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Andrew Wakefield (born 1957) is a British former surgeon and medical researcher known for his fraudulent claims of a causative connection between the measles, mumps and rubella (MMR) vaccine, autism and autistic enterocolitis. The latter controversial term was created by Wakefield to describe an unproven form of inflammatory bowel disease.
Four years after the publication of the study, the findings of other researchers failed to confirm or reproduce Wakefield's. A 2004 investigation by ''Sunday Times'' reporter Brian Deer identified undisclosed financial conflicts of interest on Wakefield's part, and most of his coauthors then withdrew their support for the study's interpretations. The British General Medical Council (GMC) conducted an inquiry into allegations of misconduct against Wakefield and two former colleagues. The investigation centred on Deer's numerous findings, including one that autistic children were subjected to unnecessary invasive medical procedures, such as colonoscopy and lumbar puncture, and that Wakefield acted without the required ethical approval from an institutional review board.
On 28 January 2010, a five-member statutory tribunal of the GMC found some three dozen charges proved, including four counts of dishonesty and 12 counts involving the abuse of developmentally challenged children. The panel ruled that Wakefield had "failed in his duties as a responsible consultant", acted both against the interests of his patients, and "dishonestly and irresponsibly" in his published research. ''The Lancet'' immediately and fully retracted his 1998 publication on the basis of the GMC’s findings, noting that elements of the manuscript had been falsified. Wakefield was struck off the Medical Register in May 2010, and may no longer practise medicine.
In January 2011, an article by Brian Deer and its accompanying editorial in ''BMJ'' identified Wakefield's work as an "elaborate fraud". In a follow-up article, Deer said that Wakefield had planned to launch a venture on the back of an MMR vaccination scare that would profit from new medical tests and "litigation driven testing". However, by that time, Wakefield's study and public recommendations against the use of the combined MMR vaccine were linked to a steep decline in vaccination rates in the United Kingdom and a corresponding rise in measles cases, resulting in serious illness and several fatalities. Wakefield has continued to defend his research and conclusions, saying there was no fraud, hoax or profit motive. The BMJ stands by its story.
Back in the UK, he worked on the liver transplant programme at the Royal Free Hospital in London. In 1995, while conducting research into Crohn's disease, he was approached by Rosemary Kessick, the parent of an autistic child, who was seeking help with her son's bowel problems and autism; Kessick ran a group called Allergy Induced Autism. In 1996, Wakefield turned his attention to researching the connection between the MMR vaccine and autism. At the time of his MMR research study, Wakefield was senior lecturer and honorary consultant in experimental gastroenterology at the Royal Free Hospital School of Medicine (from 2008 UCL Medical School). He resigned in 2001, by "mutual agreement and was made a fellow of the Royal College of Pathologists", and moved to the US in 2001 or 2004, both dates according to 'The Times'. One report noted he was asked to leave Royal Free Hospital in 2004 after he did not fulfill a request to duplicate the findings in his controversial ''Lancet'' paper.
Wakefield subsequently helped establish and served as the executive director of Thoughtful House Center for Children, a center for the study of autism in Austin, Texas where, according to ''The Times'' he "continued to promote the theory of a link between the MMR vaccine and autism, despite admitting it was 'not proved'." He resigned from Thoughtful House in February 2010, after the British General Medical Council found that he had been "dishonest and irresponsible" in conducting his earlier autism research in England. ''The Times'' reported in May 2010 that he was a medical advisor for Visceral, a UK charity that "researches bowel disease and developmental disorders".
Wakefield is no longer licensed in the UK as a physician, and is not licensed in the US. As of January 2011, he lives in the US where he has a following including celebrities like Jenny McCarthy who wrote the foreword for Wakefield's autobiography, ''Callous Disregard'', and believes her son's autism is due to vaccines. According to Deer, as of 2011, he lives near Austin with his wife, Carmel, and four children.
On 28 February 1998, a paper written by Wakefield and twelve other authors about twelve autistic children was published in ''The Lancet''. In it, the authors claimed to have identified a new syndrome which they called autistic enterocolitis, raising the possibility of a link between a novel form of bowel disease, autism, and the MMR vaccine. In the study's "findings", the authors noted that the parents of eight of the twelve children linked what were described as "behavioural symptoms" with MMR, and in its "results" reported that the onset of these symptoms began within two weeks of MMR vaccination. In the published ''Lancet'' summary, known as the "interpretation", the authors wrote:
:"We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers."
These possible triggers were reported to be MMR in eight cases, and measles infection in one. The paper was instantly controversial, leading to widespread publicity in the UK and the convening of a special panel of the UK's Medical Research Council the following month. One study done based in Japan found that there was no causal relationship between the MMR vaccine and autism in groups of children given the triple MMR vaccine and children who received individual measles, mumps and rubella vaccinations. The MMR was replaced with individual vaccinations in 1993.
Although the paper said that no causal connection had been proven, and before it was published, Wakefield made statements at a press conference and in a video news release issued by the hospital, calling for suspension of the triple MMR vaccine until more research could be done. The press conference was later criticized as 'science by press conference'. According to BBC News, it was this press conference, rather than the ''Lancet'' paper, that fueled the MMR vaccination scare. According to the BBC, "He told journalists it was a 'moral issue' and he could no longer support the continued use of the three-in-one jab for measles, mumps and rubella. 'Urgent further research is needed to determine whether MMR may give rise to this complication in a small number of people,' Dr Wakefield said at the time." He said, "If you give three viruses together, three live viruses, then you potentially increase the risk of an adverse event occurring, particularly when one of those viruses influences the immune system in the way that measles does." He suggested parents should opt for single jabs against measles, mumps and rubella, separated by gaps of one year.
In December 2001, Wakefield resigned from the Royal Free Hospital, saying, "I have been asked to go because my research results are unpopular." The medical school said that he had left "by mutual agreement." In February 2002, Wakefield stated, "What precipitated this crisis was the removal of the single vaccine, the removal of choice, and that is what has caused the furore – because the doctors, the gurus, are treating the public as though they are some kind of moronic mass who cannot make an informed decision for themselves."
In 2004, Wakefield started work at the Thoughtful House research center in Austin, Texas. Wakefield served as Executive Director of Thoughtful House until February 2010, when he resigned in the wake of findings against him by the British General Medical Council.
In February 2004, controversy resurfaced when Wakefield was accused of a conflict of interest. The ''Sunday Times'' reported that some of the parents of the 12 children in the ''Lancet'' study were recruited via a UK lawyer preparing a lawsuit against MMR manufacturers, and that the Royal Free Hospital had received £55,000 from the UK's Legal Aid Board (now the Legal Services Commission) to pay for the research. Previously, in October 2003, the board had cut off public funding for the litigation against MMR manufacturers. Following an investigation of ''The Sunday Times'' allegations by the UK General Medical Council, Wakefield was charged with serious professional misconduct, including dishonesty. In December 2006, the ''Sunday Times'' further reported that in addition to the money they gave the Royal Free Hospital, the lawyers responsible for the MMR lawsuit had paid Wakefield personally more than £400,000, which he had not previously disclosed.
Twenty-four hours before the 2004 ''Sunday Times'' report, ''The Lancet'' responded to the investigation in a public statement, describing Wakefield's research as "fatally flawed". ''The Lancet's'' editor said he believed the paper would have been rejected as biased if the peer reviewers had been aware of Wakefield's conflict of interest. Ten of Wakefield's twelve co-authors of the ''Lancet'' paper later published a retraction of an interpretation: The section of the paper retracted read as follows:
: "Interpretation. We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers."
The retraction stated:
: "We wish to make it clear that in this paper no causal link was established between (the) vaccine and autism, as the data were insufficient. However the possibility of such a link was raised, and consequent events have had major implications for public health. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon these findings in the paper, according to precedent."
In addition to Wakefield's unpublished initial patent submission, Deer released a copy of the published patent application. At page 1, the first paragraph of this stated:
: "The present invention relates to a new vaccine/immunisation for the prevention and/or prophylaxis against measles virus infection and to a pharmaceutical or therapeutic composition for the treatment of IBD (Inflammatory Bowel Disease); particularly Crohn's Disease and Ulcerative Colitis and regressive behavioural disease (RBD) (also referred to as "Pervasive Developmental Disorder)."
Before describing the research in Wakefield's 1998 Lancet paper, at the same page this patent explicitly states that the MMR vaccine causes autism:
: "It has now also been shown that use of the MMR vaccine (which is taken to include live attentuated measles vaccine virus, measles virus, mumps vaccine virus and rubella vaccine virus, and wild strains of the aforementioned viruses) results in ileal lymphoid nodular hyperplasia, chronic colitis and pervasive developmental disorder including autism (RBD), in some infants."
According to Deer, a letter from Wakefield's lawyers to him dated 31 Jan 2005 said: "Dr Wakefield did not plan a rival vaccine."
In the Dispatches programme, Deer also revealed that Nicholas Chadwick, a researcher working under Wakefield's supervision in the Royal Free medical school, had failed to find measles virus in the children reported on in the Lancet.
In January 2005, Wakefield initiated libel proceedings against Channel 4, the independent production company Twenty Twenty and Brian Deer. At the same time, Wakefield issued libel proceedings against ''The Sunday Times'', and against Deer personally over his website briandeer.com. Within weeks of issuing his claims, however, Wakefield sought to have the action frozen until after the conclusion of General Medical Council proceedings against him. Fighting back, Channel 4 and Deer obtained a High Court order compelling Wakefield to continue with his action, or discontinue it. After a hearing in court, Mr Justice David Eady ruled against Wakefield, accusing him of using legal moves "as a weapon in his attempts to close down discussion and debate over an important public issue," and stating:
:"I am quite satisfied, therefore, that the Claimant wished to extract whatever advantage he could from the existence of the proceedings while not wishing to progress them or to give the Defendants an opportunity of meeting the claims."
In pleadings submitted to the court, Channel 4's lawyers spelt out what they said Deer's programme had alleged. It said that Wakefield:
:(i) Had dishonestly and irresponsibly spread fear that the MMR vaccine might cause autism in some children, "even though he knew that his own laboratory's tests dramatically contradicted his claims and he knew or ought to have known that there was absolutely no scientific basis at all for his belief that MMR should be broken up into single vaccines."
:(ii) In spreading such fear, also acted dishonestly and irresponsibly, by repeatedly failing to disclose conflicts of interest and/or material information, including his association with contemplated litigation against the manufacturers of MMR and his application for a patent for a vaccine for measles which, if effective, and if the MMR vaccine had been undermined and/or withdrawn on safety grounds, would have been commercially very valuable.
:(iii) Caused medical colleagues serious unease by carrying out research tests on vulnerable children outside the terms or in breach of the permission given by an ethics committee, in particular by subjecting those children to highly invasive and sometimes distressing clinical procedures and thereby abusing them.
:(iv) Has been unremittingly evasive and dishonest in an effort to cover up his wrong-doing.
Proceedings continued for two years, but in December 2006, Deer reported figures obtained from the Legal Services Commission showing that it had paid £435,643 in undisclosed fees to Wakefield for him to build a case against the MMR vaccine, payments which ''The Sunday Times'' reported had begun two years before the ''Lancet'' paper.
Within days of Deer's report, Wakefield dropped all his libel actions and was required to pay all the defendants' legal costs.
In June 2005, the BBC programme ''Horizon'' reported on an unnamed and unpublished study of blood samples from a group of 100 autistic children and 200 children without autism. They reported finding 99% of the samples contained no trace of the measles virus, and the samples that did contain the virus were just as likely to be from non-autistic children, i.e. only three samples contained the measles virus, one from an autistic child and two from a neuro-typical child. The study's authors found no evidence of any link between MMR and autism.
The Institute of Medicine (IOM) of the United States National Academy of Sciences, along with the CDC and the UK National Health Service, have found no link between vaccines and autism. Reviews in the medical literature have also found no link between the MMR vaccine and autism or with bowel disease, which Wakefield called "autistic enterocolitis."
Wakefield denied the charges; on 28 January 2010, the GMC ruled against Wakefield on all issues, stating that he had "failed in his duties as a responsible consultant", acted against the interests of his patients, and "dishonestly and irresponsibly" in his controversial research. On 24 May 2010 he was struck off the United Kingdom medical register; co-author John Walker-Smith was also struck from the medical register, while junior author Simon Murch was cleared. On the same day, Wakefield's autobiography, ''Callous Disregard'' was published. It argued that he had been unfairly treated by the medical and scientific establishment.
In April 2010, Deer expanded on laboratory aspects of his findings in a report in the ''BMJ'', recounting how normal clinical histopathology results (obtained from the Royal Free hospital) had been subjected to wholesale changes, from normal to abnormal, in the medical school and published in ''The Lancet''. On 2 January 2011, Deer provided two tables comparing the data on the twelve children, showing the original hospital data and the data with the wholesale changes as used in the 1998 ''Lancet'' article.
On 5 January 2011, ''BMJ'' published an article by Brian Deer entitled "How the case against the MMR vaccine was fixed". Deer, funded by ''The Sunday Times'' of London and Channel 4 television network, said that, based on examination of the medical records of the 12 children in the original study, his research had found:
: "The Lancet paper was a case series of 12 child patients; it reported a proposed “new syndrome” of enterocolitis and regressive autism and associated this with MMR as an “apparent precipitating event.” But in fact:
:: "Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism;
:: "Despite the paper claiming that all 12 children were “previously normal,” five had documented pre-existing developmental concerns;
:: "Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination;
:: "In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school “research review” to “non-specific colitis”;
:: "The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations — all giving times to onset of problems in months — helped to create the appearance of a 14 day temporal link;
:: "Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation."
In an accompanying editorial, ''BMJ'' editors said:
Clear evidence of falsification of data should now close the door on this damaging vaccine scare ... Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children's cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. Moreover, although the scale of the GMC's 217 day hearing precluded additional charges focused directly on the fraud, the panel found him guilty of dishonesty concerning the study's admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards.
In a ''BMJ'' follow-up article on 11 January 2011, Deer said that based upon documents he obtained under Freedom of information legislation, Wakefield—in partnership with the father of one of the boys in the study—had planned to launch a venture on the back of an MMR vaccination scare that would profit from new medical tests and "litigation driven testing". ''The Washington Post'' reported that Deer said that Wakefield predicted he "could make more than $43 million a year from diagnostic kits" for the new condition, autistic enterocolitis. According to Deer's report in ''BMJ'', the ventures, Immunospecifics Biotechnologies Ltd and Carmel Healthcare Ltd—named after Wakefield’s wife—failed after Wakefield's superiors at University College London's medical school gave him a two-page letter that said:
"We remain concerned about a possible serious conflict of interest between your academic employment by UCL, and your involvement with Carmel ... This concern arose originally because the company's business plan appears to depend on premature, scientifically unjustified publication of results, which do not conform to the rigorous academic and scientific standards that are generally expected."
WebMD reported on Deer's ''BMJ'' report, saying that the $43 million predicted yearly profits would come from marketing kits for "diagnosing patients with autism" and that "the initial market for the diagnostic will be litigation-driven testing of patients with AE [autistic enterocolitis, an unproven condition concocted by Wakefield] from both the UK and the USA". According to WebMD, the ''BMJ'' article also claimed that Carmel Healthcare Ltd would succeed in marketing products and developing a replacement vaccine if "public confidence in the MMR vaccine was damaged".
The following day the editor of a specialist journal, ''Neurotoxicology'', withdrew another Wakefield paper that was in press. The article, which concerned research on monkeys, had already been published online and sought to implicate vaccines in autism.
In May 2010, ''The American Journal of Gastroenterology'' retracted a paper of Wakefield's that used data from the 12 patients of the ''Lancet'' article.
On 5 January 2011, ''BMJ'' editors recommended that Wakefield's other publications should be scrutinized and retracted if need be.
According to ''BMJ'', he says "he never claimed that the children had regressive autism, nor that he said they were previously normal. He never misreported or changed any findings in the study, and never patented a measles vaccine. None of the children were [attorney] Barr's clients before referral to the hospital, and he never received huge payments from the lawyer. There were no conflicts of interest. He is the victim of a conspiracy. He never linked autism with MMR."
In an internet radio interview, Wakefield said the ''BMJ'' series "was utter nonsense" and denied "that he used the cases of the 12 children in his study to promote his business venture". Although Deer is funded by ''The Sunday Times'' and Channel 4, he has filed financial disclosure forms and denies receiving any funding from the pharmaceutical industry, who Wakefield says is paying him. According to CNN, Wakefield said the patent he held was for "an 'over-the-counter nutritional supplement' that boosts the immune system". WebMD reported that Wakefield said he was the victim of "a ruthless, pragmatic attempt to crush any attempt to investigate valid vaccine safety concerns".
Wakefield claims that Deer is a "hit man who was brought in to take [him] down" and that other scientists have simply taken Deer at his word. While on ''Anderson Cooper 360°'', claiming he hadn't read the ''BMJ'' articles yet, he denied their validity and denied that Deer had interviewed the families of the children in the study. He also urged viewers to read his book, ''Callous Disregard'', which he claimed would explain why he was being targeted, to which Anderson Cooper replied: "But, sir, if you're lying, then your book is also a lie. If your study is a lie, your book is a lie."
Wakefield would later imply that there is a conspiracy by public health officials and pharmaceutical companies to discredit him, including suggesting they pay bloggers to post rumors about him on websites or that they artificially inflated reports of deaths from measles.
: "If it is true that Andrew Wakefield is not guilty as charged, he has the remedy of bringing a libel action against myself, the ''Sunday Times of London'', against the medical journal here, and he would be the richest man in America." He also noted that Wakefield has previously sued him and lost.
On 5 April 2011, Deer was named the UK's specialist journalist of the year in the British Press Awards, organised by the Society of Editors. The judges said that his investigation of Wakefield was a "tremendous righting of a wrong".
The Associated Press said:
: "Immunization rates in Britain dropped from 92 percent to 73 percent, and were as low as 50 percent in some parts of London. The effect was not nearly as dramatic in the United States, but researchers have estimated that as many as 125,000 U.S. children born in the late 1990s did not get the MMR vaccine because of the Wakefield splash."
ABC News Channel WWAY3 said:
: "Since Dr. Andrew Wakefield's study was released in 1998, many parents have been convinced the measels, mumps and rubella vaccine could lead to autism. But that study may have done more harm than good. According to the Centers for Disease Control and Prevention, in the United States, more cases of measles were reported in 2008 than any year since 1997. More than 90 percent of those infected had not been vaccinated, or their vaccination status was not known."
Paul Hébert, editor-in-chief of the ''Canadian Medical Association Journal'' (CMAJ) said:
: "There has been a huge impact from the Wakefield fiasco ... This spawned a whole anti-vaccine movement. Great Britain has seen measles outbreaks. It probably resulted in a lot of deaths."
A profile in a New York Times Magazine article noted:
:"Andrew Wakefield has become one of the most reviled doctors of his generation, blamed directly and indirectly, depending on the accuser, for irresponsibly starting a panic with tragic repercussions: vaccination rates so low that childhood diseases once all but eradicated here — whooping cough and measles, among them — have re-emerged, endangering young lives."
Journalist Brian Deer called for criminal charges to be brought against Wakefield.
Despite the allegations of misconduct and fraud, Wakefield continues to rely on the monetary and emotional support of fans who continue to support him. J. B. Handley of the autism and anti-vaccine advocacy group Generation Rescue noted, "To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one."
On April 1 2011, the James Randi Educational Foundation awarded Wakefield the Pigasus Award for "refusal to face reality".
Category:Medical Scandals Category:MMR vaccine controversy Category:Anti-vaccination activists Category:Health fraud Category:Scientific misconduct Category:Living people Category:1957 births Category:Date of birth missing (living people) Category:Place of birth missing (living people) Category:British medical researchers Category:Alumni of Imperial College London Category:People educated at King Edward's School, Bath
af:Andrew Wakefield de:Andrew Wakefield fr:Andrew Wakefield pt:Andrew Wakefield fi:Andrew Wakefield vi:Andrew WakefieldThis text is licensed under the Creative Commons CC-BY-SA License. This text was originally published on Wikipedia and was developed by the Wikipedia community.
Sylvie Goulard's work focuses on the necessity of pursuing European integration whilst also inviting increased public debate about European questions. Europe's citizens must become more engaged with its development in the future. They need to be informed and active: and to achieve this cultural and professional exchanges and learning foreign languages are essential.
In 2004, before accession discussions were opened with Turkey, Sylvie had taken a position in the debate concerning the eventual enlargement of the European Union to include this country by underlining the necessity of preserving the European Union's political ambitions and its capacity to act. She also called for doubts expressed by citizens facing a European venture, whose direction they do not properly understand, to be taken seriously.
At the end of 2006 she was elected president of the Mouvement Européen-France (ME-F), succeeding Pierre Moscovici, who had also been a candidate. She was re-elected as president in December 2008.
Le Mouvement Européen-France regularly organises meetings, conferences and debates which aim are to enable a dialogue between political figures, experts and the general public.
In the context of a series of monthly conferences entitled "European Realities", organised in partnership with MEDEF (Mouvement des Entreprises de France), the ME-F gave the floor to the CEOs of companies so that they could concretely explain how they live and experience Europe on a daily basis. For further details see www.mouvement-europeen.eu.
On 15 September 2010 Sylvie Goulard supported the new initiative Spinelli Group, which was founded to reinvigorate the strive for federalisation of the European Union (EU). Other prominent supporters are: Jacques Delors, Joschka Fischer, Andrew Duff, Elmar Brok.
Sylvie Goulard writes regularly in a wide range of both French (Le Monde, La Croix, Libération) and international (Süddeutsche Zeitung, Financial Times particularly) newspapers.
Category:Living people Category:French politicians Category:MEPs for West France 2009–2014
de:Sylvie Goulard fr:Sylvie Goulard pl:Sylvie Goulard
de:Sylvie Goulard fr:Sylvie Goulard pl:Sylvie GoulardThis text is licensed under the Creative Commons CC-BY-SA License. This text was originally published on Wikipedia and was developed by the Wikipedia community.
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