Wakefield's walk of shame

By Phil Plait | June 1, 2010 9:30 am

If you’ve read this blog for more than 8 nanoseconds, you know I have no love for Andrew Wakefield. Founder of the modern antivax movement, disgraced researcher, discredited "doctor", and at least partly to blame for the rise in preventable illnesses, his impact has made the world a worse place. The Sceptic’s Book of Pooh-Pooh totally eviscerates Wakefield, holding nothing back. If you have any question about this guy’s horrifying history, then go read that.

Of course, he claims he is being persecuted, victimized, etc. etc. Baloney. What has actually happened is that the forces of science and reality have called his bluff. The problem is, he still hasn’t folded.

But the collapse perhaps, is imminent. Skeptical Teacher has the story of a recent antivax rally to support Wakefield. Several skeptics showed up at this event, including Bruce Critelli and Jamie Bernstein. You may be amused by this picture they took:

wakefield-skepticninjas

Jamie gave Wakefield a note, which he said he’d read later. I wish I could’ve been there when he did. The note said:

Dear Andrew Wakefield,

I know that you truly believe that what you are doing is helping people and that the ends justify the means, but I just want you to know that the things you are doing –- the actions you have taken in the past have hurt people –- killed people. Your work has scared and manipulated parents into not vaccinating their children, putting them and their entire community at risk, all in the name of safety. Children have died because of you. I just want to make sure that you fully understand that.

Sincerely,
Jamie

BANG! I know he’s heard this a lot before, but somehow I think having a note like that handed to him at a rally for him to read later may actually hit home. It won’t change his mind at all — he has way too much invested in his antivax garbage — but I sure hope he loses some sleep over it. I know a lot of parents have lost sleep due to him.

For your further schadenfreude, Jamie recounts the events of that day, Bruce posted some video, and Skeptical Teacher has comments and some links. You may be amused to note that claims of hundreds of attendees to the rally turn out to be like every other antivaxxer claim: hot air.

In the meantime, while Wakefield still attempts to twist reality into a Möbius strip, whooping cough is on the rise, and we lose more babies because people don’t get vaccinated.

The sad truth is — to stretch the poker analogy I used above — while we hold all the cards, what Wakefield and his followers are betting is the health and safety of every person on the planet, including babies. Those stakes are simply too high.

CATEGORIZED UNDER: Alt-Med, Antiscience, Debunking, Skepticism

Comments (103)

  1. wright1

    The note handed directly to him is a great idea. I guess it’s impact will depend on how much empathy he really has.

    I really don’t want to want to see this guy as a monster; it’s clear from the note that Bernstein doesn’t. But I think of my 7 year-old nephew and the children of my best friends, and imagine them suffering from preventable diseases…

    A monster, no. Stupid and evil, yes.

    Oh, and cue the “Why don’t you ever write about astronomy you liberal punk” whiners in 1… 2…

  2. The first thing that came to my mind was Carol Tavris’s excellent book “Mistakes were made (but not by me)”. Wakefield and his ilk are in way too deep to ever admit that they made such colossal blunders that cost the lives of children. Our best hope is not to convince the anti-vaxxers, but to make them irrelevant.

  3. Richard Wolford

    It would be nice to have a little flu-shot station set up next to one of these “rallies”, just for lolz.

  4. Wow, that takes a lot of guts to hand out a note like that in person. Impressive.

  5. yeah, yeah… why don’t you ever write about astronomy you liberal punk?
    :D

  6. Loved seeing the original post by the folks that did this! Epic Pwnage!

    A Facts, not Fantasy reposting of their excellent adventure.

    And for folks concerned about how bad vaccines are, check out http://factsnotfantasy.com/vaccines.php for a point by point refuting of the anti-vax pro-disease lies.

  7. Szwagier

    Well done, Jamie! Next step, a real life kick in the unvaccinated groin. :-)

  8. @Richard Wolford

    WIN!!!

  9. Peptron

    First, I would like to ask Phil: “Why don’t you ever write about astronomy you liberal punk?”

    Second, from the general feel that I get from Andrew Wakefield, he does strike me as somewhat of a sociopath with a penchant for martyrdom. What I mean is that what he did was obviously for money, and he knew it would get to him eventually, and when it did he claimed persecution. Somehow I get the feeling that he plays on that and is just part of the game. If what I think is true, then he really couldn’t care less about children dying. If children dying are a source of revenue for him, then how is it bad?

    Third, if Phil is a liberal punk, why doesn’t he have a rainbow mohawk?

  10. If it would help, I could send Wakefield the rabid skunk we caught outside the office last month.

  11. You are now my new favorite person :) As the mother of a profoundly autistic son (and wish I’d been an astronomer!) and someone who knows that vaccines did NOT cause this in him, thank you. SO refreshing to see some non-fanatical, level-headed writing about that man and I agree whole-heartedly with everything you said. Also, monster high-five to Jaime for doing that.

  12. Ray

    @ Peptron,
    “Third, if Phil is a liberal punk, why doesn’t he have a rainbow mohawk?”

    The hat hides it.

  13. stompsfrogs

    @ Peptron: Yeah, he obviously did it for the money. You’d think he’d have slunk off by now to go enjoy it, rather than keep promoting his discredited phony science. Jamie probably gives Wakefield far too much credit, but we can’t sink to their level… It’s slimy there…

  14. Paul

    I was on the phone with family in America off and on yesterday. One of the topics was the unfortunate situation of my cousin’s child who is autistic and becoming quite violent. When the topic of vaccines being the cause I was all over it. I am still waiting to hear back from my aunt. Junkscience needs to be run out of town. My heart goes out to parents of autistic children — they are such easy prey.

  15. Josh K

    Wow, that’s bold. Love it. So, Phil, when are you going to get a picture with Glenn Beck? With a rainbow mohawk of course.

    CHALLENGE!

  16. @Peptron,

    “Third, if Phil is a liberal punk, why doesn’t he have a rainbow mohawk?”

    Did Phil ever reveal his tatoo? Maybe it’s a rainbow mohawk…. on the Hubble Space Telescope, of course. Now *there’s* a challenge for Photoshop experts out there!

  17. I’m divided on Wakefield’s motivations. Part of me wants to always assume good motives for people, even when they do harmful things. That part of my figures that he honestly believes that vaccines cause autism and he has sunk so deep into that fiction that his brain just can’t process being so wrong. (Kind of like Nigerian scam victims when they’re told that $5,000 will definitely free that $10 million after they’ve already ponied up $30,000.)

    The other part of me, the more cynical part, thinks he’s only in it for the money. This cynical side thinks he doesn’t even care whether there is any real proof for (or against) a vaccine-autism link. He’s getting money from his work and he’ll milk it for as long as he can. When the gravy train runs out, he’ll either be set for life or will move on to some other scam.

  18. el jefe

    @Ray,
    “The hat hides it.”

    I dunno about that; I saw him on Bullsh!t a couple of times now and his hair is amazingly naturally colored for a “liberal punk.” I really do think P & T should just start using Phil and Randi as counterpoints on all of their shows going forward.

  19. Dennis

    “I know that you truly believe that what you are doing is helping people and that the ends justify the means”

    I question the accuracy of that statement.
    It seems to me that he must know that what he is doing is only helping himself.

  20. @Dennis,

    He is helping people for certain values of “people.”

  21. Plutonian

    Might be a good idea to turn that letter into a giant billboard – or many giant billboards.

    Go Jamie Bernstein -well done! :-)

  22. Peptron

    @dennis #18 & @TechyDad #16:
    What makes me go for the more cynical interpretation is that IMHO, he is the only one benefiting from his own story. I really don’t see any “greater cause” in his case. The most cynical parts of me see him as another iteration of L. Ron Hubbard “if I want to make money, I’ll make my own religion”. There are just too many things adding up: him trying to “prove” big pharma wrong by lying, then having big pharma out to get him because he was lying; all the while getting money for his cause.

    @ the others:
    I think that what happens is that Phil has an INVISIBLE rainbow mohawk. The fact that you cannot see it is proof that it is there. I’d go as far as to say that all skeptics have an invisible rainbow mohawk on their head, since they are so rebelious and so obviously lacking a rainbow mohawk. I have it all figured out. If you send 500$ into my bank account, I’ll tell you the rest of my revelations.

  23. el jefe

    @peptron,
    You must be a cosmological psychic to detect those wavelengths on the ambrian spectrum that way! If your cold read worked that well over the internet I really should give you 5 Bennies; further proof that Wakefield just picked the wrong scam.

  24. TravisM

    @7. “Well done, Jamie! Next step, a real life kick in the unvaccinated groin.”
    The sad part is, it is probably a quite well vaccinated groin. Like wealthy people saying “money won’t solve your problems.”

  25. Chief

    Actually the big secret is that Phil’s tat is that of a rainbow mohawk.

    Reading the comments it occurs to me that the antivacs will never admit that what they are spouting could be wrong as we would have the basis for suing them for murder. That would certainly shut them up eh.

  26. stompsfrogs

    Welcome to America, Chief. First Amendment rights are extended, even to limey scum buckets like Wakefield.

  27. Sean

    A personal anecdote:

    My sister’s family came down with whooping cough recently, despite the fact that they were ALL vaccinated.

    Their doctor informed her that the pertussis vaccine is only about 80-85% effective. So, a high vaccination rate is critical to preventing outbreaks.

    In this case, it was my niece who probably contracted it at school ( a Bay Area public high-school ) and spread it to everyone in the house except her father.

    Thankfully, 2 weeks of antibiotics and booster-shots later, they’re all doing fine.

    But I’d hate to be the next parent my sister meets who talks about not vaccinating their kids. I expect she will cheerfully rip their head off.

    -S

  28. Sir Eccles

    Maybe it isn’t the hair on Phil’s head that is rainbow colored. Carpets, drapes…

  29. Robert

    Sean,

    Can I watch?

    Heck, I’ll even stand on their toes to give her better leverage.

  30. jcm

    Wakefield is spreading kook cooties! Run for your lives.

  31. Amanda

    @Sir Eccles: Lalalalalalalala! *screwed up eyes, fingers in ears*

    I’m totally down with Phil getting a photo with Glenn Beck. Made of win.

  32. cheerfully vaccinated

    Why not put this mercenary bag of slime inside a classroom full of unvaccinated kids for a couple of weeks and see how he feels after that?

  33. I believe that Jamie is also wearing a pro-vaccine Surly in that photo, for more hilarity…

    At least, I think that’s what I heard on SGU.

  34. Chief

    re: stompsfrogs

    But doesn’t the First Amendment right end at the point of a person admitting a crime or involvement towards participating in a crime. Surely today’s snake oil shillers can’t get away with false claims.

  35. JGH-4774

    I know dissenting opinions don’t seem welcome here, but I thought I’d give it a try.

    I’ve worked in the medical field in a clinical setting (currently primary care) for 20+ years. I’m not an MD but I’m well informed and well educated (two degrees in bio sci from the University of California). Many of us at the front lines of clinical medicine have concerns about a few aspects of vaccine safety (of course we support the vaccine program, we administer it every day). For example, however, the behavior of the FDA in regard to the PCV2 contamination found by the NIH in Merck’s RotaTeq vaccine clearly has more to do with regulatory/advisory health agency politics than proactive safety enforcement. (PCV2 is a virus that causes a wasting disease and mortality in pigs. What is it doing in the vaccine? How did it get there? No one knows. Why did Merck not catch this during their own QC? Who knows? Merck did not show up to the recent FDA hearing (though GSK did in reference to their Rotarix vaccine, also found contaminated, with PCV1). But that is all another discussion for another day.)

    As for Andrew Wakefield, everyone seems happy here (giddy?) to demonize him categorically, but ask yourself how much you really know about the man or about his background.

    Who is Andrew Wakefield?

    1) Wakefield (MB BS FRCS FRCPath) was a research gastroenterologist from the UK.

    2) Wakefield is a husband, father, and interestingly the son of two physicians himself. His mother was a GP and his father was a neurologist.

    3) Andrew Wakefield’s training in medicine was solid.

    Andrew Jeremy Wakefield graduated in 1981 with a degree in Medicine from St. Mary’s Hospital School Of Medicine, University of London; one of the finest medical schools in Europe. He then trained as a gastrointestinal surgeon and qualified as a Fellow of the Royal College of Surgeons in 1985. His residency and specialized training in GI surgery lasted eight years. During this time, Wakefield went to Canada on scholarship to train in small intestine transplantation at the leading center at the time in Toronto. His work there eventually led into a research career in inflammatory bowel disease (IBD). Upon his return to London around 1988 he joined the faculty of the prominent Royal Free Hospital School of Medicine as a Senior Lecturer (Assistant Professor) in Medicine and Histopathology and served as a key member on the university’s Inflammatory Bowel Disease Study Group. Later he developed an interest in the potential role of the measles virus (natural and vaccine strain) in the pathogenesis of Crohn’s disease and started publishing research in this area in the early/mid 90s including in the Lancet. (Investigation in this area was also taking place at the Mayo Clinic in the US and in Sweden by Dr Anders Ekbom.) In May 1997, Wakefield was made a Reader in Medicine and Histopathology at the Royal Free Hospital School of Medicine. (This is about equivalent to a senior associate professor or full professor in the American university system.) And, approximately two years after the 1998 Lancet paper, Wakefield was awarded the Fellowship of the Royal College of Pathologists in 2001 in recognition of his published research. Wakefield is author or co-author of over 130 peer-reviewed published papers (and never accussed of any malfeasance or wrongdoing during any of the other papers, interestingly just the one.)

    4) Wakefield is, of course, infamously the lead author of an “early” case report (not a study) published in The Lancet in 1988 that reported that Lymphoid Nodular Hyperplasia (LNH) and enterocolitis were found in 12 ASD children.

    5) There were two key co-authors of the 1998 Lancet paper. Professor John Walker-Smith and Dr Simon Murch. Walker Smith acted as “Senior Clinical Investigator” during the generation of this case series report. He also served as a “Senior Author” of the paper. This case report was executed by a team.

    6) Simon Harry Murch (MB BS PhD MRCP MRCS LRCP) is a highly experienced pediatric gastroenterologist. He was at the time of the generation of the 1998 Lancet study, Senior Lecturer (Assistant Professor) in Pediatric Gastroenterology at the Royal Free and University College School of Medicine. On the 1998 Lancet paper, Dr Murch served as one of the clinical gastroenterologists on the team. Dr Murch is now Professor of Pediatrics and Child Health at Warwick Medical School.

    7) John Angus Walker-Smith (MB BS MD FRCP FRACP FRCPCH) is also a highly experienced pediatrician and pediatric gastroenterologist. In fact, Walker-Smith is one of the most eminent pediatric gastroenterologists in the world. John Walker-Smith achieved outstanding excellence in his career in medicine. Retired since ~2002, he is Emeritus Professor of Pediatric Gastroenterology and literally wrote the book on pediatric gastroenterology, including Diseases of Small Intestine in Childhood (4 edns 1975, 1979, 1988, 1999), and Practical Paediatric Gastroenterology (1983, 2 edn 1995). Prof. Walker Smith is considered one of two founding fathers of the sub-specialty of Pediatric Gastroenterology. He has 300 published scientific and medical papers and publications in the field of pediatric gastroenterology. Go ahead. Google this guy.

    Indeed, in March Walker-Smith was awarded the first distinguished service medal of the European Society for Paediatric Gastro-Enterology, Hepatology and Nutrition, for which he was commended by eminent Harvard professor W. Allan Walker. Yet, in May Walker-Smith had his medical license revoked by the the 5-member panel of the GMC. (Two of which were lay. None were gastroenterologists or histopathologists.)

    (8) Professors Walker-Smith and Murch both achieved excellence and distinction in their career in medicine. Both dedicated his life to the care and treatment of children. Both, obviously, are highly qualified pediatric gastroenterologists. Personally, I find it highly unlikely that they participated in misconduct, malfeasance or incompetence during the generation of this case series report. In addition, personally, I find it highly unlikely that Professor Walker-Smith, as Senior Clinical Investigator, would participate with Dr Wakefield in ethical misconduct during the execution of this case series.

    9) I bring up Professor Walker-Smith and Professor Murch because they were also accused of professional misconduct by the British General Medical Council (GMC); though, very interestingly, this was/is never mentioned in the press. (And in breaking news, in late May 2010, Walker-Smith was struck off the register, while Murch received no such penalty. This makes no sense. More anon.)

    10) All of the parents of the children who participated in the case report published in 1998 in the Lancet vigorously support Andrew Wakefield and have called him and Drs. Walker-Smith and Murch kind and caring physicians.

    11) Isn’t it interesting that the -sole- source of the complaint that led to the GMC proceeding against Drs. Wakefield, Walker-Smith, and Murch was by Brian Deer. Who is Brian Deer? What are his medical qualifications? Who does Brian Deer work for? I’ll let you go look for yourself and reach you own conclusions.

    12) Isn’t it interesting that no complaint was filed by any of the parents whose children participated in the case report? If the children were harmed, then why do the parents state uniformly that their children’s GI symptoms were -helped- by Drs. Wakefield, Walker-Smith, and Murch (finally)? And isn’t it interesting that no (zero) complaints were filed against the Wakefield/Walker-Smith/Murch team by -anyone- until 2004 (and then only by Brian Deer)?

    Well, that’s enough for now. I’ll post again. That is if anyone is interested in a civil dialogue about this issue. I hope so.

  36. Chris

    12) Wakefield and Walker-Smith were found to have conducted invasive tests on children that were not medically indicated. This goes against modern medical ethics. Murch was not aware the procedures were not medically indicated. From the GMC determination:

    The Panel concluded Professor Murch acted in good faith albeit it has found he was in error. His actions, although comparable to professional misconduct in respect of undertaking procedures which were not clinically indicated, were mitigated by the fact that he was under a false impression that they were clinically indicated and this could not reach the threshold of serious professional misconduct.

    13) Wakefield failed to declare conflicts of interests, and payments from a legal fund.

    14) Wakefield filed a patent for a nostrum that is often called a “single measles vaccine”, but is actually a whole bit of quackery of pills made from goat colostrum. Read about here: Wakefield and the colostrum nostrum.

    15) Now a total of three Wakefield papers have been retracted by the journals they were printed in. Including one just recently:

    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. (1). 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 (1). This paper in the American Journal of Gastroenterology (AJG) (2) also includes the 12 patients in the original Lancet article and therefore we retract this AJG paper from the public record.

    Even with all the education and possibilities, he was caught. Yes, we can admire his medical degree, but we must recognize that he committed fraud. Any fraud committed in science puts a black mark on all honest researchers.

    The GMC did not judge him on the science, but on the ethics. Why are you ignoring the obvious ethical blunders committed by Wakefield? Even if Wakefield had done real science, the study would have violated several rules on the use of humans in clinical studies. One does not due lumbar punctures and colonoscopies on children unless they are medically indicated.

    Isn’t it interesting that no complaint was filed by any of the parents whose children participated in the case report?

    From Brian Deer’s latest Times article (it looks like a parent is complaining):

    As for Wakefield himself, he was recently ousted from a lucrative research post in Texas and claims he is the victim of dark forces connected with the government and the drug industry. “The allegations against me and my colleagues are both unfounded and unjust,” he told the protesters in January.

  37. TheBlackCat

    @JGH-4774: I don’t care how many papers he has published or where he got his degree, he lied for money and those lies are killing people.

  38. Markle

    Mr. Wall-O-Text,

    That Dr.Mr. Wakefield has managed to show himself to be genetically compatible with another human being is neither here nor there.* You seem to assume that we are new to the Bad Doctor. I’d say most skeptics are familiar with his relevant details. Brian Deer is a reporter. He doesn’t need any medical bona fides. The British General Medical Council has those. They reviewed Wakefield’s case and decided that he was unethical and unworthy to hold a medical license in Great Britain. Considering the aftermath of Mr. Wakefield’s paper, thank goodness Mr. Deer decided to investigate and speak up. The phrase “Isn’t it interesting” telegraphs your intent, BTW.

    You only have to kill one person to be called a murderer. The story of Fleischmann and Pons tells us that scientific reputation is an easy thing to lose. They weren’t even found to have committed fraud or done anything unethical. Mr. Wakefield cannot say the same.

    *Technically, I guess we should order up some DNA tests to be certain, but lets give Mrs. Wakefield the benefit of doubt.

  39. outcast

    Wakefield recently wrote a book, anyone seen it?

    He also showed up on a conspiracy theory podcast not too long ago.

  40. Muzz

    So, wait, the whole thing is a stitch up, Brian Deer’s a hired hatchet man and Wakefield’s a convenient scapegoat forrr…what exactly? Wakefield didn’t get paid? MMR does cause gut leakage or whatever?
    Casting aspersions is one thing but it’s really not much if there’s no alternate scenario that fits the available evidence. Saying “Everything you know about this could be wrong” doesn’t make you right.

  41. JGH-4774

    Callous Disregard by Andrew Wakefield was released in the US on May 28, 2010.

    It is on Amazon’s best seller list.

    Read his side of the story, judge for yourself.

  42. JGH-4774

    Markle, I simply supplied some background information on Mr. Wakefield (you are correct!). PS, I enjoyed the title of Mr. Wall-O-Text. Sorry for the long post.

  43. JGH-4774

    Muzz, No, the whole thing is not a “stitch-up.” But there -is- more to the story than many suspect. As for Brian Deer, take a look at the man for yourself.

    Alan Golding in the UK has recently produced a 60 min documentary featuring Brian Deer in his own words. http://www.viddler.com/explore/ziggy/videos/1/22.939/

    After viewing this video, compare Deer to Wakefield (seen in Goldings other video documentaries). Then, ask yourself, sincerely, who is more informed, reasonable? Deer or Wakefield? Who cares more about these children with serious GI problems? Deer or Wakefield?

    Brian Deer is a bully who has lied and misrepresented himself to parents of autistic children. And he, very interestingly, has access to private medical records. How did that happen? Ask yourself seriously.

  44. JGH-4774

    13) Wakefield et al. –never– claimed in this case report published by the Lancet in 1998 that the MMR vaccine causes autism, as the major news outlets have reported over & over (and falsely). This claim was never made and this hypothesis was never tested by Wakefield et al during the generation of this case series report. This is a classic example of the mainstream media not understanding scientific method. Wakefield, Walker-Smith and Murch merely reported that they found Ileal Lymphoid Nodular Hyperplasia (ILNH) and enterocolitis in twelve ASD children. Wakefield, Walker-Smith and Murch were in the very early stage of proposing hypotheses to test and further investigations to conduct.

    –Demonstrating a causal relationship between the MMR jab and colitis or between the MMR jab and autism would, of course, be impossible in a case series report, by definition.–

    14) The 1998 Lancet paper by Wakefield/Walker-Smith/Murch was not a “study” as the major news outlets reported over & over (and falsely). It was, in fact, an “early case series report.” It surprises me how many in the media and in the blogosphere who should know better (and who claim to possess significant training in science and biology) don’t understand what a “case report” is. The Wakefield/Walker-Smith/Murch case series report published in by the Lancet in 1998 is very similar to the original, famous case series report authored by Leo Kanner and published in 1944. Indeed, Leo Kanner’s famous 1944 paper on autism, which sparked the entire field of autism research, was based on the observations of 11 children.

    Prominent UK SBM advocate Ben Goldacre MD, who is a vigorous pro-vaccination advocate, said in 2005 that he thought “the [Wakefield] paper always was and still remains a perfectly good small case series report.” [1]

    15) The 1998 case report by Drs. Wakefield, Walker-Smith, and Murch published in The Lancet did NOT state or claim that the MMR vaccine causes autism. The 1998 Lancet paper reads, quote, “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome (autistic enterocolitis) described.” …. “We have identified a chronic enterocolitis in children that -may- be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunization. Further investigations are needed to examine this syndrome and its -possible- relation to this vaccine.” [2]

    16) What hypotheses were Wakefield, Walker-Smith, and Murch proposing?

    a) Are autistic children presenting GI distress/disorders at a higher rate than the general pediatric population?

    b) Are autistic children presenting a unique (novel) GI syndrome (e.g., “autistic enterocolitis”)?

    BTW, neither of the two preceding hypotheses means than vaccines are -causing- these outcomes. GI problems and autism, if there is an association, could be coexisting conditions (comorbid) for reasons not yet determined.

    c) Can administration of the polyvalent ‘live’ virus MMR vaccine when combined with the administration of all the vaccines that precede it on the “recommended immunization schedule” cause bowel disease in a small subset (~0.1%) of the pediatric population who may be genetically susceptible for reasons not fully understood?

    d) Separately, can administration of the polyvalent MMR vaccine when combined with the administration of all the vaccines that precede it on the “recommended immunization schedule” cause autism in a small subset of the pediatric population?

    Obviously the latter two hypotheses (c & d) are –extremely– controversial. And I have serious doubts about the latter (d). Nevertheless, these were (and remain) perfectly reasonable, even important, hypotheses to pursue in further research.

    Could these hypotheses prove negative? Of course, they could.

    17) Both Professor Walker-Smith and Professor Murch have publicly stated that the diagnostic procedures performed for the case series report published in the Lancet in 1998 were medically indicated and performed ethically, accurately, and correctly. Both Prof Walker-Smith and Murch have denied participating in any professional misconduct. Would you like to hear their side of the story and their testimony explaining what happened? (I would.) Too bad, the GMC has refused to disclose the testimony of Prof Walker-Smith and Murch. So much for transparency.

    18) Many are unaware that it was the Feb 28, 1998 press conference to announce the publication of the 1998 Lancet paper that played a big part in the origin of this controversy. And this may be the fault of several individuals, not only Wakefield. The press conference was orchestrated by Wakefield’s boss, Professor Arie Zuckerman, the Dean of the Royal Free and University College School of Medicine. [Individual university doctors are not able to independently call for press conferences.] Zuckerman desired to bring fame and prominence to the Royal Free School of Medicine. Zuckerman knew well that Wakefield felt strongly that the monovalent MMR vaccines had undergone more safety trials and more post-marketing surveillance than the combination MMR vaccine. Yet, Zuckerman directed the inevitable question about the combination MMR vaccine at the press conference directly to Dr Wakefield. This is where, when asked, Wakefield infamously stated he thought monovalent MMR vaccines were more safe than the combination MMR vaccine. And he recommended that parents vaccinate their children with the monovalent MMR vaccines until further research could be completed on the safety of the combo MMR. With that, the UK media circus took off. Which, one could argue, is the fault of the British scandal-loving media as much as Zuckerman’s fame seeking or Wakefield speaking his personal opinion at the press conference.

    I agree the press conference should -never- have been held. One does not trumpet personal opinion or the results from an early case report to the media (who will inevitably screw it up because they don’t understand the difference). Case reports may eventually lead to larger studies that then need to be replicated and confirmed, several times, before any hypothesis can come anywhere close to being able to claim itself “proven.”

    19) However, let’s be clear with the certain facts. At the infamous Feb 1998 press conference, Wakefield was -not- instructing parents to not vaccinate their children. He simply stated that, in his opinion, monovalent MMR vaccines were more safe than the combo vaccine. Furthermore, monovalent MMR vaccines -were- available in the UK at the time (despite Dr Paul Offit’s outright false statements to the contrary). Anyone can easily google this to confirm. In fact, monovalent MMR vaccines had been available in the UK since 1961.

    What was Wakefield basis for his concern about the polyvalent MMR? Wakefield’s concern was not without some basis. The monovalent measles vaccine had been administered in the UK since 1968. The monovalent rubella vaccines had been administered in the UK since 1971 (girls only). The combination (polyvalent) MMR vaccine was not introduced in the UK until 1988. It had originally been licensed in the USA in 1971 and in some other countries in the early 1980s. But the introduction of the MMR in Britain was attended by some difficulties. In 1992, after only four years of administration, two out of the three UK MMR vaccines (Immravax made by Merieux UK, and Pluserix made by Smith Kline Beecham), which both contained the “Urabe” strain of the mumps vaccine, had to be withdrawn from the market due to meningitis ‘side effects.’ Administration of the MMR continued with the third MMR vaccine (made by Merck) with assurances from public health officials that the remaining brand of vaccine was perfectly safe, but damage to the safety image of the MMR vaccine with UK parents was done. The MMR vaccination rate in England began to fall in 1995, well before the Royal Free press conference in Feb 1998.

    Wakefield, as a father of young children and as a physician, was acutely aware of the Urabe MMR incident. Wakefield knew that the British government continued to vaccinate with the Urabe strain MMR between 1988 and 1992, even though they knew it was unsafe and that it had been previously withdrawn by the Canadian government.

    In response, Wakefield undertook a thorough examination of the safety of the MMR (both mono and polyvalent). This eventually resulted in Wakefield writing a 250 page safety review of the MMR vaccine that he presented to his colleagues at the Royal Free. Later, Wakefield even wrote a paper entitled “Through A Glass Darkly. A Look Back At MMR’s Safety Trials” which was published in the Journal of Adverse Drug Reactions and Toxicological Review in 2000. [3]

    In sum, after the MMR recall in 1992 Wakefield researched the safety of the MMR. As a result, Wakefield was concerned about the short safety trials of the combo MMR (not one of the safety trials on the MMR followed the vaccinated children for more than six weeks, and most no longer than three weeks). And on the basis of his research, it was his opinion that the monovalent measles and rubella vaccines possessed a longer safety record than the combo vaccine. This explains Wakefield’s comments at the infamous Feb 1998 press conference.

    20) BTW, this brings up the small matter that some (like Phil) routinely characterize Andrew Wakefield as the originator/inventor of vaccine safety concern in the public in the modern era. This is incorrect.

    Significant concerns about vaccine safety have existed since the beginning of the modern vaccination period in the 1940s and 1950s. For example, the SV40 virus contamination in the early polio vaccine; the oral polio vaccine (OPV) causing paralytic polio; and then problems with the original DTP vaccine (later replaced by the DTaP vaccine). For example, Barbara Loe Fisher, co-founder of the National Vaccine Information Center (NVIC), herself the mother of a vaccine injured child by the DTP vaccine, was one of the parents who lobbied successfully for new government policies such as the National Vaccine Injury Act of 1986. Fisher co-authored a book detailing her concerns about DPT safety called, “A Shot In the Dark” in 1991.

    Concern about the MMR in the UK goes back to the MMR-I-Urabe problems of 1988-1992. Hence, Andrew Wakefield –in 1998– was not the first person to raise concern about the safety of vaccines.

    21) Next, Wakefield was not developing a “competing measles vaccine.” That accusation by Brian Deer is ridiculous. Andrew Wakefield is self-admittedly not an immunologist, nor a vaccine scientist. Wakefield is a gastroenterologist. The accusation that Wakefield, a gastroenterologist, working alone, was developing a competing vaccine to the MMR is preposterous.

    Andrew Wakefield -was- working at one point on a “transfer factor” for the -treatment- of measles (for those who already have measles infection). In addition, Wakefield was not listed as one of the applicants in the June 6, 1997 patent application; almost all the royalties from whatever product was to be developed would go to the Royal Free Hospital School of Medicine. Thus, the first applicant named on the form was the Royal Free Hospital School of Medicine. The co-applicant was South Carolina immunologist Hugh Fudenberg MD (Neuroimmune Therapeutics Research Foundation), a US doctor who did early pioneering work on the development transfer factors. In any case, the development of this transfer factor for the Royal Free went nowhere.

    21) Did Wakefield obtain blood samples from non-autistic children (to serve as a control) during a birthday party for his son? Yes. Did the GMC tribunal find this to be a violation of ethical standards? Yes.

    However, make no mistake. Wakefield did not chase unsuspecting and screaming children down the streets of London. The blood was drawn from fully consenting children, with the consent of their parents. These were the children of his friends and medical colleagues (some of them doctors), after all. The children at this party were asked by their parents beforehand if they would be willing to provide a blood sample. The parents were there at the time of the blood draws. The children who participated (all boys by the way), agreed happily to take part. At the end of the party in their going home bags Wakefield put a 5 pound note as a thank you token.

    22) Did Wakefield violate protocols surrounding funding disclosures involving the two projects he was working on. Brian Deer vigorously asserts that he did. Wakefield vigorously asserts that he did not. The GMC tribunal agreed with Brian Deer. The truth may lie somewhere in between. I’ll let you hear Wakefield’s explanation on this point (in the documentary or in his new book) and decide for yourself.

    23) Do I personally believe that Wakefield is a fraud or a quack or a charlatan (or worse) as many dug-in Wakefield detractors have called him? No, I do not. After taking a detailed look at Wakefield’s training and background, and his published papers in the medical literature, and his recent extensive interviews statements; it is my personal opinion that it is more likely that Andrew Wakefield is a good man, a well trained research gastroenterologist, and an empathetic physician (this really comes out if you read the testimony of the parents). I think Wakefield genuinely beleied in his developing hypotheses.

    Certainly, however, it was dangerous to test a hypothesis that challenged the safety of the National Immunization Program in the UK (which is run by the National Health Service/NHS), and thus one of the fundamental beliefs of medicine (which is so profoundly influenced by the multi-billion dollar pharmaceutical industry).

    Anyone who is unaware of this doesn’t work in medicine. The pharmaceutical corporations -profoundly- influence medicine at every level: medical school, clinical practice, research, and what medical journals publish. This is becoming a huge problem in medicine. Several recent books written by prominent, mainstream MDs are starting to tell the story (if anyone will listen). Two of these books were written by former editors-in-chief of the New England Journal of Medicine(!).

    a) “Overdosed America. The Promise of American Medicine. How the Pharmaceutical Companies are Corrupting Science, Misleading Doctors, and Threatening your Health.” By John Abramson MD (Harper Collins, 2005, 2008). Dr. Abramson is on the clinical faculty of Harvard Medical School.

    b) “On the Take. How Medicine’s Complicity with Big Business Can Endanger Your Health.” By Jerome P. Kassirer MD (Oxford University Press, 2005). Dr. Kassirer is Distinguished Professor at Tufts University School of Medicine in Boston, MA. He was Editor-in-Chief of NEJM for more than eight years.

    c) The Truth About Drug Companies. How They Deceive US and What we Can do About It.” By Marcia Angell MD (Random House, 2005). Dr. Angell worked at the NEJM for two decades. She is former Editor-in-Chief.

    24) Could Andrew Wakefield’s hypotheses on MMR and GI disorders be wrong???

    Remember, Wakefield -and others- have proposed several hypotheses relating to autism and the gut (see #16). But, yes, of course, one or more or all of Wakefield’s hypotheses could be wrong. Medical scientists test hypotheses all the time that turn out negative.

    25) Lastly, I will leave you with an important question to ponder. Does “autistic enterocolitis” exist? That is, is there a novel GI disorder associated with autistic children? And separately, do autistic children present with GI distress or disease at a higher rate than the general pediatric population? These are the questions that Andrew Wakefield attempted to investigate.

    I think these are valid questions to ask. And so do many in medicine (quietly). For example:

    26) “Autistic enterocolitis: Fact or fiction?” From P. Galiatsatos, MD, writing in the Canadian Journal of Gastroenterology in February 2009:

    “While genetic susceptibility is an important contributor in ASDs, the exact etiology of these pervasive developmental disorders remains unclear and is most likely multifactorial. Although the idea of a shared path physiology between GI disease and autism remains controversial, the evidence presented so far warrants further exploration at the very least. Be it an immune-mediated connection, versus a ‘brain gut axis’ interplay such as seen in irritable bowel syndrome, the increased prevalence of GI symptoms in this group of patients cannot be denied, nor the added distress that these symptoms could have on an individual who is already communicatively challenged. Clearly, more studies need to be conducted to better define the relationship between ASDs and the GI tract. In the meantime, a heightened awareness and lower threshold for work-up and management of GI symptoms may help improve the quality of life of these patients who may be suffering in silence.” [4]

    P. Galiatsatos, MD, FRCPC; Division of Gastroenterology, Department of Medicine; McGill University, Montreal. A. Gologan, MD; E. Lamoureux MD, FRCPC; Department of Pathology, McGill University, Montreal.

    Are all these MDs friends of Andrew Wakefield?

    27) And recently, Sir Nicholas Wright (MA, DSc, MD, PhD, FRCP, FRCS, FRCPath, Professor of Pathology at Barts and the London School of Medicine, University of London) asked and answered the same question in a recent editorial that was published online in the British Medical Journal on April 15, 2010 [5]:

    “So, does autistic enterocolitis exist? Children with autism often have chronic diarrhea, bloating, abdominal pain, distension, and abnormal stool consistency. A cross sectional study that compared children with autism with matched controls and children with other developmental disabilities found that 70% of children with autistic spectrum disorder had a history of gastrointestinal problems, compared with 28% of controls and 42% of those with other developmental disabilities. Certainly something seems to be going on. Moreover, several articles describe the association between inflammatory pathology and autistic spectrum disorder.”

    Yes, you read that right (and his comments were published by the British Medical Journal). Dr Wright cited a study that found that, “70% of children with autistic spectrum disorder had a history of gastrointestinal problems, compared with 28% of controls….Certainly something seems to be going on.”

    Is Sir/Prof/Dr Nicholas Wright a friend of Andrew Wakefield?

    28) Bottom line, we have a lot to learn about the unusual and sometimes extreme GI problems that many autistic children are suffer with today. We will, undoubtedly know much more in 10 to 20 years. My personal, intuitive opinion is that something is going on in the GI system of autistic children that is unique. That does not mean, however, that vaccines are causing it.
    ————————————————————————————–

    [1] *Ben Goldacre. Don’t dumb me down. We laughed, we cried, we learned about statistics … The Guardian, 8 September 2005. http://www.guardian.co.uk/science/2005/sep/08/badscience.research

    [2] Wakefield, A. et al., Ileal lymphoid nodular hyperplasia, nonspecific colitis and pervasive developmental disorder in children. The Lancet 1998;351:637-641.
    http://www.generationrescue.org/pdf/wakefield2.pdf

    [3] Wakefield AJ, Montgomery SM. “Through A Glass Darkly. A Look Back At MMR’s Safety Trials.” Journal of Adverse Drug Reactions and Toxicological Review. 2000 19(4), 265-283.
    See also: Jefferson T, Price D, et al. “Unintended events following immunization with the MMR: a systematic review.” Vaccine 2003; 21: 3954-3960.

    [4] Galiatsatos, P et al. “Autistic enterocolitis: Fact or fiction?” Canadian Journal of Gastroenterology Vol 23 No 2 February 2009.

    [5] http://www.bmj.com/cgi/content/full/340/apr15_2/c1807

  45. Shelly P

    If the case against Wakefield was brought on the findings of a journalist, then, given all the charges found to be proven, he must be one hell of a journalist.

  46. I simply supplied some background information on Mr. Wakefield

    After starting off with a baseless insult to shield your ego from the valid critique sure to follow, then demanding “civil dialogue” while completely ignoring the substantive response immediately following your initial comment.

  47. Mike Mullen

    I know all about Wakefield thank you. As a citizen of the UK I’ve had the displeasure of watching as every study and trial that disproved his theory was dismissed by his supporters as either ‘unconvincing’ or fraudulent, while his own questionable work was deemed untouchable. If JGH-4774 you would like to find out about what happens to scientists who who take on the establishment and big industry, and who actually had a theory with real merit, I suggest you look up the biographies of Richard Doll,Barry J. Marshall and J. Robin Warren. I’ll give you a bit of spoiler, the stories end with knighthoods and Nobel prizes, not skulking in the USA without a medical license.

  48. MartinM

    Isn’t it interesting that the -sole- source of the complaint that led to the GMC proceeding against Drs. Wakefield, Walker-Smith, and Murch was by Brian Deer.

    No, it isn’t. It’s the content of the investigation that matters, not who might have triggered it. Precisely nothing you’ve said has any bearing whatsoever on the evidence against Wakefield.

  49. I call concern troll on JGH-4474.

    Many of us at the front lines of clinical medicine have concerns about a few aspects of vaccine safety

    and then goes on to give a misleading account of the pig virus fragments found recently in the rotavirus vaccines; a long and off-the-point recital of Wakefield’s antecedents and history; and a back-handed slap at Brian Deer’s integrity.

    Then in the next post, JGH-4774 talks about “Wakefield’s best-seller”. Uhhm, no. It was briefly on the new-releases best-seller list, and it’s now at #672. Let’s see what Harriet Hall, the SkepDoc, has to say about Wakefield’s book

    In my opinion, the whole book is an embarrassing, tedious, puerile, and ultimately unsuccessful attempt at damage control. Wakefield has been thoroughly discredited in the scientific arena and he is reduced to seeking a second opinion from the public. Perhaps he thinks that the truth can be determined by a popularity contest. Perhaps he thinks the future will look back at him as a persecuted genius like Galileo or Semmelweis. Jenny McCarthy thinks so; I don’t.

  50. andyo
  51. 36.   JGH-4774 Says:

    June 1st, 2010 at 8:36 pm

    (blah blah, appeal to authority, blah, concern, blah)

  52. Newton believed in alchemy, so? Also, how many of the co-authors pulled their names from the “paper”?

  53. andyo
  54. 17.   TechyDad Says:

    June 1st, 2010 at 11:43 am

    The other part of me, the more cynical part, thinks he’s only in it for the money. This cynical side thinks he doesn’t even care whether there is any real proof for (or against) a vaccine-autism link. He’s getting money from his work and he’ll milk it for as long as he can. When the gravy train runs out, he’ll either be set for life or will move on to some other scam.

  55. There’s nothing cynical about that. It’s been known already that he started his “study” by being hired by lawyers of autisitic kids’ parents who wanted to sue. Oh, and… funny story… he had a competing separate vaccine for MMR. Read Brian Deer’s investigations. By the way JGH is just plain lying. Deer is an investigative reporter. Nobody needs to be an MD to do what he did. Also, Wakefield was already discredited by 2004. Nobody worth their scientific salt thought that paper was worth anything, it was just all public hysteria fueled by the press, misled by Wakefield. Not even by his paper, but from one press conference in which he just said what he “believed” the paper said, which the paper didn’t say. Paul Offit’s excellent book on this, Autism’s False Prophets gives a great account on this based on Deer’s findings and other sources.

  56. Chris

    JGH-4774, you seem to be spending lots of time supporting Wakefield. Why?

    Which version of the MMR vaccine was his set of case studies based on? The one used in the UK before or after 1992 (when they switched to the American version with the Jeryl Lynn mumps strain)?

    Why do you think he is justified in doing lumbar punctures and colonoscopies on children when it is not clinically indicated? Why do you think it is okay to announce in a press conference conclusions that were not in the paper? Why do you think it is okay to announce a recommendation for an alternate vaccine schedule without any evidence to support it?

    I would also add that there were concerns about his research a long time before Deer wrote his first article. The following are a list of papers that disputed the Lancet paper, and Wakefield’s press conference (which is where he did malign the MMR vaccine, and since it was after 1992, the same MMR vaccine that had been used in the USA since 1971). So even if Deer had not decided to investigate Wakefield, he would have been caught.

    Relationship between MMR Vaccine and Autism.
    Klein KC, Diehl EB.
    Ann Pharmacother. 2004; 38(7-8):1297-300
    *Literature review of 10 studies

    Immunization Safety Review: Vaccines and Autism. Institute of Medicine.
    The National Academies Press: 2004
    (w w w . nap.edu/books/030909237X/html) *Literature review

    MMR Vaccination and Pervasive Developmental Disorders: A Case-Control Study.
    Smeeth L et al.
    Lancet 2004; 364(9438):963-9
    *Subjects: 1294 cases and 4469 controls

    Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta.
    DeStefano F et al. Pediatrics 2004; 113(2): 259-66
    *Subjects: 624 children with autism and 1,824 controls

    Prevalence of Autism and Parentally Reported Triggers in a North East London Population.
    Lingam R et al.
    Arch Dis Child 2003; 88(8):666-70
    *Subjects: 567 children with autistic spectrum disorder

    Neurologic Disorders after Measles-Mumps-Rubella Vaccination.
    Makela A et al.
    Pediatrics 2002; 110:957-63
    *Subjects: 535,544 children vaccinated between November 1982 and June 1986 in Finland

    A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism.
    Madsen KM et al.
    N Engl J Med 2002; 347(19):1477-82
    *Subjects: All 537,303 children born 1/91–12/98 in Denmark

    Relation of Childhood Gastrointestinal Disorders to Autism: Nested Case Control Study Using Data from the UK General Practice Research Database.
    Black C et al.
    BMJ 2002; 325:419-21
    *Subjects: 96 children diagnosed with autism and 449 controls

    Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: Population Study.
    Taylor B et al.
    BMJ 2002; 324(7334):393-6
    *Subjects: 278 children with core autism and 195 with atypical autism

    No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism.
    Fombonne E et al.
    Pediatrics 2001;108(4):E58
    *Subjects: 262 autistic children (pre- and post-MMR samples)

    Measles-Mumps-Rubella and Other Measles-Containing Vaccines Do Not Increase the Risk for Inflammatory Bowel Disease: A Case-Control Study from the Vaccine Safety Datalink Project.
    Davis RL et al.
    Arch Pediatr Adolesc Med 2001;155(3):354-9
    *Subjects: 155 persons with IBD with up to 5 controls each

    Time Trends in Autism and in MMR Immunization Coverage in California.
    Dales L et al.
    JAMA 2001; 285(9):1183-5
    *Subjects: Children born in 1980-94 who were enrolled in California kindergartens (survey samples of 600–1,900 children each year)

    Mumps, Measles, and Rubella Vaccine and the Incidence of Autism Recorded by General Practitioners: A Time Trend Analysis.
    Kaye JA et al.
    BMJ 2001; 322:460-63
    *Subjects: 305 children with autism

    Further Evidence of the Absence of Measles Virus Genome Sequence in Full Thickness Intestinal Specimens from Patients with Crohn’s Disease.
    Afzal MA, et al.
    J Med Virol 2000; 62(3):377-82
    *Subjects: Specimens from patients with Crohn’s disease

    Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association.
    Taylor B et al.
    Lancet 1999;353 (9169):2026-9
    *Subjects: 498 children with autism

    Absence of Detectable Measles Virus Genome Sequence in Inflammatory Bowel Disease Tissues and Peripheral Blood Lymphocytes.
    Afzal MA et al.
    J Med Virol 1998; 55(3):243-9
    *Subjects: 93 colonoscopic biopsies and 31 peripheral blood lymphocyte preparations

    No Evidence for Measles, Mumps, and Rubella Vaccine-Associated Inflammatory Bowel Disease or Autism in a 14-year Prospective Study.
    Peltola H et al.
    Lancet 1998; 351:1327-8
    *Subjects: 3,000,000 doses of MMR vaccine

  57. Chris

    By the way, JGH-4774, if you decide to respond with the Gish Gallop list of studies that have supposedly replicated Wakefield’s finding, please do the following:

    1) remove the duplicates (one paper is cited twice, though with confusing month/year)

    2) remove any where the citations are screwed up (like the one that just names the journal and year)

    3) remove any that include Wakefield, Walker-Smith and Murch as authors (it is independent replication, that means you cannot independently replicate your own results!)

    4) remove any from non-peer reviewed journals like “Medical Hypothesis” and “Autism Insights”

    5) and remove the ones reviewed here and here

    Thank you.

  58. JGH-4774

    Naked Bunny With A Whip,

    1) I did not “completely ignore the substantive response immediately following [my] initial comment.” That is simply not true. I responded to many of them. There is, however, a limit to my availability. I have my day job (I am on lunch break right now) and two young children to attend to in the evening as well. However, I will continue to do to respond to the posts after my secong long comment, as I am doing here (and as time permits).

    2) Yes, I asked (not demanded) for a civil dialogue. What is wrong with that?

  59. JGH-4774

    I would like to expand upon the idea of civility for a moment, if I may. I feel we should value greatly the contribution of all reasoned and reasonable voices. We all possess a wide range of experience, training, background, and opinion. This is good. This is, in fact, necessary for a healthy debate.

    The point of an intellectual dialogue is not necessarily to persuade; it is to have an open exchange of ideas, information and opinions.

  60. JGH-4774

    Phil, I want to thank you for allowing my long (~29 part) comment on Andrew Wakefield, Prof John Walker-Smith, and Prof Simon Murch. Their narrative is in fact a complex one. I am acutely cognizant that, as you state above, that AW is not one of your favorite people. And I want to acknowledge that a negative analysis about AW would not be allowed on AoA. Thank you for allowing this exchange of ideas, information and opinions (even if we disagree on some or several points).

  61. TheBlackCat

    JGH-4774: You are taking a lot of isolated instances out of context to make it seem like Wakefield never intended for people to draw a link between vaccines and autism. It appears you did not bother actually reading the original post, which is about Wakefield appearing at a rally about that specific position and where he gave a speech promoting that position. He has been heavily promoting the link between vaccines and autism, and has stated numerous times that he is absolutely convinced there is a link. It isn’t our fault that his own research didn’t even begin to back up the claims he has been making.

    I want to know how you can possibly stand by Wakefield when he says things like this:

    About 15 years ago a mother from London approached him and said “Do not judge me too harshly Dr. Wakefield, but when I die I am taking my son with me. You see, I’m all he has. I’m the only one who loves him.”

    “I didn’t judge,” said Wakefield. “I was moved by the love that a mother must have for her child that she would take his life rather than have him fall upon a society that really didn’t give a damn.”

  62. JGH-4774

    Mike Mullen,

    You said, “…who actually had a theory with real merit.” Your point is well made here. But it is too soon to disregard -all- of Andrew Wakefield’s hypotheses. Andrew Wakefield (and others) have proposed -several- hypotheses about autistic children and the GI system.

    a) Are autistic children presenting GI distress/disorders at a higher rate than the general pediatric population?

    b) Are some autistic children presenting a unique or novel GI syndrome (e.g., ILNH or “autistic enterocolitis”)?

    BTW, neither of the two preceding hypotheses means than vaccines are -causing- these outcomes. GI problems and autism, if there is an association, could be coexisting conditions (comorbid) for reasons not yet determined.

    c) Can administration of the polyvalent live virus MMR vaccine when combined with the administration of all the vaccines that precede it on the “recommended immunization schedule” cause GI insult in a small subset (~0.1%) of the pediatric population who may be genetically susceptible for reasons not fully understood?

    d) Separately, can administration of the polyvalent MMR vaccine when combined with the administration of all the vaccines that precede it on the “recommended immunization schedule” cause autism in a small subset of the pediatric population?

    Personally, I suspect that (a) and (b) may have some basis (time and further medical investigations will reveal). I am much less convinced about the validity of the latter two hypotheses (c) and (d) and especially (d). Wakefield appears to be -wrong- here. I am not a blind proponent of AW. I don’t know the man. I have no horse in this race.

    However, I agree with Nicholas Wright (see #27 above), histopathologist, gastroenterologist, and Professor of Pathology at Barts and the London School of Medicine, University of London: “70% of children with autistic spectrum disorder had a history of gastrointestinal problems, compared with 28% of controls….Certainly something seems to be going on.”

    And, P. Galiatsatos MD (see #26 above), Division of Gastroenterology, Department of Medicine; McGill University, Montreal: “…. the increased prevalence of GI symptoms in this group of [autistic] patients cannot be denied, nor the added distress that these symptoms could have on an individual who is already communicatively challenged. Clearly, more studies need to be conducted to better define the relationship between ASDs and the GI tract. In the meantime, a heightened awareness and lower threshold for work-up and management of GI symptoms may help improve the quality of life of these patients who may be suffering in silence.”

    I agree wholeheartedly with the latter two sentences.

  63. JGH-4774

    Black Cat,

    How do expect me to respond to two such extreme, emotionally based and emotionally loaded statements? I don’t support either. That’s my position. And, I am not a blind advocate of AW. I do not stand by AW on every count. I do not even know him. And, I do not have a child with autism. I have no horse in this race. But, I do work in the health care field. I have been immersed in the medical world all of my life. My father was an MD (University of Illinois Med, residency at UCLA, mainstream all the way). I know this will perhaps cause some dismay and disbelief, but I do believe (sincerely) that -some- of the accusations made against AW have been unfair.

    In any event, AW is but one man. Medical science does not rest upon one man. I don’t see any motivation for AW to “fake” his science. If nothing else, AW was mainstream trained in medical science. He knows as much as anyone that -no- hypothesis is “proven” until is reproduced and confirmed by -several- teams. Why would AW fake his science? If his data is unable to be replicated, what would be the point?

    The most important bottom line now with regard to ASD and the GI system is: (a) Are autistic children presenting GI distress/disorder at a higher rate than the general pediatric population? (b) If so, why? (c) Are autistic children presenting a unique or novel GI syndrome (e.g., ILNH or “autistic enterocolitis”)?

    These are questions that deserve investigation. These are questions, I believe, that deserve to be discussed in the light of day.

  64. Chris

    (a) Are autistic children presenting GI distress/disorder at a higher rate than the general pediatric population?

    No. Though it does look like the eating habits may have more to do with digestion problems (noted in the link). If the kid will not eat fruit and veg, they tend to get more constipation (happened to my very stubborn, neuro-typical son… he now eats voluntarily eats salad).

    Which MMR vaccine is of concern? The one used in the UK before or after 1992?

  65. Muzz

    JGH-4774 quoth: ” Yes, I asked (not demanded) for a civil dialogue. What is wrong with that?

    Not that I really want to dwell on such stuff, but you did also preemptively slur Bad Astronomy readers as being closed minded group thinkers. You shouldn’t be surprised, at the very least, that this is taken as rude and paints you in a certain light, regardless of any efforts to be reasonable otherwise.

  66. JGH-4774

    Muzz, I didn’t intend to slur Bad Astronomy readers. But, I did notice that all the comments to Phil’s article above (before my post) seemed to be short , black & white, and clearly very anti-Andrew Wakefield. I think there is more complexity to the narrative of Andrew Wakefield, Prof John Walker-Smith, and Prof Simon Murch than that. And I believe there is more complexity to the narrative of the question of the relationship between ASDs and the GI tract.

    The funny thing is I completely agree with Phil and most Bad Astronomy participants (I don’t want to paint them all with the same brush) on topics of astronomy, space exploration, and generally on every other topic of science (global warming, alternative medicine, etc.). But, as a member of the medical field, I do have some reasonable (I believe) concerns about vaccine safety.

  67. Chris

    (a) Are autistic children presenting GI distress/disorder at a higher rate than the general pediatric population?

    Another “no.”

    (also, you have not answered my questions… were they not civil enough?)

  68. JGH-4774

    Chris,

    I have a response to your valid and excellent questions in the works. I am not ignoring you. … You are sharp, you ask the best questions, thus they are the most difficult to answer. I want to give you a quality response. Give me a bit more time. Tonight perhaps.

  69. JGH-4774

    Chris,

    Briefly, I respectfully disagree with your position that autistic children are -not- presenting GI distress/disorder at a higher rate than the general pediatric population. I do not think that the GI distress that we are seeing in autistic children can be fully explained by restricted diet. And I do not believe that their symptoms can be fully attributed to diarrhea.

    And Dr Nicholas Wright and Dr Galiatsatos disagree with your position, as cited above. But, I respectfully disagree with you (we can disagree can’t we?) and I concede that I do not possess certainty. Medical science is the early stages of investigating these questions. The data is incomplete. Time will tell. Wouldn’t it be tremendous to have a time machine and be able to see 20 years into the future?

  70. JGH-4774

    Liz,

    1) How, in any way, was my account of the PCV1 and PCV2 contamination recently found in GSK’s Rotarix vaccine and Paul Offit’s RotaTeq vaccine (made by Merck) inaccurate?

    http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm205545.htm
    http://www.medscape.com/viewarticle/721868
    http://www.medscape.com/viewarticle/721465
    http://www.nvic.org/NVIC-Vaccine-News/May-2010/VACCINE-CONTAMINATION–A-THREAT-TO-HUMAN-HEALTH.aspx

    2) I do sincerely have questions about investigative journalist Brian Deer’s integrity and neutrality. View the only video documentary of him (that I know of) for yourself and get back to me. See the man for yourself.

    “Brian Deer and The GMC” by Alan Golding can be found at
    http://www.goldenhawkprojects.blogspot.com/ or
    http://www.viddler.com/explore/ziggy/videos/1/22.939/

    After viewing this video, compare Deer to Wakefield (seen in Golding’s other video documentaries). Then, ask yourself, sincerely, who is more informed, reasonable? Deer or Wakefield? Who cares more about these children with serious GI problems? Deer or Wakefield?

    The facts are that Brian Deer lied and misrepresented himself to parents of autistic children. And he, very interestingly, somehow gained access to the children’s private medical records. How did that happen? Ask yourself seriously. Lastly, I find Brian Deer to be revealed as a bully in this video. And I genuinely feel that is a reasonable assessment.

    3) Your criticism of my comment that “Callous Disregard” is on Amazon’s best seller list is valid. While I do believe that I saw it on Amazon’s best seller list the one day I looked, it is entirely possible that it is now down at #672 as you assert. To my knowledge the book was just released yesterday (Tuesday, June 2, 2010) in the US. I have not read a copy yet.

    4) I find it curious that Dr. Harriet Hall says that she has read the book already. In any case, what does anyone think she is going to say about AW’s book? With all due respect (and I read her articles on SBM), Dr Hall has been a long and vigorous critic of Andrew Wakefield.

    5) I believe that we need vaccines. Because if we don’t have them and use them, infectious disease morbidity will significantly increase (and many of these targeted pathogens such as the measles virus and the pertussis bacterium can cause serious illness in children). This is why I vaccinated my two young children. And I believe, of course, that we need pharmaceuticals. But let none of us be naïve to how the pharmaceutical industry works.

  71. JGH-4774

    Chris,

    You asked about the UK’s MMR-I vs. MMR-II at #53 and again at #61, so I will try to answer quickly. Sorry it took so long to get to this one.

    Chris asked, “Which version of the MMR vaccine was his [Wakefield's] set of case studies based on? The one used in the UK before or after 1992 (when they switched to the American version with the Jeryl Lynn mumps strain)?”

    Of course, you know the answer to that question. And I suspect that you know that I know the answer to that question. So, I am curious about the reason you pose it (perhaps you will elucidate). In any event, the Wakefield/Walker-Smith/Murch team gathered the data for their case report that was published by the Lancet in Feb 1998 in 1996 and 1997 (if I’m not mistaken). Anyway, their work was going on well after the UK-MMR-I-Urabe was withdrawn from the market in the UK in 1992.

    Thus, the version of the MMR vaccine that Wakefield/Walker-Smith/Murch’s case report was based upon was the MMR-II (a non-Urabe strain MMR vaccine). Correct?

    Oh come on, this is fun isn’t it?

  72. JGH-4774

    Chris,

    Correction: In my post # 66 above, I wrote, “And I do not believe that their symptoms can be fully attributed to diarrhea.”

    I meant to write, “I do not believe that their symptoms can be fully attributed to -constipation.-”

  73. TheBlackCat

    How do expect me to respond to two such extreme, emotionally based and emotionally loaded statements?

    They are neither extreme nor are they emotionally-based, it is the official ruling of the investigation into Wakefield and it is based on his statements and what has later been found to be the truth. It is also, as near as I can tell, the most common opinion amongst the medical community. Certainly few people in the medical community are rushing to contradict them. The fact that you seem to have an emotional problem with those statements does not in any way imply that they are emotionally based, and the fact that you don’t like the conclusions does not mean they is “extreme”. You are the one with the extreme opinions here, not me. My opinion is the mainstream one.

    And, I do not have a child with autism. I have no horse in this race.

    Everyone has a horse in the race. Wakefield’s support of the vaccine-autism link (which he has done repeatedly, despite your attempts to imply otherwise) has increased the risk of your life and the life of everyone you know. Surely if you are familiar with medicine as you keep claiming you would know about herd immunity, you would know that vaccines wear off, and you would know vaccines are not 100% effective. That is ignoring the much greater risk to any additional children you might have before they are vaccinated, or children any of your friends or family have, or your children’s children if this keeps up.

    In any event, AW is but one man. Medical science does not rest upon one man. I don’t see any motivation for AW to “fake” his science.

    Money is a big motiviation for many people. Fame is a big motivation for many people. You are hopelessly naive if you think those sorts of things won’t lead some people to lie. He was paid to reach the conclusions he reached, he got a lot of fame and publicity for those conclusions, and continues to be paid and continues to receive a lot of publicity to continue to support those conclusions.

    2) I do sincerely have questions about investigative journalist Brian Deer’s integrity and neutrality. View the only video documentary of him (that I know of) for yourself and get back to me. See the man for yourself.

    I fail to see how Deer is even remotely relevant to this. All of his allegations were substantiated by the official investigations into Wakefield’s conduct, so even if Deer is pathological liar and a psychopathic mass-murder it doesn’t make any difference. Unless you think Deer somehow modified the medical records and faked Wakefield’s payment for reaching a particular conclusion and/or erased Wakefield’s conflict of interest statement from every copy of the article in the world.

    I find it curious that Dr. Harriet Hall says that she has read the book already. In any case, what does anyone think she is going to say about AW’s book? With all due respect (and I read her articles on SBM), Dr Hall has been a long and vigorous critic of Andrew Wakefield.

    So we should only pay attention to reviews from Wakefield’s supporters? Even if she doesn’t like Wakefield, that doesn’t mean here statements are automatically wrong. If you have specific disagreements with her criticisms, if that is even what she says, that is one thing, but you are just dismissing her perspective completely because she has a different opinion of Wakefield than you. That is an Ad hominem fallacy.

    And it is not the least bit curious, lots of publishers send out advance copies of books. For controversial books like this they often send them out to opponents because it drums up publicity for the book. And even if she did get the book through some sort of nefarious means, does that make her conclusions wrong, either?

    You seem to be really hung up on people’s backgrounds and opinions and life histories. That is completely irrelevant to whether the evidence they present is valid or not. We can’t trust Deer because he seems less reliable and compassionate to you. We have to trust Wakefield because he has published a lot of papers and is (or was) a doctor. We can’t trust Hall because she is mad at Wakefield.

    You are also inconsistent. Why are you so quick to trust Wakefield over so many other doctors? Either they are all lying, or Wakefield is. Why are you used quick to trust Wakefield and so quick to dismiss so many others, people for which there is no evidence of wrongdoing besides Wakefields claims to innocence?

    I do not think that the GI distress that we are seeing in autistic children can be fully explained by restricted diet. And I do not believe that their symptoms can be fully attributed to diarrhea.

    Evidence please. Argument from authority is not evidence, not when there is contradictory clinical evidence, you need some actual studies backing up your position. It also needs to be superior in some way to the evidence already cited.

    I believe that we need vaccines. Because if we don’t have them and use them, infectious disease morbidity will significantly increase (and many of these targeted pathogens such as the measles virus and the pertussis bacterium can cause serious illness in children). This is why I vaccinated my two young children.

    Well then you are totally at odds with Wakefield, who has said explicitly that he thinks vaccines are more dangerous than the diseases they prevent.

  74. Chris

    Briefly, I respectfully disagree with your position that autistic children are -not- presenting GI distress/disorder at a higher rate than the general pediatric population.

    I did not post an “opinion”, I posted links to two actual studies that did not find a correlation. Here is a third where the answer is no. Compared to the three studies, the Galiatsatos paper was a case report of two adults (and I did tell you not use any of the studies that were hashed over at http://justthevax.blogspot.com/2010/02/independent-wakefield-way-really.html ), and Wright posted an editorial. Editorials do not count as scientific papers.

    Again, since the links to the papers may have been too subtle due to the font used in this blog:
    http://www.ncbi.nlm.nih.gov/pubmed/19651585
    http://www.ncbi.nlm.nih.gov/pubmed/19886906
    http://www.plosone.org/article/info:doi/10.1371/journal.pone.0003140

    Thus, the version of the MMR vaccine that Wakefield/Walker-Smith/Murch’s case report was based upon was the MMR-II (a non-Urabe strain MMR vaccine). Correct?

    The children in the study were between three and ten years old. The vaccine was changed in 1992, any child who was born before 1991 would have had the earlier vaccine. So any child who was seven years and older at the time of publishing would have had the older vaccine, or older than five in 1996. The paper explains that the children ranged between age three and ten, to quote the first sentence in the paper’s methods section: “12 children (mean age 6 years [range 3–10],”. So at least one child had the older vaccine. And since one child was American, he would have had the Jeryl Lynn version.

    So they did not have the same MMR vaccine. If one wishes to demonize a vaccine, make sure that there is some form of consistency in the type. They started out with many more children than they chose. When one is doing research you try to keep the number of variables to a minimum. Surely they should have only chosen the children who had all been given the same version of the MMR vaccine.

    Also, Barr wanted to sue based on the Urabe mumps component. Why would they choose children who had not had that version of the vaccine? And if the mumps component was a cause of concern, why concentrate only on the measles bit?

    Also the MMR with the Jeryl Lynn mumps component has been used in the USA since 1971. What evidence exists showing the MMR had been a problem in the USA in the almost twenty years it was used before being introduced to the UK?

  75. Chris

    I have a comment in moderation… But I would like to point out that the reason Dr. Hall was given an advance copy of Wakefield’s book is because she writes a column for Oprah Winfrey’s “O” magazine. She explains this in the comment section of her review.

    If you look at my first comment above, you will see a long list of papers that were disputing Wakefield published before we had even heard of Brian Deer. So even without Deer, Wakefield would have been caught.

  76. TheBlackCat

    I’ll let you hear Wakefield’s explanation on this point (in the documentary or in his new book) and decide for yourself.

    Let’s just think about this for a second. Wakefield is now the subject of what may be one of the biggest medical scandals in history (due primarily to its impact on society rather than the extent of actual wrongdoing). He has been accused of dozens of counts of serious medical ethics violations, accused of harming children for no reason, accused of falsifying much of his data,and accused of doing all of this just to make a quick buck. We live in the information age, when it would be trivially easy to address all of these accusations in broad daylight and vindicate himself to the entire world. Given this situation, what sort of person says “I’m innocent, and I can prove it…but I’m not going to, buy my book”? Seriously, who, besides someone who is only in it for the money, would react to this sort of situation in this way?

    Think about this, he expects people pay him to find out why he is innocent. Shouldn’t he be on the defensive, trying to spread his message as far as possible, rather than trying to use this situation to his own financial advantage? Does this really sound like the way an innocent man who wants to clear his name would act?

    He expects people to believe that there is a massive, world-wide conspiracy to brain damage countless children for profit, but he isn’t going to give you the details unless you pay for them. Does that really sound like the way a noble crusader would act? What sort of noble crusader charges people to reveal the truth to them?

  77. JGH-4774

    BlackCat,

    Apparently we had a big miscommunication. When I said, “How do expect me to respond to two such extreme, emotionally based and emotionally loaded statements?” I was directly responding to the question you asked me in the last sentence of your last post (#58).

    There you asked me, “I want to know how you can possibly stand by Wakefield when he says things like this: About 15 years ago a mother from London approached him and said “Do not judge me too harshly Dr. Wakefield, but when I die I am taking my son with me. You see, I’m all he has. I’m the only one who loves him.”

    “I didn’t judge,” said Wakefield. “I was moved by the love that a mother must have for her child that she would take his life rather than have him fall upon a society that really didn’t give a damn.”

    To that I replied, “How do you expect me to respond to two such extreme, emotionally based and emotionally loaded statements? I don’t support either. That’s my position.”

  78. JGH-4774

    Chris and Black Cat,

    I did not know that Dr Hall received an advance copy of Wakefield’s book. I have no problem with that (of course). That explains how she could provide an advance review.

    Nevertheless, it is fully accurate to characterize Dr Hall as a long and vigorous critic of Andrew Wakefield (because it is true). To pretend otherwise is disingenuous. Still, I would read Dr Hall’s review (with the knowledge that she is a long-time critic of AW). I have no problem with Dr Hall (I read many of her articles on SBM). Her criticism of Wakefield’s book must judged on it’s merits.

    For everyone else, it seems unfair to judge Wakefield’s book (or his explanation of what happened) without reading it. That seems fundamental and reasonable to me.

  79. TheBlackCat

    To that I replied, “How do you expect me to respond to two such extreme, emotionally based and emotionally loaded statements? I don’t support either. That’s my position.”

    I thought you might have been replying to that, but considering you have not bothered replying to my earlier comment and your “answer” was not even remotely close an answer to the question I had asked and you totally ignored the other point I made, I gave you the benefit of the doubt and assumed you were giving a somewhat reasonable answer to an earlier post rather than a total non-answer to a more recent post.

    Nevertheless, it is fully accurate to characterize Dr Hall as a long and vigorous critic of Andrew Wakefield (because it is true). To pretend otherwise is disingenuous. Still, I would read Dr Hall’s review (with the knowledge that she is a long-time critic of AW). I have no problem with Dr Hall (I read many of her articles on SBM). Her criticism of Wakefield’s book must judged on it’s merits.

    You are contradicting yourself here. If her criticism must be judged on it’s merits, why are you even bringing up her opinion of Wakefield?

    I did not know that Dr Hall received an advance copy of Wakefield’s book. I have no problem with that (of course). That explains how she could provide an advance review.

    That didn’t stop you from suggesting wrongdoing on her part.

    For everyone else, it seems unfair to judge Wakefield’s book (or his explanation of what happened) without reading it. That seems fundamental and reasonable to me.

    Where has anyone done this? I judged his presentation of his position, but that is a different matter entirely.

    That being said, I have a hard time having much sympathy when he wants to charge me money for understanding his position. If he was so interested in people knowing the truth he wouldn’t be trying to charge them for it.

  80. JGH-4774

    Black Cat,

    Your other comments in #70 and #73 are very provocative (not necessarily a bad thing). You are correct, I -do- disagree with AW on several points about vaccination (as you correctly identified in my post above). The issue of Andrew Wakefield is not one issue. Or simple. It is several. And it is complex. For example, while I do -not- believe that the MMR causes autism (Wakefield thinks that possibility still exists), I do think that -some- of the accusations made against Wakefield are unfair.

    For example, (1) He was trying to develop his own competing vaccine against the MMR. That is not true. It’s pretty absurd if you think about it. AW was an academic gastroenterologist. Not an immunologist or vaccine developer (like Paul Offit, MD).

    (2) Other accusations made against Wakefield have been amplified to an extreme degree. He is a monster. He obtained blood samples from children without consent. Not true. AW received complete informed consent from the children and their parents (his friends, many physicians themselves). Taking blood samples at his son’s birthday party, with consent, constituted “callous disregard” for the children. I don’t agree with severity of that characterization.

    (3) AW has caused children to die. Well, yes, cases of measles (morbidity) have increased significantly in the UK (into the thousands), but the number of deaths from measles in the UK (or the US) are still very low (~0-3/year) out of millions of children born in the UK/year (and 40 million/year in the US). In addition, Wakefield -never- called for zero vaccination -including MMR vaccination. He called for the right of parents to use the monovalent measles vaccine which was available in the UK from 1961 until late 1998 (which in his opinion was safer). The UK public health department took away the ability of UK parents to use the monovalent measles vaccine in late 1998 (at the peak of there demand), not Andrew Wakefield. Furthermore, the MMR uptake rate had been falling in the UK since 1994, since the MMR-I-Urabe strain fiasco. So, the situation is much more complex than many are aware. And the MMR-I-Urabe strain fiasco (brought in from Canada despite known problems) is a whole story by itself.

    As for AW’s position on vaccination, he fully vaccinated his first two children. He fully supported vaccination in 1995 and even in 1998 (though he sincerely believed the monovalent MMR series was safer and preferable to the polyvalent MMR combo shot). AW’s position on vaccination has obviously evolved from the mid and late 1990s to where it has arrived today. I do not agree much of his position today.

    However, I am glad that ethyl mercury was taken out of US vaccines in 2000 and 2001 (except for some of the flu vaccine supply). And I made sure that my children did not receive any ethyl mercury containing vaccines. I agree with the position of the University of California – Medical Investigation of Neurodevelopmental Disorders (MIND) Institute.

    “The MIND Institute supports the removal of thimerosal from all vaccines, and encourages parents to specifically request that the vaccines given to their children be thimerosal free. There are alternative methods for preservation and all of the standard pediatric vaccines are currently available without thimerosal. Given the uncertainty about the toxicity of mercury, it is only prudent to eliminate the exposure of infant children to this toxicant.” In addition, Irva Hertz-Picciotto MPH PhD (one of the world’s leading experts in “environmental exposures in relation to perinatal and neurodevelopmental outcomes”) has stated:

    1) “The level of mercury that is “safe” to the developing nervous system has not been determined.”

    2) Indeed, that it is undetermined “what -if any- level of mercury exposure is safe to the developing infant.”

    http://www.ucdmc.ucdavis.edu/mindinstitute/research/faculty_staff.html
    http://www.ucdmc.ucdavis.edu/mindinstitute/newsroom/vaccineposition.html

    I know my position on vaccines is somewhat in the middle (in the third camp). I know this greatly frustrates some (many?) individuals that I communicate with on blogs who are solidly on either side. All I can say is sorry, and please judge my arguments on their merit.

  81. Chris

    As we are being judged simply on whether or not we are “critics” of Dr. Wakefield, I would like to ask some simple “yes” or “no” questions to JGH. This is just to see where you are coming from in terms of research design and ethics.

    1) Do you think that it is ethical to perform lumbar punctures on a child where it is not clinically indicated? Yes or No?

    2) Do you think it is ethical to perform a colonoscopy on a child if it is not clinically indicated? Yes or No?

    3) Do you think that all of the children in the study should have had the same vaccine to reduce the number of variables? Yes or No?

    4) Do you think that a vaccine schedule can be decided with the results of series of twelve case studies? Yes or No?

    5) Do you think that Wakefield’s patent on a pill made from goat’s milk as both a vaccine for measles and a treatment for the gut issues “caused” by the MMR vaccine is a “conflict of interest”? Yes or No?

    6) Do you think Wakefield should have declared payments from the tax payer funded legal fund in his paper? Yes or No?

    Thank you.

    Also, as an aside… have you checked the list of papers I posted in my first post (the ones before Brian Deer’s articles), along with the ones that I linked to in a more recently posted comment?

  82. Chris

    JGH, why are you posting off topic stuff like thimerosal? It was never in the MMR vaccine.

  83. Chris

    By the way, Wakefield was not just patenting a single measles vaccine. It was a whole lot of crazy he cooked up with Hugh Fudenburg.

    Again, I see that my link to a discussion on that was not found due to the subtle font for links used in this blog. Well, here it is:
    http://forums.randi.org/showthread.php?t=176681

    Please read it through, including the links to the patent documentation.

  84. Chris

    JGH:

    I did not know that Dr Hall received an advance copy of Wakefield’s book.

    This pretty much shows that you did not bother to read her review, and the following comments. She wrote very early on in the comments she was given an advance copy of the book because of her column in “O” magazine.

    Anyway, I am very interested in your impressions of the pills made from goat milk described in the JREF forum. The one that I have linked to twice.

  85. TheBlackCat

    (1) He was trying to develop his own competing vaccine against the MMR. That is not true. It’s pretty absurd if you think about it. AW was an academic gastroenterologist. Not an immunologist or vaccine developer (like Paul Offit, MD).

    Chris has already addressed this repeatedly, which you have ignored so far.

    (2) Other accusations made against Wakefield have been amplified to an extreme degree. He is a monster. He obtained blood samples from children without consent. Not true. AW received complete informed consent from the children and their parents (his friends, many physicians themselves). Taking blood samples at his son’s birthday party, with consent, constituted “callous disregard” for the children. I don’t agree with severity of that characterization.

    If this is what you think that you are grossly ignorant of the laws regarding research on human subjects and scientific researchers’ moral and ethical obligations to their subjects. Strange for someone who claims to be so familiar with the field of medicine.

    (3) AW has caused children to die. Well, yes, cases of measles (morbidity) have increased significantly in the UK (into the thousands), but the number of deaths from measles in the UK (or the US) are still very low (~0-3/year) out of millions of children born in the UK/year (and 40 million/year in the US).

    This in no way contradicts the point you are claiming to address. I also can’t believe you would denigrate the death of even one person in this way. It’s not a big deal because only a few people are dying a year? It is most likely that none of them would have gotten the disease were it not for Wakefield. Measles is now endemic again in the UK for the first time in decades. It isn’t just measles, either, it is the MMR shot, and people are dying from all 3.

    In addition, Wakefield -never- called for zero vaccination -including MMR vaccination. He called for the right of parents to use the monovalent measles vaccine which was available in the UK from 1961 until late 1998 (which in his opinion was safer).

    You are being extraordinarily dishonest and misleading here. He flat-out said that vaccines are more dangerous than the diseases they prevent. Under the rules of medical ethics, which you would know if you are as familiar with the medical field as you claim, that is the same as saying vaccines should not be used.

    Furthermore, the MMR uptake rate had been falling in the UK since 1994, since the MMR-I-Urabe strain fiasco. So, the situation is much more complex than many are aware. And the MMR-I-Urabe strain fiasco (brought in from Canada despite known problems) is a whole story by itself.

    Irrelevant, Wakefield was easily the largest contributor to a massive drop in vaccination rates throughout the developed world. The fact that there was some smaller drop before that is not relevant. The idea of a link between vaccines and autism would not exist to any significant degree were it not for him.

  86. JGH-4774

    Black Cat,

    I have tried to engage you and everyone here in this forum in a regular voice and in a civil way. In return, I am being attacked. How is that conductive to an open exchange of information, ideas, and opinion. I am not demanding (nor even expecting) that you agree with me. We can disagree, can’t we? Or, do you only want to hear from voices that agree with yours?

    Can we lower the hostility level?

  87. JGH-4774

    Chris and Black Cat,

    I have posted a lot of information and facts in my comments here in the last two days. Please point out where -any- of the factual information has been in error.

  88. JGH-4774

    Chris,

    [You can call me John, buy the way. That is my name. (JGH are my initials.) I’m not attempting to force a friendship, but you have supplied your name, so I will supply mine. I'm extending the courtesy.]

    You said in #81, “This pretty much shows that you did not bother to read her review.”

    Why are you criticizing me for that? I did not -know- that Harriet Hall received and advance copy of Andrew Wakefield’s book and wrote a review of it? How I can be criticized for that?

    Now that I know, however, I would be happy to read Dr Hall’s review of the book. Was it posted at SBM? I read all sources of information on vaccination safety that I can.

  89. Chris

    I have already pointed out several of your errors, but you seemed to have ignored me. You went on and on and on Brian Deer, but it is clear that there was suspicion and criticism on Wakefield’s work in the long list of papers published in 2004 and earlier, that I posted at the beginning of the comments. You seem to have ignored that.

    You posted the papers of two people, neither of which adequately support Wakefield’s study (case studies on two adults!). I posted three papers that showed that there was no real correlation between autism and GI problems, twice. But you have ignored that.

    You were commenting on Dr. Hall and her review of Wakefield and from your statements it was clear you had not read it! And yes, the review is posted at ScienceBasedMedicine (which was mentioned before). If you had actually been checking that blog you would have found it.

    And you should actually read the ScienceBasedMedicine blog’s special section on Vaccines.

    Now please answer the following questions with a simple “yes” or “no.” All other responses will be ignored. Since this article is now on the second page, I won’t bother commenting until they are answered.

    Now, really, do you actually think it is okay to do invasive tests on children when there is no clinical/medical reason? Yes or no?

    Do you think that Wakefield’s patent was a conflict of interest? Yes or no?

    Did you read about the pills made from goat milk in the link I provided twice? Yes or no?

    Don’t you think that if one is going to see if a vaccine is causing a problem that it would be a good idea that all the case reports have had the same vaccine? Yes or no? (there was a vaccine lawsuit in the UK that had to be dropped because the wrong manufacturer was being sued, so you can see why this would be significant)

  90. JGH-4774

    Chris,

    I have been bombarded by questions from you and Black Cat (and others).Your questions are good ones. I am trying to answer everyone’s questions as fast as I can within the constraints of my time (on my breaks and in the evening after my kids go to bed).

    I have a job and a marriage and children to attend to. And we moved just last week. We are still unpacking boxes (anyone want to discuss the pros and cons of moving a family of four while working full-time?) So, forgive me, if it takes some time to get to your questions. I am -not- ignoring you.

  91. JGH-4774

    Dear Moderator,

    Why was my comment at ~2:00 pm not posted? Was there a violation? Can you email me to explain?

    Thank you.

  92. JGH-4774

    Chris,

    I am going to try to answer some of your questions quickly (while I have a moment here). Because I am backed-up responding to your questions (for the reasons I explained above), I will start with the first ones you asked and work my way down.

    At #79, you asked me, “JGH, why are you posting off topic stuff like thimerosal? It was never in the MMR vaccine.” Of course, thimerosal was never used as a bacteriostat in the MMR (or any live virus vaccine).

    I was in a dialogue with Black Cat where I pointed out that AW’s position on vaccination has evolved substantially from the mid and late 1990s to where it has arrived today. Black Cat’s comments seem to reflect the idea that AW’s position on vaccines are the same today as they were in 1995 or 1998. That is not accurate.

    Then I sated, “I do not agree much of his position today. However, I am glad that ethyl mercury was taken out of US vaccines in 2000 and 2001.” I was discussing how my position differs with AW’s, but went on to mention an example of a vaccine safety concern that I do have. I think it is a valid issue (so do many in medicine, like Neal Halsey MD of Johns Hopkins and the MIND institute). There are many valid issues of vaccine safety (just like any pharmaceutical).

  93. JGH-4774

    Chris,

    At # 80, you asked, “By the way, Wakefield was not just patenting a single measles vaccine. It was a whole lot of crazy he cooked up with Hugh Fudenburg.”

    1) This was a transfer factor, not a vaccine. It was intended to be a treatment.

    2) It did not work. Yes, I agree, it certainly does seems like a “whole lot of crazy.”

    3) Yes, I’ve looked at the patent application (on BD’s website) several times. Yes, at times, it refers to the product as being a “vaccine.” I have never heard a good explanation for this error in terminology. Perhaps it was a patent attorney thing. But it was an error. Who thinks that AW, a gastroenterologist, working alone (and without partnership with GSK, Merck, Sonofi-Pasteur, etc.)could develop a vaccine? Really. And, who thinks one can formulate a vaccine from goats milk colostrum? Though colostrum is rich in antibodies and it is very important to the health of infant mammals, including humans, it is certainly not a vaccine!

    3) No, I am not impressed that AW was involved in this or with Hugh Fudenberg. But it is inaccurate to say that this transfer factor was a vaccine, no less a “competing vaccine” to the MMR.

    4) I don’t know a lot about Hugh Fudenburg, but from what I do know, I am not positively impressed. Yes, I agree with you, Hugh Fudenburg seems like a nut job. Seriously, some claim that his mental health status may not be what it should be.

  94. TheBlackCat

    I have tried to engage you and everyone here in this forum in a regular voice and in a civil way. In return, I am being attacked. How is that conductive to an open exchange of information, ideas, and opinion. I am not demanding (nor even expecting) that you agree with me. We can disagree, can’t we? Or, do you only want to hear from voices that agree with yours?

    Can we lower the hostility level?

    Sorry, I tend to react with hostility when someone says that people dying is not a big deal. Care to actually address my points are you just going to complain about how mean everyone is being to you?

    This is a science blog, and as is common with science we tear apart each others’ positions and statements to the best of our ability. I am not going to apologize for pointing out the implications of your statements, your mistakes and contradictions, or anything else that I think is in error. That is how science works, it is how we make sure only the best ideas survive, and if you can’t handle that then this is really not the place for you.

    I was in a dialogue with Black Cat where I pointed out that AW’s position on vaccination has evolved substantially from the mid and late 1990s to where it has arrived today. Black Cat’s comments seem to reflect the idea that AW’s position on vaccines are the same today as they were in 1995 or 1998. That is not accurate.

    You have provided no evidence whatsoever backing up this conclusion. You have provided some evidence that during a single press conference he wasn’t as blatant about it as he is now, but that does not imply his overall position has evolved significantly.

    That being said, I fail to see whether his position has evolved significantly is even remotely relevant to the discussion anyway. A lot of people dislike him because of the positions he holds. Whether he got those positions yesterday or 20 years ago does not in any way affect that. A lot of people dislike him because he committed serious breaches of medical and scientific ethics. When he developed his position on vaccines does not change that.

  95. JGH-4774

    Chris,

    Speaking of Hugh Fudenburg, you might be happy to hear that I agree that Gary Null is also a nut job. Needs to seek psy help caliber nut job. And, I agree that a lot of the others like him that the anti-vaxers cite in support of their claims are not credible as well.

    However, I would submit to you that Dr Picciotto (at the MIND institute) and Dr Healy (Harvard, former head of the NIH, current advisor to the IOM) have made some observations over the last couple of years that I think are valid. Neither, of course, opposes vaccination.

  96. JGH-4774

    Black Cat,

    1) Several times you have stated, “Under the rules of medical ethics, which you would know if you are as familiar with the medical field as you claim” or something similar, insinuating that I do not work in the medical field.

    I do indeed work in the medical field. Your insinuations are false. I posted a comment at 2:00 pm that detailed much of my background but it was not posted by the moderator (I don’t know why, there was nothing critical, controversial, or too private said). I will try to post another version later.

    2) Regarding the mortality rate of measles in the UK or the US in the last 15 years, I certainly am -not- denigrating or even minimizing a single life lost. That is a false and acutely unfair charge. I have dedicated my entire adult life to the health and medical care of those in my community including children. And as a parent, I am particularly hurt by your suggestion that I am denigrating the lives of those children lost. Nothing could be further from the truth.

    My only point about measles, mumps, and rubella mortality numbers is that some people declare that AW is a “monster” and a “baby killer” and imply that he has caused hundreds of pediatric patients’ lives to be lost due to plummeting MMR vaccination rates in the UK. That is simply not true. On multiple levels. Yes, measles has become endemic again in the UK (annual cases in the hundreds). Yes, Wakefield’s hypothesis, and the 1998 paper, and the Feb 1998 press conference (especially), and the resultant UK media circus had a lot to do with measles becoming endemic again in the UK. But there -is- more to the story.

    Measles is generally a well-tolerated infectious illness of childhood. Serious complications are rare in otherwise healthy children. The death rate from measles infection reported in the US by the CDC is 0.2% for the years 1985-1992. “Before a vaccine was available, infection with measles virus was nearly universal during childhood, and more than 90% of persons were immune by age 15 years.”
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf

    The uptake rate fell in the UK for multiple reasons. The MMR-I-Urabe problems of 1988-1992, which caused great concern with UK parents, was a significant part of the story. Also, parents who would have vaccinated with the monovalent measles vaccine (as they had since 1961), where unable to do so because the UK public health officials discontinued its import license in late 1998. Furthermore, in 1994 the UK had to revaccinate approximately 7.1 million schoolchildren with the MR vaccine. This caused further concern in the public about the vaccine program..

    The uptake rate in the UK fell from 92% to 81-84%. While that is significant, it is inaccurate to imply (by not providing the actual numbers) that it went lower than that. And herd immunity is still largely in effect. Also, the mortality rate for measles, mumps, or rubella in children in the entire UK (or the US) has never exceeded 0-2/year during the last 15 years (since publication of Wakefield’s case report in the Lancet in 1998). This is out of 4 million children born each year, for example, in the US.

    In addition, the efficacy of vaccines is not 100% It is often 60-80% depending upon the specific vaccine, antigen, and other factors. So, many of the cases of measles in the UK and the US in the last 15 years have occurred in vaccinated children. All the preceding are facts.

    None of the preceding means we shouldn’t vaccinate children for MMR or DTaP. We should! Vaccines do significantly inhibit morbidity from infectious disease that we vaccinate for. But the whole issue is more complex than some will concede (or are aware of). And the fact is, hundreds (or even tens) of children are not dying from measles, mumps, or rubella per year in the UK or in the US due to Andrew Wakefield.

    http://www.guardian.co.uk/society/2010/jan/28/mmr-doctor-timeline
    http://www.cdc.gov/vaccines/pubs/pinkbook/default.htm
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/appdx-full-g.pdf
    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases&deaths.pdf
    http://childhealthsafety.wordpress.com/graphs/#Rubel_Eng_Wales

  97. JGH-4774

    Chris,

    In follow-up to the last sentence in my last post (#85), I read –all– sources of information on vaccination safety (and separately autism) that I can. I see a lot of autistic children through my work and in my kid’s schools and in my community. I have tremendous empathy for full-diagnosis autistic children and their parents. I know some personally. What they go through is extremely difficult. However, I do not get all my information from anti-vax sites.

    And, I agree that anything that Jenny McCarthy says should be considered with a (very) large grain of salt, if it is considered at all. And I agree that JB Handley is a jerk and AoA is an insular group. However, I do view the TACA and NVIC and Autism Speaks websites periodically (perhaps that’s part of my problem, some will respond here;). But, I also read/utilize Pediatrics, MedscapeCME, PubMed, SBM, and This Week in Virology; so I think it balances out. Personally, I think it is important to read both sides of the controversy (if nothing else, to see what is going on on the other side).

    BTW, this all dovetails into the question of who I am and why I am here (posting at the Discover Magazine/Bad Astronomy blog). I think you have wondered. My name really is John. I really have lived in California all my life (and I did earn a BS and MS in bio sci from a UC). I am 44 years old. And I really do work in the medical field (though I am not a MD, as I have said before). And I do read the literature (some of it since I was a teen because of the influence of my father who was a MD). I have read Pediatrics for 20+ years. I read primary sources. I read, of course, the JAMA, NEJM, and the Lancet (and many other journals in areas of special interest: nutrition, sports medicine, exercise physiology, psychology). I also read articles at SBM by contributors such as Dr Hall, Steven Novella (and NeuroLogica), and Mark Crislip. I read David Gorski’s articles for the information, but I find his tone (insolent, to use a word) unappealing. Still I read most of his articles at SBM. I read Prometheus’ blog (photoninthedarkness); excellent. I have read three of Paul Offit’s books (including False Prophets). I read Ben Goldacre’s blog and book, Bad Science.

    Separately (just to flesh out who I am), I have been a member of the Center for Science in the Public Interest for 20+ years and the Union of Concerned Scientists for ~10 years. Separately, I have had an interest in astronomy (inherited from my grandfather) since I was young. Carl Sagan was an early hero. This explains why I enjoy Discover Magazine and Phil’s blog.

    So, none of this makes me particularly or unusually qualified. I am not. But I do work in the medical field (despite Black Cat insinuating several times above that I do not). My interest in the issue of vaccine safety (and separately autism) is due to my work and due to being a parent. I am not a “concern troll” as someone accused me above. My opinions are my opinions. They may be right or wrong. But they are sincere.

  98. JGH-4774

    In the previous (blocked) version of the above post, I included the web address for This Week in Virology. That appears to have blocked the posting.

  99. TheBlackCat

    Several times you have stated, “Under the rules of medical ethics, which you would know if you are as familiar with the medical field as you claim” or something similar, insinuating that I do not work in the medical field.

    I do indeed work in the medical field. Your insinuations are false. I posted a comment at 2:00 pm that detailed much of my background but it was not posted by the moderator (I don’t know why, there was nothing critical, controversial, or too private said). I will try to post another version later.

    I was insinuating nothing of the sort. What I was flat-out saying is that you are not as knowledgeable about a lot of stuff as you would like us to believe. If you try to invoke your own authority as part of an argument, then it is perfectly legitimate to call into question the level of authority you have on the subject. You may say that you don’t want us to treat you as an authority, but you have repeatedly brought up your own experience in the medical field to give weight to your statements, so you most certainly were invoking your own authority, and as such it is perfectly legitimate to criticize your level of knowledge of the subject.

    My only point about measles, mumps, and rubella mortality numbers is that some people declare that AW is a “monster” and a “baby killer” and imply that he has caused hundreds of pediatric patients’ lives to be lost due to plummeting MMR vaccination rates in the UK.

    I fail to say how stating the first in any way implies the second. I have seen no one come close to implying what you claim we are implying. And if we aren’t the ones implying it, then why are you bringing it up?

    Yes, Wakefield’s hypothesis, and the 1998 paper, and the Feb 1998 press conference (especially), and the resultant UK media circus had a lot to do with measles becoming endemic again in the UK. But there -is- more to the story.

    Of course there is more to the story. One of the big things that you keep trying to sidestep is how Wakefield has been aggressively pushing his anti-vaccine perspective and has made himself one of the leaders and spokepersons for the anti-vaccination movement. Your continuous attempts to ignore this by limiting his involvement to one paper and the corresponding press conference is highly disingenuous, as has been pointed out to you repeatedly. You know he has been done far more than that, why do you always neglect to mention it when discussing his involvement? Doing it once or twice is okay, but you have done it repeatedly despite being corrected every time, so I am starting to have a hard time avoiding the conclusion that you are being intentionally misleading in this regard. I’ll be more than happy to correct this if you can provide a legitimate reason, but so far you have not attempted to do so.

    Measles is generally a well-tolerated infectious illness of childhood. Serious…

    So what? How is that even remotely relevant to anything anyone has been saying up to this point? It is killing people, people who should not be dying. It doesn’t matter how many or what percentage.

    The uptake rate fell in the UK for multiple reasons. The MMR-I-Urabe problems of 1988-1992, which caused great concern with UK parents, was a significant part of the story. Also, parents who would have vaccinated with the monovalent measles vaccine (as they had since 1961), where unable to do so because the UK public health officials discontinued its import license in late 1998. Furthermore, in 1994 the UK had to revaccinate approximately 7.1 million schoolchildren with the MR vaccine. This caused further concern in the public about the vaccine program..

    If you actually looking at the rates of vaccination, the big drops didn’t happen until well after all these incidents you are listing.

    You keep on asserting (without evidence) that these played a significant role in the large decrease in vaccination rates we have seen. Even if it did, that would not exonerate Wakefield in any way.

    The uptake rate in the UK fell from 92% to 81-84%. While that is significant, it is inaccurate to imply (by not providing the actual numbers) that it went lower than that.

    Who implied anything of the sort and where did they do so?

    Also, the mortality rate for measles, mumps, or rubella in children in the entire UK (or the US) has never exceeded 0-2/year during the last 15 years (since publication of Wakefield’s case report in the Lancet in 1998). This is out of 4 million children born each year, for example, in the US.

    Once again, how is this remotely relevant?

    In addition, the efficacy of vaccines is not 100% It is often 60-80% depending upon the specific vaccine, antigen, and other factors. So, many of the cases of measles in the UK and the US in the last 15 years have occurred in vaccinated children.

    Yes, in fact I said as much way earlier in the thread, in a post you replied to no less. If you think this is news to me you have not been reading what I have been writing. However, none of these people would have gotten it if Measles wasn’t spreading through the population, which it would not be if we were at the levels needed to maintain herd immunity (which it isn’t anymore, by definition since the disease is endemic).

    As for your accusations of posts being blocked, there is a spam filter that sometimes holds up posts. They eventually come through when Phil gets around to it.

  100. JGH-4774

    Chris, you asked me the following questions at #78. They are good ones. And good for provoking debate (which is a good thing).

    **1) Do you think that it is ethical to perform lumbar punctures on a child where it is not clinically indicated? Yes or No?

    >>> No. It is -not- ethical to perform lumbar punctures on a child where it is not clinically indicated.

    However, the team of experienced clinical doctors at the Royal Free University Hospital in London said the diagnostic procedures -were- medically indicated in order to diagnose the children in order to effectively treat them. In addition, Andrew Wakefield was -not- a member of the clinical staff. He could -not- order these diagnostic procedures.

    **2) Do you think it is ethical to perform a colonoscopy on a child if it is not clinically indicated? Yes or No?

    >>> No. It is -not- ethical to perform a colonoscopy on a child where it is not clinically indicated.

    However, the team of -highly- experienced clinical pediatric gastroenterologists at the Royal Free University Hospital -including one of the most experienced and preeminent pediatric gastroenterologist in the world, Dr John Walker Smith (MB BS MD FRCP FRACP FRCPCH)- said the colonoscopies –were– medically indicated in order to diagnose the children in order to effectively treat them. Again, Andrew Wakefield was -not- a member of the clinical staff. He could -not- order these diagnostic procedures.

    Now, I suspect you vigorously disagree, but are you a medical doctor or a gastroenterologist? Drs. John Walker-Smith and Simon Murch are highly experienced clinical pediatric gastroenterologists and pediatricians. I understand of course that the GMC tribunal obviously disagreed with Walker-Smith and Murch, but the 5-member GMC tribunal was comprised of two lay members (barristers I suspect), and a consultant psychiatrist, a consultant physician (retired), and a general practitioner:
    Dr S Kumar, Chairman (Medical)
    Mrs S Dean (Lay)
    Ms W Golding (Lay)
    Dr P Moodley (Medical)
    Dr S Webster (Medical)

    None of the three doctors on the GMC tribunal panel were gastroenterologists (or pathologists or histopathologists). Personally, and call me crazy, I think Prof Walker-Smith and Prof Murch have (much) more training and knowledge and expertise on this specific question and in this area of medicine than the three non-gastroenterologists on the GMC panel.

    **3) Do you think that all of the children in the study should have had the same vaccine to reduce the number of variables? Yes or No?

    >>> Yes. I agree rather strongly with you here. You make some excellent points in the second half of your post at # 71. Comparing the GI outcomes in children who have been administered two different MMR vaccines (MMR-I-Urabe vs. MMR-II-Jeryl Lynn) could be (very) problematic. Good point. I would like to discuss this with you more later.

    **4) Do you think that a vaccine schedule can be decided with the results of series of twelve case studies? Yes or No?

    >>> No. Of course not. But, -no one- was deciding the “vaccine schedule on the results of [a] series of twelve case studies.” And the paper by the team of Wakefield, Walker-Smith, and Murch was absolutely not a “study.” It was an early “case report.” There is a world of difference. And it was not a “series of twelve case studies.” Do you understand this?

    I discussed this in my post #45 at part 14:

    “The 1998 Lancet paper by Wakefield/Walker-Smith/Murch was not a “study” as the major news outlets reported over & over (and falsely). It was, in fact, an “early case series report.” It surprises me how many in the media and in the blogosphere who should know better (and who claim to possess significant training in science and biology) don’t understand what a “case report” is. The Wakefield/Walker-Smith/Murch case series report published in by the Lancet in 1998 is very similar to the original, famous case series report authored by Leo Kanner and published in 1944. Indeed, Leo Kanner’s famous 1944 paper on autism, which sparked the entire field of autism research, was based on the observations of 11 children.”

    Prominent UK SBM advocate Ben Goldacre MD, who is a vigorous pro-vaccination advocate, said in 2005 that he thought “the [Wakefield et al] paper always was and still remains a perfectly good small case series report.”

    **5) Do you think that Wakefield’s patent on a pill made from goat’s milk as both a vaccine for measles and a treatment for the gut issues “caused” by the MMR vaccine is a “conflict of interest”? Yes or No?

    >>>No. It was not a vaccine. It was a treatment. It was a “transfer factor.” It was, as you say, a treatment for “gut issues ‘caused’ by the MMR vaccine.” The transfer factor treatment did not turn out to work. In addition, the patent beneficiaries were the Royal Free Hospital University and Hugh Fudenburg, not AW. How does any of this constitute a conflict of interest? And I ask that question plainly, sincerely.

    **6) Do you think Wakefield should have declared payments from the tax payer funded legal fund in his paper? Yes or No?

    >>>Yes.

    As you know AW was working on two different projects (not many know this). Technically, under the rules -at the time- he didn’t have to. >>But, yes, he should have.<>>No, I apologize, I have not had the time yet. But I will. I promise. I’m very interested in what you have put together. I’m just a little overextended this week (due to reasons I explained earlier today).

    ————————————————–

    Other questions:

    **On the question of whether autistic children are presenting GI distress/disorder at a higher rate than the general pediatric population, I have sincerely reviewed your response. But I respectfully disagree (though your position is reasonable). The data is conflicting and incomplete so far. I guess we will have to agree to disagree on this one (for the time being, anyway).

    **Chris asked at #81, “Anyway, I am very interested in your impressions of the pills made from goat milk described in the JREF forum. The one that I have linked to twice.”

    >>>Yes, I linked to it and skimmed it quickly on my lunch. I am sorry I did not have the time to read it more in depth. It looks interesting. I promise you that I will look into it more and get back to you.

    That said, my wife was able to breast-feed our kids, so I studied the benefits to the infant in depth. Colostrum is a very important substance to human infants (immunologically and otherwise), but I would never dream of –injecting– goat’s milk colostrum into children (or even human colostrum). Yes, that sounds crazy. But, as I said, I’ll check out the JREF forum as soon as I can, and get back to you in a couple of days.

    **Chris asked at #86, “Don’t you think that if one is going to see if a vaccine is causing a problem that it would be a good idea that all the case reports have had the same vaccine? Yes or no? (there was a vaccine lawsuit in the UK that had to be dropped because the wrong manufacturer was being sued, so you can see why this would be significant).”

    >>>Yes. I agree with you here (as discussed above). Excellent point Chris.

  101. JGH-4774

    Black Cat,

    “As for your accusations of posts being blocked, there is a spam filter that sometimes holds up posts. They eventually come through when Phil gets around to it.”

    Thank you for explaining that.

  102. Chris

    So you answered the questions that would point out that the children should not have had the invasive procedures. Then proceeded to do lots of hand waving to justify it, mainly by using a pointless argument from authority.

    Did you notice that the reason Murch was not sanctioned was because he was unaware the procedures were not clinically indicated. It says so right in the snippet I cut and pasted from the GMC ruling, right up there in the comments. With a link and everything.

    You are making lots of excuses for Wakefield.

    Plus anyone who says “Measles is generally a well-tolerated infectious illness of childhood” and only uses the last 15 years of measles mortality (when twenty years ago over 120 Americans were killed by measles) is being dishonest by way of cherry picking data. Measles causes serious complications in about one out of a thousand cases (deafness, blindness, permanent brain damage and even death).

    There is no way to have a dialogue with someone who is dishonest. End of discussion.

  103. JGH-4774

    Black Cat,

    You are a formidable counter point. Unfortunately, my wife informs me that I am in the doghouse (seriously) for being on this site so much the last three days. But I will be back tomorrow, BC, to respond to your last post #96.

  104. JGH-4774

    Chris,

    Wow. “End of discussion.” Why such an emotional response? This is a dialogue; an exchange of ideas, information, and opinion between several individuals with a wide variety of training, experience, and background. We are, predictably, not going to agree at all times.

    And… how am I “dishonest? That is a serious charge. Please point out where -any- of the factual information I have posted is in error?

    I was quoting the CDC pink book.

    Re. Prof Simon Murch, how could he be “unaware the procedures (i.e., colonoscopies) were not clinically indicated”??? Simon Murch (MB BS PhD MRCP MRCS LRCP) is a pediatric gastroenterologist!

  105. TheBlackCat

    This is a dialogue; an exchange of ideas, information, and opinion between several individuals with a wide variety of training, experience, and background. We are, predictably, not going to agree at all times.

    It is hard to have an honest dialogue when one side ignores most of the other side’s questions, cherry-picks data and information to paint a distorted picture, attacks others’ character and motives rather than the evidence (except in cases where character and motive are the subject of the discussion), ignores contradictory facts despite them being routinely brought to his or her attention, seems to have a lot of time to posts several page long screeds but no time to answer simple questions, throws out large numbers of on-sequiturs and irrelevant facts, accuses people of implying things or holding positions they never did, gets personally offended when people point out flaws in their reasoning, and otherwise doesn’t behave in the manner expected from an honest dialogue. We have been pointing this out to you all along but have made no effort whatsoever to improve your behavior, on the contrary you have been doing this more and more as the discussion has progressed.

    I have reached the same conclusion Chris apparently has, we have given you more than enough chances. I, like Chris apparently, have given up hope that you would realize your mistakes and make an effort to correct them. I am only sticking around to continue to point out the flaws in your reasoning. I will be pleasantly surprised if you do, but I have been in enough discussions of the last 10 years with people like you that I do not have any real hope at this point. If you had any intention of correcting your behavior you would have done so a long time ago.

    And… how am I “dishonest? That is a serious charge. Please point out where -any- of the factual information I have posted is in error?

    Surely you know there are ways to be dishonest without outright lying. There is, for instance, “lie by omission”, where someone leaves out critical information in order to paint a distorted picture of the facts. It is why courts require people to tell “the whole truth”, and why rules of science ethics require scientists to reveal information even if it may contradict their conclusions. It has been pointed out to you on numerous occasions that you are doing this, but you continue to do it with no hint of changing. As I said, it has become nearly impossible for me to conclude you are not being intentionally misleading, which is dishonest.

    Re. Prof Simon Murch, how could he be “unaware the procedures (i.e., colonoscopies) were not clinically indicated”??? Simon Murch (MB BS PhD MRCP MRCS LRCP) is a pediatric gastroenterologist!

    Maybe he was told they were when they really weren’t, or maybe he just assumed that his lab was following standard rules of medical ethics (few researchers just assume their colleagues are committing serious breaches of the rules of scientific conduct, especially since such breaches are very rare).

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