An Assessment of the Wakefield Affair, part 1

Some of you may have seen my post on Jenny McCarty’s Huffington Post article and are probably curious why I changed my opinion of Dr. Wakefield. What particular piece of information changed my mind? Well, that is a tough question to answer. I can’t point to one particular thing because the only thing I can go on is the evidence provided.

When I started looking at this, I had to use what information that was available. Admittedly, I am missing one particular piece of information from Dr. Wakefield, and that is his book. I haven’t had the time, or the money, to read this book as of now. Am I going to read it? Yes, I will. But, from what I’ve been able to gather, it is really only a rehash of his defense against Deer’s allegations. To not read Wakefield’s book and look at it with the same objective light as I’ve tried to look at everything else concerning this would be intellectually dishonest.

My evaluation looked at Brian Deer’s BMJ articles, his website, Andrew Wakefield’s defense and those websites that defended him, and finally the GMC transcripts. The transcripts were the most time consuming aspect of this case because it was over 6 million words, and I will admit that some of the things mentioned in there I didn’t completely understand. Maybe it was the language used (I’m only bilingual; I speak American, Texan and a tiny bit of Coon-ass). I’ve spent the past week, both day and night, reading, pondering, evaluating, weighing, and thinking. Sometimes, all night, just laying in bed thinking about it (which is why some of my posts on Jenny’s Huffpo article are so rife with spelling and grammar errors…I’m usually much better about things like that)

I’m not going to lie to you; I’m having a really hard time writing this. I put a little bit down, then have to step away and really think about what I need to say next. Some of my trepidation is knowing that my admission has disappointed many people I consider friends. Some of it is mental exhaustion. Some of it is self evaluation. Some of it is the realization that I don’t really have to try to convince anyone of turning against Andrew Wakefield; I only have to tell you what convinced me.

So, let me start with my thought process. You can see a little of it one of my older posts, which I will leave up. I realized that I had an emotional investment in this issue, and that to truly, objectively, evaluate the evidence, I needed to somehow detach myself from my personal investment and actually LOOK at what was being written. In this case, I tried to evaluate it with the following in mind: Deer was biased against Wakefield; Wakefield was biased for himself; and the GMC is supposed to be an unbiased 3rd party (which, I am quite sure, will be argued against…but for the sake of argument, assume that they are unbiased). This was NOT easy, so bear with me.

Over the next few days (maybe longer considering how long it’s taking me to write this), I will discuss specific items pertaining to the Wakefield affair. This will include several items from each of the above mentioned locations. I will evaluate and weigh each of these items and explain why I think the argument is weak or strong.

What jumped out at me first was the accusation that Brian Deer brought against Wakefield as to a potential motive for the 1998 Lancet paper. Essentially, Deer says that Wakefield manufactured the Lancet paper in order to scare the British parents into taking the separate M M and R vaccines, then he would market his own Transfer Factor as a potential rival for these vaccines. This, to me, was Deer’s weakest argument (and thereby Wakefield’s strongest). Yes, the application for the patent does say that it was a vaccine. However, Wakefield’s defense claims that it wasn’t meant as a rival vaccine because it was mainly to be used as a treatment for Inflammatory Bowel Disease and as a potential prophylaxis for immune-compromised patients (bottom of page one, and top of page 2). I am willing to give Wakefield the benefit of the doubt on this one, because Wakefield’s statement concerning this is corroborated by evidence. However, since Wakefield did not disclose this information when releasing the Lancet article, and in the subsequent media announcement, this is a blatant Conflict of Interest. That is bad, even if you defend Wakefield. This calls his Lancet article into serious question, even before you start looking at the science. The GMC hearings say this:

f. A proposal, dated 4 March 1998 and drafted by Mr 10, was submitted to the Royal Free Hospital School of Medicine in relation to the proposed company,
Admitted and found proved

I realized that I started in the middle, so I had to go all the way back to early 1996, when Deer alleges that Wakefield was approached by Richard Barr. To me, this is one of Deer’s strongest arguments. Barr admits to soliciting Dr. Wakefield in order to provide him with several patients for an then unheard of condition that Barr claims was linked to MMR. Over the course of the research into the ‘98 Lancet article, Wakefield received about $750 thousand dollars (plus expenses) for his work. This was also undisclosed. Not only bad, but REALLY bad. Wakefield’s defense is to claim that he was using this money to pay for a second study that he was doing, though never released. But, even if you believe Wakefield, the fact that he did not disclose this information is a serious COI. The GMC hearings say this:

a. In 1996 you were involved in advising Richard Barr, a solicitor
acting for persons alleged to have suffered harm caused by the
administration of the MMR vaccine, as to the research that would be
required to establish that the vaccine was causing injury,
Admitted and found proved

b. Mr Barr had the benefit of public funding from the Legal Aid
Board in relation to the pursuit of litigation against manufacturers of the
MMR vaccine (“the MMR litigation”),
Admitted and found proved

Ok. I think that’s enough for now. I am going to open up the comments to everyone, even those not normally allowed to comment. I have a stipulation, however. Keep it civil, guys. If the comments get out of hand, you will get one warning. If they continue to get out of hand, I will delete the comment. On the 3rd strike, you will no longer be able to comment.

Tomorrow (maybe) I will continue with my evaluation.