Martin J Walker

The Bigger the Lie ....

The Wakefield case

I have been investigating, campaigning and writing about different incidents and cases in medicine and the pharmaceutical industry since the late 1980s. In 1989, working as a private investigator I began investigating a new lobby group set up in Britain first called the Campaign Against Health Fraud and now called HealthWatch and part of a much bigger international pharmaceutical lobby that includes the Skeptics and Sense About Science.

All the investigative work and writing that I have done since then concerns the growth of this lobby and others associated with it. They are mainly funded by pharmaceutical companies and they are opposed to anything that challenges allopathic medicine and it's profitability.

In 2005, I read about Dr Andrew Wakefield and seeing that his case fitted into my writings and investigations, I contacted him and became involved in his case. It is possible that some of you here in Spain know nothing about Dr Wakefield's case. Others might know a number of things — whatever you do know, it is unlikely to be anything like the truth. Everything that has happened to Dr Andrew Wakefield was constructed by people linked to, influenced by or threatened by pharmaceutical interests, often these individuals were involved with lobby groups.

Broadly speaking, Dr Wakefield was accused over a 6 year period, 3 of which involved a trial before the UK General Medical Council, (GMC) of taking money from the government and using it to fake research showing that the MMR vaccination caused autism. He did this it was said to make money for himself and aid parents who had a legal claim on behalf of their vaccine damaged children against three international pharmaceutical companies.

By 2010, Wakefield had been erased from the medical register in the UK and had three of his published peer reviewed papers deleted from the research record; labeled as a charlatan and a crook and threatened by constant attacks on his work in the UK, he sought exile in the US. I am going to try and set the record straight in this talk.

There are two main perspectives which one can take when looking at such huge conspiracies designed to destroy an individual’s career and reputation. The first and the most common, is to investigate evidence that the accusers are involved in a conspiracy, that they have links and vested interests in common etc; for the last six years I have done this. I reported every day of the GMC trial for the parents who supported Dr Wakefield. In 2008 and 2009 I organised, edited and published two books written almost exclusively by parents, with an introduction by me. I wrote 9 essays exposing the dirty tricks organised against Wakefield.

For this talk, however, I want to lay out, very simply what Dr Wakefield did rather than what he was accused of doing. From this description of what he did, you will be able to draw your own conclusions about whether or not he was guilty of anything.

The Wakefield case is the most complex and massive of all the cases that I have ever worked on, its outcome more extremely disillusioning than any other case. Dr Wakefield's narrative is exceptionally complex. I have simplified it as far as possible.

In the late 1980s Dr Andrew Wakefield was a highly respected medical research worker in the area of Chron’s disease and bowel transplantation. He was funded mainly be pharmaceutical companies and had won a number of awards.

After working in Canada, he returned to Britain in the late 1980s after he had been head hunted by the Royal Free Hospital in North London, to organise and run an experimental gastroenterological unit.

Setting up the unit which was to concentrate on Crohn's disease and Inlammatory Bowel Disease, Wakefield gathered around him outstanding clinical workers including Professor Walker-Smith, considered one of the greatest pediatric gastroenterologists in Europe. Wakefield's contract with the hospital involved only research and did not allow any kind of clinical work.

At around the same time that Wakefield was arriving at the Royal Free Hospital, in the late nineteen eighties, three brands of the MMR vaccine developed in the 1970s were introduced by the UK Department of Health. MMR was actually a completely unnecessary multiple vaccination. It was supposed to immunize against Mumps, Measles and Rubella. But if we look at the history of vaccination and these three illnesses a number of things become clear.

Prior to MMR the UK National Health Service (NHS) did not recommend a vaccination for mumps. The Rubella vaccine was given only to women who might come into contact with Rubella while pregnant, particularly through their children. Measles vaccine was given routinely and was considered safe except that it was occasionally noted to cause bowel problems as was the wild variety.

The main support for this multiple vaccination came from the government, who were, with the pharmaceutical company GlaxoSmithKline (previously GlaxoWellcome) hell bent on the use of multiple vaccines which they said could in the future contain up to 300 viral strains, and prevent with one injection nearly all the diseases of mankind.

In the case of MMR, two of the three brands of MMR vaccine used by the UK Department of Health, contained the Urabe mumps virus strain, while the third one previously used in the US contained the Jeryl Lynn strain. There had been inadequate research into the safety of multiple vaccines and even the mixing of viruses was known to cause adverse effects.

The British government knew before they launched MMR in the UK that the Urabe mumps strain caused serious adverse reactions, principally involving meningitis. These reactions had been recorded and investigated in Canada where the vaccine was withdrawn, and in Japan were it was later to be withdrawn.

When in 1992, it became evident, in Britain, that there were many cases of adverse reaction to the Urabe strain mumps MMR vaccine the British government too withdrew this vaccine, leaving only one MMR vaccine in use. However, during the 4 years of it's use thousands of children had been damaged — the government immediately denied this damage.

Around 1993 the peace of Dr Andrew Wakefield's research at the Royal Free Hospital was disturbed by a woman who brought her autistic son to the hospital. This woman told Wakefield that after having his MMR vaccination her son had suffered the most terrible bowel problems — constant and explosive diarrhea accompanied by crippling pain. After a short time this condition was accompanied by an autism spectrum disorder that was later labeled 'regressive autism'; a state where a child who had previously been meeting all their goals, lost abilities; stopped talking, stopped eye contact, and retreated into their own world.

Initially Dr Adrew Wakefield wanted to have nothing to do with this mother and child, principally because he said, he knew nothing about autism, seeing it as a mental illness unrelated to his research. However within a very short time, word spread about the interests of the Royal Free Hospital (RFH) in Inflammatory Bowel Disease and a steady flow of parents with similarly damaged children made their way to the RFH.

On admission, Wakefield assessed these children for their bowel disorders and of course noted any autism spectrum disorder problems. The children were then passed on for a clinical assessment to Professor Walker-Smith.

As more children arrived at the hospital, it became evident to both Wakefield and Walker-Smith that despite their combined years of experience, neither of them had any idea how these children had become ill so quickly and what were the environmental triggers or causal pathways of the illness.

Around 1993, Wakefield was growing more deeply concerned about these cases of inflammatory bowel disease and regressive autism. He wrote to the NHS head of vaccine and immunology Dr Salisbury asking for a meeting to discuss what he explained might be a public health crisis developing around the MMR vaccination. It was five years before Salisbury agreed to a meeting.

As expert and conscientious doctors, who had a good rapport with parents, Wakefield and Walker-Smith decided upon a course of action. Despite the fact that many of the children showed classical signs of autism which sometimes made it hard to carry out in-hospital clinical tests, they decided on a battery of tests, including colonscopy and in the first couple of cases lumber puncture. The object of the tests, almost solely in relation to Inflammatory Bowel Disease (IBD) were to construct a clinical picture of the children and help describe the illnesses they suffered.

Beyond the Royal Free Hospital other things were happening with respect to MMR vaccines and adverse reactions. A lawyer who had been involved in a number of environmentally-trigged damage cases began to attract parents who thought that their children's illnesses had occurred as a consequence of their MMR vaccination.

In around 1992, this lawyer embarked upon a claim with a large number of parents, against three vaccine manufacturing pharmaceutical companies. Around 1994, the lawyer approached Dr Wakefield asking if he would act as an expert witness. Despite not having concluded his research Dr Wakefield agreed. He became an expert witness for the parents in a case which by 2003, had gathered over one and a half thousand claimants.

On the instructions of the lawyer, Wakefield set out a research programme that he thought would get to the bottom of why the children had become so deeply damaged so quickly. The lawyer applied for and was finally granted Legal Aid funding, which has been available to claimants in civil and criminal cases for the last 80 years in the UK, to help them prove their case with expert witnesses. It is important to stress that this was around 1995 and in the end, apart from statistical work, any work carried out with this this money on this research is not pertinent to what was to happen to Dr Wakefield.

Inside the Royal Free Hospital, around 1995/6 Wakefield took a first step to writing up a diagnostic picture of the children who had turned up and been given the clinical tests. This paper was written with 11 other contributors because these contributors had been involved in designing and carrying out the tests used on the children.

When the paper was finally published in 1998, it was not the results of a research study but a 'case review study'. The paper involved the detailed reporting of 12 children who had received clinical examinations having presented sequentially at the RFH with similar symptoms.

There is some slight debate about whether a case review study needs ethical committee approval. The rules governing such papers go something like this — If the initial cases are written up for research purposes then they need ethical committee approval; however, if the patients are seen for primarily clinical reasons then their cases do not need ethical approval to be written up.

There is a twist to this and that it that all clinical and diagnostic surgical procedures like colonoscopy entail the taking of histological samples from the body, these samples are kept by hospitals and can years later be used for research, such samples have to be covered by both parental consent and ethical committee agreement. This was the cases of all the children written up in the case review paper.

Even if this case review paper and its writing had needed ethical committee approval, John Walker-Smith had this after he was granted it more or less in perpetuity, at his previous hospital.

Wakefield submitted the paper which had 12 authors to The Lancet, edited by Dr Richard Horton. Wakefield had been published previously in the Lancet and Horton was familiar with his work. From the beginning it appeared that Horton was 100% behind Wakefield and the paper. The case review study was peer reviewed and accepted for publication.

Wakefield signed the conflict of interest clause, used by the Lancet at that time, this said that the author should make mention of anything which if not disclosed, might at a later date embarrass the author. Wakefield could think of nothing of this kind, no money had been used to carry out the case review from anywhere other than his own pocket. Certainly, the Legal Aid money granted for research had not yet been used and anyway the RFH — embarrassed by the use of money gained to fight a case for patients against the hospitals pharmaceutical research funders — had actually taken it off Wakefield and put it in the general Hospital fund.

So, in 1998, The Lancet published a case review study of 12 children which suggested a clinical association between unknown physical and environmental factors and inflammatory bowel disease, and in a majority of cases, the later onset of regressive autism.

As will be clear to you and any other thinking person, this case review could draw no conclusions about which factors had precipitated these conditions so quickly in these children. It was not a research paper, there was no epidemiology, there were no control groups.

The paper's authors did quote those parents who had mentioned in interviews that the illnesses had followed their child's MMR vaccination. Although this observation didn't constitute any kind of proof of a condition, it was absolutely correct and essential for the paper's authors to have cited these parents’ observations.

Like any researcher, Wakefield was forming his own opinions about what had caused the IBD in these children. In his opinion it was the measles vaccine virus. This however was a hypothesis, necessary for research to move forward, but presently of little evidential value.

At its simplest the Lancet paper claimed that pediatric gastroenterologists at the RFH had discovered a 'new' form of IBD, the causes, beginning and end points of which were so far unclear. It had a sudden onset, definite symptoms and in some children could be linked to the future onset of regressive autism.

On the evening of the publication of the Lancet paper, University College London which partnered the Royal Free Hospital held a press briefing about the paper. Dr Wakefield did not organize this briefing, it was organised by the Dean of the University Department who appeared at that time to be in complete agreement with Wakefield that the triple vaccine was not safe. It was becoming clear, however, that Wakefield in particular was angry with the government generally and the Department of Health for refusing to take seriously theories which could help diagnose and treat an increasing number of children that appeared to be affected by adverse reactions to the MMR vaccination.

Other academic work undertaken by Wakefield at this time showed him to be increasingly inhabiting the role of dissident. In his paper, “Through a Glass Darkly” written with Scott M. Montgomery in Jan 2001 and published in Adverse Drug Reactions, he argued that there had been woefully insufficient safety trials of the new triple vaccination.

But it was the press briefing that ended Wakefield's career. While the authors and the head of department went through the case review paper in a matter of fact way, the media was looking for a developing drama with Wakefield as the central character.

Towards the end of the briefing, a reporter asked Wakefield, what parents, who were now faced with giving their children MMR should do? Again, Wakefield acted with the utmost propriety and with an eye to the 'precautionary principle' replied, that it might be best to return to the use of single vaccines until research at the RFH was finished.

In suggesting that parents should return to single vaccines Wakefield was standing in the way of a billion dollar tank — the future of multiple vaccines. From this time onwards the assault on Wakefield, though initially muted, became over the following four years, relentless and the disintegration of his career inescapable. He was branded as the doctor who claimed that MMR vaccination caused autism — all MMR vaccination and all autism. In fact to all intents and purposes, Wakefield's story ends here, from now on the forces of darkness take over the narrative and Wakefield is affected rather than affecting.

In the months following the press briefing, the government withdrew the license for the import and prescription of single vaccines and then invented the fiction that Wakefield had held out false hope to parents when single vaccines hadn't existed in Britain for a long time. Companies that were importing single vaccines, completely legally were harassed and put under surveillance.

In the background a journalist called Brian Deer, a consumer affairs reporter working free-lance for Rupert Murdoch's Sunday Times, published a series of 'starter' stories about expert witnesses in previous vaccine trials. These experts were portrayed by Deer as cunning self obsessed careerists who knew nothing about science and were in medicine for the money.

This switch in the narrative from the parents of damaged children, to the crooked doctor, was aided by constant attempts to make the parents and their children invisible. Wakefield lost all his grants and funding; his rolling contract at the Royal Free was not renewed. His phones and his family house were bugged. Other authors of the Lancet paper were scattered and silenced under threat from unseen forces. In 2002, Wakefield felt that it was no longer safe for him in Britain and he left with his family for the US.

In 2003, the parents court case began to run into difficulties. Legal Aid was withdrawn from the decade long case, leaving one and a half thousand claimants with vaccine damaged children high and dry without a case in court.

With the civil action for damages over, Wakefield was no longer protected by sub judice. A massive propaganda campaign was initiated by the pharmaceutical companies and the government. Informal regulations were passed by the House of Lords and a commons science and technology committee, that stopped the reporting in all media of personal stories of pharmaceutical adverse reactions and determined that only scientists could write articles about medicine, drugs and adverse reactions.

In February 2004 Brian Deer produced a most scurrilous attack on Wakefield in the Sunday Times newspaper. Stretching over four pages, it was a farrago of lies, put together with the help of major figures in the vaccine establishment and a private detective agency owned by the Association of British Pharmaceutical Industries. The major accusations were:

In passing, this disgusting pastiche cited the then Minister of Health demanding that Dr Wakefield should be taken before the UK General Medical Council (GMC). On the Monday following the publication of this 'trash journalism', Tony Blair the UK prime Minister, with a slippery cynical smirk told reporters that there was much more to the story than the public knew. Off paper, Deer campaigned for Wakefield to be charged by the police, with fraud, endangerment, and other criminal offences.

Within a week of the Sunday Times article Deer had lodged his 'supporting evidence' with the GMC which then took almost three years to bring around 80 charges against Wakefield, and the two other consultants he had worked with, Walker-Smith and Murch.

The resultant Fitness to Practice hearing prosecuted by the GMC, in their building in London, lasted 3 years and resulted in February 2010 in a finding of guilt against Wakefield on every single charge. But perhaps more importantly the 3 year hearing, which joined no parents to the charges, managed to create the reality that there were no vaccine damaged children in Britain.

I attended every day of the GMC hearing, reporting the proceedings for the parents who because of their children were often unable to travel frequently to London. I explained how the GMC manipulated the evidence and pointed to such simple matters as the fact that the Chair of the Panel, 'the jury foreman' chosen by the GMC, was found to have shares in GlaxoSmithKline the manufacturers of MMR. How Richard Horton's line manager, at the Lancet, during the times of crises in 2004, was as well as being a manager at Elsevier the publishers of the Lancet, was a non executive board member of GlaxoSmithKline. And following the final verdict of the GMC, the manager of the Sunday Times and the son of Rupert Murdoch was also given a place on the GlaxoSmithKline Board.

Following the findings of the hearing, Wakefield was stripped of his registration as a doctor and two of his published peer reviewed papers were deleted from the record. Dr Wakefield, his exemplary work, the children he tried to help at the RFH in London and the parents who to this day support Wakefield have all been swept under the huge carpet of corporate Britain and made invisible — there are no cases of vaccine damage in Britain.

For those who find difficulty in the meaning of this story about Dr Andrew Wakefield and the making invisible of over 2,000 cases of vaccine damaged children, it would be beneficial to look at the reports of the Global Alliance for Vaccines and Immunization (GAVI) conference that took place on June 13 in London. At this meeting the UK government donated £800 million pound of tax-payers money to leading UK vaccine manufacturers, including GlaxoSmithKline, so that they could develop their vaccine programme for developing countries. With this kind of public money available to private enterprise during a European wide crisis — itself created by high earning corporations — it is little wonder that the pharmaceutical companies would want to deny any adverse reactions or problems with the safety of vaccines.

* * *, Andrew Wakefield, Callous Disregard: Autism and Vaccines - The truth behind a tragedy.

Silenced Witnesses: The Parents Story — the denial of vaccine damage by government, corporations and the media, written by the parents.

Posted: September 1, 2011

Scienza e Democrazia/Science and Democracy