Showing posts with label Wakefield. Show all posts
Showing posts with label Wakefield. Show all posts

Another anti-vax paper bites the dust

Anti-vaxxers learned a lesson from discredited, de-licensed former doctor Andrew Wakefield, who in 1998 published a badly flawed article in The Lancet pushing a link between vaccines and autism. Wakefield's study was eventually shown to be not only flawed but fraudulent, leading all of the co-authors except Wakefield himself to disavow it, and in 2010 the journal finally retracted it after Wakefield lost his medical license.

But it took The Lancet 12 years to retract the paper, and in that time the anti-vaccine movement flourished. Wakefield became a hero within that movement, and continues to push his anti-vaccine propaganda today, even making films presenting himself as a lone hero fighting for truth.

Other anti-vaxxers are very familiar with this saga, and they have followed Wakefield's recipe by writing scientific papers and attempting to get them published in reputable journals. Usually they fail, but now and then one slips through, which they then point to as "proof" that vaccines are harmful.

The latest example is a paper that appeared in Scientific Reports in November 2016 and that the journal just retracted last week. It has a title that sounds highly technical: "Murine hypothalamic destruction with vascular cell apoptosis subsequent to combined administration of human papilloma virus vaccine and pertussis toxin." (Wakefield's 1998 paper had a similarly obscure title.)

What that lengthy title hides is the paper's anti-vaccine message: that the HPV vaccine might cause neurological damage. The paper was quickly called out as pseudoscience by the scientific community, who reacted within days in the blogosphere and elsewhere, as described by a news article in Science that appeared just after the paper's publication.

(Aside: the HPV vaccine protects people from human papillomavirus, which causes many cases of cervical cancer as well as throat cancer. It's the first vaccine that prevents these cancers, which is an amazing breakthrough. Millions of doses have been administered with essentially zero cases of harm.)

What did the paper do? Basically, it was a setup. The authors–most of them from Tokyo Medical University–gave mice a huge dose of HPV vaccine plus (here's the kicker) a large dose of pertussis toxin. There's no valid reason to administer that toxin except to try to induce brain damage, which the authors could then blame on the HPV vaccine. The study design was clearly awful, and the paper should never have been published.

Just after the paper appeared, two groups of scientists wrote to the Nature publishing group (which publishes Scientific Reports) to protest, as reported in the Science story. One letter, from a group of HPV experts at the University of Antwerp, explained that:
"This experimental setup in no way mimics the immunization with HPV vaccines but is gross over-dosage and manipulation of membrane permeability."
This is putting it mildly. For a blunter assessment, see Orac's aptly titled "Torturing more mice in the name of antivaccine pseudoscience," which appeared in November 2016.

What was not publicly known before now was that I too wrote to the journal editors, asking them to "take action quickly, rather than waiting for over 10 years as The Lancet did." First I wrote to the immunology sub-editor, who forwarded my letter to the Editor-in-Chief, Richard White. Dr. White replied on 29 Nov 2016 that "We are looking into the specific issues raised regarding this paper."

That was the last I heard of it, until the journal announced last week that they have retracted the paper.

So in the end, the scientific record was corrected. But why did it take Scientific Reports 18 months to do it? Haven't they learned from the Wakefield debacle how much damage can be done while antivaccine articles like this one remain in the literature? The journal's editors had a responsibility to act more quickly, and they failed. The scientists who wrote those letters back in 2016 had the same complaint, as reported by Dennis Normile in Science last week. Not surprisingly, Scientific Reports refused to comment (when asked by Science) on any details of their review process.

That's not good enough. Scientific Reports is a "mega-journal," a new type of journal that publishes thousands of papers per year, with a relatively low bar for acceptance. The idea (not a bad one, in theory) is that any valid scientific study, even one that makes only a very small contribution, still merits publication somewhere.

What publishers have learned is that these mega-journals are very profitable, because they charge a publishing fee that more than covers their costs. In return for these profits, Nature Publishing has an obligation to remove harmful papers far faster than they did in this case. Otherwise, it's only a matter of time before anti-vaxxers do this again.

Finally, let me repeat something that can't be said often enough: vaccines are perhaps the single greatest medical advance in human history. They have saved millions of lives, and they continue to save lives today. Scourges such as smallpox and polio, which once swept through populations causing terrible pain, suffering, and death, have been conquered thanks to vaccines. Medical researchers continue to work on new vaccines against the infections that still plague us, and they are the real heroes.



Wakefield's claims about the MMR vaccine ruled "dishonest and irresponsible"

It's about time.

It took the General Medical Council (in the UK) nearly three years, but they finally issued a ruling about Andrew Wakefield's 1998 study that claimed a link between the MMR vaccine and autism. They ruled that he had acted "dishonestly and irresponsibly" in his research, and further that he didn't have the qualifications to be carrying out some of the experiments on children that he subjected them to. These experiments included colonoscopies and lumbar punctures, potentially dangerous and painful procedures. They also ruled that he behaved unethically when he paid the children £5 for their blood samples at his son's birthday party. (No, I'm not making this up.) He also filed for a patent on a "safer" vaccine that he was hoping to sell after he discredited the MMR vaccine. The GMC found all these behaviors amounted to "serious professional misconduct."

I've been writing about Wakefield's fraudulent for several years now, including posts last month, April 2009, April 2008, March 2008, and earlier. Many other scientists have written about him too, revealing that he was paid large sums of money by a lawyers' group for his research (which he failed to reveal to his collaborators or to the Lancet, where he published his work - another ethics breach pointed out by the MRC).

What's so awful about Wakefield's behavior is that it has directly contributed to a decline in vaccination rates, first in the UK and then in the US and elsewhere. A rise in measles cases - including a number of fatalities - can be directly attributed to this decline, as the BBC pointed out and illustrated with this figure:But it's not just measles: the anti-vaccine hysteria that Wakefield has encouraged over the years - and he's still at it - has also resulted in declining rates of vaccination for other childhood diseases, as I explained in my December 2009 post.

Meanwhile, scientists have conducted dozens of studies involving over one million people, searching for a link between vaccines and autism. No such link was found, because it doesn't exist. The Institute of Medicine conducted 8 studies and concluded after exhaustive research that vaccines had no link to autism. Despite this, Wakefield remains defiant and continues to claim that vaccines cause autism, despite the thorough discrediting of his 1998 study, which only involved 12 hand-picked children.

How did he respond today? He's still defiant: in an interview outside the hearing room, he said the charges were "unfounded and unjust" and then he proceeded to thank "the parents" who have supported him. And they have! As reported in The Times of London, he now pays himself a salary of $270,000 from his nonprofit corporation, Thoughtful House, which is supported mostly by donations. He lives in a wealthy suburb of Austin, Texas. And over at his TH website, he's posted a statement that repeats his claims that this is unfair, and that he is "dedicated to the recovery of these children." The statement goes on to warn about the possible link between MMR vaccines and autism. Wakefield really has no shame.

So finally the GMC did the right thing. But they acted far too late to prevent the damage caused by Wakefield's fraudulent study. I can only hope that their official action now will change the minds of at least a few of Wakefield's misguided supporters.

References (because I often get asked)
There are many studies showing that vaccines are safe and that there is no link to autism. The first one below is one of the largest, involving over 537,000 children (compared to just 12 in Wakefield's original study):
K. Madsen et al., A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism, New England Journal of Medicine, 347:1477-1482 (November 7, 2002).
In this study, the vaccinated children were slightly LESS LIKELY to become autistic. The authors' own conclusion is "This study provides strong evidence against the hypothesis that MMR vaccination causes autism."

Farrington CP, Miller E, Taylor B (2001) MMR and autism: further evidence against a causal association. Vaccine 19: 3632–3635.

Fombonne E, Chakrabarti S (2001) No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics 108: E58.

Fombonne et al (2006) Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations. Pediatrics 118: e139–150.

Honda H, Shimizu Y, Rutter M (2005) No effect of MMR withdrawal on the incidence of autism: a total population study. J Child Psychol Psychiatry 46: 572–579.

Kaye JA, et al (2001) Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. BMJ 322: 460–463.

Lingam R, et al. (2003) Prevalence of autism and parentally reported triggers in a north east London population. Arch Dis Child 88: 666–670.

Makela A, Nuorti JP, Peltola H (2002) Neurologic disorders after measles-mumps-rubella vaccination. Pediatrics 110: 957–963.

Patja A, et al. (2000) Serious adverse events after measles-mumps-rubella vaccination during a fourteen-year prospective follow-up. Pediatr Infect Dis J 19: 1127–1134.

Peltola H, et al. (1998) No evidence for measles, mumps, and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study. Lancet 351: 1327–1328.