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Brian Deer in the BMJ: How the case against the MMR vaccine was fixed

Posted Jan 05 2011 6:01pm

Brian Deer, the investigative journalist who broke the story of the misdeeds of Andrew Wakefield, has a new article in the BMJ, How the case against the MMR vaccine was fixed . The article is prefaced:

In the first part of a special BMJ series, Brian Deer exposes the bogus data behind claims that launched a worldwide scare over the measles, mumps, and rubella vaccine, and reveals how the appearance of a link with autism was manufactured at a London medical school

This article is damning enough, but as a series this may lay out clearly, in one place, the cases behind the multiple ethical breaches which cost Andrew Wakefield his license to practice medicine in the UK.

Some may ask “why?” There is so much information out there about Mr. Wakefield and his misdeeds. Do we really need it again? I would say yes. In this BMJ series we have the research (and other) ethical lapses laid out in a medical journal. No lengthy GMC transcripts. No news stories with false balance. No “Callous Disregard” book.

The full article is worth the read. Here is the summary from today’s article.

How the link was fixed

The Lancet paper was a case series of 12 child patients; it reported a proposed “new syndrome” of enterocolitis and regressive autism and associated this with MMR as an “apparent precipitating event.” But in fact:

•Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism

•Despite the paper claiming that all 12 children were “previously normal,” five had documented pre-existing developmental concerns

•Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination

•In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school “research review” to “non-specific colitis”

•The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations—all giving times to onset of problems in months—helped to create the appearance of a 14 day temporal link

•Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation

In multiple ways, the story of the Lancet article was crafted to support the conclusion Mr. Wakefield had—a conclusion he came to before starting on the research project.

Yes, before.

In his research proposal to the legal aid board, Mr. Wakefield made the following statement (quoted in Mr. Deer’s article):

““In contrast with the IBD cases [those set out in paragraph 2] which have a prima facie gastrointestinal pathology, children with enteritis/disintegrative disorder form part of a new syndrome. Nonetheless, the evidence is undeniably in favour of a specific vaccine induced pathology. ”

Mr. Deer presents a table comparing how the Lancet article reported the 12 children and how the records really show their cases. He compares regressive autism (only 1 patient’s records clearly show it), non-specific colitis (only 3 children showed it) and whether symptoms occured in the days following MMR (10 clearly did not, 2 are unclear). In all, none of the Lancet 12 children had all three features.

So that is the Lancet 12: the foundation of the vaccine scare. No case was free of misreporting or alteration. Taken together, NHS records cannot be reconciled with what was published, to such devastating effect, in the journal.

Mr. Deer opens his piece with a discussion he had with the father of child 11. Mr. 11 did not agree with the way his son was represented in the Lancet article. Mr. 11 states:

“Please let me know if Andrew W has his doctor’s license revoked,” wrote Mr 11, who is convinced that many vaccines and environmental pollutants may be responsible for childhood brain disorders. “His misrepresentation of my son in his research paper is inexcusable. His motives for this I may never know.”

We may never know the motives. In the end, I don’t care. It is the damage that this fraudulent research has caused to the autism communities and to public health that matter. Countless families have believed Mr. Wakefield, with parents blaming themselves for causing their child’s disability. As to public health, Mr. Wakefield is responsible for a drop in vaccine uptake in the UK, which led to disease and death.

Further reading on the subject can be found at Action For Autism with Wakefield and the MMR Autism Hoax

  1. Hilary:
    Your link doesn't work and I can't access the BMJ. is it possible to provide a link to the full article?
  2. Tweets that mention Autism Blog - Brian Deer in the BMJ: How the case against the MMR vaccine was fixed « Left Brain/Right Brain -- Topsy.com:
    [...] This post was mentioned on Twitter by Kev. Kev said: Brian Deer in the BMJ: How the case against the MMR vaccine was fixed: Brian Deer, the investigativ... http://bit.ly/f0Pd2s [...]
  3. Sullivan:
    Hilary, here is one part of the story http://www.bmj.com/content/342/bmj.c5347.full
  4. Wakefield studies slammed by BMJ | Code for Life:
    [...] be many more “short takes” in no time at all: shorter accounts of the articles can be found at Left Brain, Right Brain (includes the bullet-point summary from Deer’s article) and [...]
  5. daedalus2u:
    Is there any way Wakefield can be brought up on criminal charges for this? Children died from measles after he used fraud to scare parents away from vaccines. He knew what he was doing. He knew measles killed people. He knew parents would not vaccinate their children. He knew that would bring measles back (which it did). He knew that would kill children (which it has). He should be brought up on charges of reckless endangerment if not manslaughter or even murder.

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