Monday, May 24, 2010

Wakefield: I will continue to study autism and vaccines

The British government stripped Dr. Andrew Wakefield of his license to practice medicine today, citing "serious professional misconduct" in research methods used in his 1998 study about the Measles-Mumps-Rubella vaccine and autism, the results of which led millions of parents to stop vaccinating their children. Dr. Wakefield calls the British ruling an effort to discredit his work, and said that he will continue with his research into vaccines and autism.

"My concern is for vaccine safety, for a safety-first vaccine policy," Dr. Wakefield told me in an interview today. "I have every intention of continuing to serve this population of children for as long as I can."

I expected to be up-in-arms while talking to this controversial scientist, whose research has come under attack for being impartial and unethical. Instead, our conversation about new areas of autism research was fascinating, and he had some interesting points to make about vaccines and autism in general.

According to the Associated Press, vaccination rates in the UK have never recovered after Wakefield's 1998 study linking the MMR vaccine to autism in children -- in spite of the fact that the study involved just 12 children, clearly stated that no causal connection between the two had been proven (though it did say that the possibility had been raised), and was officially retracted in February by the Lancet, the medical journal in which it was originally published. Some people have extrapolated the findings to include all vaccinations, not just the MMR.

Wakefield, who defends himself in his new book out this week (Callous Disregard: Autism and Vaccines -- The Truth Behind a Tragedy), says that he feels there could be a benefit to reducing the number of vaccinations children receive overall. "I think there are certain vaccinations that are not justified," he says, pointing to last-year's outbreak of mumps in New York and New Jersey, in which most patients had been properly immunized, and questioning the effectiveness of the vaccine. He also takes issue with the Chicken Pox vaccine, saying that it was originally marketed as a way to help mothers avoid having to take time off from work to tend to sick children. "I do believe that there is a very good case for slowing down, for asking very very important questions about what should and shouldn't be in the [vaccination schedule]," he said.

When people conduct population-based studies, Wakefield said, they are not usually talking about these small groups of children who may be genetically predisposed to an adverse reaction. No one says that vaccines are 100 percent safe -- the side effects are well documented by the CDC -- but while the medical community rejects the idea of vaccine-autism link in general, there is scientific evidence that vaccines can act as a trigger for children with certain medical issues, like mitochondrial disease.

"I think that the MMR is just part of the equation," he said. The childhood vaccines preceding the first MMR dose used to contain Thimerosal, which Wakefield described as "exquisitely poisonous in small doses."

"One could reasonably argue that the synergistic action of a poison followed by a virus could lead to a toxic overload," he said. "The priority must be on finding a comprehensive way to look at interactions. Is there a cumulative effect? Are we damaging children's immune systems by giving them too many vaccinations?"

(Interestingly enough, a study today in the journal Pediatrics shows no significant difference in terms of brain development between children whose parents opted to delay or even avoid vaccination, and those who were vaccinated according to the CDC schedule.)

Though several large-scale studies have refuted the MMR-autism link, there are more than 5,500 claims filed by families seeking compensation for children believed to have been hurt by the MMR vaccine, the Associated Press reported, and Wakefield points to certain "vaccine court" rulings as proof that a link exists. "The American government has conceded in vaccine court that vaccines -- including the MMR -- cause autism," he said, adding that the government has been settling autism-related cases without much fanfare since the early 1990s.

At least some of those court cases involved children with acute disseminated encephalomyelitis (ADEM), an inflammation of the brain and spinal cord that damages the material that insulates nerve fibers in the brain. (The damage from the inflammation, which the court ruled was caused by the MMR vaccine, eventually led to pervasive developmental delays.) Dr. Wakefield's research focused on gastrointestinal issues, not brain inflammation, but he is currently studying the possibility of a neurological-gastrointestinal link, something that has been seen in other species. "The gut-brain link is more of a scientific interest," he said. "We're looking at it in the primate model as well, and how it might affect the developing brain."


Shannon Des Roches Rosa said...

These claims of Wakefields are not new but they are all questionable. I'll take just one: chicken pox.

Most people of childbearing age remember chicken pox as a mild condition. They don't have personal experience with the potential side effects from chicken pox include hepatitis, encephalitis, and pneumonia.

The older we get, the worse the effects of contracting chickenpox are, plus there is a condition called congenital varicella syndrome, which can cause "a group of birth defects that can include:

* Scars
* Defects of muscle and bone
* Malformed and paralyzed limbs
* A smaller-than-normal head
* Blindness
* Seizures
* Mental retardation"


So, if you're intending to become or may be pregnant, best to avoid chicken pox parties.

When parents choose to not vaccinate, they are not choosing safety; they are choosing exposing their children AND everyone their children will ever encounter to risks OVER solely exposing their child to different risks.

If you would like to talk to a clearheaded scientist + autism parent re: evaluating Wakefield's statements on vaccinations, I suggest you read the whip-smart Emily Willingham:

EJ Willingham said...

One of the primary reasons Wakefield's original paper had such a huge impact was that the news media served as the tool of dissemination for his self-aggrandizing propaganda. This man has been discredited not only by the GMC and the U.S. Vaccine Court but also by an enormous series of scientific studies from all over the world that have failed to find an iota of data to support his various and ever-changing hypotheses (i.e., which is it? MMR or thimerosal?). He himself has left a trail of ethics violations that include clear conflicts of interest, yet no one seems to pay much attention to these, which include the fact that he himself was involved in developing a vaccine and had a clear yet undeclared conflict of interest when publishing the original Lancet paper.

It's easy to sit in a chair and sound scientifically plausible to a non-scientist. But as the spare listing of links in this piece demonstrates (there are so many more), the people who do understand clearly what he's talking about know that it's nonsense, that there are no data to support it. Unfortunately, their words are lost behind the "fascination" and charisma that Wakefield seems to emanate for some. Also unfortunate is that the news media keep giving this disgraced scientist face time.

As for the Pediatrics study you reference from today, your synopsis is incorrect. The authors in fact report that on two of the neuropsychiatric parameters that they evaluated, fully vaccinated children performed significantly better, even on multivariate analysis. So, there were significant findings in this study--and they run counter to any hypothesis that vaccines or the current vaccine schedule is harming our children en masse.

Why any animal research ethics committee would approve investigations in primates in the utter absence of any human epidemiological data even hinting at a correlation is beyond me. There would be no convincing argument to allow it. He's got two flawed primate studies for which I've seen the abstracts, and after several years, they've yet to see the light of day in a peer-reviewed journal...perhaps these are the primate studies to which he refers. If there are new ones in the offing, I'd like to see the review board approval for these and what the rationale for approval was.

Very few childhood vaccines have ever contained thimerosal, and the MMR never has. But the word "exquisite" sure is pretty, isn't it? In your piece, you quote Wakefield as asking a series of questions, such as, "Are we damaging children's immune systems by giving them too many vaccinations?" as though he were the first to consider it, as though no one has addressed these questions. But they have been addressed. By actual immunologists. What one can "reasonably argue" doesn't add up to data, and sitting in a chair being charismatic and sciency doesn't add up to doing genuine research or to practicing science ethically.

Anonymous said...

There have been 58,906 Vaccine Preventable Illnesses, 510 Vaccine Preventable Deaths and 0 Autism Diagnoses Linked to Vaccines from June 3, 2007 to May 15, 2010.

LMAlphonse said...

Thank you for your comment, Squid, and for the link to Emily's blog. Your point about Chicken Pox is a good one -- the effects of contracting it as an adult is much worse than those experienced when one contracts it as a child. The effects of Mumps are also worse for adults, but as last year's outbreak of Mumps shows, immunity from certain childhood vaccines doesn't always carry over into adulthood.

Emily: Thank you for your comment. I disagree with part of your point about the media -- while the flaws in the original study were ignored in the beginning, I think they've been very much exposed by the media now, so much so that I felt that Wakefield's statements about what he was going to do next, in spite of losing his medical license, was the more newsworthy information. I know that the questions he asked about vaccines have been asked before (I've even written about them before) and I've written a fuller explaination of my post here:

My interview wasn't intended to be an evaluation of vaccinations