Re: Deer is at it again...to smear Wakefield

[Guest guest]

Deer just doesn't care that Dr. Wakefield was absolutely right.

He doesn't care that my own daughter suffered gut damage from the MMR...

Why doesn't someone look to see where Deer is getting his money? The guy is

slime. All four

feet eleven inches of him. (he's quite short.)

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> http://www.timesonline.co.uk/article/0,,2087-2524335,00.html

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[Guest guest]

Dr. Wakefield has circulated this response to Deer:

He prefaced it with this message:

 

I have attached a response and also a letter to Pediatrics in response

to the D'Souza paper. Pediatrics declined to publish it.

 

Kindest regards and have a great Christmas

 

Andy

 

 

Sunday December 24th 2006

 

Response by Dr Andy Wakefield to enquiries about expert fees.

 

Thank you for your enquiry. I hope that the points below will answer

any questions you may have about the issue of experts’ fees in the MMR

litigation.

 

1. I worked as an expert in the MMR class action litigation for nearly

9 years. As instructed, I charged for my services and this was at an

hourly rate recommended by the BMA after consulting with them on this

matter.

 

2. I worked extremely hard on this very onerous litigation because I

believed and still believe in the just cause of the matter under

investigation. This work involved nights, weekends and much of my

holidays such that I saw little of my family during this time. The

price for standing by these children has been high both for my family

and my professional status.

 

3. The money that I received was, after tax and out of pocket expenses,

donated to an initiative to create a new center, in the first instance

at the Royal Free Hospital, for the care of autistic children and

those with bowel disease. This intention was made clear, in writing, to

senior members of the medical school. The initiative was unsuccessful

at the Royal Free but ultimately succeeded in the US. 

 

4. My role as an expert was declared as a conflict of interest in

relevant publications (see references below) that discussed the

possible role of MMR vaccine intestinal disease and autism and to

journal editors in other instances. I have referenced the relevant

publications below for your convenience.

 

5. The costs judge has revised the sum payable by nearly ₤100,000 and I

am happy to abide by this ruling. He has done the same for other

experts and I am informed that this is common practice in cases such as

this. A substantial part of this money was not paid to me in the first

place.

 

6. My actions were at times taken in the best interests of children

potentially damaged by the MMR vaccine. It was my earnest desire to

establish a centre of excellence for the care of these children in the

UK. Sadly, the political climate in there made this impossible. I

remain dedicated to helping these children and resolving the issue of

whether vaccines are involved in this disorder or not. I will not be

intimidated or coerced into stopping this work prematurely. 

 

References

Stott C et al Journal of American Physicians and Surgeons 2004;9:89-91

Wakefield AJ et al. Medical Veritas 2006;3:796-802

=========================

 

Title: MMR vaccination and autism

Letter

Authors: Dr J Wakefield MB,BS., FRCS., FRCPath and Dr Carol

Stott PhD

Response to: D’Souza et al. No evidence of persisting measles virus in

peripheral blood mononuclear cells from children with autism spectrum

disorder. Pediatrics. 2006;118:1664-75.

 

Dear Sir,

The merit of D’Souza et al’s use of a study of peripheral blood

mononuclear cells to dismiss findings in intestinal biopsies is

questionable (1). A recent US study using nested PCR and sequencing

confirmed the fidelity of the original Uhlmann F-gene primers in the

detection of measles virus in intestinal biopsies from children with

autism (2).

 

D’Souza et al claim that, among other things, the ‘epidemiological

burden of evidence against such an [causal] association between MMR and

autism is overwhelmingâ€. They fail to reference the authoritative

Cochrane review of this epidemiology (3) which dismissed much of it as

being of insufficient quality to merit consideration, including

Fombonne’s own work (4) of which they said, “the number and possible

impact of biases in this study was so high that interpretation of the

results was difficult.†Even the Cochrane review failed to note that

another of Fombonne’s studies using the UK General Practice database

(GPRD)(5) tested the wrong hypothesis and lacked sufficient power to

detect an association between MMR and regressive autism.

 

So which studies are sufficient to overwhelm? Several have looked at

age of exposure to MMR vaccine and risk of autism. Such a hypothesis is

merited on the basis that younger age of exposure to measles virus is

associated with an increased risk of adverse outcome including

persistent infection and delayed disease. Richler et al posed the

question of whether there is an autism phenotype characterized by

regression associated with significant intestinal symptoms following

MMR vaccine, in a previously developmentally normal or near-normal

child (6). Children meeting these criteria were compared with all other

autistic children in their study cohort. In this, the only

epidemiologic study to at least attempt to segregate this sentinel

autism phenotype, age-of-exposure to MMR vaccine was significantly

lower (mean age 14.38 months) when compared with the remaining autistic

population (mean age 17.71 months; (p<0.05). Strangely - and at odds

with their own reported findings - the authors concluded that, ‘there

was no evidence that onset of autistic symptoms or of regression was

related to MMR vaccination’.

 

Three further aspects of age-of-exposure to MMR and autism have been

reported: DeStefano and colleagues performed a case-control study

comparing age at first MMR vaccination in children from the Atlanta

metro area (7). By 36 months of age, significantly more cases with

autism (93%) had received MMR than controls (91%)(Odds Ratio 1.49; 95%

confidence interval [CI] 1.04-2.14). This association was strongest in

the 3 to 5-year age group with an Odds Ratio of 2.34. Due to diagnostic

delay, a significant proportion of this group had yet to be diagnosed

with autism, potentially underestimating this risk.  Moreover, in a

subgroup analysis looking at children with different disease

characteristics, they found a significant association between MMR

vaccination by 36 months and autistic children with no evidence of

mental retardation (IQ>70; OR 2.54 [1.20-5.00]). The odds ratios were

increased to 3.55 in a subgroup analysis adjusted for birth weight,

multiple gestation, maternal age and maternal education, thus

strengthening the association between age-of-exposure to MMR and

autism. It is interesting that their ‘regressive group’ did not show

this effect although the interpretation of this finding is severely

constrained by their retrospective ascertainment of regression from

medical records. First, regression did not form part of the diagnostic

algorithm for autism and second, the concept of regression conflicted,

until very recently, with the beliefs of most autism diagnosticians.

IQ, on the other hand, is an objective measure and a normal IQ appears

to be an increasingly common feature among recent cohorts of affected

children (8). An IQ within the normal range may well reflect a period

of normal cerebral development and in this instance, be a better marker

of the late-onset phenotype than retrospective record review. Having

tested a hypothesis and found a significant association between autism

and age of first MMR exposure, the authors, somewhat curiously, ascribe

this effect to an ‘artifact of immunization requirements for pre-school

special education attendance in case children’. Such an interpretation

would only possibly be valid if the immunization mandate for normal

pre-school children were different from that of special education

children; it is not. Moreover, the special education group, with a

likely excess of contraindications to MMR vaccination such as seizures,

should have a lesser exposure to MMR. In addition, if there were no

true association, lower exposure in the special education group would

be expected in light of higher levels of parental concern and

consequent rates of abstention in this group, a possibility that could

have been easily checked by comparing the proportions of exemption

filings held by law in all state schools. This notwithstanding, the

data of DeStefano et al are not consistent with the author’s post hoc

rationalization.

Second, es and Baltzan (9) reanalyzed the California autism data

of Dales and colleagues (10), confirming that the age of MMR

immunization was becoming younger between 1981 and 1993. The ratio of

children immunized before age 17 months to those immunized between age

17 and 24 months increased 200% from 1981 to 1993, and the rate of

early MMR immunization is correlated with the incidence of autism. This

is an important factor in light of  DeStefano et al’s observation of a

greater statistically significant association between autism and MMR

vaccination by 36 months in more recent birth cohorts (7).

 

Third, Suissa pointed out that according to the Danish data of Madsen

et al (11) the rates of autistic disorder by age at vaccination, are

18.9, 14.8, 24.6, and 26.9 per 105 per year respectively for ages <15,

15-19, 20-24, 25-35, falling to 12.0 per 105 with age at vaccination

>35 months, compared with the overall rate of 11.0 for the reference

group of no vaccination, over all ages (12). Suissa considered it

somewhat implausible for the age-adjusted rate ratio to fall below 1

(as presented), unless the risk profile by age in the unvaccinated is

vastly different than in the vaccinated. Thus, rather than an apparent

association between exposure and outcome being a spurious result of

confounding, this would actually represent effect modification. The

data support the hypothesis of an association between exposure and

outcome, modified, rather than confounded by, age of exposure.

 

While an effect of age of exposure to MMR vaccine on autism risk is

evident from these studies, the nature of that risk is not known.

 

Aside from the issue of age of exposure, et al found a

significant clustering of parental concern within 6 months of MMR

vaccination (p=0·03)(13) and, as was later pointed out, a step-up in

number of autism diagnoses associated with the introduction of MMR

vaccination in the UK (14).  A similar step up in the autism rate with

introduction of MMR was observed in Denmark (12).

 

Overwhelmed, D’Souza et al claim that the hypothesized link between MMR

and ASD is spurious. With respect, we disagree.

 

J Wakefield MB,BS., FRCS., FRCPath and Carol Stott Ph.D

 

References

1. D'Souza Y, Fombonne E, Ward BJ. No evidence of persisting measles

virus in peripheral blood mononuclear cells from children with autism

spectrum disorder. Pediatrics. 2006;118:1664-75.

2. SJ, Hepner K, Segal J, Krigsman A. Persistent ileal measles

virus in a large cohort of regressive autistic children with

ileocolitis and lymphnodular hyperplasia: re-visitation of an earlier

study [abstract]. International Meeting for Autism Research (IMFAR)

2006,

http://www.cevs.ucdavis.edu/Cofred/Public/Aca/WebSec.cfm?

confid=238 & webid=1245.

3. Cochrane. Demicheli V, Jefferson T, Rivetti A, Price D. Vaccines

for measles, mumps and rubella in children (Review) The Cochrane

Library. Wiley & Sons, Ltd. 2005, Issue 4.

http://www.thecochranelibrary.com

4. Fombonne E, Chakrabarti S. No evidence for a new variant of

measles-mumps-rubella-induced autism. Pediatrics 2001;108:E58

5. Smeeth L, Cook C, Fombonne E, Heavey L, Rodrigues L, P, Hall

A. MMR vaccination and pervasive developmental disorders: a

case-control study. Lancet 2004,  364:963-969

6. Richler J, Luyster R, Risi S, Hsu Wan-Ling, Dawson G, Bernier R, et

al . Is there a ‘regressive phenotype’ of autistic spectrum disorder

associated with the measles-mumps-rubella vaccine? a CPEA study. Autism

Dev. Dis. 2006, 36:299-316.

7. DeStefano F, Bhasin TK, WW, Yeargin-All sopp M, Boyle C.

Age at first measles-mumps- rubella vaccination in children with autism

and school-mat ched control subjects: a population-based study in metro

politan Atlanta. Pediatrics 2004, 113:259–266.

8. Autistic Spectrum Disorders: changes in the California caseload. An

update: 1999 through 2002. California Department of Developmental

Services. A Report to the Legislature, Department of Developmental

Services. Sacramento, Calif.: www.dds.ca.gov. Accessed Oct, 2006.

9. es M, Baltzan M. MMR Immunization and Autism. JAMA 2001,

285:2852-2853

10. Dales L, Hammer SJ, NJ. Time trends in autism and MMR

immunization coverage in California. JAMA 2001, 285:1183-1185

11. Madsen MK., Hviid A., Vestergaard M., Schendel D., Wohlfarht J.,

Thorsen P., et al. A population-based study of measles mumps rubella

vaccination and autism. NEJM 2002, 347:1478-1482.

12. Stott CA; Blaxill M, Wakefield AJ.  MMR and Autism in Perspective:

the Denmark Story. Journal of American Physicians and Surgeons.

2004;9:89-91

13. B, E, Farrington P, et al. Autism and measles, mumps,

rubella vaccine: no epidemiological evidence for a causal association.

1999;353:2026-2029.

14. Wakefield AJ.MMR vaccine and autism. 1999;354:950-951.

Potential conflicts.

The authors have acted as paid experts in the UK MMR vaccine

litigation. AJW is a named inventor on two viral diagnostic patents.

=========================

On Dec 30, 2006, at 11:30 PM, Nanstiel wrote:

Deer just doesn't care that Dr. Wakefield was absolutely right.

He doesn't care that my own daughter suffered gut damage from the

MMR...

Why doesn't someone look to see where Deer is getting his money? The

guy is slime. All four

feet eleven inches of him. (he's quite short.)

>

> http://www.timesonline.co.uk/article/0,,2087-2524335,00.html

>

[Guest guest]

Well there you go ....Dr. Wakefield is a very tall dashingly

handsome man. Mr. Deer most certainly must be suffering from " little

man syndrome " spurred on by his utter jealousy of tall handsome Dr.

Wakefield. I've seen this before..it's not pretty...

>

> Why doesn't someone look to see where Deer is getting his money? The

guy is slime. All four

> feet eleven inches of him. (he's quite short.)

>

[Guest guest]

Wakefield... Class Act.

Deer... No class.

> >

> > http://www.timesonline.co.uk/article/0,,2087-2524335,00.html

> >

>

[Guest guest]

I was just having a little fun at his expense... but diminuitive proportions

aside, I think

Deer is not what he seems. He's not championing children or shutting down

quacks.

He has to be on the take.

>

> Well there you go ....Dr. Wakefield is a very tall dashingly

> handsome man. Mr. Deer most certainly must be suffering from " little

> man syndrome " spurred on by his utter jealousy of tall handsome Dr.

> Wakefield. I've seen this before..it's not pretty...

>

>

> >

> > Why doesn't someone look to see where Deer is getting his money? The

> guy is slime. All four

> > feet eleven inches of him. (he's quite short.)

> >

>

[Guest guest]

To the average " Joe Blow " citizen over in the UK who reads this

article, I suppose they could be concerned about this revelation.

The interesting part is that anyone who even minimally follows the

saga knows that conflicts of interest/motivations through money are

everywhere in this conflict. For the following list, I am

*assuming* that the UK has similar issues as we do in the US.

We have organizations whose job it is to promote vaccines also in

charge of the safety of these vaccines.

We have vaccine mfg's paying other people/organizations to do

their " safety studies " .

We have federal governments paying states for every fully immunized

child.

We have vaccine manufacturer's " donating " large sums of money to

other influential organizations.

The list could go on and on. I wonder how much of that the

average " Joe Blow " citizen knows about all those things?

Wakefield was paid for his expert opinion... he did reseach and

ultimately he had published a study which specifically stated at the

end of it.... and I quote:

" Further investigations are needed to examine this syndrome and its

possible relation to this vaccine " .

Wakefield of course also has on his side that he is actually working

with the autistic population who suffer from bowel disease as

opposed to those who just wish to ignore it.

Odd.

Sue M.

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