Readers may remember a couple posts I wrote last year discussing the British Medical Journal’s retraction of the famous 1990’s study that linked the MMR vaccine to autism. Last May, the same British doctor lost his license, and this month the same journal is publishing a series of investigative articles which highlight how that study wasn’t simply incompetent but actually was an “elaborate fraud”, with data altered to fit the erroneous findings. It was also discovered that the author, Dr Wakefield, was secretly paid by a legal team that was preparing lawsuits against vaccine companies. Here’s a description of the paper’s major fraud from an NPR article:

Where did the paper go wrong? (Reporter Brian) Deer counts the ways after scouring health records and interviewing the patients families and various doctors. A few of the lowlights:

• Only 1 of 9 kids said to have regressive autism clearly had it. Three had no form of autism.
• Contrary to the paper’s assertion that all the kids were normal before vaccination, five had some sort of preexisting developmental problems.
• Behavioral problems the paper said popped up days after vaccination didn’t actually appear for months in some kids, a fact that undercuts the causality of vaccination.

I mention all this because, as a community health & family doctor, I believe that vaccines are essential to a child’s health, and I think this one fraudulent study by one bad doctor has caused incalculable damage to the vaccine system worldwide. Dr Wakefield has single-handedly scared off hundreds of  thousands of well-meaning parents from getting their children vaccinated, and since its original publication in the late 1990’s the rates of measles and mumps infections have rebounded. Many children have become ill — and yes, even died — from these easily preventable illnesses.

I personally feel that parents should be furious at Dr Wakefield for misleading them. I especially feel that parents of autistic children should be even more angry at him for falsely distracting them from legitimate research on potential causes of autism. The journal editors put it nicely:

“Perhaps as important as the scare’s effect on infectious disease is the energy, emotion, and money that have been diverted away from efforts to understand the real cause of autism and how to help children and families who live with it.”

Here’s another nice quote from a parent with an autistic son,  from a CNN article:

Stuart Duncan, a father who blogs about his son’s autism, said he understands why many cling to the discredited hypothesis, although no other research has reproduced Wakefield’s results.

“I feel bad for the parents who for a while have a normal child, who hugs and speaks and then shortly after they turn 2, they lose all words and no longer look them in the eye. I would look for someone to blame too. If they had just gotten vaccines, I would be pretty angry too.

“No news story is going to convince them of anything. When you have that much anger and frustration, it’s passion. They’re fighting for their children.”

For more official views, here’s a blurb from the journal editors:

The Office of Research Integrity in the United States defines fraud as fabrication, falsification, or plagiarism. Mr Deer unearthed clear evidence of falsification. He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal.

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.