Wednesday, February 04, 2015

Just How Dumb & Dangerous Is Sam?

In 1998, an esteemed medical journal published a paper with a startling conclusion: that the measles, mumps, and rubella vaccine — administered to millions of children across the globe each year — could cause autism.

This study, led by the discredited physician-researcher Andrew Wakefield, is where the current vaccine-autism debate started. It has since been thoroughly eviscerated: The Lancet retracted the paper, investigators have described the research as an "elaborate fraud," and Wakefield has lost his medical license.

But public-health experts say that Wakefield's false data and erroneous conclusions, while resoundingly rejected in the academic world, still drive some parents' current worries about the MMR shot.

Here are five reasons — and many links to further reading — that should remind you just how terrible his research was.

1) Forget the fraud and data manipulation: the MMR vaccine-autism study was bad science

To begin with, Wakefield's association between the MMR vaccine and autism was based on a case report involving only 12 children. "Case reports" are detailed stories about particular patients' medical histories. And — because they basically just stories — they are considered among weakest kinds of medical studies.

In this case, many children have autism and nearly all take the MMR vaccine. Finding, among a group of a dozen children, that most of them happen to have both is not at all surprising and in no way proves that the MMR vaccine causes autism. (Wakefield also proposed a link between the vaccine and a new inflammatory bowel syndrome, which has since been called "autistic enterocolitis" and also discredited.)

But don't stop with the retracted study. The totality of the evidence opposes this vaccine-autism theory. Large-scale studies involving thousands of participants in several countries have failed to establish a link between the MMR vaccine and the mental developmental disorder. As one of the most thorough studies to date showed, nearly half a million kids who got the vaccine were compared to some 100,000 who didn't, and there were no differences in the autism rates between the two groups. "This study provides strong evidence against the hypothesis that MMR vaccination causes autism," the authors wrote in The New England Journal of Medicine.

Studies published in The Lancet, The Journal of Pediatric Infectious Diseases, PLoS One, and — among others — The Journal of Autism and Developmental Disorders have also found no association between the vaccine and autism.

2) Study author Andrew Wakefield manipulated and misrepresented his data

(The Lancet)
A British investigative journalist, Brian Deer, followed up with the families of each of the 12 kids in the study. He concluded, "No case was free of misreporting or alteration." In other words, Andrew Wakefield, lead author of the original report, manipulated his data. (See the popup chart in this report for details.)

In The British Medical Journal, Deer spells out exactly what he found, and it's rather shocking that this study was ever published in the first place. You learn that the parents of many of the kids deny the conclusions in the study; some of the kids who Wakefield suggested were diagnosed with autism actually weren't; others who Wakefield suggested were "previously normal"  actually had pre-existing developmental issues before getting their shots.

3) The paper is based on blood samples Wakefield drew at his kid's birthday party

Even more absurdly, when the General Medical Council (the UK's medical regulator) began to investigate Wakefield, they found that he had paid children at his son's 10th birthday party to donate their blood for his research. That isn't exactly a controlled and ethical setting.

In fact, in deciding to take his UK medical license away, the GMC said Wakefield acted with "callous disregard for the distress and pain the children might suffer."

4) Wakefield filed a patent for an MMR vaccine alternative

Wakefield also had financial conflicts of interest. Among them, while he was discrediting the combination measles-mumps-rubella vaccine, and suggesting parents should give their children single shots over a longer period of time, he was conveniently filing patents for single-disease vaccines.

"For the vast majority of children, the MMR vaccine is fine," he said, "but I believe there are sufficient anxieties for a case to be made to administer the three vaccinations separately." He also suggested the long-term safety studies of the MMR shouldn't be trusted.

Brian Deer
's investigation revealed that, in June 1997, he had filed a patent for a supposedly "safer" single measles vaccine. Deer writes, "Although Wakefield denied any such plans, his proposed shot, and a network of companies intended to raise venture capital for purported inventions — including 'a replacement for attenuated viral vaccines', commercial testing kits and what he claimed to be a possible 'complete cure' for autism — were set out in confidential documents."

5) Wakefield has refused to replicate the paper's findings

At the very bedrock of science is the concept of falsification: a scientist runs a test, gathers his findings, and tries to disprove himself by replicating his experiment in other contexts. When that's done, only then can he know that his findings were true.

autism wakefield
Callous Disregard, Wakefield's book. (Image via Amazon.)

Wakefield has never done this. As the editor of The BMJ points out, "Wakefield has been given ample opportunity either to replicate the paper's findings, or to say he was mistaken. He has declined to do either." In 2004, 10 of his coauthors on the original paper retracted it, but Wakefield didn't join them, and he has since continued to push his views, including doing the rounds on the anti-vaxxer speakers' circuit and publishing books.

On his own website, he portrays himself as an embattled hero: "In the pursuit of possible links between childhood vaccines, intestinal inflammation, and neurologic injury in children, Dr. Wakefield lost his job in the Department of Medicine at London’s Royal Free Hospital, his country, his career, and his medical license." He even tried to sue the BMJ and Deer, suggesting they were going after him in some sort of vendetta. So far, these lawsuits have gone nowhere.

WATCH: 'Vaccines do not cause autism, they save lives'

What is a vaccine?
Vaccines are drugs that bolster the body's immunity to particular diseases. They work by imitating — but not causing — an illness in a way that forces the body to develop a supply of defensive cells. These cells can then recognize and fight off a future infection, should it occur.
Vaccines have eliminated some of the most dangerous, fatal diseases in human history. The World Health Organization in 1979 declared smallpox globally eradicated, and the Centers for Disease Control and Prevention (CDC) that same year proclaimed polio eradicated in the United States. Other vaccines have managed to push various diseases to the brink of extinction, including tetanus and whooping cough.
The scientific community widely supports vaccines, seeing them as one of the most crucial medical breakthroughs of the past few centuries. At the same time, some groups generally oppose vaccination — both now and historically. Most recently, some vaccine opponents argued that vaccines may cause autism, although the link is not supported by current scientific research.