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Antivaccine hero Andrew Wakefield: Scientific fraud?

Pity poor Andrew Wakefield.

Actually, on second thought, Wakefield deserves no pity at all. After all, he is the man who almost single-handedly launched the scare over the MMR vaccine in Britain when he published his infamous Lancet paper in 1998 in which he claimed to have linked the MMR vaccine to regressive autism and inflammation of the colon, a study that was followed up four years later with a paper that claimed to have found the strain of attenuated measles virus in the MMR in the colons of autistic children by polymerase chain reaction (PCR). It would be one thing if these studies were sound science. If that were the case, then Wakefield’s work would have been very important and would have correctly cast doubt on the safety of the MMR. Unfortunately, they were not, and, indeed, most of the authors of the 1998 Lancet paper later withdrew their names from it.

Over the next decade, aided and abetted by useful idiots in the media, by British newspapers and other media that sensationalized the story, and the antivaccine movement, which hailed Wakefield as a hero, Wakefield managed to drive MMR vaccination rates in the U.K. below the level of herd immunity, from 93% to 75% (and as low as 50% in some parts of London). As a result Wakefield has been frequently sarcastically “thanked” for his leadership role in bringing the measles back to the U.K. to the point where, fourteen years after measles had been declared under control in the U.K., it was in 2008 declared endemic again.

Worse, this fear was based on the worst science imaginable. First, no scientist not associated with Andrew Wakefield has ever been able to replicate his work. Second, as was exposed by U.K. reporter Brian Deer, not only was Wakefield paid big bucks by trial lawyers seeking to sue vaccine manufacturers for “vaccine injury” to do his studies on autistic children, a conflict of interest he never revealed and that had to be exposed through Deer’s investigations, but months before he published his Lancet paper Wakefield had applied for a patent on a an allegedly safer single measles vaccine that could succeed best if the safety of the MMR were called into doubt. Even after all of this came to light, leading to Wakefield’s correctly being dragged in front of the General Medical Council for charges of scientific misconduct. Even after this, he still enjoys a cult of personality that I can’t figure out, and is often portrayed as being “persecuted” by the British medical establishment. Third, was revealed at the Autism Omnibus proceedings when PCR expert Stephen Bustin testified about the shoddy methods at the laboratory used to do the PCR on the colon biopsies. In brief, the laboratory used was set up such that cross contamination between the plasmids used to maintain the measles virus sequences and the area where the PCR was done. PCR is very sensitive; if there is contaminating plasmid sequence, it is very easy to amplify and detect it even when there is nothing in your samples. Indeed, I’ve experienced this very problem on occasion in my own lab. Unfortunately, in the case of Wakefield’s research, no controls were done to make sure that contamination was detected in the negative controls. Finally, Wakefield’s results were roundly refuted in an attempt to replicate his work that was published last year. As you can see, Wakefield’s work and ethics are about as bad as it gets.

Or so I thought, until readers started sending me this article published in The Times, again by Wakefield’s nemesis Brian Deer. Holy crap. If only a fraction of the allegations in this article are true, not only is Wakefield an unscrupulous and incompetent scientist but he’s a scientific fraud as well:

The doctor who sparked the scare over the safety of the MMR vaccine for children changed and misreported results in his research, creating the appearance of a possible link with autism, a Sunday Times investigation has found.

Confidential medical documents and interviews with witnesses have established that Andrew Wakefield manipulated patients’ data, which triggered fears that the MMR triple vaccine to protect against measles, mumps and rubella was linked to the condition.

The research was published in February 1998 in an article in The Lancet medical journal. It claimed that the families of eight out of 12 children attending a routine clinic at the hospital had blamed MMR for their autism, and said that problems came on within days of the jab. The team also claimed to have discovered a new inflammatory bowel disease underlying the children’s conditions.

However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children’s ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.

The complete story reveals behavior on the part of Wakefield that leaves me just shaking my head in disbelief. It’s simply unbelievable.

Let’s step back a minute. The original Lancet paper examined the cases of twelve children with autism and other neurodevelopmental disorders. In the paper, it was reported that in 8 of the 12 children with regressive autism the onset of developmental changes closely followed MMR vaccination and in one of the 12 it followed measles infection. Moreover, colonoscopy showed colon abnormalities “ranging from lymphoid nodular hyperplasia to aphthoid ulceration.” In 11 children, biopsy histology showed patchy chronic inflammation in the colon. The conclusion was that there was an apparent association between MMR vaccination and a syndrome of regressive autism and inflammatory bowel changes. Even though the paper’s tone was more tentative than one would have thought given the furor it launched and even though it stated that the authors “did not prove an association between measles, mumps, and rubella vaccine and the syndrome described,” Wakefield promoted his results to the media as though he had definitely found a link between the MMR vaccine and a syndrome consisting of regressive autism and inflammatory bowel disease. Thus was launched the scare that caused a thousand cases of measles (in 2008) that could have been avoided and caused many autistic children to be subjected to invasive procedures they didn’t need, sometimes at the cost of serious complications.

If the latest information is true, however, Wakefield is guilty of more than shoddy science and unreported conflicts of interest. He is guilty of scientific fraud and falsifying the medical reports of these children. For example, take Child 11, whose father requested a second set of testing on his child’s biopsy specimens:

MR ELEVEN’S taxi dash was a small ride in his desperate quest to find an answer for his son’s condition. Today, Child Eleven is much improved: at 17, he is a terrific scholar, although too nervous to drive.

The extra tests on his biopsies produced striking results. His father asked the cancer institute to look for the measles virus, which lay at the heart of Wakefield’s concerns over the vaccine. According to a theory that underpinned the project, this virus in MMR was the cause of bowel disease, which then did damage to children’s brains.

“It took a big fight to get the information,” said Mr Eleven. “They told me there was no measles virus. I had the tests repeated three times at different labs in the US, and they all came back negative.”

This struck a different note from what Wakefield suggested when describing his research to the world.

“We would not have presented this paper to The Lancet had we not undertaken extensive virological studies already,” he told the 1998 press conference.

Of course, this anomaly could simply have been due to the aforementioned incompetence of the lab that Wakefield used to test his specimens for MMR strain measles virus, with its procedures guaranteed to produce false positives. Unfortunately, there’s more. A lot more. Take Child One:

In the paper this claim would be adopted, with Wakefield and his team reporting that Child One’s parents said “behavioural symptoms” started “one week” after he received the MMR.

The boy’s medical records reveal a subtly different story, one familiar to mothers and fathers of autistic children. At the age of 9½ months, 10 weeks before his jab, his mother had become worried that he did not hear properly: the classic first symptom presented by sufferers of autism.

This is an incredibly common story among parents who believe that vaccines caused their child’s autism. Many vaccines are scheduled to be given during the same time that children often show the first behavioral alterations associated with autism, and it is not uncommon either for such changes to occur within a few weeks of a vaccination by random chance alone, nor is it uncommon for parents to remember incorrectly that the child’s symptoms started soon after a vaccine when they did not. Indeed, it is not uncommon at all for experts to be able to detect the subtler signs of autism on videotapes of babies before the parents noticed and before the child received the vaccinations for which parents blame the condition. Unfortunately, human memory is fallable, and it easily relates events that are not closely related, particularly in response to other information or preexisting beliefs. This happens all the time with vaccines and autism, where numerous epidemiological studies have failed to find an association between either mercury in thimerosal-containing vaccines and autism, between MMR and autism, and between vaccines in general and autism.

And Child Two:

This was Child Two, an eight-year-old boy from Peter-borough, Cambridgeshire, diagnosed with regressive autism, which, according to the Lancet paper, started “two weeks” after his jab.

However, this child’s medical records, backed by numerous specialist assessments, said his problems began three to five months later.

And the list goes on:

Only one was a girl, Child Eight, aged 3, from Whitley Bay, Tyne & Wear. She was reported in the journal as having suffered a brain injury “two weeks” after MMR.

Her medical records did not support this. Before she was admitted, she had been seen by local specialists, and her GP told the Royal Free of “significant concerns about her development some months before she had her MMR”.

Child Six, aged 5, and Child Seven, aged 3, were said to have been diagnosed with regressive autism, with an onset of symptoms “one week” and “24 hours” after the jab respectively.

But medical records show that neither boy was “previously normal”, as the Lancet article described all the children, and that both had already been hospitalised with brain problems before their MMR.

Child Six received his vaccine at the age of 14 months, but had twice previously been admitted with fits.

Child Seven was given his at the age of 20 months but, again, problems already showed.

In other words, one of two things happened, neither of which is flattering to Wakefield. Either he took the history from parents, for whom confirmation bias could easily have led to remembering incorrectly that their child’s behavioral changes were noted shortly after the MMR rather than before it or months later, in which case Wakefield was incompetent for not having examined the medical records. Alternatively, Wakefield did examine the medical records and lied about them in the Lancet paper. Take your pick.

In fact, I might have been willing to give Wakefield somewhat of the benefit of the doubt, viewing the discrepancies between the medical records and what he reported in the Lancet paper as being yet more evidence of his shoddiness and incompetence rather than malice, were it not for the major discrepancies between what Wakefield said about the histology of the biopsy specimens in the paper. The Lancet paper described a uniform pattern of patchy inflammation, but apparently what Wakefield reported does not jibe with what the pathologists saw:

“The uniformity of the intestinal pathological changes and the fact that previous studies have found intestinal dysfunc-tion in children with autistic-spectrum disorders, suggests that the connection is real and reflects a unique disease process, ” the Lancet Paper explained of the “syndrome”.

Yet pathology records of samples taken from the children show apparent problems with this evidence. The hospital’s consultants who took biopsies from the children’s colons concluded that they were not uniform but varied and unexceptional.

For Child Eight, the pathology report said: “No abnormality detected”, while the Lancet paper said: “Nonspecific colitis”. This pattern was repeated for two of the other children, Nine and Ten.

The most striking change of opinion came in the case of Child Three, a six-year-old from Huyton, Merseyside. He was reported in the journal to be suffering from regressive autism and bowel disease: specifically “acute and chronic nonspecific colitis”. The boy’s hospital discharge summary, however, said there was nothing untoward in his biopsy.

Not happy with the readings of the pathologists, apparently Wakefield’s research team met for a “research review” of the biopsy specimens. This in and of itself is not unusual. However, it is unusual that the research team overturned the original readings of so many of the specimens. As Brian Deer put it:

It was not an unusual move for a group of specialists to reconsider the evidence upon which their research was relying. It was nevertheless striking that their conclusion was that 11 of the children’s bowels were in fact diseased when their colleagues had found no abnormalities in at least seven of the cases.

Quite frankly, such conduct beggars the imagination. It’s about as unethical as it gets. But it’s all of a piece with Andrew Wakefield’s behavior. After all, as I pointed out before, he was in the pocket of a lawyer named Richard Barr seeking to sue vaccine manufacturers for “vaccine-induced” autism before he undertook his research. Not only that, but Barr was affiliated with the antivaccine group Jabs, and Wakefield apparently concocted his new “syndrome” after at least some consultation with Barr. But perhaps the most unethical, at least from a human research standpoint, was that the patients recruited to his study were not anything resembling a random or neutral sample. As pointed out by Brian Deer, the parents of these children heard through word of mouth about Wakefield. Add to that the fact that Wakefield subjected these children to unnecessary invasive medical procedures, and then incompetently analyzed the specimens obtained from them for measles virus to produce a virtually preordained result, even if it took scientific fraud to do it, and you see what I mean. Given such a level of ideological blindness that seems to think his cause so just that good science and ethics are optional in pursuit of it, a lack of concern over blatant conflicts of interest, and an appallingly inflated opinion of himself that he is seems to believe that he is actually a persecuted Galileo, is it any surprise that Wakefield may have stooped so far as to falsify research results in his campaign?

Not to me, it isn’t.

Sadly, none of this will matter to antivaccinationists, who view Wakefield as exactly that–a persecuted scientific hero. Although I have yet to see any response from antivaccine blogs like like Age of Autism, I’m sure that they’ll wax ridiculous about what a great doctor and man Wakefield is and how it’s big pharma and its minions who, frightened by the implications of Wakefield’s work, are working hard to demonize him and suppress his “science.” Unfortunately for their reality-challenged world view, sometimes things are as they appear, sometimes there really is no conspiracy, and sometimes a rat is a rat.

And Wakefield is most definitely a rat. A rat who caused thousands of cases of measles and at least one death.

Posted in: Science and the Media, Vaccines

Leave a Comment (41) ↓

41 thoughts on “Antivaccine hero Andrew Wakefield: Scientific fraud?

  1. Dr Benway says:

    Very timely and useful information. Those who promote a “biomedical” approach to autism, which posits immune and gut dysfunction among autistics and prescribes a gluten-free/casein free diet plus supplements, point to Wakefield’s work as supportive evidence. I’m having to deal with these characters more frequently.

    I like the entire post save the word “nemesis,” which might suggest that Deer’s investigative work is more personal than objective.

  2. salzberg says:

    Excellent post. We need to draw more attention to Wakefield so that people will – eventually – see him for what he is. See http://genefinding.blogspot.com/2009/02/autism-vaccines-and-andrew-wakefields.html too, which has a pointer back to this article near the end.

    Last July, Orac labeled Wakefield an “antivaccination loon” – a bit strong, but maybe strong language is needed to get people’s attention.

  3. Jules says:

    Sadly this isn’t unheard of. The big story a few years ago was estrogen, with the PI changing the numbers on his students’ research. I think before that there was even one case where a guy colored mice with a Sharpie (skin grafts).

    But I was surprised, actually, to find that none of the reviewers of the Lancet had caught on to the fact that there was no negative control–or any of the myriad shoddy-science things that he’d done. I’d think that even the most lenient reviewers would have at least demanded a control–something that should have only taken a day to get.

  4. I dunno, Dr. Benway… Nemesis is the Greek goddess who avenges crimes and punishes hubris; thus I think David’s description of Deer’s role is right on the money.

  5. Canucklehead says:

    “In other words, one of two things happened, neither of which is flattering to Wakefield. Either he took the history from parents, for whom confirmation bias could easily have led to remembering incorrectly that their child’s behavioral changes were noted shortly after the MMR rather than before it or months later, in which case Wakefield was incompetent for not having examined the medical records. Alternatively, Wakefield did examine the medical records and lied about them in the Lancet paper. Take your pick.”

    Either he’s a fool or a liar, this makes it sound like he’s both; either way he needs to be taken to task. It’s amazing how money can affect perspective.

  6. Andrew86 says:

    There’s no reason to be surprised or excited about this new information – it’s simply a confirmation of what we already knew. Calling Wakefield a “Scientific Fraud” shifts the focus away from the real issue here: How did this paper get published in the first place?

    Wakefield is more likely scientifically incompetent than a fraud (of course he may be both). But all of this should have been apparent from the original paper. A poorly selected sample size of 12 which relied on the reporting of parents who were well aware of the implications their answers would have for the results?

    There is nothing useful about this paper. This was the case ~before~ the allegations of inappropriate financial involvement and false results.

    So why are we all screaming madly at Wakefield as though he’s the real villain here? There will always be cranks out there. The real problems only arise when we start publishing them in scientific journals.

    How on EARTH did that happen?!

  7. lizditz says:

    I’ve done another round-up post — who is saying what about the Deer articles on Wakefield in the London Times. I’ve included your post.

    11 years on, Wakefield Manufactured Data showing MMR-Autism Link?

  8. SD says:

    Interesting post, although the digression about how the guy is “in the pocket of X and Y and Z” is basically paranoid character assassination of the same type used by everybody else, and particularly on you (Srn US, “y’all”). This has precisely squat to do with truth or falsity; the data and the experiment design are the important parts, and the frosting just makes you (ibid.) look whiny and petulant. If you (ibid.) would like to be taken seriously by regular people and enjoy a correspondingly greater level of popular belief, then use different tactics than the other guys. Just a hint.

    Assuming arguendo that the incidence of autism actually *is* increasing – something I do not know and will not defend – has the vaccine hypothesis actually been seriously examined statistically to identify it as a plausible candidate for further research? How? By whom? With what N? I would assume that historical evidence of autism and its conflation with other disease is the major problem in comparing “pre-vaccine-era” with “post-vaccine-era” populations in the Western world, and that lifestyle and other differences between Western populations (largely vaccinated) and unvaccinated populations elsewhere in the world are the problem with comparing contemporary populations. Are there any plausible biochemical explanations of this phenomenon (BC trumping statistics any day of the week)? If the effect is real, is it plausibly explicable by the idea that more kids are surviving to *be* autistic as a result of the vaccine, i.e. can infant mortality be controlled out of the mix? Ooo, and there’s an idea – perhaps it’s related to accelerated and widespread genetic intermixing in the modern developed world? If you radically increase the rate and diversity of combinations, you have to expect a few to not work out so well.

    So what’s the skinny? A little synopsis of the history of this whole thing might be useful. There seems to be a lot of “Does so!”/”Does not!” back-and-forth going on; the “Does so!” camp appears to have quite a bit of traction, and frankly, the idea appears to have sufficient anecdotal evidence and superficial plausibility to merit somewhat more consideration than “It’s just a bunch of woo, the plural of anecdote is not data, correlation is not causation, now shut up and take your vaccine”. On the other hand, there are a lot of conflating factors that would seem to make the picture a little more complex than “Vaccine bad!”

    As a largely disinterested party – got my vaccinations, and a few extras, and survived ‘em all – I suppose I’m inquiring about how much and what kind of consideration has taken place so far.

    “if there’s smoke…?”
    -SD

  9. Deetee says:

    SD,
    You could do worse than look at this publication called Bandolier (It addresses evidence-based medicine and is produced by Oxford University). It’s from 2005, but in the last 3 years there have been several more publications which indicate a lack of association between autism and vaccination.
    http://www.medicine.ox.ac.uk/bandolier/Extraforbando/MMRextra.pdf

    There are more than enough fora and publications dealing with the issue of vaccines/autism already. Let’s try and stick to the subject of this particular post, shall we, which is Wakefield and his fraudulent behaviour.

  10. storkdok says:

    SD,

    It is not “paranoid character assassination” when information about Wakefield taking huge sums of money from defense attorneys comes from recorded courtroom documents. The judge found this information pertinent in the autism Omnibus hearings. It is a matter of public record under sworn testimony. The testimony during the last week in England is also under sworn oath, and this information was also found pertinent.

    This is quite different from the anti-vaxers ad hominem attacks on various physicians and scientists, for which there is no evidence of any connection to “big pharma” deep pockets.

    A good synopsis of these events is Dr. Paul Offit’s book, “Autism’s False Prophets”. You can clearly see the “manufactroversy” of vaccines cause autism.

  11. David Gorski says:

    Interesting post, although the digression about how the guy is “in the pocket of X and Y and Z” is basically paranoid character assassination of the same type used by everybody else, and particularly on you (Srn US, “y’all”). This has precisely squat to do with truth or falsity; the data and the experiment design are the important parts, and the frosting just makes you (ibid.) look whiny and petulant. If you (ibid.) would like to be taken seriously by regular people and enjoy a correspondingly greater level of popular belief, then use different tactics than the other guys. Just a hint.

    Concern troll.

    It is not “paranoid character assassination” to point out that Wakefield was in the pocket of trial lawyers, mainly because it’s true. Worse, he did not disclose his clear conflict of interest. Moreover, the “truth or falsity” of Wakefield’s work (mainly its grossly incompetent falsity) has been discussed elsewhere by me and many others for example, here:

    http://www.sciencebasedmedicine.org/?p=200

    Finally, it is certainly not irrelevant to bring up charges that Wakefield may have falsified data if there is strong evidence to support such charges. Indeed, that is yet one more strong piece of evidence that his work is of no value and his conclusions incorrect.

  12. daedalus2u says:

    Andrew86, peer review is not capable of uncovering subtle scientific fraud. The presumption of the reviewers is that the authors are honest and are not deliberately falsifying their report.

    Real scientific fraud is rare.

    Short of personally reviewing the original records themselves, reviewers could not know that the timing of appearance of symptoms of autism did not correspond to what was reported. Reviewers could not have known that the reports of inflammation were exaggerated to the point of being false. Reviewers could not have known that PCR tests were done on these samples and all the PCR tests were negative. Because PCR is many orders of magnitude more sensitive and more specific, if the reviewers had been told that the PCR tests were negative, they would not have accepted the paper. That is why they were not told.

    It is unreasonable to expect peer review to uncover all instances of fraud. That is why replication by others is important. It is unfortunate that the scientific literature doesn’t sufficiently appreciate independent replications of results.

  13. Deetee says:

    Wakefield was late last year awarded the Age of Autism “Galileo Award” for his steadfastness in the face of everything his detractors could throw at him.
    http://www.ageofautism.com/2008/12/age-of-autism-awards-2008-galileo-award-dr-andrew-wakefield.html

    I now propse a new award for 2009, the “Paul Kammerer Award”.
    I suggest this be offered to Wakefield, so he can add it to his list of accolades.
    http://en.wikipedia.org/wiki/Paul_Kammerer

  14. Deetee says:

    Wakefield responds
    Brian Deer contacted Wakefield prior to publishing his new findings. Wakefield has now responded.
    http://www.rescuepost.com/files/deer-response.pdf

    The response is somewhat evasive.
    Deer: “You claim that the paper is a series of “previously normal” children, but medical records – which you had a duty to read and understand – show that some five of the 12 children were subject to concerns prior to vaccination, and were not “normal”. Other children, who you claimed to have suffered their first “behavioural symptoms” within days of vaccination, in fact had none for months.”
    Wakefield: “The diagnoses reported in the Lancet were accurate based upon the information provided to the clinicians and review of the available records1 . Where there was considered to be a pre-existing developmental problem, this was accurately described in the Lancet paper 2. This is not the place to get into a detailed discussion on developmental regression which is still a subject of debate by experts in child development and is certainly not something about which Deer has any expertise.”

    Wakefield in the Lancet:

    “Clinical details of the children are shown in tables 1 and 2. None had neurological abnormalities on clinical examination; MRI scans, EEGs, and cerebrospinal-fluid profiles were normal; and fragile X was negative. Prospective developmental records showed satisfactory
    achievement of early milestones in all children. The only girl (child number eight) was noted to be a slow developer compared with her older sister. She was subsequently found to have coarctation of the aorta. After surgical repair of the aorta at the age of 14 months, she progressed rapidly, and learnt to talk. Speech was lost later. Child four was kept under review for the first year
    of life because of wide bridging of the nose. He was discharged from follow-up as developmentally normal at age 1 year”

    The Table referred to does not give any indication of pre-vaccination developmental problems. In all cases it indicates problems followed the vaccine, from between 24 hours to 2 months later.

    So Wakefield is trying to hide his nakedness behind the defence of the Lancet paper, only to find it’s pages are completely transparent. Deer may not have experience on developmental regression, but then at the time of the Lancet article neither did Wakefield, so it seems patently obvious. Is he now going to claim ignorance as a defence?

    Wakefield on the MMR scare that led to parents ceasing to vaccinate: “Finally, I did not “create” a scare but rather, I responded to a scare that parents brought to my attention. To have ignored their concerns would have been professional negligence.”

    Sure, pull the other one, Wakers…
    And what was his response? I think we all know, and countless children worldwide have suffered as a concequence, and millions that could have gone to autism research has been wasted chasing wisps of smoke drifting in the antivaccine breeze.

  15. Andrew86 says:

    Daedalus2u: sure, the review process cannot uncover all hidden frauds. But you are missing the point entirely! One of the big things this latest investigation has uncovered is that (shock, horror!) parents, when asked to rely on their memory and in full knowledge of the implications of their answers, are NOT a reliable source of information! The reason we have a “Scientific Method” is exactly so we don’t make those sorts of mistakes. That is the very thing the review process can and should be looking out for.

    Yes, we are uncovering more and more about why this was a terrible study and they are not all things that the reviewers could have known. But so what? To avoid the terrible damage this paper has done we need to be able to identify this as poor research before publication, not after.

    And there was plenty of information that should have led any competent reviewer to that conclusion just from the original submitted paper, without all of the extra investigation that has happened since.

  16. daedalus2u says:

    Andrew86, no, what this shows is the danger in forming public policy based on a single paper, or by results by a single researcher, or results by a single group. It wasn’t the bad paper that caused the problems, it was people acting as if the bad paper was a good paper. It was the bad paper being picked up by the anti-vaccine zealots that caused the problem.

    When authors lie, as Wakefield did, peer review is not the place to try and catch it. If you expect peer review to be so thorough as to catch deliberate fraud, it will cost many times more to do it. Much more effort has been spent into uncovering Wakefield’s fraud than it took him to create it in the first place. Journals don’t have the kinds of resources it would take to subject each and every paper to an anti-fraud check.

    In hindsight, lots of things become obvious. Parents didn’t write the paper, Wakefield and other authors did. It is not the fault of the parents, it is the fault of the authors. Some of the authors retracted the paper when they found the data in it to be flawed. That is the normal and expected course. If the data in a scientific paper is wrong, the paper must be withdrawn. If you are a scientist, there is no other option. To not retract a paper with data that you know to be wrong is to commit scientific fraud.

    The children’s medical records are not oral, they are written. It is those written records that are now found to be different than what was reported in the Lancet paper 10 years ago. Those written medical records are privileged. Reviewers do not have access to those records.

    Wakefield’s story that the parents told him that and he believed it is just another lie. It is inconceivable that Wakefield personally interviewed each parent and never read the written medical records. It is inconceivable that now, 10 years later, he is relying on his memory of those interviews and not written records. It is inconceivable that he took notes, and those notes are different than what is in the children’s medical record and that those notes do not still exist. It is inconceivable that when his co-authors retracted the paper, that he did not review the written records.

    Wakefield is piling lies on top of lies. The anti-vaccine zealots don’t care. They are in the class of people that can be fooled 100% of the time, and Wakefield is doing just that. Making himself rich by exploiting the anti-vaccine zealots. Unfortunately it isn’t just the anti-vax zealots (and their children) that are being hurt.

  17. Andrew86 says:

    I can agree with you as far as you say that basing public policy on a single paper is a bad idea. But then I don’t know that public policy was indeed changed in this instance, but rather individual parents became scared.

    “When authors lie, as Wakefield did, peer review is not the place to try and catch it.” As I’ve already said, I don’t believe reviewers are to be expected to find lies. I believe it is their place to weed out dodgy methodology. If it is not, then what i the point of peer review?!

    There was more than enough reason for this study to be ditched by the Lancet based on the submitted paper alone.

    “If you expect peer review to be so thorough as to catch deliberate fraud…” No I do not expect peer review to be so thorough! I DO expect reviewers to READ the paper, however.

    “Those written medical records are privileged. Reviewers do not have access to those records.” Nobody is suggesting they did have access to privileged records. They did, however, have access to Wakefield’s paper! Any competent reviewer surely should have seen the obvious methodological flaws.

    The Lancet has a prestigious reputation. And they have a responsibility to screen bogus papers. When when a study like this is published, there will be a reaction. That reaction didn’t need to happen. It would be nice if all the parents and journalists read the paper and understood its limitations. But we both know that that’s not going to happen any time soon.

    Sure Wakefield was a liar/greedy/incompetent/a fraud/all of the above. But if the Lancet’s reviewers can’t screen out such obvious flaws in methodology, then what’s the point of reviewing?!

  18. Andrew86 says:

    Here’s Professor Trisha Greenhalgh’s perspective:
    http://briandeer.com/mmr/lancet-greenhalgh.htm

  19. Laure68 says:

    Dr. Wakefield has submitted a response to the Times. Of course, he completely skirts the major issues, but writes so much BS that the casual reader could be fooled. Any chance of a rebuttal on his rebuttal?

  20. daedalus2u says:

    Andrew86, the reviewers are just people too, they put their pants on one leg at a time just like all the rest of us.

    The scientific literature is a communication from one expert (the author) to another expert (the reader). The reader has to be responsible for understanding the paper and its limitations. There is lots of crap in the literature. If you can’t tell which papers are crap and which ones are pure gold, then you shouldn’t be making decisions based on reading papers in the scientific literature. Peer review is not magic. It is better than no review, it is no substitute for understanding the paper yourself.

    The Lancet had a prestigious reputation. It has gone down considerably due to the Wakefield fiasco. That is a shame, but these things come and go.

  21. Andrew86 says:

    Sure they’re only human… but is it too much to ask that they read the damned paper?!

    This reminds me of that Mitochondria in the journal Proteomics that PZ Myers blogged about recently. Some nutcase had gone through and added nonsense like “…a reflection of a single common fingerprint initiated by a mighty creator” through it and the reviewers just didn’t notice.

    I think we have to remember that the way journalism works today is that if an “expert” says something then it’s usually deemed worthy of print. Scientific journals kind of do journalist’s homework for them because if a paper is published then it presumably means that at least three experts are in agreement that the paper is worth printing.

    Of course this represents a terrible state of journalistic affairs, but I don’t think this issue would have had anywhere near the impact that it did if the Lancet hadn’t deemed this study worthy of being published.

    And again, yes I obviously agree that this isn’t the way things should be, but it is so we can’t afford to forget the role that the reviewers have played in the recent measles outbreaks in the UK.

  22. wertys says:

    @Andrew86

    Wakefield wrote the paper. Wakefield gave interviews about it. Wakefield has accepted a lot of money from financially interested parties as well as sincere supporters who are convinced by his posture as an ersatz Gallileo.

    If now, this far down the track, his fraud is exposed then Wakefield himself has to grow a pair and take responsibility. Oppenheimer, Einstein, Oliphant and the rest of the Manhatten Project all lived in horror of the application of their creation. But as true scientists, they didn;t try to blame anybody else, and took the lead in campaigning for avoidance of the use of the weapons they had created. they took responsibility. They didn’t blame anybody else, or try to say that somebody should have pointed out to them that thousands of people could die. Even Big Pharma has set out to redress harm that can be legitimately traced to their products. But what do we get from SCAM ? Silence, evasion and denial.

    The current outbreaks of measles are the direct result of Wakefield’s bizarre need to feel special and important. he thinks the rules of science shouldn’t have to apply to him except when somebody wants to praise him or give him money. If he had any shred of decemcy and integrity he should admit his error, if not fraud, and take the lead in campaigning to reduce measles by regaining herd immunity in the UK.

    Given his track record , nobody will be holding their breath for this to happen….

  23. The Blind Watchmaker says:

    Great news today. Science seems to matter after all.

    http://apnews.excite.com/article/20090212/D96A8QM05.html

  24. ingridity says:

    Andrew Wakefield may indeed be the biggest fraud in science, who knows, but that has absolutely no bearing on whether or not one should consider vaccines safe. You can be anti-vax and completely agree that Wakefield’s research findings are not scientifically valid and that he did poor science. However, one bad scientist doing bad science around vaccines, does not have anything to do with whether or not vaccines are safe.

    What I find strange is that all these “bad science/good science” articles never seem to address the CDC or vaccine manufacturers’ own “bad science” that leads them to make the outrageous claim the case is closed on vaccine safety.

    For one to truly make the case for vaccine safety, you’d think one would be able to show that kids who are vaccinated have NO higher incidence of neurological disorders than kids who are unvaccinated. (Or if not kids, how about at least monkeys?) Everyone acts as if there are hundreds of such studies, all leading to that same conclusion, when in reality there is not a SINGLE study out there that compares these two groups. How can such a “science minded” blog assume that vaccines are entirely safe without any such study being done? I don’t get it.

    Your site says this is a forum for “Exploring issues and controversies in the relationship between science and medicine” and yet it doesn’t seem like you *explore* the other side of the vaccine debate *at all* – you mainly just seem to resort to name calling anyone who happens to be skeptical of vaccine safety.

  25. David Gorski says:

    Please read:

    Let’s put on a study!

    Studying unvaccinated versus vaccinated populations–at least doing so ethically–is not nearly as easy as you think it is. When it’s done poorly, you get results like the Generation Rescue “study” that was in reality a poorly conducted phone survey.

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