Measles – spot the worrying trend (Updated)


Widely reported in the media, the latest figures show that cases of measles are up again in the UK. The BBC has the story here, including a graph:

bbcs-hpa-graph

…while blogging GP Euan the Northern Doctor offers some analysis here. The story has also been well covered in the Bad Science Blogosphere by both jdc and by Martin the Lay Scientist.

As if by some sort of serendipity, yesterday also marked the re-start of the General Medical Council’s protracted “Fitness to Practise” (misconduct) hearings into Dr Andrew Wakefield, one of the key originators of the UK anti-MMR panic. If there is anyone reading not familiar with the media ”manufactroversy” over MMR, Ben Goldacre offers an introduction here, while journalist Brian Deer gives a magisterial, if lengthy, summary of his investigations into Wakefield and his work on his blog.

One interesting aspect of the new measles figures, highlighted by the Northern Doctor, is that the rates of measles infections seem to vary for different parts of the country. Which got me to wondering why. Of course there are many, many possible reasons, but one variable might be the extent, and kind, of pro-vaccination information that people see.

So what material does the NHS put out?

Pretty anodyne stuff, is the answer.

If you go to the NHS immunisation information site, you can find the current NHS MMR vaccination poster:

nhs-measles-poster

- the big red blob with smaller blobs around it presumably represent a virus particle, or perhaps new virus particles budding from an infected cell, although you would possibly have to be a scientist (or at least have done GCSE science) to work this out.

To me, the whole poster seems… well, boring. It is a pretty enough piece of graphic design, and has the key verbal message, but it has no “What?” value. Just a bunch of words.

The only NHS vaccination poster which appears to have any kind of “Warning” element is the one for the winter ‘flu jab:

uk-flu_jab-pic

This one has a few scary saber-toothed gremlin-type thingies, presumably again representing nasty ‘flu viruses, and a finger-wag. But, again, nothing to really stop you short.

Im Vaterland schaffen wir das anders…

In contrast, a couple of months back my German friend “Sceptic Eric” sent me some pictures of two German posters promoting vaccination that had appeared where he lives:

german-pro-vax-ad-no1-crop

The caption says:

Lisa, aged 9, is blind because of Rubella

(The smaller writing on the red backgrounds says “Vaccinate Now!”)

And the second poster:

german-pro-vax-ad-no1-crop-2

Daniel, aged 12 – left mentally handicapped by Measles.

These appeared, note, on big advertising bill-boards – not hidden away on the wall of the GP’s waiting room. They seem to me to be much more shocking – and thus memorable – posters than the UK ones. Instead of vague exhortations, they focus on the tragic consequences that can follow infectious diseases which people commonly view as harmless.

Ah yes. “Harmless childhood illnesses”.

An argument one often hears, typically from parents who do not have their children vaccinated is

“Illnesses like measles and mumps were a normal part of childhood. Loads of older people we know had them, and they were fine.”

Well, the German campaign gives some context for this statement. Some children who catch diseases like measles are emphatically NOT fine. Some get very ill, but get better, like the child whose story is described here. Some get even sicker, with things like pneumonia and encephalitis. And unvaccinated adults can get measles, and the nasty consequences, too. As I said in an earlier post, Mrs Dr Aust treated a few seriously ill adult cases like this in her days in hospital acute medicine and Intensive care.

And for Rubella, children with the disease give it to other people. Possibly including pregnant women. After all, pregnant women often have children, including nursery- and school-age children. Schools and nurseries are the best places you can think of for children to catch bugs from one another. This is, I suspect, even truer in the UK than in some other countries. If Governments and schools bang on relentlessly about high levels of attendance; if both parents work, and employers frown on time off for family reasons; if kids are almost universally in nursery from the age of six months up – then it stands to reason that there will be plenty of children at school and nursery who are clearly sickening for something, if not frankly ill. The UK, you might notice, fulfils all the above conditions.

If a woman in early pregnancy catches Rubella, she has about a 20% chance of miscarrying spontaneously. And if her pregnancy goes to term her child has a significant chance – 20-50% depending on precisely when in pregnancy the mother caught Rubella – of being born with Congenital rubella syndrome, which can mean serious physical and developmental problems, like blindness, deafness and mental retardation – as the first German poster indicates.

So why, I wonder, do we not have similar ram-the-vaccination-message-home poster campaigns here in the UK?

Do we think it is too graphic?

Or do we think that, because of all the media’s credulous reporting of the anti-MMR and anti-vaccine scare, people will look at posters like this and see “scare tactics and thought control”?

Or do they say “well, you can get them things just from getting vaccinated, innit?”

[ Err… not. The reported rate of “serious reactions” to MMR is about 3 in 100,000. In contrast, acute measles hospitalizes roughly one child in ten and kills one in every two to five thousand]

The tricks of memory

The flawed argument about “harmless childhood illnesses” is easy to understand. Most people have never seen a case of serious illness following measles. Ergo, measles must be harmless. They are blinded by their own personal experiences, and cannot seem to grasp the statistics.

I can understand this to an extent. I am a child of the 60s, pre the measles vaccination, and I had measles. I was OK. Others, of course, were not. But not anyone I knew.

The problem (from the POV of anti-vaccine scares) is that my experience is more common than the other – getting really ill, or knowing someone closely who did. So people in my age group commonly tend to know people that had measles (them and all their friends) but who got better with no serious, or at least lasting, consequences. They in turn tell their children and friends this.

Of course, the memory may not even be accurate. Even if a cousin or friend was in hospital as a child for a week, would you remember this after thirty years? If it was a classmate? If you too were a child at the time?

Personally, I have only one lasting memory before the age of about seven, and that is that the cake for my fifth birthday was shaped like Thunderbird One and had a Walnut Whip covered in red icing for a nose-cone. And I probably only remember that because there is an old family photo of it somewhere.

So – memory is unreliable. With the benefit of years that wipe away the memory of how lousy you would have felt when you had measles, your bout of measles gets recalled as “I must have had measles, so did everyone I know, we were all fine” (which may, or may not, be accurate) and then translated on into “measles is a totally harmless childhood illness” (which of course is rubbish, as we have already seen).

Heroes in the struggle for reality-over-scares

There is a great article on this, and the underlying statistics, here, written by a retired CDC epidemiologist who survived a life-threatening bout of serious measles complications as a kid in the late 50s. The author blogs as “EpiWonk”. Over the last year or so he has done a great job on his blog of the same name deconstructing the inaccurate and spurious arguments of the MMR-equals-horrors nitwits, specifically when they misuse and abuse epidemiology

And talking of measles, vaccination, and Dr Aust’s patch in the North-west of England, an honourable “local hero” mention should go to Dr Peter Flegg, an Infectious Disease consultant from Blackpool who spends a fair amount of his time online patiently explaining risk-benefit (and related topics) to do with vaccination.

Of course, a lot of the people he is trying to explain it to are figuratively sat with their fingers stuck permanently in their ears while shouting “nyeeah nyeeah nee nyeeah nyeeah, I can’t hear you”. But he keeps trying.

For a fairly recent example of both of these, try the British Medical Journal thread here, where you will find him discussing the relative risks and benefits of vaccination (versus actually catching measles). As you would expect, the real numbers are overwhelmingly in favour of vaccination. Even more remarkable is that Dr Flegg, with heroic restraint, manages not to lose his rag with Jackie Fletcher of JABS and her equally crackers friends.

Yet another person who deserves a lot of kudos for his tireless exposition of the nonsense of the anti-MMR lobby (and anti-vaccine nuts generally) is Dr Anthony Cox, proprietor of the BlackTriangle blog.  Cox has often been found over the years taking on the thankless task of debunking the anti-science ravings of media Wakefield Über-fan Melanie Phillips, and of various inhabitants of that stew of ignorance and prejudice known as “the JABS forums”. For this Cox regularly gets abused in personal terms by the JABS crew, who of course insist endlessly that they “don’t do ad hominem attacks”

So what to do?

So what do we take from the rise in measles rates?  We conclude, I think, that it is worrying, though not as worrying as the prospect of a further rise if vaccination rates don’t increase again. And we conclude that more effort is needed to get the vaccination message out.  And to educate people on the real rates of complications of measles, rather than of vaccines.

Perhaps it is time we spent some of the money the Government likes to spend paying celebs to appear in health campaigns on a pro-vaccination campaign (with or without celeb). Or on some German-style posters. Or both. We certainly need to do something.

Euan the Northern Doctor tells us he has managed more than a decade of practicing medicine in hospital, and latterly as a GP, without seeing a single confirmed case of measles – thanks, of course, to mass childhood vaccination:


“I don’t recall having ever seen a case of measles and I am hopeful it will stay that way.”

I hope so too. Though I am not all that confident.

[bpsdb]

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Update:  Saturday  Feb 7th. Jeni Barnett is a mother and an ex-actress. So she knows all about vaccination. ..err…?

Since this post was written, the MMR vaccine has rocketed back into the news again in the UK (at least in the blogosphere) with the furore about actress turned rent-a-quote presenter Jeni Barnett and her spectacularly awful phone-in on vaccination. I have never, I think, seen an issue which has united the BadScience bloggers and the medical bloggers (like my e-friends Dr Crippen, Dr Grumble, the Jobbing Doctor and Euan the Northern Doctor) in such unanimous fashion. Indeed, it seems like Dr Aust is probably the only BadScience blogger NOT to have covered the issue (mainly because so far I can’t think of anything new or distinctive to say). Anyway, Holfordwatch has an excellent roll-call of the blogs which, in a predictable but gratifying “Streisand Effect”, have covered the issue.

Jeni Barnett’s astonishingly ill-informed comments, petulant on-air behaviour, and dismissive attitude to anyone – notably actual healthcare folks – that rang in to correct her demonstrate, yet again, just how idiotic – not to mention dangerously deluded -”personalities” can be when they comment on stuff they know F-All about.  Holfordwatch has links to all the transcripts if you haven’t already read them, or heard the programme.

It all reminded me oddly of  a depressing TV debate I saw, just a bit more than five years ago, that followed on from Channel 5′s airing of the notorious 2003 TV Play “Hear the Silence”, about a mother convinced her child had been damaged by the MMR vaccine. The play – Guardian TV review here – featured Juliet Stevenson as the mother, and had a ludicrously saintly version of Andrew Wakefield (glossily impersonated by actor Hugh Bonneville) as its main hero. It was a powerful and compelling piece of drama…

…except that everything in it relating to MMR was farcically inaccurate, and utterly wrong.

What got me, however, was not so much the play as the studio debate afterwards – in which Juliet Stevenson, a fine actor but with no scientific or medical knowledge or training, harangued the medical and scientific types about the (imaginary) risks of MMR vaccination. Embodying the role is one thing, but deciding you now know enough to harangue people about the science on national TV? As so often, the phrase “The Arrogance of Ignorance” springs to mind – see also Jeni Barnett, or Jenny McCarthy in the US.

You can read what the British Medical Journal’s commentators – child health experts David Elliman and Helen Bedford, and GP, author, and Channel 5 debate participant Mike Fitzpatrick – thought of Hear the Silence here and here. Sadly, you won’t be able to get to the full text versions unless you have BMA, University or Athens login privileges, though you will be unsurprised to hear that they were not impressed. However, you can read, for free, the Rapid Responses (e-Letters)  that the BMJ received about the articles. The thread following Fitzpatrick’s article is notable for some sane responses from another doctor-turned-author, Neville Goodman. You will be unsurprised that the thread following the other BMJ piece eventually ends up with anti-vaccine über-obsessive John Stone of JABS talking to himself (as usual) long after everyone else has left (as usual).

Meanwhile, more measles – and a death

Finally, just a couple of days ago, as the shit hit the fan over Jeni Barnett’s dismal programme, I got an e-Mail from my German-language correspondent Sceptic Eric, directing me here. This is a piece about a recent Swiss measles epidemic, including the death of a 12 year old girl from measles encephalitis (1).

Perhaps Jeni Barnett would care to read it before putting up any more ill-informed self-justification on her blog.

(1) Sorry, Google machine translation, so a bit incoherent, though you can get the gist. If you can read a bit of German, the original is here.

The same case (I think) is reported in the French-language Swiss press, e.g. here (a thank-you to Svetlana for pointing this out) – and English machine-translation is here.

—————————————————————————

Postscript

While I was writing the original lengthy ramble Californian blogger Liz Ditz drew my attention to a talk given by American scientist and “skeptic” Dr. Steven Salzberg a couple of months back in the States, and now up on youtube. If anyone needs a concise video introduction to the MMR anti-vaccine scare, it is a good place to start. Prof S thinks we should all be doing more to combat the still-bubbling anti-vaccine hysteria:

“Scientists and skeptics need to act to quell the rumors and educate the public, so that vaccines, one of the greatest medical successes in history, remain an effective tool in our fight against disease.”

The talk may be a bit US-focussed for UK listeners, but it is a good introduction to the whole story. It is in five parts – if you haven’t got the patience for the whole lot, and/or are already familiar with the main bits, you could skip to parts four and five to see the kind of things that American defenders of vaccination like Dr Paul Offit are up against (more on Offit here).

Part One,  8:31 min – Intro to autism & Wakefield’s paper.

Part Two, 7:54 – Brian Deer’s revelation of Wakefield’s misdeeds and Wakefield’s responses.

Part Three 6:34- Mostly on the thimerosal (vaccine preservative) – autism scare so beloved of ex-travel writer David Kirby

Part Four 8:54- Why Is Autism Ripe for Quacks to Exploit? segueing into “What does science say about autism?”

Part Five 8:49 – Continued discussion of increased incidence of vaccine preventable disease with fall in vaccination levels, plus a discussion of “Is there an autism epidemic?” and “What is really known about the causes of autism”. Finishes with US lawyers’ attacks on vaccines and courting of public opinion by anti-vaccine groups.

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24 Responses to “Measles – spot the worrying trend (Updated)”

  1. Alan Henness (zeno) Says:

    “blinded by their own personal experiences”

    This applies to so much anti-science, doesn’t it? The parent who ‘knows’ that their child was damaged by a vaccine and the AltMeds who have personal experience of ‘seeing’ their particular woo curing every ailment under the sun (and a few more besides!), never to budge from that ridiculous position, despite all the scientific evidence. Why? I just do not understand it.

  2. JuJu Says:

    The NPS radio show ‘This American Life’ did an episode called Ruining It for the Rest of Us, in which they interviewed some of the people at the heart of a recent measles outbreak in San Diago. The episode might no longer be free to download but is well worth a listen, particularly to hear the story of the woman whose infant son, too young to get the MMR jab, suffered horribly as a result f another family’s irresponsibility.

    http://www.thislife.org/Radio_Episode.aspx?sched=1275

  3. Teek Says:

    fantastic post Dr Aust, I love the bit about selective memory – of course our own experience clouds our judgement about ‘the bigger picture,’ and prevents most people from looking at bald statistics and drawing sensible conclusions from there.

    there is clear evidence that a drop in vaccine uptake rate caused this spike in measles cases – now is the time to ramp up the defence of vaccines as you rightly say, with a hard-hitting campaign but also with GP-based parent-oriented messages.

    great stuff (the blog post, not the fact that we have more measles…)

  4. anandamide Says:

    “Why? I just do not understand it”

    Because humans aren’t as half as we think they are. Personal experience is always going to be more immediately convincing than abstract knowledge.

    I had measles in the 80′s (my immune system never got the vaccine hint), as a 7 year old – thinking back, the experience was surreal in part because measles just doesn’t (didn’t) happen. Due to the success of vaccination, the doctors were helpless when an actual case presented, and other than confirming my parent’s fears there was nothing they could do except ‘fluids and rest’. Fortunately I never needed hospitalizing, but the experience was horrible.

  5. wilsontown Says:

    The difference between the UK and German adverising campaigns on measles and rubella is interesting. It surely can’t be because the German posters would be too graphic in a UK context. After all, some of the TV adverts we have had trying to convince people not to drink and drive, or to fasten their seatbelts when driving, have been absolutely horrific.

    If the UK did put up posters similar to the German ones, you can bet that the loonies would be out in force. So I wonder if there might be “political” reasons for not having a stronger ad campaign?

  6. Sceric Says:

    great post Dr. A…
    you probably can’t generalize the pictures as a German campaign, as these pictures were mainly shown in the “Ruhrgebiet” area (lot’s of people –> lot’s of impact) and we have those rises in measles too..at least in some areas of Germany and as I get the feeling mainly in areas/communities that are more “green” (ecologicalwise) than the rest…probably because you get more extreme tree- and bunny-huggers there, that are unfortunately prone to the esoteric side of things (note: definetly not all of them! Exihibit A: I’m married to, Exibit B: Several friends of us)…
    I agree with wilsontown, those are not more graphic and shocking than the con-drunk driving ads or the news

  7. John H Says:

    Another excellent post Dr Aust (there can never be enough well reasoned articles lancing the boil of jabbophobia).

    Orac posted a good anti-jabbophobe article on his Respectful Insolence site a few days ago (or possibly yesterday). Some useful stuff on Dr Offit, who is turning into some sort of superhero from my perspective:

    http://scienceblogs.com/insolence/2009/01/rallying_resistance_to_the_antivaccine_j.php

    I was born in 1954 and M, M and R were regarded as extremely dangerous diseases by my mother. There was a general feeling at the time that they were standard/normal childhood illnesses. However, my mother was born in rural Ireland in 1930 and saw many children die from these “simple” illnesses. Obviously the lack of decent medical care didn’t help much so only six out of thirteen of her siblings ever saw their fifteenth birthday. Most of them got nowhere near it.

    There is a table available at . . . .

    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases&deaths.pdf

    . . . . .. which details the number of cases of M,M, R pertussis etc (admittedly only for the USA) and the number of deaths which resulted.

    If you compare 1960-1966 and 1997-2003 (purely because the data is not available post 2003) the total deaths are:

    Measles 2544 versus 7
    Mumps 310 versus 5
    Rubella 131 versus 2

    Just looking at measles it peaked at 763,000 cases in 1958 and went down to 30 in 2007. Deaths peaked at 683 in 1951. In the year I was born 518 Americans died of measles. I would like to find the data for the UK if anyone can point me in the right direction.

    There were no measles deaths in 1993, 1994, 1998,2002. From 1993 to 2003 there were never more than 2 deaths maximum per annum.

    And these are only deaths. There are no records I can find of blindness, brain damage etc caused by these “normal” childhood illnesses.

    It would appear to be remarkably difficult to argue with Professor Salzberg’s comment in the post above on the effectiveness of vaccination.

    The deaths that did occur were probably among those wierd religious sects which have immunity from having their kids vaccinated on the grounds that they have a particularly pious belief in some magical sky fairy. Or just extreme bad luck – it is a bit of a bastard in the luck stakes to be the only person in a population of 260,000,000 to die of measles.

    I cannot even begin to imagine how these death rates/survival rates extrapolate globally – especially where medical care is rubbish.

    It probably violates their human rights (as if I care about them – they ride roughshod over others, like the right to life for example) but I would like to see this table tattoed in mirror image on every jabbophobes forehead.

  8. kat Says:

    I don’t remember how ill I was with measles, which I had as a child. I also don’t actually reember how ill I was when I had mumps, aged 5. However, I have a permanent reminder, with a 60% hearing loss due to it.

  9. draust Says:

    Thanks All. I’m a bit embarassed, actually – thought it was a bit same-y apart from Eric’s pictures!

    Good point about the various bad / drunk / no seatbelt driving ads in the UK, which are certainly pretty graphic. One reason for which is presumably that they have serious money behind them, and a big ad agency on the job, as well as wanting to push the message hard.

    The real question is: where is the TV pro-vaccination ad campaign in the UK? I wouldn’t really mind if it was hard-hitting, or “celebrity mother and baby” (though I could see both)… as long as there was something.

    Will tackle the personal experience vs. dry statistics (or facts) argument another time. But I think one has to say that a failure of education is involved at some level.

  10. draust Says:

    PS And thanks to Kat for the real example of a lasting consequence of childhood illness.

    One famous story about mumps is that in Finland, pre MMR vaccination, they would find that over a quarter of their 18 yr-old military recruits would get mumps during their year or whatever of barracks life. Mumps is nasty when you get it post-puberty, and almost one in every ten recruits in the 70s would get “orchitis” (painfully swollen testicle), with some rendered sterile. Mass childhood vaccination prevented this. This story is recounted on the excellent Bandolier site. The page with the story on is also rather good on the small rate of actual (as opposed to fictitious) serious adverse effects after MMR vaccination.

  11. northerndoctor Says:

    Re your comment Anandamide – to be fair to the doctors then (and myself now!) I would say that the initial treatment of measles is ‘fluid and rest’. And sit back and watch carefully for any complications of course.

    I would also agree with wilsontown and I think the reason the adverts are not so hardhitting is that there is still political sensitivity about this issue.

    I also had mumps as a kid – no issues like Kat luckily. Unlike measles I have seen a bit of mumps – there was a bit of a blip in cases a few years ago in freshers who had just missed out on MMR as kids (pre-1988 births).

  12. John H Says:

    You appear to be a remarkably quiescent Dr Aust at the moment (apart from your contribution to the Skeptics Circle Quiz.).

    For those who want a look at the distillation of global woo and quackery (and a laugh) it is here:

    http://spacecityskeptics.wordpress.com/2009/01/28/104th-skeptics-circle-the-skepticism-review-and-education-program-edition/

    Am I missing something here and the party is in full swing elsewhere.

  13. Dr Aust Says:

    Hi John

    I’ve just been very busy, so haven’t had time to do much more than produce a couple of diary entries, and kibitz a bit on other peoples’ blogs.

    The current big news items in the UK Sceptic-o-sphere are the demise of several B.Sc.s in Alt.Reality, covered on David Colquhoun’s blog, and the African adventures of the deluded homeopathic guru Jeremy Sherr, which Gimpy has been doing such a first-rate job of exposing.

  14. Some Rebuttals to Jeni Barnett’s Canards in Her LBC Radio MMR Segment « Holford Watch: Patrick Holford, nutritionism and bad science Says:

    [...] and with feeling, it isn’t. Just to emphasise this point, look through Dr Aust’s post: Measles: Spot the Worrying Trend with its remarkable illustrations of the chilling billboard advertisements in Germany that advise [...]

  15. dvnutrix Says:

    Dr Aust, it seems particularly invidious that not only did Jeni Barnett think it unnecessary to prepare for her segment on this difficult, hot-button topic, even when the lacunae in her knowledge have been exposed, she is actually proud of them as if they somehow demonstrate her humanity.

    I’m heart-sorry to learn of the death of a previously healthy young girl who was so disastrously affected by the sequelae of infection by measles.

    Not for nothing does Dr Diane Griffin details the remarkable immunosuppressant effects of the measles virus (see pg. 2738 onwards, Day 11 Autism Omnibus Hearings pdf). It seems that measles not only challenges the immune system itself, it suppresses response to other challenges so most deaths from measles are related to secondary infections.

    So there is a period of time which is initiated during this acute phase that children are more susceptible to other infectious diseases. So this is a very clinically important complication or outcome or by-product of measles and all of the data suggests that it’s clinically related, as I say paradoxically, to the fact that the immune system is so activated and so engaged in making a response to measles that it is not appropriately positioned to respond to some new challenge that comes along at this same time… [pg. 2768]…
    So a number of viruses that are particularly pathogenic, actually, have figured out how to block the interferon response in order to have a better chance of really causing a more severe disease. And wild-type measles seems to be among those viruses that can do that…[pg 2772]
    We forget in the US what a serious disease [measles] was and why it was such an early target for the development of a vaccine, because the [mortality] is substantial. And the mortality is substantial, even in developed countries. It’s less in developed countries but it’s substantial. And if everyone gets it, that’s a lot. [pg. 2797]

  16. dvnutrix Says:

    Breaking news and more revelations by Brian Deer: Brian Deer discusses Andrew Wakefield in the Sunday Times and there are claims that

    THE doctor who sparked the scare over the safety of the MMR vaccine for children changed and misreported results in his research, creating the appearance of a possible link with autism, a Sunday Times investigation has found.
    Confidential medical documents and interviews with witnesses have established that Andrew Wakefield manipulated patients’ data, which triggered fears that the MMR triple vaccine to protect against measles, mumps and rubella was linked to the condition.

    It undermines the notion that there was a strong case to answer based on Wakefield’s research and makes it the more profoundly irritating that the mainstream media ever managed to create such a crisis out of it.

  17. draust Says:

    Hi Dvn

    Re: further revelations about “Saint Andy” – goodness me. Though it is not altogether surprising, given the elastic attitude to scientific accuracy, and the arrogance and egotism, that Wakefield has displayed throughout.

    Wakefield had already shown himself to be, as a scientist would say, a “data tweaker”, by his attitude to Nick Chadwick’s work. Thus, if a sophisticated and sensitive test gave a result Wakefield didn’t like (as Chadwick’s experiments did), he would permanently deep-six the data to the dead-file. Then he would carry on puffing and promoting the data from a much less sensitive and accurate technique that supported his pre-set hypothesis. That is certainly the pretty unavoidable interpretation of what happened with Chadwick’s stuff, as described in the Omnibus Proceedings.

    As I have said repeatedly over the last several years on the blogs, I have never met a scientist who doesn’t believe that Wakefield was, at the very least, one of those super-ambitious types who wouldn’t let the data get in the way of his selling of his pet theory. The problem was that his “Saintly and Brave Maverick Doctor” schtick gave him PR and credibility, courtesy of tragically deceived parents and umpteen credulous journalists.

    Having said that, the sheer scale of what Deer is alleging now is jaw-dropping. If it proves to be true, then Wakefield would be up there with the very worst of data fabricators, and data fabrication is the greatest of all scientific sins. In terms of tweaking data, “sins of omission” are more nuanced, though the burying of Chadwick’s results was such a gross example as to be at the very bad end of the sins of omission spectrum. But extensively manipulating (fixing) the data… that is the worst of the worst, scientifically. Faking the data, and the permanent (published) record, is flat-out scientific fraud – with no room for mitigation.

  18. Alan Henness Says:

    Will it change the strongly-held views of the antijabbers? Will they finally see the light? Will they finally accept that there is no link between MMR and autism?

    I for one am not holding my breath. He’ll still be a persecuted hero who was finally martyred by Big Pharma.

  19. Brian Deer Discusses Andrew Wakefield in the Sunday Times: Many Updates « Holford Watch: Patrick Holford, nutritionism and bad science Says:

    [...] people who are unfamiliar with Salzberg, Dr Aust highlights a talk in which Salzberg argues that we need to do more to counter anti-vaccination propaganda. The talk is available from [...]

  20. Legal Chill - The Blogosphere responds « The Witch Doctor Says:

    [...] Dr Aust’s Spleen “One interesting aspect of the new measles figures, highlighted by the Northern Doctor, is that the rates of measles infections seem to vary for different parts of the country. Which got me to wondering why. Of course there are many, many possible reasons, but one variable might be the extent, and kind, of pro-vaccination information that people see.” [...]

  21. Reader Says:

    For the pre-1988ers, it’s still possible to get another MMR. I’m a 1986 vintage, and although it’s very, very likely that I received all the vaccinations I should have, including two doses of MMR, not all of my childhood jabs seem to be recorded on my notes. There was a leaflet about it in the doctors’ surgery, warning of local mumps outbreaks and that people my age weren’t protected, so I asked the nurse/doctor to give me another dose. Feeling more confident :-)

  22. Andrew Wakefield Responds to Brian Deer: Summary, “I regret nothing…Single jabs are the way ahead” « Holford Watch: Patrick Holford, nutritionism and bad science Says:

    [...] and with feeling, it isn’t. Just to emphasise this point, look through Dr Aust’s post: Measles: Spot the Worrying Trend with its remarkable illustrations of the chilling billboard advertisements in Germany that advise [...]

  23. Jeni Barnett, LBC and Global Radio, MMR Segment 7 Jan 2009 and the Ben Goldacre Coverage: Part 2 « Holford Watch: Patrick Holford, nutritionism and bad science Says:

    [...] for the NHS to put out a better campaign for the MMR vaccine. The current one has no bite to it, as Dr Aust has talked [...]

  24. Svetlana Says:

    There is the fields of human life,where freedom is possible and welcomed, but there is the fields, where freedom can’t be allowed. Nobody object against traffic rules! They are obligatory, because road traffic is dangerous sphere. Though even in this sphere Britain managed to show its folly with its right-side traffic. But even right-side traffic is based on the strict traffic ordinance.
    But why, when question arises about vaccination, does British society allow idiotism such as voluntary vaccination of children? It is inadmissible in the country where Public Health is free of charge (i.e. it allows to introduce compulsory and free vaccination of all children), but education is not free (i.e. some part of people remain half-illiterate idiots, who constantly falls into quackery and delusions). Moreover – why are these illiterate idiots allowed to express their idiotc point of view in mass media? Why does the educated part of British people, instead of introducing normal medical rules and compelling the fools to respect laws, tries to persuade idiots? They will understand nothing because of their medical ignorance.

    It is monstrously.

    Or does Britain want to kill itself?

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