Wakefield study of vaccine/autism link is a fraud

The British Medical Journal (BMJ) has published the first part of special series on Andrew Wakefield’s claim that vaccines cause autism. Turns out the whole thing was a fraud.

This is big news. There were over 1,300 stories in Google news by the end of the day today, and that’s just the beginning of the comments this story will attract. It’s not just the facts that make this big news: It appears Wakefield was employed by a lawyer who — before the study even began — planned a highly lucrative lawsuit against vaccine manufacturers. (The facts, BTW, are backed up in 124 footnotes.) It’s also the highly emotional views of those who oppose vaccines, the tragedy that there’s no explanation for the increasing prevalence of autism, and the questions raised about whether we can trust published medical research.

That last one’s a biggie. And it comes in the wake of Jonah Lehrer’s New Yorker article on how medical researchers are increasingly unable to replicate the results of important studies. These are studies that determine medical practices. Outright fraud may be rare, but it’s a bit unnerving to confront a rampant lack of scientific evidence for matters that could determine life and death.

The story

Here’s the BMJ article by award-winning journalist Brian Deer, who’s been investigating this story for seven years. (Wakefield sued him for libel.) You need to register with the BMJ to read the story, but registration is free.

Wakefield was working on a lawsuit, for which he sought a bowel-brain “syndrome” as its centrepiece. Claiming an undisclosed £150 (€180, $230) an hour through a Norfolk solicitor named Richard Barr, he had been confidentially put on the payroll two years before the paper was published [in 1998], eventually grossing him £435 643 [$674,734], plus expenses.

The lawsuit required showing a sudden-onset “temporal association” between vaccination and the onset of symptoms. When the onset was considerably delayed – or had happened before the vaccination – Wakefield simply faked the data.

Here’s the accompanying editorial in the BMJ.

[I]t has taken the diligent scepticism of one man, standing outside medicine and science, to show that the paper was in fact an elaborate fraud. …

Drawing on interviews, documents, and data made public at the GMC [General Medical Council] hearings, Deer shows how Wakefield altered numerous facts about the patients’ medical histories in order to support his claim to have identified a new syndrome; how his institution, the Royal Free Hospital and Medical School in London, supported him as he sought to exploit the ensuing MMR scare for financial gain; and how key players failed to investigate thoroughly in the public interest when Deer first raised his concerns. …

He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal. …

Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. …

[P]erhaps as important as the scare’s effect on infectious disease is the energy, emotion, and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it.

The reaction

CNN interviewed parents and concluded that the evidence of fraud may have little effect on attitudes towards vaccinations.

[T]he latest news may have little effect on those who blame vaccines for their children’s conditions. Supporters of the discredited theory echoed Wakefield’s assertion that he is a target of a “ruthless, pragmatic attempt” to crush vaccine safety concerns.

The father of an autistic child who blogs on his son commented: “The vaccine issue has torn up the autism community and diverted money, research and efforts.”

The Associated Press also quoted doubts that the exposure of Wakefield’s fraud will boost the acceptance of vaccines. Parents were scared off vaccinations by the study, and it will take an understanding of the causes of autism to convince them that vaccines are safe.

The Washington Post mentions the cost of reformulating vaccines.

Andrew Wakefield’s work convinced thousands of parents that vaccines are dangerous. Such fears have not only caused parents to skip vaccinations for their children, which critics say has led to ongoing outbreaks of measles and mumps, but have forced costly reformulations of many vaccines.

Forbes blamed the medical journal system for the 12 years it took to expose Wakefield.

[T]he bigger problem is the limitations of the medical journal system. … [M]edical journals rely more on the good faith of researchers and something called peer review, outside researchers who anonymously review papers. This is good at detecting conclusions that don’t match up with the data, flawed analysis, and and obviously faulty method. But it can leave them surprisingly vulnerable when the data itself is rotten–such as what occurs with deliberate deception or other misconduct.

Salon directed its anger at Jenny McCarthy, the celebrity who promotes a vaccines/autism link.

It’s high time the woman who once said that “I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe” took a step back and reconsidered the merits of that increasingly crackpot stance. And it’s time she acknowledged that clinging to research that’s been deemed patently fraudulent does not make one a “mother warrior.” It makes her a menace.

And USA Today reports that Jenny McCarthy is “taking a beating” on Twitter.

Jenny’s Autism organization … has posted a note on its site, saying this “media circus” over the findings is “much ado about nothing.”

It’s an outrage

It’s a big, outrageous story. To perpetrate a fraud for your own financial benefit at the expense of parents who are suffering from their children’s illness has got to be a new low. You have to wonder how this man manages to look himself in the mirror every day.

Resources:

Image: Daylife

Brian Deer, How the case against the MMR vaccine was fixed, British Medical Journal, January 5, 2010 (requires free registration)

Fiona Godlee, Jane Smith, and Harvey Marcovitch, Wakefield’s article linking MMR vaccine and autism was fraudulent, British Medical Journal, January 5, 2010 (requires free registration)

Madison Park and Elizabeth Landau, Few swayed by fraud finding in autism study, CNN, January 6, 2011

Reuters, Journal says doctor faked data linking autism to vaccines, Washington Post, January 6, 2011

Will autism fraud report be a vaccine booster?, Associated Press, January 6, 2011

Fraudulent Autism Vaccine Study Shows The Flaws In Medical Journal System, Forbes, January 6, 2011

Mary Elizabeth Williams, Jenny McCarthy’s autism fight grows more misguided, Salon, January 6, 2011

Jenny McCarthy under fire on Twitter, USA Today, January 6, 2011

Jonah Lehrer, The Truth Wears Off, The New Yorker, December 13, 2010 (does not require subscription)