Not quite sure you’ve got this matey

Amazon and Apple are profiting from an anti-vaccination documentary directed by the discredited former doctor Andrew Wakefield.

The film, which backs his fraudulent research linking vaccines with autism, is available for customers to watch for 99p on Amazon Instant Video and £6.99 on Apple’s iTunes. On Vimeo, a popular YouTube-style streaming service, it costs £3.17.

Scientists and autism campaigners urged the web companies to remove the film Vaxxed after The Times discovered that it had been put on sale in Britain this week.

Edzard Ernst, professor emeritus of complementary medicine at Exeter university, said: “Any company or person trying to make money by alarming people and thus endangering public health is not just unethical and immoral but also despicable and irresponsible.

“Wakefield’s data has been shown to be wrong. That he still insists on discouraging people from getting vaccinated is disturbing and a risk to public health. I just hope that the British public recognises a charlatan when they see one.”

Wakefield is indeed wrong, he’s even dangerous. And yet he still enjoys the same free speech rights as the rest of us.

Those rights don’t include forcing someone to sell his film, entirely true, but insisting that they don’t sell his film because you don’t like the content is pretty limiting, isn’t it?

39 comments on “Not quite sure you’ve got this matey

  1. Tim, my huge respect for you stops dead when you dismiss; “Wakefield is indeed wrong, he’s even dangerous.”

    Wakefield was investigating the time-coincidence of the triple vaccine with a huge upsurge of autism. I don’t believe he had drawn any conclusion, but was shafted right out of medicine for even daring to research.

    My grandson, who was an extremely bright boy, at about 2, is still an extremely bright boy, stuck in the same time and aged now at 14. He is virtually grown physically, but stick mentally, and will face a life of living in an institution on a few years time.

    I understand that 50% of black boys in the USA face the same prospect, Wakefield’s (on someone’s) investigations MUST continue in this field.

  2. Sorry to hear about that ineffable sadness.

    However, here’s reality calling. Vaccines definitely damage some subset of those who get them. 1 in 50,000? 1 in a million? That sort of range. We know this. We also know that without vaccination some 5 -25% of children will die from the diseases vaccinated against. Horrible trade off but the one that is made.

    Wakefield however, with autism and vaccines, was simply made up shit. It’s really important that we separate out the two issues.

  3. I agree vaccines are valuable. My only concerns is that adding 3 all in one injection could easily be overloading the host, when one alone is tolerable, surely that IS worth investigating.
    ?

  4. The insistence of the medical profession that MMR is the only way, even when parents would prefer to pay for separate vaccines, is deeply suspicious.

  5. Why? Anyone actually think the medical profession would like to see more autism around? Because that’s the allegation you’re making.

  6. ‘Edzard Ernst, professor emeritus of complementary medicine at Exeter university’.

    complementary medicine – any of a range of medical therapies that fall beyond the scope of scientific medicine.

    Snake oil salesman complaining of other snake oil salesman muscling in on his business.

    I do like the way Apple premium customers have to pay £6.00 more than the scum class that uses Amazon.

  7. Concern that multiple vaccines injected into one spot could reinforce each other and become more than the sum of their parts is an obvious result.
    Even people who know nothing about vaccines could imagine this to be the case.

    Bliar’s government decided it was prepared to put all it had got behind MMR, when, if he had wanted higher uptake of the vaccines he would have allowed spearate injections.

  8. I remember the MMR controversy chiefly for that twat Blair telling everyone it was safe and then refusing to confirm that his own baby had received it. Good leadership there, eh?

  9. Tim Worstall – “Why? Anyone actually think the medical profession would like to see more autism around? Because that’s the allegation you’re making.”

    Well not quite. Doctors, like any other group of professionals, are perfectly capable of responding poorly when questioned, of retreating behind their certificates and saying “We are the experts and you should listen to us.” Respect our Aaauuthorite!

    Look at Semmelweiss. Or these days MRSA.

  10. We do not have a cover up here, even though as JuliaM says it can look suspicious…

    Multipule vaccines are cheap, and easy for the medical profession to administer. O.K. the more vaccines given at the same time increase the risk, but the risk is VERY low, and the benefits are high. Of course the main benefit is potential lower health care cost in the future! Driving down costs is very important for many in the medical profession, and it leaves more money to spend on keeping the bloated organisations running!

    What is sad is that the Pharmaceutical companies do not need to publish their bad news, and that medical professionals do not always read or understand the potential side effects. Who is on the side of the patient or consumer? erm… No one.

    It is also a big problem that the medical profession for all their talk of informed consent, are still not completely transparent about risk.

    The other very sad episode is the why are the rates of Autism increasing, well as far as I know we havn`t a clue. This is not good enough…

    So as a former pharmaceutical chemist, I can tell you that vaccines are safer than eating peanuts, how much safer? Well we don`t know, as we have difficulty measuring absolute safety.

    It is not helpful to keep attacking Wakefield, he has made mistakes, he has behaved badly and now his job is to keep parents happy that think it was the vaccine that made tiher child ill. I wish the medical profession had spent the time and energy that they have devoted to Wakefield in more useful way such as investigating Autism.

  11. @TJ: “I wish the medical profession had spent the time and energy that they have devoted to Wakefield in more useful way such as investigating Autism.”

    THIS!

  12. The MMR controversy was triggered by his finding a handful of autistic boys with abnormal small intestine pathology. This has not been investigated further by experiment or new data. Instead Wakefield was buried in an avalanche of studies using metadata from smaller previous studies, nothing new. I say the case against him is unproved if prospective studies are not done and in the absence of a meaningful number of biopsies from autistic and normal children.

  13. Paul Power,

    ‘have you any evidence to back your claim re Professor Ernst?’

    No, it would appear that I have wrongly maligned Professor Ernst.

    He has a website http://edzardernst.com/

    He states ‘my research focussed on the critical evaluation of all aspects of alternative medicine. I do not aim to promote this or that therapy, my goal is to provide objective evidence and reliable information. This ambition did not endear me to many believers in alternative medicine.’

    My confirmation bias made me wrongly jump to the conclusion that his title of ‘professor emeritus of complementary medicine at Exeter university’ meant he was an advocate for said ‘any of a range of medical therapies that fall beyond the scope of scientific medicine.’

    Apologies to the good professor.

    Perhaps his title should be ‘professor emeritus of debunking quack medicine at Exeter university’ to avoid any future confusion.

  14. “It is not helpful to keep attacking Wakefield, he has made mistakes…”

    He did more than make mistakes: he is fraudulent, publishing a paper in the Lancet that contained deliberately false data.

    His hypothesis might be true, but it looks very unlikely indeed. No one has been able to replicate his results.

    That said, I can’t see what is wrong with anyone selling this film. The calls for the film to be banned are the usual public health authoritarianism. If the film is misleading, refute it – don’t ban it.

  15. Paul Power,

    I should have done some simple basic research before shooting my mouth (keyboard) off.

    Thanks for calling me out on it.

    (now I will sit on the naughty step for a bit)

  16. @Theo

    He did more than make mistakes: he is fraudulent, publishing a paper … that contained deliberately false data.

    His hypothesis might be true, but it looks very unlikely indeed. No one has been able to replicate his results.

    With a small edit (“…”), we could be talking about MMGW.

    Where’s the outcry for the likes of “An Inconvenient Truth” to be dropped from Amazon?

  17. One possible reason for the rise in diagnosis of autism is simply the hugely increased awareness of it. My son has Aspergers Syndrome and he’s had support all through his life. With hindsight it’s pretty certain that my father had it too but he was never diagnosed or treated – he was just the harmless weird bloke in the pub.

  18. Paul Power,

    ‘I wasn’t calling you out’

    either way, cheers for calling my attention to it, I shouldn’t have made a post like that without thinking about it and I have emailed Tim to see if he can edit my original post to point to the retraction further down.

  19. JuliaM,

    Without wanting to pick a dog in the fight, I can see immediate, clear practical reasons why MMR would be more popular with providers than three independent vaccinations.

    Firstly, cost: from memory the cost of an MMR injection (for actually buying the dose of vaccine) was about the same as for each of the three constituents: like a £4.99 bottle of wine, very little of the purchase price actually pays for what’s in the bottle, it’s the manufacture, packaging, shipping and handling that cost. Not huge, but significant.

    More importantly, three seperate immunisations mean three sets of visits, so tripling the workload on a practice; and even if you sensibly offload this sort of basic stuff to a practice nurse, if you triple the time they spend injecting children that’s time they can’t spend taking stitches out of motorcyclists’ knee injuries (the scar’s faded now though) or other worthy tasks.

    And perhaps most importantly, it’s hard enough getting a large percentage to turn up for a course of MMR; triple the attendance requirements, and you greatly increase the numbers of incomplete vaccinations, which defeats the point of herd immunity and – from an engineer’s view not a medical person – sounds like a way to encourage vaccine-resistant strains to get a toehold, similar to people who don’t complete a course of antibiotics.

    Of course, none of this is incompatible with “I is doctor with expensive qualification and big trade union and NHS, so YOU DO AS YOU IS TOLD, peasant!” as SMFS points out.

  20. “Urging “he shouldn’t be allowed to say that” ain’t quite, no.”

    To be fair, I don’t think they crossed that line, more, asking Amazon/Apple to remove it, calling them arseholes for selling it.

    That said, it’s very impractical to get into this stuff because what makes the likes of iTunes and Amazon so amazing is precisely that it’s all run by a load of servers in a warehouse with almost no humans. I’m constantly angry at calls for “Amazon should” or “Twitter should” or “Facebook should” because they all involve lots of humans checking things. If you can’t do it with an algorithm, it’s going to kill the services.

  21. Bob Rocket

    I think you pointed out the most useful nugget of information in that piece: that Amazon charges £0.99 and Apple £6.95 for the same film. There is a hint of Apple’s eventual fall.

  22. Can they all lose?, Wakefield was initially given some credibility by the medical establishments prior history of refusing to countenance new theories e.g. ulcers.

  23. Tim Worstall said: “Why? Anyone actually think the medical profession would like to see more autism around? Because that’s the allegation you’re making.”

    The autism scare was specifically to do with the MMR vaccine, not vaccines in general.

    IIRC the scare began when children were falling sick in Japan and for a while the UK was using the same component strains for the vaccine. Japan went back to separate jabs. The UK changed the components but the scare stuck. The problem was compounded by the NHS withdrawing the triple jab as an option. *If herd immunity was viewed as so critical to the government* it should have retained the triple jab as an option. It is a worrying example of government bloody mindedness clashing with public health issues.

    Jason Lynch,

    MMR didn’t come out of nowhere. Children were already being vaccinated in large and rising numbers.(pdf) MMR was supposed to improve on already good numbers but due to the governments eagerness to take a reputable option off the table it reduced vaccinations.

  24. TJ

    “Multipule vaccines are cheap, and easy for the medical profession to administer. O.K. the more vaccines given at the same time increase the risk, but the risk is VERY low, and the benefits are high. ”

    The increased risk probably is insignificant, I didn’t take much interest at the time because our son had already had the MMR vaccine. From what I did follow though I didn’t have much time for Dr Wakefield.

    However what I find obnoxious is the way worried parents were treated, as if there was no increased risk and they were being silly compared to the way we are told to stop eating roast potatoes because there’s a minuscule increase in the risk of cancer. There were even threats of visiting restaurants and closing them down if they overcooked food.

    Its the the establishment’s inconsistency that is the problem for me.

  25. No need for conspiracy theories the medical profession has spent a couple of thousand years accidentally killing people out of arrogance/ignorance. You’d like to think that in this day and age they’d ALL realise that maths (ie good experimental design) is just a little important.

  26. Ljh said: “The MMR controversy was triggered by his finding a handful of autistic boys with abnormal small intestine pathology. This has not been investigated further by experiment or new data. Instead Wakefield was buried in an avalanche of studies using metadata from smaller previous studies, nothing new. I say the case against him is unproved if prospective studies are not done and in the absence of a meaningful number of biopsies from autistic and normal children.”

    The point about what Wakefield did has been lost and grossly misrepresented. He basically said, here is a group of cases which need further looking into as they developed autism after they had the vaccine. That’s it. Not saying the vaccine caused the autism, just something which needs further research.

  27. Tim, my huge respect for you stops dead when you dismiss; “Wakefield is indeed wrong, he’s even dangerous.”

    Wakefield was investigating the time-coincidence of the triple vaccine with a huge upsurge of autism. I don’t believe he had drawn any conclusion, but was shafted right out of medicine for even daring to research.

    Wakefield failed to disclose his funding (there was conflict of interest), he and his 12 co-authors misrepresented their sample selection, they cherry-picked their data and they conducted invasive procedures on the children without ethical oversight. Procedures included colonoscopies, lumbar punctures, ‘barium meal and follow through’.

    It is true that the conclusion of the original paper in 1998 was not as explicit as Wakefield at his press conference about the same.

    Following the MMR scare – fueled by a media that also distorted and cherry picked and misrepresented (including such experts as Libby Purves, Suzanne Moore and Lynda Lee-Potter) – the uptake of the vaccine decreased and the frequencies of mumps, measles and rubella cases increased.

    Incidentally, in 2002 Wakefield published two papers about PCR work showing measles virus in intestinal tissue samples from children with bowel problems and autism. He had a financial stake in the lab that did the work. And apparently that too had its problems: no transparency, unreliable protocols and techniques, disregard for contamination, no reproducibility by independent investigators.

  28. The point about what Wakefield did has been lost and grossly misrepresented. He basically said, here is a group of cases which need further looking into as they developed autism after they had the vaccine. That’s it. Not saying the vaccine caused the autism, just something which needs further research.

    No it hasn’t been grossly represented. He committed fraud.

    And he didn’t just ask for “further research”. Since then he has doubled down on his idiocy and linked himself with others of his true ilk — those that oppose vaccines outright and are prepared to make up data to get the results they want.

    He’s a dangerous man, as Tim says.

  29. The point about what Wakefield did has been lost and grossly misrepresented. He basically said, here is a group of cases which need further looking into as they developed autism after they had the vaccine.

    If a child were diagnosed with autism that diagnosis would occur after the child’s first MMR jab. Because the former would occur at 18 months and the latter at 12 months.

    Not saying the vaccine caused the autism, just something which needs further research.

    In its Findings section, the 1998 paper said, “Onset of behavioural symptoms was associated, by the parents, with measles, mumps, and rubella vaccination in eight of the 12 children, with measles infection in one child, and otitis media in another. ”

    In its Interpretation section, the 1998 paper said, “We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.”

    During his press conference, Wakefield said, “It’s a moral issue for me and I can’t support the continued use of these three vaccines given in combination until this issue has been resolved.
    “Urgent further research is needed to determine whether MMR may give rise to this complication in a small number of people.”

    Nothing in the 1998 paper justified that.

  30. Further to “Not saying the vaccine caused the autism, just something which needs further research”, Wakefield’s patent application in 1998 says, “It has now also been shown that use of the MMR vaccine … results in … pervasive developmental disorder including autism (RBD) in some infants.”

    And regarding the issue of free speech, I recall that Wakefield tried to sue Sunday Times and Channel 4 journalist Brian Deer for libel in England. The judge said of Wakefield that he “chose to issue these proceedings and to use them, as I have described above, as a weapon in his attempts to close down discussion and debate over an important public issue.” After Deer exposed Wakefield’s financial conflict, Wakefield dropped the case and was ordered to pay costs.

    Wakefield also tried to sue Brian Deer (and the BMJ) for defamation in Texas. The court decided it didn’t have jurisdiction and ordered Wakefield to pay costs. Wakefield appealed and lost.

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