Wakefield: Proquad claims. Liar or incompetent?

[noblegiraffe]

This just came up on another thread, and I thought it was worth wider publicity, given Wakefield's apparent continuing influence, and the current measles outbreak.

I was discussing whether 'vaccine overload' had any basis in science, or any evidence for it. (No, btw).

I was directed to the claim that giving a 4 in 1 jab against measles, mumps, rubella and chicken pox (called the MMRV) doubled adverse reactions. I found an interview with Wakefield where he claimed this showed that giving extra vaccinations at the same time was dangerous. He said:

"If you just take for example, MMR and you add in the varicella vaccine, the chickenpox vaccine, MMRV as ProQuad what happens is you double the rate of convulsions as an adverse reaction. So just adding one and not 999,000 but just one extra vaccine in, you double the rate of an adverse, a potentially serious adverse reaction. To the extent that that ProQuad vaccine had to be withdrawn. So the notion that you could give a child a hundred thousand vaccine antigens on one day is utter nonsense. And what is extraordinary, what is telling I suppose is that no other immunologist or vaccinologist or any other person with any credible standing has stood behind Dr. Offit and said yes, you can go for it."

2 points need to be made

1. Proquad has not been withdrawn. It is still licensed for use. The advisory body in the US did amend their recommendation in light of the extra adverse reactions (4.3 extra febrile seizures per 10,000). ProQuad used to be their preferred injection for both initial and booster jab, now it is just recommended for the booster jab.
   www.merckvaccines.com/Products/ProQuad/Pages/recommendations

2. Wakefield suggests that it was giving an extra vaccine that caused the extra adverse events (vaccine overload), however the comparison of adverse events was not between the MMRV and the MMR (4 vaccines versus 3) but the MMRV versus the MMR plus the chickenpox vaccine given on the same day (4 versus 4). Nothing to do with an extra vaccine, and he is trying to use this to make a point which simply isn't valid.
   www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm123798.htm

Now Wakefield still has an agenda regarding spaced out single vaccines (as recent headlines show).
Was he lying when he made these easily researched incorrect claims about ProQuad, or was he simply too thick to correctly assess the information widely available?

Now if he wanted to discuss why there were more adverse events to the 4 in 1 versus the 3+1, he might have a point (I'm not sure they contain exactly the same vaccines) but he didn't. He made a completely false point, one which is proudly featured on an antivax website.

Please treat anything Wakefield says with the caution it deserves.

Also, the Krigsman paper appeared in Wakefield's own Vanity Journal, Gonzales was paid for her project by Thoughtful House and Wakefield is a co-author on the Furlano paper... Independent the Wakefield way ;)

Magdalen - I'd be really interested in your opinion of the Walker paper - I have read it, but was left with a profound "and so...?" feeling, while everyone on the "other side" waves it as "independent confirmation of Wakefield's findings", we knew that altered gene expression is associated with autism from GWAS studies and Pat Levitt's work on MET (for example). I find that one confusing...

Maybe it would be really helpful to have a closer look at what Wakefield is trying to say rather than fighting him.

www.vaccinationcouncil.org/2011/06/01/vaccines-and-brain-inflammation/

That's a fantastically open-minded and neutral site you've found, rosi7

"We are profoundly critical of the practice of vaccination. Vaccination is an unacceptable risk to every member of society, regardless of age"

I wonder if it can be trusted to be unbiased?

Where do they stand on the elimination of Smallpox, and the enormous reduction in polio?

PigletJohn, it might actually be useful to look at the content rather than continuing your habit of discrediting people or institutions without looking at what they have to say.

I had a look, but I see you are a committed antivaxxer, so no point in trying to debate with you.

That is exactly my point, PigletJohn.

I'm glad you accept that.

Magddalen have you read the 1998 Wakefield et al Lancet paper?

Do you understand what it was about?

I think like a lot of people you are getting too hung up on the MMR/autism part of the equation and completely forgetting that the beginning of all this is a case report of children presenting with intestinal disease.

You do realise that Professor Walker Smith is a gastroenterologist? Right? That the children were at the Royal Free in order to see a paediatric gastroenterologist because they had gut issues.

You have asked me to provide papers that replicate the findings of the 1998 Lancet paper but do you actually know what those findings were? It appears not because you have just made several posts seemingly surprised that the papers replicating the findings of the Lancet paper don't test a connection between MMR and autism

No they don't. Do you know why ?

Because the findings of the Lancet paper were concerned with the gut inflammation the children presented. That is the bit that everybody goes on about not having been replicated when it quite clearly has in the papers I linked to for you.

Deer claimed that Wakefield did not find the inflammation he claimed to - that was the fraud.

Although of course it was a ridiculous claim to make and caused Godlee and the BMJ much embarrassment. Indeed they attempted to backtrack once it became obvious that they had to also accuse Professor Walker Smith and Dr Dhillon of fraud in order for their claims to actually make any sense.

I suggest you read the Professor Walker Smith appeal decision for information on how the children were referred to the Royal Free and on both their status as clinically ill with gut issues and their autism diagnoses.

Deer's article was full of crap and it angered the parents of the Lancet children deeply. They were very very upset as it was clear that Deer had had access to confidential medical records and private emails and that he then published information from them for all the world to read and published incorrect information. Godlee should be ashamed of herself. She should also be ashamed of herself for claiming that Deer's nonsense had been externally peer reviewed (it hadn't she and other BMJ editors reviewed it) and for having to have it dragged out of her that the business partnerships that the BMJ have with both Merck and GSK were an undeclared conflict of interest with regards to Deer's articles. Apparently it didn't occur to Godlee that they need declare such a conflict of interest

The whole thing was an embarrassment for Godlee and the BMJ. (And Deer but then we are all used to that. It is rather a different matter for a medical journal and its editor to plaster egg all over their faces. Mind you Horton and the Lancet have done it too...)

So I'm afraid that there are no claims of fraud that actually stand up. And the findings of the Lancet paper have been replicated several times over.

These children are sick. They have intestinal disease and the claims of Deer and Deer the BMJ and Deer the GMC that they don't, well, that is really sick.

Funny how it all keeps coming back to Deer isn't it. Someone else who repeatedly fails to declare conflicts of interest such as enjoying the hospitality and speaking at conferences of Merck's partner the Foundation Merieux. Plus being the source of the complaint to the GMC (now repealed for Professor Walker Smith). Deer really is in it up to his neck isn't he?

I have read the paper (more than once, actually). The paper claims that it was looking at a series of children who were consecutively referred to a GI specialist. We know now that this is a lie. And it is not a trivial lie, because it implies you can just take 12 consecutive kids and they'll all have had measles containing vaccine, then started GI problems, then started autism and that is not the case.

oh and the 6 degrees of separation only ever apply to Godlee and Deer, not to Krigsman, who worked in Wakefield's clinic when he publishes something in Wakefield's own vanity journal.

And the findings of the Lancet paper have been replicated several times over.

No, they have not.

What all this comes down to (particularly the Walker paper) is that Horton should retract his retraction of the Lancet paper, the GMC should revoke and the BMJ should retract Deer's articles.

Wakefield et al's findings in the Lancet paper have been shown to be valid. It has been shown (by Professor Walker Smith's successful appeal) that there was no fraud or gross misconduct in the Royal Free actions. The children were sick, they had autism, they had gut issues, their condition merited clinical investigation, the finding of the clinical investigation has been shown to be valid. The research is therefore both valid and ethical. That is the long and the short of it.

Wakefield's findings were:

We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.

He didn't show the association with MCV in the first place, but certainly no one else has.

Wakefield's basic timeline is also completely out (MMR then autism - it was the other way round). Deer's access to confidential medical records enabled the truth (about the time line) to emerge.

I think his worst crime was to completely and selfishlyand heartlessly misleed the parents of 12 children for his own gain.

I have read the paper (more than once, actually). The paper claims that it was looking at a series of children who were consecutively referred to a GI specialist. We know now that this is a lie. And it is not a trivial lie, because it implies you can just take 12 consecutive kids and they'll all have had measles containing vaccine, then started GI problems, then started autism and that is not the case.

That would be an accusation against Professor Walker Smith as the clinician CatherinaJTV. Or it would be if it made any sense.

Do you understand what a case series is?

Professor Walker Smith would have had hundreds of children with GI disturbances referred to him over the period - hundreds of them would not have autism, probably many of them would not have had MMR or other vaccines. The Lancet children weren't 12 children consecutively referred to Professor Walker Smith - they were 12 children consecutively referred to Professor Walker Smith who had similar symptoms and history. That is what a case series is.

The Lancet case report was a report of a series of children who presented ASD/GI symptoms who had the common history of having been vaccinated with MMR and in which some of the parents associated the onset of their symptoms with that incident. All this is clearly stated in the paper.

CatherinaJTV Sun 28-Apr-13 10:47:44

Wakefield's findings were:

We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.

You are correct CatherinaJTV and it is notable that several papers have subsequently come to the same histopathological conclusions regarding this population of children and that as long as they don't mention 'environmental' triggers, their papers are neither retracted, nor accused of fraud nor smeared in the press, nor are the authors hauled up before the GMC (or US equivalent).

Bit like how only the three authors of the Lancet paper/Royal Free team who refused to retract the possibility of a possible environmental association were the only three of the 12 authors to be accused of gross misconduct by the GMC.

It used to be verboten to make any association between ASD and GI disease at all - now it seems you can get away with it as long as you categorically do not mention the patient's medical history or parental observation of the onset of symptoms.

This is politics CatherinaJTV, not medicine.

Beachcomber science is about testing hypothesis - if you can't find a credible hypothesis to test, it's not science. It also needs to be objective not subjective.

Your comments smack of conspriacy theories "don't mention the medical history or parental observation" ...

As parents we are notoriously subjective and extremely liable to the power of suggestion, particularly when our child is ill and we do not understand why.

And it is interesting to see that coorong supports a journalist publishing his misinterpretation of details of children's confidential medical records for all the world to read. Plus such an action being condoned by a so called professional medical journal and its editor. Plus the editor of said journal failing to declare a very compromising conflict of interest through financial partnerships with vaccine manufacturers.

I guess that is the level of ethics and honesty (or rather lack of) that we are dealing with here.

Abhorrent.

Yeah, yeah, coorong - we've had the 'the parents are deluded' stuff before.

Yup, thousands of parents and their doctors have observed children changing in remarkably similar ways after exposure to the triple vaccine but best just to ignore them because that is how science is done.

Except it is not. Patient history and observation is the bedrock of medicine.

Plus the editor of said journal failing to declare a very compromising conflict of interest through financial partnerships with vaccine manufacturers.

I guess that is the level of ethics and honesty (or rather lack of) that we are dealing with here.

Hi Beachcomber

can you imagine your hero, ex-Doctor Wakefield doing anything like that?

You know PigletJohn, I wouldn't describe Dr Wakefield as a 'hero'. Nor would I describe Professor Walker Smith as such. Seems to me that they were doing their job and they chose not to stop doing their job simply because they encountered children, and happened to end up working in an area, that was going to make them unpopular with public health officials and pharma companies.

PigletJohn, I know I took a while to do it, but i did answer your earlier question to me and I would appreciate it if you could answer my earlier question to you; what is your opinion of Professor Walker Smith? Do you think he is a liar, a cheat and a fraud? Do you think he should have lost his appeal?

thousands of parents

yet in 5000 cases in the Autism Omnibus proceedings, all test cases fell through - all conspiracy?

As said (was it earlier in this thread?): I saw, with my own eyes, my husband start a 40 degree fever, the first time he spiked a temp that high in 20 years, the very night after a cancelled flu shot appointment. A friend had a similar experience with her son's very first (delayed) baby shot appointment - she postponed it yet again and that very weekend, her son broke out in severe eczema.

I am not saying that vaccines cannot trigger adverse events (and MMR can cause encephalitis, in about 1 in 1 million vaccinees). The daughter of an acquaintance had her first grand mal after her second DTaP (a smaller seizure, thought febrile after the first) - everyone told her it was the vaccine, including her doctor. She has found out in the meantime that her daughter has Dravet Syndrome, a genetic form of epilepsy (like many others, who were thought to have vaccine damage, when it was really Dravet all along). If the vaccine had not triggered the first grand mal, it would have been a hot bath, or a visit to the doctors.

A lot of genetic conditions don't become apparent until years or even decades after seemingly total normal development (think Huntington's). That is, as difficult it may be to accept, a lot more likely than vaccine damage leading to autism, whether via the gut as per Wakefield myth, or directly by action on the brain.

Beachcomber,
Who exactly suggested the parents of any children are deluded?
It is simply that just because parents believe their child's ASD was caused by MMR does not mean it was.
This paper looks at parental recall:

www.psychologytoday.com/blog/radical-behaviorist/201002/the-autism-vaccines-myth-the-impact-the-media
"Brent Taylor and colleagues reported an interesting and unsettling finding related to the impact of the MMR controversy. In Taylor et al. (2002), multiple parental interviews were obtained for many children diagnosed with an ASD about when they noticed the onset of autistic symptoms. A review of each individual case was made. It was found that several parents reported different times of the onset of autistic symptoms in different interviews. "A review of each record showed that in 13 children the history given by the parents had changed after the extensive publicity about MMR vaccine and autism. Before the publicity the parents often reported concerns early in their child's life, usually before their first birthday; the current history for the same children recorded symptoms as developing only after MMR vaccination, in some cases shortly after. This bias associated withhfh changes in the history given by the parents necessitates particular care when interpreting [parental report]" (Taylor et al., 2002)."

They are not saying the parents are deluded. Human memory is fallible, as studies show time and time again (not just relating to onset of autism, but to lots of other things).
Cheers.

Drat, link didn't convert:
www.psychologytoday.com/blog/radical-behaviorist/201002/the-autism-vaccines-myth-the-impact-the-media