Already retracted autism/MMR study now deemed an elaborate "fraud"

*Note: sorry about the design issues. Trying to work them out...*

It would be irresponsible of me to let this go by without mention. The Associated Press, New York Times, CNN, and a host of other media outlets tonight are reporting on the discovery that disgraced researcher Andrew Wakefield's flawed and already redacted study suggesting a link between MMR vaccine and autism was actually more than bad science. It was fraud. And since this blog is about the manipulation of science, I must report on this, especially as that single study has done incalculable damage to public health, both in the United States and in England.

CNN reports that an investigation published by the British medical journal BMJ concludes Wakefield, misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study -- and that there was "no doubt" Wakefield was responsible. I just need to highlight this. He misrepresented or altered the histories of ALL 12 of the patients he studied. The way he altered these histories only underscores the complete lack of merit of the paper to begin with: he didn't mention that a large percentage of the children he claimed "changed" right after they received the MMR shot had actually been suffering from documented developmental problems prior to the shot. This reminds me of the poor parents who tried to sue vaccine makers in Vaccine Court for their child's autism. A developmental psychologist for the defense viewed home movies of the child before the MMR vaccine had been administered, when the child was "perfectly normal," and quietly pointed out what, to him, were obvious signs of a burgeoning developmental disability.

Again, CNN: "It's one thing to have a bad study, a study full of error, and for the authors then to admit that they made errors," Fiona Godlee, BMJ's editor-in-chief, told CNN. "But in this case, we have a very different picture of what seems to be a deliberate attempt to create an impression that there was a link by falsifying the data." Britain stripped Wakefield of his medical license in May. "Meanwhile, the damage to public health continues, fueled by unbalanced media reporting and an ineffective response from government, researchers, journals and the medical profession," BMJ states in an editorial accompanying the work.

This issue about vaccines and autism isn't a battle of pride, like politics. All parents want what is best for their children. No one goes to bat for a theory about their child's health knowing consciously, or letting themselves understand, that following that theory might result in serious injury, disease, or even death--for their child or others. Like Ms. Godlee, I blame the media for doing an absolutely atrocious job of reporting on this issue. I cannot think of a single scientific topic in which a single paper, based on a sample size of 12 people, has received more press than Wakefield's study. Then, add to this the fact that the study was disavowed by 10 of its 13 authors, that the study itself was redacted from the journal in which it appeared, that the lead researcher lost his license to practice medicine because of fraud, and now this revelation of intentional altering of patients' medical histories, and you have irresponsible, dangerous journalism. There is no reason on earth this study should have been treated as anything more than a fringe piece of meaningless research. But it wasn't. And that's why we have measles outbreaks in this country. People have actually said to me: "Polio doesn't exist anymore." Or: "I've never seen measles in my lifetime." This is a testament to how wonderful public health measures have been, that some of us actually believe this. But in India, for example, and Africa, there are polio outbreaks fairly regularly. Measles outbreaks in our country have become much more common. Many of these outbreaks start from a traveler from one of these countries where these diseases are alive and well. Once passed on to an unvaccinated child, we're in trouble.

Across the country, doctors are finally speaking out about this (one of my pet peeves is the tolerance of pediatricians, and so tacit approval, of parents who choose not to vaccinate their children based on Wakefield's study). MinnPost reports:


In an e-mail, Greg Poland, MD, of the Mayo Clinic, who is also editor-in chief at the journal Vaccine, wrote that the so-called vaccine hypothesis put forth by Wakefield "has hurt individuals, families, communities, and the broader public health. Children whose parents made fear-based decisions based on these claims have died, and these families are forever damaged and broken."


And Robert Jacobson, MD, chair of pediatrics at the Mayo Clinic in Rochester, Minn., blamed Wakefield for "worldwide drops in vaccination rates as well as a number of outbreaks of mumps and measles that centered in the British Isles but were felt the world over. In fact, the 2006 Iowan mumps epidemic and the 2009 New York mumps epidemic can both be traced to the British mumps virus that circulated as a result of loss of confidence in vaccination with MMR due to Wakefield."
Steve Lauer, MD, of the University of Kansas in Kansas City, had more blame to lay at Wakefield's feet: the ongoing pertussis epidemic in California. Lauer told ABC News/MedPage Today that the increase in pertussis deaths in California is "another example of completely preventable deaths linked to the decline in vaccination rates. Study after study in numerous countries involving hundreds of thousands of children have never shown any link between autism and any vaccination. That Dr. Wakefield's lies have led to increased illness and deaths among innocent infants and children is a social and medical disaster."
The damage inflicted by the Wakefield papers can be measured not only in disease and death, but also in time and anxiety, said Leonard Rappaport, MD, of Children's Hospital in Boston, who wrote in an e-mail that it was "impossible to quantify the amount of time wasted in pediatric practice discussing why we believe that the MMR does not cause autism and that children should be immunized. Second, the heartbreak and worry for parents of children with autism who have secretly believed in the quiet of the night that they were responsible for their child having an autism spectrum disorder and the anxiety of parents approaching immunization time with so much false information and fear flying around them is impossible to comprehend.

If you want to read an absolutely fascinating exchange between pediatricians on the topic of vaccinations, I highly recommend you visit Seattle Mama Doc's blog (I am having problems posting links right now). The following comment from a working pediatrician was so profoundly compelling to me, that I wanted to share it in its entirety. I had to take to my bed after reading about the two-year-old whose parents wanted a delayed vaccination schedule who then contracted pneumococcal meningitis, survived, but is now deaf for life. He would have been fine if he had been vaccinated on schedule...Read on.


I finished residency 11 years ago and have seen many. Like others have said, I also took care of a 6 week old infant that was on ECMO and went on to die from a pertussis infection she got from her father. Last year we had a 2 year old in our practice, whose parents wanted to take the “slow and careful” approach, who got pneumococcal meningitis. He survived, but is deaf for life. I would expect any pediatrician to have enough of a science background to understand the data, and avoid using personal anecdotes to dictate policy. I would not suggest that because I have not seen a case of HiB that it isn’t important to prevent, any more than I would suggest the diseases I have seen are the ones needing more treatment. We need to look at global incidence to protect our children.
I never turn a family away from my practice for refusing or delaying vaccines.
I have a 2 minute talk for parents. It comes up often. I totally understand parents questioning vaccines. They have been told by Dr. Gordon and others that vaccines cause all kinds of disease. If you search on the internet you will find people (like the ever FOS Dr. Tenpenny) who say vaccines cause diabetes, epilepsy, SIDS, ADHD, MS, cancer, autism, Parkinson’s disease, shaken baby syndrome, learning disabilities, IBD, lupus, allergies, arthritis, eczema, death and more. I think Frank Swain said it more clearly than I could, in his recent blog at scienceblogs.com.
“When mothers decide to not vaccinate their children, they are choosing to do so with only the very, very, very best intentions in the world. That they’ve been lead to believe not vaccinating is the best thing for them does not mean that they are stupid, evil, ill-intentioned, moronic. They’ve just been told a better story by ‘the other side’.”
We need to develop a relationship with parents that is based on trust. We do not recommend vaccines to make money. We do not recommend vaccines because “Big Pharma” tells us to. We recommend vaccines because we care about our patients and want to protect them.

So this news today makes me both happy and said. Happy that my children are both fully vaccinated and on schedule. But so sad for the parents who chose not to vaccinate their children or even altered the schedule because of fear of a link to autism that has, time and time again, been shown--in reputable scientific studies devoid of fraud--to be nonexistent. And I speak as someone who, with her first child, delayed an MMR vaccination by three months out of fear. My second child received her MMR at twelve months on the dot. And I am grateful every day that I have access to these vaccinations.

At the end of the day, though, despite my personal comments here, this story is about fraud and manipulation of science. In my opinion, this kind of deception is unforgivable, because those of us who are not scientists look to those who are to tell us what's safe and what's not. It's great to know that more than 90% of studies about BPA have found that there is some harmful effect to ingesting the chemical, even at low levels, because we can take steps to avoid it. What's so devious about this Wakefield study is that false information lead many people down a very dangerous road. What's worse is that so many people put their children on that road, literally out of the goodness of their hearts. And it's going to be hard for them to let go of this. I doubt we'll see Jenny McCarthy stepping forward in the next few days to apologize for encouraging people to listen to Wakefield, to take his science to the bank. That would be the human thing to do. For people who took this study to the bank to begin with, a designation of fraud will only solidify their views on this nonexistent link, will only strengthen their belief that Wakefield is somehow being persecuted. And, in fact, I see that this is exactly what is happening today. To me it is incomprehensible. What Wakefield should do, and maybe one day he will do this if his conscience bothers him enough, is to come forward and tell the truth about all this. The old Penguin editor in me wishes I was still working in publishing. I'd be on the phone so fast with a large offer for a book deal for Wakefield, if he writes about the fraud and the lies, and finally comes out and says "it was all smoke and mirrors."

Here is the link to the CNN article and