Ask HN: What really happened with Andrew Wakefield? • Hacker News Board

Post by thediff » Tue, Oct 03, 2017, 2:39 AM UTC

Yesterday I went to watch a movie called The Pathological Optimist. It's Dr. Andrew Wakefield's side of the story about what happened with the 1998 paper he published that reported cases of the MMR vaccine leading to autism.

Some parents noticed that after giving their child the MMR vaccine the child developed autism. This came out in a paper and lead to over 100 failed attempts to replicate this study. Eventually Wakefield was accused of fraud, stripped his medical license in the UK, and the paper got retracted. A legal process went on and on until (iirc) 2010.

On one side scientists couldn't reproduce the study. On the other parents had a kid that was ok before the MMR and now has autism.

This seems to me like a very strange data point, and strange data are the most interesting data. Wakefield believes there is a link between the MMR and autism, but there isn't scientific data to support it. Except parents. As if some truth is revealed only to humans and can't be reproduced in the lab.

There is some speculation of a coverup from the pharmaceutical companies around the dangers of the MMR vaccine (e.g using placebos that contained aluminum, so the placebo behaved like the vaccine). And there are data that show an increase in autism since the MMR was introduced. But the main thing here isn't (so much) the coverup.

In short, why is this data point neglected? If true, it's increasing autism! Why did a scientist who tried to help, acted ethically and disclosed his data, ended up having his career end?

Fake news is one thing. But is this a new phenomenon where we should also worry about disclosing data that are hard to get?

*btw: Wakefield's recommendation isn't to end the vaccine, but to give each one separately, ideally one year apart.

Post by ineedasername » Tue, Oct 03, 2017, 3:02 AM UTC

It does not take a significant amount of research to determine the above characterization of Wakefield's actions are, at best naively optimistic about either his competency, his ethics, or both.

The publicly available and extensively detailed [1] findings of the review board that rescinded his license show with little room for interpretation an impressive list of conflicts of interest, improper treatment of patients, poorly conducted research, and fraudulent activities.

Also extensively researched was the journalism efforts of Brian Deer [2], which uncovered an impressive level of data fraud. His work is worth reading, but in the interest of brevity I will quote the abbreviated synopsis found in Mr. Wakefield's wikipedia entry [3]:

The paper in The Lancet was a case series of 12 child patients; it reported a proposed "new syndrome" of enterocolitis and regressive autism and associated this with MMR as an "apparent precipitating event." But in fact:

1. Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism;

2. Despite the paper claiming that all 12 children were "previously normal", five had documented pre-existing developmental concerns;

3. Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination;

4. In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school "research review" to "non-specific colitis";

5. The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations—all giving times to onset of problems in months—helped to create the appearance of a 14 day temporal link;

[1] http://briandeer.com/solved/gmc-charge-sheet.pdf

[2] http://www.bmj.com/content/342/bmj.c5347.full

[3] https://en.wikipedia.org/wiki/Andrew_Wakefield