How the vaccine crisis was meant to make money
BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.c5258 (Published 11 January 2011) Cite this as: BMJ 2011;342:c5258
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It is not surprising to me having had many robust discussions with a
variety of skeptics on a variety of subjects that they assume a cognitive
dysfunction when it comes to making absolute statements in support of
their own pet theories. MMR causes Autism.
I'm not sure that the rights of parents to voice their concerns
should contain statements such as "vacuous" and "flat earthers" either as
offered by Professor Greenlaugh.
I rebut in the strongest terms allegations as to the depth of
knowledge and understanding that parents have about this issue. I give
this example -
"... if your child has clinical indications of an immune system
abnormality, such as unusual or difficult to treat infections, or your
family has a long and extensive history of immunological problems, we
recommend that you consult with your physicians about the safest options
for immunizing your children."1
Where does this advice come from? Well it comes from the following
organisation the University of California.
The University of California Davis has within its facilities the MIND
Institute and is a collaboration of all the stakeholders in the ASD
community.
It was founded by
"...six visionary families, five who have sons with autism..."2
On its board is an astonishing array of talent and community ranging
from Community Volunteers, Parents and of course a wide variety of
University personnel.It has its own clinical providers numbering some 13
staff and I was able to count at least 5 Ph.Ds' on the staff. Attached as
well, is a Research Faculty of 35 personnel of which 28 hold Ph.Ds' .
The facilities and deep knowledge at UC Davis cannot be disputed it
is currently running
a number of investigative research studies into Autism.
* Autism Phenome Project (APP)
* EarlyInfants at Risk for Autism: A Longitudinal Study
* A Randomized Multi-site Clinical Trial of Intervention for Infants
at Risk for Autism: Early Start Denver Model.
*Genomics and Phenomics Center: APP and AGRE-NIMH
and the most interesting
*Childhood Autism Risks from Genetics and the Environment (CHARGE)
Unlike others in this debate it has made a conscientious decision to
set all prejudice aside and look at the children and parents before it,
listen to their accounts and start their investigations from that logical
starting point. It is the kind of facility that the UK medical
establishment should be insisting on being opened in their country and
that discussion should be being led by one of the country's leading
medical journals.
The MIND Institute clearly states its current position on vaccines
and Autism. It acknowledges the many epidemiological studies. It also
recognises the clear and present danger of measels and the effect it may
have on an unvaccinated population.
The MIND institute clearly has the best interests of a community of
people that share a common cause. It is open to a range of hypotheses that
could have and should have been generated during and after "Wakefield."
"Does this mean that we can say without a doubt that vaccines do not
cause autism in some children? The answer to this question is "no". There
is emerging evidence that some children are immunologically compromised
and therefore may respond in an atypical way to vaccinations."1
"We do not currently understand how atypical immune responses might
influence the developing nervous system or how commonly such adverse
effects occur. Further, we currently have no way to identify those
children who might respond adversely to vaccines."1
Parents are concerned that their requests for assistance are met with
dignity and care. That their stories have an open and honest platform to
be heard and objective science and health provision is not met with scorn
and cynicism.
Parents and the broader community require that research is ongoing,
objective and broad in setting hypotheses and rejecting them and that they
are informed and part of this research.
My children only one diagnosed with ASD are fully immunised on time
and schedule. They will both be immunised again in the near future.
Not all the issues are related to the simple construct of MMR causes
Autism.
regards
for the reader interested in accessing more material about ASD and
the fine clinical and research work being carried out UC Davis
1.http://www.ucdmc.ucdavis.edu/mindinstitute/newsroom/vaccineposition.html
Competing interests: Father of son ASD
We presented the Wakefield article to a group of our students at
journal club today. Articles are generally selected for their public
health relevance, but also as examples of the fallibility of the
scientific process. For years we have used Wakefield's 1997 Lancet paper
as an example of an article that received the imprimatur of respectability
despite being based on a very limited evidence base.
The recent revelations in BMJ render all that moot. It seems that
the issue is not that claims based on hypothesis-generating exercise went
far beyond what the evidence would support, but rather that the entire
paper was a sham. In her accompanying editorial, Dr. Godlee emphasized
the public health consequences, opportunity costs, and erosion of the
public's trust in vaccines that followed the article's publication. To
that we must add another casualty: loss of faith in the scientific process
itself. It is bad enough that an investigator's financial conflicts of
interest could corrupt the scientific process to this extent, but to learn
of the Lancet's role in backing the article even after compelling evidence
of fraud had been presented in 2004 is far more discouraging. Our
students learned a sad, but important lesson this day.
Competing interests: No competing interests
I don't condone the flat-earthers for one moment but let's not advocate a society where their strident claims are censored before getting on the page. Surely the vaucuous arguments being put forward in support of Wakefield's research illustrate precisely the point which Deer is making?
Competing interests: No competing interests
From this article: "...the lawyer had offered to pay the school for
a "clinical and scientific study," and had sent a first instalment of
[Pounds sterling] 25000. This was held in suspense while Zuckerman sought
confidential ethical advice from the British Medical Association, although
Wakefield had already started spending it."
In earlier Rapid Responses in the BMJ to editorials and other
articles discussing this sad affair, those believing the MMR-autism link
would summarily dismiss anyone with an opposing view who had the flimsiest
of "vested interests". Now we see that Wakefield had the most venal of
vested interests: he was paid to find a link. I have not looked in detail,
but there seems nothing about this on the support group (JABS) website
(http://www.jabs.org.uk/). Clicking there on "Vaccine News and Info"
brings up first a story from the Daily Mail in 2004 titled "MMR killed my
daughter". Wakefield still remains a hounded hero to them.
The sub-head to last week's editorial was "Clear evidence of
falsification of data should now close the door on this damaging vaccine
scare",(1) but it won't. Only clear evidence of the real cause of autism
would do that - although perhaps even that would not be enough.
What it is time for is a closure of dialogue in the BMJ on this
matter. The editorial saw the resurfacing of all the invalid arguments
that we have read so many times before. Those who discount and decry the
mass of evidence now available that MMR is not linked to autism have had
their say in this journal, and it is time for that door to close. The
Earth is not flat and that is that. Or, perhaps more appropriately, the
Apollo missions did indeed land on the Moon.
1 Godlee F, Smith J, Markovitch H. Wakefield's article linking MMR
vaccine and autism was fraudulent. BMJ 2011;342:c7452
Competing interests: No competing interests
BMJ and its editors are to be commended for this much-needed update.
Unfortunately, it tells us that charlatans remain in the medical
profession as well as in other walks of life. Public trust requires
integrity and accountability, both in research and clinical practice.
Mistakes will continue to occur, but all must remain vigilant to protect
our patients and the public health. Those refusing vaccination because of
this fraud have, unwittngly most likely, contributed to resurgence and
importaion of measles, with risk of its attendant complications.
Another brand of 'snake-oil' is the off-shore promotion of stem cell
transplantation without documentation, and preying on the desperate
looking for miracle cures.Integrity must be taught and part of our
character. Edmund Burke's famous quote is a bluntreminder-'All that is
necessary for the triumph of evil, is for good men to do nothing!'
Robert E. Dedmon, MD MPH FACP FACOEM
1.Sheldon, T. Dutch Clinic is ordered to stop giving stem cell
therapy. BMJ 2006;333:770
2. Dedmon, RE. Stem Cell Tourism:the new 'Snake Oil' of the 21st Century.
Asian Biomedicine 2009;3(3):339-342
Competing interests: No competing interests
Re:Re:Re:Let's not curtail free speech correction
Greenlaugh should read Greenhalgh.
Competing interests: Father of ASD