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Dr. Wakefield, MMR & the GMC Hearing – Calling the British Media’s Bluff

Posted Jan 22 2010 12:00am

Dr. wakefield By John Stone

With the General Medical Council hearing against Drs Wakefield, Walker-Smith and Murch due to announce its preliminary findings in less than a week there is little doubt that the UK media will play the line that whatever happens the science is over – yet they have every reason to believe that this is not true and continue to blank the specific criticisms with ad hominems against supporters of Andrew Wakefield. They have had it demonstrated:

1) The persistence of measles of virus in the gut (the most controversial part of Wakefield’s hypothesis)  is an established reality

2) The epidemiological evidence base for the safety of MMR vaccine (and particularly in relation to autism) is non-existent

3)  Autism incidence has spun out of control despite denials

Until they answer the criticisms their journalism will remain vacuous  opinionising: no better than propaganda. Above all, they can scarcely counter that they are unaware of the problems, because I for one have assiduously placed them back under their noses, year after year – notably with such opinion leaders as Jeremy Laurance, medical editor of the Independent, and Ben Goldacre, author of the Guardian’s Bad Science column.

In the case of Laurance (although Goldacre is deeply implicated to) I placed a challenge for him in BMJ Rapid Responses recently (BMJ HERE), and then when he did not reply, placed the link in an editorial he wrote in his own newspaper (Independent HERE ).

Laurance set the scene with his comment on the MMR affair in his review of the decade in British Medical Journal:

No vaccine in recent history has provoked so much anger, fear, and ill informed speculation. It started in 1998 with the publication of the now infamous Lancet paper linking MMR vaccine with bowel disease and autism. Vaccination rates with MMR stood at 91% in 1997-8 but had slipped to 80% in 2003-4 and as low as 60% in parts of London. Although the rates have since recovered to 85%, hundreds of thousands of children remain unprotected from the diseases and cases of measles have soared.


One of the greatest puzzles of the saga is what has sustained this level of mistrust in the medical authority. Unlike most scientific controversies, which flare up and die away, this one has simmered for a decade. And it looks set to be fired up again by the conclusion of the General Medical Council case against the chief author of the Lancet paper, Andrew Wakefield, which is expected to conclude early in 2010.

To which I responded:

Laurance [1] writes:

"One of the greatest puzzles of the saga is what has sustained this level of mistrust in the medical authority."

It may seem like this to a newspaper journalist, not paying enough attention to the small print, but it does not seem like this to many autism parents. One of the features of this episode is the reverse spin given to studies which actually support further concern.
For instance, a widely reported study by Hornig et al 'Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study' actually immeasurably enhanced the plausibility of the Wakefield hypothesis by showing the persistance of measles virus in the ileum of two patients (one autistic, one control, but both with bowel disease and having had MMR) confirmed in 3 laboratories. To cap it all in the discussion the authors stated:

"Our results differ with reports noting MV RNA in ileal biopsies of 75% of ASD vs. 6% of control children... Discrepancies are unlikely to represent differences in experimental technique because similar primer and probe sequences, cycling conditions and instruments were employed in this and earlier reports; furthermore, one of the three laboratories participating in this study performed the assays described in earlier reports. Other factors to consider include differences in patient age, sex, origin (Europe vs. North America), GI disease, recency of MMR vaccine administration at time of biopsy, and methods for confirming neuropsychiatric status in cases and controls." thus, quietly endorsing the results of the Uhlmann (O'Leary/Wakefield) study [2,3]. These anomalies were not picked up or reported by mainstream journalists.

Another key case is the Cochrane review of MMR 2005 [4], which actually gave a poor review to the six autism studies included, and found little evidence for the vaccines safety - indeed, had found the safety studies to be "largely inadequate" - against which the claim that it had not found any evidence that MMR causes autism and bowel disease has to be assesed for its relevance [5].

Meanwhile, a Cambridgeshire study of autism in children detected an incidence of ~1 in 60 [6], a result which the Observer newspaper was pilloried for reporting by Ben Goldacre and the lead author Simon Baron Cohen, ahead of the GMC hearing against Wakefield and colleagues [7], but which later turned out to be well-founded.

Whatever happens at the GMC, I suggest, the greatest gap in credibilty lies with a scientific profession which has failed to explain what is happening to our children.

[1] Jeremy Laurance, 
'Health stories of the decade'  

[2] Hornig et al, 
'Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study'  

[3] Uhlmann et al,
'Potential viral pathogenic mechanism for new variant inflammatory bowel disease'

[4] Demicheli et al,  'Vaccines for measles, mumps and rubella in children' 

[5] John Stone,  'Re: Evidence is not bullying'  

[6] Baron-Cohen et al,
'Prevalence of autism-spectrum conditions: UK school-based population study', Br J Psychiatry. 2009 Jun;194(6):500- 9,  

[7] Ben Goldacre, 
'MMR: the scare stories ar back',  
Competing interests: Autistic son

Equally, these issues have been repeatedly placed before Goldacre, both on his Guardian Blog and BMJ Rapid Responses.

So far they have absolutely no answer except the arrogance of their own silence, and the act is wearing a pretty thin. The time has come for the truth: how can they be censorious about Wakefield when they behave like this?

John Stone is UK Editor for Age of Autism.


 

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