Special Advisory Update - September 2, 2009

Arizona Center for Advanced Medicine
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Phone: 480-240-2600 Fax: 480-240-2601
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NBC Dateline Tackles Autism & Wakefield

On Sunday, August 30, NBC aired a special Dateline, "A Dose of Controversy," about the autism debate. In the program, host Matt Lauer spoke with Dr. Andrew Wakefield, whose 1998 medical study was the first in the world to suggest a possible link between the MMR vaccine and autism.

The post-program reactions are coming in. Last week, we posted a letter from the autism group "Thoughtful House" explaining why, after reviewing the possible downsides, they agreed to participate in the program. After the program aired, Thoughtful House issued a response. Also, Dr. Andrew Wakefield distributed a letter in the last of couple days. Excerpts of both:

THOUGHTFUL HOUSE

"This broadcast was the first time a network has taken the time to address some of these difficult questions, and attempted to deal with complex answers; answers that can be impossible to put into sound bites or easy black-and-white comments.

We are aware of the time limitations in a news broadcast of this nature; inevitably, crucial questions go unanswered and important facts are omitted. Quick answers and segues leave questions open, and can even lead to misunderstanding.

Among the most crucial incorrect statements were that "(experts) have taken this study and blown it to bits…that despite studies showing otherwise…Dr. Wakefield insists autism and bowel disease are linked..." This is in fact not the case, and NBC was given the correct information in great detail. Five separate studies in five countries have confirmed the presence of a novel bowel disease in children with autism. Additional publications confirming these findings are in process. This hypothesis was the crux of the 1998 Lancet paper, as well as several subsequent publications by Dr. Wakefield.

Additionally, the Danish and Finnish studies that were referred to, with NBC stating that "much larger studies showed absolutely no link [to MMR]" were presented as if they had not garnered their own share of criticism and debate. In fact, these studies have been reviewed by other scientists in depth and found to be lacking. And as Dr. Healy points out, the number of children involved in these studies might not have been substantial enough to answer the question of a possible link.

Dr. Paul Offit (a frequent media spokesperson for the current vaccine schedule and champion of stopping research into vaccine safety and autism) was asked a relevant question about his conflict of interests. While finally acknowledging he has made millions and millions from the development of vaccinations, what Dr. Offit failed to disclose in his answer is that he has been a consultant for the pharmaceutical giant Merck, a manufacturer of the MMR vaccine. While serving as a consultant is not unusual or wrong, his failure to disclose this when answering a question about potential conflicts of interest is misleading in the extreme. He is actually guilty of the very thing that Dr. Wakefield has been accused of. (Note that Dr. Wakefield provided NBC with numerous documents proving he was innocent of this charge, and that he had declared any possible conflict of interest in a timely manner throughout the course of his career.) We certainly do not condone any threats or attacks against anyone, including Dr. Offit (we have been on the receiving end of these threats and accusations ourselves); however, we urge Dr. Offit to be prompt and thorough in disclosing his motives and conflicts.

As for Brian Deer, much has been written and said about his crusade against Dr. Wakefield. His lies, conflation of facts, and distortions of truth are documented and will continue to be revealed as more facts emerge. The biggest omission in the broadcast concerning Mr. Deer is the clear evidence that the entire General Medical Council investigation is based on a complaint he filed himself. A reporter creating the news is a story in itself, and one that will continue to be discussed as the GMC and the Press Complaints Commission in the UK review the facts at hand.

While we sympathize with pediatricians who must answer more questions from better informed parents, we disagree with Mr. Lauer's assessment that it is the pediatricians who "are dealing with the collateral damage." We see mountains of collateral damage every day in our waiting rooms, our community, and our homes.

As the health and lives of children continue to improve and the research into causation and best courses of treatment moves forward, we remain committed to follow our mission of fighting for the recovery of children with autism and developmental disorders.

We hope this broadcast will open a productive dialogue on the challenges of autism and the treatment that will help them reach their fullest potential. The issue of vaccine safety must become a priority for those who have been tasked with protecting our children. We hope that science will prevail over profit and policy and that this research will be supported in order to answer these questions once and for all. All children deserve nothing less."

Anissa Ryland
Director of Operations
Thoughtful House Center for Children

DR. ANDREW WAKEFIELD

Dr Andrew Wakefield

A. There has been extensive replication of the finding of bowel disease in children with autism (ASD) from five different countries. These findings have been published in peer-reviewed journals or presented at scientific meetings. It is therefore incorrect and misleading of Matt Lauer to have stated that every aspect of my original hypothesis has been disproved. On the contrary, the main findings of the original Lancet paper, that is, bowel disease in autistic children, has been repeatedly confirmed. This obvious inaccuracy requires clarification by NBC.

B. The shortcomings and the flaws of the studies quoted by Dr. Offit, claiming to disprove an association between vaccines and autism, were not discussed in the program. In my interview with Mr. Lauer I took as an example a paper from Dr. DeStefano from the CDC claiming to exonerate MMR that actually showed that a younger age of vaccination with MMR is associated with a greater risk of autism.

This study confirms the association and has been falsely portrayed as vindicating the vaccine. This should have been included in order to provide balance to the program.

C. Reference was made to an autistic child in the vaccine court whose claim for MMR damage was overturned by the judge. No reference was made to the successful vaccine court case on behalf of the child Bailey Banks, coming just one week after the unsuccessful claim described by Mr. Lauer, in which the judge ruled that MMR vaccine can cause autism. Therefore, in the view of vaccine court, it is not a question of whether or not MMR can cause autism, but rather how many children are affected.

D. There was a complete absence of comment on the lack of any adequate safety studies of childhood vaccines and the vaccine schedule in particular. There was no mention of the admission by vaccine regulators that there is no data on the long-term safety of vaccines, the chronic disease burden caused by vaccines, and the likely potentially harmful interactions between various vaccines in the routine schedule.

E. Undue credibility was given to Brian Deer, a discredited freelance journalist, whose false reporting has caused so much misunderstanding and damage to children through the misrepresentation of the doctors and parents who were seeking answers to the vaccine-autism question. Deer has repeatedly misled the public and the medical profession and has been unable to respond to clear evidence of his false reporting in the Sunday Times through the UK's Press Complaints Commission.

F. It was not disclosed that I have repeatedly invited Dr. Offit to take part in public debate on the safety of MMR vaccine and the false and misleading claims that he has made in the media and his book. He has refused to accept this invitation and has continued to hide from an open and honest debate.

G. NBC alluded briefly to the fact that Richard Horton, editor of The Lancet, was informed of my participation as a medical expert in the MMR litigation almost one year before publication of the Lancet paper in 1998. NBC failed to clarify that when Horton was challenged to respond to the fact that when he so enthusiastically denounced me and the paper in 2004 the Lancet staff was already fully aware of the facts and at that time did not consider them to be relevant. Horton refused to be interviewed by NBC and the interview segment shown was from 2004. This refusal is in sharp contrast to his willingness to denounce me in the media in 2004. NBC also failed to mention that in the light of these facts Horton has been reported to UK's General Medical Council on an allegation of perjury.

H. It was unfortunate that NBC, having stated their determination to resist external pressure to distort the balance of the program, yielded to such pressure from the American Academy of Pediatrics, allowing them the final word in the program while denying representation from the National Autism Association who put forward to NBC a rational and well reasoned call for further science to resolve this very real issue.

I. Dr. Offit cited a large population study of autism and MMR from Denmark in support of his claim to ‘certainty that there is no link.' This study was so flawed that it was rejected from consideration by the gold standard scientific review by the highly influential Cochrane Collaboration. Dr. Offit, who is not an epidemiologist, was clearly at a loss to understand the study's fatal flaws.

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