Black Triangle

Despite the overwhelming amount of science failing to find a link between MMR vaccine and autism, as well as the dishonest and unethical behaviour of Wakefield, there are a number of journalists still prepared to push the hoax. One of these is Fiona Phillips. You can watch her talking about MMR on Question Time, and read her call the “callous” Andrew Wakefield a caring doctor. Here she recounts her appearance on the Jeremy Vine show:

On Wednesday I was on Radio 2’s Jeremy Vine show where I had the displeasure of being shouted down by journalist Cristina Odone who said that the MMR vaccine is indisputably safe for all toddlers and that parents of children with autism are “hysterical”.

Another typical response from the bullying might of the pro-vaccine army.

It is simply irresponsible to assert that MMR suits all children and that anyone who disagrees is a hysterical parent.

Some children have an allergic reaction to peanuts. Most don’t.

Does that mean you feed peanuts to all children?

Fiona Phillips is, in part, a little bit right, but a hell of a lot more wrong. Cristina Odone is wrong to say MMR vaccine is “indisputably safe for all toddlers”. It isn’t, and sensible commentators do not make this claim. The manufacturers’ datasheet, such as immunodeficiency, leukaemias, and a history of hypersensitivity to the components of the vaccine. There are also known adverse effects of the vaccine, including the Idiopathic Thrombocytopenic Purpura (ITP) noted by the MHRA in 2001 [PDF]. However, ITP is more common with measles infection. That the MHRA should publicise a rare and serious adverse event during the MMR vaccine scare should come as some reassurance that conspiratorial views that the government and vaccine manufacturers are involved in a cover-up of vaccine harms are just that, conspiracy theories.

The peanut analogy employed by Phillips would be a good one, if there was evidence that the autism-MMR vaccine link existed. But it doesn’t. You can’t compare a real known risk, with an imaginary risk pushed by quacks pushing “cures” based on a vaccine cause.

UPDATE: You can hear Fiona Phillips on the Jeremy Vine show here.

The 1998 Wakefield paper has been retracted by The Lancet. Google Scholar suggests the paper has been cited 971 times since it was published, mostly I suspect by further studies refuting it, or editorials about the MMR-autism hoax. It’s not the only crap published by Wakefield in The Lancet. How he ever got his letter in The Lancet alleging a temporal link between MMR vaccine and autism is also beyond me.

Links worth reading:

BMJ news report:

Evan Harris, a Liberal Democrat MP and doctor, who had called for the retraction, said: “The whole thing is flawed. You should not publish or leave in the literature papers which are unethical.”

His call was echoed in the BMJ this week by Trisha Greenhalgh, professor of primary health care at University College London, who says: “The Lancet’s editor, Richard Horton, is no doubt familiar with the guidelines of the Committee on Publication Ethics (http://publicationethics.org/guidelines), which recommend that a journal should formally retract a paper if its findings are subsequently shown to be unreliable as a result of either misconduct or honest error or if the work turns out to have been conducted unethically” (Observations, BMJ 2010;340:c644, doi:10.1136/bmj.c644).

Michael Fitzpatrick on why Wakefield is not solely to blame:

The impact of the campaign against MMR cannot be reduced to the activities of one man, or even to the three men brought before the GMC: a wider failure of medical quality control and public scrutiny allowed junk science to have an adverse effect on children’s welfare and public health. Dr Wakefield’s research was supervised by the senior (adult) gastroenterologist at the Royal Free; the press conference at which he launched the demand for separate vaccines was staged by the Royal Free medical school; the transparently flawed study was peer-reviewed and published by the Lancet. Dr Wakefield’s subsequent collaborators also have a case to answer. Studies jointly published by Dr Wakefield and the Dublin pathologist John O’Leary, claiming to have demonstrated measles virus in bowel biopsies taken from children with autism, have been authoritatively dismissed as invalid, if not fraudulent.

Despite having advance warning of the Lancet paper, the government’s Department of Health and the Medical Research Council were slow off the mark in responding to the challenge and remained several steps behind Wakefield’s skilful manipulation of the media. Before Brian Deer took up the case in 2004, the media generally and shamefully took Wakefield at his own estimation as a courageous maverick.

The effect of the retraction on the US anti-vaccine celeb culture.

How Wakefield’s work has been used as part of the Cure Culture for autism, which has led care for autistic children down a dead end (quite literally in some cases.)

Liz Ditz has a full list of article and blog posts if you are interested.

In an editorial full of fail in the Mail about the Wakefield judgment, two point stands out for me. The first is an amazing lack of knowledge about the public money spent on the Wakefield hoax:

And the parents? They were denied the legal aid (available to every Tom, Dick and terrorist [they really are beyond parody] Harry) to fund a court case that might have resolved the matter quickly and conclusively.

It is worth remembering that Wakefield had received £55,000 in legal aid in 1996 concerned with these cases two years prior to the Lancet paper. Even more importantly, the Legal Services Commission had spent £15 million on the cases by 2003, and only denied further monies when it was clear that nothing would come of spending a further £10 million of public money. A court case quite clearly was not resolving the matter quickly and conclusively. You only need to look to the US to see the likely outcome, where Wakefield’s research was described as a “deception”.

The second point relates to the invocation of the John Gummer:

After all, when it comes to health issues, governments and scientists are not infallible.

Who can forget John Gummer forcing his daughter to eat a beef burger at the start of the BSE crisis, the thalidomide scandal, the countless drugs that have had to be withdrawn, and HIV infected blood supplies?

The Gummer comment is interesting because the Mail pushed the Blair should tell us about Leo Blair’s vaccination status at every opportunity, helped by the anti-MMR Member of Parliament Julie Kirkbride. Blair’s aides at the time were very concerned not be seen to be using the children for political purposes, and probably didn’t think the story would get the legs it eventually got. Blair stuck to the scientific advice he was given, as well as citing international bodies like the WHO. I know some have criticised Blair for his judgment on this, although not David Cameron, but at the time Gummer’s example was the more recent example of the use of children by politicians. I think Blair was unfairly maligned on the issue of Leo Blair. Far more criticism should be made of the rightwing press and dodgy MPs were attempting to use his children for political purposes a la Gummer.

Apart from people who have boosted Andrew Wakefield’s discredited and dishonest wild theories about MMR vaccine over the years (Lucy Johnston, Melanie Phillips, Fiona Phillips et al), one journalist will forever be associated with Wakefield: Brian Deer.

Brian Deer is no shill for the pharmaceutical industry. Back in the 90s he tackled the harms of Septrin (a widely prescribed antibiotic), and later went on to tackle Merck over Vioxx. Brian has pursued Wakefield in the same way as he carried out his investigations of “big pharma”. Not that this has protected him from allegations about his motivations, his detractors being unable to accept that a journalist might investigate the Wakefield hoax without help from “big pharma” or a conspiring UK government. Melanie Phillips alleged he was part of a witch hunt, although she was incorrect. Last year, the increasing lunatic fringe of the UK’s anti-vaccine movement alleged Brian’s sexuality was the reason for his investigative reporting:

By all accounts a gay man and therefore unlikely ever to have to face the multiple vaccine risk agonised over by parents from around the world in relation to their children, Brian Deer has made it his business to portray the parents of these autistic vaccine damaged children as deluded mendacious chancers.

We now know that the man with callous disregard for children’s welfare was the man they have supported; Andrew Wakefield. He had the financial conflict of interest. He treated children unethically. He exposed children to “high-risk” procedures without ethical approval and against their best clinical interests [Here's an example of what can happen].

Brian was also subjected to a libel action brought against him by Wakefield, the current toy of the rich (Wakefield leads a comfortable life in Texas now, working at a quack treatment centre for £170,000 a year). In an article at the Sunday Times today, Deer talks of the benefits of exposing Wakefield.

Wakefield will probably never admit to his errors. But exposing his methods has been worthwhile, according to medical sources.

“People can’t understand whether a scientific study is valid or invalid,” said a senior doctor who had watched vaccination rates slump, even in the face of endless research on MMR safety. “But they can understand ‘right’ and ‘wrong’, and they can understand ‘honest’ and ‘dishonest’.”

Lawyers have told me that any one of the more than 30 charges that were proved against Wakefield would typically lead to his being struck off. His days as a medical practitioner will soon be history. A further hearing will determine whether “serious professional misconduct” was committed.

Yet more troubling for Wakefield’s future are his prospects for research, or at least of getting it published.

“Any journal to which a researcher shown to be dishonest submitted a paper would reject it,” said Richard Smith, former editor of the British Medical Journal, this weekend. “They would say, ‘This man can’t be trusted’. His career as a researcher is effectively over.”

On the latter point, I’m not so sure. His days as a real researcher are over, but he and his friends already have a plan to tackle that obstacle.

I haven’t posted here for nearly three months, so hello. I’ve recently obtained a full-time lecturer post at Aston University, so the blog has been a low-priority. However, it seems a shame for the blog to die, since it will be seven years old in February.

One of the issues this blog has followed fairly closely is the MMR-autism hoax. I had an interest in this before blogging , first on newsgroups, then in letters to my professional journal in response to Paul Shattock’s ridiculous claims that the evidence for the safety of MMR vaccine was equivalent to the evidence for homeopathy. To some extent I have become bored of the whole debate, but this week the GMC investigation in Andrew Wakefield will come to a partial head. Brian Deer has published another story about the forgotten victims of the scandal – the children and parents involved in the study:

On Thursday this week the panel is expected to give its judgments. Vaccine safety will be back in the news. Not the old chestnut about whether MMR causes autism: this time the debate will be about the extent to which those who proposed the link can or cannot be trusted.

As for the Lancet 12 themselves, they are now young adults. Only one came, briefly, to listen. Others are in institutions, either full-time or during the week. Just a handful might comprehend their place in history.

What was reported on these children in 1998 triggered an epidemic of fear. But there have been other — forgotten — victims of the scare: the parents, who for years believed it was their own fault that a son or daughter had a brain disorder. The debate over MMR stalks their souls.

I’ll be posting some more material on Wakefield’s misleading spin later.

The recent tragic death of Stephen Gately, which may have been due to a heart problem, was exploited by Jan Moir in her Daily Mail column to make a wider point:

All the official reports point to a natural death, with no suspicious circumstances. The Gately family are – perhaps understandably – keen to register their boy’s demise on the national consciousness as nothing more than a tragic accident.

Even before the post-mortem and toxicology reports were released by the Spanish authorities, the Gatelys’ lawyer reiterated that they believed his sudden death was due to natural causes.

But, hang on a minute. Something is terribly wrong with the way this incident has been shaped and spun into nothing more than an unfortunate mishap on a holiday weekend, like a broken teacup in the rented cottage.

Consider the way it has been largely reported, as if Gately had gently keeled over at the age of 90 in the grounds of the Bide-a-Wee rest home while hoeing the sweet pea patch.

The sugar coating on this fatality is so saccharine-thick that it obscures whatever bitter truth lies beneath. Healthy and fit 33-year-old men do not just climb into their pyjamas and go to sleep on the sofa, never to wake up again
[...]
Another real sadness about Gately’s death is that it strikes another blow to the happy-ever-after myth of civil partnerships.

Gay activists are always calling for tolerance and understanding about same-sex relationships, arguing that they are just the same as heterosexual marriages. Not everyone, they say, is like George Michael.

Of course, in many cases this may be true. Yet the recent death of Kevin McGee, the former husband of Little Britain star Matt Lucas, and now the dubious events of Gately’s last night raise troubling questions about what happened.

It is important that the truth comes out about the exact circumstances of his strange and lonely death.

Daniel Finkelstein of The Times suggests three errors in Jan Moir’s “statistics”.

The first is that you can learn something useful from a sample size of two.

The second is that you select your sample by reading back copies of the Daily Mail and finding famous people who fall into the category you wish to study who have been in front page news stories in the last month.

There is, you see, a chance that this method will bias the sample.

And third, Ms Moir appears to have forgotten how useful it is to have a comparison group.

It did not strike her that by employing the same sample selection method (Daily Mail stories) she could have found two marriages to compare with the civil partnerships.

Of course, Finkelstein flatters the mail by using the word statistics, but his post does highlight one aspect of the Mail. They use individual anecdotal cases to “prove” their pre-existing prejudices.

Stephen Gately’s death and Kevin McGee’s death are linked to suggest dangers of a homosexual lifestyle. It’s fair to say that the Mail is a homophobic newspaper.

The death of a girl following HPV vaccination (unrelated to the vaccine), and the case of another child who developed health problems following MMR vaccine (unrelated to the vaccine) are used to cast doubt on vaccines. It’s fair to say the Daily Mail is an anti-vaccine newspaper.

Charlie Booker nails the Mail with more style:

It has been 20 minutes since I’ve read her now-notorious column, and I’m still struggling to absorb the sheer scope of its hateful idiocy. It’s like gazing through a horrid little window into an awesome universe of pure blockheaded spite. Spiralling galaxies of ignorance roll majestically against a backdrop of what looks like dark prejudice, dotted hither and thither with winking stars of snide innuendo.

In the space of 4 days we have had a flurry of irresponsible news reporting about HPV vaccine following the death of a child. One of the rent-a-gobs that newspapers persist in obtaining quotes from is Jackie Fletcher, “leader” of the JABS campaigning group. JABS is largely concerned with propagating the hoax MMR vaccine-autism association, but in recent years has taken on a more overtly anti-vaccine stance. This has led to Jackie Fletcher being approached on stories unrelated to MMR vaccine in recent months. So how did she fare this week?

Daily Express:

Last night, Jackie Fletcher of Jabs, a campaign group for safe vaccinations, called for immediate withdrawal of all the HPV jabs. She said: “These dangerous side-effects must be investigated straight away. Recalling the jabs is not scare-­mongering.”

and again:

Jackie Fletcher, founder of the support group JABS, said: “We feel the Department of Health should suspend the programme temporarily until they have got to the bottom of this girl’s sad death.

“We have girls registered with us who believe they have been severely affected by the HPV vaccine, including semi-paralysis and muscle weakness. There is at the very least a question mark over its safety.

“This is an invasive procedure and should be removed from schools and put into the hands of GPs.

“The Department of Health just seems to want to allow girls to play Russian roulette with their health.”

The Yorkshire Post:

“A young girl went to school on Monday and she did not come home,” says Jackie Fletcher, founder of Jabs, the support group for children damaged by vaccines.

“Until investigations have been carried out and until the conclusions are made public, the immunisation programme, not just in Coventry, but across the country, should be suspended.

“We have had reports of girls who are now facing long-term health problems following the injections.

“One girl has been in hospital since September suffering from paralysis, another has suffered multiple seizures which means she can no longer drive and another has had severe muscle spasms.

“As an organisation, we are not claiming that these cases are directly linked to the immunisation programme, but they are very serious complaints and surely it is worth thorough investigation?”

So in the space of four days Fletcher has:

• Called for the withdrawal of a vaccine that will save hundreds of women’s lives
• Made further unsubstantiated claims against HPV vaccine off the back of this tragedy
• Accused the government of playing Russian Roulette with girls lives

We know now that the vaccine is extremely unlikely to have caused the tragic death of a young girl; she passed away because of an invasive tumour in her lungs and heart. Will Fletcher retract any of this ill-informed nonsense? Will newspapers ever stop going to her for inflammatory quotes?

In the case of the MMR vaccine-autism “controversy” (it never was in scientific circles), the media argued that a balance had to be struck between the opposing sides of the debate. When Wakefield was pushing his orginal theories, one might give the media some slack. He was, or appeared at the time, a respectable scientist presenting his opinions at a press conference at the Royal Free Medical School – hardly a quack institution.

In the case of Jackie Fletcher and JABS, no such case can be made. It is quite clear they are an anti-vaccine organisation. Already, forum members at JABS are insinuating foulplay in the post-mortem in the current case:

Be interesting to get a little more information on the pathologist who carried out the post-mortem examination. What is his background, how independent is he from government influences. Will the results be verified by a second/third opinion?

No serious journalist should be approching JABS or Jackie Fletcher for comments about vaccines. They are not a legitimate organisation concerned with true vaccine safety, unlike the authorities who they criticise who have an appallingly difficult job in this environment, but a crank organisation more akin to a flat earth society.

The sad death of a young girl which occurred on the same day she was given the HPV vaccine, which is unlikely to be linked to the vaccine, has prompted Theodore Dalrymple to write the following.

The death of a 14-year-old girl shortly after immunisation against cervical cancer is certainly a dramatic — and terribly tragic — event. It is increasingly unlikely that the vaccine was responsible for her death: one event following closely upon another is not in itself sufficient proof of causation. But let us, for the sake of argument, accept that the vaccine caused her death. What then?

When the immunisation programme against cervical cancer started, it was estimated, or guessed, that the vaccine might cause one death in a million cases: 1.4 million girls have been immunised, and this might be the first death caused by it.

The estimate, or guess, has therefore proved accurate; and if the trials of the vaccine are to be credited, the estimated number of lives eventually saved will far exceed one, and the extra years of life saved will be far in excess of those lost. This is no consolation to the grieving parents, of course; but it is how the rest of us ought to think.
[...]
Not long ago I reviewed favourably a book about the MMR vaccine controversy by a scholar who took what, in my view, is the correct view that the claims made that it causes autism are false and based on the most obviously deficient scientific research, something that could and should have been obvious from the very first. Indeed, so bad was the science that it should never have been published.

When my review appeared, I was immediately in receipt of abusive letters, not one of which pointed to any fact, but all of which assumed, without any evidence whatsoever (for no such evidence exists), that I was in the pay of the vaccine companies.

Why does immunisation arouse such passions? Are we secretly in love with the diseases that we know, and want them to continue?

The whole article is worth reading, and the MHRA press release on HPV vaccine is here.

The safety of the vaccine is not in question and no link can currently be made between the girl’s death and the vaccine.

The national HPV vaccination programme will continue as there are no supply issues associated with Cervarix. New stock is readily available.

MHRA Chief Executive, Professor Kent Woods, said the risk/benefit profile for Cervarix remains positive and that the safety and efficacy of the vaccine had been extensively researched in clinical trials before licensing.

“More than 1.4 million doses of HPV vaccine have now been administered in the United Kingdom and there have only been a little more than two thousand reports of adverse reactions.

“This is comparative with what we would normally expect from any vaccination programme and the reports of reaction to Cervarix have been relatively mild, including fever, headache, fatigue, muscle pain, nausea, vomiting and diarrhoea.”

Professor Woods said many women’s lives will be saved in the future as a direct result of this vaccine.

“More than 3000 women are diagnosed with cervical cancer every year and approximately 1000 women die from it,” he said.

“This young girl’s death is an absolute tragedy and our condolences go out to her family and friends.

“We are working with the Department of Health and the vaccine manufacturer GSK, and we all wait now for the results of the investigation. As soon as more information is known, we will take the appropriate action as necessary.”

NHS National statistics have released a report entitled Autism Spectrum Disorders in adults living in households throughout England – report from the Adult Psychiatric Morbidity Survey 2007 . The key facts in this document that they list are:

• Using the recommended threshold of a score of 10 or more on the Autism Diagnostic Observation Schedule, 1.0 per cent of the adult population had ASD. Published childhood population studies show the prevalence rate among children is also approximately 1.0 per cent.
• The ASD prevalence rate was higher in men (1.8 per cent) than women (0.2 per cent). This fits with the gender profile found in childhood population studies.
• There is no indication of any increased use of treatment or services for mental or emotional problems among adults with ASD. This is borne out by the recent National Audit Office publication “Supporting People with Autism Through Adulthood”.
• A greater proportion of single people were assessed with ASD than people of other marital statuses combined. This was particularly evident among men.
• Prevalence of ASD was associated with educational qualification, particularly among men. The rate for men was lowest among those with a degree level qualification and highest among those with no qualifications.

Understandably, the BBC have focused on an aspect not covered by these key points. The fact that the existence of a similar proportion of autistic adults to the proportion of children who are autistic undermines the idea that MMR vaccine has led to an increase in autism.

Latest autism figures should dispel any fears about the MMR jab being linked to the condition, say experts.

The NHS Information Centre found one in every hundred adults living in England has autism, which is identical to the rate in children.

If the vaccine was to blame, autism rates among children should be higher because the MMR has only been available since the early 1990s, the centre says.

Rather strangely the BBC provides a link on that news story to the JABS website, which continues to scaremonger about MMR and other vaccines. That editorial decision shows just how difficult it is going to be to ever disentangle vaccine conspiracy theories from autism.

Cross-posted to LBRB.