Wakefield questions

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It turns out I didn't get an inch past the shoreline when I dipped my toes into the Andrew Wakefield Lancet paper retraction story a few weeks ago, so I decided to revisit it. To give the man at the centre of the controversy the opportunity to respond to media statements being made about his ethics and integrity, I contacted him.

To recap, The Lancet retracted Wakefield's 1998 paper suggesting a potential link between the measles, mumps, rubella (MMR) vaccine and the bowel disorders he was seeing in his autistic patients. Journalists and medical professionals alike have been cheering ever since: the so-called hoax and vaccine conspiracy theory has been exposed, and we can now apparently relax in the safety of the MMR vaccine.

I asked Wakefield if it was true that he'd been paid over 400 000 pounds by trial lawyers working to prove the vaccine unsafe. "I worked as a medical expert for nine years on the MMR litigation," he wrote in an email. "When the case folded because Legal Aid was withdrawn, the lawyers refused to pay what was owed and the costs judge took a lot of the fees back from the various experts. What I did earn was donated to an initiative to build a new centre for gastroenterology care and research at the Royal Free [in London]. Unfortunately I was forced out and it never got built."
Not a single penny of Legal Aid Board (LAB) money was spent on the Lancet paper. A LAB grant was provided for a separate viral detection study, but the Lancet paper had been submitted for publication before the LAB grant was even available.

What about allegations that Wakefield had been working for a company making a rival vaccine? He was involved in developing a nutritional immune stimulant they hoped would clear up chronic vaccine-induced measles infection. But this, he says, "could in no way have competed with a live viral vaccine and was not intended for that purpose. The patent was owned by the medical school and not by me. It was never progressed."
The charge that Wakefield is responsible for new outbreaks of measles, mumps and rubella is, to my mind, absurd. Parents have become wary of vaccines, true, but this, it seems to me, is the doing of vaccines, not of Dr Wakefield.

Further, outbreaks among the vaccinated happen all the time—77 percent of those affected in the recent New York and New Jersey outbreak were immunized. And though the outbreaks in England and Wales have reportedly occurred mostly in unvaccinated children, the question we ought to be asking is whether we need to fear measles as much as we do. United States mortality statistics indicate that the mortality rate—13.3 per 100 000 in 1900 and 0.2 by 1945—was negligible by 1963 when the vaccine was introduced.

What Wakefield did is publish a case study of a group of patients in which he'd identified a common thread. These kinds of studies often lead to new hypotheses. This is how science is supposed to work. The feeling of the parents of the children involved in the study and the many who have since been helped by Dr Wakefield's work is that he was being a responsible physician in pursuing the cause of his patients' illness.

But industry has a habit of quashing science that may not be good for business. Follow the links: The Lancet is published by Reed Elsevier. The CEO of Reed Elsevier during the time period in question was Sir Crispin Davis, who was also a non-executive director of GlaxoSmithKlein, one of three defendant drug companies in the MMR controversy.

We all know that money is power, and that money wins legal battles, and that the pharmaceutical industry has money like no other. As Noam Chomsky would say, it takes effort not to see what's happening. This is not conspiracy theory. Wakefield has been singled out for the purpose of discouraging other doctors willing to listen to their patients and do the relevant research even when it challenges vaccine dogma. His career and reputation have been severely harmed as a result of putting his patients ahead of his own protection.

But Wakefield views that as trivial compared to what has been lost to the children. In his mind, they are the real victims. V

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