Lancet MMR autism fraud

Last updated

Lancet MMR autism fraud
ClaimsResearch linking the measles, mumps and rubella vaccination with autism
Year proposed1998
Original proponents Andrew Wakefield
(Overview of pseudoscientific concepts)

The Lancet MMR autism fraud centered on the publication in February 1998 of a fraudulent research paper titled "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children" in the Lancet . [1] The paper, authored by now discredited and deregistered Andrew Wakefield, and twelve coauthors, falsely claimed causative links between the measles, mumps, and rubella (MMR) vaccine and colitis and between colitis and autism. The fraud involved data selection, data manipulation, and two undisclosed conflicts of interest. It was exposed in a lengthy Sunday Times investigation [2] [3] [4] [5] by reporter Brian Deer, [6] [7] [8] resulting in the paper's retraction in February 2010 [9] and Wakefield being struck off the UK medical register three months later. Wakefield reportedly stood to earn up to US$43 million per year selling diagnostic kits for a non-existent syndrome he claimed to have discovered. [10] He also held a patent to a rival vaccine at the time, and he had been employed by a lawyer representing parents in lawsuits against vaccine producers.

Contents

The scientific consensus on vaccines and autism is that there is no causal connection between MMR, or any other vaccine, and autism.

1998 The Lancet paper

In February 1998, a group led by Andrew Wakefield published a paper [1] in the British medical journal the Lancet , supported by a press conference at the Royal Free Hospital in London, where the research was carried out. [11] [12] This paper reported on twelve children with developmental disorders referred to the hospital and described a constellation of bowel symptoms, as well as endoscopy and biopsy findings, that were said to be evidence of a new "syndrome" that Wakefield would later call "autistic enterocolitis". The paper described MMR vaccination as the "apparent precipitating event", tabulated the parents of eight of the twelve children as linking their developmental symptoms with MMR vaccination, suggested the connection between autism and the gastrointestinal pathologies was "real", and called for further research. [13] But it admitted that the research did not "prove" an association between the MMR vaccine and autism.

At a press conference accompanying the paper's publication, later criticized as "science by press conference", [11] Wakefield said that he thought it prudent to use single vaccines instead of the MMR triple vaccine until this could be ruled out as an environmental trigger. Wakefield said, "I can't support the continued use of these three vaccines given in combination until this issue has been resolved." [13] In a video news release issued by the hospital to broadcasters in advance of the press conference, he called for MMR vaccine to be "suspended in favour of the single vaccines". [14] In a BBC interview, Wakefield's mentor, Roy Pounder, who was not a coauthor, "admitted the study was controversial". He added: "In hindsight it may be a better solution to give the vaccinations separately ... When the vaccinations were given individually there was no problem." [15] These suggestions were supported neither by Wakefield's coauthors nor any scientific evidence. [16]

British television coverage of the press conference was intense, [17] but press interest was mixed. The Guardian and the Independent reported it on their front pages, while the Daily Mail only gave the story a minor mention in the middle of the paper, and the Sun did not cover it. [18]

Controversy over MMR

Multiple subsequent studies failed to find any link between the MMR vaccine, colitis, and autism. [19] In March 1998, a panel of 37 scientific experts set up by the Medical Research Council, headed by Professor Sir John Pattison found "no evidence to indicate any link" between the MMR vaccine and colitis or autism in children. [19] [20]

Public concern over Wakefield's claims of a possible link between MMR and autism gained momentum in 2001 and 2002, after he published further papers suggesting that the immunisation programme was not safe. These were a review paper with no new evidence, published in a minor journal, and two papers on laboratory work that he said showed that measles virus had been found in tissue samples taken from children who had autism and bowel problems. There was wide media coverage including distressing anecdotal evidence from parents, and political coverage attacking the health service and government peaked with unmet demands that Prime minister Tony Blair reveal whether his infant son, Leo, had been given the vaccine. It was the biggest science story of 2002, with 1257 articles mostly written by non-expert commentators[ citation needed ]. In the period January to September 2002, 32% of the stories written about MMR mentioned Leo Blair, as opposed to only 25% that mentioned Wakefield. Less than a third of the stories mentioned the overwhelming evidence that MMR is safe. [18] The paper, press conference and video sparked a major health scare in the United Kingdom. As a result of the scare, full confidence in MMR fell from 59% to 41% after publication of the Wakefield research. In 2001, 26% of family doctors felt the government had failed to prove there was no link between MMR and autism and bowel disease. [21] In his book Bad Science , Ben Goldacre describes the MMR vaccine scare as one of the "three all-time classic bogus science stories" by the British newspapers (the other two are the Arpad Pusztai affair about genetically modified crops, and Chris Malyszewicz and the MRSA hoax). [22]

A 2003 survey of 366 family doctors in the UK reported that 77% of them would advise giving the MMR vaccine to a child with a close family history of autism, and that 3% of them thought that autism could sometimes be caused by the MMR vaccine. [23] A similar survey in 2004 found that these percentages changed to 82% and at most 2%, respectively, and that confidence in MMR had been increasing over the previous two years. [24]

A factor in the controversy is that only the combined vaccine is available through the UK National Health Service. As of 2010 there are no single vaccines for measles, mumps and rubella licensed for use in the UK. [25] Prime Minister Tony Blair gave support to the programme, arguing that the vaccine was safe enough for his own son, Leo, [26] but refusing on privacy grounds to state whether Leo had received the vaccine; in contrast, the subsequent Prime Minister, Gordon Brown, explicitly confirmed that his son has been immunised. [27] Cherie Blair confirmed that Leo had been given the MMR vaccination when promoting her autobiography. [18] [28]

The government stressed that administration of the combined vaccine instead of separate vaccines decreases the risk of children catching the disease while waiting for full immunisation coverage. [29] The combined vaccine's two injections results in less pain and distress to the child than the six injections required by separate vaccines, and the extra clinic visits required by separate vaccinations increases the likelihood of some being delayed or missed altogether; [29] [30] vaccination uptake significantly increased in the UK when MMR was introduced in 1988. [29] Health professionals have heavily criticized media coverage of the controversy for triggering a decline in vaccination rates. [31] No scientific basis has been found for preferring separate vaccines, or for using any particular interval between them. [30] [32]

In 2001, Mark Berelowitz, one of the co-authors of the paper, said "I am certainly not aware of any convincing evidence for the hypothesis of a link between MMR and autism". [33] The Canadian Paediatric Society, [34] the Centers for Disease Control and Prevention, [35] the Institute of Medicine of the National Academy of Sciences, [36] and the UK National Health Service [37] have all concluded that there is no link between the MMR vaccine and autism, and a 2011 journal article described the vaccine–autism connection as "the most damaging medical hoax of the last 100 years". [38]

Newspaper investigation

Conflict of interest

Public understanding of the claims sharply changed in February 2004 with revelations by The Sunday Times of an undisclosed conflict of interest on Wakefield's part in that, two years before the paper's publication, he had been approached by Richard Barr, a lawyer of Justice, Awareness and Basic Support, who was looking for an expert witness to start a planned class action regarding alleged "vaccine damage". Barr hired Wakefield at £150 per hour, plus expenses, and only then did they recruit the twelve children, [39] actively seeking the parents of cases that might imply a connection between MMR and autism. Barr and Wakefield convinced the UK Legal Aid Board, a UK government organization to give financial support to people who could not afford access to justice, to assign £55,000 to fund the initial stage of the research. According to journalist Brian Deer, the project was intended to create evidence for the court case, but this only became publicly known six years after the Lancet report, with the newspaper's first disclosures. [40] [ page needed ]

Based on Deer's evidence, the Lancet's editor-in-chief Richard Horton said Wakefield's paper should have never been published because its findings were "entirely flawed". [2] Although Wakefield maintained that the legal aid funding was for a separate, unpublished study [41] (a position later rejected by a panel of the UK General Medical Council), the editors of The Lancet judged that the funding source should have been disclosed to them. [42] Horton wrote, "It seems obvious now that had we appreciated the full context in which the work reported in the 1998 Lancet paper by Wakefield and colleagues was done, publication would not have taken place in the way that it did." [43] Several of Wakefield's co-researchers also strongly criticized the lack of disclosure. [2]

No ethical approval

Among Deer's earliest reported allegations was that, contrary to a statement in the paper, Wakefield's research on the 12 children was conducted without any institutional review board authorization—a claim quickly denied in February 2004 by both the paper's authors and the Lancet. [44] The paper itself said, "Ethical approval and consent. Investigations were approved by the Ethical Practices Committee of the Royal Free Hospital NHS Trust, and parents gave informed consent." The dispute over this would remain unresolved, however, until settled in the English High Court in March 2012, where a senior judge vindicated Deer. Quoting the text, Justice Mitting ruled, "This statement was untrue and should not have been included in the paper." [45]

Retraction of an interpretation

The Lancet and many other medical journals require papers to include the authors' conclusions about their research, known as the "interpretation". The summary of the 1998 Lancet paper ended as follows: [1]

Interpretation We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.

In March 2004, immediately following the news of the conflict of interest allegations, ten of Wakefield's 12 coauthors retracted this interpretation, [46] while insisting that the possibility of a distinctive gastrointestinal condition in children with autism merited further investigation. [47] However, a separate study of children with gastrointestinal disturbances found no difference between those with autism spectrum disorders and those without, with respect to the presence of measles virus RNA in the bowel; it also found that gastrointestinal symptoms and the onset of autism were unrelated in time to the administration of MMR vaccine. [48]

Later in 2004, the newspaper's investigation also found that Wakefield had a further conflict of interest in the form of a patent for a single measles vaccines, [2] [4] had manipulated evidence, [3] and had broken other ethical codes. The Lancet paper was partially retracted in 2004 and fully retracted in 2010, when Lancet's editor-in-chief Richard Horton described it as "utterly false" and said that the journal had been deceived. [49] Wakefield was found guilty by the General Medical Council of serious professional misconduct in May 2010 and was struck off the Medical Register, meaning he could no longer practise as a doctor in the UK. [50] In 2011, Deer provided further information on Wakefield's improper research practices to the British Medical Journal , which in a signed editorial described the original paper as fraudulent. [7] [51]

Deer continued his reporting in a Channel 4 Dispatches television documentary, MMR: What They Didn't Tell You, broadcast on 18 November 2004. This documentary reported that Wakefield had applied for patents on a single measles vaccine that claimed to be a potential rival of MMR, and that he knew of test results from his own laboratory at the Royal Free Hospital that contradicted his own claims. [4] Wakefield's patent application was also noted in Paul Offit's 2008 book, Autism's False Prophets .

In January 2005, Wakefield sued Channel 4, 20/20 Productions, and the investigative reporter Brian Deer, who presented the Dispatches programme. However, after two years of litigation, and the revelation of more than £400,000 in undisclosed payments by lawyers to Wakefield, he discontinued his action and paid all the defendants' costs.

In 2006, Deer reported in The Sunday Times that Wakefield had been paid £435,643, plus expenses, by British trial lawyers attempting to prove that the vaccine was dangerous, with the undisclosed payments beginning two years before the Lancet paper's publication. [5] This funding came from the UK legal aid fund, a fund intended to provide legal services to the poor. [13]

Support for Wakefield

Despite The Sunday Times disclosures, Wakefield continued to find support. Melanie Phillips, an influential columnist with the Daily Mail , called the reporting of Wakefield's contract with the solicitor Richard Barr "a smear whose timing should raise a few eyebrows."

According to Deer writing in the BMJ, the General Medical Council hearing was also criticized by Richard Horton, the Lancet editor: "My own view is that the GMC is no place to continue this debate. But the process has started and it will be impossible to stop." [52]

Manipulation of data

The Sunday Times continued the investigation, and on 8 February 2009, Brian Deer reported that Wakefield had "fixed" results and "manipulated" patient data in the Lancet, creating the appearance of a link with autism. [3] Wakefield falsely denied these allegations, [53] and even filed a complaint with the Press Complaints Commission (PCC) [54] over this article on 13 March 2009. The complaint was expanded by a 20 March 2009 addendum by Wakefield's publicist. [55] In July 2009, the PCC stated that it was staying any investigation regarding the Sunday Times article, pending the conclusion of the GMC investigation. [56] In the event that Wakefield did not pursue his complaint, Deer published the complaint with a statement saying he and The Sunday Times rejected the complaint as "false and disingenuous in all material respects", and that the action had been suspended by the PCC in February 2010. [57]

UK General Medical Council inquiry

Responding to the first Sunday Times reports, the General Medical Council (GMC), which is responsible for licensing doctors and supervising medical ethics in the UK, launched an investigation into the affair. [58] The GMC brought the case itself, not citing any specific complaints, claiming that an investigation was in the public interest. The then-secretary of state for health, John Reid, called for a GMC investigation, which Wakefield himself welcomed. [59] During a debate in the House of Commons, on 15 March 2004, Dr. Evan Harris, [60] a Liberal Democrat MP, called for a judicial inquiry into the ethical aspects of the case, even suggesting it might be conducted by the CPS. [61] In June 2006 the GMC confirmed that they would hold a disciplinary hearing of Wakefield.

The GMC's Fitness to Practise Panel first met on 16 July 2007 [62] to consider the cases of Wakefield, Professor John Angus Walker-Smith, and Professor Simon Harry Murch. [63] All faced charges of serious professional misconduct. The GMC examined, among other ethical points, whether Wakefield and his colleagues obtained the required approvals for the tests they performed on the children; the data-manipulation charges reported in the Sunday Times, which surfaced after the case was prepared, were not at question in the hearings. [64] The GMC stressed that it would not be assessing the validity of competing scientific theories on MMR and autism. The GMC alleged that the trio acted unethically and dishonestly in preparing the research into the MMR vaccine. They denied the allegations. [65] The case proceeded in front of a GMC Fitness to Practise panel of three medical and two lay members. [66]

On 28 January 2010, the GMC panel delivered its decision on the facts of the case, finding four counts of dishonesty and 12 involving the abuse of developmentally disabled children. Wakefield was found to have acted "dishonestly and irresponsibly" and to have acted with "callous disregard" for the children involved in his study, conducting unnecessary and invasive tests. [67] [68] The panel found that the trial was improperly conducted without the approval of an independent ethics committee, [69] and that Wakefield had multiple undeclared conflicts of interest. [70]

On 24 May 2010, the GMC panel ordered that he be struck off the medical register. [71] John Walker-Smith was also found guilty of serious professional misconduct and struck off the medical register, but that decision was reversed on appeal to the High Court in 2012, because the GMC panel had failed to decide whether Walker-Smith actually thought he was doing research in the guise of clinical investigation and treatment. The High Court criticised "a number of" wrong conclusions by the disciplinary panel and its "inadequate and superficial reasoning". [72] Simon Murch was found not guilty. [71]

In response to the GMC investigation and findings, the editors of the Lancet announced on 2 February 2010 that they "fully retract this paper from the published record". [73] The Lancet's editor-in-chief Richard Horton described it as "utterly false" and said that the journal had been deceived. [49]

The Hansard text for 16 March 2010 reported [74] Lord McColl asking the Government whether it had plans to recover legal aid money paid to the experts in connection with the measles, mumps and rubella/measles and rubella vaccine litigation. Lord Bach, Ministry of Justice dismissed this possibility.

Full retraction and fraud revelations

In an April 2010 report in The BMJ , Deer expanded on the laboratory aspects of his findings recounting how normal clinical histopathology results generated by the Royal Free Hospital were later changed in the medical school to abnormal results, published in the Lancet. [75] Deer wrote an article in The BMJ casting doubt on the "autistic enterocolitis" that Wakefield claimed to have discovered. [75] In the same edition, Deirdre Kelly, President of the European Society of Pediatric Gastroenterology and Nutrition and the Editor of the Journal of Pediatric Gastroenterology and Nutrition expressed some concern about The BMJ publishing this article while the GMC proceedings were underway. [76]

On 5 January 2011, The BMJ published the first of a series of articles by Brian Deer, detailing how Wakefield and his colleagues had faked some of the data behind the 1998 Lancet article. By looking at the records and interviewing the parents, Deer found that for all 12 children in the Wakefield study, diagnoses had been tweaked or dates changed to fit the article's conclusion. [39] Continuing BMJ series on 11 January 2011, [77] Deer said that based upon documents he obtained under freedom of information legislation, [10] Wakefield—in partnership with the father of one of the boys in the study—had planned to launch a venture on the back of an MMR vaccination scare that would profit from new medical tests and "litigation driven testing". [78] The Washington Post reported that Deer said that Wakefield predicted he "could make more than $43 million a year from diagnostic kits" for the new condition, autistic enterocolitis. [10] WebMD reported on Deer's BMJ report, saying that the $43 million predicted yearly profits would come from marketing kits for "diagnosing patients with autism" and "the initial market for the diagnostic will be litigation-driven testing of patients with AE [autistic enterocolitis, an unproven condition concocted by Wakefield] from both the UK and the USA". [79] According to WebMD, the BMJ article also claimed that the venture would succeed in marketing products and developing a replacement vaccine if "public confidence in the MMR vaccine was damaged". [79]

In an editorial accompanying Deer's 2011 series, The BMJ said, "it has taken the diligent scepticism of one man, standing outside medicine and science, to show that the paper was in fact an elaborate fraud", and asked:

Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he 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? 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. Moreover, although the scale of the GMC's 217 day hearing precluded additional charges focused directly on the fraud, the panel found him guilty of dishonesty concerning the study's admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards. [7] [51]

Summarizing findings as of January 2011 in The BMJ, Deer set out the following analysis of the cases reported in the study: [39]

The Lancet paper was a case series of 12 child patients; it reported a proposed "new syndrome" of enterocolitis and regressive autism and associated this with MMR as an "apparent precipitating event". But in fact:

  • Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism.
  • Despite the paper claiming that all 12 children were "previously normal", five had documented pre-existing developmental concerns.
  • Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination.
  • In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school "research review" to "non-specific colitis".
  • The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations—all giving times to onset of problems in months—helped to create the appearance of a 14 day temporal link.
  • Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation.

In subsequent disclosures from the investigation, Deer obtained copies of unpublished gastrointestinal pathology reports on the children in the Lancet study that Wakefield had claimed showed "non-specific colitis" and "autistic enterocolitis". But expert analyses of these reports found bowel biopsies from the children to be overwhelmingly normal and with no evidence of any enterocolitis at all. [80]

In September 2020, Johns Hopkins University Press published Deer's account of the fraud in his book The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines . The book includes reporting of parents whose children were among the twelve recruited by Wakefield in the Lancet study. One described the paper as "fraudulent" while another complained of "outright fabrication". [81]

Aftermath

Characterised as "perhaps the most damaging medical hoax of the 20th Century", [82] The Lancet paper led to a sharp drop in vaccination rates in the UK and Ireland. Promotion of the claimed link, which continues in anti-vaccination propaganda despite being refuted, [83] [84] led to an increase in the incidence of measles and mumps, resulting in deaths and serious permanent injuries. [85] [86] Following the initial claims in 1998, multiple large epidemiological studies were undertaken. Reviews of the evidence by the Centers for Disease Control and Prevention, [35] the American Academy of Pediatrics, the Institute of Medicine of the US National Academy of Sciences, [36] the UK National Health Service, [37] and the Cochrane Library [87] all found no link between the MMR vaccine and autism. [38] Physicians, medical journals, and editors [93] have described Wakefield's actions as fraudulent and tied them to epidemics and deaths. [94] [95]

Among commentators drawing on Deer's investigation, academic Peter N. Steinmetz summarizes six fabrications and falsifications in the paper itself and in Wakefield's response in the areas of findings of non-specific colitis; behavioral symptoms; findings of regressive autism; ethics consent statement; conflict of interest statement; and methods of patient referral. [96]

Wakefield has continued to defend his research and conclusions, saying there was no fraud, hoax or profit motive. [97] [98] [99] He has subsequently become known for anti-vaccination activism. In 2016, Wakefield directed the anti-vaccination film Vaxxed: From Cover-Up to Catastrophe .

See also

Related Research Articles

<span class="mw-page-title-main">Vaccination</span> Administration of a vaccine to protect against disease

Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.

<span class="mw-page-title-main">MMR vaccine</span> Combined vaccine against measles, mumps, and rubella

The MMR vaccine is a vaccine against measles, mumps, and rubella, abbreviated as MMR. The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, with at least four weeks between the doses. After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella. The vaccine is also recommended for those who do not have evidence of immunity, those with well-controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized. It is given by injection.

<span class="mw-page-title-main">Richard Horton (editor)</span> British medical editor

Richard Charles Horton is editor-in-chief of The Lancet, a United Kingdom–based medical journal. He is an honorary professor at the London School of Hygiene and Tropical Medicine, University College London, and the University of Oslo.

<span class="mw-page-title-main">Brian Deer</span> British investigative journalist

Brian Deer is a British investigative journalist, best known for inquiries into the drug industry, medicine, and social issues for The Sunday Times. Deer's investigative nonfiction book The Doctor Who Fooled the World, an exposé on disgraced former doctor Andrew Wakefield and the 1998 Lancet MMR autism fraud, was published in September 2020 by Johns Hopkins University Press.

Roy Pounder is a British physician and entrepreneur. He was Professor of Medicine at the Royal Free and University College Medical School in London and clinical vice president of the Royal College of Physicians of London. He is now a London University Emeritus Professor of Medicine.

<span class="mw-page-title-main">Vaccine hesitancy</span> Reluctance or refusal to be vaccinated or have ones children vaccinated

Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others. Although adverse effects associated with vaccines are occasionally observed, the scientific consensus that vaccines are generally safe and effective is overwhelming. Vaccine hesitancy often results in disease outbreaks and deaths from vaccine-preventable diseases. Therefore, the World Health Organization characterizes vaccine hesitancy as one of the top ten global health threats.

Generation Rescue is a nonprofit organization that advocates the scientifically disproven view that autism and related disorders are primarily caused by environmental factors, particularly vaccines. The organization was established in 2005 by Lisa and J.B. Handley. Today, Generation Rescue is known as a platform for Jenny McCarthy's autism related anti-vaccine advocacy.

Arthur Krigsman is a pediatrician and gastroenterologist best known for his controversial research in which he attempted to prove that the MMR vaccine caused diseases, especially autism. He specializes in the evaluation and treatment of gastrointestinal pathology in children with autism spectrum disorders, and has written in support of the diagnosis he calls autistic enterocolitis. The original study that tied the MMR vaccine to autism and GI complaints conducted by one of Krigsman's associates has been found to be fraudulent, and the diagnosis of "autistic enterocolitis" has not been accepted by the medical community.

<span class="mw-page-title-main">Jenny McCarthy</span> American actress and model (born 1972)

Jennifer Ann McCarthy-Wahlberg is an American actress, model, and television personality. She began her career in 1993 as a nude model for Playboy magazine and was later named their Playmate of the Year. McCarthy then had a television and film acting career, beginning as a co-host on the MTV game show Singled Out (1995–1997) and afterwards starring in the eponymous sitcom Jenny (1997–1998), as well as films including BASEketball (1998), Scream 3 (2000), Dirty Love (2005), John Tucker Must Die (2006), and Santa Baby (2006). In 2013, she hosted her own television talk show The Jenny McCarthy Show, and became a co-host of the ABC talk show The View, appearing on the program until 2014. Since 2019, McCarthy has been a judge on the Fox musical competition show The Masked Singer.

Claims of a link between the MMR vaccine and autism have been extensively investigated and found to be false. The link was first suggested in the early 1990s and came to public notice largely as a result of the 1998 Lancet MMR autism fraud, characterised as "perhaps the most damaging medical hoax of the last 100 years". The fraudulent research paper, authored by Andrew Wakefield and published in The Lancet, falsely claimed the vaccine was linked to colitis and autism spectrum disorders. The paper was retracted in 2010 but is still cited by anti-vaccine activists.

<span class="mw-page-title-main">Andrew Wakefield</span> British former doctor (born 1956)

Andrew Jeremy Wakefield is a British fraudster, discredited academic, anti-vaccine activist, and former physician.

The Australian Vaccination-risks Network Inc., formerly known as the Australian Vaccination-Skeptics Network (AVsN), and before that known as the Australian Vaccination Network (AVN), is an Australian anti-vaccination pressure group registered in New South Wales. As Australia's most controversial anti-vaccination organisation, it has lobbied against a variety of vaccination-related programs, downplayed the danger of childhood diseases such as measles and pertussis, championed the cause of alleged vaccination victims, and promoted the use of ineffective alternatives such as homeopathy.

Autism spectrum disorders (ASDs) or autism spectrum conditions (ASCs) describe a range of conditions classified as neurodevelopmental disorders in the DSM-5, used by the American Psychiatric Association. As with many neurodivergent people and conditions, the popular image of autistic people and autism itself is often based on inaccurate media representations. Additionally, media about autism may promote pseudoscience such as vaccine denial or facilitated communication.

Warnings About Vaccination Expectations NZ (WAVESnz), formerly the Immunisation Awareness Society (IAS), is a New Zealand anti-vaccination lobby group.

<span class="mw-page-title-main">John Walker-Smith</span> Australian gastroenterologist

John Walker-Smith is an Australian gastroenterologist well known for his work in pediatrics. From 1985 until his retirement in 2001, he was professor of pediatric gastroenterology at the University of London. He also formerly served as the editor-in-chief of the Journal of Pediatric Gastroenterology and Nutrition.

<i>Vaxxed</i> 2016 anti-vaccination documentary film

Vaxxed: From Cover-Up to Catastrophe is a 2016 American pseudoscience propaganda film alleging a cover-up by the Centers for Disease Control and Prevention (CDC) of a purported link between the MMR vaccine and autism. According to Variety, the film "purports to investigate the claims of a senior scientist at the U.S. Centers for Disease Control and Prevention who revealed that the CDC had allegedly manipulated and destroyed data on an important study about autism and the MMR vaccine"; critics derided Vaxxed as an anti-vaccine propaganda film.

Extensive investigation into vaccines and autism spectrum disorder has shown that there is no relationship between the two, causal or otherwise, and that vaccine ingredients do not cause autism. The American scientist Peter Hotez researched the growth of the false claim and concluded that its spread originated with Andrew Wakefield's fraudulent 1998 paper, and that no prior paper supports a link.

Misinformation related to immunization and the use of vaccines circulates in mass media and social media in spite of the fact that there is no serious hesitancy or debate within mainstream medical and scientific circles about the benefits of vaccination. Unsubstantiated safety concerns related to vaccines are often presented on the internet as being scientific information. A large proportion of internet sources on the topic are mostly inaccurate which can lead people searching for information to form misconceptions relating to vaccines.

JABS is a British pressure group launched in Wigan in January 1994. Beginning as a support group for the parents of children they claim became ill after the MMR vaccine, the group is currently against all forms of vaccination.

<span class="mw-page-title-main">Anti-vaccine activism</span> Activism against vaccination

Anti-vaccine activism, which collectively constitutes the "anti-vax" movement, is a set of organized activities proclaiming opposition to vaccination, and these collaborating networks have often fought to increase vaccine hesitancy by disseminating vaccine-based misinformation and/or forms of active disinformation. As a social movement, it has utilized multiple tools both within traditional news media and also through various forms of online communication. Activists have primarily focused on issues surrounding children, with vaccination of the young receiving pushback, and they have sought to expand beyond niche subgroups into national political debates.

References

  1. 1 2 3 Wakefield A, Murch S, Anthony A, et al. (1998). "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children". The Lancet. 351 (9103): 637–41. doi:10.1016/S0140-6736(97)11096-0. PMID   9500320. S2CID   439791 . Retrieved 22 June 2024. (Retracted, see doi:10.1016/S0140-6736(10)60175-4, PMID   20137807,  Retraction Watch)
  2. 1 2 3 4 The Sunday Times 2004:
  3. 1 2 3 Deer, Brian (8 February 2009). "MMR doctor Andrew Wakefield fixed data on autism". The Sunday Times. London. Archived from the original on 8 March 2023. Retrieved 9 February 2009.
  4. 1 2 3 2004 BBC documentary:
  5. 1 2 Deer B (31 December 2006). "MMR doctor given legal aid thousands". The Sunday Times. London. Archived from the original on 23 February 2007.
  6. Deer, Brian (2020). The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines . Baltimore, Md.: Johns Hopkins University Press. ISBN   978-1-4214-3800-9.
  7. 1 2 3 Godlee F, Smith J, Marcovitch H (2011). "Wakefield's article linking MMR vaccine and autism was fraudulent". The BMJ . 342: c7452. doi:10.1136/bmj.c7452. PMID   21209060. S2CID   43640126. Archived from the original on 11 November 2013. Retrieved 3 February 2019.
  8. Editorial (12 January 2011). "Autism Fraud". The New York Times. New York. Archived from the original on 27 May 2021. Retrieved 27 May 2021.
  9. Dyer, Clare (2 February 2010). "Lancet retracts Wakefield's MMR paper". BMJ. 340: c696. doi:10.1136/bmj.c696. ISSN   0959-8138. PMID   20124366. S2CID   43465004. Archived from the original on 25 March 2019. Retrieved 3 February 2019.
  10. 1 2 3 Stein, Rob (11 January 2011). "Wakefield tried to capitalize on autism-vaccine link, report says". The Washington Post. Archived from the original on 30 June 2012. Retrieved 12 January 2011.
  11. 1 2 Moore Andrew (2006). "Bad science in the headlines: Who takes responsibility when science is distorted in the mass media?". EMBO Reports . 7 (12): 1193–1196. doi:10.1038/sj.embor.7400862. PMC   1794697 . PMID   17139292.
  12. "New Research Links Autism and Bowel Disease" (PDF). Royal Free Hospital School of Medicine (Press release). 26 February 1998. Archived (PDF) from the original on 23 March 2011. Retrieved 16 November 2022 via briandeer.com.
  13. 1 2 3 Deer B (2 November 2008). "The MMR–autism crisis – our story so far". Archived from the original on 8 May 2019. Retrieved 6 December 2008.
  14. Deer B. "Royal Free facilitates attack on MMR, in Dr Andrew Wakefield "single shots" video". Archived from the original on 11 July 2007. Retrieved 27 July 2007.
  15. "Child vaccine linked to autism". BBC News. 27 February 1998. Archived from the original on 2 February 2003. Retrieved 5 September 2007.
  16. "MMR – the controversy". 1 August 2005. Archived from the original on 26 September 2007. Retrieved 6 September 2007.
  17. Deer (2020), p. 70.
  18. 1 2 3 Goldacre B (30 August 2008). "The MMR hoax". The Guardian. London. Archived from the original on 6 February 2015. Retrieved 30 August 2008.
  19. 1 2 "MMR research timeline". Archived from the original on 6 October 2021. Retrieved 6 October 2021.
  20. Sir Kenneth Calman. "From the Chief Medical Officer" (PDF). Department of health UK. Archived from the original (PDF) on 16 August 2000. Retrieved 6 October 2021.Official letter
  21. Halvorsen R (2007). The Truth about Vaccines. Gibson Square. ISBN   978-1-903933-92-3.
  22. Goldacre, Ben (2009). Bad Science. London: Fourth Estate. p. 283. ISBN   978-0-00-728487-0.
  23. "Health professionals 2003 childhood immunisation survey report" (PDF). NHS Immunisation Information. 2003. Archived from the original (PDF) on 29 September 2006. Retrieved 6 September 2007.
  24. BMRB Social Research (2004). "Health professionals 2004 childhood immunisation survey executive summary" (PDF). Immunisation Information England. Archived from the original (PDF) on 29 September 2006. Retrieved 6 September 2007.
  25. "MMR vaccine – measles, mumps, rubella vaccine". Immunisation Scotland. Archived from the original on 25 June 2018. Retrieved 1 July 2010.
  26. "Blair signals support for MMR". BBC News. 7 February 2002. Archived from the original on 27 June 2006. Retrieved 10 July 2008.
  27. Nic Fleming My son has had MMR jab, says Brown (in dig at Blair) Telegraph 7 February 2006
  28. "Cherie Blair: what she said". The Guardian. 12 May 2008. Archived from the original on 30 April 2010. Retrieved 9 March 2012.
  29. 1 2 3 "Why is MMR preferable to single vaccines?". Health Protection Agency. 2008. Archived from the original on 23 March 2014. Retrieved 31 August 2008.
  30. 1 2 MMR vs three separate vaccines:
  31. "Doctors issue plea over MMR jab". BBC News. 26 June 2006. Archived from the original on 7 July 2018. Retrieved 4 February 2009.
  32. Gerber JS, Offit PA (February 2009). "Vaccines and autism: a tale of shifting hypotheses". Clinical Infectious Diseases. 48 (4): 456–61. doi:10.1086/596476. PMC   2908388 . PMID   19128068.
  33. "MMR: myths and truths". NHS Immunisation Information. 2004. Archived from the original on 13 September 2008. Retrieved 31 August 2008.
  34. Infectious Diseases; Immunization Committee; Canadian Paediatric Society (2007). "Autistic spectrum disorder: No causal relationship with vaccines". Paediatrics and Child Health. 12 (5): 393–5. PMC   2528717 . PMID   19030398. Archived from the original on 2 December 2008. Retrieved 17 October 2008. Also published in "Autistic spectrum disorder: No causal relationship with vaccines". Can J Infect Dis Med Microbiol. 18 (3): 177–9. 2007. doi: 10.1155/2007/267957 . PMC   2533550 . PMID   18923720..
  35. 1 2 "Measles, mumps, and rubella (MMR) vaccine". Centers for Disease Control and Prevention. 22 August 2008. Archived from the original on 7 April 2008. Retrieved 21 December 2008.
  36. 1 2 Institute of Medicine (US) Immunization Safety Review Committee (17 May 2004). Immunization Safety Review: Vaccines and Autism. Institute of Medicine of the National Academy of Sciences. doi:10.17226/10997. ISBN   978-0-309-09237-1. PMID   20669467. Archived from the original on 26 October 2009. Retrieved 13 June 2007.
  37. 1 2 "MMR The facts". NHS Immunisation Information. 2004. Archived from the original on 7 January 2013. Retrieved 19 September 2007.
  38. 1 2 Flaherty DK (October 2011). "The vaccine-autism connection: a public health crisis caused by unethical medical practices and fraudulent science". Annals of Pharmacotherapy. 45 (10): 1302–4. doi:10.1345/aph.1Q318. PMID   21917556. S2CID   39479569.
  39. 1 2 3 Deer, Brian (2011). "How the case against the MMR vaccine was fixed". The BMJ. 342 (jan05 1): c5347. doi: 10.1136/bmj.c5347 . PMID   21209059. Archived from the original on 12 January 2011. Retrieved 3 February 2019.
  40. Deer (2020).
  41. Wakefield A (2004). "A statement by Dr Andrew Wakefield". The Lancet. 363 (9411): 823–4. doi: 10.1016/S0140-6736(04)15710-3 . PMID   15022650. S2CID   4476737.
  42. Horton R (2004). "A statement by the editors of The Lancet". The Lancet. 363 (9411): 820–1. doi:10.1016/S0140-6736(04)15699-7. PMID   15022645. S2CID   29122754.
  43. Horton R (2004). "The lessons of MMR". The Lancet. 363 (9411): 747–9. doi:10.1016/S0140-6736(04)15714-0. PMID   15016482. S2CID   5357597.
  44. Boseley S (26 February 2004). "Was the original MMR study unethical?". The Guardian. Archived from the original on 20 September 2021. Retrieved 20 September 2021.
  45. "Professor John Walker-Smith v. General Medical Council 2012 EWHC 503 (Admin) (7 March 2012)". www.bailii.org. Archived from the original on 4 September 2021. Retrieved 20 September 2021.
  46. Murch SH, Anthony A, Casson DH, et al. (2004). "Retraction of an interpretation". The Lancet. 363 (9411): 750. doi:10.1016/S0140-6736(04)15715-2. PMID   15016483. S2CID   5128036.
  47. Fitzpatrick M (2004). MMR and Autism: What Parents Need to Know. Routledge. ISBN   978-0-415-32179-2 . Retrieved 2 February 2011.
  48. Hornig M, Briese T, Buie T, et al. (2008). Cookson MR (ed.). "Lack of association between measles virus vaccine and autism with enteropathy: a case-control study". PLOS ONE. 3 (9): e3140. Bibcode:2008PLoSO...3.3140H. doi: 10.1371/journal.pone.0003140 . PMC   2526159 . PMID   18769550.
  49. 1 2 Boseley, Sarah (2 February 2010). "Lancet retracts 'utterly false' MMR paper". The Guardian. London. Archived from the original on 17 January 2021. Retrieved 14 January 2015.
  50. Triggle, Nick (24 May 2010). "MMR doctor struck off register". BBC News . Archived from the original on 11 April 2017. Retrieved 24 May 2010.
  51. 1 2 Deer B (2011). "Wakefield's article linking MMR vaccine and autism was fraudulent". The BMJ . 342: c5347. doi: 10.1136/bmj.c5347 . PMID   21209059. Archived from the original on 12 January 2011. Retrieved 3 February 2019.
  52. Deer B (18 January 2011). "The Lancet's two days to bury bad news". The BMJ). Archived from the original on 14 May 2021. Retrieved 5 August 2021.
  53. Gever, J. (11 February 2009). "Father of vaccine–autism link said to have fudged data". MedPage Today. Archived from the original on 28 October 2018. Retrieved 11 February 2009.
  54. "Complaint to UK". Box.net. 20 March 2009. Archived from the original on 27 March 2020. Retrieved 8 January 2011.
  55. "Countering Age of Autism". Counteringageofautism.blogspot.com. 28 January 2010. Archived from the original on 8 July 2011. Retrieved 27 June 2024.
  56. "Dr Wakefield and The Sunday Times". Press Complaints Commission. 8 February 2009. Archived from the original on 7 August 2011. Retrieved 8 January 2011.
  57. "Andrew Wakefield: Submission to the UK Press Complaints Commission (with a statement by Brian Deer)" (PDF). Archived (PDF) from the original on 12 July 2018. Retrieved 8 January 2011.
  58. Deer, B. (11 September 2005). "MMR scare doctor faces list of charges". The Sunday Times. London. Archived from the original on 15 February 2024. Retrieved 10 July 2008.
  59. Meikle, James (23 February 2004). "Demand grows for full MMR inquiry". The Guardian. Archived from the original on 2 July 2018. Retrieved 31 May 2018.
  60. Evan Harris (29 January 2010). "Dr Andrew Wakefield and the MMR Scare – Evan on C4 News". Archived from the original on 2 July 2018. Retrieved 8 January 2011.
  61. Deer, Brian. "Evan Harris demands inquiry into MMR research on children". Archived from the original on 7 March 2011. Retrieved 8 January 2011.
  62. "Andrew Wakefield, John Walker-Smith, Simon Murch. General Medical Council Fitness to Practise Panel – Charge Sheet" (PDF). 16 July 2007. Archived (PDF) from the original on 4 March 2016. Retrieved 8 January 2011.
  63. "Fitness to Practise Panel Hearing 28 January 2010" (PDF). 2 June 2010. Archived from the original (PDF) on 2 June 2010.
  64. "Father of Vaccine-Autism Link Said to Have Fudged Data". Medpagetoday.com. 11 February 2009. Archived from the original on 28 October 2018. Retrieved 8 January 2011.
  65. "MMR scare doctor 'paid children'". BBC News. 16 July 2007. Archived from the original on 18 August 2007. Retrieved 9 March 2008.
  66. General Medical Council. "Dr Andrew Wakefield, Professor John Walker-Smith, Professor Simon Murch". Archived from the original on 27 September 2007. Retrieved 6 September 2007.
  67. Boseley, S. (28 January 2010). "Andrew Wakefield found 'irresponsible' by GMC over MMR vaccine scare". The Guardian . London. Archived from the original on 15 November 2012. Retrieved 3 February 2019.
  68. "Doctor in MMR-Autism Scare Ruled Unethical". Time. 29 January 2010. Archived from the original on 2 February 2010. Retrieved 12 May 2010.
  69. Rose D (3 February 2010). "Lancet journal retracts Andrew Wakefield MMR scare paper". The Times. Archived from the original on 15 February 2024. Retrieved 13 January 2011.
  70. Rose, D. (29 January 2010). "Fall of Andrew Wakefield, 'dishonest' doctor who started MMR scare". The Times. Archived from the original on 15 February 2024. Retrieved 13 January 2011.
  71. 1 2 Sanchez R, Rose D (25 May 2010). "Dr Andrew Wakefield struck off medical register". The Times. London. Archived from the original on 1 June 2010. Retrieved 3 February 2019.
  72. Aston, John (7 March 2012). "MMR Doctor John Walker-Smith wins High Court appeal". The Independent. Archived from the original on 25 September 2015. Retrieved 16 April 2012.
  73. Lord McColl of Dulwich (16 March 2010). "Legal Aid: Questions". Parliamentary Debates (Hansard) . House of Lords. col. WA164. Archived from the original on 14 October 2010. Retrieved 8 January 2011. Archived 8 December 2022 at the Wayback Machine
  74. 1 2 Deer, Brian (2010). "Wakefield's 'autistic enterocolitis' under the microscope". The BMJ. 340 (apr15 2): c1127. doi: 10.1136/bmj.c1127 . PMID   20395277. Archived from the original on 18 April 2010. Retrieved 3 February 2019.
  75. Brian Deer. "Response to feature Wakefield's 'autistic enterocolitis' under the microscope from ESPGHAN". The BMJ. Archived from the original on 4 May 2010. Retrieved 8 January 2011.
  76. Deer, Brian (11 January 2011). "How the vaccine crisis was meant to make money". The BMJ. 342 (jan11 4): c5258. doi:10.1136/bmj.c5258. PMID   21224310. S2CID   37724643. Archived from the original on 26 December 2019. Retrieved 3 February 2019.
  77. "Vaccine study's author held related patent, medical journal reports". CNN. 11 January 2011. Archived from the original on 27 January 2019. Retrieved 12 January 2011.
  78. 1 2 Russell, Peter (11 January 2011). "MMR Doctor 'Planned to Make Millions,' Journal Claims". WebMD Health News. Archived from the original on 15 January 2011. Retrieved 12 January 2011.
  79. Deer, Brian (2011). "Pathology reports solve 'new bowel disease' riddle". The BMJ. 343 (nov11): c6823. doi: 10.1136/bmj.d6823 . PMID   22077090. Archived from the original on 28 April 2019. Retrieved 12 August 2021.
  80. Deer (2020), pp. 279–82.
  81. Flaherty, Dennis K. (13 September 2011). "The vaccine-autism connection: a public health crisis caused by unethical medical practices and fraudulent science". The Annals of Pharmacotherapy. 45 (10): 1302–1304. doi:10.1345/aph.1Q318. ISSN   1542-6270. PMID   21917556. S2CID   39479569.
  82. Hussain, Azhar; Ali, Syed; Ahmed, Madiha; Hussain, Sheharyar (2018). "The Anti-vaccination Movement: A Regression in Modern Medicine". Cureus. 10 (7): e2919. doi: 10.7759/cureus.2919 . ISSN   2168-8184. PMC   6122668 . PMID   30186724.
  83. Gross, Liza (26 May 2009). "A Broken Trust: Lessons from the Vaccine–Autism Wars". PLOS Biology. 7 (5): e1000114. doi: 10.1371/journal.pbio.1000114 . ISSN   1544-9173. PMC   2682483 . PMID   19478850.
  84. McIntyre P, Leask J (2008). "Improving uptake of MMR vaccine". The BMJ. 336 (7647): 729–30. doi:10.1136/bmj.39503.508484.80. PMC   2287215 . PMID   18309963.
  85. Pepys MB (2007). "Science and serendipity". Clinical Medicine. 7 (6): 562–78. doi:10.7861/clinmedicine.7-6-562. PMC   4954362 . PMID   18193704.
  86. Di Pietrantonj, Carlo; Rivetti, Alessandro; Marchione, Pasquale; Debalini, Maria Grazia; Demicheli, Vittorio (20 April 2020). "Vaccines for measles, mumps, rubella, and varicella in children". The Cochrane Database of Systematic Reviews. 4 (4): CD004407. doi:10.1002/14651858.CD004407.pub4. ISSN   1469-493X. PMC   7169657 . PMID   32309885.
  87. Gever, John (5 January 2011). "BMJ Lifts Curtain on MMR-Autism Fraud". MedPage Today. Archived from the original on 14 May 2019. Retrieved 8 January 2011.
  88. Godlee F (January 2011). "The fraud behind the MMR scare". The BMJ. 342 (jan06 1): d22. doi:10.1136/bmj.d22. S2CID   73020733. Archived from the original on 13 June 2019. Retrieved 3 February 2019.
  89. Deer, Brian (6 January 2011). "Brian Deer: Piltdown medicine: The missing link between MMR and autism". BMJ Group Blogs. Archived from the original on 9 January 2011. Retrieved 8 January 2011.
  90. "Link between MMR Vaccines and Autism conclusively broken". IB Times . 7 January 2011. Archived from the original on 6 April 2012. Retrieved 8 January 2011.
  91. Broyd, Nicky (6 January 2011). "BMJ Declares Vaccine-Autism Study 'an Elaborate Fraud', 1998 Lancet Study Not Bad Science but Deliberate Fraud, Claims Journal". WebMD Health News. Archived from the original on 31 March 2019. Retrieved 8 January 2011.
  92. [88] [89] [90] [91] [92]
  93. Poland GA, Jacobson RM (13 January 2011). "The Age-Old Struggle against the Antivaccinationists". The New England Journal of Medicine. 364 (2): 97–9. doi:10.1056/NEJMp1010594. PMID   21226573. S2CID   39229852.
  94. Jasek, Marissa (6 January 2011). "Healthwatch: Disputed autism study sparks debate about vaccines". WWAY Newschannel 3. Archived from the original on 24 July 2011. Retrieved 7 January 2011.
  95. Steinmetz, Peter N. (November–December 2020). "The Scientific Frauds Underlying the False MMR Vaccine–Autism Link". Skeptical Inquirer . Amherst, New York: Center for Inquiry. Archived from the original on 8 August 2021. Retrieved 8 August 2021.
  96. "Statement From Dr. Andrew Wakefield: No Fraud. No Hoax. No Profit Motive". PharmaLive.com (Press release). PRNewswire. 13 January 2011. Archived from the original on 17 January 2011. Retrieved 13 January 2011.
  97. Godlee, Fiona (7 February 2011). "BMJ replies to emails". BMJ. London, UK. Archived from the original on 28 September 2011. Retrieved 12 April 2011.
  98. Ziv, Stav (10 February 2015). "Andrew Wakefield, Father of the Anti-Vaccine Movement, Responds to the Current Measles Outbreak for the First Time". Newsweek . Archived from the original on 31 July 2017. Retrieved 17 February 2015.