Vaccines, autism and actresses.

Jenny versus Jennifer

How would you describe an actress and a mother who makes public statements about the nation’s vaccination programme?

Brainwashed simpleton?

That is a bit strong, even when applied to Jenny McCarthy. But this is the EOHarm email list passing judgement on a different actress, Jennifer Garner whose crime was to speak up in favour of vaccines, namely the flu vccination programme in the United States. Another letter described her as,

Just another Hollywood uninformed propagandist?

This without a hint of irony from members of a group that has nothing but praise for their own Hollywood uninformed propagandist, the aforementioned Jenny MCarthy! Another letter suggests that Jenny McCarthy might want to pop round to Jennifer Garner’s house for coffee and presumably put her right on the vaccine issue at the same time.

I feel she would get short shrift. Jennifer Garner will have been ably briefed by the American Lung Association. She knows that with an annual death toll of 36,000 from influenza and its complications, this is the number eight killer in the USA with 2.7% of all deaths. It used to be 4% which suggests that the vaccine is having a positive impact. EOHarm takes its inspiration from “Evidence of Harm,”  a book that purports to be a balanced investigation of the alleged connection between the mercury content in childhood vaccines and the growth in the prevalence of autism, but ends up providing uncritical support for the belief that we are in the midst of an autism epidemic caused by mercury poisoning.

Original Biomedical Theory

Once upon a time biomedical explanations and interventions for autism revolved around diets, anti fungals and vitamin supplements. I have a book, “Biological treatments for autism and PDD” by William Shaw dated 1997 which even contains a recommendation for parents to vaccinate their children against Streptococcus Pneumoniae. 

The closest it comes to implicating vaccines is the author’s belief that adverse reactions to vaccines may be one of the factors contributing to recurrent infections that require antibiotics. It is the antibiotics that are supposed to do the real damage, destroying the natural flora in the gut.  Consequently fungal infections damage the gut and allow poorly digested peptides to enter the blood stream. If these get into the brain they attach to opioid receptors and cause the symptoms we diagnose as autism. Three years later Karen Seroussi wrote “Unraveling the Mystery of Autism and Pervasive Developmental Disorder” [Simon and Schuster 2000] which repeated Shaw’s basic hypothesis. Vaccines, typically MMR but also DPT, were again accorded a supporting role in exacerbating a pre-existing difficulty coping with infections. Mercury, heavy metal poisoning and chelation therapy did not get a mention.

Mercury Rises

There was a problem with this “Opioid Excess” theory of causation. [apart from the obvious one that even today it remains a tentative theory with little hard science to support it.] It had originally been expounded  in 1979 [Panksepp J. A Neurochemical Theory of Autism] Even if the MMR was an added factor, it too had been around since the 1970s. But the dramatic increase in reported cases of autism in children suggested that something else was happening. There were perfectly good reasons not to believe in an epidemic. But for those parents already primed to blame MMR, the growth in autism led them to look for vaccine-related causes. During the 1990s the number of mandatory vaccines for children in the USA grew steadily alongside the autism figures. In some cases children could have received in excess of the stringent safety limits for mercury exposure if they had receieved all  their vaccine shots. A paper pointing to supposed similarities between mercury poisoning and autism was published in a fringe journal. Information supporting the mercury hypothesis was widely disseminated amongst parents via the internet. David Kirby wrote his book, “Evidence of Harm” and the rest, as it were, is history.  

Blame all Vaccines

Now that mercury has been removed from all mandatory childhood vaccines and autism shows no signs of decreasing you would think that people would move on and look for other explanantions for autism prevalence. Perhaps this article in Time Magazine or this interview with Dr Gernsbacher and Dr Neuschaffer could offer a less catastrophic interpretation of the figures.

But parents who have invested so much intellectual and emotional capital into their belief in vaccine damaged kids as a source of autism are increasingly blaming the vaccines themselves. The real vaccine/autism scare began with the MMR fiasco in the UK. That resonated in the USA where Dr Andrew Wakefield is a popular figure at Defeat Autism Now events. As I understand it, in one variation on a theme, the mercury in vaccines was supposed to weaken the immune system and the measles component of the MMR subsequently overwhelmed it. IF you believe this and IF you also buy into the conspiracy theory that the US government [in the form of the FDA and the CDC]  and the big drug companies knew about this and are now engaged in a cover-up, it is a short step to believing that all vaccines are dangerous and everything that the government tells us about vaccine safety and efficacy is a lie.

For the true believers 36,000 preventable deaths from influenza [and that is in the USA alone, never mind the rest of the world] are as nothing compared to the hypothetical possibility that vaccines cause autism. Brainwashed Simpletons? No,  more like sadly deluded.

Media Response to the Observer and Autism

The Observer’s recent scare story on autism has at least two good points.

1. They have taken such a beating that it is unlikely that they will publish another PR story for Wakefield for a long time to come.
2. I have discovered a lot of interesting blogs which support rational discourse and look forward to reading them on a regular basis.

Then there are the bad points. Most of the press ran with the story without questioning its veracity. Very few have picked up on the faults in the Observer story. This is the best I could find when doing a google news search on the terms Observer and Autism.

Press Round Up on the Observer, Wakefield, MMR and Autism

The Observer’s 8 July front page, featuring the claim of a one-in-58 risk of autism from the MMR jab, has prompted its sister paper, ‘The Guardian’, to run a meticulous debunking of the story in its Bad Science column. Its author, Goldacre, suggests the media that peddle such untruths should be “in the dock, alongside [Dr Andrew] Wakefield”. Despite the kicking, morale remains high at ‘The Observer’. Many of its own journalists thought the story deserved a good trashing.

The Independent July 22nd 2007

Whatever you think about Andrew Wakefield, the real villains of the MMR scandal are the media. Just one week before his GMC hearing, yet another factless “MMR causes autism” news story appeared: and even though it ran on the front page of our very own Observer, I am dismantling it on this page. We’re all grown-ups around here.

[…]

Nothing has changed, and this scare will never be allowed to die. If we had the right regulatory structures, almost every section of the media would be in the dock, alongside Wakefield.

Dr Ben Goldacre in The Guardian July 18 2007

New fears over big surge in autism’; ‘I told the truth all along, says doctor at the heart of autism row’. Headlines in last week’s Observer (8 July) provide a media boost for Dr Andrew Wakefield as he faces charges of professional misconduct at the UK General Medical Council (GMC) over the conduct of the research that first suggested a link between the MMR vaccine and autism in 1998.  [read on]

Dr Michael Fitzpatrick in Spiked Online July 17th 2007

What the Blogs say about the Observer and Autism

These are the most recent blogs (last seven days) courtesy of Google that add something new to the debate. Lots of others either linked to or repeated Ben Goldacre’s excellent rebuttals in his badscience blog or to Mike Fitzpatrick’s equally trenchant piece in Spiked Online.

A couple of weeks ago The Observer (UK ‘quality’ Sunday paper) printed an article claiming an as yet unpublished study shows a dramatic rise in the prevalence of autism. They also managed to crowbar in the MMR vaccine as well just to raise the general levels of hysteria. [ read on ]

This Sunday The Observer nearly apologizes for its disgraceful front page report on Autism a fortnight ago. But they still don’t get it. [ read on ] I wrote this one 🙂

The Observer deserves sackcloth and ashes for its autism, MMR coverage. The British Medical Journal (BMJ) embarrassed itself by uncritically reproducing that 1 in 58 figure but at least it had the good grace to take a piece by Dr Ben Goldacre that criticised the media coverage of this issue. [ read on ]

It’s one thing to get a story wrong. Everyone does that – I’ve certainly done a couple of howlers in my time. It’s quite another to, on being informed of your howler, try and cover it up. And, it appears, this is exactly what The Observer is doing after it’s truly appaling MMR/autism front story from last weekend. [ read on ]

This article and its subsequent coverage in the other press has set back public understanding of this subject by several years and unreasonably made the public question science even more, ironically when it is proper science that is the only way to truth in this, rather than the mumbo-jumbo “science” practised by Wakefield. [ read on ]

The main issue is that the Observer misinterpreted the results of this unpublished research. The paper claimed the research showed an increase in the prevalence of autism. Based on this misinterpretation it then blamed the supposed increase on the MMR vaccination, saying that two of the seven authors of the report privately thought the MMR jab might be partly to blame for the alleged rise in autism. [read on ]

Last week I blogged about the, now infamous, MMR  piece by Dennis Campbell in the Observer. Campbell’s piece contained this.

“the MMR jab which babies receive at 12 to 15 months, might be partly to blame. Dr. Fiona Scott and Dr. Carol Stott both say it could be a factor in small numbers of children.”

Dr Scott subsequently e-mailed Ben Goldacre. The e-mail contained the serious allegation that some of the stuff in the Observer piece had been “fabricated”. [read on]

A short break from your usual Patrick Holford coverage – courtesy of some more awful mainstream media MMR reporting. It was disappointing to see the Observer running such god-awful autism/MMR stories, but to see the BMJ pick up the Observer’s inaccurate figures (the claim that 1 in 58 children is on the autistic spectrum) is even more disturbing. [read on ]

In the aftermath of the Observer debacle, one of those described in the original piece as being an MMR believer responded in the comment thread of The Guardian readers editor page. Her words are very telling and show, once more, what a shoddy and deliberately misleading piece of work this was. [ read on ]

Speaking of Bad Science and bad reporting and how the two seem to go together so frequently, Ben Goldacre goes after The Observer big time in yesterday’s Bad Science column. The Observer, of course, continued to do its bit on behalf of scientific illiteracy with scare story on 9 July over yet another purported link between the MMR vaccine and the apparent rise in autism in the UK [read on ]

 I’m annoyed with the Observer. I had a nice Holford Watch post mostly written – looking at some particularly odd claims for vitamin C – and was planning on spending the rest of the day relaxing with a newspaper. Then I saw the Observer’s truly dismal (2nd) attempt at an apology for their terrible MMR/Autistic Spectrum Disorder (ASD) coverage. Now I can’t buy myself an Observer, and feel obliged to insert a break in your usual Patrick Holford coverage to write another post on the Observer. [ read on ]

Most significant of all is Fiona Fox’s contribution. Fiona Fox is director of the Science Media Centre and according to her blog, after sending a note to Denis Campbell warning him that she could not defend his piece to angry scientists.

The result was an invitation to meet with him, the readers’ editor and a variety of other Observer news editors at their offices. So, with two leading MMR experts at my side, I went to highlight the concerns.

According to their website

The Science Media Centre is first and foremost a press office for science when science hits the headlines. We provide journalists with what they need in the form and time-frame they need it when science is in the news – whether this be accurate information, a scientist to interview or a feature article.

If you read Fiona Fox’s blog she makes quite plain the help and advice that the SMC offered to the Observer in the aftermath of their diasterous front page story. Judging by their continued weaseling in today’s edition, The Observer is still clinging to the wreckage of its original story despite the advice of the SMC.

As an added irony, when I looked up who funds the SMC  I found the Associated Press (Daily Mail, Mail on Sunday, Evening Standard) DailyExpress, Trinity Mirror (Daily Mirror, Sunday Mirror, Daily Record, the People etc.) and News International (Times, Sunday Times, Sun) all represented. In fact, apart from the Telegraph and the Independent, nearly every national newspaper in the UK supports the SMC except the owners of the Guardian and the Observer.

There has been a lot of discussion recently about how bloggers cannot meet the standards  of professional journalists. Judging from this incident I am not sure that I aspire to the standards of journalists like Denis Campbell. I will end with a modest proposal from Brian Deer in the comments section of Kev’s blog.

My suggestion is that people should write to the Observer and suggest that, since there is still so much confusion about the duty of reporters, and what – on this matter of grave public interest, affecting the safety of children – are a newspaper’s reasonable duties to accuracy, the Observer should join with the complaining readers and refer the matter – jointly and with agreement – to the Press Complaints Commission for adjudication.

See what they say to that!

My letter is in the post. I even put a stamp on the envelope.  If I get a response I will let you know next week.

The Observer replies over Wakefield, autism and MMR.

This Sunday The Observer nearly apologizes for its disgraceful front page report on Autism a fortnight ago. But they still don’t get it. Today’s Observer says that,

The report from the ARC was entitled the Final Report of a three-year research project for the Shirley Foundation, a private charitable trust that has an interest in the issue of autism. The foundation paid almost £300,000 for the study which Dr Scott, one of the authors, described in an internal email as ‘very thorough’. As such The Observer believed it legitimate to report its findings, given the apparent status of the work. Professor Simon Baron-Cohen, the director of the ARC, has subsequently said that the data in the report is still being analysed and is therefore incomplete.

•  Final Report in this context means final report to the funding body. It cannot be equated with the final report of the research team to their peers. This was an academic work in progress. When they eventually spoke to Professor Baron-Cohen the Observer learned that the data in the report is still being analysed and is therefore incomplete. Therefore it is not a legitimate source for their story.
• The Observer claims they were unable to contact Dr Scott prior to publication. Post publication, the Times and the Telegraph had no problem contacting Dr Scott.
• Meanwhile Dr Scott had to contact the Observer via their online comments form in order to respond to their misrepresentation of her views. But they are able t0 quote “internal” (i.e. private) emails from Dr Scott.
• So we have a prestigious national newspaper that has access to a private document (the interim report of the research team to its funding agency) and access to the private emails of one of the researchers. But said newspaper is unable to obtain public access to either the lead researcher (Professor Simon Baron-Cohen) or Dr Scott prior to publication.
• Here is a thought. Why didn’t the Observer delay publication until after they had spoken to  Professor Baron-Cohen and Dr. Scott? This was not breaking news. They could have waited. Surely, this report’s timing was not influenced by the same reporter’s “exclusive” interview with Andrew Wakefield in the same issue, prior to his disciplinary hearing before the GMC?
• Here is another thought. Someone offers the Observer a story on a plate: leaked report; leaked emails; background briefing. Oh, and while you are at it, how about an exclusive interview with the main man? 
• Should they check it out or accept it uncritically? What do you think happened?

Meanwhile, today’s statement merely compounds their error. To continue:

The 1 in 58 figure was described by one of the authors as ‘our primary analysis’ and was the only figure presented in the Final Report’s summary. It was therefore highlighted by The Observer. In the body of the ARC’s report the figures 1 in 74 and 1 in 94 were also published.

• Do tell. Which one of the authors described 1 in 58 as our primary analysis? Dr Stott, anybody?

The Observer should have reported these figures in the news story so that readers were aware that there were different interpretations of the findings. That they were left out was due to a reporting and editing error.

• A very misleading error in my opinion. And just to be clear, reporting errors are made by reporters. Editing errors are made by editors. People screwed up here. The people should admit their error and apologize.

There’s more.

Dr Stott, one of the authors of the Final Report and described by The Observer as believing that there maybe a link in a small number of cases between MMR and autism, does some work for Thoughtful House, the autism centre in Texas that treats children from all over the world. Dr Wakefield works at Thoughtful House. Dr Stott’s links to Dr Wakefield should have been made clear in The Observer news report.

• So Stott and Wakefield are both employees of Thoughtful House? They bump into each other in the canteen now and again? Not exactly. Wakefield is Executive Director of Thoughtful House. Stott is a senior researcher there. She and Wakefield have issued joint press releases answering critics of Thoughtful House.  Does that make it clear?

It gives me no pleasure to see a newspaper like the Observer squirm like this. Your sister paper, the Guardian, has already published a damning critique of the whole affair. Why continue to defend the indefensible when a simple, “Sorry, we were wrong.” would have sufficed?

Cry Shame on Wakefield and MMR

There is a new website up called Cry Shame. It is supported by JABS, Autism Treatment Trust and Treating Autism. One of its aims is

• To reveal the political and financial interests surrounding the role of vaccines – specifically MMR and thimerosol [sic] containing vaccines – in the onset of autistic-like regression and to make transparent the ruthless attempts to discredit those professionals who aim to shed light on the situation.

First amongst those professionals is Andrew Wakefield who, along with Professor Walker-Smith and Professor Murch, is the subject an inquiry into allegations of serious professional misconduct. On Monday, 16th July the Fitness to Practise Panel of the General Medical Council will commence its investigation into these allegations.

It is alleged that the three practitioners were named as Responsible Consultants on an application made to the Ethical Practices Committee of the Royal Free Hospital NHS Trust (“the ethics committee”) in 1996 to undertake a research study involving children who suffered from gastrointestinal symptoms and a rare behavioural condition called disintegrative disorder. The title of the study was  “A new paediatric syndrome: enteritis and disintegrative disorder following measles/rubella vaccination”. The Panel will inquire into allegations that the three practitioners undertook research during the period 1996-98 without proper ethical approval, failed to conduct the research in accordance with the application submitted to the ethics committee, and failed to treat the children admitted into the study in accordance with the terms of the approval given by the ethics committee. For example, it will be alleged that some of the children did not qualify for the study on the basis of their behavioural symptoms.

It is further alleged that the three practitioners permitted a programme of investigations to be carried out on a number of children as part of the research study, some of which were not clinically indicated when the Ethics Committee had been assured that they were all clinically indicated. These investigations included colonoscopies and lumbar punctures. It is alleged that the performance of these investigations was contrary to the clinical interests of the children.

The research undertaken by the three practitioners was subsequently written up in a paper published in the Lancet in February 1998 entitled “Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis and Pervasive Developmental Disorder in Children” (“the Lancet paper”).

It is alleged that the three practitioners inaccurately stated in the Lancet paper that the investigations reported in it were approved by the ethics committee.

The Panel will inquire into allegations that Dr Wakefield and Professor Walker-Smith acted dishonestly and irresponsibly in failing to disclose in the Lancet paper the method by which they recruited patients for inclusion in the research which resulted in a misleading description of the patient population in the Lancet paper. It is further alleged that Dr Wakefield gave a dishonest description of the patient population to the Medical Research Council.

The Panel will inquire into allegations that Dr Wakefield and Professor Walker-Smith administered a purportedly therapeutic substance to a child for experimental reasons prior to obtaining information about the safety of the substance. It is alleged that such actions were irresponsible and contrary to the clinical interests of the child.
The Panel will inquire into allegations that Dr Wakefield was involved in advising solicitors acting for persons alleged to have suffered harm by the administration of the MMR vaccine. It is alleged that Dr Wakefield’s conduct in relation to research funds obtained from the Legal Aid Board (“LAB”) was dishonest and misleading. It will be alleged that Dr Wakefield ought to have disclosed his funding from the LAB to the Ethics Committee but did not.

The Panel will inquire into allegations that Dr Wakefield ordered investigations on some children as part of the research carried out at the Royal Free Hospital from 1996-98 without the requisite paediatric qualifications to do so and in contravention of his Honorary Consultant appointment.

The Panel will inquire into allegations that Dr Wakefield failed to disclose his involvement in the MMR litigation, his receipt of funding from the LAB and his involvement in a Patent relating to a new vaccine to the Editor of the Lancet which was contrary to his duties as a senior author of the Lancet paper.

The Panel will inquire into allegations that Dr Wakefield acted unethically and abused his position of trust as a medical practitioner by taking blood from children at a birthday party to use for research purposes without ethics committee approval, in an inappropriate social setting, and whilst offering financial inducement.

MMR Scare

How convenient then for Wakefield that the MMR scare is resurrected on the front page of today’s Observer. Meanwhile Wakefield is given a two page spread to defend himself in advance of next week’s hearing. Despite the caveats in both pieces the overall message is clear. Any reader who is unfamiliar with the details of the controversy could be forgiven for coming away from the articles with the impression that MMR is still open to question, that Wakefield acted honourably in raising the issue and that, in closing ranks againts him, the medical establishment is also closing its collective mind. They are investigating Wakefield when they should be investigating his ideas. Thankfully a number of bloggers who have taken the time to familiarize themselves with the details have been quick to point out the fallacies in today’s articles.

Autism Diva, Autism Vox, BadScience, Black Triangle, LeftBrain/Right Brain, Public Address and Breath Spa for Kids , Tim Worstall, Tony Hatfield,

I would like to end by crying shame on those journalists who have uncritically reiterated the follies of the Observer in the online editions of The Telegraph and The Mail. Will tomorrow’s print editions be any better?

Vaccines, Autism and Perception of Risk

This week’s New Scientist contains the first major discussion of the Autism Omnibus Proceedings that I have seen in the UK media. There are a few minor inaccuracies. For example the Omnibus is not just about thimerosal. There are three theories of general causation proposed by the Petitioners Steering Committee: thimerosal; MMR; thimerosal and MMR combined. And the case of Michelle Cedillo  with which the proceeedings have opened is based on the final hypothesis, that thimerosal containing vaccines administered in the first year of life damaged her immune system to such an extent that the MMR caused her to become autistic.

Leaving aside the particulars of  individual cases the New Scientist makes some important points. After outlining the preponderance of scientific opinion  against thimerosal as a causative factor in autism the New Scientist editorial goes on to say,

On the surface then, this looks like a battle between the reasoned arguments of experts and irrational parents. This is how health officials have interpreted vaccine disputes in the past, but in so doing they alienated the people they are meant to be advising.

In the UK, a similar debate kicked off in 1998, when scientist and doctor Andrew Wakefield cast doubt on the safety of the measles, mumps and rubella (MMR) vaccine. The response of the medical establishment was well intentioned but disastrous. Experts met behind closed doors and emerged to tell the public the vaccine was safe. Leaflets gave celebrity endorsements of MMR. Rather than examine Wakefield’s claims, which were shaky at the time and are now widely discredited, the government merely told parents not to be silly. Not surprisingly, parents did not buy it. Take-up of MMR fell from 92 to 82 per cent, close to the minimum level needed if isolated cases are to be prevented from developing into epidemics.

At the time of the MMR crisis I remember feeling patronized and my intelligence insulted by what seemed like another attempt to replace serious debate with a public relations spin job by the government and their officials. They made me want to believe Wakefield. And for a while I very nearly did. 

Let me be clear. I am not denying. that a small number of children do have adverse reactions to vaccines, sometimes with disasterous consequences. But prior to vaccines every child had adverse reactions to the diseases we vaccinate against and many of the outcomes were tragic. I speak as a survivor of measles, mumps and whooping cough. Today’s parents may be forgiven for failing to appreciate just how serious these diseases can be. The very success of the vaccine programme has led to complacency in this respect.

It has also contributed to the high level of risk aversion in the affluent societies of the world. In my grandparents time it was expected that some children would die. Around 100 years ago infant mortality rates in the USA and the UK were horrendous. One in ten children died before their first birthday. That would put the UK and the USA in the top ten for infant mortality today ahead of countries like Ethiopia and Sudan.

Vaccination rates have contributed to the steady decline in infant mortality. As it happens the current US figure of just under 7 children in a thousand for infant mortality is slighter higher than their rate for autism.

But parents do not consider statistical probabilities when making decisions about their child. When you sit in the doctor’s waiting room with a healthy 18 month old infant in your arms the chances of them dying in infancy are miniscule compared to the chance that they might develop autism. And if there were the tiniest doubt in your mind about the safety of childhood vaccines you would walk out of that waiting room.

In reality most parents have vaccinated their children with overwhelmingly positive outcomes. But for a minority of parents the doubt has been planted post hoc and some of them have thus been led into the logical fallacy of post hoc ergo propter hoc and blame the vaccines for causing their child’s autism.

The New Scientist suggests that the way to avoid this in the future is for scientists to be

open, and admitting what science does not know. It takes time and effort, but the alternative is that parents and health officials talk past each other.

I can see their point. For a long time science has been presented as the infallible source of truth, not by scientists but by opinion makers in politics and the media. A minority of scientists may have been seduced by this and others have challenged it. But I suspect that most have got on with the job, oblivious to the impact that reports of their work have on public opinion.

However, I am not convinced. Most people’s perceptions of science are not based on what scientists say, but on media reports of what they say. And the standards of science reporting in the popular media are frankly terrible.

This is caused by a mixture of ignorance and laziness that even affects magazines like New Scientist, for whom scientific ignorance should not be an issue. Yet too often they carry short reports based on pilot studies that are not yet ready for public consumption. These are then picked up by the non-scientific media and presented as “proof positive” when no such proof exists.

As an example of laziness, their main article on the Autism Omnibus proceedings contains a reference to mercury as “a known neurotoxin.” Amongst the anti-vaxers this carries the subtext, “They knowingly injected a neurotoxin into our children.” They did it on purpose, dammit!

Is there any circumstance in which New Scientist reporters would describe a substance as an unknown neuro-toxin? The phrase, known neurotoxin, is  code for a whole set of assumptions to which New Scientist certainly does not subscribe, but to which it gives unwitting approval by the careless use of language.

Overall, the New Scientist coverage is informed by support for the standards of scientific proof and rigorous criticism for those who fall short of those standards. At the same time it respects the sensibilities of those for whom autism and its causation is not primarily a discussion of scientific principle but a very personal and immediate issue. This discussion has focused primarily upon the issues raised by the New Scientist editorial. I hope to return to the substantive article tomorrow.

The MMR Gravy Train

Dr Michael Fitzpatrick has just published an excellent commentary on the recent revelations about the anti-MMR gravy train. This refers to the multi-million pound bonanza paid out by the Legal Services Commission(LSC) to fund a legal case on behalf of 1200 children whose autism was alleged to result from exposure to the MMR vaccine. Funding began in 1992 and was stopped by the LSC in 2003, “as we were not satisfied the evidence demonstrated a sufficiently strong case.” (scroll down to read the whole letter.)

Now, if I was one of those parents I would want to know why, after 11 years of collecting evidence and running up massive legal bills in the process, my legal team was not yet ready to take the case to court? The answer was simple. The evidence did not exist.

At the time we were presented with a picture of Andrew Wakefield as a lone campaigner battling against the might of the medical establishment to prove what parents already knew – that MMR had caused their children’s autism. He was the hero of a television drama, Hear the Silence, screened just before Christmas 2003 and enjoyed support from such widely differing sources as the voice of conservative middle England, the Daily Mail, and the scourge of the establishment, Private Eye. But all this journalistic interest overlooked one important fact. Wakefield was not alone. He was supported by legal firm, Dawbarns to the tune of £439,553.  It turns out that nearly every professional who ever spoke up in support of Wakefield’s MMR/autism hypothesis was also employed as an expert witness. Professor O’Leary’s laboratory, Unigenetics received  £773,317 to fund its search for measles virus in the gut of autistic children. The total bill for expert witnesses came to over £3.4 million.  To put these figures in perspective,

The Government gave the MRC an extra £2.75 million for autism research in 2002. Since then we have invested £3.1 million in this important area, funding six major new research projects.

Whenever we read accusations of conflict of interest aimed at scientists whose research contradicts the claims of the anti-MMR campaigners we should remember the potential conflict of interest when researchers are being hired by legal firms and paid handsomely to find results to support litigation. As the LSC ruefully observed,

‘in retrospect, it was not effective or appropriate for the LSC to fund research’, conceding that ‘the courts are not the place to prove new medical truths’

There is still one unanswered question in all this. Never mind that the scientific experts  proved an expensive failure. £3.4 million over 11 years is not an unreasonable sum to spend on science. And if the science is flawed and inconclusive or even downright wrong that does not matter, so long as it is published and subject to peer review. But what I want to know is this. What were the legal eagles doing all this time that justified their massive share of the pie? £9,731,430 plus tax was paid out to solicitors and barristers for a case that never came to court!

It is safe to assume that the drug companies who were defending this action paid out at least as much to their legal teams. What a waste!

Wakefield’s MMR Bonanza

FOLLOW THE MONEY

Anthony Cox has just blogged Brian Deer’s latest report on MMR and autism published in yesterday’s Sunday Times. He shows how the British government spent nigh on £16 million of taxpayers’ money to assist those making claims that their children were damaged by the MMR vaccine and became autistic as a result. Most of it went to the lawyers but a substantial amount went to independent researchers and expert witnesses in the case. Andrew Wakefield collected one of the biggest pay-off, £435,643 in fees, plus £3,910 expenses.

He has issued a statement in response to Brian Deer’s article in which he says,

I worked extremely hard on this very onerous litigation because I believed and still believe in the just cause of the matter under investigation. This work involved nights, weekends and much of my holidays such that I saw little of my family during this time.

Well, if the going rate for expert witnesses is between £120 and £200 pounds an hour or £1000 a day, I should jolly well hope he was doing it on his own time!

(Memo to self: remember to charge school £120 an hour for all marking, planning and preparation and report writing carried out during nights, weekends and much of my holidays.)

According to the Sunday Times he says he gave the money to charity. In an email which is currently being circulated on the web he goes into more detail.

The money that I received was, after tax and out of pocket expenses, donated to an initiative to create a new center, in the first instance at the Royal Free Hospital, for the care of autistic children and those with bowel disease. This intention was made clear, in writing, to senior members of the medical school. The initiative was unsuccessful at the Royal Free but ultimately succeeded in the US.

Is Wakefield referring to Thoughtful House, the autism treatment centre which he established in Texas? I wonder if anyone else at Thoughtful House also chipped in with their expert witness fees and expenses to set him up in private practise in the USA? Brian Deer has compiled a useful list of expert witnesses which includes two of Wakefield’s colleagues at Thoughtful House.

• Carol Stott – fees: £94,916. Plus expenses: £5,198
• Arthur Krigsman – fees: 16,986

(Memo to self: When head teacher pays up for work carried out in my own time, set up autism charity with proceeeds and employ self as director of said charity.)

NEW YEAR QUIZ

Seeing as it is the new year I suppose I should have one of those quizzes that fill the newspapers at this time of year. But as I am so busy with all that work carried out during nights, weekends and much of my holidays I only have time to ask one question.

If you had £16 million to spend on autism, what would you spend it on?

a. Lawyers?

b. So-called “expert” witnesses?

c. Something else, like autism services perhaps?

HAPPY NEW YEAR EVERYBODY!!