Unwell: The Argument Against Wakefield

The following article is the full response to a news item published in The Vue Weekly out of Edmonton a week ago, available here. An abridged version of the letter was published in The Vue on March 18, 2010, but here is the complete response from the Committee for the Advancement of Scientific Skepticism at the Centre for Inquiry Canada.

In Connie Howard’s article, Well, Well, Well: Wakefield Questions in The Vue Weekly on March 11 2010, Ms. Howard tries to explain the facts as she sees them concerning the retraction of the 1998 study published in the British medical journal The Lancet by Andrew Wakefield. We at the Committee for the Advancement of Scientific Skepticism (CASS) for the Centre for Inquiry feel she fails to make a convincing argument of a persecuted scientist being silenced by a conspiracy of big business interests. Instead, she sets up a series of straw man arguments that reflect poorly the true harm done by Mr. Wakefield, the media who reported the study, and the many, misguided anti-vaccination groups that have sprung up since then.

We are glad that Ms. Howard contacted Mr. Wakefield directly, but we would have asked different questions of him. Her first assertion that Wakefield failed to collect on the money owed him by a consortium of lawyers attempting to sue the manufacturers of the MMR vaccine fails to get to the essential conflict of interest: that Wakefield was promised money to prove the MMR vaccine unsafe. Even more distressing is Wakefield’s misleading assertion that he was not producing an actual vaccine that rivaled the MMR. As reported by Channel 4 and Sunday Times reporter Brian Deer, the patent application that Wakefield wrote on behalf of the Royal Free Hospital School of Medicine describes “…a new vaccine for the elimination of MMR and to a pharmaceutical or therapeutic composition for the elimination of inflammatory bowel disease…” Despite his attempt to re-write his own history, Wakefield had a large conflict of interest prior to publishing this study (the patent was filed in June 1997.)

Ms. Howard is correct in asserting that Wakefield was not single-handedly responsible for the reduction in MMR vaccination and the subsequent outbreaks in mumps and measles seen in the UK and in North America. His paper was picked up by the British media and uncritically announced as proof that the MMR was harming children. When Wakefield’s assertions were later found to be unsupportable and other groups failed to find any link between MMR and chronic illness, the media ignored the story and perpetuated the myth.

What is most distressing is Ms. Howard’s argument that measles is not all that bad and her implication that vaccines are not necessary. Her data concerning measles mortality contradicts actual scientific studies on the topic. Up to 10% of children with measles die in communities with poor nutrition or health care. According to the World Health Organization, measles caused 874 000 deaths a year as recently as the year 2000. As well, death is not the only complication of measles; it can lead to dangerous encephalopathy, or swelling of the brain, cause life-threatening pneumonia, and increase susceptibility to secondary infections. In 2007, 197 000 children died from a measles infection worldwide. This decline in measles infection is due to better vaccine coverage: measles is a dangerous disease and children should not be made to suffer it.

Ms. Howard’s comment on how science works is only half true. Many hypotheses that are put forward and studied turn out to be scientific dead ends, but the questions they ask are often important. Wakefield’s assertion, however, that the children had a history of inflammatory bowel disease was false: it was not a part of their previous medical records, and yet Wakefield, who made this assertion in his paper, sedated these children and performed a colonoscopy on them. Passing a camera through the anus and deep into the bowel of these children who had no prior history of IBD was not approved by the ethics board, and would not have been had he thought to ask them. This is not how science works, and is very unethical indeed.

The idea that The Lancet retracted the paper due to pressure from big business does not hold any water either. I will take Ms. Howard at her word when she makes connections between the CEO of The Lancet and the board of directors for GlaxoSmithKline, the makers of the vaccine in Europe. However, if the company had wanted to quash the publication of the paper due to some threat to its business, you would think they would have never allowed the paper to be published in the first place! This is not what happened and it took years of pressure and the finding of the General Medical Council for The Lancet to retract the paper.

The skeptical community has been maligned for supporting what appear to be positions that back big business and so-called “Big Pharma”. The truth, however, is very simple: we look to the data. The storm of controversy over the MMR and other vaccines was put to the test by other labs and researchers and there was found to be no link between this or any other vaccine and autism or IBD. Vaccines are among the most tested and safest therapies for disease prevention known to human kind, and manufacturing and perpetuating the fallacy that vaccines are dangerous has a cost: it harms children. That should be a sobering message for us all.

by Michael Kruse, on behalf of the Committee for the Advancement of Scientific Skepticism for the Centre for Inquiry – Canada.

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  • Michael Kruse

    Michael is an advanced-care paramedic in York Region, just north of Toronto, Ontario. A semi-retired theatrical lighting designer as well, he re-trained in 2005 as an EMT-PS at the University of Iowa and as an ACP at Durham College, and is currently working towards a B.Sc at the University of Toronto. Michael is a founder and the chair of the board of directors of Bad Science Watch. He is also the recipient of the first annual Barry Beyerstein Award for Skepticism. Follow Michael on twitter @anxiousmedic. Michael's musings are his own and do not necessarily represent those of his employer or Bad Science Watch.