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Why the MMR-autism ?war? is far from over

Posted Sep 12 2008 12:00pm
Posted on 30 May 2008

This blog is about the safety of MMR and the science and politics surrounding this issue. I didn’t have any intention of writing about this until very recently. Let me say up front I have no special interest in this area, other than having met a significant number of people who believe their children have been damaged by vaccines. I mentioned the possibility of vaccine damage in my blog of last Friday which can you read here. This remark came in a post that was mainly about the limited value of the concept of ‘statistical significance’ in the real world.

In summary, my point was that what is deemed ‘statistically significant’ is determined by arbitrary cut-offs known as ‘P-values’. I mentioned MMR vaccination because statistical significance is often invoked when we are being ‘persuaded’ that MMR is safe. But, as I was at pains to point out, just because there is no ‘statistically significant’ link between MMR and some adverse effect, doesn’t prove that MMR doesn’t cause that adverse effect. To provide a graphic example of this I used an analogy: crossing the road may not be linked with a statistically significant increased risk of getting run over, but that doesn’t mean you can’t get run over crossing the road. Accidents can happen, after all.

One of the reasons I chose to focus on MMR last Friday is because it’s an issue where I think some have attempted to use ‘science’ to silence anyone who expresses an opinion that they do not like or disagree with and would like labeled as a ‘dissenter’. Sometimes I have been aghast at the bullying, aggressive, uncaring tone of those who would have us see those who believe their children may have been damaged by vaccination as stupid, or hysterical, or simply looking for someone or something to blame for their child’s illness.

So, I perhaps should have been too surprised when someone took me to task over the merest mention of the concept that MMR vaccination might not be a safe as we are repeatedly told it is. ‘Jdc’ in his comment (number 18) seems keen to show me what he believes are the errors of my ways, and then draws our attention to the UK Government’s dedicated MMR site. Have a look here for the soothing reassurances it offers regarding the safety of MMR.

You can read my reaction to the largely misleading, irrelevant, nonsense written there in my comment number 20 here. It seems clear to me that some will bend over backwards to insist that MMR is safe, even if that means taking people for complete dummies.

Thinking about this yesterday reminded me of how the whole MMR/autism debacle got underway. And anyone who knows anything about this subject at all will be familiar with the name Dr Andrew Wakefield. For he is the doctor often ‘blamed’ for any mistrust in MMR as a result of his study, published a decade ago, which suggested that their might be link between vaccination (the measles component of the MMR vaccine) and bowel disease/autism.

Some of you may know that on and off now for about the last year Andrew Wakefield has been answering charges put to him by the General Medical Council in the UK (this is the body that regulates medical practice in the UK, and it has the power to strike individuals off the medical register). Dr Wakefield stands accused of a variety of charges including conflict of interest (it is alleged he received money from legal sources that he did not declare when he published his paper). He also is accused of subjecting children in his research to unnecessary tests, and not having ethical approval for the research in the first place.

Now, most of us will be aware of the big brouhaha regarding Wakefield’s research, but the reporting on his case with the GMC has been scant to say the least. There are no restrictions on the reporting of this case, so why the near ‘radio silence’? In a quiet and undisturbed couple of hours yesterday I thought I’d find out what I could about the Wakefield case, and report it here.

Looking at press reports, I did find a flurry of activity in April when it emerged that Dr Wakefield had admitted on questioning, that he didn’t know that much about the medical ethics of paediatrics cases. The ‘shock horror’ way this was reported was somewhat surprising to me. Because it seems to me that whether the research was ethical or not was not Dr Wakefield’s call. That was the call of the ethical committee. So, the real issue is whether the research he undertook had ethical approval or not (more on that later). This story was, to all intents and purposes, a non -story.

Since then, from what I can make out, we’ve had no stories in the mainstream press regarding how the case is going. I did find this radio broadcast/podcast though on a site dedicated to autism issues ( http://www.autismone.org ). It features the accounts of the Dr Wakefield/GMC trial from Dr Carol Stott (a psychologist and friend of Andrew Wakefield) and Jim Moody (a lawyer with a special interest in the area). This piece is hosted by someone called Polly Tommey. The first quarter or so of the piece focuses on the alleged misdemeanours of the journalist Brian Deer, who had investigated Dr Wakefield for the Sunday Times and Channel 4 in the UK, and who some believe instigated the GMC case against Dr Wakefield. This section of the recording is all a bit melodramatic and cloak and dagger for my liking, and its true relevance to the case is somewhat tenuous, I believe. However, I reckon it’s worth sitting through, though, if only to get to the interviews with Dr Carol Stott and Jim Moody.

It appears from their accounts that Dr Andrew Wakefield has put up a very robust defense with regard to all the allegations he faces. From what I could glean here, there really is no case to answer. If you listen to Jim Moody’s interview, he suggests that the prosecution team have made deliberately false allegations concerning Dr Wakefield, or at the very least did not do their due diligence with regard to the case or were just extremely careless.

Other revelations even more significant revelations followed. Dr Wakefield’s research was published in the Lancet medical journal, edited by Dr Richard Horton. Ever since the MMR/autism storm started Dr Horton has been trying doing his level best to distance himself from Wakefield’s research (although, it should be pointed out that the Lancet organised a press conference to trumpet Wakefield’s findings).

Perhaps as part of this effort, Dr Horton has said that if he knew about Dr Wakefield’s alleged financial conflict of interest prior to publication, he would not have sanctioned its publication. Dr Horton testified to this effect in front of the GMC last year. However, listening to the autismone podcast I discovered that evidence has come to light which appears to prove that Dr Horton was aware of the alleged conflict of interest well before the study was published. In other words, it appears Richard Horton is lying (or has a very bad memory indeed). Jim Moody suggests there’s a case for Richard Horton himself to be up in front of the GMC, on a charge of giving false testimony.

To me, this really is news, and of an order of magnitude far, far greater than the fact the Andrew Wakefield has no specific expertise in paediatric ethics. Hands up now, how many of you out there knew about the fact that the editor of the Lancet medical journal (one of the most ‘respected’ medical journals in the World) appears to have committed perjury? I’d be surprised if many of you do, because I can’t find a single reference about this in the mainstream press. Remember, there are no restrictions on the reporting of this trial.

So, while this week I had no intention to write about MMR, I now feel compelled to do so as a result of what I found when I looked: It seems to me that some distinctly shoddy science and no small amount of bullying has been used in an attempt to ‘silence’ those who dare suggest there is a link between MMR vaccination and autism, including countless parents who believe they witnessed the regression into autism of their children after MMR vaccination before their very eyes. And of course someone’s head had to roll, and Dr Wakefield’s was the obvious one to lop off. Yet, it seems that there really was never any case to answer. And now we find it looks as though the editor of the medical journal who published Dr Wakefield’s research is prepared to lie through his teeth to save his skin and ensure that any fingers of accusation point elsewhere. And the press, for some reason, is keen to have Dr Wakefield the pariah, and is not interested in reporting honestly and openly about the case brought against him by the GMC.

But getting back to the safety issue, it is my contention that the science used to ‘prove’ MMR does not cause autism is simply inadequate. And I’m not the only person who thinks so: In my research yesterday I came across this video interview where you can see and hear Dr Bernadine Healy, former director of the National Institutes of Health in the USA, express her concern about the way in which a link between vaccination and autism has been so readily dismissed. She accuses the US Government health officials of deliberately not doing the scientific which would show, once and for all, whether vaccines can cause autism, and if so, what the extent of the risk is (so that parents can make an truly informed choice about whether to have their child vaccinated or not). And Dr Healy also suggests that the reason for why the US Government has not done the definitive scientific work is because it is afraid of what it might find when it looks. The interview concludes by Dr Healy stating that the question about whether vaccination can cause autism has still not been answered.

In the interview, Dr Healy refers to research in primates which has been dismissed. Even this month, research has come to light which finds that subjecting infant primates to a ‘human’ vaccine schedule led them to exhibit autistic symptoms. And on top of this, the US Government recently conceded (out of court) that a child’s (Hannah Poling) autistic state had been significantly contributed to by vaccines she had as a toddler.

The issue of MMR’s safety has not been a debate, more a war. And a brutal one at that. Some, it seems, have attempted to misuse science to bludgeon dissenters into silence. But they have not gone away, and neither should they. And now some dirty great cracks are starting to show in the defense of the pro-vaccine lobby. I might be wrong, but I think the MMR vaccine/autism war is far from over. In fact, I reckon it’s only just begun. And while the reason that the debate rages on is usually put down to the likes of Dr Wakefield and the parents who believe their children were damaged by MMR, the real guilty parties here have been our Governments whose intransigence regarding proper, definitive research in the area has inevitably left a huge question-mark hanging over MMR.

Now, I’ve got a sneaking suspicion that those of the pro-vaccine lobby will want to claim that this blog is scaremongering by making out that MMR vaccination causes autism. So, just to be clear, I’m not saying that at all. What I am saying though is that there’s a huge pile of anecdotal evidence and some experimental evidence too which supports the idea that MMR vaccination might cause autism. The evidence used to persuade us of the safety with regard to autism is simply inadequate. The fact is, I don’t know whether MMR causes autism or not. But then again, it seems neither do those who insist it is safe.

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