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The antivaccine crankosphere rallies around its hero, and Brian Deer strikes back

When I wrote last week about the latest legal thuggery against an opponent of antivaccine pseudoscience, this time by hero of the antivaccine movement, who sued investigative reporter Brian Deer for defamation, there was one thing about the case that confused me, one aspect that didn’t add up to me. Part of it was why Wakefield sued Brian Deer over an article he wrote for the BMJ a year ago, although in retrospect it’s become apparent to me that it was almost certainly because the statute of limitations for a libel action in Texas is one year. More importantly, the silence of the antivaccine movement in general and the propaganda organ of the antivaccine group Generation Rescue, Age of Autism, was utterly deafening. Usually, AoA is Wakefield’s biggest cheerleader. As I mentioned before, ever since Deer’s BMJ article, AoA has been unrelenting in defending Wakefield and doing its best to slime Deer. Be it John Stone’s half-baked rants, AoA’s one trick pony Jake Crosby doing his one trick (i.e., his painfully tortured “six-degree-of-separation”-style attempts to find or make up financial conflicts of interest for anyone who criticizes Wakefield), or other members of AoA’s merry band of propagandists circling the wagons, AoA’s reaction to this news was in marked contrast to the reaction of its minions on Facebook and elsewhere, who rejoiced. It took until yesterday for the propaganda machine to crank up to full bore.

Meanwhile, in the antivaccine crankosphere, it was nearly two days before AoA provided a perfunctory acknowledgment of the libel suit in the form of a verbatim excerpt from a Guardian article about the suit. With AoA being silent, other antivaccine outlets jumped into the breach. Interestingly, one of these, Gaia Health, actually provided a preview of one line of attack the antivaccine movement is using to try to convince those not knowledgable about Wakefield’s fraud that he has a case in the form of an post entitled BMJ Focuses on Science Fraud, But Is Their Own Exposed by Wakefield Lawsuit? After regurgitating the accusations in Wakefield’s complaint, the anonymous author of the Gaia Health piece turns his attention to the question that’s been puzzling all of us: Why did Wakefield sue in Texas, rather than in the plaintiff-friendly U.K. legal system? Inadvertently, more is perhaps revealed than was intended:

British law favors the well-heeled accuser. It costs money, lots and lots of money, to successfully bring a defamation lawsuit in Great Britain. Dr. Wakefield’s income has been destroyed by the attacks on him. He has been struck off the register and can no longer practice as a doctor, which has prompted his move to the US. It’s hard to imagine that he has bottomless pockets. Therefore, his ability to prosecute a defamation lawsuit in Great Britain is severely diminished.

If Wakefield is broke, which is quite possible given that he lives in a very exclusive area of Austin and that he hasn’t had what could be described as a regular job for nearly two years, this actually makes some sense. This next excuse, however, is pure conspiracy-mongering, so much so that I laughed aloud when I read it:

In Britain, a successful defamation prosecution by Wakefield could stand as a precedent that would harm the government itself, as it knowingly purchased the Urabe MMR vaccine that was in effect in the children Wakefield was studying. (See Andrew Wakefield Speaks to Private US Physicians on the Smear Campaign Against Him.) This vaccine was known to cause severe harm, so the manufacturer, SmithKline Beecham, refused to sell it without a waiver of indemnity, which the UK government granted. Therefore, the government itself is on the hook if it’s officially found that there’s a connection between the vaccine and autism. When you consider the number of children involved and the degree of harm done to them, it’s so large that the financial stability of the government would likely be at risk.

Got it? Wakefield is such a threat to the British government that he can’t sue in the U.K. because the government would make sure he couldn’t win because if he did the government would go bankrupt! Seriously, you can’t make stuff like this up. At least, I can’t.

But the delusion goes even further.

Not only is Wakefield suing in Texas because he can’t sue in the U.K. because the British government can’t let him win, but he’s got such s strong case that there’s no reason he shouldn’t use the U.S. court system, even though unlike the British system, it’s weighted towards the defendants in libel cases. In fact, see if you can resist chuckling out loud as you read this passage:

Finally, there’s the fact that US court settlements, though generally more difficult to obtain, tend to be significantly higher. If Dr. Wakefield’s case is strong–and it seems to me that it’s exceedingly good–then he certainly doesn’t need the ease of the British defamation laws.

Why wouldn’t Dr. Wakefield choose to utilize the American court system? Anyone who has followed this case with an open mind must be aware that Wakefield’s research was excellent and that the claims against him are false. He has suffered hugely, and the autistic children have been left in the dust.

Personally, I favor the explanation that Wakefield knows he can’t win this case but needed to bring it to rally his followers, even the most rabid of whom wonder why he didn’t sue Deer for libel after BMJ published his analysis of how he committed research fraud if, as Wakefield claims, the allegations are lies. Suing in Texas instead of the U.K. allows Wakefield to put on a show of “fighting back” for his followers at the lowest cost. If the case goes forward, he wins. If the case doesn’t go forward, he wins as well, because in this latter case he can cry “conspiracy” or “unfair,” secure in the knowledge that his groupies will eat it up.

Speaking of Wakefield groupies, the next line of argument they make is basically the same as what’s in the complaint in that they trot out “whistleblower scientist” David Lewis. You remember Lewis, don’t you? He’s the putz who provided the BMJ with the original scoring sheets used by one of Wakefield’s co-investigators, pathologist Dr. Paul Dhillon, thinking that they would somehow exonerate his newfound buddy Wakefield, when in fact they did exactly the opposite, as I discussed a couple of months ago. Now that Wakefield has sued Deer for libel, Lewis has crawled out of the woodwork yet again, issuing a press release that AoA has credulously reposted. Basically, it expresses Lewis’ pique that the BMJ didn’t use the documents he provided it in the way that he expected, which he pours out in a 3.7 MB PDF that can be downloaded from a link in AoA’s post. I made the mistake of reading most of it. It turns out, however, that my time would have been much better spent reading Brian Deer’s response to Lewis’s accusations, entitled, aptly enough, David L Lewis: indignant abuse
as complaints turn to nothing
. It’s worth reading every word of Deer’s response, but I can’t resist pointing out a few key points.

Perhaps the most amusing part of Deer’s response is this:

DAVID L LEWIS: “My report, which I have submitted to UCL, UKRIO and HEFCE, includes 72 emails exchanged between me and the BMJ’s editors.”

DEER: I offer the recipients at UCL, UKRIO and HEFCE my sympathy.

It’s funny how Deer zeroed right in on the part of Lewis’s PDF that caught my eye. Here’s a good rule of thumb: When someone badgers people with that number of e-mails, he is almost certainly a crank. I get e-mails from people like Lewis from time to time. I usually ignore them.

In any case, Deer addresses point by point pretty much every one of Lewis’ accusations, many of which are repetitive. For example:

DAVID L LEWIS: “To support their new fraud theory, Godlee rewrote my Rapid Response, removing any evidence that undermined their allegations against Wakefield and others.”

DEER: Lewis’s rapid response was extensively re-written because it was false and defamatory. Legal advice was taken. Two peer reviewers rejected the submitted text. No changes had any effect in supporting any “fraud theory”, whether new or otherwise. Lewis approved the published text.

Deer’s amusing sarcasm aside (seriously, no wonder Orac likes him; he lays down the Insolence, both Respectful and not-so-Respectful while refuting nonsense), he writes a long and detailed response that leaves no doubt that Lewis is an opportunist, cherry picker, and doesn’t know what he’s talking about. For example:

DAVID L LEWIS: “Copies of the pathologist grading sheets and other data from the 1998 study, which I obtained from Wakefield’s personal files, however, appear to show that the diagnosis was not fabricated.”

DEER: The documents Wakefield gave Lewis show nothing of the sort. They evidence that the claim in Table 1 of the Lancet paper of “histological findings” of colitis for 11 of 12 patients is false. Two consultant histopathologists are named in the paper. Both have separately denied making histological findings of colitis, and pathology reports or grading sheets confirm their statements.

And:

DAVID L LEWIS: “To begin with, they cherry-picked a treasure trove of hitherto unpublished evidence from Wakefield’s files, selecting the only set of documents they could possibly use to support their new fraud theory.”

DEER: Nothing was “cherry picked”. It took me, “with no formal training in medicine or science” approximately six minutes to realise that Dr Dhillon’s grading sheets reported overwhelmingly normal findings. I urged Dr Godlee to test my judgment by putting the documents out to peer review. This she did. All reviewers confirmed my impression.

Dr Dhillon’s sheets were raw data from his observations of biopsies which Wakefield claimed evidenced a “new inflammatory bowel disease”, and were hence of significant interest. This was the material which the GMC panel had been told was grounds for changing gut diagnoses from healthy to diseased. It was missing material from a consultant histopathologist. Nothing else from Lewis had anything remotely like the significance of this data.

So thorough is Deer’s evisceration of Lewis’ arguments that it’s a joy to behold. It’s also long, even by Orac standards, but I can’t complain. In any case, Lewis is, as Sullivan points out, a sideshow to the main show of Wakefield’s pathetic attempt to rally his troops and punish his nemesis. It won’t work, but unfortunately, even in the U.S. with its high bar to prove libel, Wakefield might well be able to inconvenience Deer and BMJ editor Fiona Godlee.

I also rather suspect that Wakefield will be able rake in some much-needed green stuff, as his followers have conveniently set up the Dr. Wakefield Justice Fund. That’s the main show. That’s the goal of this lawsuit, to raise funds for Andrew Wakefield. As for Lewis, who knows what his motivations are for joining Team Wakefield? Maybe he perceives Wakefield as someone who’s “persecuted,” which is clearly how he perceives himself. Or maybe it’s just a case of crank magnetism. Whatever the reason, he has thus far failed to impress anyone; anyone, that is, except for the antivaccine crankosphere, which now seems to view him as the Boy wonder to Andrew Wakefield’s Batman. Given his claimed expertise in sewage management, Lewis should fit right in.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

203 replies on “The antivaccine crankosphere rallies around its hero, and Brian Deer strikes back”

The first paragraph of this posting ends rather abruptly. It’s sort of dramatic, but does leave the reader in the dark.

Not all the anti-vax whackos are lining up behind Wakefield. The One Click Group have this to say:

Since Wakefield has failed to Appeal the GMC decision that found him dishonest in 2010, it seems extraordinary that he is now taking this litigious step in Texas. Is this merely a highly ill-advised mickey mouse Wakefield publicity stunt or has this doctor lost the plot we ask?

You know you’re in trouble when One Click Group thinks you’ve lost it.

http://www.theoneclickgroup.co.uk/news.php?id=6752#newspost

….

Has someone summarized the Andrew Wakefield trajectory? His story certainly is an interesting combination of shock journalism, science, personal ambition, a vulnerable demographic, the culture of celebrity and Real Journalism.

Were there warning signs before he conducted that so-called study?

He has been struck off the register and can no longer practice as a doctor, which has prompted his move to the US.

Wait, didn’t Wakefield move the U.S. and start working for Thoughtful House a couple of years before that?

This vaccine was known to cause severe harm, so the manufacturer, SmithKline Beecham, refused to sell it without a waiver of indemnity, which the UK government granted.

Ah, I was wondering why various anti-vaxxers were going on about the mumps component of MMR when Wakefield was all about the measles component. But if the UK government has to pay for any lawsuit losses that SmithKline Beecham, it makes more sense.

However, that’s still a vanishingly small amount of sense. Wakefield lawsuit is about what appeared in BMJ a year ago, which wasn’t just a rehashing of the GMC trial and other things Deer has written, so even if Wakefield won it wouldn’t in any way rehabilitate the Lancet paper. Further, even if it did somehow show him to be innocent of all charges of fraud (rather than just the fraud alleged in the BMJ a year ago), it wouldn’t save the Lancet paper from being horribly, fatally shoddy. And yet further, even if it somehow made the paper non-shoddy, it would still be just a pilot study involving just 12 children, and couldn’t in-and-of-itself be used to win a lawsuit.

And speaking of it being a pilot study: if, as Wakefield’s supporters claim, the Lancet paper has been replicated, the studies that did the replication could be used in lawsuits against the vaccine manufacturers without the help of Wakefield or his Lancet paper, making Wakefield mute in the context of any lawsuits against vaccine manufacturers. So why do his supporters think that he and his paper would be so vitally important to any lawsuit?

Ben Goldacre wrote about it well in Bad Science though I’m still waiting for him to write Part 2! Especially as he was a lot more forgiving of Wakefield than hindsight shows he should have been.

Yeah, the relevant question in the lawsuit is whether or not Wakefield was libeled, not whether or not vaccines cause autism. It’s entirely possible from a legal point of view for Wakefield to have been libeled even if vaccines don’t cause autism or for Wakefield to not have been libeled even if vaccines cause autism.

On its Facebook page, AoA is reporting that Wakefield’s wife Carmel has been injured in a car accident. The publicly-viewable VINE FB page (linked on my ‘nym – you’ll need to scroll down a bit) has a number of supporters wondering if it was “arranged”.

Hilariously, Lewis was supposed to interview AJW on Kohn’s show Tues( Progressive Radio Network.com/ archives) *however* A had some sort of “family emergency”** so the two whistle-blowers interviewed each other ( and blew whistles, I guess-I didn’t listen to it).

**I wonder what!

They have since corrected it, but originally the Gaia Health article read:

There is a great deal of truth in the claim British law strongly favors the accuser. In Great Britain, the burden of proof is on the plaintiff. That is, the plaintiff must prove his innocence, rather than the accuser having to prove his guilt.

Curiously, I can’t find any independent confirmation of the accident – which was, per FB, reported by (Scopie’s law) as a quote from her son on Carmel’s FB page. One would think that an accident of that severity (states multiple fractures and severe injuries) would be reported in the papers, especially given her husband’s “celebrity” status…

DAVID L LEWIS: “… and identified me as “an expert in clinical studies involving the collection and examination of colonic biopsy samples.”

DEER: This would be a misleading characterisation of Lewis’s credentials. He’s a retired environmental microbiologist, who previously specialised in sewage sludge contamination for the Environmental Protection Agency, from which he was involuntarily terminated in 2003.

DAVID L LEWIS: “I have not been employed as an environmental microbiologist, self or otherwise, since leaving the U.S. Environmental Protection Agency (EPA) in 2003. I live almost entirely on my federal retirement pension. For the past couple of decades, I have derived additional income as an expert witness in federal and state court cases involving the collection and examination of colonic biopsy samples. This is an area in which I have extensive professional credentials.”

DEER: I’d be interested to learn of any references to these cases, so as to establish Lewis’s involvement. I suspect that any claim by Lewis of expert status in bowel histopathology may usefully be investigated by counsel for those he gave evidence against, or counsel for any party which has paid him. The “collection” of colonic biopsies is a surgical procedure and their examination is a task for medical doctors with specialist training in histopathology.

This particular claim stood out to me and of course, Mr. Deer nails it. Dr. Lewis appears to be rather misleading with regards to his “expertise” on the collection and examination of colonic biopsies. For example, he testified for the respondent in http://w3.health.state.ny.us/opmc/factions.nsf/58220a7f9eeaafab85256b180058c032/ad4e9d90aa71965b852575830061a449/$FILE/HRG%20139943.pdf

New York State v. Goldweber (respondent) for infecting multiple patients with hep C in a colonoscopy clinic. A summary of Lewis’ testimony is in sections 119 and 120 pp. 31. He merely testified that fomites could have been the source of infection, no expertise in “collection” or “examination” of colonic biopsies was needed nor noted.

From what I can tell, his only other case that I could find: http://dockets.justia.com/docket/georgia/gasdce/1:2010cv00058/50517/ is along the same lines. So not only does Dr. Lewis inflate his credentials (which is a shame because he does have some research and publication cred) but he does seem to like the underdog, regardless of how slimy.

Reading about events like these make me so pleased that I studied psychology!

Suppose for a moment you were in AJW’s position: his source of income, celebrity, credibility, and self-esteem have been steadily seeping away like sands drain from the top of an hourglass settling at a lower position while he holds on desperately for dear life. Is it any wonder that he’s striking out? I am not, of course, even considering the fact that his own despicable actions have gotten him into this position in the first place: perhaps he has convinced himself after these long years of public and professional humiliation that *he* is the victim. The source of his woes is of course externalised ( much like his theory externalises the causation of autism) thus the problem lies outside himself: he has been wronged and seeks retribution.

One of my profs was interested in what types of excuses ( read *alibis* in this case) children use when they get caught doing something wrong. Often, they blame another person or external events; later on, they may more realistically attribute it to their own personal weaknesses or personality flaws.

Looking at criminal alibis, I’ve often been amazed how convoluted a web would be woven to explain what was in reality, a rather simple event that could be traced back to simple motives: they wanted money, love, or both.

A few weeks ago I read an article by Mr Hitchens where he discussed how it felt losing his capacities for doing what *defined* him: speaking and writing. He scared the h-ll out of me. It’s topic we all consider when dealing with seriously ill or aged people as they lose their sources of identity and self esteem as their capacities decrease- while they detach from the world: psychologically, dying takes a long time. How would I feel if I couldn’t do what I do? Observing this in someone else is un-nerving as it dredges up contemplations of this future existential dilemma in yourself: in resonance, threats to careers and relationships often also feel like the end of the world.

Even understanding this, I can’t muster a shred of sympathy for AJW.

You’ll recall me soliciting advice re Nicole Sandler’s interviews with Wakefield and Deer. It only confirmed what I thought when I read Wakefield’s original paper. He’s not a simple con-man or fraud. There’s just something wrong with how he reasons.

Wakefield’s research was lousy, but can you (or anybody else) prove that he intentionally used weak data that didn’t support his claims – as opposed to an awful case of confirmation bias? And that is the implication of the term “fraud”: to intentionally deceit.

I think one undermines ones position by carelessly using words such as “fraud” and I am afraid that Wakefields case, no matter how frivolous it may seem to you, is stronger than you are aware.

Brian Deer’s documentation of Wakefield’s fraud was very persuasive. It convinced me. I will therefore continue to refer to Andrew Wakefield as a scientific fraud, because in my opinion the evidence is overwhelming that he is, in fact, a scientific fraud.

“Why wouldn’t Dr. Wakefield choose to utilize the American court system? Anyone who has followed this case with an open mind must be aware that Wakefield’s research was excellent and that the claims against him are false.

That squishing sound is the cerebral hemispheres of the “open-minded” falling out onto the floor.

I think one undermines ones position by carelessly using words such as “fraud” and I am afraid that Wakefields case, no matter how frivolous it may seem to you, is stronger than you are aware.

What Wakefield’s defamation suit and his attack Bichon Frise, Lewis have stated is not en pointe with what Mr. Deer actually stated in the BMJ with regards to Wakefield’s fraud (something which the GMC also found with a criminal standard of evidence). I’m afraid Wakefield is tilting at windmills and his disciples won’t be able to see the subtleties of this latest deception because they don’t want to; they never do.

Aaaaand, that should be “on point”, not “en pointe” although Wakefield would make less fool of himself at this point if he did don a tutu and pointe shoes.

I spent the wee hours this A.M. reading Brian Deer’s brilliant analysis and rebuttal to the scurrilous accusations of Dr. Lewis.

Science Mom has provided a link to the New York State Office of Professional Medical Conduct in the matter of Dr. Goldweber. Dr. Goldweber, whose medical license was revoked due to multiple instances of infecting multiple patients because of his improper handling of vials of Propofol…a hypnotic commonly infused during colonoscopy and endoscopy procedures. It was proved to the satisfaction of the OPMC hearing officers, that Dr. Goldweber used a multi-dose vial of Propofol for multiple patients and on at least one occasion did contaminate the vial by drawing up additional medication with a contaminated used syringe. “Double dipping” with a contaminated syringe into a multi-dose vial has been implicated in other cases of transmission of hepatitis B and hepatitis C by physicians.

In an effort to defend himself against these charges, Dr. Goldweber used an “expert witness”. Dr. Lewis claimed credentials as “a micro-biologist with expertise in hepatitis surveillance involving colonoscopy and endoscopy infected scopes and re-use of contaminated forceps and cleaning brushes used to clean off the gross material before sterilizing of equipment used in a procedure”. He was disqualfied as an expert witness in these areas by the OPMC.

I think Science Mom has provided information for the impeachment of Wakefield’s “expert witness”, Dr. Lewis, should the case go forward in the Texas courts.

I have to wonder why anti-vaxxers have come to defend this person. He patented a vaccine of his own and his discrediting of MMR was at best a massive conflict of interest and at worst scientific fraud. He was stridently pro-vax – his vaccine, so the way autism groups embrace him is supremely ironic.

— He has been struck off the register and can no longer practice as a doctor, which has prompted his move to the US. —

Wait, didn’t Wakefield move the U.S. and start working for Thoughtful House a couple of years before that?

Yes. In fact, his being struck from the UK register, coupled with the Lancet retraction, probably led Thoughtful House to force his resignation.

Wakefield’s research was lousy, but can you (or anybody else) prove that he intentionally used weak data that didn’t support his claim

Wakefield reported, “In eight children, the onset of behavioural problems has been linked, either by the parents or by the child’s physician, with measles months and rubella immunisation. . . . In these eight children, the average interval from exposure [to MMR] to first behavioural symptoms was 6.3 days (range 1-14)”

However, Wakefield was apparently aware that the parents of at least ten (not eight, as he wrote) of the children claimed that MMR was temporally linked to the onset of behavioral signs, and (since this group of children was assembled for study precisely because the parents suspected that association) it would be quite surprising if Wakefield was not aware that the parents of at least ELEVEN of the twelve children claimed that link.

Wakefield included the results for Child 5 in a draft of his paper, but deleted that information from the publication. The mother of Child 9 clearly indicated that she believed that MMR caused her child’s autism, but for that child, too, Wakefield wrote that there had been no “exposure [to MMR] identified by parent or doctor.” Wakefield himself wrote “autistic spectrum disorder and bowel disorder following MMR” above his signature in the Child 12’s chart, but he wrote in the Lancet paper there was no “exposure [to MMR] identified by parents or doctor” that the parents or doctors associated with the development of symptoms.

Those omissions helped to significantly reduce the “average interval from exposure [to MMR] to first behavioural symptom.” If he had not selectively edited his data (or, perhaps, simply forgotten to include some of the most significant data for his paper), none of us would have ever heard of Wakefield.

So there it is. As Fiona Godlee noted in her editorial in the BMJ: “A great deal of thought and effort must have gone into drafting the paper to achieve the results [Wakefield] wanted: the discrepancies all led in one direction; misreporting was gross.” [BMJ 2011; 342:c7452]

I have to wonder why anti-vaxxers have come to defend this person. He patented a vaccine of his own and his discrediting of MMR was at best a massive conflict of interest and at worst scientific fraud. He was stridently pro-vax – his vaccine, so the way autism groups embrace him is supremely ironic.

Can’t vouch for the non-American ones, but in the US, I suspect that in large part (particular where the movement’s leaders and most vocal activists are concerned), we’re dealing with a bunch of smart but lazy (and/or math-and-science-phobic) liberal arts majors who are often quite good at putting words together and have a deep distrust of the health care industry, especially as it’s run in the US. (I say this as a liberal arts major who has had feet in both the woo and scientific camps.)

The problem is that the antivax and woo crowd conflate a few greed-driven entities with the scientific method, and so toss the scientific baby out with the greed-is-good bathwater.

Weren’t the concerns over the Urabe MMR vaccine to do with the mumps component rather than the measles component?

Yes, Mojo. Which also brings up the question of which MMR vaccine Wakefield was supposed be doing a study on (there was more than one in the UK between 1988 and 1992), and why there was an American child who would have had an MMR vaccine with the Jeryl Lynn mumps strain.

@ mojo: Yes, our posting colleague “Chris” has posted extensively about the Urabe mumps component.

At the right top of this RI page “Search Science Blogs” key in “Chris Urabe strain mumps” for her excellent explanations of this topic.

I sincerely hope, if Wakefield gets SLAPPed, that the judge takes into account the fundraising activities (conveniently captured for his or her honor’s edification by Team Andy on the website) in awarding the mandatory punitive damages.

If I were the judge, I’d be inquiring as to precisely how much money has been raised through the “Legal Justice Fund,” and would be at pains to ensure the damages exceeded the amount by enough to serve as a deterrent.

Moreover, if Wakefield uses the funds for something other than legal costs, isn’t he committing fraud? (Again.)

@Anj:

Were there warning signs before he conducted that so-called study?

As I understand, yes. He tried to do something similar with Crohn’s Disease. In fact, I believe that that was why Barr chose him to do this “study”.

@Mojo:

Weren’t the concerns over the Urabe MMR vaccine to do with the mumps component rather than the measles component?

Yes, but (assuming the anti-vaxxer Orac quoted is right) the UK government signed a contract with the manufacturer of that version of MMR to to indemnify them against lawsuits over MMR. Depending upon how that contract is worded, it might mean that the government would have to indemnify them even if the lawsuit was over the measles component of the vaccine.

What is wrong with today’s headline at AoA and the comment by its “managing editor”?:

Ron Paul’s Stance Against Vaccine Mandates Featured on Huffington Post

Ron-Paul Managing Editor’s Note: Here is an excerpt from Ron Paul: No To Mandatory Immunization by James Freedman on Huffington Post. Feel free to comment at HuffPo.

(hint) The article headlined by AoA appeared January, 2008 in the Ho-Po and “comments” about the article were closed four years ago.

(hint) The article headlined by AoA appeared January, 2008 in the Ho-Po and “comments” about the article were closed four years ago.

I’d say a more serious problem is that Paul’s political juvenalia is limited to the federal government, which has no role in school vaccine requirements. Paul of course has no problem with states mandating, say, childbirth by way of outlawing abortion.

Matthew — I suspect you’re right that the government would have to indemnify them for any damages arising from that complete vaccine, even if it wasn’t due to the Urabe mumps strain. It would be hard to separate out “Urabe-related lawsuits” successfully in such an indemnification.

But it doesn’t really matter, since Wakefield is not suing the manufacturer for vaccine damages. He’s suing Deer et al for libel. So while one could put on a tinfoil hat and argue that the whole campaign against Wakefield is to prevent impugning a vaccine which was impugned by totally different processes and is no longer used, it still doesn’t really explain why he filed this suit in Texas. This suit cannot bankrupt the UK’s government, and he lost much more pertinent cases years ago; he represents precisely zero threat to the manufacturer and the British government.

Of course, that’s something his followers won’t accept, since persecution of their hero is a major theme. If he’s not being persecuted, they will need to invent persecution in order to keep things going.

Dr. Wakefield Justice Fund : This may be the main reason why Wakefield has avoided the UK, there is a(albeit rather archane) inhibition on fighting funds set up to underwrite a claim for libel. Where the case is lost, anyone shown to be contributing to the financing of the claimant’s case is deemed liable for costs, which can be considerable. In the US, Wakefield can rally the troops to his cause in terms of their dollar commitment.

This may become a cause celebre, attracting support from a whole gammut of anti science cranks.

I suspect that John Walker-Smith who is appealing the determination by the GMC to revoke his license, is not enamored with the idea of being deposed by Wakefield’s counsel or by Deer’s.

The Wakefield “Just Us” fund is going to need a bundle of dough to depose witnesses before trial or during the trial. That, plus paying off the costs of defense, when he loses, will really be the ultimate ruination of St. Andy and his supporters.

@Anj

Were there warning signs before he conducted that so-called study?

I’m not sure that you would call these “warning signs,” but I think that Julian Frost is on point (but probably not en pointe):

Isr Med Assoc J. 2009 Sep;11(9):558-63.

Considerable attention has focused on the role of measles infection and/or vaccination in the pathogenesis of ulcerative colitis and Crohn’s disease, particularly in view of the increasing incidence of the latter. The first cohort study, published in 1995 [24], found an association between measles vaccination and IBD, which was not corroborated by a later case control study [25]. The association between measles infection and IBD is also contentious. An initial report of high rates of Crohn’s disease among pregnancies affected by measles infection [26] was followed by negative studies [27]. The same discrepancy is found in laboratory investigations; while some investigators claimed to find persistent measles infection among patients with IBD, others, using highly sensitive polymerase chain reaction techniques [28], were not able to replicate the findings. In summary, available evidence does not support an association between measles-containing vaccines and risk of IBD, nor between measles infection and IBD. . . .
24. Thompson NP, Montgomery SM, Pounder RE, Wakefield AJ. Is measles vaccination a risk factor for inflammatory bowel disease? Lancet 1995; 345: 1071-4.
25. Feeney M, Ciegg A, Winwood P, Snook J. A case-control study ofmeasles vaccination and inflammatory bowel disease. The East Dorset
Gastroenterology Group. Lancet 1997; 350: 764-6.
26. Ekbom A, Daszak P, Kraaz W, Wakefield AJ. Crohn’s disease after in-utero measles virus exposure. Lancet 1996; 348: 515-17.
27. Nielsen LL, Nielsen NM, Melbye M, et al. Exposure to measles in utero and Crohn’s disease: Danish register study. BMJ 1998; 316: 196-7.
28. Chadwick N, Bruce IJ, Schepelmann S, et al. Measles virus RNA is not detected in inflammatory bowel disease using hybrid capture and reverse transcriptionfollowed by the polymerase chain reaction. J Med Virol 1998; 55: 305-11.

Wakefield also implicated mumps in IBD, but apparently that, too, was refuted:

The British Cohort Study that claimed that atypical measles infection in childhood was a risk factor for IBD also implicated mumps infection before age 2 years with an increased risk for ulcerative colitis (odds ratio 25) [29]. However, the mumps virus genome was not detected by reverse transcriptase-PCR in intestinal specimens of IBD patients, and anti-mumps IgG titer was not significantly different between patients and controls, weakening the causal link between persistent mumps virus infection and IBD [30]. . . .
29. Montgomery SM, Morris DL, Pounder RE, Wakefield AJ. Paramyxovirus infections in childhood and subsequent inflammatory bowel disease. Gastroenterology 1999; 116: 796-803.
30. Iizuka M, Saito H, Yukawa M, et al. No evidence of persistent mumps virus infection in inflammatory bowel disease. Gut 2001; 48: 637-41.

Part of the problem (in a striking parallel to his MMR work) was that Wakefield used an assay that produced abundant false-positive reactions; in this case his assay to detect measles virus used a monoclonal antibody that turned out to produce false-positive results by reacting postively not only with measles but also with a human protein. [Iizuka M et al. Absence of measles virus in Crohn’s disease. Lancet. 1995 Jan 21;345(8943):19; IIzuka M et al. Immunohistochemical analysis of measles related IBD. Gut 2001;48:136-137]

If replications of Wakefield’s research threaten the financial stability of the UK government, one wonders why Wakefield himself turned down the invitation to extend his pilot study into a replication?

For Wakefield to lose Godlee and Deer are going to have to show up in the U.S. for court. A real court with a real jury. Not some corrupt UK kangaroo court. Wonder if they’ll ask them how they got a hold of confidental medical records without the patients permission?

I have no knowledge of US legal system, so I’m wondering how much binding can be donations to a legal fund.
What will happen if Wakefield drops charges? Is he required to return money, or can he claim that he used it to cover costs (fees, research, etc.) already occured?
Will he be required to account for every dollar spent?

Polly,

Not some corrupt UK kangaroo court.

What evidence do you have for that statement?

Wonder if they’ll ask them how they got a hold of confidental medical records without the patients permission?

Maybe. Makes you wonder why nobody’s thought of that before. Or why they haven’t bothered to prosecute them in the UK. I’m shocked – SHOCKED! – that nobody’s thought of that until now and it took a suit in a US court to bring that up. Assuming Dr. Wakefield’s attorneys are smart enough to think of that line of questioning as well, of course.

For Wakefield to lose Godlee and Deer are going to have to show up in the U.S. for court. A real court with a real jury.

You don’t seem to have much of a grasp on civil procedure.

Polly,
Thanks for sharing that bit of idiocy. Well done. Can you get your friends to come out and play as well? It would be better if there was a Wakefield supporter with at least half a brain to ask some questions (again).

Wakefield put up NO defense at the GMC hearing. Why?
Wakefield dropped charges against Deer before and paid all costs. Why?
Wakefield had a delightful vaccine of his own and stood to make millions if his work fraud was accepted. How is that COI acceptable?

There’s tone more but I don’t expect much in the way of an intelligent response from you Polly, or your AoA friends.

richard77 @38
The US legal system varies from State to State. Even in the Federal system and applying only Federal laws, there are 10+ distinct court systems each which its own history of precedent in interpreting the law. The Supreme Court is more likely to hear an appeal if it will help unify precedent between different US Appellate circuits.

So for a suit filed in Texas under Texas state law, one would need an attorney versed in Texas statues and case law (legal precedents). I have not discovered if the (Austin?) court has an online docket system to watch the case from afar. For a nominal copying charge, if you visit the courthouse in question you should be able to get copies of the non-sealed filings, but you are unlikely to receive much help in locating the exact name of the case.

I’ve been reading Jon Ronson’s “The Psychopath Test.”

I wonder if Wakers is just a psycho?

Polly: Wonder if they’ll ask them how they got a hold of confidental medical records without the patients permission?
If you had delved into this for yourself, instead of simply parroting AoA material, you would know that these materials were read into the public record during the GMC hearings. So asking that question in court would make the questioner look rather foolish & ill-informed.

@ Narad: Regarding “Polly” and her posts here. I’ve tangled with this poster before…many times.

Not only is Polly “clueless” about civil court procedure in the United States, she also posts with deliberately redacted PubMed citations…which I nailed her on.

Polly…try reading some of Orac’s blogs and Brian Deer’s articles. If you have any questions about this dubious lawsuit of Andy’s, come back to post…we will be happy to provide some correct information/explanations to you.

@ rpenner: “I have not discovered if the (Austin?) court has an online docket system to watch the case from afar.”

Here you go, “Google” “Travis County Courts” and click on “Civil Courts Online” in the right margin.

@Calli Arcale:

But it doesn’t really matter, since Wakefield is not suing the manufacturer for vaccine damages. He’s suing Deer et al for libel.

Yes, but the “logic” of Wakefield’s supporters is that if he wins the libel suit it will rehabilitate his Lancet paper, enabling the paper to be used in a lawsuit against the vaccine manufacturer.

@Polly:

Wonder if they’ll ask them how they got a hold of confidental medical records without the patients permission?

Argh! How many times do we have to go over this? Wakefield sued Deer for libel. To defend himself, Deer needed to show that what he had said was true. To do that, he needed access to the medical records of the children. Thus, the court granted him access to the medical records, though he couldn’t share them with anyone else at that point in time. Then, once the medical records became public via the GMC hearings, Deer was as free to discuss them as anyone else.

I have not discovered if the (Austin?) court has an online docket system to watch the case from afar.

It appears that this functionality exists only at the appellate level and above. The case was filed in Travis County District Court according to AoA.

If you had delved into this for yourself, instead of simply parroting AoA material, you would know that these materials [medical records] were read into the public record during the GMC hearings.

Who knows what more will emerge from discovery in the Texas defamation case, when the defendants are entitled to access any evidence that Wakefield may have as to his reputation and the truth of the allegations? What fun!!

@ Orac- who speculated about Lewis’ motivation for supporting AJW:

Misery loves company. Both are seeking revenge against the cause of their woes- as perceived or by “transference”( as noted by BD), respectively. Again, if you toss out self-criticism- in the interest of self-perservation- you’ll find fault exclusively in the *external* world which is then peopled by your *betes noires* and runs full-bore on plots aimed at your destruction. If your life appears to be slipping through your fingers, you might feel the urge to claw back in any way you can. Lewis’ compadre, Kohn, spouts off at Axe-grinders’ Central (the Progressive Radio Network) where AJW is a *cause celebre*.

Two guys – no longer young**- looking back over diminishing returns: they had expected recognition of an entirely different sort at this point in their careers. They’re experiencing the damp, chill air of that dark place that
awaits us all not that far down the road without the comforting warmth of accomplishment and recognition from their peers to soften the blow.

( My own work awaits me now)

** I’m over 50, too.

Here is a personal message from “Andy” to his minions at AoA:

From Andy Wakefield: ‘Grateful’

Carmel was involved in a head-on collision on Monday night when an oncoming pickup lost control and crossed into her lane. She was trapped for 45 minutes and was finally transferred to Brackenridge Hospital in Austin. She sustained severe injuries but with exceptional care she has been stabilized and is pain-free. She has remained conscious throughout and has no significant head trauma. It’s going to be a long haul back but she is in good spirits and we are most grateful for the kindness that she has been shown by the autism community, family, and friends. Andy

@ Stagmom: I see you have been “slumming” at RI and took note of my comment at # 30 above and revised your “notation” about the Ron Paul article that appeared in the Ho-Po in 2008:

“Managing Editor’s Note: Here is an excerpt from Ron Paul: No To Mandatory Immunization by James Freedman on Huffington Post. Paul came in second in NH, and Bachman opened the vaccine safety conversation the 2012 race. The topic is as, or more relevant, than it was in ’08.”

No need to thank me Kim…I’m happy to edit your blogs.

St. Andy:

She sustained severe injuries but with exceptional care she has been stabilized and is pain-free.

Before my son was discharged from the hospital last week, the nurse offered him influenza and pneumonia vaccines. I wonder if Brackenridge Hospital will offer Mrs. Wakefield vaccines?

Tony Mach @14:
Wakefield’s research was lousy, but can you (or anybody else) prove that he intentionally used weak data that didn’t support his claims – as opposed to an awful case of confirmation bias? And that is the implication of the term “fraud”: to intentionally deceit.

Wakefield’s case against Deer and the BMJ explicitly accuses them of malice. He has no qualms about inferring their intent. Why is the barrier so much higher for imputing deceitful intent to Wakefield?

@ Tony Mach:

Even if one were to let the pathology aspects slide as an error (which wouldn’t be much better; “gross incompetence” doesn’t even begin to cover it) the charge of fraud would still be irrefutable. The 12 children were represented as consecutive referrals. They were in fact specifically recruited from the plaintiffs in the lawsuit. This cannot possibly be credibly claimed as a mistake, cognitive biases or no.

It can only be explained as deliberate fraud.

Mr. Mach, what do the following three studies have in common with Wakefield’s retracted 1998 Lancet paper?

Lancet. 1999 Jun 12;353(9169):2026-9.
Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association.

BMJ. 2002 Feb 16;324(7334):393-6.
Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study.

Arch Dis Child. 2003 Aug;88(8):666-70.
Prevalence of autism and parentally reported triggers in a north east London population.

@ Chris: “Before my son was discharged from the hospital last week, the nurse offered him influenza and pneumonia vaccines. I wonder if Brackenridge Hospital will offer Mrs. Wakefield vaccines?”

According to the Texas Health and Safety Code [161.00529(b)]
the State Health Department has only mandated that elderly (ages 65 and older) patients be offered/educated about the vaccines and be given the vaccines:

(b) The executive commissioner of the Health and Human Services Commission by rule shall require a hospital to inform each elderly person admitted to the hospital for a period of 24 hours or more that the pneumococcal and influenza vaccines are available. If the elderly person requests a vaccine, and if a physician, or an advanced nurse practitioner or physician assistant on behalf of a physician, determines that the vaccine is in the person’s best interest, the hospital must make the vaccination available to the person before the person is discharged from the hospital.

It has been my experience that all hospitalized patients in my County are questioned about a history of receiving the pneumonia vaccine and questioned if they have received the current seasonal influenza vaccine. They are always offered and provided before hospital discharge…if the patients signs a consent form.

#11 Deice Walter

later on, they may more realistically attribute it to their own personal weaknesses or personality flaws.

Those afflicted with a Narcissistic Personality Disorder don’t grow out of it.
NPD’s are also masters of manipulation and are usually very astute in the recognition and grooming of potential allies. An NPD will make a concerted effort in paying lip service to those who they perceive will support/advance their delusions of superiority.

I’m confused by this “Dr. Wakefield Justice Fund”.

If they really want justice for Dr. Wakefield, shouldn’t the fund’s website be taking donations for Brian Deer’s work?

AJW’s supporters value his hypotheses because they provide ego-enhancement while casting off blame: autism is caused by malfeasance, not by genes, parental actions, or the blind random play of spontaneous mutation, thus giving a boost to hurt, disappointed parents who feel victimised by difficult daily lives. The vaccine-autism hypothesis was there prior to his project: he merely capitalised on it.

Like other alt med supporters, they rally around a person who casts aspersion on the medical establishment while replacing it with financially lucrative wishful thinking: is it any surprise that malcontents would gather around him? A few supporters even may create or resurrect a career through their association with him. Additionally alt med or natural health advocates may feel that his battle is also their battle: if he was proved wrong, can their personal comeuppance be far away?

Note: please forgive any errata or transpositions in my comments today as I have been burning the candle at both ends but felt my take might provide some useful insight into understanding motivation: for those who do not learn from people are forever doomed to being f–cked over by them. ( my apologies to GS)

Tony Mach @14

Wakefield’s research was lousy, but can you (or anybody else) prove that he intentionally used weak data that didn’t support his claims – as opposed to an awful case of confirmation bias?

To add to my response @22:

Wakefield wrote in the Lancet paper: “Child 4 was kept under review for the first year of life because of wide bridging of the nose. He was discharged from follow-up as developmentally normal at age 1 year.”

Let’s unpack that.

There’s a lot going on just in this case.

(1) Wakefield apparently diverged from the child’s records by stating that the child was “developmentally normal” at the time that the health visitor recorded “delayed development.

(2) The child has more than just a “wide bridging of the nose”: he has a deletion in his only copy (males have only a single X chromosome) of the Fragile X Mental Retardation 1 gene in which mutations often cause mental impairment and autism (and repetitive behavior).

(3) The child’s rapid brain growth (unusually small at birth, with unusually rapid early postnatal growth) followed a pattern that is commonly seen in in autism, although Wakefield would not have known that.

(4) The child’s stated that the child’s development slowed months after MMR at age 15 months, but Wakefield reported that the onset of symptoms was “immediately” after the “exposure [to MMR] identified by parents or doctor” at 4.5 years of age.

After reading Deer’s work (2/3rds anyway…skipped a bit in the middle), Lewis sounds a bit like Monckton.

@ Sauceress:

My prof was referring to the *average* course of events. While we really shouldn’t diagnose anyone….. we may of course, discuss *observations* we make…..heh, heh.

I have a comment about “supporters” in moderation. Excuse me while I pass out ( lots of complicated “typing and figuring” going on lately at Maison Walter)

@ brian: I looked up Fragile X FMR 1 gene deletion, it is marked by abnormal facial characteristics noted at birth, including low set ears and a broad nasal bridge. I presume this is the reason for the genetic testing.

As the child develops, more anomalies are noted including dysmorphic facies and skeletal structures. There are always developmental problems, oftentimes degrees of mental retardation and pronounced autistic behaviors.

Is anyone still wondering why Wakefield refused to offer a defense to the GMC charges…and why Wakefield has not appealed the revocation of his medical license?

@lilady

Yes, the files for Child 4 in Wakefield’s Lancet paper also include this:

“[D]elayed development was acknowledged by the health visitor at 1 year of age but at this stage [Mrs 4] did not accept that [Child 4] was slow. I was concerned that we may be missing a syndrome, particularly in view of his odd looking head . . . .”

By the time Wakefield wrote his Lancet paper in 1997, it had been clear for at least 15 years that mutations in FMR1 (the gene that is partially deleted in Child 4) are frequently associated with autism, abnormal development, and dysmorphic features such as “wide bridging of the nose.” In fact, mutations in FMR1 are the most common cause of intellectual disability in males and the most common single-gene cause of autistim.

Why would anyone interested in investigating purported vaccine-related developmental changes in “previously normal” children include in a group of 12 children a child with an “odd looking head” and an identified mutation in a gene associated with the development of precisely the condition under study, especially if “delayed development was acknowledged by the health visitor at 1 year of age” for that child, and particularly if “the professionals who have known [Child 4] since birth . . . [suggest] that some of [Child 4]’s problems may have started before vaccination”?

Augustus, please go find a dictionary and look up the difference between these two words: “offer” (which is what I used) and “want” (the word you used).

Because he makes more money playing the “martyr” card….

I don’t mean to quibble but I disagree. Wakefield has been reduced to earning his income by very unpredictable means such as speaking engagements, book sales (paltry) and I suppose skimming a wage from whatever donations go into the various charities and organisations he has created or signed onto. He lost his post at Thoughtful House due to being struck off the GMC registry, prior to that he lost his post at Royal Free. No, he wants to be legitimate but martyrdom is all he has left.

Yes, much better. Well, she might want it to avoid getting one of three influenza strains, and being very sick for two weeks. And if she turned it down, he could give the reason that my son turned down the influenza vaccine, he had his last October.

“Why would anyone interested in investigating purported vaccine-related developmental changes in “previously normal” children include in a group of 12 children a child with an “odd looking head” and an identified mutation in a gene associated with the development of precisely the condition under study,….”

I dunno, perhaps the lawyer Mr. Barr, who sent the children to Wakefield could explain that.

I cannot understand how these “warrior mommies and daddies” or anyone, for that matter, stills supports this odious man who violated the trust of the patients in his care. He used them for his own glory, prestige and for the money he did derive from his unholy alliance with Barr. This greedy man sought to secure his financial future…as an “expert witness”, as the patent-holder of an alternative vaccine and holding yet more patents, once he developed new tests for the made-up autistic enterocolitis diagnosis.

I’ve cared for children who underwent invasive diagnostic procedures. My own son underwent many diagnostic lumbar punctures and other medical procedures. It is a horrible thing to see these frightened weeping youngsters.

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