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Andrew Wakefield: The Galileo Gambit writ large in The Observer

I just don’t understand it.

I just don’t understand how anyone can take discredited antivaccination loon Andrew Wakefield seriously anymore. In particular, I don’t understand how any reputable newspaper can actually take him seriously anymore, given how thoroughly he and his “work” have been discredited. First came the news in late December that at the time he did his “research” that purported to show a link between the MMR triple vaccination and autism and bowel problems, Dr. Wakefield was in the pay of lawyers looking to sue for “vaccination injury” and failed to disclose his clear conflict of interest. Indeed, for that he is scheduled to appear before Britain’s General Medical Council on July 16 to answer this charge, among many others, including ethical lapses in their research such as doing unnecessary procedures that were not medically indicated.

More recently, his reputation took an even nastier pummeling during the Autism Omnibus hearings in Washington, D.C. Dr. Stephen Bustin, a world expert on the polymerase chain reaction (PCR), particularly quantitative PCR, explained in gory detail how the laboratory that Wakefield used to measure measles virus RNA sequences from the colon biopsies of autistic children used such shoddy technique and failed to use proper controls that it was very clear that the measles virus RNA that Wakefield claimed to have detected in the colon biopsy specimens was in reality due to widespread contamination of the laboratory with plasmid containing measles sequences. Worse for Wakefield, Dr. Nicholas Chadwick testified that in every case in which he detected measles sequences by PCR, sequencing the product revealed that it was the same as the laboratory strain and didn’t match up with any known natural or vaccine strains of measles and that all the specimens that he tested were either negative for measles virus or turned out to be false positives. Worse still, he testified that he informed Dr. Wakefield of his results. If the combination of Wakefield’s conflict of interest, unethical conduct, shoddy science, and reporting of results that one of his underlings had shown to be incorrect aren’t enough to destroy his credibility forever, I don’t know what is.

All of which makes this article in yesterday’s Observer all the more puzzling, emblazoned with the headline, I told the truth all along, says doctor at heart of autism row. In antivaccination land, Wakefield remains a persecuted hero, and he’s now playing the martyr for science role to a nauseating extreme:

To supporters, Wakefield is a hero, a lone crusader for truth and a principled, caring doctor challenging a policy that is harming significant numbers of children. Some scientists, a handful of doctors and parents of sons and daughters they claim have been damaged by the triple vaccine see him as the victim of a Department of Health-led plot to discredit him, and the GMC hearing as a show trial designed to suppress an uncomfortable truth. Wakefield, talking to The Observer in his only interview before the hearing, says he plans to defend himself vigorously against allegations he sees as ill-conceived and malicious. ‘I’ve done what I’ve done because my motivation is the suffering of children I’ve seen and the determination of devoted, articulate, rational parents to find out why part of them has been destroyed, why their child has been ruined. Why would I go through this process of professional isolation if it was simply to do with egomania? My alleged egomania doesn’t explain things very well. There’s been no upside for me in having pursued this issue. It’s been very difficult.

‘As Vaclav Havel once said: “Follow the man who seeks the truth; run from the man who has found it.” I can’t tell you that we know that the MMR vaccine causes autism. But the Department of Health can tell you with 100 per cent certainty that it doesn’t, and they believe that, and that concerns me greatly.’

Václav Havel? The playwright turned political activist in Czechoslovakia who spent several terms in prison for his political activities opposing the Soviet-style Communist government in the 1970s and 1980s, who ultimately played a major role in the Velvet Revolution of 1989 that led to the bloodless overthrow of Communism and then became President of Czechoslovakia and later the first President of the Czech Republic? A man whose nonviolent resistance and frequent imprisonment has led him to be compared to Gandhi and Nelson Mandela? My, Wakefield sure has an inflated opinion of himself, doesn’t he? Continuing with the metaphor, he then follows the script and cries persecution:

Wakefield explains that legal advice and his desire not to turn the GMC panel against him, mean he is unable to respond directly to the allegations. But friends say that he views the GMC hearing as part of a long-running ‘Stalinist’ campaign to ruin his reputation. He and his co-accused deny all the claims.

Wakefield told The Observer that he has no regrets for saying what he did in 1998 nor for continuing to seek to prove his view of MMR as the likeliest explanation for the rise in cases of autism in Britain. Almost every child health expert, though, regards the jab as hugely beneficial to public health and rules out any connection between it and autism.

‘My concern is that it’s biologically plausible that the MMR vaccine causes or contributes to the disease in many children, and that nothing in the science so far dissuades me from the continued need to pursue that question’, Wakefield said. ‘The trend in autism has gone up sharply in many countries. It’s interesting that that increase coincides in many places with the introduction of the MMR vaccine. That doesn’t make it the cause. But it’s an observation that needs to be explained, because there was clearly some environmental change at that time that led to growing numbers of children becoming autistic. It’s a legitimate question if MMR is one of those factors. I fear that it may be.’

“Stalinist campaign”? Nice touch, given his previous Havel analogy.

Despite what Wakefield says, a link is, in 2007, not biologically plausible. Even back in 1998 when Wakefield first published his paper and stirred up hysteria about the MMR, it was only a borderline plausible hypothesis. Subsequent science, including virology and epidemiological studies among others, have failed to find any correlation between MMR and autism in the intervening nine years have rendered the hypothesis even less plausible than it was then. Of course, if you want to invoke the Galileo gambit these days, you want to do it with a more contemporary spin to it, and Wakefield doesn’t disappoint:

As the Havel quote suggests, Wakefield sees himself as a dogged seeker after a disturbing truth. He compares himself to the small band of doctors who, soon after Aids emerged in the Eighties, pinpointed a previously unknown virus (HIV) as the cause, only for their theory to take years to become established.

‘In the Thatcher-Reagan era, Aids was originally seen as something politically unacceptable, as an act of God or a gay plague – as anything but our problem. People were stigmatised,’ he said. ‘We are looking at something with autism which is similarly politically unacceptable. That is, how could one of medicine’s modern miracles possibly be associated with damage to children? Because if it’s shown to be linked, then it becomes less of a miracle and more of a potential scandal.’ He believes that the Department of Health introduced MMR into the UK in 1988 to save money and that he has been persecuted for daring to take on powerful political and drug industry interests.

Yes, indeed, like all good cranks, Wakefield sees dark conspiracies against him because he has The Truth, and, like many good cranks, he vows to fight on, no matter what the cost…for the children, of course:

In the Italian restaurant, Wakefield fires a parting shot before another meeting with his lawyers. ‘I’m determined to continue to do this work, regardless of the personal cost. It has to be done. Because the parents of these children deserve an answer, and their children deserve help and they can be helped’, he says. ‘My colleagues and I won’t be deflected by the interests of public health policymakers and pharmaceuticals. I want to help children with autism; they are my motivation. If the work ultimately exonerates the vaccines, that’s fine. If not, we need to think again.’

Sure, Andy. Anything you say.

Why a newspaper would give an interview to someone like Andrew Wakefield, as pompous and self-serving as he is, is something that I can sort of understand. After all, he’s controversial, and he caused a lot of mischief, not the least of which is the anti-MMR hysteria and fear that gripped the U.K. in the years after his dubious paper was published, which ultimately led to a significant decrease in the vaccination rate, with an increase in the number of measles cases. Indeed, last year, for the first time in 14 years, a boy died of the measles. The boy was not vaccinated. Given that background and Wakefield’s upcoming hearing in front of the GMC, he’s newsworthy, and any reporter worth his or her salt would love to get an interview with him. Of course, any reporter worth his or her salt would not have given such a fawning, sycophantic interview. Any reporter worth his or her salt would have asked some–shall we say?–uncomfortable questions. (Calling Brian Deer!) True, the Observer did trot out the expected voices for “balance” pointing out that there’s nothing to support Wakefield’s allegations, but the overall tone of the interview was very sympathetic to Wakefield and his point of view.

What I can’t explain is the second article that was published in the same edition, New health fears over big surge in autism:

The number of children in Britain with autism is far higher than previously thought, according to dramatic new evidence by the country’s leading experts in the field.

A study, as yet unpublished, shows that as many as one in 58 children may have some form of the condition, a lifelong disability that leads to many sufferers becoming isolated because they have trouble making friends and often display obsessional behaviour.

Seven academics at Cambridge University, six of them from its renowned Autism Research Centre, undertook the research by studying children at local primary schools. Two of the academics, leaders in their field, privately believe that the surprisingly high figure may be linked to the use of the controversial MMR vaccine. That view is rejected by the rest of the team, including its leader, the renowned autism expert, Professor Simon Baron-Cohen.

Let’s parse this a bit. First of all, it’s an unpublished study, which immediately makes me wonder why it was reported to the press. Professor Simon Baron-Cohen is a reputable autism researcher and would presumably have been unlikely to have gone to the press with the story before the results of whatever study he is working on had been accepted for publication. Now, consider that two of the team are reported to think that these results somehow link the MMR to autism.

Gee, I wonder which team members leaked the story to the press. I also wonder about the timing of this particular story, coming so soon before Wakefield’s appearance before the GMC. More importantly, I wonder why the Observer didn’t tell its readers about the two who seem to think this study somehow links autism to the MMR vaccine, Drs Fiona Scott and Carol Stott. For example, Ben Goldacre points out that Dr. Stott has long been a player in the “MMR causes autism” movement, pointing out a very bizarre, profanity-laden, late night e-mail exchange that she had with Brian Deer, the journalist who has done more to reveal the depths of Wakefield’s mendacity than anyone else, behavior that led her to be warned by the British Psychological Society, the UK regulatory body for chartered psychologists. She’s also followed Dr. Wakefield to his Thought House Center for Children. Moreover, as reported by Brian Deer, both Drs. Stott and Scott both collected big bucks in the MMR Autism U.K. litigation, £100,000 to Dr. Stott and just over £27,000 to Dr. Scott.

Arthur Allen recently wrote an excellent article about why the myth that vaccines cause autism just will not die, no matter how much the science argues against it. Basically, confirmation bias and the fallacy of thinking that correlation equals causation combine with two of the most potent emotional forces in existence, a parent’s bond to his or her child plus the desire to raise a child as he or she sees fit, with the resulting resentment of what some see as intrusive government mandates, among which the requirement that children be vaccinated is a huge one. Couple that with the need to blame something or someone for their child’s autism, and for all too many parents of autistic children, the result is a rock solid belief that vaccines, be it the MMR vaccine or thimerosal in vaccines, cause autism, a belief that, for some parents, no amount of scientific evidence countering it will dispel, because any such evidence is attributed to a vast “conspiracy” to hide The Truth. Sadly, that belief still appears to be alive and well in the U.K. to perhaps an even greater extent than in the U.S.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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