Wakefield has not been vindicated and the courts do not think MMR causes autism

By Helen Petousis Harris 07/08/2013 21


Bit of a buzz on anti-vaccination websites about apparent court rulings in favour of MMR/autism cases. An example is  from a website called “why don’t you try this?” which cites as a source Whiteout Press (“if its blacked out, covered up of censored you can find it here”)  which in turn cites The Liberty Beacon which for its part cites Health Impact News Daily , that cite a press release from Autism Media Channel  at which point the trail goes cold because there do not appear to be any press releases on that website, although an article by anti-vaccination author David Kirby in the Huffington Post  seems a likely source for some of this baloney.

Anyway, back to the issues circulating in the apparent absence of any credible sources. According to the buzz, pharmaceutical companies and governments have admited that vaccines cause autism. There appear to be general themes presented – presumably to support this idea:

  • Andrew Wakefield has been vindicated by new research
  • The vaccine courts have awarded damages to children made autistic by vaccines

Wakefield is playing victim again. The material appears to derive from his own propaganda.

He has posted clips on YouTube explaining what a legend he is and how he has been victimised by the UK health authorities. Let’s take a look at some of what he has to say – these are snippets that are circulating on the aforementioned websites. To set the scene he starts by saying he is not seeking any attention, has been denied the opportunity to redress allegations made against him, that legitimate debate has been blocked by the government…it wasn’t me, I didn’t do it etc… Then he goes on:

The important thing to say is that back in 1996 — 1997 I was made  aware of children developing autism, regressive autism, following exposure in many cases to the measles mumps rubella vaccine. Such was my concern about the safety of that vaccine that I went back and reviewed every safety study, every pre-licensing study of the MMR vaccine and other measles containing vaccines before they were put into children and after. And I was appalled with the quality of that science. It really was totally below par and that has been reiterated by other authoritative sources since.

I compiled my observations into a 200 page report which I am seeking to put online once I get permission from my lawyers. And that report was the basis of my impression that the MMR vaccine was inadequately tested for safety certainly compared with the single vaccines and therefore that was the basis of my recommendation in 1998 at the press conference that parents should have the option of the single vaccines.

So fifteen years later he comes up with a report that must be so secret it could not be published revealing inadequate testing of the MMR vaccine. Now he is going to post it online.

Generally it is not considered necessary to conduct an efficacy trial for a vaccine that combines antigens that have previously been demonstrated efficacious (e.g. measles, mumps and rubella). It is the demonstration of non-inferior immunity that is required. Vaccine safety will be assessed against existing vaccines. Also, once a vaccine is in use it becomes unethical to conduct a placebo controlled trial and new vaccines are assessed against existing vaccines. So if anyone is looking for a placebo controlled trial for MMR vaccine that is not a crossover design they will probably turn up little.

One thing that is really important to point out is that MMR vaccines were first licenced in the US in 1971, the first measles vaccines in around 1963. There is no doubt that the regulatory requirements have changed over the past 50 years. Also, vaccine safety monitoring has changed dramatically. I think we must certainly acknowledge that safety monitoring in the 1970’s would have been no match for today’s systems. Despite this, even 50 years ago vaccination programmes were required to be monitored and the systems were adequate to identify many safety issues. Examples include concerns about the safety of whole cell pertussis vaccines and acute encephalitis after measles vaccination. So even 30-60 years ago, safety systems existed and they successfully picked up safety signals.

All this aside, Wakefield (like all good anti-immunisation activists) carefully avoids the vast global data from both passive safety surveillance systems and active safety monitoring studies that overwhelmingly demonstrate the safety profile of MMR vaccine and clearly refute any association with autism (and any other behavioural or neurological condition). .

Just one example that Wakefield ignores – A Cochrane review published in 2012 assessed the adverse effects associated with MMR vaccine in children up the age of 15 years. The authors included randomised controlled trials, a controlled clinical trial, cohort studies, case-control studies, time-series trials, case cross-over trial, ecological studies, and self-controlled case series studies involving approximately 14,700,000 children. Exposure to MMR was found unlikely to be associated with autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn’s disease, demyelinating diseases, bacterial or viral infections. Conditions known to have an increased risk associated with MMR vaccines are aseptic meningitis within three to five weeks of weeks of Urabe-containing and Leningrad-Zagreb MMR vaccines (not the ones we use), febrile seizures within two weeks of MMR vaccines and idiopathic thrombocytopenic purpura (ITP) within six weeks. MMR vaccines continue to have an excellent safety profile worldwide.

He goes on then to criticise the National Health Service for depriving parents who had legitimate concerns about the vaccine to purchase single vaccines. He complains that the health authorities only served to protect their MMR programme with disregard for children. Then Wakefield introduces the well-known issue (as if it is a revelation) with the Urabe mumps vaccine component, this strain of attenuated mumps had an increased risk for vaccine associated meningitis. This issue was detected in Japan and Canada ~1988, verified in the UK, identified and the vaccine removed (1992 UK). What has this got to do with autism? Apparently this leads on to his conspiracy theories about cover-ups and how he (Andrew Wakefield) took the stand on MMR, and he was so deeply and justifiably concerned:

So the next question is beyond the fact that MMR vaccine is not safe and has not been adequately tested; not just my opinion but the opinion of many; is does MMR vaccine cause autism?

Now this question has been answered not by me but by the courts, by the vaccine courts in Italy and in the United States of America where it appears that many children over the last 30 years have been awarded millions of dollars for the fact that they have been brain-damaged by MMR vaccine and other vaccines and that brain-damage has led to autism. That is a fact.

Mmmm. So the scientific question of whether or not MMR vaccine increases the risk for autism has been answered by the courts!! Really!! Firstly, the Vaccine Injury Compensation Programme (VICP) is a no-fault system whereby cause does not have to be proven. Causation in law is not the same as that accepted in science and epidemiology. In some cases this can mean “slightly more than 50%” chance of a drug having caused an injury. Secondly, the courts are in no position to make scientific judgements, and thirdly…now brain damage leads to autism? What happened to the all-important bowel component of Wakefield’s MMR/autism disorder? The original claim by Wakefield was that MMR caused associated gastrointestinal disease and developmental regression. Maybe he has changed his theory. I heard that the Special Masters in the US Court of Federal Claims for the VICP concluded that MMR was not linked to the development of autism based on existing scientific evidence. However the Programme has indeed awarded compensation for many families and individuals for a variety of adverse events (remember this is a no-fault system, causality does not have to be proven). There is a difference here and Wakefield seems to be twisting the facts. 

In December 2012, two landmark decisions were announced that confirmed Dr. Wakefield’s original concern that there is a link between the MMR vaccine, autism and stomach disorders. The news went mostly unreported, but independent outlets like The Liberty Beacon finally began publishing the ground breaking news.

A closer examination of the issue of the courts and these cases was executed by Orac  earlier this year. Bottom line is the plaintiffs were awarded compensation for possible encephalopathy after MMR vaccine, not autism. From what I can see of the medical histories presented in these cases this seems reasonable.

But this is the very best part:

Now it is very important for people to bear in mind that MMR   doesn’t protect against measles. Measles vaccine protects against measles. The mumps and rubella components are irrelevant. So, if single vaccines were available; if the government had not withdrawn the availability of a vaccine, then there would be no outbreak of measles in Wales, there would be no discussion of measles cases and potential measles deaths. So, the blame for this must lie on the shoulders on those who withdrew the option of the single vaccine from the parents who were legitimately concerned about the safety of the MMR. Not because of me but what had happened because of that vaccine long before I came on the scene.

The error is so profound it really does not warrant a comment. Of course MMR protects against measles – AND mumps AND rubella.

MMR vaccine uptake is at an all-time high. So why are we now seeing measles outbreaks in highly vaccinated populations. It would be very interesting to find out how many of those children in the current outbreak have  actually been vaccinated. I suspect many. And this has been seen before.

Actually the UK has cohorts with very low coverage. He then goes on about vaccine failure, particularly mumps vaccine and some bizarre idea that by repeatedly using virus seed stock the vaccines have lost their potency. I can’t find any data on vaccine status of confirmed cases in the UK outbreak but they certainly have a cohort with the lower MMR coverage – those who were eligible for vaccine in the late 1990’s and early 2000’s, people aged around 10-18 years whose parents became freaked out about the vaccine thanks to Wakefield’s fraud. According to newspapers these are the most affected by the current epidemic. Perhaps Wakefield was channelling Blackadder in the 90’s and came up with a plan so cunning he could put a tail on it and call it a weasel!?

During the most recent measles outbreak in NZ most cases were unvaccinated. Can’t imagine it would be different in the UK. Below table 5 from the 2011 measles report from ESR. Important to point out that the denominator for one or two doses is most of the population and the denominator for not vaccinated is relatively small.

Immunisation status of measles cases in NZ 2011. Source ESR.

 

I can’t listen to any more… have skipped to the end which appears to be personal attack on the Health Authorities and lots more “it wasn’t me, I didn’t do it” and a challenge to David Salisbury who was the head of the UK National Immunisation Programme.

BTW, I was interested in how Wakefield’s forehead remained so motionless.

 


21 Responses to “Wakefield has not been vindicated and the courts do not think MMR causes autism”

  • Grant Jacobs linked to your terrific post, while he was posting at Orac’s Respectful Insolence blog.

    You’ve done a superb job of chronicling the disgraced and discredited Andrew Wakefield’s feeble attempts to keep himself in the spotlight and to keep himself relevant in the science community.

    Only the diehard anti-vaccine, anti-science crowd pays attention to this public health menace, now. The rest of us just point and laugh at his press conferences and his groupies.

  • lillady: “Grant Jacobs linked to …” Shhhhh! 😉

    (Just kidding.)

    For what it’s worth a local anti-vaccine group featured the piece Helen refers to. (WAVESnz, previously were IAS.)

  • Unfortunately, I think there are a few people uncertain, but potentially swayed by misleading scaremongering. Having something as well written and comprehensive as this, goes a long way towards reassuring those people.

    • Hello Edward,
      You have provided a link to an on line magazine who recruit their writers from an internet invitation. There are some requirements for participation – be able to string words together without needing editing, not plagiarise and to be willing to write about a specific topic you like. Cant see anything about journalistic codes of ethics – yes, real journalists have a code of practice. Natural News has established itself as a popular purveyor of woo. The article by PF Louis has attempted to attract credibility by using the British Medical Journal Logo and appearances of links to the British Medical Journal but is does no such thing. I would say this is misrepresentation. Here is a link to a real BMJ press release citing the BMJ editor in Chief Dr Fiona Godlee from the real BMJ website on Wakefled.
      cheers
      helen

  • I can;t understand, how this guy gets his medical license revoked, is thoroughly debunked by peer review, demonstrably has a financial gain, should his viewpoint be taken up, is still used as the basis for fringe support world wide. He is the direct cause of the measles outbreak in Minnesota recently. I can;t wait for theis a$$hole to get criminally prosecuted for causing this mass, albeit fringe, hysteria.

    • I hear your pain.
      Sadly I have never heard of anyone like Wakefield being prosecuted. Technicality I should imagine!

  • Andrew Wakefield has never done anything but report his findings and defend the process by which they were derived. You can attempt to crucify him over and over and over again and it changes nothing for those of us who are able to read exhaustively and think for ourselves. You are wrong about Wakefield, wrong about cellular metabolism when faced with oxidative stress and cytokine storm induced by vaccination, wrong about what makes one prone to disease states in the presence of pathogens, and wrong to think that the paradigm you defend will survive for another 10 years. Long live good nutrition and holistic medicine, and long live parents who know how to read and defend freedom of choice for their families in the face of lies such as those purveyed by your article.

  • Dan Hill: “cytokine storm induced by vaccination”

    Why would exposure to a small number of antigens via vaccination elicit a ‘cytokine storm’, when exposure to far greater numbers of antigens on a daily basis (including, for 70+ young people in Hamilton, live measles virus) does not?

  • I am confused, did you actually read the pages you attached under “a no fault system whereby cause does not need to be proven”? It clearly states that the money is given to people who are injured due to vaccinations. They say they set it up because they know that some people will be damaged by the vaccinations, so it is only fair to compensate these individuals in societies where vaccination is expected for the greater good of the people. How in the world did you get the impression that they are saying there was actually no fault? They are only saying they didn’t intentionally damage people,but they know it will happen sometimes anyway. I guess people are okay with that logic until it is their child that suffers long term difficulties or even death due to vaccines. Did you not read it, or did you think your readers were too stupid to read it?

  • Kara,

    Near the opening portion of that document it explains the point of no-fault systems. The section Standard of proof explains that the standards used are usually not of rigorous proof.

    It says that the point of ‘no fault’ is that without a particular individual, etc., to ‘blame’ it’s difficult to get compensation under law. This is saying that the ‘no fault’ aspect is for the benefit of those looking for compensation.

    The standards of proof—according to what that document says—are usually more generous that you’d usually find in regular courts. (I recall one legal expert saying words to the effect that vaccine courts in the USA use 50% chance and a feather.)

    “It clearly states that the money is given to people who are injured due to vaccinations.”

    My understanding is that these courts etc. don’t seek ‘proof’ that the vaccination caused the problem and in general they can’t, but the idea is that if there is reasonable argument that the vaccination might have caused problems, they can offer compensation.

    “They say they set it up because they know that some people will be damaged by the vaccinations,”

    My understanding is that they’re actually set up so that on one hand vaccine companies (and vaccination programs) would not walk off because of overly keen attempts at suing them and on the other provide a means for compensation given the ‘no fault’ issue.

    “They are only saying they didn’t intentionally damage people,but they know it will happen sometimes anyway.”

    It’s more useful to look to the surveys that have checked to see what, if any, cases can be medically confirmed. I don’t have the information at hand, but I can recall seeing large surveys examining claims filed finding that the rates of actual ‘injury’ are very very low. A point is that the large majority of things on closer inspection prove to not actually be vaccine ‘injury’.

    (I can’t confirm this, but related to this I have read that there is a problem with the way the vaccine companies use the ‘side effects’ information. They’re supposed to file known side effects, ones that have been confirmed, but I’ve read some suggest they include ‘possible’ but not known side effects to cover themselves legally.)

    “I guess people are okay with that logic until it is their child that suffers long term difficulties or even death due to vaccines.”

    Borrowing your words, the alternative would be a much larger number of children suffering long term difficulties or even death due to the illnesses the vaccines prevent (including their own children).

  • Adding to this issue: there’s evidence that those who catch VPDs ‘naturally’ are more likely than those who haven’t to develop arthritis, atherosclerosis, & other inflammatory diseases later in life. In other words, childhood vaccinations protect against more than ‘childhood’ diseases (which of course VPDs are not, anyway; they affect adults as well).

  • Dr Helen Petousis-Harris,

    I’ve been looking into issues of vaccine safety/efficacy for a few months and came across this blog while looking for updates on court cases. I wasn’t going to make any comments initially because of how old this post is, but I did notice recent comment activity…so maybe I’ll go ahead and mention a few thoughts I have.

    I must say I’m quite surprised at your general attitude in this post. I’ve not read any of your other posts, so I don’t have any comparative examples…nevertheless, it seems that, at least in this post, you carry a tone not unlike that of an over-sensationalizing journalist, rather than of a biologist. I understand that your specific interest in vaccinology makes you keenly sensitive to perceived threats to the “success” of vaccination programs. But what I don’t understand is the specific reasons you perceive Wakefield to be one of those threats. I’m going to address a number of your statements in this post and perhaps demonstrate some misconceptions that may be leading you to join others in the needless and futile attempts to implicate him in all things evil. I would suggest to you that one of the real threats to vaccination programs are the very ones who oversee their implementation.

    “So fifteen years later he comes up with a report…”

    The report mentioned here was compiled by Wakefield prior to 1998 and was the basis for his recommendations during the press conference that year concerning the single measles, mumps, and rubella vaccines. It was not, as you suggest, put together 15 years after those events.

    “Vaccine safety will be assessed against existing vaccines.”

    This is precisely what Wakefield was doing, compiling observations from pre-licensing AND post-licensing studies concerning the safety of the MMR vaccine against that of the single vaccines. If junk science formed the basis of those studies, then you would have every reason to be concerned about the safety of MMR vaccines, especially as reports started to roll in from concerned parents as well as from other countries who recalled the same vaccines.

    “Wakefield (like all good anti-immunisation activists)…”

    I don’t see how you can reasonably conclude that Wakefield is an “anti-immunisation activist”. His activism is quite limited in scope to a very small subset of vaccines, namely MMR, as they relate to complications arising from them which may or may not lead to autism spectrum disorders in certain vulnerable people.

    “…carefully avoids the vast global data…”

    I think you’re going to have to provide more than just your “Cochrane review” example to support this claim. First, this review was done nearly 15 years after Wakefield made his initial observations about the MMR vaccine. So there’s a huge chronological disparity, meaning that many (if not most) of the studies included in the Cochrane review were produced long after Wakefield’s review in the 1990’s. Thus it’s dishonest to claim that Wakefield “ignored” global data. More importantly, the main conclusion by the authors of the Cochrane review was that practically all of the included studies suffered from moderate to severe design and/or implementation flaws. And even the review project itself had significant limitations. As for analysis of efficacy and overall safety of the MMR vaccine, the review merely regurgitated the results of those studies, and then, as just mentioned, stated that these studies were wholly inadequate for drawing generalized conclusions.

    “Then Wakefield introduces the well-known issue (as if it is a revelation) with the Urabe mumps vaccine component, this strain of attenuated mumps had an increased risk for vaccine associated meningitis.”

    Wakefield’s whole point in mentioning the Urabe strain vaccine is to demonstrate a history of negligence/irresponsibility with regard to introduction of newly licensed vaccines. Pluserix was introduced in the UK around 1988 even though it was known by then that it was causing high incidence of meningitis in Canada. The Joint Committee On Vaccination And Immunisation ignored this issue and also refused to initiate active surveillance, resulting in it taking 4 years to determine that the vaccine (which arguably never should have been introduced) needed to be hastily removed. It’s totally irrelevant that this vaccine is no longer used anywhere. Wakefield was simply systematically pointing out the dangerous shortcomings of those responsible for regional oversight of immunization. If their oversight, and the studies they base their decisions on, are methodologically flawed, then there is reason to be concerned about any of the vaccines currently being used.

    “Firstly, the Vaccine Injury Compensation Programme (VICP) is a no-fault system whereby cause does not have to be proven.”

    Actually, this might have sufficed as a description of the system when it was first introduced. However, it (the US program) has undergone much revision over the last 20 years, and now it is to the point where at least 90% of cases involve injuries other than what is stated in the Vaccine Injury Table. What this means is that the petitioners in these cases must prove beyond reasonable doubt that their injury was causally associated with vaccination, and they must do so in an increasingly adversarial, lengthy, costly, and complicated litigation process.

    “Secondly, the courts are in no position to make scientific judgements”

    This statement is further evidence that you may not be all that familiar with the vaccine courts in question (Italy and US specifically). In the US, the cases Wakefield is referring to are decided by “masters” (who are chosen for their expertise in law and medicine) typically after evidence is presented to them by other medical experts and rigorously discussed. Don’t you think that would be considered a “scientific judgement”?

    “What happened to the all-important bowel component of Wakefield’s MMR/autism disorder?”

    It’s actually quite irrelevant that Wakefield initially suspected a gastrointestinal component and is now drawing attention to an encephalopathy component. His initial suspicion was due to the fact that the children who were referred to him all had gastrointestinal symptoms. Further research of course has not supported that component, and so it makes sense to now follow the evidence trail that is now mounting for an encephalopathy component to some incidences of regressive autism which may be triggered by certain vaccinations.

    “Of course MMR protects against measles – AND mumps AND rubella.”

    I think you are again missing Wakefield’s point here. The point is that it was perfectly in line with vaccine policy at that time to have single vaccine doses of the MMR components available as an option for concerned parents. Unfortunately, those single vaccines were withdrawn as parents became concerned about the only other option, MMR.

    “According to newspapers these are the most affected by the current epidemic.”

    First of all, which newspapers? Second, I would think a scientist would want something a lot more substantial than “newspapers” for credible information.

    “During the most recent measles outbreak in NZ most cases were unvaccinated.”

    It indeed seems accurate to say that “most cases” were unvaccinated, but that hardly seems all that relevant, when the numbers in the table suggest that the ratio of vaccinated to unvaccinated could be 1 (vaccinated) for every 5 (unvaccinated) or perhaps even higher. This is strongly indicating a vaccine efficacy issue that should be addressed.

  • Dylan –

    “you carry a tone not unlike that of an over-sensationalizing journalist, rather than of a biologist”

    “your specific interest in vaccinology makes you keenly sensitive to perceived threats to the “success” of vaccination programs”

    Characterisations and strawmannery aren’t helpful, I think; whatever you go on to write you’ve undone yourself before you’ve begun, as it were, and made yourself look guilty of what you accuse others of. Helen may have in places been to the point about Wakefield, but her piece doesn’t characterise him in the way you’ve characterised her. Better to have just presented substance.

    “The report mentioned here was compiled by Wakefield prior to 1998 and was the basis for his recommendations during the press conference that year concerning the single measles, mumps, and rubella vaccines. It was not, as you suggest, put together 15 years after those events.”

    Helen quoted that the report was written earlier herself, I can’t see her saying this was written 15 years latter as you say. ‘Come up with’ can mean ‘to present’, not ‘to write’ – I suggest you try the former meaning, it fits what was written: she was saying it was presented 15 years later. (Which raises a question why now, not 15 years ago.)

    In writing that, you’ve left out (or sidestepped?) the key point – that Wakefield’s ‘recommendations’ were wide of the mark. (Also inflammatory – and self-serving given his paid interest in promoting one vaccine against the existing vaccine.) The ‘recommendations’ Wakefield made are a central aspect to ‘the Wakefield saga’, they can’t really be overlooked.

    “I think you’re going to have to provide more than just your “Cochrane review” example to support this claim.”

    She wrote that it was just one example.

    As for links to autism, if you are researching as you say you are you’ll know there is quite a number of large studies finding no association between the MMR vaccines (or vaccines in general) and autism and that Cochrane report cited reiterates that. I recall correctly, some of these studies also consider other negative effects besides autism.

    You’ll also know the Cochrane studies gather together earlier studies that meet specific ‘usefulness’ criteria: her example is the consensus of many studies. I imagine that it is a consensus of studies is the reason she choose to use it as her example.

    “So there’s a huge chronological disparity, meaning that many (if not most) of the studies included in the Cochrane review were produced long after Wakefield’s review in the 1990′s. Thus it’s dishonest to claim that Wakefield “ignored” global data.”

    Wakefield was to be presenting his old study as evidence after the studies Helen refers to. If there is a chronological curiosity here, I’d have thought it’d be that an old study might trump newer ones after the field has had 15 year more experience with the subject, etc.

    “More importantly, the main conclusion by the authors of the Cochrane review was that practically all of the included studies suffered from moderate to severe design and/or implementation flaws.”

    The main conclusion for the practice of using the MMR vaccine was that the evidence supported the safety and efficacy of the MMR vaccine, here it is verbatim:


    Implications for practice

    Existing evidence on the safety and effectiveness of MMR vaccine supports current policies of mass immunisation aimed at global measles eradication and in order to reduce morbidity and mortality associated with mumps and rubella.

    Implications for research

    The design and reporting of safety outcomes in MMR vaccine studies, both pre and post-marketing, need to be improved and standardised definitions of adverse events should be adopted. More evidence assessing whether the protective effect of MMR could wane with the time since immunisation should be addressed.

    (If you’re begging for honesty, best to reflect report‘s conclusions accurately?)

    If you read the review itself, you’ll see the suggestions offered about study designs are more nuanced than you make out; the conclusion for future research doesn’t cover them in a single sentence or two, which is pretty understandable. (Best to try grasp the whole picture, rather than the cherry-picked sentences, or parts, that anti-vaccine lobby groups tend to offer.)

    “and now it is to the point where at least 90% of cases involve injuries other than what is stated in the Vaccine Injury Table. What this means is that the petitioners in these cases must prove beyond reasonable doubt that their injury was causally associated with vaccination, and they must do so in an increasingly adversarial, lengthy, costly, and complicated litigation process.”

    A more obvious explanation might be that having screened out the claims that are on the Vaccine Injury Table that proved insubstantial—reflecting that few claims of adverse effects due to vaccines prove to be substantial on closer examination—they were left mostly with the things they aren’t able to examine because they’re limited to examining the things on the Vaccine Injury Table.

    re pointing at “ the courts are in no position to make scientific judgements” – the courts are unable to make scientific judgements. It’s subtle point that seem to trip quite a few people up, hence my added emphasis (and one which quite a few anti-vaccine stances play on). They can use them, but not make them. See the difference? If I recall correctly one of the judges even explicitly pointed that they cannot make scientific judgements out in one of the rulings.

    “so it makes sense to now follow the evidence trail that is now mounting for an encephalopathy component to some incidences of regressive autism which may be triggered by certain vaccinations.”

    Forgive me for being to the point, but this is not what research shows. Anti-vaccine groups have long offered claims of links between autism and vaccines but there is no good evidence of such a link. Possible links between autism and vaccines have been examined many times & no link found; recent work increasingly points to a very early origin for autism with some evidence pointing to a congenital (prior to birth) origin.

  • Greetings Mr. Jacobs

    I’m sorry for making you wait so long for a response. Kind of a combination of busyness and not realizing for some time that you had responded to me (I thought I would receive an e-mail notification or something like that. In any case, I’m still hoping Dr. Petousis Harris will respond to my initial comments, rather than let someone else steal her thunder. In the meantime, I’m interested to see where our dialogue goes.

    “Characterisations and strawmannery aren’t helpful, I think; whatever you go on to write you’ve undone yourself before you’ve begun, as it were, and made yourself look guilty of what you accuse others of.”

    I really don’t see how those two statements of mine you quoted could possibly be labelled as characterization or “strawmannery” (I mean come on, did you just make up that word?). If I wanted to characterize her, I would have said something like “You are an over-sensationalizing journalist, rather than a biologist”. At worst, it could be argued that I was characterizing her tone, but such characterization is appropriate for helping others realize how they come across by their tones/language.

    If you want to see characterization, try these phrases from Helen’s post: “Wakefield is playing victim again.”; “He has posted clips on YouTube explaining what a legend he is…”; “All this aside, Wakefield (like all good anti-immunisation activists)…”; seriously, I haven’t come close to anything like that.

    “Helen quoted that the report was written earlier herself, I can’t see her saying this was written 15 years latter as you say.”

    If it’s all the same to you, I’ll leave it to the good Dr. to answer for herself as to what she was intending by her statement, especially since I was directly addressing her rather than you. I will state though that your point is ultimately beside the point anyway…their could be any number of legitimate reasons for Wakefield’s decision to “sit on” his report for so long. Making a provocatively-toned and worded statement about the decision doesn’t really serve to discredit that decision in and of itself.

    “In writing that, you’ve left out (or sidestepped?) the key point – that Wakefield’s ‘recommendations’ were wide of the mark. (Also inflammatory – and self-serving given his paid interest in promoting one vaccine against the existing vaccine.)”

    Whoa whoa whoa, hold on a second. First, I need to see some evidence that his recommendations were wide of the “mark”. What mark are you referring to, and what proof do you offer that individual vaccines were not, at the time of his recommendations, available to physicians as per the recommended vaccine schedule? If you have no proof, then your claim that his recommendations were “inflammatory” is totally unfounded. Secondly, you offer no evidence that Wakefield had a “paid interest” in his recommendations. So your claim that his recommendations were somehow self-serving is quite unconvincing.

    “you’ll know there is quite a number of large studies finding no association between the MMR vaccines (or vaccines in general)…”

    Ah yes, the often regurgitated “no association found” argument. This argument is in several respects weak, namely because a finding, even many findings, of “no association” is actually a far cry from the conclusion that “no association exists”. When you actually place yourself in the mindset of competent researchers, you come to realize that most of these “studies” you refer to are either small-scale studies done with incredibly small sample size or are larger-scale “reviews” of these small-scale studies. Importantly, the large reviews don’t really add anything new from a discovery standpoint…they merely attempt to summarize and bring together distinct yet related sets of data in order to analyze the state of a body of knowledge. For the competent researcher, the finding of “no association” typically means that more research is needed, especially as most of these studies will explicitly state that after acknowledging their respective study limitations. The reason past and current studies are deemed inadequate is because their design makes it nearly impossible to come to any meaningful conclusions about vaccine safety other than “no likely or significant association was found”. You have to understand that the inclusion criteria for these studies is so strict that sampling size is almost always a huge limitation. It’s like walking into a massive, multi-room building, looking into several of the rooms, and then reporting that there’s no significant reason to think there’s anything going wrong in the building. That’s not an exaggeration…it represents the framework or context through which every study/review is viewed and understood.

    “If there is a chronological curiosity here, I’d have thought it’d be that an old study might trump newer ones after the field has had 15 year more experience with the subject, etc.”

    Wakefield is not claiming that his research done in the 90’s might somehow “trump” later research. His intention in releasing his research is so that there might be a greater understanding of the philosophical and scientific context of the recommendations he made prior to the publishing of the Lancet paper. I really do think you, along with Dr. Petousis Harris, have a large number of misunderstandings with the background to this case and with the statements made by Wakefield. I don’t think it’s entirely a stretch to think that you have undergone a sort of brain-washing regarding this whole matter and are therefore not really applying your critical reasoning faculties all that well.

    “The main conclusion for the practice of using the MMR vaccine…”

    Ah but you are applying a bit of misdirection/goal post-shifting here. Notice that I was describing the Cochrane review’s conclusion regarding the overall reliability of the studies themselves, and not the review’s conclusion regarding current practical use of the MMR vaccine. We have to once again place ourselves within the mindset of the competent researcher/reviewer. The conclusions that 1) more and better safety/efficacy research is needed, and 2) current practice regarding vaccine use should continue, are not mutually exclusive. Their conclusion that evidence supports continuation of the current practice, within the overall context of the review’s findings, simply means that they were unable to find significant evidence within the review warranting a revision of current policy. In other words, they would have needed to have discovered significant safety/efficacy issues within the results of the reviewed studies in order to warrant revision of practice recommendations. The fact that they found no such evidence, clarified by their highly critical analysis of the included studies, effectively communicates an important point: if there was a problem, detection of that problem would be highly unlikely given the types of studies that are being carried out. I would argue that their conclusion about continuing the MMR program is largely because of two main reasons: if a problem does exist, continuation of the program is crucial to identifying it; and the reviewers would all be systematically crucified if they suggested otherwise. By the way, I avoid “anti-vaccine lobby groups” just like I avoid sold-out pro-vaccination lobby groups. Agendas destroy the cooperative search for truth.

    “A more obvious explanation might be that having screened out the claims that are on the Vaccine Injury Table that proved insubstantial—reflecting that few claims of adverse effects due to vaccines prove to be substantial on closer examination—they were left mostly with the things they aren’t able to examine because they’re limited to examining the things on the Vaccine Injury Table.”

    Yet more evidence that you don’t seem to have the foggiest idea about the vaccine courts. I suggest you download and read this thorough and important research done on the matter:

    http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2018430

    “the courts are in no position to make scientific judgements”

    There seems to be confusion on your end about this. The first has to do with the word “judgements”. Judgement, in this context, does not mean establishment of a fact. It means a legally-binding conclusion. However, the courts do make these conclusions based largely on empirical, hard scientific findings. The point is, if such conclusions (judgements) are repeated over a period of time and to sufficient degree, at some point it will be reasonable to perceive them as scientific findings amounting to an established scientific conclusion warranting ethical considerations. That is what is implied by scientific judgements, and as I stated before the vaccine courts are well within their purposes to make them.

    “Possible links between autism and vaccines have been examined many times & no link found”

    You simply reiterated the same trite argument I addressed above…could you please now stop trying to use it.

    “recent work increasingly points to a very early origin for autism with some evidence pointing to a congenital (prior to birth) origin.”

    Your are either purposely trying to fool me by using vague terms like “recent work”, “very early”, and “some evidence”, or you are truly ill-informed about the spectrum of neuro-developmental disorders and their pathology. But I’ll give you the benefit of the doubt…please show me how autisms can be lumped together into one very early pathological origin.

  • Dylan,

    Brief remarks as I can’t do more right now.

    I’m travelling and can’t reply in kind easily.

    Helen is away, with poor network access. She sent me as quick note after I wrote thanking me for reply to you. I would like to think from that what I wrote is fine.

    Right throughout you pick on the person. Better to deal with the substance. Contrary to what you say I’m familiar with this topic.

    Briefly: your rebuttals are incorrect, but I haven’t time to explain.

    (You’re best to drop titles (eg ‘Mr’) unless you know their titles. Scientists rarely use them . If you follow the links on my name you can find out that I’ m a scientist too – ie not a ‘Mr’.)

  • Hmm, interesting. Not to be rude, but I’m simply reluctant to believe you to be an authority on what’s “best” for me with regard to the use of titles like “Mr.” I also tend not to take someone’s own word for it that they are a scientist. I’m sorry if my referring to you as Mr. Jacobs was somehow distasteful to you. But the suggestion that a “scientist” somehow ceases to be a “Mr.”, or that being a scientist somehow renders void the customary respect implicit in the use of “Mr.”, just flat out makes no sense. You claim that scientists rarely use titles. But you indicate you would rather me use a scientist’s title rather than the generally respectful “Mr.” Furthermore, I am not a scientist, so it’s quite meaningless to me for you to say that scientists rarely use titles. Finally, one other reason I’m inclined to use “Mr.” is that your professed expertise does not happen to be in the subject matter addressed in this blog post. From my perspective, you are operating outside of your expertise in addressing my statements. If so, it would seem strange to me not to refer to you as Mr. Jacobs.

    “Right throughout you pick on the person.”

    As I mentioned above, I haven’t been picking on anyone. I have in fact been analyzing arguments and the tones behind them to evaluate level of knowledge and barriers to effective communication. I understand that questioning someone’s level of knowledge can sometimes be interpreted as being “picked on”. Please understand that is not my intention. It actually is a legitimate concern that “experts” nowadays have a tendency to either consciously or otherwise believe that their scope of knowledge extends quite beyond their formal experience.

    “Contrary to what you say I’m familiar with this topic.”

    Which topic are you referring to?

    • Dylan, this is a blog not a scientific paper. It is a forum where people can express themselves a little more freely than within the confines of their day job as peer reviewed scientists. This is the place where I can criticise Wakefield’s behaviour in a less formal manner– as long as I can justify why I am criticising him, and I believe I have made that quite clear. As Grant as pointed out, most of your comments appear to be of the ad hominum variety, therefore there is really no discussion to be had. If you had actually been genuinely interested in Grant’s expertise you would quickly have learned that he is extremely well qualified to comment on Wakefield’s pseudoscience, some of which has involved work in gene sequencing and other areas of molecular biology.

      However, the expertise of any of us is far less relevant than how we apply the scientific method. Did you have anything to say about the science and facts presented?
      Helen

  • Helen, it’s all good and well for you to explain that this is a blog, and that you have relatively more freedom of expression here (eg to criticize others, often by effective employment of rhetoric). It is your claim that you have justified your criticism which is under contention. Thus I have invited you to substantiate your criticism by either clarifying your justification or providing rebuttals to my comments. If you just simply don’t feel like doing that, then I’ll just drop it and you’ll likely not hear from me again. Grant has vaguely pointed out that I was “picking on” you…he said nothing about ad hominum, neither has he provided anything to substantiate his accusation (eg claiming that I have undone myself from the beginning is not the same as demonstrating that I have done so). In my view, there’s plenty of meaningful discussion to be had if you were to address my perfectly relevant arguments without unnecessarily treating them like overt personal attacks. Again, if one or both of you were more specific in clarifying this accusation, then I might have something to work with.

    As for the scientific method, I thought it would have been clear from just my first response that I was unconvinced that much of your post was either scientific or factual. You claim that this is a blog post, as opposed to a scientific paper…but then you claim to present “science and facts” via application of the scientific method. I’m confused at what you are trying to state here, and can only hope that you’ll either try reading over again what I wrote and respond to it or simply tell me that we are done here…at which point I would deem it beneficial that I direct my time otherwise.

  • I have read these comments with interest as I am curious to hear both sides of a critique of Dr Wakefield. My interest in the matter is because of personal experience. I know people whose children have received MMR vaccine or others, and within hours their child is no longer a functioning human being. The criminal courts level of proof would find the guilty party, but the “scientific” method ridiculously claims because it cannot establish a causal link (except by coincidental observation which they claim is does not establish cause) then there is no proof.
    I think some of the claims by anti vaccine advocates are not as bad as the pro vaccine people who say that the vaccines are safe. There is a risk with vaccines and it needs to be recognised as such. It is the professed infallibility that is creating the argument and which feeds the anti vaccine movement. If I choose to bungy jump, I have to acknowledge I am taking a risk. If I want a vaccination, I need to be aware of the risks and then make a choice.At the moment if I question a vaccination risk vs efficacy, I am treated as a nut. Therein lies the problem with vaccinations.

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