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Fraud alleged in original study linking childhood vaccines and autism

An article (the first in a series) and an editorial published online today in the medical journal BMJ charge that the original paper that linked childhood vaccines with autism was based not just on sloppy research, but on fraud.   

An article (the first in a series) and an editorial published online today in the medical journal BMJ charge that the original paper that linked childhood vaccines with autism was based not just on sloppy research, but on fraud.   

That paper, written by Andrew Wakefield, a former British surgeon and medical researcher, claimed to link the measles, mumps and rubella (MMR) vaccine with an increased risk of autism and bowel disorders.

The paper has since been renounced by 10 of its 13 authors and was retracted in 2010 from the journal in which it was published (the Lancet). Also last year, the U.K.’s General Medical Council issued a scathing ruling that charged Wakefield with unethical behavior and “callous disregard” for the children used in the study. He was subsequently stripped of his British medical license.

By the time of the retraction, writes BMJ editor Dr. Fiona Godlee in her editorial today, “few people could deny that [Wakefield’s 1998 paper] was fatally flawed both scientifically and ethically. But it has taken the diligent skepticism of one man [British journalist Brian Deer], standing outside medicine and science, to show that the paper was in fact an elaborate fraud.”

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As Deer reports in his investigative BMJ article, Wakefield altered many facts about the children’s medical histories in the study, including, incredibly, when they had been first diagnosed with development delays (early signs of autism). In fact, five of the 12 children had exhibited documented developmental delays before they received the MMR vaccine, Deer reports, not afterwards, as Wakefield claimed.

Wakefield also claimed other children had begun exhibiting behavioral symptoms within days of receiving the MMR, when in actuality, says Deer, the symptoms had not begun to appear until many months later.

“Is it possible that [Wakefield] 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?” asks Godlee “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.”

Tragic consequences
All of us should be concerned about these revelations, for Wakefield’s bogus research has had serious — indeed, sometimes tragic — consequences. Here’s what several public-health experts told ABC News/MedPage Today:

In an e-mail, Greg Poland, MD, of the Mayo Clinic, who is also editor-in chief at the journal Vaccine, wrote that the so-called vaccine hypothesis put forth by Wakefield “has hurt individuals, families, communities, and the broader public health. Children whose parents made fear-based decisions based on these claims have died, and these families are forever damaged and broken.”
And Robert Jacobson, MD, chair of pediatrics at the Mayo Clinic in Rochester, Minn., blamed Wakefield for “worldwide drops in vaccination rates as well as a number of outbreaks of mumps and measles that centered in the British Isles but were felt the world over. In fact, the 2006 Iowan mumps epidemic and the 2009 New York mumps epidemic can both be traced to the British mumps virus that circulated as a result of loss of confidence in vaccination with MMR due to Wakefield.”
Steve Lauer, MD, of the University of Kansas in Kansas City, had more blame to lay at Wakefield’s feet: the ongoing pertussis epidemic in California.
Lauer told ABC News/MedPage Today that the increase in pertussis deaths in California is “another example of completely preventable deaths linked to the decline in vaccination rates. Study after study in numerous countries involving hundreds of thousands of children have never shown any link between autism and any vaccination. That Dr. Wakefield’s lies have led to increased illness and deaths among innocent infants and children is a social and medical disaster.”
The damage inflicted by the Wakefield papers can be measured not only in disease and death, but also in time and anxiety, said Leonard Rappaport, MD, of Children’s Hospital in Boston, who wrote in an e-mail that it was “impossible to quantify the amount of time wasted in pediatric practice discussing why we believe that the MMR does not cause autism and that children should be immunized. Second, the heartbreak and worry for parents of children with autism who have secretly believed in the quiet of the night that they were responsible for their child having an autism spectrum disorder and the anxiety of parents approaching immunization time with so much false information and fear flying around them is impossible to comprehend.”

None of this will change the minds of many anti-vaccine activists, however. A quick read of their websites this morning reveals that they continue to blame and vilify the messenger — in this case, Deer and Godlee — rather than examine the financial motives and inappropriate actions of Wakefield.

BMJ has made full versions of both the first part of Deer’s report and Godlee’s editorial available to interested readers (here and here). The rest of the series is scheduled to run later this week.

Deer has also written a blog post in which he compares Wakefield’s research to the fraudulent claims behind one of the most infamous hoaxes in science: the “Piltdown Man.”

“The Piltdown scandal lay in fossils,” he writes, “while the MMR scare rested on the status of young children. But the parallels are striking. The modus operandi was essentially the same: the dishonest representation of pre-assembled artifacts. The dramatis personae, meanwhile, were similar in their conduct: they contrived, or they were duped, or they failed to act.”