May 24, 2010: Andrew Wakefield Struck off the UK Medical Register. He's Still Harming Autistic People

Today in history: 2010: Andrew Wakefield struck off the UK's register of physicians.

Sarah Boseley, The Guardian's health editor, wrote on May 24, 2010,

"Andrew Wakefield, the doctor who triggered anxiety among parents over his suggestion of a link between the MMR vaccine and autism, was struck off the medical register today for offences relating to dishonesty and failing to act in the best interests of vulnerable child patients."

Backstory: Jeremy Laurance writing at The Independant, looking back at February 1998: I Was There When Wakefield Dropped His Bombshell

"The Royal Free took a different tack. It decided to deal with the inevitable press interest head on. It called a press conference before a panel of five doctors, led by Professor Arie Zuckerman (a virologist and dean of the medical school, but not an author of the paper), who were carefully selected to present a balanced view. All were eminent in their own fields but, fatally, each had a different opinion.

The five had rehearsed the press conference in advance and agreed the line they would take, which was to recommend continued use of the MMR vaccine pending further research. Under questioning, however, this carefully constructed consensus fell apart."

On April 19, 2008, Owen Dyer published "Wakefield admits fabricating events when he took children’s blood samples" in the British Medical Journal (BMJ)

The doctor whose study triggered a collapse in public confidence in the combined measles, mumps, and rubella (MMR) vaccine told a disciplinary panel last week that he made up details of his son’s birthday party—at which he took blood samples from several children—when giving a speech in California....

The GMC’s charges against Dr Wakefield include allegations that, in 1998 while a consultant at the Royal Free Hospital, London, he unethically paid children at his son’s 10th birthday party £5 (€6; $10) each to give blood samples he wanted for his research.

Last week the GMC panel saw video footage of a speech Dr Wakefield gave in 1999 at a meeting of parents of autistic children called by the Mind Institute of the University of California, Davis, where he jokingly described children fainting and vomiting after giving blood.

“Two children fainted, one threw up over his mother,” he told his laughing audience in the clip. “People said to me, you can’t do that—children won’t come back to your birthday parties. I said we live in a market economy; next year they’ll want £10.”

But Dr Wakefield told the GMC panel that he had made up these details to amuse his listeners. “It was the end of a long and rather exacting talk for the parents, and it was an attempt to introduce a little bit of levity,” he said. “It was a quip, just a story. The way these stories are told, if the audience responds you tend to respond back. So the story was told. But it had no bearing on the truth at all.”

ON January 11, 2011, Brian Deer began publication of a many-part series on the extent of Wakefield's iniquities, with Piltdown medicine: the missing link between MMR and autism in the British Medical Journal.

At first, the comparison may feel disconcerting. The Piltdown scandal lay in fossils, 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.

This week, the BMJ begins a series which lays bare the MMR scandal in detail never published before. Drawing on interviews, documents, and properly obtained data, collected during seven years of inquiries, we show how one man, former gastroenterology researcher Andrew Wakefield, was able to manufacture the appearance of a purported medical syndrome, whilst not only in receipt of large sums of money, but also scheming businesses that promised him more. His was a fraud, moreover, of more than academic vanity. It unleashed fear, parental guilt, costly government intervention, and outbreaks of infectious disease.

Notwithstanding Brian Deer's devastating series, after Wakefield was struck off, a wave of support gathered for him on both sides of the Atlantic, using various lies to cover up his many misdeeds. In 2012, Matt Carey published "Andrew Wakefield’s many statements that MMR causes autism" at the blog LeftBrain/RightBrain Autism.

The problem for Mr. Wakefield’s supporters is that Mr. Wakefield did not limit his discussion to the Lancet. As already noted, he held a press conference to announce his results and has made many more statements over the years. More to the point, Mr. Wakefield *did* say that the MMR causes autism.

Here is a collection of Mr. Wakefield’s statements which range from suggesting a possibility that the MMR causes autism to outright claiming that he “has shown” that the use of the MMR vaccine causes autism.

Mr. Wakefield’s patent application states clearly and unequivocally that the MMR vaccines has “been shown” to cause “pervasive developmental disorder”

In 2012, I wrote a post here on the outcome of a hearing for one of Wakefield's colleagues, "What the UK High Court's Ruling on John Walker-Smith Means and Doesn't Mean", which I post part of as follows:

On March 3, 2012, Mr. Justice Mitting of the UK's High Court of Justice ruled that the UK's General Medical Council (GMC) had acted improperly in Professor John Walker-Smith's hearing on charges of serious professional conduct, and therefore he quashed both the finding of serious professional misconduct and the sanction of erasure. (You can find the entire ruling at http://www.bailii.org/ew/cases/EWHC/Admin/2012/503.html.)

It's important to be very clear about what this ruling means. Mr. Justice Mitting did not find that Professor Walker-Smith's actions were medically necessary or ethical. The ruling does not exonerate Walker-Smith. That was not what the hearing was about. Mitting was only ruling on the conduct, the decision-making, of the GMC's Fitness to Practice panel. More broadly, Mitting found aspects of the GMC's procedures to be flawed.

And Mitting's ruling has nothing to do with the retraction of the 1998 paper. It's still retracted. It does not validate Andrew Wakefield's integrity, or affect the likely outcome of Andrew Wakefield's defamation suit in Texas, (see below).

Mr. Justice Mittings wrote in his opinion:

"There is now no respectable body of opinion which supports [Wakefield's] hypothesis, that MMR vaccine and autism/enterocolitis are causally linked."

Many more details of Wakefield's fraud and perfidy came out after the GMC hearing. I wonder if Mr. Justice Mitting silently took that into account in his ruling -- that Walker-Smith was not a party to Wakefield's unscrupulous doings and in effect, was betrayed by Wakefield.

Nevertheless, Wakefield enthusiasts and fans continue to insist that the Mitting ruling "exonerated" Wakefield. Here are two more looks at the matter.

Legal scholar Dorit Rubenstein Reiss, at Skeptical Raptor:

"Does Walker-Smith’s decision exonerate Andrew Wakefield? The decision, if read generously, can cast doubt on one set of findings against Wakefield–that he subjected some of the children to invasive tests that were not clinically indicated. It leaves untouched, however, the rest of the charges found proved against Wakefield, and in fact, reinforces several of the allegations–for example,that Wakefield conducted research without ethics committee approval, that Wakefield included misrepresentations in the paper, and that Wakefield did not disclose conflicts of interests. It’s anything but an exoneration, and the charges against Wakefield, as the GMC concluded, amount to serious ethical violations."

Joel Harrison for Every Child by Two: Expert Commentary Series Andrew Wakefield Has Never Been “Exonerated”: Why Justice Mitting’s Decision in the Professor John Walker-Smith Case Does Not Apply to Wakefield by Joel A. Harrison, PhD, MPH August 1, 2016

This paper will show that Justice Mitting’s decision in no way exonerated Wakefield, that even with regard to John Walker-Smith, the decision was based on a procedural error, not factual innocence. In addition, despite what antivaccinationists have written, Justice Mitting’s decision also made clear that he considered the research showing no relationship between the MMR vaccine and autism to be established science.

In February of 2018, Julia Belloz reviewed the evidence against Wakefield in "20 years ago, research fraud catalyzed the anti-vaccination movement. Let’s not repeat history", published at Vox on the 20th anniversary of the publication of the infamous, retracted paper.

What’s more, when a British investigative journalist Brian Deer followed up with the families of each of the 12 kids in the study, he found, “No case was free of misreporting or alteration.” In other words, Wakefield, the lead author of the original report, manipulated his data. (See the pop-up chart in this report for details.)

Wakefield also had major financial conflicts of interest. Among them, while he was discrediting the combination MMR vaccine and suggesting parents should give their children single shots over a longer period of time, he was conveniently filing patents for single-disease vaccines. Even more absurdly, the General Medical Council (the UK’s medical regulator) found that he had paid children at his son’s 10th birthday party to donate their blood for his research. (In deciding to take away his UK medical license, the GMC said Wakefield acted with “callous disregard for the distress and pain the children might suffer.”)

In the spring of 2017, there was an outbreak of measles in Minnesota, largely (95%) in the Somali community. In previous years, Wakefield had traveled to Minnesota and spread the myth to the Somali community there about the MMR-autism connection. " U.S.-born children of Somali descent (Somali children) accounted for 55 (85%) of the cases. "

On February 28, 2018, Jonathan D. Quick MD, MPH, and Heidi Larson published The Vaccine-Autism Myth Started 20 Years Ago. Here's Why It Still Endures Today in Time Magazine.

"Stunningly, the vaccine-autism myth still persists. It was amplified by the British media during its early years, later by celebrity endorsement and more recently by worldwide social media. Wakefield has continued his own relentless personal campaigning, moving well beyond the initial MMR vaccine scaremongering to attacking the CDC in his controversial film Vaxxed. The film was pulled before screening at the Tribeca Film Festival but found its way into independent theaters in the U.S. and Europe. Europe’s four-fold increase in measles cases and 35 measles-related deaths in 2017 — due largely to people not getting vaccinated — also reflects how Wakefield’s vaccine-autism scare can spark vaccine refusals that lead to debilitating and fatal cases of measles."

Can we at last put the vaccine-autism myth behind us?