The Problem with Vaccines

Comment on “Doctors Counter Vaccine Fears In Pacific Northwest reported on All Things Considered 09/13/11, where I discuss some of the mistakes in this news report, as well as some of our current state of knowledge about mercury in vaccines and the incidence of autism. This post is in no way exhaustive.

Summary

NPR Reporter Martin Kaste covers a story about an increasing number of kindergartners not being vaccinated for school, with the poorest record in the states of Washington and Oregon. Public Health officials call this “vaccine hesitancy” and often occurs among well-off, educated parents. There are many people who consider vaccination as a conspiracy by the “medical-industrial complex”. Vaccine hesitancy by parents can occur as the complete avoidance of any vaccination to picking and choosing which vaccines to have their child get. These parents want to discuss every vaccine in the same way they want to discuss a surgery. Disease that can be prevented with vaccines are on the rise. This report refers to the 1998 study in The Lancet by Dr. Andrew Wakefield that showed a link between MMR (Measles, Mumps and Rubella) vaccines and autism, as fraudulent, which appeared to give rise to some of the vaccine hesitancy seen today. Some blame the plethora of studies showing a link to problems with vaccines, combined with states who offer easy exemptions to vaccination rules.

My Comment Posted at NPR

Vaccine hesitancy is based upon some real fears that have yet to be addressed by the medical community. Some research surveys show that it is unlikely that autism in humans is caused by vaccinations, and no experimental test for vaccines as a cause of autism in humans has been done. I discuss this on my blog posting “The Problem with Vaccines” at https://marthalhyde.wordpress.com/2011/09/19/the-problem-with-vaccines/, along with other aspects of the autism-vaccine link, including:

  • The “fraudulent” study by Wakefield mentioned by NPR was later supported by research published in peer-reviewed journals,
  • Lies in the reports that Wakefield was fraudulent,
  • Hints of big money involved and connections to drug companies and James Murdoch,
  • Wakefield’s study did not suggest autism was caused by vaccines,
  • A lot of research showing a link have between autism and vaccines has been published in peer-reviewed journals
  • There is a role for news reporters to educate us on ALL aspects of particular medical studies: biological, psychological, social, political, and financial.

More of My Ideas

Experimental Evidence

Vaccines are a natural culprit to expect might cause a disorder which appears very early in children, and for which there is no evidence of developing later in life.  Since all children will be listed by doctors as needing vaccinations early in life, all children in the developed nations who have gotten autism have had vaccinations. I know of no case of autism in a child who has never had a vaccination, but this is difficult to document since vaccination is a hallmark of pediatric medicine in the developed nations, as is close observation and documentation of medical health through a public health system.  Confounding all of the dispute in the news is the fact that autism is not defined very precisely, simply because there are a whole array of symptoms that not all autistic children have, and some neurological disorders can accompany autism (National Capital Poison Center). For this reason, people refer to ASD (Autism Spectrum Disorder).

Signs of Autism (freely provided by PiecebyPiece who doesn’t want a linkback)

It is true that we have absolutely no experimental evidence in humans that would tell us whether vaccines cause autism. We just have some interesting correlations and many anecdotal observations.  However, there are two lines of evidence from which we attempt to draw conclusions: epidemiological studies of populations that should show a link, and experimental studies in animals that show behavioral and biochemical symptoms similar to those of autistic children.

An examination of  medical records and epidemiological data suggests a link in humans (Geier and Geier 2006, Majewska et al 2010, Mutter et al 2005, Rice et al 2000, Young et al 2008). However, there are epidemiological studies that suggest there is no link (Chen et al 2004, Honda et al 2005, Fombonne et al 2006, Madsen et al 2002, DeStefano et al 2004, Stehr-Green et al 2003, Hviid et al 2003, Andrews et al 2004, Verstraeten et al 2003).

Studies that show that many of the behavioral and biochemical symptoms of autism in human children appear in experimental animals when they are exposed to mercury in doses within the range given in vaccines (Falluel-Morel et al 2007, Olczak et al 2009a,2010b, Rice 1996, Rice et al 2000, Slotkin and Bartolome 1987).  However, Hornig et al (2004) demonstrates that some effects may depend upon differences in the species being tested, warning that it may be difficult to generalize to humans from the non-human research.

To be fair to the drug industry, there are many possible ways that the immune system can be compromised, and vaccines are one way of doing this, since they reduce immunity briefly. After all, we are injecting foreign proteins into the body.  Many people who get the flu shot are susceptible to viruses immediately after a vaccination, some of which may cause the flu. If a person is allergic to eggs, they will respond to vaccines that are produced from chicken eggs.  To describe the process very simply, producers inject fertilized chicken eggs with the bacterium against which we want immunity, cause it to grow in the egg, then collect antibodies produced by the embryonic chicken in response to the bacterium, and make the vaccine from these antibodies.  The image above shows the same process in humans when a vaccine is injected into the body (basically the same steps happen when bacteria invade us or are injected into chicken eggs.

Autism Cycle and Immunity (from Homeopathy Center of Houston)

Some vaccines have clearly saved a lot of lives when compared to a time when no vaccines were present. Some cases of autism may be extreme examples of children with compromised immunity being given a vaccination at the wrong time. However, there is an increasing amount of experimental research published in peer-reviewed journals that show that mercury in the form of thimerosal, in the dosages present in most vaccines, damages the nervous system ((Baskin et al 2003, Burke et al 2006, Dórea 2010, Falluel-Morel et al 2007, Hornig et al 2004, Laurente et al 2007, Nagashima 1997, Olczak et al 2009a, 2010a,b, Rice 1996, Rice et al 2000).

A valid criticism is that none of this research was done experimentally on humans, but that statement is an ethical non-sequitur. We do not have to do controlled experiments on humans to discover that low-level mercury does harm. There is evidence of mercury’s effects on the human body that is in line with the results of experimental tests on mice, rats, hamsters, and monkeys (from the cited studies) as seen in Eto et al (2002), where the effects of minamata disease (mercury poisoning) were observed in human autopsies.

Minamata disease has been studied intensively for several generations since it was discovered that women who were pearl divers off the coast of Japan contracted it from the polluted Pacific Ocean waters which were contaminated by effluent from factories using mercury. It is based upon these studies that our conclusions about the deleterious effect of mercury on the nervous system were drawn (The Poisoning of Minamata).  By closely examining the immune response to mercury in non-human animals, we can see patterns of response that are exactly the same or similar to responses of humans for which the cause is unknown.  For this reason, there are some who suggest that the symptoms of autism are a lot like the symptoms of mercury poisoning (Bernard et al 2001).

A true experiment on vaccines as a cause of autism would require two randomly assigned groups of people, one containing experimental subjects who are vaccinated, and another containing age- and gender-matched control subjects who are not vaccinated. It is not ethical to randomly assign people to a group, given the strong evidence that vaccines have saved lives. However, a non-randomly controlled experiment (that combines epidemiological and laboratory methods) could be done, where people who sign up for the study choose the group to which they wish to belong. Since no one is asked to do anything that they would not do on their own volition, no ethics are violated. Furthermore, since the participants are gathered for the study before they decide which group they choose, the health status and health history of the infant before as well as after the vaccine is given is known. In observational studies, that is not always the case.

However, there is a limitation to such a study: the lack of randomization. Lack of randomization is a minor issue here, however, when compared to having no experimental information at all.  It just alters the way the statistics are done. Maybe such a study will not meet the gold standard, but possibly the brass standard (some would say the “mercury” standard). Furthermore, many doctors would protest because they, understandably, could claim that the experimental subjects cannot be suitably informed of the risks they are taking, assuming that these people are uneducated. This assumption flies in the face of the evidence given in NPR’s interview by Dr. Grossman who says that most of the people choosing not to vaccinate come from well-off, educated backgrounds. How much education is enough education?


Could There Be a Link Between Autism and Vaccines?

Doctors may not be very good at determining who should get a vaccine and when they should get it. Note the precautions concerning the flu vaccine where the elderly and immune-compromised are urged to get the vaccine, while very young babies who have not developed a strong immune system (so they are also immune-compromised) should not get the vaccine.  Sounds a bit contradictory.  Most doctors fail to look at all the possible causes of immune failure. One of the most prominent is caused by the presence of toxins. I suggest that they are most likely the basis of what medical researchers refer to as “autoimmune” responses.

Toxicologists restrict their testing of the body to blood and blood organs, ignoring the major areas of the body where toxins can invade without getting into the blood vasculature: the hypodermis and sub-epithelial transport system. I discuss the chemistry of toxins in the body in ““Toxins”  where there are references to other posts discussing toxins’ effects on physiology.

There have been many other studies published that question the safety of some vaccines, and thimerosal in particular (and its metabolites ethylmercury, inorganic compounds of mercury, and elemental mercury). There are also some that find no effects (Berman et al 2008, Price et al 2010, Thompson et al 2007). However, there have been no experimental studies (for which causation is the only way to determine) done on humans that show that vaccines do not cause autism, despite the headlines. For a more detailed review of the Price et al (2010) and the Thompson et al (2007) studies, go to the website Science-Based Pharmacy. The Price et al (2010) study was touted as the final word on the causation question but it was a purely observational study, despite the fairly large sample size (256 children), matched pairs in two groups, one group with autism, and the other without, and fairly good statistical odds determined by conditional logistic regression, all hallmarks of what we should do in an experimental study–except for one thing, the children were not randomly assigned to a group first, and one group vaccinated and the other not. It is not the definitive study claimed, even though it raises doubts that vaccines cause autism. The same criticism can be applied to the Thompson et al (2007) study, with an even larger sample size. For excellent reviews of studies on the controversial topic of the effects of thimerosal on the nervous system, I refer the reader to Olczak et al (2010b) and Dórea (2010).


Political Games and Complete Reporting

The Lancet retracted the “fraudulent” study mentioned in this report (Wakefield on a relationship between MMR [Measles, Mumps and Rubella] vaccines and gut problems in autistic kids), when a journalist for the Sunday Times of London, Brian Deer, who was hired by James Murdoch (with strong links to vaccine-maker GlaxoSmithKline) presented “evidence” (Deer 2011) of ethical violations by Dr. Wakefield in this study that were confirmed later by a medical review board, and reported on by BMJ. NaturalNews.com discusses the fiasco in both coverage and interpretation of Wakefield’s findings.  They also discuss how the financial ties of BMJ, James Murdoch (and thus, Brian Deer), and other medical journals can affect their publication or retraction of critical studies. Wakefield has never published anything mentioning a link between vaccines and autism (so the news reports got this part completely wrong).

The firestorm that erupted over his paper (whose findings were later supported by two other studies since 1998, and BMJ as a result, apologized to Wakefield) shows the political nature of medical research and how difficult it is to separate the personal, financial, and social standing in a community from what is supposed to be objective research. How can we expect parents to not make an emotional decision that could be life-altering about vaccinating their child?

Therefore, there are many people who, as they read these news reports, wish to avoid those risks. My message to all news reporters wanting to cover medical research is what reporter Carl Bernstein was told by “Deep Throat”in the movie, All the President’s Men: “follow the money”. All medical journals rely upon the pharmaceutical industry to fund their publications. It is no accident that most Americans think of the practice of medicine as only including drug prescriptions and surgery. The important message here is that we need a lot of education to understand the benefits and risks of vaccines, especially since there has been a major increase in the number of vaccines available, most of which have become required for school children. That education appears to include not only biological and medical information, but also political, psychological, social, and economic information–a great journalist’s dream.

Despite conspiracy theory advocates’ claims, some educated people have raised valid complaints that pharmaceutical companies, by promoting and gaining legislation requiring vaccination for an increasing number of disease, have insured rapid and lucrative return for their research efforts, supported by recent news that Gov. Rick Perry (Texas) got more than $29,000 (more than he admits) in campaign contributions from Big Pharma. Because there are no requirements for transparency, we have no idea how much PAC money Big Pharma has contributed to anyone.

The Human Papilloma Virus Vaccine

Human Papilloma Virus (from CureByte)

Comment on “Bioethicists Offer Reward For Proof On HPV Vaccine Claim” on All Things Considered 09/15/11, which discussed claims by Michele Bachmann that a woman told her that her daughter developed mental retardation after getting the HPV vaccination. Bioethicists Dr. Steven Miles and Arthur Caplan immediately offered a reward to the woman who made this claim if she could provide medical proof that her daughter got mental retardation from the vaccine.

What I Posted at NPR

Pres. candidate Michele Bachmann should go to the website http://www.NaturalNews.com for extensive reviews of research done on all types of vaccines. It was one of the first popular websites to point out that the HPV vaccine has never been tested on humans for effectiveness in preventing cancer, or for that matter, effectiveness in preventing or killing the human papilloma virus over a long period of time.  Logistically, the study would have to be long-term (at least 10-15 years long), because the vaccine’s primary benefit would not be realized until the girls become sexually active (some Texans think it will encourage premarital sex as reported since this report on NPR), and thus too expensive to carry out. I discuss more of this at my blog post “The Problem with Vaccines” at https://marthalhyde.wordpress.com/2011/09/19/the-problem-with-vaccines/

Extended Comments

Just after writing this post, I heard the report on Morning Ed.  about the science behind the controversy on HPV vaccine where Richard Knox interviews other doctors who doubt the vaccine’s necessity.

Even though conclusions drawn at http://www.NaturalNews.com can be controversial, and appear to be biased against vaccines, it is one of the better sites for understanding the controversy, since it discusses peer-reviewed studies that raise doubts about vaccine effectiveness and safety.  It is one of the best for following the autism-vaccine link, since reporting on this topic is so sketchy in most news agencies (few have scientists/doctors on staff capable of talking about newsworthy science). The best way to become educated is to NOT depend upon reporters, even those who are doctors on TV shows, but to read articles, both at NaturalNews.com, and those published in the vaccine company-funded journals, as well, that either promote or question the use of the vaccines.

Contrary to what Dr. Steven Miles says, there are lots of peer-reviewed studies that show strong correlations between nervous system damage and vaccines, but no studies that refute vaccines as a cause of autism in humans (only experimental trials can determine cause and effect–all other studies are observational and determine correlations only). Only a few are covered at NaturalNews.com, but see two peer-reviewed articles: a major review in the journal Neurochemical Research and one that reviews very relevant recent research in the journal Folia Neuropathologica.

There are also serious questions that have been raised about the purity (globally) of the HPV vaccine in particular, and other serious questions about the safety of the HPV vaccine have been raised. However, for all that, no experimental study has been done to show a particular disorder is caused by the HPV vaccine.  In fact, no experimental study on humans has been done to show that it is effective in preventing cervical cancer, either. Thus, the challenge raised by bioethicists sounds a lot like an attempt to divert our attention away from the issues about vaccines that we should be discussing–the effect of funding, politics, pride, and poor understanding about health effects on vaccine research. The sounds of the ruffling of feathers and stomping of feet come to mind upon hearing this report.


Relevant Websites

The Poisoning of Minamata

More Evidence That Mercury In Vaccines Doesn’t Cause Autism. Science-Based Pharmacy 

Wakefield Proven Innocent on Vaccine Autism Data Charge–Demands Retraction from BMJ

Documents emerge proving Dr Andrew Wakefield innocent–BMJ Guilty on Vaccine Charge

Vaccinations and allergy shots causing allergies to aluminum

Thimerosal-free childhood vaccines still suspect in autism

Sixth study in recent months links mercury in flu shots to brain damage, autism (refers to Dórea 2010 study)

Multiple studies link autism to mercury–still present in flu vaccines (refers to Olczak 2010a study)

The Lancet retraction of vaccine autism paper condemned as Big Pharma Conspiracy to Discredit Dr. Wakefield

Andrew Wakefield responds to article about journal retraction of autism study report

BMJ admits that fraud claim against Dr. Andrew Wakefield has no basis in fact

BMJ-Merck Tied During Publication of Attacks Against Wakefield

Wakefield Proven Innocent of Charges–BMJ Caught Distorting Facts

New Study Verifies Mercury in Flu Shots is Toxic (refers to Dórea 2010)

Vaccines Do Not Cause Autism: How Was the Erroneous Link between Vaccines and Autism Created?

SANE Vax Inc. Discovers Potential Bio-hazard Contaminant in Merck’s Gardasil™ HPV 4 Vaccine

References

Andrews, N.; Miller, E.; Grant, A.; Stowe, J.; Osborne, V.; Taylor, B. 2004. Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United Kingdom does not support a causal association. Pediatrics 114:584–591.

Baskin, D.S.; Ngo, H.; Didenko, V.V. 2003. Thimerosal induces DNA breaks, caspase-3 activation, membrane damage, and cell death in cultured human neurons and fibroblasts. Toxicol.Sci. 74: 361-368.

Bernard, S.; Enayati, A.; Redwood, L.; Roger, H.; Binstock, T.; 2001. Autism: A novel form of mercury poisoning. Med.Hypotheses 56: 462-471.

Burke, K.; Cheng, Y.; Li, B.; Petrov, A.; Joshi, P.; Berman, R.F.; Reuhl, K.R.; DiCicco-Bloom, E. 2006. Methylmercury elicits rapid inhibition of cell proliferation in the developing brain and decreases cell cycle regulator, cyclin E. Neurotoxicology 27: 970-981.

Chen, W.; Landau, S.; Sham, P.; Fombonne, E. 2004. No evidence for links between autism MMR and measles virus. Psychol. Med.34:543–553.

Deer B. How the case against the MMR vaccine was fixed. BMJ 2011;342:77-82.

DeStefano, F.; Karapurkar, T.; Thompson, W.W.; Yeargin-Allsopp, M.; Boyle, C.  2004. Age at first measles–mumps–rubella vaccination in children with autism and school-matched controls:  A population-based study in metropolitan Atlanta. Pediatrics 113:259–266.

Dórea,José G. 2010a. Integrating experimental (in vitro and in vivo) neurotoxicity studies of low-dose thimerosal relevant to vaccines. Neurochemical Research 36(6): 927-938.

Eto K; Tokunaga H; Nagashima K; Takeuchi T. An autopsy case of minamata disease (methylmercury poisoning) – pathological viewpoints of peripheral nerves. Toxicol Pathol 2002; 30: 714-722.

Falluel-Morel A; Sokolowski K; Sisti HM; Zhou X; Shors TJ; Dicicco-Bloom E. Developmental mercury exposure elicits acute hippocampal cell death, reductions in neurogenesis, and severe learning deficits during puberty. J Neurochem 2007; 103: 1968-1981.

Fombonne, E.; Zakarian, R.; Bennett, A.; Meng, L. & McLean-Heywood; D. Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations. Pediatrics 2006;118:e139–e150.

Geier, D.A.; Geier, M.R. A meta-analysis epidemiological assessment of neurodevelopmental disorders following vaccines administered from 1994 through 2000 in the United States. Neuro Endocrinol Lett 2006; 27: 401-413.

General Medical Council. Fitness to Practice Panel Hearing 28 January 2010. London.

Honda, H.; Shimizu, Y.; Rutter, M. 2005. No effect of MMR withdrawal on the incidence of autism: A total population study. J Child Psychol Psychiatry 46:572–579.

Hornig, M.; Chian, D.; Lipkin, W.I. 2004. Neurotoxic effects of postnatal thimerosal are mouse strain dependent. Mol.Psychiatry 9: 833-845.

Hviid, A.; Stellfeld, M.; Wohlfahrt, J.; Melbye, M. 2003. Association between thimerosal-containing vaccine and autism. JAMA 290: 1763–1766.

Laurente J; Remuzgo F; Ávalos B; Chiquinta J; Ponce B; Avendan~o?R; Maya L. 2007. Neurotoxic effects of thimerosal at vaccines doses on the encephalon and development in 7 days-old hamsters. Ann.Fac.Med.Lima 68: 222-237.

Madsen, K.M. et al. 2002. A population-based study of measles, mumps, and rubella vaccination and autism. N.Eng.J.Med. 347:1477–1482.

Majewska, M.D.; Urbanowicz, E.; Rok-Bujko, P.; Namyslowska, I.; Mierzejewski, P. 2010. Age-dependent lower or higher levels of hair mercury in autistic children than in healthy controls. Acta Neurobiol Exp (Wars) 70: 196-208.

Mutter, J.; Naumann, J.; Schneider, R.; Walach, H.; Haley, B. 2005. Mercury and autism: accelerating evidence? Neuro.Endocrinol.Lett. 26: 439-446.

Nagashima, K. 1997. A review of experimental methylmercury toxicity in rats: Neuropathology and evidence for apoptosis. Toxicol.Pathol. 25: 624-631.

Olczak, M.; Duszczyk, M.; Mierzejewski, P,; Majewska, M.D. 2009. Neonatal administration of a vaccine preservative, thimerosal, produces lasting impairment of nociception and apparent activation of opioid system in rats. Brain Res. 1301: 143-151.

Olczak, Mieszko; Duszczyk, Michalina; Mierzejewski, Pawel; Wierzba-Bobrowicz, Teresa; Majewska, Maria Dorota. 2010a. Lasting neuropathological changes in rat brain after intermittent neonatal administration of thimerosal. Folia Neuropathol. 48 (4): 258-269.

Olczak, M.; Duszczyk, M.; Mierzejewski, P.; Bobrowicz, T.; Majewska, M.D. 2010b. Neonatal administration of thimerosal causes persistent changes in mu opioid receptors in the rat brain. Neurochem. Res. 35: 1840-1847.

Price, Cristofer S.; Thompson, William W.; Goodson, Barbara; Weintraub, Eric S.; Croen, Lisa A.; Hinrichsen, Virginia L.; Marcy, Michael; Robertson, Anne; Eriksen, Eileen; Lewis, Edwin; Bernal, Pilar; Shay, David; Davis, Robert L.; DeStefano, Frank; 2010. Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism. Pediatrics 126(4): 656-664.

Rice, D.C. 1996. Sensory and cognitive effects of developmental methylmercury exposure in monkeys, and a comparison to effects in rodents. Neurotoxicology 17: 139-154.

Rice, D.; Barone, S., Jr. 2000. Critical periods of vulnerability for the developing nervous system: Evidence from humans and animal models. Environ.Health Perspect. 108 Suppl 3: 511-533.

Slotkin, T.A.; Bartolome, J. 1987. Biochemical mechanisms of developmental neurotoxicity of methylmercury. Neurotoxicology 8: 65-84.

Stehr-Green, P.; Tull, P.; Stellfeld, M.; Mortenson, P.; Simpson, D. 2003. Autism and thimerosal-containing vaccines: lack of consistent evidence for an association. Am.J.Prev.Med. 25:101–106.

Thompson, William W.; Price, Cristofer; Goodson, Barbara; Shay, David K.; Benson, Patti; Hinrichsen, Virginia L.; Eriksen, Eileen; Ray, Paula; Marcy, S. Michael; Dunn, John; Jackson, Lisa A.; Lieu, Tracy A.; Black, Steve; Stewart, Gerrie; Weintraub, Eric S.; Davis, Robert L.; DeStefano, Frank; Vaccine Safety Datalink Team. 2007. Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years. N.Engl.J.Med. 357(13):1281-1292.

Verstraeten, T.; Davis RL; DeStefano F; Lieu TA; Rhodes PH; Black SB; Shinefield H; Chen RT; Vaccine Safety Datalink Team. 2003. Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases. Pediatrics 112:1039–1048.

Young, H.; Geier, D.; Geier, M. 2008. Thimerosal exposure in infants and neurodevelopmental disorders: An assessment of computerized medical records in the Vaccine Safety Datalink. J.Neurol.Sci. 271: 110-118.

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© Copyright 2014 by Martha L. Hyde and https://marthalhyde.wordpress.com.

One thought on “The Problem with Vaccines

  1. BMJ online, 7 February 2011

    Fiona Godlee, Editor in Chief

    Since we published the first of three articles by Brian Deer on the secrets of the MMR scare [1] and a linked editorial [2] on 5 January 2011, the BMJ has been the subject of an orchestrated campaign of emails. In response to questions raised in these emails, we make the following statement.

    The BMJ stands by the article and the editorial. The article, which was subjected to peer review and editorial checking, was based on enquiries carried out over some seven years, involving, among other things, interviews with parents of children enrolled in Andrew Wakefield’s research. Four such parents are quoted in the article. As made clear in the article, the core data on which the findings were based were evidenced, except in the case of one child, by the transcript of a General Medical Council fitness to practise hearing which sat between July 2007 and May 2010.

    In many of the emails we have been sent, it is suggested that Andrew Wakefield did not have access to GP records and therefore could not be responsible for discrepancies between those records and what was published in the Lancet in February 1998. The case we presented against Andrew Wakefield that the 1998 Lancet paper was intended to mislead is not critically reliant on GP records. It is primarily based on Royal Free hospital records, including histories taken by clinicians, and letters and other documents received at the Royal Free from GPs and consultants.

    We draw attention to the finding of the fitness to practise panel, on which we are entitled to rely, that “the project reported in the Lancet paper was established with the purpose to investigate a postulated new syndrome and yet the Lancet paper did not describe this fact at all. Because you [Wakefield] drafted and wrote the final version of the paper, and omitted correct information about the purpose of the study or the patient population, the panel is satisfied that your conduct was irresponsible and dishonest.”

    Contrary to other suggestions contained in the emails, we made no allegation of dishonesty against Andrew Wakefield’s co-authors, or indeed against anybody else. As the GMC panel heard, it was Andrew Wakefield who wrote the Lancet paper, using data which he anonymised, with little oversight by other authors. We confirm that under the uniform requirements for manuscripts submitted to biomedical journals all authors should be in a position to speak to data, but the evidence is that in this case they were not.

    We are aware of recent claims made by Andrew Wakefield that “new documents have come to light” purportedly confirming his claims in the Lancet. The material he cites was presented to the GMC panel two and a half years ago. Andrew Wakefield was last year erased from the medical register and he has chosen not to appeal that decision. As indicated, the very many charges proven against him include dishonesty in his research.

    We are unaware of any peer reviewed paper replicating Andrew Wakefield’s research or confirming his claims to have identified a new syndrome of regressive autism and inflammatory bowel disease associated with MMR vaccination. With respect to gastrointestinal issues, we draw attention to an authoritative consensus statement published last year by experienced specialists in this field [3] and particularly to statement 4: “The existence of a gastrointestinal disturbance specific to persons with ASDs (eg ‘autistic enterocolitis’) has not been established.”

    Fiona Godlee, Editor in Chief, BMJ

    References

    1. Deer B. How the case against the MMR vaccine was fixed. BMJ 2011; 342:c5347 doi: 10.1136/bmj.c5347

    2. Godlee F, Smith J, Marcovitch H. Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ 342:doi:10.1136/bmj.c7452

    3. Buie T, Campbell DB, Fuchs GJ, et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus statement. Pediatrics 2010;125;S1-S18.

    Like

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