[back] Wakefield GMC Hearing 2007



by Martin J Walker

The Politics
    The Introduction of MMR
    Dr Andrew Wakefield
    The Consequences of Dr Wakefield’s research
The science?
    Science and politics
    Wakefield’s Hypothesis
The Campaign in Support of Dr Wakefield and others

The fitness to practice case being heard at the General Medical Council (GMC) against Dr Andrew Wakefield and Professors Murch and Walker-Smith, appears to involve an analysis of the scientific research and clinical practice of these doctors. However, almost all of the case and the attacks that have taken place against Dr Wakefield since the mid 1990s are politically inspired. They are a part of the governments drive to produce a single multiple vaccine containing hundreds of viral strains and also a key part of the government’s co-ordinated policy for health care, that has been resolved in negotiation with the pharmaceutical companies since New Labour came to power in 1997. The following analysis of Dr Wakefield’s ‘road to the GMC’ is divided into two parts, political and scientific.

The Politics

The Introduction of MMR

 In 1988 three brands of MMR were introduced into the UK programme, two of which contained the Urabe strain mumps virus. The brands containing the Urabe mumps strain were withdrawn, in Canada, Japan and eventually Britain after they had been linked with aseptic meningitis and serious brain damage. In Japan, the affected children and their parents took their cases to court and were paid compensation.

             The two brands of MMR were withdrawn from the UK market in 1992 after the problem with Urabe was acknowledged. Typically the Government of the time pretended that the superior vigilance of government agencies had brought the ‘slight’ problems to light and the government had then acted with alacrity. In fact not only were the government slow in responding to a public health crisis but stocks of this withdrawn vaccine were then made available and sold to less affluent nations, eg Brazil. Since the withdrawal of the Urabe strain MMR brands in the UK the British Government and the pharmaceutical companies have refused to acknowledge any legal claims for damages from either these or other MMR brands despite claims from parents whose children showed very similar presentations to the successful claimants in Japan.

             At this time the British Government was left with only one brand of MMR vaccine. Had they admitted problems with this vaccine there would almost certainly have been calls for a reversal of their ‘combination’ vaccine policy and a return to single vaccines.

 Dr Andrew Wakefield

 In the late 80s and the first years of the 1990s, Dr Andrew Wakefield was a well respected academic gastroenterologist researching Crohn’s disease. He had already won acclaim for proving the mechanism for Crohn’s. His work was well endowed with pharmaceutical grants.

             In the mid-nineties, he began to be contacted by parents who said that their children’s health problems had been caused by the MMR  or MR (measles, rubella) vaccination not only had severe gut problems but also were exhibiting behavioural problems – that later came to be perceived as ‘regressive autism’.

             Dr Wakefield alerted the Department of Health to what he considered to be a public health crisis, and asked for a meeting with the health minister and with the Head of Immunology in the NHS. It took months for the DoH to answer his first letter and almost six years for them to organise the meeting that was finally held in October 1997.

             At this meeting the health minister and the chief medical officer gave an undertaking that there would be a complete review attended by independent international experts of Dr Wakefield’s research, the meeting would be relatively open and all opinions would be considered. When it was organised by the MRC one MP who asked to go to this review on behalf of constituents was told there were not enough chairs, when he said he would stand he was told this was not allowed!

             Between the mid-nineties and 1998 hundreds of children suffering from the syndrome (vaccination – gastrointestinal problems – regressive autism) first identified by Dr Wakefield and colleagues approached the Royal Free Hospital, and many of their parents attributed their child’s illness to MMR or MR. A number of these parents, had contacted solicitors in order to make a claim against three vaccine manufacturers. Although the case on behalf of the parents was almost 10 years in the making, six months before it was due to go to court in 2004, legal aid was suddenly withdrawn and this dealt the case a terminal blow.

             In 1998, Dr Wakefield and twelve other academics and clinicians, had the now famous paper published in the Lancet (Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA. Inflammatory Bowel Disease Study Group, University Department of Medicine, Royal Free Hospital and School of Medicine, London, UK The lancet, Mar 6;363(9411):750)

             This paper was a case series describing twelve children, 8 of whose parents said their children had begun to experience serious problems soon after MMR /MR vaccination. On clinical examination, diagnosis and treatment at the Royal Free, a majority of these children were found to have both serious gastrointestinal problems together with behavioural problems that presented like regressive autism.

             This paper submitted to the Lancet was actually accompanied by another paper giving details of biological findings relating to the twelve children. The intention was that the two papers should have been published together. However, while the first simple case series was published, two out of the three peer reviewers turned down the second paper. So it happened that the Lancet case series appeared without any scientific explanation of how the authors suggested these conditions had occurred in children.

 The Consequences of Dr Wakefield’s research

 Since the mid-nineties through to the present date there has been constant character assassination carried out against Dr Wakefield, this began to get worse after he tried, on a number of occasions, to organise a meeting with the Department of Health.

             After the 1998 paper, harassment and denial grew massively funding grants from pharmaceutical companies were withdrawn, articles began to appear in the press and other media about his lack of science and the general daftness of his ideas and finally in 2001 his contract at the Royal Free was ended,.

             Dr Wakefield was essentially forced out of the country and went to work in the USA where, with others, he set up the Thoughtful House project to continue his research into environmental triggers, gastrointestinal problems and autism.

             By 2003/2004, the British Government needed to deal a death blow to Wakefield’s work.  This was probably another strategy related to the court case, for which legal aid was withdrawn in 2004, and the need to discredit Wakefield as a possible expert witness in any proceedings.

             In February 2004, Brian Deer, a Sunday Times journalist, who had written a number  of pro vaccine articles uncritical of vaccine manufacturers, wrote a long expose in The Sunday Times that claimed to be an investigation into Dr Wakefield and the work of the gastrointestinal team at the Royal Free. This article made Wakefield out to be a money grabbing crook and a useless scientist. Embedded in the article was a quote from the then Minister of Health, John Reid who stated clearly that Dr Wakefield should be reported to the General Medical Council. Within two days of the article appearing, Brian Deer had lodged the sole complaint against Dr Wakefield and his co authors, with the General Medical Council. 

            Apparently it took the GMC, almost four years to introduce any sense into the charges against the doctors and in July 2007 they were arraigned before a GMC fitness-to-practice panel. Although there were almost 100 charges against the three doctors, it was clear from the beginning that the main purpose of the hearing was to ensure that Dr Wakefield was kept out of circulation and unable to comment again on the vaccine and autism issue.

             The hearing which was initially scheduled to last for a number of months, has been dragged out by the GMC, in such a way that though it started in July 2007, it is now not due to finish before the end of the first quarter of 2009.

             There has been no press coverage of the prosecution case at the GMC except on the first day when all the main charges were advertised by newspapers and television. In fact, the Science Media Centre and Sense About Science and the activists linked to these two pharmaceutically funded lobby groups have been running a campaign since the early 2000’s to censure from the media all criticisms of science corporations and scientific processes. Following the last major article in the Observer that appeared just before the GMC hearings began (see Walker M. J. Guardian of What? www.slingshotpublications.com) the editor at the Observer resigned after being put under heavy pressure amongst other things, about this article. And in 2007, the BBC banned, world wide, one already shown episode of the Judge John Deed drama series, that dealt with MMR, written and produced by Gordon Newman.

The science?

 Science and politics

 Although the case against Dr Wakefield, Professor Murch and Professor Walker-Smith appears to be one of scientific misconduct and the GMC are suggesting that they have committed a number of ethical and other misdemeanours, in reality the case against the Royal Free doctors and the whole campaign against Wakefield has parameters beyond science.

             A wider interpretation of what has happened to Dr Wakefield can be put down to the denial of vaccine damage by the government, but an even wider one involves the increase in cases of autism in Britain and the US and the possibility that these are triggered by environmental factors.

             The science lobby groups and the New Labour government are insistent that high technology and new medical processes cannot cause adverse reactions. Nowhere do they argue this with more force than in the case of vaccination. In fact their determination appears to be in more or less exact relationship to the damage that MMR and MR have done to children – the more damaged children there are, the more aggressive the government cover-up becomes. The government, the science lobby groups and the medical establishment argue vociferously that autism is a genetic condition not caused by environmental exposures, for which there is no treatment. As is the case with a number of other ‘undiagnosed’ illnesses the medical establishment cannot afford to ‘find’ an environmental cause of autism.

             Government money granted to the MRC to look into bio-medical and environmental causes of autism has been given-over solely to genetic research. This is a repeat of what happened with ME. In the case of ME money for research into bio-medical and environmental causes of the condition was given to researchers who believe in a psychiatric aetiology of the illness and who refused to look at environmental triggers. 

            One of the ways that the division between science and politics can be illustrated, in the Wakefield case, is through the case of Arpad Pusztai. In 2001, Pusztai who was a well established and highly qualified research worker at the Rowett Institute, came to the conclusion through his research that genetically modified potatoes (GM), caused illnesses in the rats that he was experimenting on. Within a matter of months of his publicly announcing his research results, Pusztai had lost his job and been vilified in the press. The reason for this, was that the immensely powerful GM lobby, of which the science lobby groups are a centre aspect, were not willing to tolerate any public criticism of GM produce. (see www.gmwatch.com )

             We can see how in the Pusztai case, the normal course of science was diverted. The normal course of science is quite clear. The only thing that can assess or rebut the conclusions of a scientific study, is a new research project, carried out by independent scientists, that replicates the research results after carrying out research under similar conditions, using similarly defined subjects in order for comparisons to be made.

             If good scientific procedure is followed, there is no way round this. For instance you cannot just carry out a review of all the research papers which mention GM potatoes and health in their title and conclude that none of them mention serious illness. This is not scientifically credible because although these previous papers might have GM potatoes in their title they might be focused on ways of germinating GM potatoes or ways of cooking them or any number of things other than the specific clinical effect in rats which have been fed certain quantities. The research has to be replicated exactly.

 Wakefield’s Hypothesis

 Dr Wakefield’s paper in the Lancet was a case series describing twelve children most of whom had been said by their parents to have reacted adversely to the MMR vaccine with gastrointestinal difficulties and then behavioural problems that have been labelled as regressive autism. Wakefield’s hypothesis can be put as follows.

 There exists a subset of children who are vulnerable, for immunological reasons, to developing a particular form of developmental regression following previously normal development, in combination with a novel form of inflammatory bowel disease. Onset, which may be acute or insidious, may be triggered by exposure to a measles containing vaccine, predominantly the measles-mumps-rubella vaccine (MMR). Exposure leads to long-term infection with measles virus within key sites, including the intestine, where it is associated with lymphoid hyperplasia and acute and chronic mucosal inflammation.

 Neither the Medical Research Council nor any government agency has sought to replicate the clinically based research of Dr Wakefield. It is, however, important to understand what replication would mean. The clinical research would have to begin with children who reported gastrointestinal problems combined with loss of previously acquired skills. A large proportion of the parents of these children would have made some connection between vaccination and their children’s gastrointestinal difficulties. In other words, any test of Wakefield’s hypothesis would need to investigate children with a similar presentation to the clinical cohort of 12 children who had initially reported to doctors with serious gastrointestinal problems.

             Instead of entering into a scientific debate, the government, the MRC and the science lobby groups funded by the pharmaceutical industry, did a number of things in addition to vilifying Dr Wakefield. They published, re-published or drew attention to a number of epidemiological studies that had looked at large numbers of cases of children who had received MMR. They suggested that these studies proved that MMR did not cause autism, however most of these studies did not look at autism and its links to MMR, most of the studies did not look at children who had bowel disease and none of the studies were of children whose parents had reported an adverse reaction to MMR or any other vaccine.

             Large scale epidemiological studies are not the right instrument for tracking the clinical cause of an illness. While a properly designed epidemiological study might show a variety of correlations between different factors, further clinical work would always be necessary to trace the exact cause, course and reason for any illness. Of course, if epidemiological studies are improperly designed, or designed for another purpose, they will not even show the correlation between various important factors. In this case, Dr Wakefield is one of the only people whose research has been based on the clinical findings in children and has established the novel course of the illness.  Consequently, the many epidemiological studies that have been carried out both before and after this work, since they do not look at children with the same combinations of illness as those studied by Dr Wakefield are fundamentally flawed and are simply used to suggest that there is no validity to the Wakefield hypothesis. 

             The other tactic that the government, the medical establishment and the science lobby groups have used is to suggest that Wakefield and his supporters have actually said: ‘Autism is caused by vaccination’. By turning the finally balanced clinically-based observations of Dr Wakefield, that refer to a definite sub-group of children, into a crude suggestion like this Wakefield and his followers can not only be made to appear ridiculous but also the ‘theory’ can be simply discredited by looking at children who are autistic but have not been vaccinated or conversely the thousands of children who have been vaccinated without developing any kind of autism.

             Finally the ‘opposition’ has insisted from the first publication of the Lancet paper, that a group of 12 children demonstrate nothing, especially without a ‘control group’. The truth is of course that the paper was not the report of a random double blind clinical trial, but a simple case review of 12 cases that had been given clinical assessment and then treatment at the Royal Free. Indeed at the time of publication the paper carried a foot note that indicated that 40 children had been investigated and 39 of these had been found to have the same bowel findings and within a year of the publication of this paper Dr Wakefield and the team at the Royal Free had announced that they had dealt with many more children who presented with similar symptoms.

             However, despite the unscientific propaganda of the lobbies, the government and the vaccine industry, scientific evidence is gradually being presented that adds weight to each part of Dr Wakefield’s proposition, amongst the many papers are ones such as these three:

 Poling, JS, Frye RE, Shoffner J, Zimmerman AW. Developmental regression and mitochondrial dysfunction in a child with autism. Journal of Child Neurology. 2006;21:170-172.

  Gonzalez, L., et al., Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms: A Preliminary Report. GEN Suplemento Especial de Pediatria 2005. 1: p.41-47.

  Welch, M.G., et al., Brain effects of chronic IBD in areas abnormal in autism and treatment by single neuropeptides secretin and oxytocin. JMol Neurosci, 2005. 25(3): p. 259-74.

 A major bibliography of the published links between regressive autism, bowel disease and MMR can be found at the end of David Thrower’s useful paper, ‘Regressive Autism, Ileal-Lymphoid Nodular Hyperplasia, Measles Virus and MMR Vaccine: Summary of Published Studies Offering Evidence for Linkages’ This can be seen at: http://www.vaproject.org/thrower/mmr-briefing-20070430.htm. And can be downloaded in Pdf form.

             In Britain all court cases on behalf of vaccine damaged claimants have been stopped. However, in America, last November, a judge in a Federal Vaccine Court awarded an out of court settlement of a life-time care compensation package, to one of three test cases, representing 4,900 children who it was agreed was damaged by multiple vaccines and is now autistic. Pharmaceutical companies agree out of court settlements for only two reasons, first they see that they are facing defeat on the science at trial and second faced with defeat they prefer not to have a Judge make a legal ruling that will act as a precedent in future cases.

             This out of court settlement the first to acknowledge the link between vaccinations and autism, is bound to have a considerable effect upon the way in which Wakefield’s work is now considered. This decision, made in concert with the pharmaceutical companies, gives the lie to all the lobby group’s previous propaganda.

The Campaign in Support of Dr Wakefield and others

 Not one parent has complained about the treatment that their child received under the care of the clinical team at the Royal Free. Indeed, because the parents of vaccine damaged children, entirely support the work of Wakefield, Murch and Walker-Smith, the GMC clearly could not call any of them as complainants against the doctors. Because they didn’t want Brian Deer’s motives disclosed under cross examination, they have not called him either. So it would appear that there is no real complainant behind the GMC hearings. More importantly perhaps the voices of the children and the parents have been stifled in this whole process while both the government and the GMC have tried hard to convince the public that there are no vaccine damaged children.

             For all the above reasons the CryShame group, of parents and professionals are about to publish a book written by the parents, that discusses how they have coped with and cared for their vaccine damaged children and the denial of their circumstances by the government, the pharmaceutical companies and the science lobby groups. The book will be available after March 23 from www.cryshame.com  and via www.slingshotpublications.com. Also available on the Cry Shame web site is a short film shot at the opening of the GMC case that includes interviews with parents of vaccine damaged children who support Dr Wakefield.

             And it is principally for this reason, as well as to give support to the doctors that there is a Demonstration outside the GMC, on the Euston Road, on the morning of March 27th 2008 beginning at 8.30 so that parents and their vaccine damaged children can make public their opposition to the GMC, corporate lobby groups, the paediatric establishment and Brian Deer.

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 CryShame needs to raise money to finance the demonstration and other ventures. If you are able to distribute this and other CryShame information on any lists please do so. Send this document out with your own email explaining the need for funding.