The Other Side of the Wakefield MMR Vaccine and Autism Saga
No, he is not the Godfather of the anti-vaccine movement. His 1998 study did not claim MMR vaccines caused autism.
What people believe about Dr. Andrew Wakefield generally depends on which sources they have chosen to investigate. The general consensus is that Wakefield is an unscrupulous doctor who falsified data in a 1998 Lancet research paper in order to show that MMR vaccine causes autism, all the while concealing conflicts of interest which could make him a lot of money if the public lost confidence in the MMR vaccine. Most of the narrative for this came through an investigative reporter named Brian Deer. What you first need to understand about Brian Deer is that this entire investigation, which was covered by Brian Deer for years as a "dispassionate journalist", began with a single complaint submitted to the UK General Medical Council (GMC). Want to know who submitted that complaint? Brian Deer.
Clearly this is a very complex issue, if you want to really understand what happened here you must commit to spending some time looking at multiple alternative sources, hopefully including some that I will cite shortly. If instead you decide you want to save some time and immediately go to Google and read articles by "Skeptics" bloggers like the one who calls himself "Orac", you will likely reinforce your current beliefs but will not gain any understanding of the truth.
Dr. Wakefield is often labeled “The Father of the Anti-Vaccine Movement", and throughout this saga he was singled out and systematically destroyed because he dared to question the safety of the MMR vaccine. This is generally what happens to anyone who questions vaccine safety. Don't believe me? Look up what happened to former CDC researcher Dr. Gary Goldman after he published a research study which found that the main driver for the increase in incidence of shingles was the use of the chickenpox vaccine. He was instructed by the CDC not to publish, he did so anyway and although the record shows that he resigned, I can tell you with confidence that he was forced out.
The first issue which I would like to deal with directly here is the allegation that Dr. Wakefield is "anti-vaccine", and that he is the cause of the measles outbreaks in the UK and elsewhere. To the contrary, Dr. Wakefield has always been a staunch proponent of measles vaccination. Prior to his 1998 study he had undertaken an independent investigation of combined MMR (measles, mumps and rubella) vaccine safety and was very concerned with what he found. For starters the previous MMR vaccine had been licensed in the UK despite the fact that it had already been banned in Canada and other countries because the mumps portion of the vaccine was known to cause meningitis in some children. The use of this vaccine did eventually have to be suspended in the UK because it did indeed cause many cases of meningitis there.
Through the course of his research he became even more concerned about the combined MMR vaccine, and with the albeit preliminary results from his 1998 Lancet study he recommended that parents opt for individual vaccines until more research was done on the safety of the combined MMR vaccine. Shortly after that, after uptake of MMR vaccine had already dropped due to public concern about its safety, and use of single vaccines had markedly increased, the British government, in conjunction with the vaccine manufacturers (think about that for a moment) summarily and inexplicably suspended licensing for the individual vaccines...so they were no longer available to parents. As a direct result of the British government’s action, overall measles vaccination rates dropped precipitously in the UK.
It is also very important to understand that the Deer complaint to the GMC implicated not only Dr. Wakefield, but also his two colleagues, the senior author of the Lancet paper and clinician Prof. John Walker-Smith as well as Prof. Simon Murch. Dr. Wakefield attempted to defend himself but was denied funding. When Walker-Smith, who was provided legal funding, appealed against the GMC’s findings, the High Court threw out all charges, particularly in regard to the Lancet paper, and Dr. Wakefield was left standing technically guilty of things which had been found to never have happened - and which were not further appealed by the GMC. Likewise further allegations which had been made by Deer in the British Medical Journal were incompatible with the High Court findings. If you are interested to learn more about the significance of Walker-Smith’s exoneration and how it is directly relevant to the charges against Dr. Wakefield, you should read this great summary:
The UK High Court Decision in the appeal by Professor John Walker-Smith
Justice Mitting’s Conclusion:
“Both on general issues and the Lancet paper and in relation to individual children, the panel's overall conclusion that Professor Walker-Smith was guilty of serious professional misconduct was flawed…[there was] inadequate and superficial reasoning and, in a number of instances, a wrong conclusion… the medical records provide an equivocal answer to most of the questions which the panel had to decide. The panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The [GMC] panel’s determination cannot stand. I therefore quash it.” (March 7, 2012)
For anyone interested in learning the truth about Dr. Wakefield, my first request would be that you read the abstract for Dr. Wakefield's 1998 Lancet paper. You will notice that in direct contrast to what just about everyone will tell you, its objective was not to link vaccines with autism. In fact, in its Discussion the paper states:
We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described. Virological studies are underway that may help to resolve this issue.
It was in fact a case series initial report looking into a novel medical condition of gastrointestinal issues in children who had also experienced a regression in cognitive and developmental abilities. And yes, it only had 12 subjects and no control group, this is very typical of case series reports. Dr. Wakefield’s only crime here was simply noting that for 8 of the 12 children in his study, the parents reported that their children’s first behavioral and gastrointestinal issues began shortly after receiving their MMR vaccine. In all fairness I must tell you that this paper has been retracted, but this had much more to do with the ramifications of bringing up safety concerns regarding MMR vaccine than it does the actual content and findings of this paper. The findings of the paper itself have not been contested. Later on I will cite research which is consistent with Dr. Wakefield's findings.
Instead of going through all of the remaining details of the Wakefield saga myself, I am going to cite a number of references in the hopes that folks who are curious will spend some time to learn the truth about Dr. Wakefield, the truth about his research, and most importantly the truth about whether the MMR vaccine can cause autism.
So for starters, here is the infamous (retracted) 1998 Lancet paper:
The easiest way for you to get a general understanding not only of the Wakefield study, but also the overarching issue of whether MMR vaccine can cause autism and how the CDC has systematically covered up any association, would be to watch the 2016 documentary "VAXXED: From Coverup to Catastrophe". Full disclosure, Dr. Wakefield is the Director of this documentary. Best to remain skeptical, but consider this as a starting point to get a general frame of reference.
In my opinion the following articles and videos are the best general rebuttals to the allegations against Dr. Wakefield, the first two are good quick overviews of the main misconceptions, the next two are from Dr. Wakefield himself:
Del Bigtree Interview with Dr. Andrew Wakefield on “The HighWire”:
For the Discerning Journalist: 8 Wakefield Myths Deconstructed
Dr. Andrew Wakefield Deals With Allegations (~25 min)
Dr. Andrew Wakefield Lecture at Brandeis University 2011 (Warning: 1.75 hrs!)
A Thorough Analysis of the Case Against Dr. Andrew Wakefield by Mary Holland, JD
Apparent Egregious Ethical Misconduct by British Medical Journal, Brian Deer: Detailed report by Dr. David Lewis to the UK Research Integrity Office (UKRIO)
Keeping Anderson Cooper Honest: Is Brian Deer The Fraud? - By JB Handley
The most comprehensive report on what happened with Dr. Wakefield is the following very detailed (and long!) article by Vera Sharav from The Alliance for Human Research Protection (AHRP):
L’affaire Wakefield: Shades of Dreyfus & BMJ’s Descent into Tabloid Science
The following is a statement from one of the parents of two children in the 1998 Lancet study:
Dr Andrew Wakefield, The Lancet Study and My Two Boys – Isabella Thomas
Dr. Wakefield was concerned about the safety of MMR vaccine primarily because this vaccine includes three live-virus vaccines, and it was (and still is) unknown whether it is safe to inject three live-virus vaccines simultaneously into children. Importantly, research had already found there to be a risk from exposure to natural mumps and measles virus in close temporal proximity, and the research pointed to...you guessed it...gastrointestinal disorders:
Paramyxovirus infections in childhood and subsequent inflammatory bowel disease
"Mumps infection before age 2 years was a risk for ulcerative colitis (odds ratio, 25.12; 95% confidence interval, 6.35–99.36). Measles and mumps infections in the same year of life were significantly associated with ulcerative colitis and Crohn's disease, with odds ratios of 7.47 (2.42–23.06) and 4.27 (1.24–14.46), but not with IDDM. These relationships are independent of each other as well as sex, social class at birth, household crowding in childhood, and family history of IBD."
It is now well established that gastrointestinal problems are much more common in children on the autistic spectrum, and more recent research is finding that these problems are closely related to differences in the integrity of both blood-brain barrier and the gastrointestinal tract. This is entirely consistent with the findings of the 1998 Lancet study and later research by Dr. Wakefield.
A Putative Blood-Based Biomarker for Autism Spectrum Disorder-Associated Ileocolitis
http://www.massgeneral.org/about/pressrelease.aspx?id=2041
https://molecularautism.biomedcentral.com/articles/10.1186/s13229-016-0110-z
"Altered expression of genes associated with blood-brain-barrier integrity and function and with inflammation was detected in ASD tissue samples, supporting the hypothesis that an impaired blood-brain barrier associated with neuroinflammation contributes to ASD."
"That analysis revealed that 75 percent of the individuals affected by ASD had reduced expression of [intestinal] barrier-forming cellular components, compared with controls, and 66 percent showed a higher expression of molecules that increase intestinal permeability."
So at the very least we have established biological plausibility that Dr. Wakefield's findings could be correct.
Dr. Wakefield's research has been replicated and reinforced by researchers worldwide, here is just a sample of references from this article:
Furlano R, Anthony A, Day R, Brown A, Mc Garvey L, Thomson M, et al. “Colonic CD8 and T cell filtration with epithelial damage in children with autism.” J Pediatr 2001;138:366-72.
Sabra S, Bellanti JA, Colon AR. “Ileal lymphoid hyperplasia, non-specific colitis and pervasive developmental disorder in children”. The Lancet 1998;352:234-5.
Torrente F., Machado N., Perez-Machado M., Furlano R., Thomson M., Davies S., Walker-Smith JA, Murch SH. “Enteropathy with T cell infiltration and epithelial IgG deposition in autism.” Molecular Psychiatry. 2002;7:375-382
Ashwood P, Anthony A, Pellicer AA, Torrente F. “Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology.” Journal of Clinical Immunology, 2003;23:504-517.
Gonzalez, L. et al., “Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms”. Arch Venez Pueric Pediatr, 2005;69:19-25.
Balzola, F., et al., “Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsule enteroscopy: Another piece in the jig-saw of the gut-brain syndrome?” American Journal of Gastroenterology, 2005. 100(4): p. 979- 981.
S. Walker, K. Hepner, J. Segal, A. Krigsman “Persistent Ileal Measles Virus in a Large Cohort of Regressive Autistic Children with Ileocolitis and Lymphonodular Hyperplasia: Revisitation of an Earlier Study” Balzola F et al .
“Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients.” Gastroenterology 2005;128(Suppl. 2);A-303.
Controversial Doctor and Autism Media Channel Director proven right - MMR Vaccine Causes Autism & Inflammatory Bowel Disease (includes “list of 28 studies from around the world that support Dr. Wakefield’s research”)
New Published Study Verifies Dr. Andrew Wakefield’s Research on Autism - Again
I hope that this information will pique the curiosity of at least some readers to further investigate this issue to get a better understanding of what happened to Dr. Wakefield, and why. But more importantly, it is critical that people begin to understand that vaccines can and do cause autism, and that the Center for Disease Control has been covering this up since Day 1. This could be the subject of its own essay, or book.
Let me just close with this Press Release from a senior research scientist from the CDC itself, Dr. William Thompson, who was co-author on the primary paper which supposedly proved that MMR vaccines do not cause autism:
FOR IMMEDIATE RELEASE—AUGUST 27, 2014
STATEMENT OF WILLIAM W. THOMPSON, Ph.D., REGARDING THE 2004 ARTICLE:
EXAMINING THE POSSIBILITY OF A RELATIONSHIP BETWEEN MMR VACCINE AND AUTISM
"My name is William Thompson. I am a Senior Scientist with the Centers for Disease Control and Prevention, where I have worked since 1998.
I regret that my coauthors and I omitted statistically significant information in our 2004 article published in the journal Pediatrics. The omitted data suggested that African American males who received the MMR vaccine before age 36 months were at increased risk for autism. Decisions were made regarding which findings to report after the data were collected, and I believe that the final study protocol was not followed."
(The link to this press release is from the Wayback Machine because the actual press release was subsequently removed.)
This was not the first time that the CDC has covered up research showing a link between vaccines with autism. In fact, the very first study to find that vaccines can cause autism was carried out by the CDC itself in 1999, but this study was never published. Instead, over the course of 4 years the data was manipulated at least 5 times until all but one statistically significant finding (Tourette Syndrome - tics) went away...and then this was published in 2003 as a negative study “proving” that vaccines do not cause autism.
Want to learn more about THIS saga? The quickest way to get up to speed on this would be to watch an earlier documentary called "Trace Amounts", you can stream it from their website. This covers in excruciating detail how the CDC covered up research showing that exposure to mercury in vaccines very significantly increases the risk of autism and other neuro-developmental disorders in young children. Here is a short summary of direct quotes from the “Simpsonwood Conference”, a meeting held by the CDC along with vaccine manufacturers and government officials to discuss the inconvenient results of the 1999 CDC study. Here is a much longer comprehensive summary of this entire saga.