Saturday, April 23, 2011

Andrew Wakefield and the "MMR Vaccine Causes Autism" Deception

The New York Times Magazine has a long feature on the post-disgrace life of Andrew Wakefield, the titular head of the anti-vaccine crowd who has lost his license to practice medicine and been cast as an unethical scientist as a result of his fraudulent study. He was even forced to drop his libel suit against Channel 4 in England because, well, they told the truth (which meant he also had to pay their costs).

P2P Foundation founder Michel Bauwens shared the link on his Facebook page and it created an animated debate between two people who represent the opposing views in the autism debate.

One view, best represented by Jenny McCarthy, is the "science is all lies" and "we can't trust the medical establishment" perspective. She now claims to have cured Even (her son) of autism through diet, an approach saner people have been arguing for decades.

The other view is that "science is the only answer" and "medicine is the only way to discover answers" perspective, best represented by the scientific community who largely dismissed Wakefield's "proof" from day one.

I'm not sure why I weighed in on the discussion, but I did - and it seems to me this is simply one manifestation of how ignorance about science (in general) and the inability to use discernment (in particular) are causing all kinds of problems in our culture. I think this is as true for scientists sometimes as it is for the general populace.

Here is some of the article from the NYT magazine:

The Crash and Burn of an Autism Guru

Published: April 20, 2011

As people streamed into Graceview Baptist Church in Tomball, Tex., early one Saturday morning in January, two armed guards stood prominently just inside the doorway of the sanctuary. Their eyes scanned the room and returned with some frequency to a man sitting near the aisle, whom they had been hired to protect.

The man, Andrew Wakefield, dressed in a blazer and jeans and peering through reading glasses, had a mild professorial air. He tapped at a laptop as the room filled with people who came to hear him speak; he looked both industrious and remote. Broad-shouldered and fair at 54, he still has the presence of the person he once was: a conventional winner, the captain of his medical school’s rugby team, the head boy at the private school he attended in England. Wakefield was a high-profile but controversial figure in gastroenterology research at the Royal Free Hospital in London when, in 1998, he upended his career path — and more significant, the best-laid plans of public-health officials — by announcing at a press conference that he had concerns about the safety of the measles-mumps-rubella vaccine (M.M.R.) and its relationship to the onset of autism.

Although Wakefield did not claim to have proved that the M.M.R. vaccine (typically given to children at 12 to 15 months) caused autism, his concerns, not his caveats, ricocheted around the world. His belief, based on a paper he wrote about 12 children, is that the three vaccines, given together, can alter a child’s immune system, allowing the measles virus in the vaccine to infiltrate the intestines; certain proteins, escaping from the intestines, could then reach and harm neurons in the brain. Few theories have drawn so much attention and, in turn, so much refutation: a 2003 paper in The Archives of Pediatrics and Adolescent Medicine, which reviewed a dozen epidemiological studies, concluded that there was no evidence of an association between autism and M.M.R., and studies in peer-reviewed journals since have come to the same conclusion. In Britain, the General Medical Council revoked Wakefield’s medical license after a lengthy hearing, citing numerous ethical violations that tainted his work, like failing to disclose financing from lawyers who were mounting a case against vaccine manufacturers. The Lancet, which published the original Wakefield paper, retracted it. In a series that ran early this year, The British Medical Journal concluded that the research was not just unethically financed but also “fraudulent” (that timelines were misrepresented, for example, to suggest direct culpability of the vaccine).

Andrew Wakefield has become one of the most reviled doctors of his generation, blamed directly and indirectly, depending on the accuser, for irresponsibly starting a panic with tragic repercussions: vaccination rates so low that childhood diseases once all but eradicated here — whooping cough and measles, among them — have re-emerged, endangering young lives.

You can read the article for yourself - it's actually pretty fair.

The following is my comment from this FB discussion - I try to ground my views in the facts, as well as some science that is often not recognized as part of the debate. I have expanded my thoughts a bit here, since this is an easier format to write in than the FB comments box, and I have included links to relevant articles.

* * * *

The facts of the case speak for themselves:
I hate big pharma as much as the next person (and I totally distrusted their flu hysteria last year), but I really HATE greed masquerading as a science and seeing gullible people who do not understand science being sucked in by a weasel. Wakefield is a weasel who will never back down as long as he is making millions from the anti-vaccine crowd in the U.S.

People seem to lack discernment (as well as knowledge) around issues like these.

For example, it's entirely possible that some kids with autism do also have an intestinal disorder (we know the gut contains many of the
same neurotransmitters as the brain - and that bacteria in the gut can influence brain function). It's entirely possible he was on to something with his gut hypothesis, but he went the wrong direction and has refused to change direction.

There has never been any evidence that the MMR vaccine is involved in gut disease. Even his own lab could not replicate the results linking the measles vaccine to "
autistic enteropathy." At this point, most scientists feel the MMR vaccine is the only thing we can rule out as a cause of autism - Wakefield's original paper spurred tons of research, none of which confirmed or replicated his results.

It's also alarming that Wakefield's supporters fail to consider the incredible lack of ethical integrity he exhibited with that paper and his defense of it. It's one thing to generate research that is disproved - that happens to a lot of great scientists and it's why the scientific method relies on replication of results, so that an anomalous finding can be checked and rechecked.

However, it's a whole other thing to manipulate the research to provide the results you are looking for - and to have a financial interest in those results. Not to mention the use of unwarranted invasive procedures:

including colonoscopies, colon biopsies and lumbar punctures ("spinal taps") on his research subjects without the approval of his department's ethics board and contrary to the children's clinical interests (BBC News, 2007)
Two of the commentators on FB seem to me to be arguing form the extremes of each perspective, but science, while not the answer to everything, is more reliable than general distrust of science, especially when we are dealing with physiological systems - so Science Guy (SG), in my opinion, is on more solid ground, although I am more skeptical in general than he is

To me, Anti-Vaccine Girl (AVG) is offering the type of argument that wants "intelligent design" to be taught as an equal theory to evolution. She distrusts science and medicine so she attaches to anything that confirms her distrust. But the scientific method works incredibly well, even if she does not believe in it. As proof, she drives a car, uses electronic devices, does not have polio, and so on, including having food in cupboards that does not rot - all of which resulted from the scientific method

Where I see the current science heading is toward the kind of systems model SG advocates. For example, we are learning more about how nutrition impacts brain function (if your kid has ADHD, s/he should eat only whole natural foods, get plenty of omega-3 fats, and consume little to no sugar, including fruit sugar/juices, only whole fruit such as berries). We are also learning that the enteric nervous system (the gut) is highly integrated in brain function - all of this points to the mind = brain/body, not just the brain.

It saddens me to so little understanding of science in those who could most benefit from it (parents of autistic children) - and so little discernment when people become emotionally involved in a cause.

* * * *

There are a lot more perspectives to the autism issue than just these - we would also need to be looking at:
  • Environmental toxins such as xenoestrogens
  • Epigenetic influences from the mother and father before the pregnancy, and from the mom during pregnancy
  • More research into nutritional status
  • Some follow-up on the connection (if any) between the function of the enteric nervous system and autism
  • Likely over-diagnosis of the disorder in recent years because parents pressure doctors into explaining why their kid is not gifted
  • Lack of complete understanding of developmental processes and pacing even in healthy kids (some kids grow out of being autistic)
  • The subjective experience of the autistic child might offer a huge insight
  • What role does Big Pharma play in promoting autism as a disorder for which they hope to have a drug - lots of autistic kids are already drugged with antipsychotics to keep them docile
The list could go on for days - the point is that we need to take an integrative (or integral) approach to this very complex problem.


Anonymous said...

I'm disappointed by your comment on this controversy. Having followed the subject for many years, these are my conclusions. Wakefield's theory was wrong. He was entirely sincere in his research and belief in it. The ethics claims against him wildly overstate his misdeeds, and then invent motivations for them that seek to destroy him personally.

We need good ongoing research into vaccine safety. Is that going to be possible now?

Allison said...

First of all, I do not think that Wakefield was sincere in his research. A sincere person does not cause a worldwide panic supported by data that is inconsistent and falsified. Not only did it cause this anti vaccine movement but it put the health of children who were not administered the MMR vaccine in jeopardy. There are many issues behind his experiments and data that were collected. Overall Wakefield’s experiment and conclusions became a complete conflict of interest. His experiments were funded by a company that was against the success of vaccine manufacturers. His data was collected on patients that already had symptoms of autism before being administered the vaccine. Wakefield's medical ethnics are also in question because he performed invasive, harmful procedures to the patients. The Immunization Safety Review Committee has deeply researched this matter and concluded that Wakefield's claims were false. Other scientists performed Wakefield's experiment step by step and did not end up with his conclusion that the MMR vaccine is linked to autism. On top of all of this, Andrew Wakefield is a gastroenterologist; not an expert in neurological disorders or vaccines in any way shape or form.