in an article of 2000 words. I wonder if she is paid per column inch.) No. This is just another way to reiterate the myth of the martyrdom of Andrew Wakefield at the GMC.

 No stone is being left unturned by the medico-political establishment and its creatures in the media to ensure that this doctor is destroyed.

Ms Phillips, like David Kirby, has pretensions of impartiality.

As I have repeatedly said, I have no idea whether Wakefield is correct or not in his concerns about the possible adverse effects of the MMR vaccine on a small sub-set of vaccinated children. Nor do I know whether any of the charges being levelled against him at the GMC has any legs. But I do believe — as I wrote in my series of articles on the subject for the Daily Mail in 2003 here, here and here — that many of the statements made by the Department of Health and medical establishment about the ‘proof’ of the vaccine’s unchallengeable safety are deeply misleading.

Wow! She has no idea about MMR and autism. She has no opinion on Wakefield’s culpability. But she does have an opinion on the stated opinions of the Department of Health and the medical establishment on these very matters. Furthermore, her opinion of the opinions of others on matters on which she has no opinion is the same opinion she had 5 years ago and we can read it “here, here and here.” Meanwhile, back to the present and a few more gems from Ms Phillips.

No-one has ever suggested that the MMR vaccine causes all or most of the incidence of autism. If Wakefield is correct, it is only a small proportion of children whose immune systems may be unable to cope, for whatever reason, which makes them particularly vulnerable to such ill-effects.

No-one? How about the  presenter of “Origins of the Autism Epidemic,” Andrew Wakefield. And how small is a small proportion? Researchers like Cass and Baird provide us with data. According to Wakefield:

“We have over the last 10 years evaluated several thousand children on the autistic spectrum who have significant gastrointestinal symptoms. Upper and lower endoscopy and surgical histology have identified mucosal inflammation in excess of 80% of these children.”

“Several thousand children?” We know he had examined 12 children by 1998 There were around 1300 children in the UK class action against MMR that failed.  Perhaps he examined them all. Then Wakefield went to work for Jeff Bradstreet, an exorcist in Florida before setting up Thoughtful House in 2005 where Arthur Krigsman scopes every child that walks through the door. If we average it out and say 2 children a day every day, not counting weekends and holidays for 10 years that gives us around 5000 kids with and endoscopic investigation and 4000 turned up positive for enterocolitis and autism. Yeah, whatever. Perhaps Wakefield will publish his data one day and end all the guesswork.

And contrary to the message being pumped out by the medical establishment that the vaccine has been proved to be safe — by studies which are all either flawed, inadequate or irrelevant — the fairest and most accurate thing to say is that the jury is still out.

Vaccines will never be “proved safe” if by this you mean that they will be absolved of all risk. But they are safer than the diseases they protect against. How about it Ms Phillips? Would you like polio or the polio vaccine?

One of the most reprehensible weapons being wielded in the witch-hunt against Wakefield is the claim that anyone who gives any credence whatever to his concerns is responsible for the incidence of measles amongst children whose parents are as a result too frightened to give them the MMR vaccination. There are two obvious points to make in response to this piece of moral blackmail: 1) the whole panic could have been avoided by offering single measles, mumps and rubella jabs rather than the triple MMR, and 2) it is surely just as important as avoiding cases of measles mumps and rubella to avoid causing the kind of catastrophic damage to the brain and gut displayed by the children at the heart of this controversy.

Wrong again! Offering single vaccines is tantamount to admitting that MMR is dangerous. It would have destroyed public confidence in the whole vaccine schedule and take up of the three shots would have been significantly less than the triple shot, always assuming we could source three separate vaccines that had been adequately tested for safety. And regarding point 2), hang on! How do you know that single vaccines would avoid this “kind of catastrophic damage” unless you already had an opinion about the effects of the MMR? Remember? The opinion that Ms Phillips claims not to have?

And there is a further and quite appalling point to note. This whole saga started because parents of such children found that their family doctors were dismissing out of hand their children’s gut and brain problems, accordingly refusing to alleviate their suffering. Now, as a direct result of the animosity towards Wakefield that has been whipped up — and the fear that any doctor who suggests he might be right will similarly find him or herself at the receiving end of the medical establishment’s fist — children exhibiting this combination of gut and brain damage are finding it difficult to obtain treatment.

Yes! Because quacks like Wakefield and their silly media acolytes have made it next to impossible for a doctor to diagnose and treat GI disorders in autistic children without being tarred with the same brush! Thank you Dr. Wakefield. Thank you Ms Phillips.

As the resumption of the GMC hearing draws nearer, one has to ask whether this will serve the cause of truth and justice and the relief of suffering — or is it instead merely a show trial which will bring about the precise opposite?

I hope that Wakefield is severely chastised and that we can move on to addressing the real needs of autistic children and adults free from the need to constantly address spurious scare stories about vaccines.

Melanie Phillips writes for the Spectator. It’s editor used to be Boris Johnson, who masked his intellectual prowess with the appearance of dimwitted buffoonery. Ms Phillips is just the opposite.

March 23rd, 2008 Posted by Mike | Andrew Wakefield, Autism, MMR, journalism, parents, politics, vaccines | 13 comments

MMR not linked to Autism

Have we finally turned a corner with the MMR/Autism scare? News reports today are almost unanimous in heralding the latest piece of research to find no evidence of a connection between the MMR vaccination and autism. One or two papers are grudging in their acknowledgements and turn to long time critics of the MMR vaccine like JABS spokesperson Jackie Fletcher and Dr Richard Halvorsen, a supplier of single vaccines for “balance.”

But the consensus seems to be that the MMR scare has run its course. This is the latest and largest case control study to look for evidence of the persistence of measles virus or elevated levels of measles antibodies in the blood of autistic children.

The results are reassuring. Researchers found no significant difference between autistic children, children with learning difficulties and typical controls. When they looked at differences within the autism group they got the same result. Children with childhood autism [ICD-10 classification equivalent to DSM-IV autistic disorder] showed no significant difference from children with other autistic spectrum disorders. It was the same when they compared regressive to non-regressive autism.

Having read the study I can see no obvious confounds that should undermine our confidence in its conclusion that:

No difference was detected in the distribution of measles antibody or in measles virus in ASD cases and controls whether the children had received the first, second or both MMR vaccinations. This remained true when the analysis was restricted to ASD cases with a history of regression. Only one child had symptoms of possible enterocolitis, and this child was in the control group.

Opponents of the MMR vaccine have, nevertheless, raised a number of objections. My favourite is Jackie Fletcher who is quoted by the BBC as saying that:

It is making a leap from having the actual data on the antibodies and saying MMR does not cause autism.

This shows a serious misunderstanding of the basic tenets of scientific proof. The authors are not saying that MMR does not cause autism. They are saying that they found no evidence to support the hypothesis that MMR causes autism and that we have an accumulation of data that suggests otherwise. The difference is that we do have “the actual data.” In the absence of any “actual data” that suggests otherwise there is no reason to give the MMR hypothesis any consideration at all.

Other critics of the paper have tried to question the data. John Stone has responded on a number of comments sections to alleged a high dropout rate. Either he misunderstands the process or he is being dishonest. This study took advantage of a larger study by Baird et al in order to focus on MMR. Parents all knew that the focus was on the MMR. Out of 1770 initial subjects selected for screening 735 declined or failed to complete the screening. After screening 255 of the remaining 1035 were selected for in depth assessment. John Stone is comparing the final study group with the initial sample. And, given that the researchers informed parents that the study was about the MMR vaccination, it is extremely unlikely that parents who believed that MMR was implicated in their child’s autism would withdraw.

There was a significant withdrawal at the next stage when 100 subjects either declined to provide or were unable to provide a suitable blood sample. Again, it is extremely unlikely that parents who believed that MMR was implicated in their child’s autism would withdraw at this stage. And most of the withdrawals were of children with learning difficulties but no autism.

Another objection is the use of blood tests rather than biopsies or lumbar punctures to obtain CSF samples. These are highly invasive procedures that are only indicated when there is clinical benefit to the child. It would be unethical to subject children to unnecessary and potentially risky medical procedures purely for the purposes of research. And such procedures are unnecessary unless you believe that measles virus and antibodies mysteriously vanish from the blood of autistic children when they enter the gut or the CSF. The authors clearly state that:

Measles virus replicates in a range of cells during infection, including the upper respiratory tract, intestinal cells, several T cell lineages and macrophages. Replication occurs for similar periods in these different sites. An earlier study had suggested detectable virus using PCR in PBMCs from children with ASD. We used PBMCs in this study as a proxy for gut mucosal cells, which were not obtained for ethical reasons.

The earlier study they cite was:

Kawashima H, Mori T, Kashiwagi Y, et al. Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism. Dig Dis Sci 2000;45:723–9.

If you visit Springerlink you learn that the fifth named author was Andy Wakefield. Critics cannot have it both ways. If Baird is wrong to look for measles virus in blood how can Wakefield be right to do the same thing? Or is Baird being criticized, not because she used the wrong method, but because she got the wrong results?

Another potentially valid criticism is that 255 is too small a number to reveal the small numbers of children who may have had an adverse reaction. But all the case studies purporting to find measles in the blood had considerably less subjects. It is quite possible for autistic children to have adverse reactions to vaccines just like other children. It is quite possible for them to have elevated levels, just like other children. In fact Baird et al. found three children with abnormal results on. They suggest:

two possible explanations for the finding of one RT-PCR-reactive sample in 98 cases of ASD and two in the 90 TD children. Immunity to measles is not always complete and measles genome has been detected in the PBMCs of asymptomatic people during measles epidemics. C2 and D6 measles genotypes were detected in the UK population before 2002. The finding may also be due to laboratory cross-contamination, which can be problematic with RT-PCR assays.

So will this study end the controversy? Probably not. As the Guardian leader writer put it today

So the evidence is now clearer than ever that the causal link does not exist. The reality, however, is that this may not alter the views of some who still insist MMR is a threat, for their thinking was never scientific and so is not amenable to the developing facts.

There are those who are instinctively hostile to technology, who always want to believe that modern medicine will do harm. Then there are those who want to believe that the state is a pernicious conspiracy, bent on endangering children. Last, but not least, are those with a vested interest in continuing to spread the mistrust. Dr Andrew Wakefield led the original research postulating the link, and he is currently before the General Medical Council on various charges, some relating to whether his work has been financed in ways that could have compromised his objectivity. Whether that charge is upheld or not, it is already clear that much of the media has stoked up unfounded fears on the irresponsibly selfish grounds that sensationalism sells.

The Guardian is not completely blameles in all this but it has a better record than its sister paper, the Observer. The important thing is that the majority of the media are finally reporting the science and turning their backs on the MMR circus.

February 6th, 2008 Posted by Mike | Andrew Wakefield, Autism, MMR, vaccines | 10 comments

A Tale of Two Wakefields

Compare and contrast this colonoscopy risk consent form  from the Wakefield Clinic in Adelaide, Australia with this consent form from Andrew Wakefield.

Both are consent forms for colonoscopies. The first one clearly explains what the alternatives are and advises patients of potential hazards, including,

3. Perforation of the colon

A perforation is when a hole or tear is made in the colon by the colonoscope. This is rare, occurring in 1 in 500 – 1000 cases. If it occurs, then it would be likely that an operation would be required to repair the damaged area. This would involve a stay in hospital for approximately 1 week.

4. Bleeding from the bowel

Small amounts of blood are not uncommon after biopsies or polypectomy (removal of polyps). In 1 in 100 cases of polypectomy the bleeding may be sufficient enough to require transfusion.

The second one is from Andrew Wakefield’s clinic at the Royal Free in London when he was researching the possible connection between entercolitis and autism. It describes  colonoscopy procedure thus. There is no mention of any risk for this procedure or for the lumbar puncture that would be performed straight afterwards while the child was still under sedation. 

 
At least one family has cause to rue this omission.  According to the Daily Mail 

An autistic boy has won a £500,000 payout after a hospital at the centre of an MMR scandal carried out an operation that was “not clinically justified”. Jack Piper, then five, was left battling for life after the procedure, which his parents claim was carried out to establish links between his condition and bowel problems. His bowel was perforated in more than 12 places during surgery at the Royal Free Hospital in Hampstead, North London.

The court approved a cash payment of £482,300 by the Royal Free Hampstead NHS Trust  which may still be liable for further costs of £1 million depending on Jack Piper’s lifetime care needs. They admit to negligence in carrying out the colonoscpy, which caused Jack to suffer

multiple organ failure, including kidney and liver problems, a swollen brain and neurological problems. He has also developed epilepsy and suffered stomach ulcers. The botched operation “significantly increased” his dependence on others. Now aged 14, Jack needs round-the-clock care.

Because of the settlement some serious claims will not now be tested in the courts.

High Court papers alleged the colonoscopy procedure performed on Jack in 1998 was “not clinically indicated or justified”. They also claimed the “principal reason” for the surgery was to further research into links between autism and bowel conditions rather than Jack’s clinical needs. The documents also claimed that Jack’s parents were not warned of the risks of the procedure or the “controversial and uncertain” link between autism and bowel conditions. This meant the surgery was performed “without lawful consent” and was an “assault” on Jack.

These are similar to some of the charges laid against Dr Simon Murch, the doctor who recommended Jack Piper’s colonoscopy, by the General Medical Council. So we may eventually see a resolution to these concerns. Meanwhile, the Piper family, quite reasonably, have chosen to safeguard Jack’s future. Having sacrificed him once in the name of research it would be unreasonable to expect them to jeopardize his financial settlement in order to prove a point of law.

December 9th, 2007 Posted by Mike | Andrew Wakefield, Autism, MMR, vaccines | 11 comments

Vaccines, autism and actresses.

Jenny versus Jennifer

How would you describe an actress and a mother who makes public statements about the nation’s vaccination programme?

Brainwashed simpleton?

That is a bit strong, even when applied to Jenny McCarthy. But this is the EOHarm email list passing judgement on a different actress, Jennifer Garner whose crime was to speak up in favour of vaccines, namely the flu vccination programme in the United States. Another letter described her as,

Just another Hollywood uninformed propagandist?

This without a hint of irony from members of a group that has nothing but praise for their own Hollywood uninformed propagandist, the aforementioned Jenny MCarthy! Another letter suggests that Jenny McCarthy might want to pop round to Jennifer Garner’s house for coffee and presumably put her right on the vaccine issue at the same time.

I feel she would get short shrift. Jennifer Garner will have been ably briefed by the American Lung Association. She knows that with an annual death toll of 36,000 from influenza and its complications, this is the number eight killer in the USA with 2.7% of all deaths. It used to be 4% which suggests that the vaccine is having a positive impact. EOHarm takes its inspiration from “Evidence of Harm,”  a book that purports to be a balanced investigation of the alleged connection between the mercury content in childhood vaccines and the growth in the prevalence of autism, but ends up providing uncritical support for the belief that we are in the midst of an autism epidemic caused by mercury poisoning.

Original Biomedical Theory

Once upon a time biomedical explanations and interventions for autism revolved around diets, anti fungals and vitamin supplements. I have a book, “Biological treatments for autism and PDD” by William Shaw dated 1997 which even contains a recommendation for parents to vaccinate their children against Streptococcus Pneumoniae. 

The closest it comes to implicating vaccines is the author’s belief that adverse reactions to vaccines may be one of the factors contributing to recurrent infections that require antibiotics. It is the antibiotics that are supposed to do the real damage, destroying the natural flora in the gut.  Consequently fungal infections damage the gut and allow poorly digested peptides to enter the blood stream. If these get into the brain they attach to opioid receptors and cause the symptoms we diagnose as autism. Three years later Karen Seroussi wrote “Unraveling the Mystery of Autism and Pervasive Developmental Disorder” [Simon and Schuster 2000] which repeated Shaw’s basic hypothesis. Vaccines, typically MMR but also DPT, were again accorded a supporting role in exacerbating a pre-existing difficulty coping with infections. Mercury, heavy metal poisoning and chelation therapy did not get a mention.

Mercury Rises

There was a problem with this “Opioid Excess” theory of causation. [apart from the obvious one that even today it remains a tentative theory with little hard science to support it.] It had originally been expounded  in 1979 [Panksepp J. A Neurochemical Theory of Autism] Even if the MMR was an added factor, it too had been around since the 1970s. But the dramatic increase in reported cases of autism in children suggested that something else was happening. There were perfectly good reasons not to believe in an epidemic. But for those parents already primed to blame MMR, the growth in autism led them to look for vaccine-related causes. During the 1990s the number of mandatory vaccines for children in the USA grew steadily alongside the autism figures. In some cases children could have received in excess of the stringent safety limits for mercury exposure if they had receieved all  their vaccine shots. A paper pointing to supposed similarities between mercury poisoning and autism was published in a fringe journal. Information supporting the mercury hypothesis was widely disseminated amongst parents via the internet. David Kirby wrote his book, “Evidence of Harm” and the rest, as it were, is history.  

Blame all Vaccines

Now that mercury has been removed from all mandatory childhood vaccines and autism shows no signs of decreasing you would think that people would move on and look for other explanantions for autism prevalence. Perhaps this article in Time Magazine or this interview with Dr Gernsbacher and Dr Neuschaffer could offer a less catastrophic interpretation of the figures.

But parents who have invested so much intellectual and emotional capital into their belief in vaccine damaged kids as a source of autism are increasingly blaming the vaccines themselves. The real vaccine/autism scare began with the MMR fiasco in the UK. That resonated in the USA where Dr Andrew Wakefield is a popular figure at Defeat Autism Now events. As I understand it, in one variation on a theme, the mercury in vaccines was supposed to weaken the immune system and the measles component of the MMR subsequently overwhelmed it. IF you believe this and IF you also buy into the conspiracy theory that the US government [in the form of the FDA and the CDC]  and the big drug companies knew about this and are now engaged in a cover-up, it is a short step to believing that all vaccines are dangerous and everything that the government tells us about vaccine safety and efficacy is a lie.

For the true believers 36,000 preventable deaths from influenza [and that is in the USA alone, never mind the rest of the world] are as nothing compared to the hypothetical possibility that vaccines cause autism. Brainwashed Simpletons? No,  more like sadly deluded.

November 21st, 2007 Posted by Mike | Andrew Wakefield, Autism, MMR, vaccines | 11 comments

Media Response to the Observer and Autism

The Observer’s recent scare story on autism has at least two good points.

1. They have taken such a beating that it is unlikely that they will publish another PR story for Wakefield for a long time to come.
2. I have discovered a lot of interesting blogs which support rational discourse and look forward to reading them on a regular basis.

Then there are the bad points. Most of the press ran with the story without questioning its veracity. Very few have picked up on the faults in the Observer story. This is the best I could find when doing a google news search on the terms Observer and Autism.

Press Round Up on the Observer, Wakefield, MMR and Autism

The Observer’s 8 July front page, featuring the claim of a one-in-58 risk of autism from the MMR jab, has prompted its sister paper, ‘The Guardian’, to run a meticulous debunking of the story in its Bad Science column. Its author, Goldacre, suggests the media that peddle such untruths should be “in the dock, alongside [Dr Andrew] Wakefield”. Despite the kicking, morale remains high at ‘The Observer’. Many of its own journalists thought the story deserved a good trashing.

The Independent July 22nd 2007

Whatever you think about Andrew Wakefield, the real villains of the MMR scandal are the media. Just one week before his GMC hearing, yet another factless “MMR causes autism” news story appeared: and even though it ran on the front page of our very own Observer, I am dismantling it on this page. We’re all grown-ups around here.

[...]

Nothing has changed, and this scare will never be allowed to die. If we had the right regulatory structures, almost every section of the media would be in the dock, alongside Wakefield.

Dr Ben Goldacre in The Guardian July 18 2007

New fears over big surge in autism’; ‘I told the truth all along, says doctor at the heart of autism row’. Headlines in last week’s Observer (8 July) provide a media boost for Dr Andrew Wakefield as he faces charges of professional misconduct at the UK General Medical Council (GMC) over the conduct of the research that first suggested a link between the MMR vaccine and autism in 1998.  [read on]

Dr Michael Fitzpatrick in Spiked Online July 17th 2007

What the Blogs say about the Observer and Autism

These are the most recent blogs (last seven days) courtesy of Google that add something new to the debate. Lots of others either linked to or repeated Ben Goldacre’s excellent rebuttals in his badscience blog or to Mike Fitzpatrick’s equally trenchant piece in Spiked Online.

A couple of weeks ago The Observer (UK ‘quality’ Sunday paper) printed an article claiming an as yet unpublished study shows a dramatic rise in the prevalence of autism. They also managed to crowbar in the MMR vaccine as well just to raise the general levels of hysteria. [ read on ]

This Sunday The Observer nearly apologizes for its disgraceful front page report on Autism a fortnight ago. But they still don’t get it. [ read on ] I wrote this one

The Observer deserves sackcloth and ashes for its autism, MMR coverage. The British Medical Journal (BMJ) embarrassed itself by uncritically reproducing that 1 in 58 figure but at least it had the good grace to take a piece by Dr Ben Goldacre that criticised the media coverage of this issue. [ read on ]

It’s one thing to get a story wrong. Everyone does that - I’ve certainly done a couple of howlers in my time. It’s quite another to, on being informed of your howler, try and cover it up. And, it appears, this is exactly what The Observer is doing after it’s truly appaling MMR/autism front story from last weekend. [ read on ]

This article and its subsequent coverage in the other press has set back public understanding of this subject by several years and unreasonably made the public question science even more, ironically when it is proper science that is the only way to truth in this, rather than the mumbo-jumbo “science” practised by Wakefield. [ read on ]

The main issue is that the Observer misinterpreted the results of this unpublished research. The paper claimed the research showed an increase in the prevalence of autism. Based on this misinterpretation it then blamed the supposed increase on the MMR vaccination, saying that two of the seven authors of the report privately thought the MMR jab might be partly to blame for the alleged rise in autism. [read on ]

Last week I blogged about the, now infamous, MMR  piece by Dennis Campbell in the Observer. Campbell’s piece contained this.

“the MMR jab which babies receive at 12 to 15 months, might be partly to blame. Dr. Fiona Scott and Dr. Carol Stott both say it could be a factor in small numbers of children.”

Dr Scott subsequently e-mailed Ben Goldacre. The e-mail contained the serious allegation that some of the stuff in the Observer piece had been “fabricated”. [read on]

A short break from your usual Patrick Holford coverage - courtesy of some more awful mainstream media MMR reporting. It was disappointing to see the Observer running such god-awful autism/MMR stories, but to see the BMJ pick up the Observer’s inaccurate figures (the claim that 1 in 58 children is on the autistic spectrum) is even more disturbing. [read on ]

In the aftermath of the Observer debacle, one of those described in the original piece as being an MMR believer responded in the comment thread of The Guardian readers editor page. Her words are very telling and show, once more, what a shoddy and deliberately misleading piece of work this was. [ read on ]

Speaking of Bad Science and bad reporting and how the two seem to go together so frequently, Ben Goldacre goes after The Observer big time in yesterday’s Bad Science column. The Observer, of course, continued to do its bit on behalf of scientific illiteracy with scare story on 9 July over yet another purported link between the MMR vaccine and the apparent rise in autism in the UK [read on ]

 I’m annoyed with the Observer. I had a nice Holford Watch post mostly written - looking at some particularly odd claims for vitamin C - and was planning on spending the rest of the day relaxing with a newspaper. Then I saw the Observer’s truly dismal (2nd) attempt at an apology for their terrible MMR/Autistic Spectrum Disorder (ASD) coverage. Now I can’t buy myself an Observer, and feel obliged to insert a break in your usual Patrick Holford coverage to write another post on the Observer. [ read on ]

Most significant of all is Fiona Fox’s contribution. Fiona Fox is director of the Science Media Centre and according to her blog, after sending a note to Denis Campbell warning him that she could not defend his piece to angry scientists.

The result was an invitation to meet with him, the readers’ editor and a variety of other Observer news editors at their offices. So, with two leading MMR experts at my side, I went to highlight the concerns.

According to their website

The Science Media Centre is first and foremost a press office for science when science hits the headlines. We provide journalists with what they need in the form and time-frame they need it when science is in the news - whether this be accurate information, a scientist to interview or a feature article.

If you read Fiona Fox’s blog she makes quite plain the help and advice that the SMC offered to the Observer in the aftermath of their diasterous front page story. Judging by their continued weaseling in today’s edition, The Observer is still clinging to the wreckage of its original story despite the advice of the SMC.

As an added irony, when I looked up who funds the SMC  I found the Associated Press (Daily Mail, Mail on Sunday, Evening Standard) DailyExpress, Trinity Mirror (Daily Mirror, Sunday Mirror, Daily Record, the People etc.) and News International (Times, Sunday Times, Sun) all represented. In fact, apart from the Telegraph and the Independent, nearly every national newspaper in the UK supports the SMC except the owners of the Guardian and the Observer.

There has been a lot of discussion recently about how bloggers cannot meet the standards  of professional journalists. Judging from this incident I am not sure that I aspire to the standards of journalists like Denis Campbell. I will end with a modest proposal from Brian Deer in the comments section of Kev’s blog.

My suggestion is that people should write to the Observer and suggest that, since there is still so much confusion about the duty of reporters, and what – on this matter of grave public interest, affecting the safety of children – are a newspaper’s reasonable duties to accuracy, the Observer should join with the complaining readers and refer the matter – jointly and with agreement – to the Press Complaints Commission for adjudication.

See what they say to that!

My letter is in the post. I even put a stamp on the envelope.  If I get a response I will let you know next week.

July 22nd, 2007 Posted by Mike | Andrew Wakefield, Autism, MMR, journalism | 13 comments

The Observer replies over Wakefield, autism and MMR.

This Sunday The Observer nearly apologizes for its disgraceful front page report on Autism a fortnight ago. But they still don’t get it. Today’s Observer says that,

The report from the ARC was entitled the Final Report of a three-year research project for the Shirley Foundation, a private charitable trust that has an interest in the issue of autism. The foundation paid almost £300,000 for the study which Dr Scott, one of the authors, described in an internal email as ‘very thorough’. As such The Observer believed it legitimate to report its findings, given the apparent status of the work. Professor Simon Baron-Cohen, the director of the ARC, has subsequently said that the data in the report is still being analysed and is therefore incomplete.

•  Final Report in this context means final report to the funding body. It cannot be equated with the final report of the research team to their peers. This was an academic work in progress. When they eventually spoke to Professor Baron-Cohen the Observer learned that the data in the report is still being analysed and is therefore incomplete. Therefore it is not a legitimate source for their story.
• The Observer claims they were unable to contact Dr Scott prior to publication. Post publication, the Times and the Telegraph had no problem contacting Dr Scott.
• Meanwhile Dr Scott had to contact the Observer via their online comments form in order to respond to their misrepresentation of her views. But they are able t0 quote “internal” (i.e. private) emails from Dr Scott.
• So we have a prestigious national newspaper that has access to a private document (the interim report of the research team to its funding agency) and access to the private emails of one of the researchers. But said newspaper is unable to obtain public access to either the lead researcher (Professor Simon Baron-Cohen) or Dr Scott prior to publication.
• Here is a thought. Why didn’t the Observer delay publication until after they had spoken to  Professor Baron-Cohen and Dr. Scott? This was not breaking news. They could have waited. Surely, this report’s timing was not influenced by the same reporter’s “exclusive” interview with Andrew Wakefield in the same issue, prior to his disciplinary hearing before the GMC?
• Here is another thought. Someone offers the Observer a story on a plate: leaked report; leaked emails; background briefing. Oh, and while you are at it, how about an exclusive interview with the main man? 
• Should they check it out or accept it uncritically? What do you think happened?

Meanwhile, today’s statement merely compounds their error. To continue:

The 1 in 58 figure was described by one of the authors as ‘our primary analysis’ and was the only figure presented in the Final Report’s summary. It was therefore highlighted by The Observer. In the body of the ARC’s report the figures 1 in 74 and 1 in 94 were also published.

• Do tell. Which one of the authors described 1 in 58 as our primary analysis? Dr Stott, anybody?

The Observer should have reported these figures in the news story so that readers were aware that there were different interpretations of the findings. That they were left out was due to a reporting and editing error.

• A very misleading error in my opinion. And just to be clear, reporting errors are made by reporters. Editing errors are made by editors. People screwed up here. The people should admit their error and apologize.

There’s more.

Dr Stott, one of the authors of the Final Report and described by The Observer as believing that there maybe a link in a small number of cases between MMR and autism, does some work for Thoughtful House, the autism centre in Texas that treats children from all over the world. Dr Wakefield works at Thoughtful House. Dr Stott’s links to Dr Wakefield should have been made clear in The Observer news report.

• So Stott and Wakefield are both employees of Thoughtful House? They bump into each other in the canteen now and again? Not exactly. Wakefield is Executive Director of Thoughtful House. Stott is a senior researcher there. She and Wakefield have issued joint press releases answering critics of Thoughtful House.  Does that make it clear?

It gives me no pleasure to see a newspaper like the Observer squirm like this. Your sister paper, the Guardian, has already published a damning critique of the whole affair. Why continue to defend the indefensible when a simple, “Sorry, we were wrong.” would have sufficed?

July 22nd, 2007 Posted by Mike | Andrew Wakefield, Autism, MMR | 10 comments

Cry Shame on Wakefield and MMR

There is a new website up called Cry Shame. It is supported by JABS, Autism Treatment Trust and Treating Autism. One of its aims is

• To reveal the political and financial interests surrounding the role of vaccines – specifically MMR and thimerosol [sic] containing vaccines - in the onset of autistic-like regression and to make transparent the ruthless attempts to discredit those professionals who aim to shed light on the situation.

First amongst those professionals is Andrew Wakefield who, along with Professor Walker-Smith and Professor Murch, is the subject an inquiry into allegations of serious professional misconduct. On Monday, 16th July the Fitness to Practise Panel of the General Medical Council will commence its investigation into these allegations.

It is alleged that the three practitioners were named as Responsible Consultants on an application made to the Ethical Practices Committee of the Royal Free Hospital NHS Trust (“the ethics committee”) in 1996 to undertake a research study involving children who suffered from gastrointestinal symptoms and a rare behavioural condition called disintegrative disorder. The title of the study was  “A new paediatric syndrome: enteritis and disintegrative disorder following measles/rubella vaccination”. The Panel will inquire into allegations that the three practitioners undertook research during the period 1996-98 without proper ethical approval, failed to conduct the research in accordance with the application submitted to the ethics committee, and failed to treat the children admitted into the study in accordance with the terms of the approval given by the ethics committee. For example, it will be alleged that some of the children did not qualify for the study on the basis of their behavioural symptoms.

It is further alleged that the three practitioners permitted a programme of investigations to be carried out on a number of children as part of the research study, some of which were not clinically indicated when the Ethics Committee had been assured that they were all clinically indicated. These investigations included colonoscopies and lumbar punctures. It is alleged that the performance of these investigations was contrary to the clinical interests of the children.

The research undertaken by the three practitioners was subsequently written up in a paper published in the Lancet in February 1998 entitled “Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis and Pervasive Developmental Disorder in Children” (“the Lancet paper”).

It is alleged that the three practitioners inaccurately stated in the Lancet paper that the investigations reported in it were approved by the ethics committee.

The Panel will inquire into allegations that Dr Wakefield and Professor Walker-Smith acted dishonestly and irresponsibly in failing to disclose in the Lancet paper the method by which they recruited patients for inclusion in the research which resulted in a misleading description of the patient population in the Lancet paper. It is further alleged that Dr Wakefield gave a dishonest description of the patient population to the Medical Research Council.

The Panel will inquire into allegations that Dr Wakefield and Professor Walker-Smith administered a purportedly therapeutic substance to a child for experimental reasons prior to obtaining information about the safety of the substance. It is alleged that such actions were irresponsible and contrary to the clinical interests of the child.
The Panel will inquire into allegations that Dr Wakefield was involved in advising solicitors acting for persons alleged to have suffered harm by the administration of the MMR vaccine. It is alleged that Dr Wakefield’s conduct in relation to research funds obtained from the Legal Aid Board (“LAB”) was dishonest and misleading. It will be alleged that Dr Wakefield ought to have disclosed his funding from the LAB to the Ethics Committee but did not.

The Panel will inquire into allegations that Dr Wakefield ordered investigations on some children as part of the research carried out at the Royal Free Hospital from 1996-98 without the requisite paediatric qualifications to do so and in contravention of his Honorary Consultant appointment.

The Panel will inquire into allegations that Dr Wakefield failed to disclose his involvement in the MMR litigation, his receipt of funding from the LAB and his involvement in a Patent relating to a new vaccine to the Editor of the Lancet which was contrary to his duties as a senior author of the Lancet paper.

The Panel will inquire into allegations that Dr Wakefield acted unethically and abused his position of trust as a medical practitioner by taking blood from children at a birthday party to use for research purposes without ethics committee approval, in an inappropriate social setting, and whilst offering financial inducement.

MMR Scare

How convenient then for Wakefield that the MMR scare is resurrected on the front page of today’s Observer. Meanwhile Wakefield is given a two page spread to defend himself in advance of next week’s hearing. Despite the caveats in both pieces the overall message is clear. Any reader who is unfamiliar with the details of the controversy could be forgiven for coming away from the articles with the impression that MMR is still open to question, that Wakefield acted honourably in raising the issue and that, in closing ranks againts him, the medical establishment is also closing its collective mind. They are investigating Wakefield when they should be investigating his ideas. Thankfully a number of bloggers who have taken the time to familiarize themselves with the details have been quick to point out the fallacies in today’s articles.

Autism Diva, Autism Vox, BadScience, Black Triangle, LeftBrain/Right Brain, Public Address and Breath Spa for Kids , Tim Worstall, Tony Hatfield,

I would like to end by crying shame on those journalists who have uncritically reiterated the follies of the Observer in the online editions of The Telegraph and The Mail. Will tomorrow’s print editions be any better?

July 8th, 2007 Posted by Mike | Andrew Wakefield, Autism, MMR, Quackery, vaccines | 9 comments