Black Triangle

Despite the overwhelming amount of science failing to find a link between MMR vaccine and autism, as well as the dishonest and unethical behaviour of Wakefield, there are a number of journalists still prepared to push the hoax. One of these is Fiona Phillips. You can watch her talking about MMR on Question Time, and read her call the “callous” Andrew Wakefield a caring doctor. Here she recounts her appearance on the Jeremy Vine show:

On Wednesday I was on Radio 2’s Jeremy Vine show where I had the displeasure of being shouted down by journalist Cristina Odone who said that the MMR vaccine is indisputably safe for all toddlers and that parents of children with autism are “hysterical”.

Another typical response from the bullying might of the pro-vaccine army.

It is simply irresponsible to assert that MMR suits all children and that anyone who disagrees is a hysterical parent.

Some children have an allergic reaction to peanuts. Most don’t.

Does that mean you feed peanuts to all children?

Fiona Phillips is, in part, a little bit right, but a hell of a lot more wrong. Cristina Odone is wrong to say MMR vaccine is “indisputably safe for all toddlers”. It isn’t, and sensible commentators do not make this claim. The manufacturers’ datasheet, such as immunodeficiency, leukaemias, and a history of hypersensitivity to the components of the vaccine. There are also known adverse effects of the vaccine, including the Idiopathic Thrombocytopenic Purpura (ITP) noted by the MHRA in 2001 [PDF]. However, ITP is more common with measles infection. That the MHRA should publicise a rare and serious adverse event during the MMR vaccine scare should come as some reassurance that conspiratorial views that the government and vaccine manufacturers are involved in a cover-up of vaccine harms are just that, conspiracy theories.

The peanut analogy employed by Phillips would be a good one, if there was evidence that the autism-MMR vaccine link existed. But it doesn’t. You can’t compare a real known risk, with an imaginary risk pushed by quacks pushing “cures” based on a vaccine cause.

UPDATE: You can hear Fiona Phillips on the Jeremy Vine show here.

The Royal Pharmaceutical Society of Great Britain appears to have changed its opinion on homeopathy. The poor quality information on the RPSGB’s website is to be pulled and replaced.

On Monday the Council of the Society decided it did not endorse homeopathy, due to the lack of scientific evidence to demonstrate its effectiveness, and agreed to substitute the information currently on the RPSGB website with different information. The replacement information will for example highlght key differences between herbal medicines and homeopathic products.

There are no news reports as of yet.

If you are a UK pharmacist, there is now a Facebook group called UK Pharmacists for 1023

How Wakefield spoke at an US anti-vaccine conference in the early 2000s (transcribed from audiotape sample no longer on web).

the upside of infection, yes the upside of infection, we are survivors of infection, we are here not in spite of infection, but because of infection. Our immune system has been conditioned over millions and millions of years by infection, and if we alter the way in which infection is delivered to our systems we must expect that by changing the ecosystem, there will be a downside, there will be attrition, we will render some children damaged.

“If I am wrong I will be a bad person because I will have raised this spectre.”

Andrew Wakefield, March 3, 1998. Interview in The Independent.

The 1998 Wakefield paper has been retracted by The Lancet. Google Scholar suggests the paper has been cited 971 times since it was published, mostly I suspect by further studies refuting it, or editorials about the MMR-autism hoax. It’s not the only crap published by Wakefield in The Lancet. How he ever got his letter in The Lancet alleging a temporal link between MMR vaccine and autism is also beyond me.

Links worth reading:

BMJ news report:

Evan Harris, a Liberal Democrat MP and doctor, who had called for the retraction, said: “The whole thing is flawed. You should not publish or leave in the literature papers which are unethical.”

His call was echoed in the BMJ this week by Trisha Greenhalgh, professor of primary health care at University College London, who says: “The Lancet’s editor, Richard Horton, is no doubt familiar with the guidelines of the Committee on Publication Ethics (http://publicationethics.org/guidelines), which recommend that a journal should formally retract a paper if its findings are subsequently shown to be unreliable as a result of either misconduct or honest error or if the work turns out to have been conducted unethically” (Observations, BMJ 2010;340:c644, doi:10.1136/bmj.c644).

Michael Fitzpatrick on why Wakefield is not solely to blame:

The impact of the campaign against MMR cannot be reduced to the activities of one man, or even to the three men brought before the GMC: a wider failure of medical quality control and public scrutiny allowed junk science to have an adverse effect on children’s welfare and public health. Dr Wakefield’s research was supervised by the senior (adult) gastroenterologist at the Royal Free; the press conference at which he launched the demand for separate vaccines was staged by the Royal Free medical school; the transparently flawed study was peer-reviewed and published by the Lancet. Dr Wakefield’s subsequent collaborators also have a case to answer. Studies jointly published by Dr Wakefield and the Dublin pathologist John O’Leary, claiming to have demonstrated measles virus in bowel biopsies taken from children with autism, have been authoritatively dismissed as invalid, if not fraudulent.

Despite having advance warning of the Lancet paper, the government’s Department of Health and the Medical Research Council were slow off the mark in responding to the challenge and remained several steps behind Wakefield’s skilful manipulation of the media. Before Brian Deer took up the case in 2004, the media generally and shamefully took Wakefield at his own estimation as a courageous maverick.

The effect of the retraction on the US anti-vaccine celeb culture.

How Wakefield’s work has been used as part of the Cure Culture for autism, which has led care for autistic children down a dead end (quite literally in some cases.)

Liz Ditz has a full list of article and blog posts if you are interested.

In an editorial full of fail in the Mail about the Wakefield judgment, two point stands out for me. The first is an amazing lack of knowledge about the public money spent on the Wakefield hoax:

And the parents? They were denied the legal aid (available to every Tom, Dick and terrorist [they really are beyond parody] Harry) to fund a court case that might have resolved the matter quickly and conclusively.

It is worth remembering that Wakefield had received £55,000 in legal aid in 1996 concerned with these cases two years prior to the Lancet paper. Even more importantly, the Legal Services Commission had spent £15 million on the cases by 2003, and only denied further monies when it was clear that nothing would come of spending a further £10 million of public money. A court case quite clearly was not resolving the matter quickly and conclusively. You only need to look to the US to see the likely outcome, where Wakefield’s research was described as a “deception”.

The second point relates to the invocation of the John Gummer:

After all, when it comes to health issues, governments and scientists are not infallible.

Who can forget John Gummer forcing his daughter to eat a beef burger at the start of the BSE crisis, the thalidomide scandal, the countless drugs that have had to be withdrawn, and HIV infected blood supplies?

The Gummer comment is interesting because the Mail pushed the Blair should tell us about Leo Blair’s vaccination status at every opportunity, helped by the anti-MMR Member of Parliament Julie Kirkbride. Blair’s aides at the time were very concerned not be seen to be using the children for political purposes, and probably didn’t think the story would get the legs it eventually got. Blair stuck to the scientific advice he was given, as well as citing international bodies like the WHO. I know some have criticised Blair for his judgment on this, although not David Cameron, but at the time Gummer’s example was the more recent example of the use of children by politicians. I think Blair was unfairly maligned on the issue of Leo Blair. Far more criticism should be made of the rightwing press and dodgy MPs were attempting to use his children for political purposes a la Gummer.

The Independent asked at the start of the GMC investigation into Andrew Wakefield the following question:

Are we wrong to detect the distant whirr of the same spin spin machine that so recently set about destroying the reputations of David Kelly, Andrew Gilligan and others?

Independent leader from February 24th 2004

This week they have finally come to a conclusion on this point.

Dr Wakefield has accused the GMC of staging a sort of show trial, designed to punish him for daring to dissent from the views of the medical establishment regarding the safety of this vaccine. This seems a conspiracy theory too far.

Independent leader from January 29th 2010

Apart from people who have boosted Andrew Wakefield’s discredited and dishonest wild theories about MMR vaccine over the years (Lucy Johnston, Melanie Phillips, Fiona Phillips et al), one journalist will forever be associated with Wakefield: Brian Deer.

Brian Deer is no shill for the pharmaceutical industry. Back in the 90s he tackled the harms of Septrin (a widely prescribed antibiotic), and later went on to tackle Merck over Vioxx. Brian has pursued Wakefield in the same way as he carried out his investigations of “big pharma”. Not that this has protected him from allegations about his motivations, his detractors being unable to accept that a journalist might investigate the Wakefield hoax without help from “big pharma” or a conspiring UK government. Melanie Phillips alleged he was part of a witch hunt, although she was incorrect. Last year, the increasing lunatic fringe of the UK’s anti-vaccine movement alleged Brian’s sexuality was the reason for his investigative reporting:

By all accounts a gay man and therefore unlikely ever to have to face the multiple vaccine risk agonised over by parents from around the world in relation to their children, Brian Deer has made it his business to portray the parents of these autistic vaccine damaged children as deluded mendacious chancers.

We now know that the man with callous disregard for children’s welfare was the man they have supported; Andrew Wakefield. He had the financial conflict of interest. He treated children unethically. He exposed children to “high-risk” procedures without ethical approval and against their best clinical interests [Here's an example of what can happen].

Brian was also subjected to a libel action brought against him by Wakefield, the current toy of the rich (Wakefield leads a comfortable life in Texas now, working at a quack treatment centre for £170,000 a year). In an article at the Sunday Times today, Deer talks of the benefits of exposing Wakefield.

Wakefield will probably never admit to his errors. But exposing his methods has been worthwhile, according to medical sources.

“People can’t understand whether a scientific study is valid or invalid,” said a senior doctor who had watched vaccination rates slump, even in the face of endless research on MMR safety. “But they can understand ‘right’ and ‘wrong’, and they can understand ‘honest’ and ‘dishonest’.”

Lawyers have told me that any one of the more than 30 charges that were proved against Wakefield would typically lead to his being struck off. His days as a medical practitioner will soon be history. A further hearing will determine whether “serious professional misconduct” was committed.

Yet more troubling for Wakefield’s future are his prospects for research, or at least of getting it published.

“Any journal to which a researcher shown to be dishonest submitted a paper would reject it,” said Richard Smith, former editor of the British Medical Journal, this weekend. “They would say, ‘This man can’t be trusted’. His career as a researcher is effectively over.”

On the latter point, I’m not so sure. His days as a real researcher are over, but he and his friends already have a plan to tackle that obstacle.

Today 1023 held their mass overdose event, using homeopathic preparations, outside Boots the Chemists. I’ve already detailed my views on this with regard to the wider profession of pharmacy – it is not a problem only associated with Boots. However, the BBC report today has some two (amongst other) poor defenses of the sale of homeopathy:

The Society of Homeopaths said it did not expect the protesters to suffer any adverse reactions from taking large quantities of the remedies.

The society’s chief executive, Paula Ross, said: “This is an ill advised publicity stunt in very poor taste, which does nothing to advance the scientific debate about how homeopathy actually works.”

Homeopathy does not work. It is pointless to have a scientific debate about the mechanism of homeopathy’s action if you cannot demonstrate an effect in patients using a randomised controlled trial. There isn’t a scientific debate to advance.

Paul Bennett, professional standards director from Boots, said the company follows advice from the Royal Pharmaceutical Society of Great Britain on the correct selling of complementary medicines.

This is to some extent a circular argument.

The Royal Pharmaceutical Society of Great Britain (RPSGB) provides advice on homeopathy on the basis that the public use homeopathy, and Boots uses the fact the RPSGB issues such advice to justify (in part) their supply of homeopathy to the public. Indeed, the RPSGB are part of the problem. Despite being ostensibly a scientific organisation, it currently suspends its scientific roots when dealing with homeopathy.

There is some good news. I hear on the grapevine that the RPSGB is currently looking at its policy on homeopathy and there will hopefully be a shift in policy. At present, the RPSGB’s stance is an appalling mess. Citing them in your defense is about as useful as the preparations people overdosed on today.