Tag Archives: Andrew Wakefield

Is Andrew Wakefield a fraud and a bully?

I had hoped that, after he disappeared into obscurity in the United States, I could safely ignore Andrew Wakefield, the disgraced former surgeon, who lost his licence to practise medicine in the UK for his dishonest and unethical role in the MMR Hoax. He did surface last year alongside Polly Tommey, who followed her hero into exile in the USA, when they tried to sell an autism reality show. The premise was simple. Film autistic children in distress. Take them to Arthur Krigsman to be given a colonoscopy and diagnosed with autistic enterocolitis. Then cure them with special diets and supplements and film the happy outcome.

This project never came to fruition. But Wakefield and Tommey did intervene in the case of Alex Spourdalakis. They filmed this young man in distressing circumstances in hospital. They made allegations about the treatment he received, relying on the patient confidentiality enshrined in US law to prevent health authorities from responding to their claims. They had a willing accomplice in Alex’s mother and arranged for Alex to be treated by Arthur Krigsman. But refusing conventional treatment and opting for quack remedies did not have the desired effect. Alex was subsequently murdered poisoned and stabbed to death by his mother. We await the outcome of her trial. Both Wakefield and Tommey were complicit in attempts to use their film to justify her crime.

Wakefield’s most recent exploit pales in comparison to that example of sleaze. It seems that he has taken exception to being called a fraud. Actually he has been called a fraud many times, most noticeably by Brian Deer and Fiona Godlee in the British Medical Journal. He tried to sue them but a Texas court rejected his claim and the appeal has yet to be settled. Time Magazine reported that Wakefield was a fraud. So did CNN, The Daily Telegraph. David Whelan, writing for Forbes Magazine even suggested that the US authorities should deport Wakefield to face fraud charges in the UK. With the exception of his outstanding appeal with regard to the BMJ Wakefield has not responded to any of these reports until now when Emily Willingham, also writing for Forbes Magazine called him a fraud.

Actually Ms Willingham did not make a big deal about the fraud. Her main point was to highlight a recent review of gut issues and autism in Pediatrics which suggests that

It is clear that greater clinical and research scrutiny is needed to increase awareness on this topic and thus support development of the best standards of care. Previous controversy surrounding the MMR vaccine and proposed causal link between ASD and infection of the GI tract probably deterred investigators from dedicating resources to examine GI functioning in this population while fostering uncertainty in the ASD community regarding the validity of this line of inquiry.

This seems perfectly clear to me. Wakefield’s fraudulent research has tainted the investigation of potential links between autism and GI functioning. He has discouraged other investigators into this link and made it difficult for them to obtain funding. He has performed a great disservice to science. More importantly, autistic people with genuine GI dysfunction have struggled to have their symptoms taken seriously. They or their parents have had their concerns dismissed by health professional who are chary of any association with Wakefield’s ideas. It is a bitter irony that some are then welcomed by Wakefield’s acolytes into the alt-med world of untested and unproven biomedical remedies for autism.

Wakefield has written a  letter to Ms Willingham threatening her and Forbes Magazine with prosecution, “pending legal advice.”  He concludes

You are also advised that I live and work in Austin, Texas where my business is headquartered, and that my work is conducted throughout the US. Your defamatory statements about me will undoubtedly cause me to suffer significant personal and financial damage.

My lawyers are currently dealing with Deer and his co-defendants. They will be turning their attention to you well within the statute of limitations for filing a case against you and Forbes.

Three things strike me. One, this is Wakefield acting off his own bat. He has not taken legal advice. That is pending. He has written a threatening letter to a blogger to bully her into silence “pending legal advice.“  Two, he is not going to do anything unless he gets a successful outcome in Texas regarding his action against the BMJ (Deer and his co-defendants ). Three, talk of prosecution and defendants in relation to civil law is a total nonsense. There is only one criminal in this case and he can count himself lucky that nobody has seen fit to prosecute him yet.

So why is he doing it? My best guess is that he has issued this threat and published it on Age of Autism to rally the troops and revitalize his flagging support. And why is he doing it to Ms Willingham? Perhaps he thinks she is more vulnerable than CNN or Time Magazine. Maybe he hoped that Forbes would take the corporate view and silence her to fend off a potential troublesome lawsuit. Not for the first time he has been proven wrong. Ms Willingham is an eminent scientist, an educator and an accomplished journalist. Forbes recognize her talent and show no signs of surrendering to Wakefield’s bluster.

Why are Wakefield’s views on MMR still news?

Wakefield ipaper

Today’s i Paper and Independent carry a front page story that gives Andrew Wakefield everything he could wish for. Two days ago I blogged a piece on Wakefield’s recent attempt to capitalize on the measles outbreak in Wales. He issued a statement on Age of Autism, a blog that reflects the views of its sponsors, US organizations like Safe Minds and Generation Rescue. For them autism is a man made epidemic caused by vaccines and other environmental toxins. It can be cured by a combination of diets, vitamins, detox programmes and other “alternative” (i.e. unproven) therapies. Needless to say these ideas have no support within mainstream scienceofautismscience. The recent booklet, The Good and Bad Science of Autism, provides a clear and accessible rebuttal in an excellent guide to the current state of our knowledge and understanding of autism

It speaks volumes that Wakefield is now dependent on media outlets like Age of Autism to get his message across. He is a marginal figure, reduced to touting proposals for a reality TV show, “The Autism Team” to US producers, as reported by Mark Hannaford in the Guardian. He still has nuisance value within the autism community. His acolytes continue to repeat the MMR hoax on blogs and other social media. But his days as a mainstream media figure are clearly over.  At least I thought they were until I picked up my copy of the i Paper today.

The article is neither a criticism of Wakefield for being the architect of the MMR scare behind the measles outbreak in South Wales nor a critique of the lies and distortions in his self-serving statement. It effectively gives him the right to reply.

  1. His picture and his words form the headline. The expert rebuttal comes a poor second.
  2. Although the print version of the i Paper concentrates on the single vaccine question, the Independent in print and online gives full coverage to his statement, which is printed in full. This statement repeats the lies that MMR is unsafe and causes autism. Incidentally, the Independent credits its source for Wakefield’s statement as healthimpactnews.com, a “news” site that was set up to promote the owners’ business, selling coconut based products as health foods. It also publishes their views on Darwin, prescription drugs, GM food and vaccines. They oppose them all while defending creationism or intelligent design and alternative medicines and therapies.
  3. Getting an expert to respond to Wakefield’s statements inevitably puts the expert on the defensive and makes him sound less convincing than Wakefield, who is never questioned on any of the dubious statements published without comment. It also gives a false air of legitimacy. This was always the problem in the original coverage of the MMR Hoax. By appearing balanced it gave equal weight to very unequal ideas. Outside of the medical fringe there has never been any support for Wakefield amongst doctors or researchers.
  4. There is an attempt to place Wakefield’s statement in context. But the message comes across that the question of single vaccines versus MMR is a legitimate topic for debate and that Wakefield, despite being struck off for malpractice in relation to research into MMR, has a legitimate voice in that debate.

MMR and Autism

Measles graphicThe continuing outbreak of measles in South Wales has once more drawn attention to Andrew Wakefield, the man who did more than most to create a panic over MMR and autism. He was aided and abetted by scare stories in the media which presented Wakefield as a lone hero, battling against an establishment cover up on behalf of the children. Many of those now affected missed out on vaccines because of this scare. According to Dr Roland Napier, consultant epidemiologist for Public Health Wales, speaking to the Daily Telegraph

”There was a sustained campaign against MMR by the local evening paper [the South Wales Evening Post in the late Nineties] and my colleagues noted at the time that its circulation area had a proportionate fall in vaccinations compared to other regions in Wales. So there is a connection,”

This time round the media are united in condemning Wakefield while failing to acknowledge or apologize for their part in promoting the MMR Hoax. But if you look in the comments section of the online articles you will find a small but determined minority of people who still believe the lies and distortions so faithfully repeated by the media in the past. Andrew Wakefield himself has summarized these for us in a statement published on Age of Autism.

Blame the Government.

Wakefield’s argument then and now is that the government was to blame for withdrawing single vaccines and taking away choice after he raised doubts about MMR and recommended single vaccines. This ignores the fact that prior to MMR there had never been a single vaccine for mumps in the UK. Furthermore, replacing the two MMR doses with six separate doses one year apart would have left more children unprotected for longer, even assuming that vaccine take up did not suffer from six doctors visits instead of two. All the evidence suggests that uptake is lower for single doses and children often do not complete the course. And Wakefield has never addressed the question of how, if any component parts of the MMR vaccine are implicated in autism or bowel disease, giving them separately would mitigate that risk.

MMR is not safe

Two versions of MMR vaccine were withdrawn because the mumps component based on the Urabe strain carried a risk of developing aseptic meningitis. This was known before they were introduced but the rate of infection, 1 in 100,000 was much less than the natural rate of infection from mumps itself. They were only withdrawn in favour of vaccines using the Jeryl Lynn strain of mumps, which does not cause aseptic meningitis, when a more intensive study found a rate of 1 in 3000 for aseptic meningitis among children following MMR vaccination in Nottingham. Even then if the Jeryl Lynn strain had not been available, the health authorities would have continued with the vaccine because the rate of aseptic meningitis in actual mumps is around 1 in every 10 cases.

But Wakefield’s target has always been the measles component of MMR, not mumps or rubella. According to official statistics in the 20 years prior to the introduction of MMR there were 436 recorded deaths from measles in England and Wales. In 1988, the year MMR was introduced, there were 16 deaths. In the next twenty years there were 28 recorded deaths in England and Wales. Apart from death, there is the misery of the disease itself and the risk of side effects like convulsions (1 in 200:  MMR 1 in 1000), meningitis/encephalitis (1 in 5000: MMR 1 in 1000000 ), bleeding disorders (1 in 3000: MMR 1 in 100000). These figures reflect the safety of MMR based on 500 million doses given worldwide over a thirty year period.

MMR can cause autism

Wakefield bases this assertion on the decision by the US Vaccine Court to award damages to a small number of “children whose autism followed vaccine-induced brain damage. A recent government concession in the US Vaccine Court confirms that the parents’ claims were valid all along.”

He does not mention the Autism Omnibus Proceedings at the same court. A team of lawyers recruited thousands of parents who believed that vaccines had caused their child’s autism. They selected their strongest cases to present three general causation theories of autism resulting from either MMR, Thimerosal containing vaccines, or a combination of the two. Expert witnesses were summoned on both sides. Surprisingly Andrew Wakefield was not called as an expert by the petitioners. Every case was lost and the theories were dismissed. The successful individual petitioners mentioned by Wakefield have never argued that vaccines cause autism. That case was lost. They followed a different path. The vaccine court includes a list of table injuries that cover recognized side effects like encephalitis. You do not have to prove that the vaccine caused these injuries, only that they occurred within a specified timescale after the vaccine was administered. Some parents have persuaded the court that a) the injury occurred within the necessary timescale and b) their child is permanently disabled as a result. Hence the generous compensation payments.

But this does not prove that vaccines cause autism. According to Wikipedia

From 1988 until March 3, 2011, 5,636 claims relating to autism, and 8,119 non-autism claims, were made to the VICP. 2,620 of these claims, one autism-related, were compensated, with 4,463 non-autism and 814 autism claims dismissed; awards (including attorney’s fees) totaled over $2 billion. The VICP also applies to claims for injuries suffered before 1988; there were 4,264 of these claims of which 1,189 were compensated with awards totaling $903 million.[9]

Taking a prevalence figure for autism of 1 per cent in the general population we would expect a similar proportion among children winning claims for vaccine injury. So twenty or thirty individual cases of autistic children winning their claims would not be unusual. It is not evidence that vaccines cause autism any more than the “814 autism claims dismissed” are evidence vaccines do not cause autism. The evidence is in the science and we now have 15 years of accumulated evidence that does not support the vaccine autism hypothesis.

Wakefield ends by offering “to debate any serious challenger on MMR vaccine safety and the role of MMR in autism, live, in public, and televised.”  That is how politicians operate not scientists. Science proceeds via research, publication and academic discourse. In all these arenas Wakefield’s ideas have been tested and found wanting. Giving him the opportunity to grandstand on television may help to rally the faithful. It will add nothing to our understanding of vaccines or autism.