Field of Science

Autism's false theories

The St. Petersburg (Florida) Times last week ran a feature story on the controversy surrounding autism and vaccines. I’ve written about this before and you can found many blogs and websites devoted entirely to autism - some good, some bad. The “controversy” is due to some people’s belief that autism is caused by the measles, mumps, and rubella (MMR) vaccine, which was first proposed in a 1998 article – later revealed to contain fraudulent data – by by Andrew Wakefield and colleagues. (10 of Wakefield’s 12 co-authors retracted their findings and repudiated the study.)

The St. Pete Times article does a better-than-average job at presenting the issue, although its title - “Debate rages over need for vaccines” – is very misleading, and I worry that the title alone will make some parents withhold vaccines from their children. But if you read the article, the reporter (Lisa Greene) does point out clearly that:
“Since then, the study [by Wakefield and colleagues] has been harshly criticized. Most of the researchers involved have retracted their results. In September, researchers who conducted a similar study said they found no link between measles virus and autism.”
Vaccines do not cause autism. After >20 studies, some of them quite large, there is no serious scientific debate over this question. But Greene makes an interesting point when she writes: “This is no longer principally a debate about science. The real question is whether Americans still believe in science — or at least, in the nation's scientists.”

That’s a good question. The anti-vaccine camp often uses conspiracy-theory arguments to make their case, as in “the government is hiding the truth” or “big pharma” doesn’t want us to know that vaccines are harmful. If you want to read some really extreme conspiracy-theory arguments, just look at what Robert F. Kennedy Jr. has been saying about thimerosal and vaccines. (And it worries me that his name is being floated for possible high-level positions in the Obama administration.) These arguments are indeed an effort to convince people (not just Americans, of course) not to believe scientists, but instead to believe, well, non-scientists, who make all sorts of other claims, ranging from the merely ignorant to the outright fraudulent. These frauds include people such as Mark and David Geier, who offer testosterone-reduction and chelation drugs to autistic children and claim that these treatments work, despite evidence that they don't - and that they might even cause serious harm.

Why do people prefer to trust quacks rather than science? Neurologist and skeptic Steven Novella has one explanation: “I know that when you are a parent of a sick child the gears of science may grind maddeningly slowly” and science hasn’t yet determined the cause, or a cure, for autism. So when someone comes along, perhaps someone with seemingly respectable credentials (but not always), and says he knows the answer, parents understandably want to believe it.

The St. Pete Times article includes a very interesting set of tables and charts (as a special supplement, not in the main article, alas) with real numbers showing the dramatic reductions over the years in the prevalence of measles and other diseases as vaccines were introduced. The press rarely does enough to point out what a major public health benefit vaccines represent, so kudos to SPT for their special report. As the Vaccine Ethics site at U. Penn says, “Vaccines are credited with having saved more lives than any medical treatment ever developed.”

Note: the title of this posting is a reference to Paul Offit’s outstanding new book, Autism’s False Prophets. I highly recommend it – Offit is a terrific writer who knows the science and the history of research on autism as well as anyone I've ever read.

3 comments:

  1. Fraudulent? Isn't that just an allegation at this stage? I don't know how much of the GMC hearing is made public, but I'm not aware of him having admitted to or been found guilty of the charges (yet). Not that I'm going to defend his behaviour...

    It's interesting to contrast your take on Wakefield with this extract from Ben Goldacre's book. I agree with almost everything Ben says about the behaviour, but I can't really agree with his characterisation of Wakefield's role -- his misdemeanor, if the charges are correct, is bigger than just "speaking his mind" and "holding bad ideas".

    ReplyDelete
  2. oops -- that was meant to say "... Ben says about the behaviour of the media, but..."

    ReplyDelete
  3. Yes, Wakefield committed fraud, in several ways. (Webster's dictionary defines "fraud" as "deceit, trickery, sharp practice, or breach of confidence.")
    First, Wakefield represented the 12 children in the study as "consecutive referrals" from a unit in his own hospital. He did NOT reveal that nearly all the children were clients (through their parents) of a lawyer who was trying to build a case against vaccine makers. Quoting the statement made by the editors of The Lancet when this was revealed: "Contrary to the statement that children were 'consecutively referred' to the department of paediatric gastroenterology ... children were invited to participate in the study by Dr. Andrew Wakefield and Dr. John Walker-Smith, thus biasing the selection of children in favor of families reporting an association between their child's illness and the MMR vaccine." Thus the paper itself contains a very deceptive statement about who these children were.

    Second, Wakefield did not reveal to his co-authors or to the Lancet (the journal) that he had been receiving consulting fees from this same lawyer's group. This is a clear case of fraud, in my view - no honest scientist would do this to his co-authors (or to a journal). His co-authors retracted their findings when they found out - which wasn't until several years later. See the retraction here: Lancet retraction.

    So yes, the study was fraudulent, and Wakefield was deceptive. It's not just an interpretation - the facts here are clear. It might be that the legal system would still give one room to interpret, or to argue, about whether this is legal fraud (in the UK, or the US, or elsewhere), but I'm talking about scientific fraud. I can't imagine everything I'd do if a co-author of mine behaved as Wakefield did, but I'd certainly call it fraudulent.

    ReplyDelete

Markup Key:
- <b>bold</b> = bold
- <i>italic</i> = italic
- <a href="http://www.fieldofscience.com/">FoS</a> = FoS