The Wakefield vaccination/autism scandal

The British Medical Journal isn’t on my usual list of things to read. I came across this story about the washup of the Wakefield/autism scare. It is a dreadful story of medical fraud which resulted in real harm. I suggest you read the article in full. It is a case study for many things.
The only ones to come out of it with much credit is Brian Deer and his paper The Sunday Times, which as you will remember is owned by that evil magnate Rupert Murdoch.The Lancet, which originally published the article by Wakefield took 12 years to retract the article which was peer reviewed and carried the names of several scientists who say they “trusted” Wakefield.
In Australia there is quite a strong anti-vaccination movement which presents itself as giving “information” about vaccination, though clearly it is arousing doubt and fear among mothers. I will accept that these people are misguided rather than fraudulent. Whatever – vaccination rates here are down and infection rates for diseases up.
Correction: I said that the BMJ published the original article. It was Lancet.
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50 Responses to The Wakefield vaccination/autism scandal

  1. Judith Sloan says:

    The ACCC has been running after the Anti-Vaccination lobby here in Australia, which is a good thing.

  2. jtfsoon says:

    If there are any loony anarchist libertarians reading, prepare to be flamed …

  3. Jarrah says:

    The network effects of vaccination make it one of the few issues where I think parental choice should be overridden. My family got worried when my sister said she wasn’t going to vaccinate her baby, but we talked her around. Except for Hep B, but we let it rest there. Plenty of time for that shot before exposure to infectious bodily fluids is likely.

  4. hc says:

    The analytics are interesting. If there is the smallest probability of harm then a good choice for a parent is to not immunise and hope every other child does immunise. Then their child gets the benefit without the small risk. Its not a Prisoners Dilemma since if you assume others won’t immunise their children you should.

    Its a standard argument for opposing what Libertarians would see as ‘freedom of choice’. You make it compulsory – or impose huge costs of not immunising such as exclusion from child care – and everyone is better off even if they live with a miniscule risk.

    And the risks are very small or close to non-existent. BTW it is good to see Catallaxy promoting a non-junk science cause! (I am tempted to make a snarky remark about contrary endorsements of climate change delusionism and ‘Say’s Law’ but under your wise influence, Ken, I won’t).

  5. hc says:

    The remarks went up before I saw Jason’s comments.

  6. Infidel Tiger says:

    The analytics are interesting. If there is the smallest probability of harm then a good choice for a parent is to not immunise and hope every other child does immunise. Then their child gets the benefit without the small risk

    The parents attempting yuour “freerider” proposition should be shot in the town square.

  7. rog says:

    There are several issues here;

    1 the fraud by Wakefield

    2 the earlier discovery of unsuitable strains in the MMR vaccine.

    The Foster case has nothing to do with Wakefield – the tribunal found that there was sufficient evidence to link Foster’s condition with the MMR jab. Adverse effects from MMR jabs were previously identified and a number of vaccines were withdrawn from the market and the ensuing legal battle has made parents understandably cautious. Wakefield piggybacked his fraud onto the controversy.

  8. The BMJ, while perhaps not as slow as the Lancet, has taken its time to publish this story too. It’s been around a while.

    The anti-vaccination movement is seriously weird, ranging from the anti-technology, Gaia will protect us nutters to those who think they have a right to spread their infections to others without restriction.

    I’m dead against socialised medicine, but obligatory vaccination is consistent with liberal principles as I see it.

  9. C.L. says:

    Published in the Lancet – the ‘medical journal’ which published the now demolished George Soros-funded Iraq War death tolls – wacky claims wholly accepted by the obscurantist left, of course.

  10. Judith Sloan says:

    There is an interesting parallel with our own Dr William McBride who originally published a letter in the Lancet obsesrving a link between birth deformities and the mother having taken Thalidomide (McBride was an obstetitrician). He subsequently undertook lab based work to provide an physiological understanding of the link. All admirable stuff and he was duly rewarded/recognised.

    He then however went on to claim a link between birth defects and Debeondox (an anti-morning sickness drug) on the basis of fraudulent data. He was struck off the Medical Register, although he was subsequently reinstated.

    Interestingly, his more recent work has demonstrated the use of Thalidomide in reducing the growth of cancerous tumours.

  11. ken n says:

    Gee, I’m glad you didn’t give into temptation to make that snarky remark hc….
    I don’t think I would make immunisation compulsory. Quite a few mothers do feel strongly against it on all sort of grounds – I know some and they are quite sensible on most other things – and i don’t think the image of screaming babies being torn from their mothers’ arms by doctors would look good on the TV news.

  12. ken n says:

    Yes, Judith. Different motives, i think.
    McBride seems to have been trying to repeat his earlier triumph (as if it wasn’t enough for one career) and then, it seems, massaged the data on Debeodox when it did not turn out as expected.
    Wakefield was on the other hand motivated by the money the lawyers had paid him to find a link between vaccination and autism.
    McBride’s behavior was perhaps a bit more understandable. and it caused little harm.

  13. Infidel Tiger says:

    Quite a few mothers do feel strongly against it on all sort of grounds – I know some and they are quite sensible on most other things

    If they feel so strongly about the risks, we should sterilise them. Thereby preventing their and our risk for their idiocy.

  14. conrad says:

    “If there is the smallest probability of harm then a good choice for a parent is to not immunise and hope every other child does immunise”

    No it isn’t, it’s the probability of getting sick to a similar level from one of the diseases you wern’t immunized against minus the probability of you getting sick from the immunization. If this is greater than zero, it’s worth getting the vaccination — I think you have forgotten that simply because all other children your child is likely to encounter might be vaccinated doesn’t imply, for example, that I won’t be contagious after I come back from working in the place otherwise known as the Africa of Europe each year (Indeed, I think I’m not immunized against Rubella — perhaps I should get that). What this means is that even if there was some potential harm from the vaccine, it might still be worth taking, lest I cough on your children.

  15. jtfsoon says:

    huh? isn’t vaccination compulsory?

  16. ken n says:

    Jason – nope.

  17. jc says:

    Really? I recall they had a way around it at NYC schools. Parents of course didn’t have to vaccinate their kids but they weren’t allowed in a school. So the choice was vaccinate or home schooling.

  18. Andrew Reynolds says:

    ken n,
    Try getting your kids into Government subsidised child-care without it, though.

  19. jtfsoon says:

    so it is de facto compulsory. an exemption can be obtained but only under specific cases?

  20. Infidel Tiger says:

    The avoiders are usually eastern suburbs latte hippies who have been instructed by their yooga teacher or dog walker to give it a miss.

  21. jc says:

    More or less yea. I’m with jarrah on this. This is about the only thing I agree that ought to be as close to compulsory as possible.

    I think the American system actually sets a good balance in that you’re not forced to vaccinate the rug rats but make sure you like them at home a lot.

    Thinking out loud… if you don’t vaccinate what problems could that cause the kids that are as they’re more or less immune, no?

  22. ken n says:

    I don’t think it is even that Jason – in most schools there is pressure but no compulsion. In some areas – I think Byron Bay is one – so many do not vaccinate that schools n all have just about given up.

  23. jtfsoon says:

    Infidel
    you’re delusional if you think the eastern suburbs are full of hippies.

  24. ken n says:

    This is about the only thing I agree that ought to be as close to compulsory as possible.

    Ok I’ll go with that jc.
    They talk of herd immunity jc. A small number of non-immunized kids in a school isn’t a problem. Immunization isn’t 100% effective – for most diseases – so something approaching an epidemic would put even those who have had it at risk.

    I’m not usually in favour of government propaganda on health matter but I’d make an exception in this case. and fluoridated water.

  25. ken n says:

    Jason I understand Newtown is a non-immunized hotspot.
    Maybe Carlton in Melbourne?

  26. jtfsoon says:

    hmm i guess you could make a case that newtown is in the eastern suburbs though I’d rather think of it as inner city. I was thinking more of my area – surry hills, darlo, paddo, bondi

  27. ken n says:

    I think you can look it up somewhere Jason…

  28. jc says:

    Its a standard argument for opposing what Libertarians would see as ‘freedom of choice’. You make it compulsory – or impose huge costs of not immunising such as exclusion from child care – and everyone is better off even if they live with a miniscule risk.

    And the risks are very small or close to non-existent. BTW it is good to see Catallaxy promoting a non-junk science cause! (I am tempted to make a snarky remark about contrary endorsements of climate change delusionism and ‘Say’s Law’ but under your wise influence, Ken, I won’t).

    Nice attempt at an upper cut Harry.

    You really don’t understand libertarianism. You don’t seem to understand principles like self-harm as against doing harm or potential harm to others and the interplay in all that with regards to the state.

    Vaccination is a freaking public health issue that the government has to be involved with. Cigarette smoking like drinking a bottle of plonk each night the I way I think you’ve characterized your drinking habit is not a public health issue. It’s a private health matter.

    And as for those rejecting science… I would bet a few dollars that the anti-science anti-vaccination crowd would tend to support the Greens, which incidentally is the party you threw your support to at the las election by publicly saying so in The Oz no less. Honestly, i felt a tinge of embarrassment/sorrow for you after reading that.

    I thought how can he (Harry) go that far? Is there anything i could do to help you through that period in your life.

  29. Mt Isa Miner says:

    And the communities of Byron Bay and Coffs Harbour and Belingen hinterland also according to my GP.

  30. jc says:

    Hey Miner,

    Peter Garrett, better known as Lurch who is now in charge of schools comes from Hippie Bay (Byron Bay). i wonder where he stands on the issue of vaccination.

  31. Jarrah says:

    “I would bet a few dollars that the anti-science anti-vaccination crowd would tend to support the Greens”

    That rings true. My personal experience is that anti-vaccination people tend to be the same ones who attend the Mind Body Spirit Festival, buy the Fair Trade brand, oppose GM food, and vote Green.

  32. Judith Sloan says:

    The real danger of falling rates of vaccination is for very young babies – generally not the child who has not been vaccinated. I have recently be re-vaccinated for whooping cough because of the presence of little ones in my life – the vaccination wears off and whooping cough is now quite prevalent in the community. It was actually quite expensive but worth every cent.

    My dad, who was paediatrician, would be turning in his grave – he saw the occasional appalling outcome for children of contracting these infectious diseases, including measles, mumps, whooping cough and, of coure, in the past polio. For those scientists/doctors who developed the polio vaccine, including Salk, my dad had unbounded admiration.

  33. Infidel Tiger says:

    you’re delusional if you think the eastern suburbs are full of hippies.

    I tend to divide Sydney in two. West or east of Parramatta and all poof.

  34. Susanne says:

    Infidel Tiger has a point, the avoiders are usually alternative therapy believers, yoga devotees, or inner city latte trendies. I believe not immunising your child puts them at risk. There’s a reason western countries no longer have these diseases. I have an autistic child, one of twins, his sister is not autistic. I’ve been hearing and reading about the MMR vaccine as a possible cause for autism for years now and am not a believer. My belief is autism is a genetic predisposition, the exact gene has not been located. Scaremongering doesn’t help anyone. I fully understand parents wanting to know why this has happened to their child and look for reasons, it’s human nature, but I think they’re on the wrong track with this one.

  35. Peter says:

    Risk with vaccination works like this. If someone is vaccinated successfully, the chance of getting the disease is less. If enough of the herd is vaccinated, the chance of an non-vaccinated person catching the disease falls as obviously there is less of the disease around. Side effects of vaccination vary with the vaccine, but for any one disease may be taken as a constant. So, as the chance of getting the disease if not vaccinated falls the relative chance of side effect versus disease rises. Many side effects are trivial, some are serious.
    From a population point of view the overall risk to the population is always greater as the % vaccinated rises. To a non-vaccinated individual the value of prevention falls as herd immunity rises and so some then choose to refuse vaccination. Which then decreases herd immunity and then it is better to be vaccinated than not.
    And so, given that in Australia vaccination is not compulsory, the cycle goes round and round.

  36. amortiser says:

    ken n said:
    “McBride’s behavior was perhaps a bit more understandable. and it caused little harm”.

    Caused little harm eh? Easy to say when you don’t have a wife who has her head in a toilet bowl all morning because Debendox has been taken off the market. She is a GP and knew that it was the only effective drug to combat morning sickness.

    I drove all over Brisbane to find a Pharmacy that had stocks left and was fortunate to find one. That pharmacist was scathing about the decision to pull stocks but understood it because of the enormous costs that the Drug company would be up for with the threat of legal action.

    This sort of fraud is enormously harmful both to patients and to development of new drugs as the risks escalate.

    Severe morning sickness is no joke and causes enormous distress.

  37. ken n says:

    Yes, amortiser, there were consequences and I should not have suggested that taking the drug off the market did little harm.
    I was trying a bit too hard to contrast it to W’s fraud (which seems to have been intentional) which had very serious results from the spread of serious diseases and some deaths.
    By the same token, removal of Vioxx has caused greater pain to many – that was a decision based on apparently good research. But it was a judgment call by the regulators who themselves were not arthritis sufferers.
    Seems to me that more of these risk assessments should be made by the patients with their doctor’s advice.

  38. John H. says:

    By the same token, removal of Vioxx has caused greater pain to many – that was a decision based on apparently good research. But it was a judgment call by the regulators who themselves were not arthritis sufferers.

    Well if the prick Pharma company hadn’t suppressed data and engaged in bullshit research then perhaps the drugs may have stayed on the market. If you look at some US estimates it can range as high as 200,000 NSAID related deaths. If the research had been more honest then many of these deaths could have been prevented by simply identifying at risk individuals(cardiovascular).

    Fortunately a solution is at hand: nitric oxide donors together with NSAIDs. Problem solved.

  39. . says:

    What about anti depressants? I’ve heard some horror stories about Zoloft/Serzone.

  40. John H. says:

    Anti-depressants have an excellent safety profile(even neuroprotective which is why I enjoy the occasional low dosing of the same) but are massively over prescribed and relied on far too heavily for depression treatment.

    I’ve tried Zoloft, a disaster for me. Effexor is one antidepressant I am worried about because withdrawal can be horrific. But of course they won’t use the term “withdrawal” but rather discontinuation syndrome, a term that simply means: you have to dry out from your addiction. Zoloft also has “discontinuation syndrome” issues and has its share of horror stories.

  41. Jacques Chester says:

    I’ve been on a low dose of zoloft for years now and have the usual side-effects (insomnia, restlessness); but I wouldn’t trade it for quids. Until something better comes along I’ll stick with it.

    As an aside on the actual topic of the thread, I wrote an epidemic simulator for an honours course. It was quite interesting to see how effective vaccination could be at stopping the spread of disease out of isolated pockets.

  42. papachango says:

    I’ve got 2 kids with (thankfully mild & high functioning) autism. I normally don’t use the sort of language JC and others do, but I’ll make an exception here.

    These anti-vaccination nutcases are fucking scumbags, the lowest of the low. They infest any autism related discussion boards and harangue parents, exploiting all their feelings of anguish and concern for their childrens’ development, throwing in Bug Pharma conspiracy theories and pseudo-science.

    When you consider that the first signs of autistic behaviour are usually noticed at about 24 months, and that just happens to coincide with the MMR vaccine, it makes parents vulnerable to their bullshit. With number 2, you know what to look for and tend to notice things way before the MMR.

    Then there’s the coterie of snake-oil salesmen who promise they can ‘cure’ autism with stuff like high pressure chambers, and chelation therapy (chemicals to try and extract mercury from the body) – none of which has a single iota of scientific evidence to support it.

    The worst thing is that these fuckheads actually call themselves libertarian. They deserve to be rounded up and shot quite frankly.

  43. Steve Edney says:

    Peter Garrett, better known as Lurch who is now in charge of schools comes from Hippie Bay (Byron Bay)

    No he doesn’t. He was a Sydney North shore raised, Midnight oil were very much a sydney pub rock band on the nth beaches/ eastern suburbs.

  44. Susanne says:

    Papachango, totally agree with all your comments. My boy is at the more severe end of the spectrum and is non-verbal, the signs were there before 12 mnths old. I’ve been bombarded with all the vaccine propaganda from people for years now plus a whole heap of stuff about toxins and diets and you name it, I’ve seen it. I’m more interested in education and therapy for him not why he’s autistic, that’s not going to help me at this point.

  45. Capitalist Piggy says:

    Compulsory vaccination eh?

    Suppose a parent refuses to vaccinate their child. What are you going to do, shoot them?

  46. Duncan Spender says:

    Ken N – re your support for government propaganda re fluorideated water (comment at 5:03pm on 6 Jan), is that support in any way shaken by today’s revised recommendation by the EPA that fluoride levels should be reduced, to levels below those that we have in most Australian cities (0.7 rather than 1mg/L)?

    Hopefully all the commenters here who support propaganda and (quasi) compulsion re vaccination are nonetheless factoring in the possibility of similar future adjustments in our scientific understanding re the net benefits of the current vaccination schedule.

    A libertarian position on compulsory vaccination does not seem clear cut to me, and seems worthy of calm discussion (without being tarred with the same brush as the nutcases), eg:

    How dangerous does a virus need to be before we consider failure to vaccinate to be akin to reckless assault?

    Is there a risk of vaccination policy being based on a net benefit for a small subset of Australians, or on a net global benefit, but not on an overall net benefit for Australians?

    Is there some discomfort with compulsion in instances of net social benefits but net private costs for an individual (or is the victory of utilitarianism complete)?

    For viruses eradicated in Australia, is it at all foreseeable that the focus could shift to controlling transmission from international travel/immigration?

    Instead of blanket compulsion, is it at all foreseeable that policy could focus on (1) identification and quarantining of infected people, and/or (2) penalising actual instances of transmission in public space from an unvaccinated person to a vaccinated person, resulting in severe harm and death?

  47. Infidel Tiger says:

    Suppose a parent refuses to vaccinate their child. What are you going to do, shoot them?

    No. We’ll shoot their kids. With vaccine.

    It doesn’t need to be compulsory. It just needs to be understood that those that refuse must live outside the city walls.

  48. ken n says:

    Thanks Duncan. It seems to me that fluoridation of water has been one of the great public health successes of the last 50 years. Dental decay has been almost abolished and if there were serious deleterious effects they would have appeared by now.
    I understand the “compulsory medication” argument but in this case, it does not bother me. With other medications it probably would.
    I would not make vaccination compulsory, except perhaps in an emergency in the face of a serious epidemic. Again, it seems to me that vaccination has been a huge success. I grew up in the days when parents were terrified by the risk of polio and most knew someone who had been seriously affected by it.
    The suggestions in your last para would not have had any effect on the polio epidemic or the whooping cough epidemic, which is showing signs of coming back, apparently because of pockets on non-immunisation.

    I am not an absolute libertarian. We accept some restrictions on freedom to live in a society and, to me, the lines are not too difficult to draw. C.L. disagrees.

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