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Dr. Wakefiled and the MMR study

222 replies

Uwila · 12/06/2006 09:50

"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.....

OP posts:
homemama · 26/06/2006 22:13

Thanks, I'll give them a call.

Not sure what it is with the goats milk but he seems to digest it better and it has an all round positive effect on him. I was worried he was getting hayfever although I know he is very young for it as this summer he has been forever rubbing his nose and ears but even that seems to have virtually stopped. We've only been doing it for 10days but I'm going to stick with it.
Thanks again.

mrsnoah · 27/06/2006 21:05

just a comment on the goats milk theory..if your children have improved on that try Rice milk.. might make even more of a difference.
If the child is intolerant to cow's milk protein, the goats milk protein is pretty similar, and althought there may have been some improvement, you may be amazed after two weeks of a dairy free diet .
(if you do try this route it means label reading to eliminate whey, casein etc.)
DD2 is allergic to cows milk and the symptoms are v.obvious.

plummymummy · 28/06/2006 17:48

Just wanted to say how disgusted I am at the rudeness displayed by DC to Jimjams, especially in light of the hardship she has endured. I feel sorry for his kids as I can't imagine him being an attentive father, though admittedly he is good at fairy stories. Oh and yes, I am being shamefully judgemental but I really don't give a toss.

ruty · 03/07/2006 23:11

I'm sorry to bump this thread but i've been away and only just read it and I just had to say - JimJams - I LOVE YOU! How you remain calm and speak with such clarity and intelligence astounds me. Right, sorry, pretend i didn't bump this...

harpsichordcarrier · 03/07/2006 23:30

here's the link for the patent application made by Andrew Wakefield in June 1997

quote: "the present invention relates to a new vaccine for the elimination of MMR and measles virus..." The patent is for a vaccine AND treatment.

ruty · 03/07/2006 23:32

oh no. I knew i shouldn't have bumped it.

Jimjamskeepingoffvaxthreads · 03/07/2006 23:38

oh come on - read the whole thing and look at the emphasis- it mentions treatment of autistic enterocolitis repeatedly- it would be strange to miss out a potential use on a patent application, of course any vaccine produced against a mealses virus will have a potential to be a prophylactic as well, so it will be mentioned. But if you read the whole application form I would find it staggering if you could then suggest that he had some evil aim to undo the MMR. Wakefield himself believes the MMR is safe for the majority of children.

Wakefield is a gastro-enterologist- he treats children with autistic enterocolitis (very few do, he's a novelty)- what's he going to be producing a treatment for? He doesn't vaccinate children with single measles, he treats children with autism and bowel disease.

He has explained elsewhere how he wouldn't personally receive any money from this application anyway. If you look at the name given as the applicants it is "Royal Free Hospital School of Medicine and Neuroimmuno therapeutics research foundation" . Well shock horror, research team lodges patent application. Blimey that's newsworthy.

Jimjamskeepingoffvaxthreads · 03/07/2006 23:49

read it again and he says

  1. Vaccine will be for treatment of bowel conditions bit of blah blah

Then
2) Measles vaccination has been introduced and in generally effective

  1. Unfortunately some people appear to develop bowel problems following measles vacination- talks a bit about crohns.

  2. So a safer vaccination is needed. -

  3. Then it says that they have a vaccine that is safer to adminster, won;t cause the bowel problems and can be used to treat the bowel/regressive behaviour stuff.

Then goes into pages of bowel disease, treatment and regression.

Yep radical stuff, a safer vaccine, now why would anyone want that? From a hospital research group. Really dodgy indeed.

harpsichordcarrier · 04/07/2006 06:51

jimjams, obviously I don't disagree with you that developing this treatment is a valid subject for research, and that developing a safer vaccine (whatever that might means in this context) is a Good Thing. He may well have been justified in developing such a vaccine and he is certainly justified in applying for a patent if he is working on it. But I don't think anyone can say that he didn't apply for a patent for a vaccine. The issue is to do with whether he should have declared it as a conflict of interest.

Jimjamskeepingoffvaxthreads · 04/07/2006 10:18

Wakefield's response:

"The Sunday Times and the Dispatches programme of 18th November raise a number of issues in relation to MMR, autism and events at the Royal Free Hospital. Since many of the claims by journalist Brian Deer have been demonstrably false and there in no objectivity in the manner of their intended portrayal, I declined to participate in any way in the making of the Dispatches programme. In addition, vulnerable parents have complained of being "tricked" into participating in the programme. I was not invited to comment on the Sunday Times article prior to its publication.
The claim appears to be that, whilst at the Royal Free Hospital, I was developing a new vaccine to compete with MMR and that I conspired to undermine confidence in MMR vaccine in order to promote this new vaccine, and that this represented a conflict of interest. This is untrue. The facts are that:

  • no vaccine or anything resembling a vaccine was ever designed, developed or tested by me or by any of my colleagues at the Royal Free Hospital;
  • it has never been my aim or intention to design, produce or promote a vaccine to compete with MMR;
  • my genuine concerns about the safety of MMR are wholly unrelated to any desire or opportunity to develop a competing vaccine;
  • there was no conspiracy as insinuated by the Sunday Times article;
  • there was no conflict or interest, actual or perceived.

In contrast, it was our intention, at one stage, to conduct a formal therapeutic clinical trial of a compound that might have the ability to promote the body?s immune response to measles in order to assess the effects of this therapy upon the disease in children with regressive autism and bowel disease. This compound is known as Transfer Factor and whilst there is a large scientific literature on this subject, the nature and mechanism of action of Transfer Factors are largely unknown.

The Transfer Factor that was intended for use in the trial was to be against measles virus. I have urged and continue to urge parents to have their children vaccinated against measles using the current vaccines. This would be in direct conflict with the intentions that are part of the claim that I was developing a new vaccine to bring onto the market. Whether a Transfer Factor could ever protect children against measles is entirely speculative and is something that was never studied or pursued by me or any of my colleagues.

The Channel 4 programme implies commercial aspirations for personal gain. In fact, the aim of the patent was to generate funding for the research programme and a new Centre for Gastroenterology at the Royal Free Hospital. This can be substantiated by contemporaneous documentation.

The patent application was motivated by two main factors. First, it was felt that there may be difficulty in raising traditional grant funding for cutting edge, controversial work that was vulnerable by virtue of the fact that it might conflict with perceived wisdom and the commercial interests of others. Secondly, there was, and is, a government-led emphasis on commercial exploitation of discoveries within the medical school.

Transfer Factor (TF)

  • A clinical trial of measles-virus specific transfer factor was planned in order to determine whether there was benefit to children with regressive autism and inflammatory bowel disease.
  • It is not known at this stage whether this therapy would work. The purpose of the trial was to start to answer exactly this question as well as to monitor the safety of TF in these children.
  • This was a treatment trial, not a vaccine trial.
  • A trial of TF was based upon an extensive scientific literature, demonstrating safety and efficacy of TF in different diseases. I consulted widely with experts in the UK and US on the history and scientific background to TF both prior to and in the planning of the trial.
  • The protocol was extensively peer-reviewed with written endorsement from experts in the UK and US. The trial protocol was submitted to, and subsequently approved by, the Ethical Practices Committee of the Royal Free Hampstead NHS Trust.
  • The trial protocol was approved by the participating physicians.
  • The trial was funded by charitable foundations after independent peer-review.
  • The trial was cancelled due, in part, to my departure from the Royal Free.

The Patent

  • A provisional patent filing was made for the use of measles virus-specific TF in regressive autism and inflammatory bowel disease (Regressive Bowel Disease; RBD).
  • The reference to the possible use of TF to protect children against measles infection ? the thrust of the Sunday Times? conspiracy theory ? was put in as an afterthought in the patent. It was entirely speculative and never pursued in any shape, manner or form.
  • The provisional patent filing was entirely speculative and was for a possible therapy; as such, it had no bearing on the 1998 Lancet paper. It constituted no potential conflict until the patent was awarded. When the patent was later awarded, this fact was communicated directly to the Editor of the Lancet in order that it might accompany a letter, written in response to a paper by Taylor et al that claimed to find no evidence of a link between MMR vaccine and autism. The editor did not consider the patent disclosure of sufficient significance to publish it alongside my letter.
  • Since it was awarded, the patent has been disclosed in relevant publications. The claims have since been abandoned.

Drs Nick Chadwick (NC) and Ian Bruce (IB): measles virus detection in intestinal biopsies.

NC was employed as a post-graduate researcher in my laboratory, studying for a PhD. He investigated various technologies for measles virus detection using gene amplification. Due to problems within the laboratory with contamination and the need for additional expertise, we collaborated with IB at the University of Greenwich. IB and NC developed a technique that increased the sensitivity of measles virus detection over standard methodology from approximately 1 million viral copies in a reaction to 10,000 copies. In other words, even with the enhanced technique, the technology could not detect this virus when present below 10,000 copies.

We published the fact that we could not detect measles virus in Crohn?s disease using this technique. This publication went ahead on my recommendation, despite some resistance to publishing negative data. I considered that failure to publish negative data was inconsistent with good scientific practice and proceeded to publication.

By the time we applied the viral detection technology to the intestinal tissues of children with autism, new and more sensitive technology had come to my attention. This includes the technique of TaqMan PCR and was state-of-the-art technology being used by a few expert centres, including that of Professor John O?Leary (JO?L), then at Cornell University in New York. I went to New York to meet with JO?L. He presented evidence that his technique could detect down to 2 viral copies, compared with NC?s 10,000. The advantages were obvious and the possibility that NC?s results were falsely negative (i.e. that the virus was present in the tissues but at very low levels that NC?s technique could not detect) could now be addressed by the new technology.

Using JO?L?s technology the virus was detected in controlled studies and these results were published. They confirmed that our previous results were falsely negative due to the limitation of the technique we were using. TaqMan PCR, one of the techniques used by JO?L to detect measles virus in the autistic children, is now the gold-standard and the technology used by NC has been abandoned. On entirely scientific grounds I was proven correct on this occasion. The facts stated above can be supported by contemporaneous documentation.

AJW"

northerndad2006 · 06/07/2006 00:55

I personally think that the Wakefield group were totally sincere committed doctors investigating a reasonable theory. The Lancet paper was peer-reviewed and valid. It presented novel bowel problems in a subset of autistic children. I think that it was ill-advised for Dr Wakefield to suggest having single jabs given the likely furore, but I'm sure he did it with the best of intentions - to prevent harm to children (even if he was wrong). It's quite possible that the Lancet paper would have been picked up by the media and turned into a controversy anyway; I expect the Lancet is one of the journals they keep an eye on for interesting headlines.
JimJams, whilst I accept that the gut/autism theory has acceptance within the medical autism world (not from my own reading, but from yours, really), how accepted is the measles theory? Is it still just a plausible mechanism or is there some more direct evidence? The last stuff I read was in 2000! Am I wrong, but isn't it the case that most cases of autism tend to become apparant about 13-14 months - about the time when MMR is given. We always look for something to blame. Clearly, there are some children who have a dramatic regression. Is there a seriously plausible mechanism linking a gut problem (even with a genetic predisposition) and such a dramatic change? (I ask out of interest, with an open mind)
On a separate point, I would say that although I'm not overly struck with DC's choice of words (just plain rude), it's surely true that most people (men and women, I hasten to add) are pretty ignorant of statistics and find it hard to comprehend and weigh up risks (I'm no wunderkind with p values, myself). This thread is scientifically literate in a way which is completely unrepresentative of society. That's not being snobbish in any way, it's just the way things are. Hence the way the media can scare parents, as we bounce from one threat to the next, rarely put in context, even if not imaginary.

ruty · 06/07/2006 09:30

Sunderland university have a research unit looking at just that northerndad, but mostly to do with how casein and gluten proteins can effect the brain in children with 'leaky' guts and cause autism, not the measles factor.

ruty · 06/07/2006 09:34

sorry i should probably say potentially trigger autism. There is a scientific study that documents cases of regression in autism around the two year mark through studying family video footage of a number of children 'before' and 'after'. It is in archives somewhere but Jimjams might be able to link to it. The study confirms that regression does occur in some cases, and more research needs to be done to find out what can trigger it.

Jimjamskeepingoffvaxthreads · 06/07/2006 11:10

northerndad- the key really is when you say "clearly there are some children who have a dramatic regression", that's what people are talking about when they link MMR as a trigger. Incidentally MMR may not be working alone, there may be an earlier factor with thimerosal containing jabs, and there may be an association with vaccinating when not well (or shortly after being ill- eg with chickenpox).

As for evidence- the MMR group do appear to have other differences- in their urinary profiles for example. Whilst 2 of my sons have leaky guts (and a particualr uruanry profile) it is not the same as an MMR damaged child.

The main evidence is coming from the presence of measles virus in the CSF and gut. It has been found in a high proportion of autistic children with autistic enterocolistis and not at all in controls.

If you google Autism one conference you can link to Andrew Wakefield's powerpoint slides form May- gives a good idea of the current state of affairs.

As for autism becoming aparent at 13 monthsish- they used to say 18 months - when MMR was given then!! No seriously though, research published last year showed that parents are accurate at judging when/if regression has occurred- they are reliable witnesses. The regression linked with MMR tends to be pretty severe, rapid and linked to physical problems- especially seizures/constant diarrhoea/blood in stools etc.

Jimjamskeepingoffvaxthreads · 06/07/2006 11:12

oh also there are a (very) few recorded regressions at 4 after the pre-school boosters, which are obviuosly very obvious. They wouldn't necessarily be diagnosed as autism though- more likely to be diagnosed as childhood disintegrative disorder.

CristinaTheAstonishing · 06/07/2006 11:33

In today's Guardian: "Further evidence has emerged to disprove a link between MMR jabs and autism.
Scientists in Canada found that more children developed the disorder after MMR take-up decreased and thimerosal - a compound that is 49% mercury and was thought to have been linked to autism - was eliminated from vaccines.

The study, by researchers at McGill University Health Centre, confirms the findings of a Japanese study last year. The new research, which assessed 28,000 children, found that after thimerosal was phased out in Quebec in 1996, the autism rate rose from 52 per 10,000 to 70 per 10,000. "

latest Canadian study showing no MMR-autism link

Jimjamskeepingoffvaxthreads · 06/07/2006 11:53

And it completely fails to address the 7% question so totally meaningless wrt to MMR.

Thimerosal results contradict results from California, but accuracy will depend on when thimerosal was removed and when autism is diagnosed. If a lot of the children in that study have been diagnosed at age 6+ then they would have recieved thimerosal anyway. Also depends on mercury from other sources. Lathe makes a big thing about fish.

Can't imagine why anyone would want to have their child injected with a known neurotoxin at 8 weeks old, especially when pregnant mothers are advised to limit tuna intake because of mercury levels, but hey ho if someone wants to campaign for their right to inject their child with mercury it's a free world.

Jimjamskeepingoffvaxthreads · 06/07/2006 11:56

"Witness in Lawsuits Fombonne has worked as an expert witness on behalf
of vaccine makers defending lawsuits in the U.S. that allege mercury causes
autism. While none of Fombonne's research is industry- funded, Illinois
radiologist David Ayoub said omissions in the Montreal study and Fombonne's
testimony on behalf of drugmakers raise the question of whether he can
independently analyze the research data.
``This is just another heavily biased study by an author with a long
track record of financial ties to the drug industry, and whose previous
views on the epidemiology of autism have been discredited," wrote Ayoub, who
also is medical director of the Foundation for Autism Information and
Research, in an e-mailed response to questions.
Ayoub said Fombonne's effort ignored several papers that link mercury
and autism.
The study shows a four-fold increase in autism rates during the
10-year period examined, Ayoub said. In addition, some children may have
been exposed to mercury from other vaccines that still contained mercury
after 1996, including a hepatitis inoculation given to children and flu
shots that pregnant women may receive, he said in a telephone interview."

northerndad2006 · 06/07/2006 12:01

JimJams, aren't the autistic children with these physical e.g. bowel problems a minority (of autistic children)?
I wonder whether you can really cite MMR as causal or even as a trigger in these children or whether the abnormalities of the gut would simply lead to some residual measles virions. Not sure about the measles in the CSF; if this is of relevence, then is a sort of measles encephalitis being proposed?
Even if the MMR as an immunological challenge could be shown to be a trigger in children with abnormal bowels (does the bowel disorder predate the challenge to some extent and confer the vulnerability?) isn't it very likely that at some point any other wild type virus would cause a similar problem - children cannot avoid viruses, and the vaccine strains are not particularly virulent (by definition). Or are you suggesting that the thimerosal is acting as an adjuvant to trigger this abnormal reaction? (although it is no longer used, is it?) Just some thoughts.

northerndad2006 · 06/07/2006 12:03

Cannot envisage why it would be thought sensible to inject children with mercury. Frankly, would rather not have it in my mouth, even in an amalgam

Jimjamskeepingoffvaxthreads · 06/07/2006 12:15

Depends what you mean by bowel problems. Have a look at opioid excess theory - google it- and you'll see one bowel problem common in autistics (80%???) Basically leaky membranes. (blood brain as well as gut). Not associated with MMR though.

The idea with the MMR is that the MMR itself triggers the development of autistic enterocolitis - and that shoots effectively big holes in the membranes - n goes massive amounts of opioids etc etc and leads to regression. That is very simplistic. Obviusly there is a genetic suscpetibility and thimerosal appears to affect the immune response in some individuals. Also look up Hornig- the problem here may be for those with leaky blood brain barriers. immune system problems are suspected to be common in those with autism, one study found few developed antibodies to rubella after vaccination for example.

Worth googling on gulf war syndrome as well as autistics and GW vets with GWS appear to be physiolgically similar in lots of ways.

The MMR group are believed to form approx 7% of the autistic population. Small numbers.

Other viruses- certianly involved- herpes viruses commonly implicated (interesting to me as ds1 had a regression following eczema herpeticum- and that is never disputed by the docs). I think persitant herpes infection is believed to be a problem along with persitant measles. Also chickenpox seems to cause some problems.

Richard Lathe recommends vaccinaiton to decrese likelihood of encephalitis as one potential way of avoiding the development of autism. He also thinks it is reasonable to suggest that about 5% have had their autism triggered by MMR.His book "autism the brain and the environment" is the best summary of current knowledge concerning the genetics and environmental factors. He thinks the big rise (and he spends a chapter going through why the rise is real) is likely to be due to the incrtease in heavy metals and other chemicals in our environment. His belief is that autistics are those that are unusually susceptible.

One thing that is certian is that there are many ways to autism.

Please look at Andy Wakefield's presentation for Autism One- it's easily found on google - he provides a much more detailed description of the propsed mechanism involving MMR than I can (and I am meant to be working)

Jimjamskeepingoffvaxthreads · 06/07/2006 12:18

It was cheaper to inject children with mercury though. They saved approx a dollar per shot injecting it into ds1. Not very cost effective- his education is costing them over 60 000 a year I believe, and he'll require 24 hour care for the rest of his life. He was born before the fish warning as well though.

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