The Lancet Recants Study Linking Autism To Vaccine 590
JamJam writes "The Lancet, a major British medical journal, has retracted a flawed study linking the measles, mumps, and rubella vaccine to autism and bowel disease. British surgeon and medical researcher Andrew Wakefield and his colleagues originally released their study in 1998. Since then 10 of Wakefield's 13 co-authors have renounced the study's conclusions and The Lancet has said it should never have published the research. Wakefield now faces being stripped of his right to practice medicine in Britain. The vaccine-autism debate should now end."
The Retraction (Score:5, Informative)
Here's the actual retraction, rather than reporting on reporting on the retraction:
The Lancet, Early Online Publication, 2 February 2010
doi:10.1016/S0140-6736(10)60175-7
Retraction—Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children
The Editors of The Lancet
Following the judgment of the UK General Medical Council's Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al(1) are incorrect, contrary to the findings of an earlier investigation.(2) In particular, the claims in the original paper that children were "consecutively referred" and that investigations were "approved" by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.
References
1 Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998; 351: 637-641
2 Hodgson H. A statement by The Royal Free and University College Medical School and The Royal Free Hampstead NHS Trust. Lancet 2004; 363: 824.
Re:For our sake (Score:5, Informative)
So why exactly should I not believe the original study? From where I stand (which is little to zero knowledge on the subject) I could conclude that each of the co authors one by one were persuaded by the various pharmaceutical companies which standed to be harmed by this research.
From Quackwatch.org [quackwatch.org]:
The only "evidence" linking MMR vaccine and autism was published in the British journal Lancet in 1998. An editorial published in the same issue, however, discussed concerns about the validity of the study. Based on data from 12 patients, Dr. Andrew Wakefield (a British gastroenterologist) and colleagues speculated that MMR vaccine may have been the possible cause of bowel problems which led to a decreased absorption of essential vitamins and nutrients which resulted in developmental disorders like autism. No scientific analyses were reported, however, to substantiate the theory. Whether this series of 12 cases represent an unusual or unique clinical syndrome is difficult to judge without knowing the size of the patient population and time period over which the cases were identified.
If there happened to be selective referral of patients with autism to the researchers' practice, for example, the reported case series may simply reflect such referral bias. Moreover, the theory that autism may be caused by poor absorption of nutrients due to bowel inflammation is senseless and is not supported by the clinical data. In at least 4 of the 12 cases, behavioral problems appeared before the onset of symptoms of inflammatory bowel disease. Furthermore, since publication of their original report in February of 1998, Wakefield and colleagues have published another study in which highly specific laboratory assays in patients with inflammatory bowel disease, the posited mechanism for autism after MMR vaccination, were negative for measles virus.
Re:For our sake (Score:5, Informative)
second entry on Google:
http://online.wsj.com/article/SB10001424052748704022804575041212437364420.html [wsj.com]
Ten of the 13 authors of the original paper, all of whom were researchers at the Royal Free Hospital and School of Medicine in London, partially retracted the paper in 2004. However, the first author, Andrew Wakefield, didn't. Dr. Wakefield, who is now at the Thoughtful House Center for Children in Austin, Texas, didn't immediately return phone calls seeking comment.
"Many consumer groups have spent 10 years waging a campaign against vaccines even in the face of scientific evidence," said Dr. Horton of the Lancet. "We didn't have the evidence back in 2004 to fully retract the paper but we did have enough concern to persuade the authors to partly retract the paper."
The Lancet decided to issue a complete retraction after an independent regulator for doctors in the U.K. concluded last week that the study was flawed. The General Medical Council's report on three of the researchers, including Dr. Wakefield, found evidence that some of their actions were conducted for experimental purposes, not clinical care, and without ethics approval. The report also found that Dr. Wakefield drew blood for research purposes from children at his son's birthday party, paying each child £5 (about $8).
The Lancet's Dr. Horton said the journal was particularly concerned about the ethical treatment of the children in the study, and that the children had been "cherry-picked" by the study's authors rather than just showing up in the hospital, as described in the paper.
The authors "did suggest these children arrived one after another and this syndrome was apparent, which does lead you to think this is something serious," said Dr. Horton.
Re:For our sake (Score:5, Informative)
(1) Wakefield performed at least some parts of his study in an unethical manner.
(2) Subsequent to the publication of this study, other researchers have tried to duplicate Wakefield's results but nobody has succeeded in doing so.
(3) Wakefield is not a disinterested party; he has received a great deal of money from those who stand to profit from his conclusions.
(4) Various circumstances [including (2) and (3) above] have caused others in the medical community to suspect Wakefield of fraud related to this "study".
Re:For our sake (Score:4, Informative)
Sure.
His methodology was deeply flawed:
his selection of research subjects very biased as he chose subjects he already had experience with and knew their problems so he could skew the control group like he wanted,
Some research subjects were selected/tested at a children's birthday party,some without parents consent (serious violation of research ethics).
No proper double blinding was done,
and even then the results were mismanaged in such a way that they showed a strong correlation (which in fact, even his skewed results did not really show).
Apart from him (Dr.Wakefield) having ties to anti vaccination groups and heading some of them and making a ton of money on his scare tactics (the results of which are little things like an increase in children dying from measles and other such lovely things).
basically, anything which could be done wrong WAS done wrong. I've seen better done research in homeopathy journals, and they're not really known for using science at all.
Re:For our sake (Score:5, Informative)
The guys over at Science-Based Medicine have you covered: http://www.sciencebasedmedicine.org/?p=3660 [sciencebasedmedicine.org]
If you look back through their post archives, you can find dozens more touching on the subject of Wakefield's paper in particular and vaccines in general, among other things.
Nice of Lancet to come around (Score:5, Informative)
Click on Dr. Wilson's link to see his copy of a graph showing the slight drop in MMR vaccinations resulting in a sharp increase in measles cases. Fortunately, a mere thousand or so more per year will only mean a couple of deaths, blindings, sterilizations, and so forth. Words fail me.
Re:For our sake (Score:3, Informative)
Wakefield had a financial conflict of interest with lawyers [briandeer.com] suing HM Government
His sample size was 12
His study population were not randomly recruited
Some of the study siubjects showed signs of autism prior to their MMR vaccination
To name just one (Score:4, Informative)
It's amazing what results you can get if you keep repeating the experiment until you get the results you want.
Re:The debate is long from over. (Score:2, Informative)
me too, but that's my point which you might be missing. You can't take one healthy MMR-vaccinated person and prove that all MMR vaccine cases will never cause any side-effects.
It only takes one person with a side effect LINKED to the MMR vaccine to prove that they're all potentially dangerous. Note the link has to be well proven.
I'm not saying it is or isn't a good vaccine, I'm just talking about proofs.
Re:End the debate? (Score:5, Informative)
The unethical conduct is just the last nail in the coffin.
1. The original supposition, based on 12 patients, was that MMR vaccine may have been the possible cause of bowel problems which led to a decreased absorption of essential vitamins and nutrients which resulted in developmental disorders like autism. No analysis was provided to substantiate this, it was pure unfounded supposition.
2. Subsequent laboratory assays on the patients in question found no evidence of measles virus DNA, indicating that the vaccine was not responsible for the cases of inflammatory bowel disease.
3. Clinical evidence doesn't support a link between IBD and autism.
4. Twelve subsequent studies have failed to find any evidence of a link between MMR and autism.
Calling the possibility of a link "laughably remote" is an understatement.
Swine Flu (Score:2, Informative)
(1) I admitted anecdote.
(2) I don't believe the vaccine in general is bad. I do believe the hospital got a bad batch.
(3) I don't have hard numbers, but I can tell you that my brother lives in Redding CA. I'm not sure which hospital he works for, or even if it's in Redding. If you really care, I'm sure you can find it.
(As a side note, the vaccine that first came out was a nasal variety that was supposed to be weakened, live flu. It was still supposed to be safe for those without a compromised immune system. The shot in the arm is a different beast altogether.)
Re:Swine Flu (Score:2, Informative)
Re:Oh, the naivete. (Score:5, Informative)
Scientists are, by nature, skeptics. They don't believe anything you tell them; they have to see the data themselves and replicate the results. In science, if you make a claim, but can't substantiate it, then your claim is unproven.
The Lancet is retracting the original paper not because the claims were not substantiated by further studies; normally the paper would remain in publication. Subsequent investigations also found that the study was highly flawed and that Wakefield misrepresented or changed data to support his claim.
In the original study, Wakefield reported 8 of 12 children in a hospital clinic experienced symptoms of autism as well as inflammatory bowel disease within days of a vaccination. Later investigation [timesonline.co.uk] revealed that the autism symptoms described by Wakefield were different from those described to the hospital, and that in only one case did the autism symptoms occur a few days after the vaccination. The majority were reported before the vaccination occurred. Hospital physicians at the time did not find any signs of inflammatory bowel disease but the study reported that they did.
Dr. Wakefield's integrity was questioned when it was revealed that he had been paid by parents of autism children to determine if the MMR vaccine was the culprit. This conflict of interest was not reported to the Lancet before the paper was published.
Comment removed (Score:2, Informative)
Re:But (Score:4, Informative)
Re:The debate is long from over. (Score:2, Informative)
I'd suggest looking up the mortality rates of the diseases you're failing to immunize against.
Negatory ghost rider. Statistics mean nothing to the individual, only to large groups. According to statistics, both my kids should have had Down Syndrome (from the scans) but neither of them have. That doesn't disprove the measurement theories for early detection of Down Syndrome, just that in my case we had 2 exceptions.
If he wants to ignore the vaccine, and go with the consequences, then that's up to him, so long as he accepts the consequences whatever they may be (including death).
Plenty of Studies Linking Vaccines to Ill Effects (Score:2, Informative)
Those who argue against vaccination based on the risk of autism may well be on shaky ground, but there are PLENTY of studies linking vaccines to other ill effects, here are a (very) few:
MMR VACCINE
Pancreatis Caused by Measles, Mumps, and Rubella Vaccine Pancreas vol. 6 no 4 1991 [2] :86 [4 pgs.]
Mumps Meningitis Following Measles, Mumps and Rubella Immunization Lancet July 1989 [1 pg]
Optic Neuritis Complicating Measles, Mumps, and Rubella Vaccination American Journal of Opthalmology 1978
A Prefecture-wide Survey of Mumps Meningitis Associated with Measles, Mumps and Rubella Vaccine (Infec Dis J 1991 Vol 10 pg 204-209)
Risk of Aseptic Meningitis after Measles Mumps and Rubella Vaccine In UK Children (Lancet April 93 Pgs. 979)
A Prefecture -Wide Survey of Mumps Meningitis Associated With Measles, Mumps and Rubella Vaccine Pediatri Infect Dis J 1991; 10 [6pgs]
Guillain-Barre syndrome after measles, mumps, and rubella vaccine Lancet jan 1 1994 Vol 343 [1 pg]
RUBELLA VACCINE
Two Syndromes Following Rubella Immunization (Suggests a polyneuropathy in both syndromes) (JAMA 1970 Vol 214 no 13) [5pgs.]
Chronic Arthritis After Rubella Vaccination Clinical Infec Dis. 1992 15;307-12 [6pgs]
Acute Arthritis Complicating Rubella Vaccination (ARTHRITIS AND RHEUMATISM 1971 41) [4pgs]
Joint Symptoms Following an Area Wide Rubella Immunization Campaign Report of a Survey Am J of Public Health Vol 62 no 5 [4pgs]
Polyneuropathy Following Rubella Immunization Am J Dis Child 1974 Vol 127 [5pgs]
Postpartum Rubella Immunization: Association with Development of Prolonged Arthritis, Neurological Sequelae, and Chronic Rubella Viremia (THE JOURNAL OF INFECTIOUS DISEASES 1985 vol 152 no 3) [7pgs]
MEASLES VACCINE
Thrombocytopenic Purpura Following Vaccination With Attenuated Measles Virus Amer J Dis Child Jan 1968 Vol 115 [3pgs]
Investigation of a measles outbreak in a fully vaccinated school population including serum studies before and after revaccination (Pediatr Infec Dis J 1993 12) [8pgs.]
Risk of Aseptic Meningitis after Measles, Mumps , and Rubella Vaccine in UK Children Lancet 1993 Vol 341 [4pgs]
An Explosive point-source measles outbreak in a highly vaccinated population (American Journal of Epidemiology 1989 Vol 129 no 1) [10]
A Persistent Outbreak of Measles Despite Appropriate Prevention And Control Measures ( American Journal of Epidemiology Vol 126 No3) [13pgs.]
Measles Vaccine and Crohn’s Disease Gastroenterology vol. 108 no 3 1995 [3pgs]
Aseptic Meningitis after Vaccination Against Measles and Mumps (Pediatr Infec Dis J 1989 8 pg 302-308) [7pgs]
Measles Vaccine Associated Encephalitis in Canada Lancet Sept. 1983 [2pgs]
Guillain -Barre Syndrome Following Administration of Live Measles Vaccine Amer J of Med 1976 Vol 60 [3pgs]
Pancreatitis Caused by Measles, Mumps, and Rubella Vaccine Pancreas vol 6 no 4 [2pgs]
Measles Vaccine and Neurological Events Lancet May 1997 [2pgs]
MUMPS VACCINE /evidence for large scale vaccination failure Arch Pediatr Adolesc Med 1995 Vol 149 [5pgs] Summary: 54 students developed mumps --of those 54, 53 had been fully immunized.
Mumps Outbreak in a Highly Vaccinated School Population
Aseptic Meningitis as a Complication of Mumps Vaccination (Ped Infec Dis J 1991 Vol 10 No 3) [5pgs]
Guillain -Barre Syndrome occurrence following combined mumps- rubella vaccine Am J Dis Child Vol 125 1973 [2pgs]
Mumps Vaccines and Meningitis/ Heterogeneous Mumps Vaccine (more on Urabe strain vaccine) Lancet Vol 340 1992 [2pgs.]
Flu Vaccine
Neuropathy After Influenza Vaccination (this deals with Swine flu vaccine) Lancet Jan 29, 1977 [ 2 pgs.]
Isolated Hypoglossal Nerve Paralysis Following Influenza Vaccination Am J Dis Child 1976 vol 130 [2pgs]
Guillain -Barre Syndrome Lancet Sept. 1978 [1pg]
Relapsing Encephalomyelitis Following the use of Influenza Vaccine Arch Neurol Vol 27 1972 [2pgs]
Optic Atrophy Following Swine Flu Vaccination Annals of Opthalmol
Re:It wasn't much of a debate to begin with (Score:4, Informative)
Re:For our sake (Score:3, Informative)
because Globbal warming studies have been looked at by many different scientist and many studies have been done that show that all the data we have points to global warming being influenced by C02 emissions.
This was just ONE study, done fraudulently in order to support and non scientific anti vaccine movement.
Also the difference is that global warming has been studied for 40 years, as we get more data and new data the overwhelming mountain of it points to global warming.
Except that... (Score:4, Informative)
First, the problem with statistics is that they deal in huge quantities to be accurate, and, the human body is sufficiently complex that lurking behind any "outlier" might exist a causal relationship for just that person.
Second, the medical establishment has made some spectacular mistakes through the years and people simply do not trust them.
By anyone's admission, the number of medical mistakes and fatalities from them are so enormous that literally every family has a story where the doctor screwed up. Advice given out by the medical community has changed, as well.
At one point in time, the medical establishment advocated a diet of four food groups, one of which would turn out to be loaded in cholesterol. At one point in time, antibiotics were hailed as the end of bacterial infections, and now medicine is essentially backpedalling against a resurgance in diseases once thought "cured".
Most damningly though, is, the whole question of whether or not medical science is actually worth the expense. Some studies have shown that once you factor out hygeine and nutrition, the lifespan of humans has not actually changed in 100 years. Essentially, if you get a virus, you will either recover or not, and bacterial infections are actually not common enough to really effect the larger course of affairs.
Finally, the politicization of science has happened even in medicine. The whole concept of the university, and by extension, the doctor was of someone who earned a decent living but was removed from the field of genuine wealth in order to be free from not only its temptations, but its distractions. Now, we have very real cases where doctors are rigging double blind studies in order to try and sell stock in their biotech company, manipulating the lives of real patients solely to cash in.
Who do you trust in medicine these days? Who do you trust in science? As soon as universities started amassing huge patent warchests and enormous funds, as soon as science got -expensive-, it became political, and because it is political, it cannot be trusted, as much as nothing else political can be trusted.
Re:The debate is long from over. (Score:3, Informative)
Still when your child starts acting weird, and stops talking within days after getting a shot it is easy to draw a conclusion.
"For every problem, there is an answer that is simple, obvious, and wrong."
Re:But (Score:4, Informative)
As my memory serves, almost as soon as the paper was published, it was attacked. By 2003-2004 it was pretty well established that Wakefield's paper was a crock of shit and Wakefield was, at best, a quack, and at worst, an out-and-out profiteering con man (more than likely the latter). The Lancet, whose reputation ain't exactly inviolate as far as "questionable" papers getting published, sat around on its fucking ass for six fucking years, knowing full well that Wakefield was a fraud, that his "study" was worse than useless and that it had already spawned a whole legal industry dedicated towards getting Big Pharma, not to mention a great deal of damage to public health.
This isn't the matter of a paper that drew some weak conclusions, or was based on some bad data, this was a matter of the Lancet giving a fraudster a veneer of respectability and trust, and despite all the evidence, not blowing a hole in Wakefield's boat until long after the damage had been done.
The one up side is hopefully that Lancet has been irretrievably damaged by thus.
Re:For our sake (Score:0, Informative)
because Globbal warming studies have been looked at by many different scientist and many studies have been done that show that all the data we have points to global warming being influenced by C02 emissions.
This was just ONE study, done fraudulently in order to support and non scientific anti vaccine movement.
Also the difference is that global warming has been studied for 40 years, as we get more data and new data the overwhelming mountain of it points to global warming.
Oh, ye of way too much faith - yes, FAITH:
Climate change emails between scientists reveal flaws in peer review [guardian.co.uk]
A key component in the story of 20th-century warming is data from sparse weather stations in Siberia. This huge area appears to have seen exceptional warming of up to 2C in the past century. But in such a remote region, actual data is sparse. So how reliable is that data, and do scientists interpret it correctly?
In March 2004, Jones wrote to Professor Michael Mann, a leading climate scientist at Pennsylvania State University, saying that he had "recently rejected two papers [one for the Journal of Geophysical Research and one for Geophysical Research Letters] from people saying CRU has it wrong over Siberia. Went to town in both reviews, hopefully successfully. If either appears I will be very surprised". ...
But the draft seen by the Guardian asserts that the difference between his findings on Siberia temperatures and that of Jones is "probably because the CRU compilation contains too little correction for urban warming."
Interestingly, we now know that Jones probably cooked the books [guardian.co.uk] on warming data from China - in the same way:
A Guardian investigation of thousands of emails and documents apparently hacked from the University of East Anglia's climatic research unit has found evidence that a series of measurements from Chinese weather stations were seriously flawed and that documents relating to them could not be produced. ...
The history of where the weather stations were sited was crucial to Jones and Wang's 1990 study, as it concluded the rising temperatures recorded in China were the result of global climate changes rather the warming effects of expanding cities.
The IPCC's 2007 report used the study to justify the claim that "any urban-related trend" in global temperatures was small. Jones was one of two "coordinating lead authors" for the relevant chapter.
Helluva pattern there, isn't it?
IF the world really is warming because of the acts of humanity, then these CLOWNS have destroyed the credibility needed for scientists to produce an obviously unbiased recommendation for what to do about it.
Getting that credibility back is going to require SERIOUS house cleaning in the scientific community.
Re:The debate is long from over. (Score:4, Informative)
Even starting with the premise that the vaccine does have a 0.1% chance of causing autism, measles has a mortality rate much higher than that, especially in undeveloped countries.
I was doubting your claim of a "much higher" mortality rate for measles, but after a quick web search it appears you're right - if we're talking about worldwide mortality. One UNICEF article [unicef.org] states that "measles infects 25 to 30 million children each year and kills over 345,000", which is about 1.15%, an order of magnitude higher than the 0.1% chance for autism you stated (from which source, btw?). On the other hand, in countries where professional medical care is more advanced and/or more available to the general public, the mortality rates are much, much lower. According to this article [unicef.org], the mortality rate for acute (!) cases in the U.S. was about 0.25% - 0.28%. Between 1993-1999, there was only one reported death. Given that the complications of a measles infection can generally be handled when adequate medical care is available, and that autism is (as far as we know) "final", the decision isn't quite as clear-cut as you present it.
That's assuming that your 0.1% figure is accurate. FWIW, I'm not in any way opposed to the MMR vaccination, and I'm not buying the autism scare either. Where I live, this vaccine is administered to children systematically, and hardly anybody ever opts out.
CJ
Re:The debate is long from over. (Score:5, Informative)
It certainly raises a red flag for me when you consider that a single vaccine can give a child an exposure 5-10x the OSHA limit for mercury poisoning.
It doesn't. The OSHA limit is for chronic exposure to methylmercury. Thimerosal exposes you (via breakdown) to ethylmercury, and only once. It's the wrong substance and is a non-chronic exposure. There is not an established toxicity for ethylmercury, as far as I recall -- it is generally thought that the toxicity is lower than methylmercury, and so the limits for methylmercury are used. (But again, the limit you are referring to is the chronic-exposure limit.)
Re:Oh, the naivete. (Score:3, Informative)
On the other hand Sir Roy Meadows got away with giving evidence in court that lead to hundreds of children being wrongly taken away front heir parents because his stupid and negligently given evidence (basically he gave evidence on odds without understanding probability, and gave evidence that specialists disagreed with) was "honestly held".
Going back to autism, the British government also made things worse by what it told parents, which amounted to "do not worry your little heads about it, we know best and are telling you what to do". Their publications said things like "no evidence has been found" without" describing what effort had been made to look for evidence. On the other hand, the Danish study simple produced strong statistical evidence that there was no link, and that was that.
Re:The debate is long from over. (Score:2, Informative)
That doesn't happen in the UK, hence the rise in cases of all three diseases in some area - particularly London.
A policy of coercing the public into any kind of medical intervention here is very unpopular. Unfortunately when we're up against highly misleading reporting of science and health scare stories in the popular press, there's not a lot of alternative.
Re:The debate is long from over. (Score:3, Informative)
The FDA hasn't established limits on ethyl mercury and has several articles suggesting that the methyl mercury limits be used for chronic exposure. See my other post showing one daily exposure limit was being exceeded by 3x for a typical 6-month getting his vaccinations.
I know you're an idiot who likes to argue for no reason, but I will point out that a "daily exposure limit" is that amount you are allowed to be exposed to every day ad infinitum. To calculate an approximate single exposure limit you would take that daily limit and multiply it by the half life of the substance in the body.
The half life of methyl mercury in the body is about 80 days, so a single exposure limit would be about 80X the daily limit.
The half life of ethyl mercury in the body is about 8 days, so if the EPA actually determined a daily limit scientifically, you would expect it to be about 10X the daily limit for methyl mercury.