False autism study has done un­told harm

Montreal Gazette - - Editorial -

Im­mu­niza­tion rates for measles, mumps and rubella have never re­cov­ered from a con­tro­ver­sial link made be­tween the MMR vac­cine and autism.

The link – de­nounced last week as an outand-out fraud – was first pub­lished in 1998 by one of the world’s most pres­ti­gious med­i­cal jour­nals, the Lancet.

Wor­ried par­ents were faced with a dilemma. Should they go ahead and im­mu­nize their chil­dren against com­mon and some­times deadly child­hood dis­eases at the risk of trig­ger­ing an in­cur­able syn­drome? Or should they skip the shot and hope for the best?

An un­known but wor­ry­ing num­ber of par­ents chose not to im­mu­nize their chil­dren. As a re­sult, Bri­tain and the United States have seen out­breaks of pre­ventable child­hood ill­nesses. In some places in Bri­tain, measles is now en­demic. (For­tu­nately, the Que­bec Health Depart­ment says there has not been a de­crease in the vac­ci­na­tion rate in this prov­ince.)

There is no guar­an­tee that de­bunk­ing the orig­i­nal study is go­ing to sway all par­ents. Med­i­cal ex­perts are go­ing to have to work hard to try to undo the dam­age in­flicted by what is ap­par­ently a rogue med­i­cal re­searcher whose work was in­ad­e­quately vet­ted by a top-ranked in­ter­na­tional jour­nal.

The new anal­y­sis of the orig­i­nal study should set off alarms at all med­i­cal jour­nals. In a paper pub­lished on­line by the Bri­tish Med­i­cal Jour­nal, jour­nal­ist Brian Deer found that facts about the 12 chil­dren in the orig­i­nal study had been al­tered to make a con­nec­tion be­tween the MMR vac­cine and autism, where no such link ex­isted. Dates were changed, di­ag­noses mis­rep­re­sented, and the young pa­tients them­selves found by anti-MMR cam­paign­ers.

Deer also re­ported that the re­searcher, An­drew Wake­field, was se­cretly paid $675,000 through a law firm that had plans to launch a class-ac­tion suit against the MMR vac­cine. Wake­field, stripped of his Bri­tish med­i­cal li­cence in May, in­sists that he is the vic­tim of a smear cam­paign by the phar­ma­ceu­ti­cal in­dus­try.

Caught be­tween what look like con­flict­ing claims, some par­ents might never be per­suaded that the truth be­hind the vac­ci­na­tion is now known. It is a tru­ism that peo­ple are more eas­ily scared than “un­scared.” “You can do study af­ter study, but peo­ple are far more com­pelled by their fears than by their rea­son,” U.S. pe­di­a­tri­cian Paul Of­fit told me­dia. And, in­deed, two Que­be­cers whom The Gazette spoke to last week – one the founder of an autism sup­port group, the other the author of a book about autism, and both par­ents of autis­tic chil­dren – said they think many par­ents are un­likely to change their anti-vac­cine stand.

Sci­ence, as the edi­tor of the Bri­tish Med­i­cal Jour­nal wrote last week, is based on trust. Other re­searchers, re­view­ers, read­ers and crit­ics take on faith that the orig­i­nal data on which a study is based are ac­cu­rate and hon­estly doc­u­mented. Yet surely Wake­field’s study – with its tiny num­ber of pa­tients and lack of a con­trol group – should have prompted more vig­i­lance than it did.

The Lancet needs to speak up. Is there a need for an in­quiry into how the peer-re­viewed process failed in this case? Could a sim­i­lar fraud­u­lent study see the light of day? It might take years for sci­en­tists to re­gain the trust of par­ents. And in the mean­time, on­ce­van­quished child­hood ill­nesses could once again spread freely.

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