Andrew Wakefield up before the GMC

[marina]

report here

I feel he has been treated very badly by the medical establishment - criticised in the Lancet for doing nothing more or less than most doctors have done in their careers (carrying out research which is funded by a drugs company) - losing his job - and he and his family driven out of the UK.

The MMR vaccine may be safe for many children but it's clearly not safe for all, and Dr Wakefield was right to raise his concerns when he did IMO.

I wish him luck.

Brian Deer has spent a great deal of time and energy researching this case, so I imagine his evidence is pretty relevant.
as I am sure you know Wakefield brought a libel claim against Deer refuting the allegations made against him by Deer in the C4/Sunday Times investigations.
Wakefield has since withdrawn all his allegations of libel and paid Deer's and the other Defdt's costs.
the course of that claim has made interesting reading.

I've never understood why Brian Deer stated that Wakefiled was making a single vaccine to compete with the MMR. Wakefield has always talked about it as a treatment for autistic enterocolitis and the patent application makes it clear the emphasis is on this. Also Wakefield would not have personally gained financially from the patent as it was set up in trust with the Royal Free. I did email Deer to ask why he misrepresented this but he never replied so I'm none the wiser.

If you go to Cry Shame you can download a long document about Brian Deer (and his funding). It also mentions why Wakefield was forced to drop his libel case. Basically the defendents in the libel trial demanded disclosure of all defence material for the GMC case and the judge said they had to comply. He chose to withdraw the action (unsurprisingly).

why is that unsurprising?
if you choose to bring a libel claim, shouldn't you expect to have to reveal relevant documents? The judge ordered their disclosure, so he must have agreed they were relevant. Wakefield was very heavily criticised by the judge for his conduct in his libel case, inparticular for the huge delays in his pursuit of it.

Brian DEer makes the statement that Wakefield was making a vaccine to compete with the MMR because that is what his patent applcation says, pretty clearly to be honest.

No one wants to have to go in front of the GMC so from that point of view he has my sympathy but the fact remains that thanks to his scaremongering we are at real risk of serious outbreaks of measles which kills. There have been numerous large studies showing absolutely no link between the MMR and autism but there is still this fear out there. The pertussis vaccine scare was similar to the MMR one in that it was a very small group of cases of brain damage (10) thought to be linked to the vaccine. They have subsequently shown that not one of these cases can clearly be linked to the vaccine and most already had signs of problems before they even had the vaccine.

Wakefield suggested MMR was responsible for a very small number of autism cases -about 7% of all cases - very hard to prove in a large statistical study. However no less devastating to those children and parents involved.
The real tragedy in all of this is that Wakefield may have made some mistakes, but his research was jumped upon and his character ripped apart from those furious that he was questioning the medical status quo, and that those children vulnerable to MMR [even if they are a small proportion of the general population] continue to be ignored and unprotected.

And the patent application starts by saying that it relates to a new vaccine for the elimination of MMR and measles virus and to a treatment for IBD and crohns and regressive behavioural disease

A 'vaccine for the elimination of MMR. ie the elimination or MMR strain virus from the gut'. I'm not quite sure why he would be vilified for producing a safer vaccine anyway. Of course a patent application will mention any potential use, but it's pretty clear that the focus in on it's therapeutic potential for use with autistic enterocolitis. You only have to look at the claims at the end to see where the emphasis lies (and reading the application expands thatl)

The patents were initiated through commerical subsidary of the Royal Free medical school. They relinquished claims to IPR when they decided that the patent application wasn't going to go anywhere (surely not that unusual - how many patent claims are developed?).

I will admit I can't stand Brian Deer. Nothing to do with Wakefield though. I think the gloating he has had on his website for the last few years about the accidental death of a mother is in extremely poor taste.

"the fact remains that thanks to his scaremongering we are at real risk of serious outbreaks of measles which kills."

Are we - why? I wrote to the Dept of Health and asked why they didn't allow single jabs to prevent measles outbreaks as my perception was the confidence in the MMR was at an all time low and they replied that confidence in the MMR was high, surveys showed that, they always kept an eye on that and I was totally mistaken if I thought that people were avoiding the MMR.

They can't have it both ways.

"the pertussis vaccine scare was similar to the MMR one in that it was a very small group of cases of brain damage (10) thought to be linked to the vaccine. They have subsequently shown that not one of these cases can clearly be linked to the vaccine and most already had signs of problems before they even had the vaccine."

The US Institute of Medicine has concluded that pertussis can cause brain damage and various studies have put the rate at as between one in 17 000 and one in 110 000 - so quite a wide range there. DTP was contraindicated for those with epilepsy though.

The problem with 'the children had something wrong with them anyway' is that currently that's not considered either before vaccination or in the light of an adverse reaction. The recent payout in the States for MMR damage in a child with a mitochondrial disorder is an example of such a case- the underlying disorder was not found until vaccine damage had occurred. how many autisitc chidren have mt disorders? NO idea. I know one who is being investigated.

That has always been Wakefield's point. That the MMR is dangerous in a small group of susceptible children- ie in children who already have something wrong with them. That doesn't meant they would have regressed into severe autism without the MMR. They could have carried on having something non-progressively wrong with them for the rest of their life. (such as the girl with the mitochondrial disorder).

Yurt - can you mail me please?

elesbells @ hotmail.co.uk

"Wakefield suggested MMR was responsible for a very small number of autism cases -about 7% of all cases "

Ruty, I understood there is no evidence whatsoever for that and Wakefield had used it as a fall back position after his earlier claims were shown to be unsubstantiated?

you understood it from where Upwind?

BTW the Cochrane report, the government's own investigation into MMR safety following Wakefield's claims, concluded there was insufficient evidence to prove that MMR was unsafe or safe . But still jumped upon by the media as 'conclusive' evidence of MMR's universal safety...

Perhaps from reading Ben Goldacre over the years. Please correct me if I am wrong. Are you aware of any evidence to back up Wakefield's claims?

Wakefield has never put a figure on the number of affected children. He has only ever talked about a subgroup.

The figure comes from an estimate of the number of children who have the particular type of bowel disease they have and parental reports (parental reports actually run a little higher- about 10%). Other people have suggested this figure. Although accurate figures for autism are notoriously difficult to obtain.

The gut disease is real. The issue is what caused it.

Well as Yurt said Richard Horton of the Lancet praised Wakefield's original paper. Wakefield's research, and anyone else's has now been stopped. You think anyone wants to risk their reputation and career following in his footsteps? That is what is so galling.
And as the Cochrane report pointed out, there is insufficient evidence to prove that MMR is universally safe. Statistical studies exclude a whole range of factors, not least that doctors refuse to acknowlege if a child has a sudden regression following an MMR jab [they had it already you parents didn't notice, it was just a coincidence that your child had a seizure following the jab, etc]
And the study in Japan which was supposed to prove that singles were no safer than MMR, gave the singles about four weeks apart. Not enough time in between for there to be a significant difference in the austism rates. As far as I know.

Ruty and Yurt for your research and in-depth knowledge. There's so much airy prejudice about this issue and so often you nail the details.

can't take the credit. I'm just a hanger on. [to Yurt]

It doesn't read that way! And I understand a little of the circs that have given rise to some of Yurt's research so I know it's not "just" an area of interest for her. I always like to sling in my tuppenyworth of support but my own reading into the issue was done such a long time ago I soon run out of resources and learn a lot from what you both put down here.

yurt helped me a lot when my son had severe gut problems when he was younger. very grateful to her and her knowledge.