Damaging autism paper retracted

This article was published on the Yahoo! 7 News Blog on February 16, 2010

Deadlines are deadly things. That is why about five minutes after I emailed off the last column the world heard the great news that a medical journal had retracted one of the most damaging papers to appear in a scientific publication in the last few years. Dangerous because children died as a direct result of the fraudulent paper.

In 1998, the medical journal The Lancet published a paper written by, among others, Dr Andrew Wakefield. This paper suggested a connection between the MMR vaccine and bowel disorders and between bowel disorders and autism. The same issue of the journal contained a paper which used epidemiological data to refute any causal link between the vaccine and autism, but this did not stop Dr Wakefield becoming an instant hero of the anti-vaccination movement. The science in the paper was always suspect, simply because it looked like Wakefield had cherry-picked the subjects of his research. There were only 12 subjects in total, and nine of them were autistic. It looked like Wakefield was working backwards from autism to MMR in order to find what he wanted to find, but nothing could be proved because the paper said that the subjects were a sequential group of children who had presented at a hospital. In English, the word "sequential" suggests that they arrived in that order without any intervening patients.

In March 2004 ten of the paper’s original 13 authors issued a statement saying that the paper was not evidence of a connection between MMR vaccine and autism. We now know that some of the subjects were not randomly selected but were supplied to Dr Wakefield by a firm of lawyers acting for the parents. These parents were convinced that their children had become autistic as a result of vaccination and were getting ready to sue the pharmaceutical companies who had made the vaccines. Dr Wakefield was paid £55,000 for his work and was going to receive more payments as an expert witness when the lawyers got into court against the vaccine manufacturers. Put bluntly, Wakefield was paid to find a certain result (which matched his beliefs anyway) and was going to get a lot more money if he found it. Later, it was found that Wakefield may have received more than half a million pounds for his work. He had also applied for a patent on a measles vaccine which would have earned him an immense amount of money had it been able to replace the vaccine already in use. Another thing which was learnt later was that Wakefield had ignored laboratory tests which showed no evidence to back his hypothesis and he had hidden this fact from his co-authors.

One immediate result of the publication of the paper was a demand that parents be allowed to have their children vaccinated for measles, mumps and rubella as separate injections rather than in a single shot. While this may sound reasonable, it was promoted by people who are committed to the idea that all vaccinations are at best useless and at worst extremely dangerous. The real agenda was to increase the number of doctor’s visits necessary for a full vaccination program, therefore reducing the probability that children would receive the full schedule of shots. Dr Wakefield has said that he is not opposed to vaccination and only wants the procedure to be safe, but all the anti-vaccination campaigners say that. I once saw him speaking (to a standing ovation) at a conference run by America’s leading anti-vaccination organisation, the National Vaccine Information Center, about his ongoing research. I watched his speech live on the Internet but I had to turn it off when he said that one of the subjects in his current project was not autistic - yet.. He included the child in the autistic group because the child had been vaccinated and was therefore probably going to be autistic soon. This is supposed to be science.

In a massive fall from grace (and a major win for rationality) the UK General Medical Council has now ruled that Wakefield acted unethically in the way he treated the children used in his research. Almost immediately after this was announced The Lancet retracted the 1998 paper completely. This means that it cannot be cited or referenced in any scientific work – it has effectively ceased to exist. The reaction from the anti-vaccination community was to increase Dr Wakefield’s heroic status. One suggestion was that the Lancet retraction increased the value of Wakefield’s research because it showed how frightened real medicine was of his work!

An article of faith for the anti-vaccinators is that vaccination causes autism. The reality is that autism is usually detected at about the age when children are receiving certain shots, and several epidemiological studies involving millions of children (Finland, Denmark, California) have demonstrated no link. It has been blamed on the mercury in the preservative used in vaccines in the past, but MMR has never contained this preservative (although at least once a month I am told that it has). Dr Wakefield’s “research” provided another chance for the anti-vaccination campaigners to frighten parents away from protecting their children against preventable diseases. It was never science; it was always propaganda.

PS. Almost immediately after I heard the good news about Wakefield and the Lancet paper, more good news came in. The President of the Australian (anti-)Vaccination Network announced that she was resigning and the AVN would close on February 28 if a replacement could not be found. I immediately applied for the job, but I haven’t heard back yet.

The next one of these columns is due on March 2, so hopefully I can write a suitably joyous obituary for this dangerous organisation.

You can see the article and comments here.