Reflections on investigating Wakefield
BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c672 (Published 02 February 2010) Cite this as: BMJ 2010;340:c672
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Editor,
John Stone recounts that the judge stressed that it was the funding
issues, rather than the merits of the case, which had driven the decision
not to allow (MMR) claims to proceed.
Wakefield and his colleagues, as I pointed out in my Rapid Response
MMR Toxicity Explained, clearly demonstrated that the vaccine caused
Methylmalonicacid Urea in genetically susceptible children.
Methylmalonicacid urea means Cobalamine Deficiency. In infants
"cobalamin deficiency may present as failure to thrive, developmental
delays or regression, progressive or persistent neurologic disorders, or
hematologic changes. The symptoms may be evident as early as 3 weeks of
age but often are subtle and difficult to detect, partly because of the
large variation in normal development in this age group. Long-term
neurologic consequences depend on the severity and duration of cobalamin
deficiency, but deficiency during infancy, even when treated successfully,
may result in permanent developmental disabilities".[1]
There is no doubt that the claims of the victims of the MMR vaccine
are legitimate. It is incredible that "funding issues" should inhibit
Justice in the UK.
Michael Innis
Reference
1. Bjorke- Monsen AL, Torsvik I, Saekran H etal;Common Metabolic
Profile in Infants Indicating Impaired Cobalamin Status Responds to
Cobalamin Supplementation.PEDIATRICS Vol. 122 No. 1 July 2008, pp. 83-91
Competing interests:
As previously declared
Competing interests: No competing interests
Prof Dodge is right to recall the unsatisfactory circumstances in
which the MMR litigation was concluded. When the case was finally wound up
nearly four years after the initial Legal Services Commission decision
Nikki Tait reported in the Financial Times [1]:
"The judge stressed that it was the funding issues, rather than the
merits of the case, which had driven the decision not to allow claims to
proceed.
""It is not because the court thinks that the claims have no merit.
Although this litigation has been going on for very many years, the
question whether the claims have merit has never been addressed by the
court," Mr Justice Keith said.
"The reason the claims had not been allowed to proceed, he said, was
"because everyone has realistically recognised for some time that it is
just not practicable for the claims to proceed without public funding".
"He went on: "With no realistic prospect of public funding being
restored for any of the claims save for the two which are now to proceed
as unitary actions, the dissolution of the litigation became inevitable.""
But the Legal Services Commission, which could not even support a
class action against Merck over Vioxx [2], is patently incapable of
representing the public interest against the pharmaceutical industry on
any issue. This is something to bear in mind before accepting any of the
industry's products: it is entirely at your own risk.
[1] Nikki Tait, 'MMR class action on verge of collapse', Financial
Times, 9 June 2007, http://www.ft.com/cms/s/4fb0e88a-1625-11dc-a7ce-
000b5df10621.html
[2] Question of Mr Cox to Maria Eagle, Hansard 22 July 2008,
http://www.parliament.the-stationery-
office.co.uk/pa/cm200708/cmhansrd/cm080722/text/80722w0050.htm
Competing interests:
Autistic son
Competing interests: No competing interests
Mr Deer has drawn attention to the MMR litigation proceedings he
attended in 2003 prior to starting his assignment to investigate Dr
Wakefield. That case was withdrawn, but in saying that this was because
the lawyer for the parents “couldn’t make the case” he may have
unwittingly misled readers into believing that there was no case to be
made. In fact, the lawyers expressed their disappointment that legal aid
had been withdrawn by the LSC, making it impossible for them to continue.
They unsuccessfully appealed the legal aid decision a year later, in 2004.
I am sure he will agree that in addition to sparing a sympathetic thought
for Dr Wakefield’s two colleagues “left in the shadows” we should also
remember the parents of disabled children, who are the hidden victims
in this protracted tragedy.
Competing interests:
None declared
Competing interests: No competing interests
On 7 March 2004 the Sunday Times published a leader 'The MMR
Superstition' in which it stated [1]:
"There will be those who still believe that Dr Wakefield was right or
that this newspaper had a hidden agenda in seeking to undermine his
findings. It is untrue."
So, it is fascinating now to read from Brian Deer's own pen that he
was approached in September 2003 by a Sunday Times section editor who told
him "I need something big" on the MMR [2].
[1] Sunday Times leader 'The MMR Superstition' 7 March 2004,
http://www.timesonline.co.uk/tol/news/uk/health/article1040402.ece
[2] Brian Deer, 'Reflections on investigating Wakefield, 2 February
2010 http://www.bmj.com/cgi/content/full/340/feb02_4/c672
Competing interests:
Autistic son
Competing interests: No competing interests
I was glad to see, in the journalist Brian Deer's 'Reflections on
investigating Wakefield' that he gave some consideration to the two
doctors 'left in the shadows', Dr. Simon Murch and Professor Walker-Smith.
As a former patient of Professor Walker-Smith at the Royal Free, I
have often felt sorry that this should have happened. Thirteen years ago,
he turned a sick, miserable little girl back into a happy, optimistic one.
What is more, he inspired her to become a doctor; "you don't need to lower
your sights" he said.
I am just one amongst hundreds of children that Professor Walker-
Smith must have treated during his long career, and I'm sure there will be
many who feel just as grateful towards him as I do. Whatever has happened
since, I still hold him and Dr. Murch in high regard and will always be
thankful for their care and expertise.
Competing interests:
None declared
Competing interests: No competing interests
Reflections on thalidomide, whistleblowing and the Sunday Times
The role of the Sunday Times in the investigation of thalidomide was
very different from Brian Deer's probing into the alleged crimes against
the MMR.
It was a medical whistleblower who first raised the alarm over
thalidomide. In 1962, William McBride, an Australian obstetrician,
reported to the Lancet on 'a small case series' that warned that there
might be an increased risk of congenital abnormalities in babies delivered
of women who were given the drug thalidomide (Distival) during pregnancy.
[1] McBride was subsequently proved right over his early warning. There is
still no proof that Andrew Wakefield is wrong over the MMR's possible role
in damaging a small subset of genetically vulnerable children: the science
has not honestly been done.
Professor McBride blew the whistle on thalidomide but his subsequent
career was tainted by controversy. [2]
The Sunday Times, under the editorship of Harry Evans, decided to
campaign for those British children affected by the drug: in 1972, the
newspaper won a £32.5m deal over Distillers, the UK distributor of
thalidomide. The Sunday Times then fought an injunction against the
further investigation of thalidomide. In 1976, it was eventually revealed
"that both Grunenthal and Distillers had not met the basic testing
requirements of the time." [3]
Peter Wilmshurst has been silent about Andrew Wakefield and his
colleagues. The consultant cardiologist and whistleblower has spent much
of his professional life exposing research misconduct. Last year he said,
"Many whistleblowers I know have been forced out of medicine. They give up
because the medical establishment makes their life so difficult or tries
to 'get them' by suggesting they're the problem. I know of cases when
whistleblowers were falsely accused of dishonesty, said to be mentally
ill, unfairly dismissed, or had their working conditions changed so badly
that they resigned." [4]
The corporate drug industry can look after itself. However, there is
a difference between standing up for ordinary citizens against the drug
companies, and standing up for the vaccine industry against the ordinary
citizen. For Brian Deer to suggest, however unwittingly, that the Sunday
Times' actions over thalidomide might be comparable to his own
investigations, emphasises for me, the imbalance in his journalism.
[1] McBride WG (1962). Thalidomide and congenital abnormalities.
Lancet 2:1358.
http://www.jameslindlibrary.org/trial_records/20th_Century/1960s/mcbride...
[2] http://en.wikipedia.org/wiki/William_McBride_(doctor)
[3] John-Paul Flintoff, The Sunday Times, March 23, 2008.
Thalidomide: the battle for compensation goes on. Fifty years after the
drug was launched in Britain, its victims are still fighting for
compensation from its German makers.
http://www.timesonline.co.uk/tol/life_and_style/health/article3602694.ece
[4] Whistleblowing, Name and shame, Jane Cassidy. BMJ 24 July 2009,
doi:10.1136/bmj.b2693.
http://www.bmj.com/cgi/content/full/339/jul24_1/b2693
Competing interests:
None declared
Competing interests: No competing interests