Andrew Wakefield Responds to Brian Deer: Summary, “I regret nothing…Single jabs are the way ahead”

Dr Andrew Wakefield has responded to the series of claims made in Brian Deer’s Sunday Times‘s articles: Andrew Wakefield’s Response To Brian Deer (pdf) (also now online in html). Wakefield continues to imply that any mistakes are the responsibility of his colleagues (see earlier indications of this) and his clearest message is that he regrets nothing:

There was and continues to be every reasonable basis for suspecting a possible link between MMR vaccination and autistic regression…

Measles outbreaks are preventable, immediately, by offering to parents with entirely valid concerns about the safety of MMR vaccine, a choice of single measles vaccine; not to do so is unethical and puts the vaccine policy, “our way or no way”, before the wellbeing of children.

The Sunday Times would help us all if they would respond, provide some documents etc. that would head off any speculation because, as is all too clear, for anti-vaccinationists and their heroes their maxim is:

Doubt is our product.

No and no, Dr Wakefield. There is a good reason why no set of reputable researchers has been able to replicate your original findings. There have been many detailed explanations as to why the findings you observed were within normal scope and not indicative of gross pathology, far less a new syndrome.

As for the issue of single jabs, major charities have reviewed this issue and they have come to a very different conclusion. I would urge interested readers to download and study the Sense Position Statement on the issue of MMR because it also responds to the calls for single jabs.

An immunisation strategy can only ever be effective if there is mass uptake, meaning that choice between single vaccines and MMR cannot be part of an effective vaccination programme. One of the difficulties with MMR uptake is that, while the prevalence of measles, mumps and rubella in the UK is low, the incentive to vaccinate can appear less. From the perspective of an individual parent, the risk of their child contracting an infectious disease can seem small compared with the risk of possible (or perceived) adverse reactions to immunisation. However, this is only true if vaccination levels remain high. It is actually the counter-argument to this view that is the rationale for vaccination programmes – that the risk of vaccine damage is extremely low compared with the risk of the ill-effects of contracting the disease.

At the same time, low uptake of rubella vaccination could actually have worse consequences than no uptake. If there were no vaccination against rubella, then most people would catch rubella in childhood and would subsequently be immune. A low uptake of vaccination would mean that the virus would still be able to circulate, but that fewer children would become immune in childhood. Outbreaks of rubella would be less common than the epidemics that would occur with no vaccination, and so a cohort of unvaccinated and un-immunised children would increase each year and get older, with the burden of the disease shifting to those who are most at risk. Thus the impact of an outbreak in terms of congenital rubella syndrome births could be greater.

For MMR vaccination to be effective, uptake needs to be above 95%: this is why boys as well as girls need to be vaccinated. From 1970 to 1988, schoolgirls were vaccinated against rubella, and this did have some success in reducing the number of rubella births. However, the real breakthrough came in 1988 when MMR was introduced for all children. This reduced rubella births by a further 90% – there were 447 congenital rubella births between 1971 and 1980 and 38 between 1991 and 2000…

Thanks to vaccination, rubella damage is now rare. However, this means that many people do not realise how dangerous rubella can be. In the United States, people from the Amish community have exercised their right for their children not to be immunised against rubella. As a result, in 1995, one baby in 50 born to Amish parents was born severely rubella damaged…

It has been be argued that even if the Government believes MMR to be safe, they should provide single vaccines as an alternative because then more children would be vaccinated. However, there is absolutely no evidence to support the suggestion that allowing single vaccines would lead to a greater uptake of MMR, and a significant amount of evidence to show that it would have the opposite effect. Single vaccines would be less effective than MMR and there is no evidence that they would be safer. Sense believes that it is unethical to promote six invasive procedures instead of two without sound scientific support, and when there is evidence that such a strategy would have negative effects. [They then give their reasons and some very good, supportive figures.]…

parents may opt not to vaccinate their children, particularly their sons, against rubella. This would lead to increased risk to pregnant women. Unvaccinated boys can catch rubella and go on to infect pregnant women, including their own mothers. This is exactly what happened before MMR was introduced….

[Reprise of what happened the last time single vaccines were offered because of a (groundless) vaccine scare.] In the 1970s, following a decrease in uptake of the diphtheria, tetanus and pertussis (DTP) vaccine, single vaccines for pertussis (whooping cough) were offered, with diphtheria and tetanus vaccines given separately. What happened was that over half of parents chose to vaccinate their children without the pertussis component. Coverage fell from 80% to 30%, there were three epidemics of pertussis, thousands of hospital admissions and around a hundred deaths. It took nearly fifteen years for vaccine uptake levels to recover…

[Sense list of recommendations] The Government should continue to offer MMR and should not make single vaccines available as an alternative.

This is an eminently sensible position. <a href=”AP Gaylard lists some additional literature on this topic that is worth reading.

For readers concerned about the safety of MMR, AP Gaylard has usefully produced a table of what Dr Paul Offit styles as “Studies exonerating MMR”, drawn from Offit’s book, Autism’s False Prophets (Gaylard has thoughtfully provided the full references and links to online content, where available.)

Touching on the myth of “measles is a trivial illness” – no, it isn’t. Once more and with feeling, it isn’t. Just to emphasise this point, look through Dr Aust’s post: Measles: Spot the Worrying Trend with its remarkable illustrations of the chilling billboard advertisements in Germany that advise the uptake of vaccinations and warn of the potential consequences of preventable childhood illnesses. Martin Robbins of The Lay Scientist also provides a comprehensive run through of why Measles is dangerous.

Just to emphasise the message that the word childhood is not a synonym for trivial, I would direct interested readers to The Expert on Measles, Dr Diane Griffin. Dr Griffin is the editor of the definitive Field’s Virology and her status is such that she has contributed the chapter on measles for the last 3 editions. She gave testimony at the Autism Omnibus Hearings in the US. She details the remarkable immunosuppressant effects of the measles virus (see pg. 2738 onwards, Day 11 Autism Omnibus Hearings pdf). It seems that measles not only challenges the immune system itself, it suppresses response to other challenges so most deaths from measles are related to secondary infections.

So there is a period of time which is initiated during this acute phase that children are more susceptible to other infectious diseases. So this is a very clinically important complication or outcome or by-product of measles and all of the data suggests that it’s clinically related, as I say paradoxically, to the fact that the immune system is so activated and so engaged in making a response to measles that it is not appropriately positioned to respond to some new challenge that comes along at this same time… [pg. 2768]…
So a number of viruses that are particularly pathogenic, actually, have figured out how to block the interferon response in order to have a better chance of really causing a more severe disease. And wild-type measles seems to be among those viruses that can do that…[pg 2772]
We forget in the US what a serious disease [measles] was and why it was such an early target for the development of a vaccine, because the [mortality] is substantial. And the mortality is substantial, even in developed countries. It’s less in developed countries but it’s substantial. And if everyone gets it, that’s a lot. [pg. 2797]

Even Andrew Wakefield is prepared to adopt a public stance of advocating vaccination against measles because of its acknowledged impacts and common sequelae.

Even Former Visiting Professor Patrick Holford is prepared to lend lip-service to the need for measles vaccination although strongly hinting that all any child needs is a strong immune system and vitamin A.

Updates and Related Reading

DeeTee has some useful comments about Wakefield’s Response to Brian Deer.

Dr Dave Gorski has written up a magisterial account both of the Deer revelations and the findings from the Autism Omnibus: 2009: Shaping up to be a really bad year for antivaccinationists.

BPSDB

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16 Comments

Filed under Andrew Wakefield, autism, measles, MMR, patrick holford, vaccination, vaccines

16 responses to “Andrew Wakefield Responds to Brian Deer: Summary, “I regret nothing…Single jabs are the way ahead”

  1. Did you spot that Wakers is now citing the “Cry Shame” website as a reliable source of information about what has been going on at the GMC hearings? It is footnote / reference 6 in Wakers’ response.

  2. Yes. I hid my head in shame for him. As much as Andrew Wakefield irritates me I couldn’t mention the horrible fact that he mentioned Cry Shame but it is as well that someone did as it indicates his desperation to find any source that will echo-chamber or amplify him, no matter how questionable.

  3. Pingback: Brian Deer Discusses Andrew Wakefield in the Sunday Times: Many Updates « Holford Watch: Patrick Holford, nutritionism and bad science

  4. Pingback: Jeni Barnett and the LBC Radio MMR Vaccine Segment: Updated with links of blog coverage « Holford Watch: Patrick Holford, nutritionism and bad science

  5. This will get anyone directly through to my list of studies listed by Offit. It’ll save anyone the bother of working through the rest of the post.

    Admin edit: thank you, link inserted into main post.

  6. The NHS also provides several useful factsheets that illustrate why Wakefield is so very wrong about single vaccines:
    MMR, single vaccines and choice
    MMR Factsheet 3 – see pages 4 and 5.

    The reference (in the first document) to the unfounded concerns over the pertussis vaccine in the 1970s and 1980s is telling: the NHS provided the option of not taking the pertussis component; coverage fell to 30% and, “Hundreds of thousands of children caught whooping cough in the course of three epidemics, many thousands were admitted to hospital, and around 100 died. We must not repeat that experience with the MMR vaccine.” [emphasis mine]

    It seems that Wakefield and his acolytes are not thinking very clearly about this recent historical lesson, among many other things.

    Admin edit: that is probably where Sense obtained their figures – thank you for this.

    Those figures are so compelling that it is hard to understand that Wakefield and his fellow travellers don’t view them the same way.

  7. Pedant

    “Brain Deer”?

    Admin edit: if anyone doesn’t get this, check the opening strap for the Wakefield letter. :-)

  8. Pingback: Jeni Barnett and the Missing Blog Posts About MMR Segment on LBC Radio « Holford Watch: Patrick Holford, nutritionism and bad science

  9. Pingback: Jeni Barnett, LBC and Global Radio, MMR Segment 7 Jan 2009 and the Ben Goldacre Coverage: Part 2 « Holford Watch: Patrick Holford, nutritionism and bad science

  10. Lizzie

    I accept that truly great people usually say that they only achieved what they did through complete self-belief. Wakefield convinced himself and others (including me) that he is a great man. I suppose it’s what sceptics usually call the Gallileo Gambit.

    I read somewhere that one of the experts in the vaccine court hearings said that people like Wakefield had convinced parents that the sun moves around the earth.

    It seems that nothing will make him change his opinion of himself.

    I still can’t believe I feel for it. I know lots of people will see the latest rulings as a cover-up but when you read these things in black and white it exposes them.

  11. I think one of Wakefield’s greatest misdeeds is the extent to which he mislead the parents. I know that one can argue that his bomb-proof self-belief means that he was totally sincere throughout, but….

    – had the parents been told about his previous track record in trying to claim MMR caused another disease, and that that theory had been comprehensively rubbished, and indeed quietly dumped by the man himself;
    – had they known about the patent applications and that Wakefield stood to make a lot of money out of proving the theory;
    – had they really known he was not in any way properly qualified to give them paediatric medical advice;
    – had they been clearly told that he and his views were “well outside the mainstream” and got the opposing view from someone else better qualified in paediatric gastroenterology…

    Anyway, I am sure it wouldn’t have made any difference to some of the parents, possibly most of them, but it might have spared a few. How much time, energy and “emotional capital” have they invested in this doomed crusade?

    It has always been relatively easy for scientists and other doctors to see through Wakefield. Doctors know that bad doctors exist, because they’ve seen them at work, and scientists know that bad scientists do, ditto. The overwhelming consensus in the trade since very early on has been:

    “A bloke who wouldn’t let inconvenient facts get in the way of his messianic belief in his right-ness, even to the extent of finagling the data”.

    Nick Chadwick’s revelations really just confirmed what everyone already suspected, which is why the new stuff, if confirmed, will come as no great surprise except as demonstrating the extent and long-standing nature of it all.

  12. Pingback: Patrick Holford on Andrew Wakefield: He Needs to Issue an Update « Holford Watch: Patrick Holford, nutritionism and bad science

  13. zack

    You know, as long as he sticks to that line it will probably work for him.

    Conned people don’t want to believe that they are conned. They will go to absurd lengths to defend him even if it does make them look ridiculous.

    • I came across a good comment somewhere along the lines that if Bernie Madoff hadn’t confessed, the clients he had duped would be lining up to say that he was being persecuted by the authorities for being too successful.

      Even if Andrew Wakefield put up his hands and confessed, there would be all sorts of conspiracy theories about his family being got at or kidnapped or such.

      It happened during the Autism Omnibus Proceedings, one of the Petitioners’ ‘expert witnesses’ was so bad that leading anti-vax figure, Sherri Tenpenny was forced to spin a remarkable theory.

      Ya have to wonder if someone got to her or threatened her kids by her response. Absolutely unbelievable and I would suspect was really unexpected by the Chin-Conway team or they wouldn’t have put her on the stand. [NB Chin-Conway were the legal team for the petitioners.]

      So, there is a precedent.

      • Wulfstan

        His upcoming book (A Lesser Truth – why equivocate, why not call it, My Life and Times – nothing like the truth: a self-justification)) will probably contain lots of references to alleged burglaries, like that ridiculous teenage-starstruck-fan piece by Ruth Picardie who was so taken with Andy’s glossy hair and his lovely, likeable family.

        You’re right. Even if Wakefield did a Madoff, his loyalest supporters wouldn’t believe it. If they accepted his family was not sequestered or under threat, they’d probably claim Wakefield had been given an umbrella full of MMR and mysterious forces are now controlling his brain and forcing him to say these things.

  14. jaws

    Single vaccines are the way ahead if you are the doctor looking to make money out of giving them and can not be held liable for any outbreaks if people don’t follow through on an immunization schedule.

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