| briandeer.com | MMR: PRIVATE EYE ON THE ROPES



Heather Mills defends her credibility as Wakefield's UK MMR campaign crumbles

This page is material from the award-winning investigation by Brian Deer for The Sunday Times of London, the UK’s Channel 4 TV network and BMJ, the British Medical Journal, which exposed vaccine research fraudster Andrew Wakefield | Investigation summary

    After years of campaigning against MMR, including the production of a stand-alone supplement attacking the vaccine (far left), published in May 2002, on November 26 2004 the British magazine Private Eye adopted a new stance. First, it attacked Brian Deer, both personally and with baseless attempts to cast doubt on his investigation. Second, it claimed that it wasn't really anti-vaccine at all, but that "the jury is still out". In fact, Ms Heather Mills, author of much of the work, had nourished her recent career reheating scraps from Wakefield's strange table

As the back cover box (left) reveals, Ms Mills proudly declared that her work was based substantially on the assertions of Jackie Fletcher, Rosemary Kessick and David Thrower - all litigants in a now-failed lawsuit against vaccine manufacturers. Mills's enraged attack of November 2004 is reproduced below in
navy. Brian Deer's comments in response to the tirade are set out in tasteful maroon. There's something to be said for cutting to a brief reply, but the text below contains many new observations on the MMR scare that are well worth study by afficianados of what history may yet remember as a hollow joke


MMR: OH DEER, OH DEER

They really worked hard on this one.

The makers of Channel 4’s MMR: What The Never Told You in the Dispatches strand should perhaps have thought twice before engaging journalist Brian Deer to present a hatchet job on Dr Andrew Wakefield.

Presumably, they would have done better engaging Ms Heather Mills of Private Eye, to give Wakefield a long, slow... well, we'll leave it there.

According to Deer, Dr Wakefield, the gastroenterologist at the centre of the MMR controversy, was little more than a snake oil salesman who led a Royal Free medical school conspiracy to discredit the MMR triple vaccine and make money from a vaccine it was developing itself.

Strictly speaking, Mr Wakefield is a gut surgeon.

Deer also claimed that when Wakefield voiced his concerns about the triple jab, he had already tested for and failed to find measles in the autistic and gut-diseased children he was treating...

If “gut-disease” includes constipation, which has been reported with unusual frequency in autistic children since before MMR was ever introduced, and we are talking about molecular tests, as the programme made clear, this sentence is correct.

... and moreover that those children were abused in the name of his flawed research.

Brian Deer reported the opinion of a Royal Free consultant, who Deer had interviewed on the telephone. This was made clear in the programme.

There were plenty of other allegations thrown into the mix but those are the main ones and certainly the ones over which m’learned friends are currently rubbing their hands.

It's unlikely that m’learned friends are rubbing their hands. In fact, in October 2005, they spent some 120,000 of the Medical Protection Society's money unsuccesfully trying to stall Wakefield's threats to sue Channel 4, after the broadcaster told him to "put up or shut up" over such threats. They ended up paying something like a million quid, after abandoning a "gagging writ" libel suit, and paying Deer compensation.

What Deer failed to point out is that until Wakefield voiced concerns over MMR, he was a high flyer at the forefront of advances in understanding and treating inflammatory bowel diseases.

Wakefield attracted praise with a 1989 paper describing the vascular processes in Crohn’s disease. But even by the mid-1990s he was damaged by controversy surrounding his eccentric claim that inflammatory bowel disease was caused by measles virus - even then an opinion that commanded little respect among his peers. It would be fairer to describe Wakefield as a middle-ranking academic gut surgeon doing laboratory work in the Royal Free's medical school.

Yet Deer made no mention of Wakefield’s previous career or credentials; no mention of the science which preceded the controversial 1998 paper which Deer claims started the MMR scare...

The Private Eye text really needs to be read aloud to get a sense of the gushing, barely-contained hysteria that lies behind the printed words. As it happens, Wakefield’s claims to have identified measles virus in Crohn’s disease - using microscopic antibody staining techniques - was called into question when other researchers found that the antibodies he had used in apparently controlled tests didn't appear to be specific for measles virus, but binded to a human protein [that was presumably present in both Crohn's and control group subjects]. So, folk wondered, how did Wakefield get his results? Answers on a postcard.

... no mention of the research since (including that which has found measles virus in the guts, spinal fluid and in one case the brain of an autistic child).

Such claims are for the most part presented in a house journal not found on the international database Pubmed (and therefore not generally recognised as even part of the medical literature), or verbally, without controls, and generally without accompanying sequences which can be verified by other scientists. These claims fall below the threshold of reliability to be accepted as fact.

Wakefield and his supporters have been reduced to publishing such claims in the Journal of American Physicians and Surgeons, house magazine of a right-wing American fringe group, the Arizona-based Association of American Physicians and Surgeons, which campaigns against US vaccination policies. The association is also vocal in opposing moves to combat fraud by private doctors, and medical professional efforts to reduce deaths from domestic firearms. In 2005, Time Magazine reported that the association had only 4,000 members. Although cited by Private Eye in stories attacking MMR, the association's journal - recently renamed from the Medical Sentinel, presumably for the purpose of attempting to give its ideologically slanted material the aura of science - is barely credible as an independent forum for such material. No objective medical scientist with important information of any standard would submit it to such a publication, unless they couldn't get it published anywhere else.

Nor was there any acknowledgment that the controversial paper in question - only partially retracted last year - did indeed identify a new disease process in these children’s guts.

The retraction concerned a previously-claimed possible link between autism and MMR - in short, what this whole thing is about. Retractions of this kind are extremely unusual, and it attracted considerable public and professional interest.

A high incidence of gut problems in autistic children has been reported since before MMR. The "lymphoid nodular hyperplasia", referred to in the paper, sounds impressive to the uniformed, but is actually nothing more than swollen glands near the join between the small and large intestine - long recognised by Wakefield's own collaborators as a frequent finding in young children, without developmental disorders. This hyperplasia makes great pictures, but multiple standard reference sources describe it as a "benign", or even a "normal", finding. Many parents of autistic children - and it appears Private Eye journalists - were evidently misled into thinking that this was a newly discovered condition, distinctive to autism.

The paper also talks of nonspecific colitis (inflammation of the colon). But despite viewing multiple presentations by Wakefield over a period of some years, Brian Deer has yet to see him illustrate his talks with pictures of this colitis in autistic children. Despite the inclusion of colour slides in the Lancet paper, none is of colitis. Where video is available, colitis is not seen. In a Panorama investigation, for instance, the child in question's colon was found to be normal, as it was in a Royal Free hospital video news release, issued in 1998 as part of the attack on MMR. Considerable evidence suggests that the claimed "new disease process" mentioned by Heather Mills, doesn't, in fact, exist.

Deer’s personalised documentary follows his allegations earlier this year in The Sunday Times that when Dr Wakefield’s paper was published, he had not yet declared that he had become an expert adviser to the children in the UK litigation against the vaccine manufacturers.

This falsely represents both Brian Deer’s investigation and the conflict of interest, which impelled 10 of the 13 authors of the Lancet paper to vote to retract the finding of a possible link between MMR and autism. Deer’s revelation was that when Wakefield started the research on the children, he did so in execution of a contract from a solicitor, who was authorised by the Legal Aid Board to pay him 55,000 to carry out “clinical and scientific” tests on 10 claimant children, in a bid to prove that the vaccine was dangerous. In the event, two cheques for 25,000 are confirmed as having been paid by Richard Barr's firm Dawbarns. The details of this deal weren't even disclosed to the closest medical colleagues of Wakefield, who, six years later, greeted the revelations in The Sunday Times with astonishment and dismay. You can even hear such a reaction in MP3 audio at this website.

That Wakefield was also an expert witness, advising solicitors and barristers - and drawing 150 an hour, plus expenses, from the litigation - is a separate issue, and should be unravelled in due course. The key question here was: where did Wakefield get the 12 autistic children for the Lancet paper? He was specifically asked this at a special meeting called by the Medical Research Council in March 1998. In reply, Wakefield dissembled. Later, he was asked squarely, with reference to research including the Lancet 12: "Who funded your study?" Again, he didn't say.

But now we know where he got them. We even know their names, their legal aid numbers, and when they were admitted to the Royal Free.

Although the issue of a conflict of interest was actually raised in the Lancet six years ago, its resurfacing in the Sunday Times has led to Dr Wakefield and two others from the Royal Free’s research team now defending the charges in an unprecedented hearing before the general medical council.

This wording is sly. Nothing "resurfaced". A letter from a doctor, published in The Lancet after the paper of February 1998, and shown by Brian Deer to one senior author of the paper before The Sunday Times revelations were published, challenged Wakefield on a speculated conflict of interest. Wakefield’s answer was to explictly deny any such conflict, and was sufficiently cleverly-phrased to leave the medical profession, including both of the two fellow researchers who are facing a GMC hearing, in the dark about his legal contract. Both of those colleagues - interviewed by Brian Deer and later by the editor of the Lancet - denied all knowledge of Wakefield's legal contract. The editor of The Lancet also denied knowledge of it, saying that, had he known of it, he would never have published Wakefield’s paper in the first place.

The retraction of the paper in 2004 is widely-regarded as a significant victory for investigative journalism. Sucks, boo, yaa, Ms Mills.

Deer’s most recent demonisation of Wakefield and his theory was based on the fact that nine months before publication of the 1998 paper, Wakefield and the Royal Free sought to patent a treatment, called Transfer Factor, with a spin-off vaccine and that this had been kept secret until now. The team at the Royal Free were indeed at one stage intending to carry out a treatment trial of a method of boosting immune response to measles virus using cell lymphokines, part of the body’s defence mechanism.

And it was derived from passing measles virus through mice, extracting their white cells, passing alleged transfer factors “three times” through pregnant goats, before drawing the goats' colostrum, in a methodology that caused every expert Brian Deer spoke to on the subject to laugh.

The technology which attracted the interest of the 1000-bed Royal Free's medical school was largely the brainchild of Professor Hugh Fudenberg of Spartanburg, South Carolina - Wakefield's named co-inventor on the patent documents. In a videotaped interview in 2004, Professor Fudenberg claims to cure autism with his own bone marrow, rolled out, he says, on his kitchen table "like pasta" into a sheet, “three molecules deep”, which he says he keeps in his refrigerator. Professor Fudenberg is referenced in The Lancet paper of 1998, and in ethics committee applications, where he is named as an investigator on Wakefield's project - which produced the frank claim by Wakefield, in the very first sentence of an undisclosed patent document, to have invented a vaccine.

Professor Fudenberg, who was banned indefinitely from prescribing medicines in 1995, was interviewed in Deer's Dispatches documentary, saying that Wakefield offered him 60,000 a year for them to go into business together.

Pity they didn't, really.

In the event this was never pursued by the Royal Free: there was no trial, no treatment and no vaccine.

Right. They flopped. For all Wakefield's commercial ambitions, and all the trouble he caused, the stuff was crap. Nevertheless, it was pursued to the point of expensive patent applications, and an ethics committee submission [also filed before the famous press conference of February 1998]. Money was allocated to the project by the group Allergy-Induced Autism, and a contractor in Colorado was recruited by another Wakefield organisation, Visceral, to make capsules for autistic children. In a recent statement, Wakefield says that the plan lapsed when he left the Royal Free in December 2001 - which was 3.5 years after the first patent application in the vaccine/autism series was filed.

Wakefield also started a company, Immunospecifics Ltd (intended to be launched as Carmel Healthcare) in which one of his fellow shareholders was Professor John O'Leary - to exploit his patented theories through the sale of diagnostic kits to parents. Another was Professor Roy Pounder.

A patent was, however, granted in 1999. But contrary to Deer’s suggestion, Wakefield did declare it. The Eye has seen a letter he wrote to the Lancet in 1999 informing the editor of the patent. The Lancet decided not to mention it.

This stuff is so disingenuous it blows your mind. Brian Deer has long had a copy of the same letter, although he hasn't verified that it was actually sent to, or received by,The Lancet. It says: “ Wakefield is named inventor on a UK patent for measles virus diagnostics”. It doesn't mention a vaccine, or a treatment, or even “a complete cure” for inflammatory bowel disease and autism - the claims in the applications filed in 1997 and 1998.

Indeed - to the further embarrassment of Wakefield, Ms Mills and Private Eye - it might equally refer in its vagueness to an earlier series of undeclared Wakefield patent applications, first lodged in March 1995 - the month before Wakefield and the Royal Free hospital medical school called an earlier televised press conference, concerned with a previous poor-quality paper in the Lancet: claiming a possible link between measles-containing vaccines and Crohn’s disease.

Two series of Wakefield patent applications... two papers soon after in the Lancet... two heavily-promoted press conferences that inflamed public opinion. Spot a pattern yet?

In any event, the earlier undeclared patent series - with a priority date of March 28 1995 - is called, would you believe, “Diagnosing Crohn’s disease or ulcerative colitis by detection of measles virus.”

Ooops.

The patent is also mentioned on at least three subsequent research papers.

Ho ho. Ms Mills, you should quit. These papers were published after Brian Deer’s Sunday Times investigation. Kawashima et al (2000); Wakefield, Anthony et al (2000); Furlano et al (2001); Torrente et al (2002); Uhlmann et al (2002); Ashwood et al (2003) - in fact all of Wakefield's research papers from this period - contain no mention of any patents (or indeed his contractual and financial relationships with lawyers). Nor do any of Wakefield’s discussion papers during these years, such as the notorious "Through a glass darkly," (2000), which further stoked public opinion against MMR. The first paper to mention any patent appears to be Bradstreet et al, in the right-wing fringe publication, published in the summer of 2004 - after Deer had first challenged Wakefield over his commercial ambitions, and after production had commenced on Deer's television documentary, MMR: What They Didn't Tell You. Wakefield's belated disclosures in his papers are welcome admissions that such acknowledgements should properly be made, but again, the description was vague enough to attract no attention.

Why Private Eye makes this claim is somewhat disturbing as to motivation, competence in this field, or both.

Wakefield voiced general concerns about the combined measles vaccines as early as 1992, many years before the Royal Free patent application was filed in 1997.

As previously noted, Wakefield speculated, and lodged patents on his claim, that measles virus was the cause of inflammatory bowel disease - a claim quickly rejected by specialists in this field. These days, it's regarded as a joke. An international conference in Oxford in the Summer of 2004, on the spookily appropriate topic of "the pathogenesis of inflammatory bowel disease", didn’t even include measles virus as a topic of discussion. Nor was it raised by anybody. When the proposition was mooted by Channel 4's programme-makers, participants at the conference laughed. The chief organiser said he only knew of one person who claimed that measles virus caused IBD: " Wakefield".

Perhaps the most disingenuous part of Deer’s programme was that viewers may have been left with the impression that not only was there no reason to believe measles virus present in the Royal Free children’s gut at the time the paper was published...

Here indeed is the heart of the matter. Let's recap. As Wakefield sat at the press conference of February 1998, and took part in a video news release, launching panic over MMR and calling for its "suspension" in favour of single shots, he knew, but didn’t say:

(a) That his research project on autistic children had begun with a commission from lawyers attempting to sue MMR manufacturers, and who believed MMR's suspension would help them sue - a fact he didn't disclose to his closest medical colleagues.

(b) That he'd laid claim, in a patent application, to extraordinary products, which could only have succeeded if MMR’s reputation was damaged. These included, in the first sentence of the patent document, his own single vaccine: against measles. Nice one Andy.

(c) That his own laboratory had tested the autistic children for measles virus - the presence of which he alleged to be the ultimate culprit for their disorders - and found no trace of the virus, using methods [RT-PCR and NASBA] that he'd personally validated.

... but that is still the case today.

On this point, the documentary actually made no reference to today.

This is untrue on both counts - unless one of the world’s leading pathologists, Professor John O’Leary, chair of pathology at Trinity College, Dublin, is seriously in error.

It’s far from clear that Professor John O’Leary, at his lab in the Coombe women’s hospital, would make such a lofty claim for his status. Brian Deer's consultations with noted US authorities in the field of Aids, in which O'Leary is said to be an important figure, produced statements that they had never heard of him. In any event, Professor O’Leary hadn't carried out the tests referred to on these samples at the time the Lancet paper was published. His work, published in 2002, has subsequently been the subject of controversy in High Court proceedings, where very serious error is indeed alleged. Surprisingly, Professor O'Leary reported finding measles virus in between 96% and 97% of Wakefield samples, apparently taken from consecutive autistic children with bowel symptoms, recruited through solicitors, parent campaign groups and media coverage. Through solicitors, Professor O'Leary denies misconduct.

But he wasn't even relevant to the position 4.5 years previously.

Before publication of the 1998 paper, researchers had already found measles virus protein in the gut tissue, although not the virus itself. Further, at the site of the inflammation in the gut there were clusters of cells that are typically seen in chronic virus infection.

This must surely have been dictated to Ms Mills by Wakefield. The microscopic methods employed - similar to those used in his Crohn’s work - were so rough-and-ready that experts in this field say that, were these methods to detect evidence of measles virus [as Wakefield apparently claims in a paper still not published eight years later], it would be next to impossible for the virus to fail to be identified by molecular RT-PCR methods. How Wakefield claims to have seen evidence of something under the microscope that evaded established and carefully verified molecular detection methods is another of the mysteries awaiting solution.

The Royal Free medical school was so impressed with Wakefield's work in this area that it issued a press release. Check it out Ms Mills.

Other scientists, meanwhile, have separately and independently stated to Brian Deer that they looked at slides presented by Wakefield as purported evidence of the presence of measles virus in Crohn's tissues, and have declared that they couldn't see what Wakefield says he saw.

Wakefield's methods involved looking at slides for evidence of a brown stain. Brian Deer can suggest where to look for one now.

On the programme, both of Wakefield’s former collaborators told Brian Deer that if the measles virus was there they would have found it.

Correctamundo. A big moment in the programme. And, as molecular biologists who worked on Wakefield's project, they would be in better position to know than a Private Eye hack.

But at the time they shared Wakefield’s concerns that the methods and equipment (now obsolete)...

The methods are not obsolete, and have been found by widely-published authorities in this field of science to be as sensitive as Professor O'Leary's. The technique, reported by Wakefield and colleagues, was found to be capable of detecting "as few as ten functional measles virions". The idea that these methods - more sophisticated than those which discovered HIV - would accomplish this (and also find virus in control tissues), but repeatedly and consistently miss a persistent viral infection - allegedly capable of causing an inflammatory bowel disease capable of eating through the gut wall to release peptides into the bloodstream that are supposed to go on to cause autism - is somewhat off-the-wall. Even by Wakefield's standards.

... used to detect the virus DNA was not sensitive enough. They put their names to the negative finding research paper which Wakefield himself insisted was published even though it went against his own hypothesis.

The paper in question (on inflammatory bowel disease in adults, not autism in children) merely noted that either the virus was absent, or it was present in quantities below detection. That is not a statement that the method "was not sensitive enough". Given the number of collaborators on the project, Wakefield could hardly have done otherwise than agree to publication of that paper. It was also the topic of a PhD thesis being written in his lab.

It concluded: “These results show that either the measles virus DNA was not present in the samples or was present below the sensitivity limits known to have been achieved.”

The co-authors were baffled by how it could be that Wakefield, a surgeon, claimed that measles virus could be identified by microscopic methods, but they, specialists in these technologies, couldn't find it by RT-PCR molecular methods. Their conclusion in the inflammatory bowel disease paper - drawn up under the supervision of the corresponding author - Wakefield - was a correct statement of the facts.

The position was made clear in the programme: that both of Wakefield’s collaborators interviewed - one of them a full professor specialising in these techniques, and the other Wakefield's research assistant - believed that the virus wasn't present in the autistic children whose cases were included in the 1998 Lancet paper.

The tests on the children - carried out by Nicholas Chadwick, under the direction of Professor Ian Bruce, and personally supervised by Wakefield - were specified, with the investigators named, in the founding protocol and study description of the Lancet work. Brian Deer believes that Wakefield was not fairly entitled to unilaterally and retrospectively decide that the results were "false negatives", when they didn't suit his theory.

And so it proved to be.

As with Wakefield’s clinical interest in the children - which began in 1996 with a protocol document specifically naming a “new paediatric syndrome” before research was carried out that might have discovered any such syndrome - so it was with the molecular virology. Wakefield appeared to intuit results of laboratory tests in advance of the tests actually being performed. Scientists often regard such foresight as worrying.

In a statement, issued after the Dispatches documentary, Wakefield seems to imply that he didn't announce the negative results from his lab, reported to him in 1997, because they would be contradicted years later by Professor John O’Leary. At the time, he hadn't even met, and quite possibly had never heard of, O'Leary.

Incidentally, there is no mention at all here of Dr Kawashima, a key player at the time, whose results appear to be included in patent documents and submitted to hospital authorities in a pregnant goat protocol, as substitutes for the Chadwick-Bruce work. This is all very mysterious indeed.

Shortly afterwards the samples were sent to Prof O’Leary.

If about a year later is “shortly afterwards”.

As indicated, Professor O'Leary became a business colleague of Wakefield's: in the company Immunospecifics. They met through the intervention of one of the litigant parents involved in the Lancet series, who was also a member of the group Allergy-Induced Autism, run by Mrs Rosemary Kessick, one of Wakefield's closest collaborators, and parent of a child enrolled in his lawyer-commissioned research.

Using state-of-the-art viral detection methods and equipment, he found measles virus in the guts of children with autism.

Professor John O’Leary’s techniques have been compared with others, and not found to be more sensitive. The benefits of his approach are largely to do with quantification and convenience. Professor O’Leary has faced multiple claims that his laboratory - built and operated with 800,000 from the MMR litigation, for which records show he tested samples from approximately 60 autistic children, and another 250,000 [yup, a cool quarter million sterling] from Wakefield's organisation Visceral - is a victim of contamination, very common with PCR work - an allegation he denies. Professor O’Leary declined to take part in an inter-laboratory quality control survey, which might have resolved the matter. The world's leading authority on measles virus says he was approached with a view to collaborating with Wakefield and O'Leary, but withdrew after identical coded samples were returned to him from O'Leary's lab with, first, positive, then negative, results.

Oddly, Professor O'Leary reports finding measles virus in substantial quantities [up to 300,000 copies] - quantities which would certainly be expected to have been found by the technique approved by Wakefield at the Royal Free hospital. This compounds the mysteries over why they weren't. Did the virus get into the tissues afterwards? Or did something else happen? Government labs have tried to obtain Royal Free samples to test, but requests have apparently been rejected.

Professor O’Leary’s paper was published 4.5 years after the Lancet paper. Professor O’Leary has still failed to publish the sequences of the viruses which he says he has found. Experts say that sequencing viruses is standard laboratory practice, and to fail to supply them on request to other investigators is highly unusual, and raise questions about the basis for publication. A mystery also surrounds the extraordinary cost of Professor O’Leary's tests [which many scientists would send off to a contracting lab like the rest of us send holiday pictures to the chemist, and which he costed elsewhere at a fraction of what he was apparently paid]. He has denied any problems, was the subject of a High Court order requiring access to his raw data, and has removed his name from a recent Wakefield paper in the rightwing house magazine.

If Ms Mills is impressed by the Wakefield-O'Leary collaboration, she might ask Wakefield for the meales virus test results from Professor O'Leary's lab on three healthy control subject children: Wakefield C, I and S.

Oh dear, oh dear, indeed.

It has since been found in the spinal fluid and brain.

Brian Deer knows of no authoritative publication in which this claim is substantiated.

That work does not prove a link with autism, but it should at least raise alarms.

When such work involves Wakefield, the lack of alarm is perhaps understandable, given his past record in manufacturing alarms (twice in close proximity to patent applications).

The response has always been that the O’Leary tests have not been replicated, but then other methods have always been used.

This is wrong. John O’Leary’s equipment, a Taqman PCR machine, is a standard item of laboratory equipment, albeit frequently held out to parents by Wakefield's supporters as being some kind of wonder device. It's about the size and general finish of a desktop Xerox machine. Experts in this field guess that there might be thousands in the UK alone. Other equipment has been shown to be equally, or more, effective at detecting measles virus.

Only now in the US are researchers seeking to properly replicate the work in what both sides of the debate are looking to as a definitive study. Prof Ian Lipkin of Columbia University, NY, who is leading the research, is internationally renowned for his work in immunology and viruses.

Waiting for his results might at least keep someone employed at Private Eye for another year or so. Meanwhile, British researchers are writing-up a large study, expected to be published in 2005, looking for measles virus in autistic children, complete with a large control arm and the use of a Taqman PCR machine. Rumour has it that it has refuted the Wakefield theory again. And bigtime.

Deer’s allegation that Wakefield “abused” the Royal Free children by subjecting them to invasive procedures...

Brian Deer made no such allegation.

... might have carried more weight if it had come from parents. But they consented to their children’s treatments as part of the ongoing clinical investigation.

Lumbar punctures - reported to be used on 30 children in a search for measles virus - aren't part of the clinical investigation of either autism or inflammatory bowel disease. In a recorded conversation, one mother of a "Lancet 12" child told the programme-makers she didn't believe that her son was a victim of MMR, or that he needed a lumbar puncture, but was persuaded on both counts while at the Royal Free hospital. After lumbar puncture at the Royal Free, her son was admitted as an emergency, by ambulance, from his home to another hospital, suffering from apparent adverse effects. Headaches from lumbar punctures can last up to a year, and the investigators described the procedure as "high risk". Consents improperly obtained are invalid. Parental desperation is no cover.

Those children were being treated for appalling and painful gut disease - many had impacted bowels or persistent diarrhoea.

Almost all had severe, impacted, constipation, often with overflow - a common problem recognised in autism and mental disability before MMR was ever introduced. This can cause pain, and unnatural posturing, often due to solid blockage of the colon. Constipation was reported as common in autistic children, as in many children with neurological disabilities, before the first MMR product was even licensed, in the US in 1971.

Doctors at the Royal Free were diagnosing and treating, and in many cases alleviating, symptoms. They were not merely using the children for research.

The programme said that. For the most part, the clinical team were relieving constipation with encopresis. This shouldn't have required any invasive procedures, which were carried out for research purposes, as defined by the Royal College of Physicians. Constipation can be diagnosed by plain x-ray.

Constipation with encopresis is a staple of paediatric gastroenterology. It's often intractible to treat in non-autistic children, often requiring elaborate dietary and behavioural interventions by parents. It's a pity that Wakefield's clinical colleagues - led by an eminent paediatric gastroenterologist - failed to discuss this in the Lancet paper. While they were at it, they might have said that they had previously published on lymphoid nodular hyperplasia, reporting it to be a common finding in children.

Deer focused exclusively on Wakefield’s past...

Wakefield's present and future were unknown to the programme-makers, except for a brief moment when Brian Deer met him at a conference in Indianapolis - when Wakefield attacked the camera and fled.

... and did not consider any of the other relevant science.

MMR: What They Didn't Tell You wasn't a science programme. However, "other relevant science" has contradicted every aspect of Wakefield's campaign.

For example, in the week of the Channel 4 attack, a team from the John Hopkins University School of Medicine in Baltimore...

You mean Johns Hopkins.

... looking at brain tissue of autistic patients, found chronic inflammation triggered by abnormal immune response. Although it was a small study of 11 autistic people who had died, they also found similarly high levels of inflammatory cytokines (messengers that run between cells) in the spinal fluid from six autistic children. The researchers found an immune reaction similar to that found in dementia associated with HIV virus.

Did they say anything about MMR? Nope.

These sort of studies suggest Dr Wakefield is not the lone lunatic that Deer would have us believe.

Lunatic? That must be Fudenberg and the goats. Even Ms Mills must think that stuff’s crazy.

Despite allegations to the contrary, Private Eye is not anti-vaccine...

No. It only published a newsstand supplement by Heather Mills attacking MMR, god knows how many stories, based on the unsubstantiated views of Wakefield, Barr, Limb, Fletcher, Kessick et al, and two thirds of a page attacking Brian Deer - as it similarly attacked him in February 2004 - for the sake of balanced discussion.

I see.

... and has never said Dr Wakefield hypothesis is right. We have merely maintained that his work deserves proper investigation and that single jabs, used long before MMR, should be made available as a precautionary measure to keep up herd immunity.

This appears to be a transparent, and rather sad, effort to lay down something to quote in the future. It’s telling that Heather Mills appears to have neither the guts to stick with her long-running campaign against MMR, nor to admit that she didn’t know about the legal contract, the patent applications for a vaccine and treatments, the crazy guy in Spartanburg, the measles virus results...

That proper investigation is finally taking place in the US; but until Prof Lipkin and others report, the jury is still out.

Does that mean you keep your job awhile longer, or what?

Interestingly, in Lancet editor Richard Horton’s book on the MMR controversy, he disclosed how “one of the protagonists in the affair had said openly and publicly that his intention was to ‘rub out’ Wakefield”. The protagonist in question? Step forward Brian Deer.

Brian Deer’s conversations with Dr Horton were recorded, and nowhere is the reported expression, or anything like it, used by Deer.


Although Heather Mills made no effort to contact Brian Deer prior to publication of her attack, on Monday November 29 Deer called Mills at Private Eye, and asked whether she was the author of the story. Heather Mills said: "I don't have to tell you anything." Deer then asked whether she didn't feel she had a duty prior to publication to contact a person being attacked. Heather Mills said: "I don't think I have to engage with you in any way at all." This is the general calibre of behaviour from those campaigning against MMR



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