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The Lancet has retracted a 1998 study that kindled a firestorm of opposition to vaccines by suggesting that autism arose in a handful of children because they had received measles-mumps-rubella shots.
On January 28, the U.K. General Medical Council sealed the fate of the controversial study, saying its selection of participants may have been biased and that lead author Andrew Wakefield committed several breaches of ethics in his work.
The Lancet formally retracted the paper February 2. “It has become clear that several elements of the 1998 paper by Wakefield et al. are incorrect,” the journal editors wrote.
They weren’t the first to lose faith in the study. Six years ago, 10 of the 13 coauthors on the report got queasy about the findings and disowned the paper, fearing it could damage public health efforts.
Since then the Sunday Times of London has done much of the heavy lifting in bringing down the dubious research, publishing details of recruitment bias and ethics questions. The General Medical Council investigated and agreed, leading to the Lancet retraction this week.
Formally, the scientific paper no longer exists.
In the original study, the researchers analyzed the health of 12 children who had developed signs of autism and colon inflammation shortly after receiving MMR vaccinations.
Although the study raised alarms about vaccine and autism that continue to reverberate, a closer look shows warning signs embedded in the paper. The authors were exceptionally cautious in their conclusions: “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome [colitis and autism] described,” they stated flatly. “We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunization. Further investigations are needed to examine this syndrome and its possible relation to this vaccine.”
That’s tame language, and 12 patients constitute a tiny study. But Wakefield presented the findings forcefully at the time, saying the study raised a “moral issue” that called for “urgent further research,” according to a BBC story. He said that he couldn’t support giving the vaccine to children.
But criticism of the paper arose promptly, and Wakefield resigned from the National Health Service in 2001 and later moved to the United States. Meanwhile, studies in Britain, Japan and Finland have found no connection between MMR shots and autism.
The final straw for this paper was more like a bale of hay. Children who were supposedly “consecutively referred” to the investigators were not. There was evidence of a pick-and-choose recruitment bias, which discredits the conclusions. What’s more, Wakefield breached ethics standards because he said the kids were referred to him for stomach problems even though he knew that some were part of a lawsuit against MMR vaccine manufacturers. Wakefield even got paid for advisory work on that very lawsuit and had a hand in a patent for a competing vaccine being developed, the Sunday Times investigation revealed.
Wakefield continues to deny any wrongdoing, but many scientists consider the damage already done. In the decade since publication of the Lancet paper, measles vaccination rates fell in Britain. During that time, cases of measles in England and Wales rose 25-fold to 1,370 cases in 2008, according to the British Health Protection Agency.
The flawed report has also helped lead to a wave of antivaccine fervor in the United States ("What's with the vaccine-o-phobia?, On the Scene Blog, SN Online: 10/31/09).
Found in: Biomedicine and Science & Society
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Honda H et al. 2005. No effect of MMR withdrawal on the incidence of autism: a total population study. Journal of Child Psychiatry and Psychology, Vol. 46: 572 – 579. Doi: 10.1111/j.1469-7610.2005.01425.x
- Taylor B, et al. 1999. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet, 353: 2026-2029.
- Peltola, H. et al. 1998. No evidence for measles, mumps and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study. Research letters: Lancet: Volume 351,(May 2),1327 – 1328.
- Nathan Seppa. 2009. FROM THE INFECTIOUS DISEASES MEETING: WHAT'S WITH THE VACCINE-O-PHOBIA? Science News Online. (October 31). Available [Go to]
- The Sunday Times coverage critical of the original Lancet study: [Go to]
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Editors of The Lancet. 2010. Retraction — Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet, Feb. 2, online. DOI: 10.1016/S0140-6736(10)60175-4
- Wakefield, A.J. et al. 1998. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet, 351:637-641.
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Jerry, what's one-sided about this story?
"Six years ago, 10 of the 13 coauthors on the report got queasy about the findings and disowned the paper, fearing it could damage public health efforts."
There's been six years to readdress this particular paper by Dr. Wakefield, to what avail? Kudos to Lancet for finally doing the right thing.
Science, more than anything else needs to adhere to a standard that is above and beyond what most of us would consider proof. With Meredith's information this guy really deserves some kind of disciplinary action. The effects are still being felt today!
The current retraction is not because the authors reached an incorrect conclusion--that happens all the time and is not a reason to regret publishing initial research. The current retraction is because of ethical violations and the paper's inaccurate description of the researcher's conduct and methods. This paper was not fit for publishing even if the conclusions had been correct, which would only have been by chance in a study which was essentially invalid and/or fraudulent.
It is not quite accurate to say,
> "They weren’t the first to lose faith
> in the study. Six years ago, 10 of the
> 13 coauthors on the report got queasy
> about the findings and disowned the paper,"
Depending on exactly what one means by "lose faith", it should be mentioned that in 2002, The Lancet published its own editorial titled, "Time to look beyond MMR in autism research" in which it was explicitly stated that the MMR vaccine is safe, and all evidence shows that it does not cause autism.
That was published 2 years before the majority of the paper's authors wrote their retraction.
1978 124,067 20
1979 77,363 17
1980 139,487 26
1981 52,979 15
1982 94,195 13
1983 103,700 16
1984 62,079 10
1985 97,408 11
1986 82,054 10
1987 42,158 6
1988 86,001 16
1989 26,222 3
1990 13,302 1
1991 9,680 1
1992 10,268 2
1993 9,612 4
1994 16,375 0
1995 7,447 1
1996 5,614 0
1997 3,962 3
1998 3,728 3
1999 2,438 3
2000 2,378 1
2001 2,250 1
2002 3,232 0
2003 2,488 0
2004 2,356 1
2005 2,089 0
2006 3,705 1
2007 3,670 1
2008 5,088 2
Summary: Trend is declining without change after Wakefield, with attainment of a steady-state at a low level, fluctuating between years without statistical significance between years. For the years 1989-1998 there were 18 deaths. For the years 1999-2008 there were 10. With a high degree of confidence it can be said that Wakefield had no discernable impact on the continuing decline.
John's figures are amazing. Just eyeballing the numbers, measles first showed a dramatic decrease in incidence in the 1989 numbers and continued a steep decline through 1999 (with a small peak in 1994), when cases leveled off. There is a small increase starting in 2006, but it is relatively trivial, with virtually no deaths.
I was going to accuse Wakefield of murder by proxy but if John's figures are real, nothing has happened despite the reduction in vaccination rates. What are the numbers that they keep talking about? Is it just vaccination rates and the risk of resurgence that they are worried about?
At any rate, John's numbers confirm that the MMR has been amazingly effective: a 98% decrease in clinical cases and more than 90& fewer deaths.
Come to think of it, only 20 deaths from measles in England in 1978 seems suspiciously low. It should have been at least in the low hundreds, I think, based on a fatality rate of, very roughly, 1/2 to 1%. Can we get a confirmation on these numbers, John? Where can we find these numbers independently?
"Most U. S. Measles Cases Reported since 1996"
www DOT cdc DOT gov SLASH measles SLASH resources SLASH media DOT html (can't remember if SN blocks clickable links)
131 reported infections in a 7-month period. About half (63) were children who could have been vaccinated but the parents declined.
That report links to another, which says, "compared with an average of 63 cases per year during 2000--2007".
You can't normally establish a cause with just a couple numbers, but the basic image is that 2008 would have been a fairly average year, if not for 63 cases of unvaccinated kids being infected. EXCEPT... that was only as of July for that year!
I also found this report from 1998, in which the CDC essentially though that measles had gone away:
"Analysis of epidemiologic data for
1998 suggests measles is no longer
an indigenous disease in the United
States."
cdc.gov SLASH mmwr SLASH preview SLASH mmwrhtml SLASH mm4834a1.htm
EDIT: Note that these are infections, not deaths.
If you go the the referenced "other article" Jerry Amundson mentions, you will see that it attracted a lot of anti-vaccine... "theorists". I think Jerry Amundson may be trying to slip in the common line that were are all acting as shills for vaccine manufacturers, hence the mysterious "sales" comment.
Wakefield never said don't vacinate children from measles, he said don't use the vaccine that has mercury in it! Thats a world of difference. The drug companies have quit using the mercury preservative and the only recent use of that compound was a swine flue vaccine in 2010 in the USA.
Drug companies quickly realised the liability risks associated with the Wakefield report and attacked him with gusto. The other supporters quickly deserted the sinking Wakefield ship. I am not a researcher but I feel that studies should be continued on Mercury compounds being used in medacine. The compound was autistically related only to a few individuals per thousand that took the Measles vaccine.
I don't need to punish the drug companies for using a supposidly safe preservative but I do think further research is warranted if that preservative is to be used in the future. The use in 2010 swine flue shots has me more conserned than the methodology of the Wakefield research.
Wakefield wasn't a researcher he was primarily a doctor, his research into a patient led him to certain conclusions and he blew the whistle. Good for him!!! No matter if he is right or wrong doctors are supposed to do no harm. Wakefield stood up to that standard when in his own mind patients were being harmed by a heavy metal preservative in vaccines commonly given to children.
The use in the2009-2010 swine flue vaccine was a cost cutting measure obveously related to the discrediting of Wakefield. I have no issue with the drug companies fighting for their existance in a liability crisis. I do however have an issue with them reinserting merucry into vaccines ten years after the fact without study, that reeks of irresponsibility.
Study the mercury compound before reinserting it into the vaccine and I will support you. Recklessly deal with the public health and I will support lawsuits th punish you. A child saved from autism is worth a study. There is already a link, we should have a targeted study to be sure that it isn't a factor. Just my opinion!!!
Measles vaccine is a live virus and doesn't have preservative in it. That would kill the virus. the problems Dr Wakefield noted in most of the children was measles virus in their gut which he bbelieved led to their gastrointestinal problems. Further investigations have confirmed Dr Wakefield's findings noting the vaccine strain of virus in the gut of hundreds of kids with gastrointestinal problems.
The retraction by 10 of the authors can be read in its entirety (it's only a few lines long) at The Lancet. the full article is available for registering free.
In the retraction the 10 are ambiguous to the extreme. they defend the study and claim that the findings have been supported by others. they also emphatically state that the study did not show an association between MMR and autism. So what did they retract? If you carefully read the retraction it appears they are retracting one of two things. Dr Wakefield's statements in the news conference the day after the release of the study or the media's mis-interpretation of Dr Wakefield's remarks, writing stories claiming MMR causes autism.
Of course you cannot retract someone else's statement, and I believe that was the purpose of the 10's ambiguity. To support the study and distance themselves from the association of MMR and autism, while making it look like they are retracting the study.
Why would scientists make such a convoluted statement? If they disagreed with the study why not come right out and say it? Only the 10 can explain why they did what they did
The article by nathan is filled with the ordinary falsehoods shills continue to attempt to slam Dr Wakefield with.
1. Seppa claims the paper suggests MMR causes autism. No, the paper clearly states that parents and some physicians associated autistic symptoms with MMR, and the authors CLEARLY stated the paper did not show an association between MMR and autism
2. "10 co-authors disowned the paper", they did not.
3. Seppa claims the Sunday times brought down the study, but it was Brian Deer publishing lies in the Sunday Times that was the impetus. The Sunday Times is owned by James Murdoch son of Rupert, who also is on a Glaxo Board. Glaxo is a defendant in MMR litigation
4. the GMC emphatically stated that their investigation was not concerned wioth the science in the study. firther the ethics charges they levelled at Dr Wakefield he was cleared of by The Royal Free's own ethics board. the ethics charges came down to opinion, not real ethics vilations and had no effect on the truthfullness of the science of the paper, which is being supported and replicated today.
5. Seppa casually refers to studies in Britain, Japan and finland finding no connection between MMR and sutism.
a. In the Finnish study they never looked at autism and H. Peltola, one of the authors, publicly stated that the research was not designed to pick up cases of autism.
b. In the Japanese study it was claimed that discontinuation of the MMR did not result in a drop in autism. What they didn't state was that the MMR was not merely dropped, but replaced by closely spaced single valent vaccines of measles, mumps and rubella.
c. Finally the British study was done by fombonne in 2001. The Cochrane Review thoroughly trashed this study... "The number and possible impact of biases in this study is so high that interpretation of the results is impossible".
Why does Seppa have to resort to deception when attempting to prove his points?
With the deceptive/fraudulent/lying efforts shills make to protect vaccine manufacturers and regulating bodies one thing becomes unavoidable, there must be something wrong with vaccines to have so many people so desperate to resort to lying
There are many other problems with Seppa's article, but I think I have exposed more than enough to give everyone a good picture of what is going on here
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