Dr. Wakefiled and the MMR study

[Uwila]

"If found guilty, Mr Wakefield could be struck off the medical register."

\link{http://news.bbc.co.uk/1/hi/health/5070670.stm\MMR Doc to face charges}

Discuss, please.....

jimjams and edam, roll on courtcase...it will be like mclibel and will backfire massively on those that are bringing it (and lets face it it will be being brought through govt pressure), and give wakefield a chance to clear his name and make those that are pursuing him look like that totally immoral and outrageously self interested parties they are.

peachyClair, there's no myth or hearsay- just read his papers. The first one didn't even mention not giving MMR as far as I can remember. O Leary is worth reading as well. He has been finding the same things as Wakefield but has been very careful to say pretty much nothing about the MMR.

The one person whose work it is bloody difficult to read is Walsh's- which is a PITA as I would like to know more about his (not that involved with the MMR).

In fact just thought I should be able to track down Wakefield's yearly talk at A2- will see if I can find it. Always an interesting read.

Jimjams - Edam's post below:
'Wakefield's big mistake wasn't doing the research, or even publishing it....It was saying, at a press conference, that in his opinion, the safest thing to do until more research had been done to confirm or refute his findings, was look at providing single jabs.'

You're too nieive sophable. These are the same people who continued to reaassure us that thimerosal was perfectly safe to inject into 8 week old babies (although foetuses coming into contact with mercury via their mothers eating fish was not- riiigghhht) because- and I quote- because on hearing this I let go of every getting any recognition/justice etc for ds1 so its stuck in my mind "the risk is only theoretical". Oh that's OK then. I'd like to show the silly cow who said that some theory in this house. They still removed it from the baby jabs though. Wonder why if the risk was only theoretical.

I haven't read any of this for a long time, but weren't there issues about the research methods / co0nflicts? Now, if the research findings are completely valid, they can only stand scientifically if the methods etc are infalliable. had he disclosed these conflicts of interest at the outset, then any findings he did make would be far more likely to be considered valid, and therefore far more likely to help people such as yourself JimJams because the info would be accepted by the medical fraternity. Surely that would have been better? And perhaps an investigation will break down what was valid and what wasn't, given those conflicts?

The thing is, research costs millions and rightly this research was funded into a perfectly valid theoretical proposition- autism and vacciantion. That's great. Then by not declaring his interests etc he blew any possible scientific acceptance of his work. HWATEVER he found would have been dismissed as a result. I do agree that vaccinations is a contentious issue and mroe likely to get him slated, but then he had a bigger responsibility to double tick every box about ethics. And he didn't.

What if Scientist X had been given the funding for the same research after Wakrefield theoretically absented himself due to ethical concerns after discussing with his ethics committee as he should have done (the discussion at least)? If Scientist X had got the same results, then it would have been so much more powerfulfor the autistic community, and people may well have spent the subsequent decade performing replication studies to validate (essential for validation- all studies should be replicable) instead of being d=funded to disprove everything Wakefield found.

Its a purely scinetific standpoint, I know far more about that than the research itself, but if I grasped all that through a year of undergrad Psychology on amixed major course, then he should have known it down pat.

It was a mistake for his career. But I still think he was right.

Incidentally. He requested meeting after meeting after meeting wth dept of health officials beofre publication of the research as he was so concerned by what he had found.

I think he was over-emotional. I think the first severely autistic child he treated was Tom kessick, word got out that there was a Dr in London who would treat bowel disorders and so parents started asking for referrals to him. He found child after child with the same novel bowel disorder and parents saying that they regressed after the MMR. These were severely autistic children- and so he was dealing with families personal tragedies (and sorry, but severe autism is a f*** tragedy- particularly if the child appears to have been developing normally). Because all these children appeared to have come out of nowhere he was concerned that there were vast numbers.

That's where he was wrong, there weren't vast numbers. They still exist though. GI disorders are believed to be under-dxed in autism though anyway.

Jimjams- 'peachyClair, there's no myth or hearsay- just read his papers. ' that what I mean by myth or hearsay.... Dr W says there may be a link; paper X says there is a link; Mrs C says you can't give MMR- a lot of myth and hearsay has built up around this case; I dont mean the findings necessarily, more what people thought he found.

The research was not funded into autism and vaccinations, it's research into autism and bowel disorders. I don't think there is any publically funded research into autism and vaccinations.

The Americans are heavily funding the autism- mercury stuff, but I don't think with public money.

Not just a mistake for his career, Jimjams, but one that has unfortunately had the consequence of causing a massive explosion of mumps cases due to the fall in MMR uptake. There has been real damage done by this to many many people.

Whether one man can be help accountable for this is another question and this is where I think the media have to take responsibility for whipping up hysteria. If we had a more scientifically literate press then Wakefield's views could have sparked a debate without having such extreme consequences.

This is Wakefield's response to the accusations anyway.

"Serious allegations have been made against me and my colleagues in relation to the provision of clinical care for children with autism and bowel disease, and the subsequent reporting of their disease. These allegations have been made by journalist Brian Deer who has expressed, in front of witnesses, his aim of destroying me.

All but one of the allegations, which are grossly defamatory, have been shown to be baseless. One allegation remains against me personally. That is, that I did not disclose to the Lancet that a minority of the 12 children in the 1998 Lancet report were also part of a quite separate study that was funded in part by the Legal Aid Board.

It is the Lancet's opinion but not mine that such a disclosure should have been made since it may have been perceived as a conflict of interest. This is despite that fact that the funding was provided for a separate scientific study.

It needs to be made clear that the funds from the Legal Aid Board were not used for the 1998 Lancet study, and therefore I perceived that no financial conflict of interest existed.

The Lancet defines a conflict of interest as anything that might embarrass the author if it were to be revealed later. I am not embarrassed since it is a matter of fact that there was no conflict of interest. I am, however, dismayed at the way these facts have been misrepresented.

Whether or not the children's parents were pursuing, or intended to pursue litigation against the vaccine manufacturers, had no bearing on any clinical decision in relation to these children, or their inclusion in the Lancet 1998 report.

It is a matter of fact that there was no conflict of interest at any time in relation to the medical referral of these children, their clinical investigation and care, and the subsequent reporting of their disease in the Lancet.

As far as the 1998 Lancet report is concerned, it is a matter of fact that we found and reported inflammation in the intestines of these children.

The grant of £55,000 was paid not me but to the Royal Free Hospital Special Trustees for my research group to conduct studies on behalf of the Legal Aid Board. These research funds were properly administered through the Royal Free Hospital Special Trustees.

The Legal Aid research grant to my group was used exclusively for the purpose of conducting an examination of any possible connection between the component viruses of the MMR - particularly measles virus - and the bowel disease in these children. This is entirely in line with other studies that have been funded by the Legal Aid Board (latterly the Legal Services Commission) and reported in the BMJ. If and when this work is finally published, due acknowledgement will be made of all sources of funding.

It is unfortunate that, following full disclosure of these facts to the editor of the Lancet, he stated that in retrospect he would not have published facts pertinent to the parent's perceived association with MMR vaccine in the 1998 Lancet report. Such a position has major implications or the scientific investigation of injuries that might be caused by drugs or vaccines, such as Gulf War Syndrome and autism, where possible victims may be seeking medical help and also legal redress.

Health Secretary John Reid has called for a public enquiry. I welcome this since I have already called for a public enquiry that addresses the whole issue in relation vaccines and autism.

It has been proposed that my role in this matter should be investigated by the General Medical Council (GMC). I not only welcome this, I insist on it and I will be making contact with the GMC personally, in the forthcoming week.

This whole unpleasant episode has been conflated to provide those opposed to addressing genuine concerns about vaccine safety with an opportunity of attacking me - an attack that is out of all proportion to the facts of the matter.

I stand by everything that I have done in relation to the care, investigation and reporting of the disease that I and my colleagues have discovered in these desperately ill children.

My family and I have suffered many setbacks as a direct consequence of this work. As a family, we consider that our problems are nothing compared with the suffering of these children and their families. For the sake of these children, this work will continue."

'It was a mistake for his career. But I still think he was right.

Incidentally. He requested meeting after meeting after meeting wth dept of health officials beofre publication of the research as he was so concerned by what he had found'

i think he was right to start the process of this research- to set the theoretical question- but he should have let someone without his associations carry it through, that would have been a bigger service to all. Any research into MMR / Autism is going to be tainted to the masses by this, and there is a hole in the potential funding spent (and my Lecturers would say wasted because of lack of scientific valisity through etical concern) on this that would have been spent so much better on exactly the same thing, by someone else. Would your son have been worse off f someone else had made the same findings, dsomeone whose research was then accepted?

ANY research question is valid is testable and perferably repeatable; but a scientist has an ethical responsibility to pass on research that is a conflict of interest. I did an essay on autism (well on semantic pragmatic disorder, and linked it to autism) recently and completely avoided this whole area as I knew it would be struck through be the lecturer as ethically questionable.

of course, you can clearly see my AS tendencies coming in thick here... give me an ethical rule and I'll adhere it. And I do understand what you're saying; I just think the whole sorry episode would have so much less likely had he stepped back beforehand and passed the funding to a colleague.

If he's right about the lancet being wrong, then surely its in his benefit for it to be tested in a GMC action?

And why was there not a massive explosion in the cases of measles and rubella. Oh because the government allowed the import of measles and rubella jabs but made it very difificult for single jabs clinics to get mumps.

Anyway one of the largest groups contracting mumps was the university students who were jabbed with MR or single measles, or MMR and protection had since worn off.

If the govt had followed Wakefield's suggestion "give singles rather than combined" then there would either have been no mumps epidemic, or there would have been in the young adult population, So I don't really see what he has to do with it.

Does anyone on here actually care about the children who have regressed following MMR? Or are you all buying the "parents were too stupid to notice" line. Durr hadn't noticed my child having seizures before. Must have missed the time he was in ICU.

I agree he was too emotional pecachyClair but faced with a succession of doctors who frankly don't give a shit (and insist on doing ridiculous things to ds1 like show him what they're going to do to him with a doll (ffs- just pin him down and get on with it or it won't happen) I don't think that's a bad thing. Not very sensible, but rather endears him to me. I assume he knew it was a risky career wise.

"Anyway one of the largest groups contracting mumps was the university students who were jabbed with MR or single measles, or MMR and protection had since worn off. "

Absolutely, but the point is that the unvaccinated children with the illness are providing a reservoir for infection.

And who is responsible for the fact that these children were vaccinated against measles and rubella but not mumps?

Kathy, if the governement really want so increase uptake, they should offer them singly. Or possibly they could end the scare tactics by including private single jabs in their statistics?

And I agree with you entirely on that, the trouble is that the scientific community doesn't. No point trying that doll crap with Sam either- i'd be amazed if someone would get him to look at the doll- I just do believe that someone else doing th research would have been better long term

he's obv a kind man who cares- but that's not always best for these things the way they are perceived by the lab rats. Which is a damn rotten shame, of course.

don't quite follow

Oh I see Uwila, your/Jimjam's point is that it is the government's fault for not providing single jabs.

As I understood it one of the biggest reasons for not offering single jabs is that this itself would lead to a lower uptake as the more separate jabs you try to get the kids to have, the fewer people actually manage to get their kids in for all of them. Cost is obviously a factor as well, what with money not being infinite in the NHS....
They presumably underestimated the number of people who wouldn't be reassured on MMR.

Well, if they offered singles, more people would get them. But, since they don't some go pay for rhem privately but those jabs aren't counted in the stistics. And other people don't get jabs at all because they can't afford to pay privately (it ain't cheap!). So if they pffered single on the NHS, more people would actually get the vaccination.

For example, my DD is 3 and due for the booster soon. She had singles. But, money is tight in my house and I'm thinking for an extra 5% chance of effectiveness can I really afford another round of jabs at some £300. I'm seriously considering skipping these jabs on the basis of cost, and because she is most likely already protected.

It did provide a reservoir- I got Mumps at Uni last term, and was grateful Sam had been vaccinated with MMR. As with the others.

Isn't the potential for a huge measles epidemic enough for concern? Surely its better to worry in advance, than panic after the event or when its too late to do anything?

For single jabs, I'd say absolutely (on the NHS- hate the way some kids I know are excluded because parents said no to MMR and GPs surgery didn't get it, and they were on low income) to anyone with at risks factors (sibling or close relative with, health problems which might indicate gut problems, etc) but MMR should be encouraged for all others as it is this herd immunity that can protect the kids having single jabs whilst they takle effect. No-one should be refused single though; that's morally wrong and against parental choice.

Same reason that thimerosal remained in baby jabs in the UK for years after it had been removed from the jabs in Aus, NZ and (kind of) the States then. Cheaper. It was a dollar cheaper to inject my son with thimerosal (3 dollars I guess since he had 3 lots of jabs). His education alone is currently costing 70 grand a year. Add in DLA, carers allowance, full time 24 hour care for the rest of his life, the fact that I will never return full time to the workplace and become a contributer again. False economy?

Ah yes. Some of us would go get some and not be bothered with the rest. That is most insulting a patronising crock of stinky poo I have ever heard from the NHS (and they have lots of stinky poo). So, they wrap all three jabs into one ensuring that the choice is theirs, not mine. WELL... (deep breath.... count to 10.... no. 100) Anyone who thinks the decisions regarding my child's welfare are theirs before mine has another thought coming. In fact, when I realised that the NHS wraps all the jabs into one as a means to take choice away from me, I decided to go for singles.

Personally (having had measles myself) I'd rather ds2 and ds3 took the chance with measles than autism.

But yes measles is a concern, especially for certain groups. I think a huge measles epidemic is highly unlikely though as these "only 60% of children vaccinated" headlines completely fail to account for the numbers vaccinated singly. As singles measles jab is easy to get hold off and most people are terrified of measles I don't think there's a huge at risk population. Still think they should give teen boosters though if they're going to vaccinate everyone.