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How not to do science
In 1998, the medical journal The Lancet published a paper written by, among others, Dr Andrew Wakefield. This paper suggested a connection between the MMR vaccine and bowel disorders and between bowel disorders and autism. The same issue of the journal contained a paper which used epidemiological data to refute any causal link between the vaccine and autism, but this did not stop Dr Wakefield becoming an instant hero of the anti-vaccination movement. The science in the paper was always suspect, simply because it looked like Wakefield had cherry-picked the subjects of his research. There were only 12 subjects in total, and nine of them were autistic. It looked like Wakefield was working backwards from autism to MMR in order to find what he wanted to find, but nothing could be proved because the paper said that the subjects were a sequential group of children who had presented at a hospital. In English, the word "sequential" suggests that they arrived in that order without any intervening patients.
The Lancet is now saying that it wished it had not published the paper, and is saying that it would never have published if it had known the truth about funding for the research, the subject selection and Dr Wakefield's conflict of interest. In March 2004 ten of the paper's original 13 authors issued a statement saying that the paper was not evidence of a connection between MMR vaccine and autism. We now know that some of the subjects were not randomly selected but were supplied to Dr Wakefield by a firm of lawyers acting for the parents. These parents were convinced that their children had become autistic as a result of vaccination and were getting ready to sue the pharmaceutical companies who had made the vaccines. Dr Wakefield was paid £55,000 for his work and was going to receive more payments as an expert witness when the lawyers got into court against the vaccine manufacturers. Put bluntly, Wakefield was paid to find a certain result (which matched his beliefs anyway) and was going to get a lot more money if he found it.
One immediate result of the publication of the paper was a demand that parents be allowed to have their children vaccinated for measles, mumps and rubella as separate injections rather than in a single shot. While this may sound reasonable, it was promoted by people who are committed to the idea that all vaccinations are at best useless and at worst extremely dangerous. The real agenda was to increase the number of doctor's visits necessary for a full vaccination program, therefore reducing the probability that children would receive the full schedule of shots. Dr Wakefield has said that he is not opposed to vaccination and only wants the procedure to be safe, but all the anti-vaccination campaigners say that. He recently spoke (to a standing ovation) at a conference run by America's leading anti-vaccination organisation, the National Vaccine Information Center, about his ongoing research. I watched his speech live on the Internet but I had to turn it off when he said that one of the subjects in his current project was not autistic – yet. He included the child in the autistic group because the child had been vaccinated and was therefore probably going to be autistic soon. This is supposed to be science.
It may surprise rational people to find that there is an organised opposition to vaccination. The campaigners all claim that they are not opposed to vaccination per se but just want it to be safe. Perfectly safe. With no possibility of any adverse reaction at all to any vaccine, where "adverse reaction" includes crying after the shot. You may think that I am making this up, but I have spent some time dealing with these people and about the most polite thing I could say is that some of them seem to be insane. I have been told that measles is "benign" and less harmful to a child than a hangnail. (Measles kills 745,000 children each year around the world and is the leading cause of infant blindness in developing countries.) I have been told that all cases of shaken baby syndrome are actually adverse vaccine reactions and I have been challenged to produce scientific evidence from trials and experiments to show that children can be harmed in any way by shaking. I have been told that the World Health Organisation and the Save The Children Fund are maintaining a policy of genocide in Africa where they are using vaccines to deliberately kill children.
An article of faith for the anti-vaccinators is that vaccination causes autism. The reality is that autism is usually detected at about the age when children are receiving certain shots, and several epidemiological studies involving millions of children (Finland, Denmark, California) have demonstrated no link. It has been blamed on the mercury in the preservative used in vaccines in the past, but MMR has never contained this preservative (although at least once a month I am told that it has). Dr Wakefield's "research" provided another chance for the anti-vaccination campaigners to frighten parents away from protecting their children against preventable diseases. It was never science; it was always propaganda.
This article was published as the Naked Skeptic column in the April 2004 edition of Australasian Science
Update: In January 2010 Dr Wakefield was found by the UK General Medical Council to have behaved unethically while conducting his "research". The Lancet subsequently retracted Wakefield's 1998 paper. It is a pity that it took 12 years and several children dead from measles as a result of Wakefield's behaviour before corrective action was taken.
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