Difference between revisions of "Andrew Wakefield"

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'''Andrew Jeremy Wakefield''' (born 1957) is a British surgeon who received a lot of attention with a 1998 publication in ''The Lancet'', both among experts and in public. The article titled ''Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children''<ref name=Wakefield98>Wakefield AJ et al.: ''Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children''. Lancet. 351(9103), 1998, S. 637-41 PMID 9500320 ([http://www.healthprotection.org.uk/ncbugs/ACROBATS/Wakefield98.pdf PDF, 592 kB])</ref> correlates MMR vaccination with autism. As a consequence, vaccination rates dropped, especially in Great Britain.
  
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[[image:Wakefield.jpg|thumb]]
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In 2004, it became public that Wakefield had received 55,000 £ from lawyers representing parents of autistic children prior to the publication of his article.<ref>Brian Deer: ''[http://briandeer.com/mmr/lancet-deer-1.htm Revealed: MMR Research Scandal]'' The Sunday Times (London) February 22 2004</ref>. Lawyers were looking for connections between autism and vaccination in order to sue manufacturers of vaccines. This was known neither to Wakefield's co-authors nor to ''The Lancet''. As a consequence, ten of thirteen authors stepped back.<ref>Murch SH et al.: Retraction of an interpretation. Lancet. 2004;363(9411):750 PMID 15016483</ref> In February 2010, the article was retracted by ''The Lancet''.<ref name="retraction">The Editors of The Lancet: Retraction &ndash; Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, Early Online Publication, 2 February 2010. doi:10.1016/S0140-6736(10)60175-7</ref>
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'''Andrew Jeremy Wakefield''' (born 1957) is a british surgeon, who created a lot of attention with an 1998 publication in ''The Lancet'' in both among experts and in the public. The article titled ''Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children''<ref name=Wakefield98>Wakefield AJ et al.: ''Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children''. Lancet. 351(9103), 1998, S. 637-41 PMID 9500320 ([http://www.healthprotection.org.uk/ncbugs/ACROBATS/Wakefield98.pdf PDF, 592 kB])</ref> correlates MMR-vaccination with autism. As a consequence, vaccination rates dropped, especially in Great Britain.
 
  
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Wakefield resigned from his position in the ''Royal Free Hospital'' in London 2001, and now works for a private hospital in the USA. In 2007, he had to face charges by the British Medical Association.<ref>Reiner Luyken: ''[http://images.zeit.de/text/2007/17/M-Anti-Impfkampagne Panik vor dem Piks]''. DIE ZEIT, 19.04.2007, 17/2007</ref>In May 2010 he received an occupational ban<ref name='NIH'>http://www.spiegel.de/wissenschaft/medizin/0,1518,696472,00.html</ref>.
  
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2004 wurde bekannt, dass Wakefield vor der Veröffentlichung 55.000&nbsp;£ von Anwälten erhalten hatte, die Eltern autistischer Kinder vertraten.<ref>Brian Deer: ''[http://briandeer.com/mmr/lancet-deer-1.htm Revealed: MMR Research Scandal]'' The Sunday Times (London) February 22 2004</ref> Diese suchten Verbindungen zwischen Autismus und der Impfung, um Hersteller des Impfstoffes zu verklagen. Die Gelder waren weder den Mitautoren noch der Zeitschrift bekannt gewesen. Daraufhin traten zehn der dreizehn Autoren des Artikels von diesem zurück.<ref>Murch SH et al.: Retraction of an interpretation. Lancet. 2004;363(9411):750 PMID 15016483</ref> Im Februar 2010 wurde der Artikel von ''The Lancet'' zurückgezogen.<ref name="retraction">The Editors of The Lancet: Retraction &ndash; Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, Early Online Publication, 2 February 2010. doi:10.1016/S0140-6736(10)60175-7</ref>
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His long refuted theories nonetheless are still accepted by esoteric or [[CAM]] inspired circles and persons, e.g. [[Christopher Maloney]].
  
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Wakefield gab 2001 seinen Job im ''Royal Free Hospital'' in London auf, und arbeitet heute für eine Privatklinik in den USA. 2007 musste er sich aufgrund der Vorwürfe vor einem Gericht der britischen Ärztekammer verantworten.<ref>Reiner Luyken: ''[http://images.zeit.de/text/2007/17/M-Anti-Impfkampagne Panik vor dem Piks]''. DIE ZEIT, 19.04.2007, 17/2007</ref> Im Mai 2010 wurde gegen ihn in Großbritannien ein Berufsverbot verhängt<ref name='NIH'>http://www.spiegel.de/wissenschaft/medizin/0,1518,696472,00.html</ref>.
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==''The Lancet'' article in 1998==
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In February 1998, a group around Andrew Wakefield published a report titled "''Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children''" in the renowned medical publication ''The Lancet''.<ref name=Wakefield98>AJ Wakefield et al.: ''Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children''. Lancet. 351(9103), 1998, S. 637-41 PMID 9500320 [http://www.healthprotection.org.uk/ncbugs/ACROBATS/Wakefield98.pdf PDF]</ref> The report analysed the cases of twelve autistic children who were treated in the Royal Free Hospital in the north of London in 1996-1997. The report described bowel related symptoms which, according to Wakefield, were to be seen as proof of a completely new syndrome which he later called Autistic Enterocolitis. Wakefield recommended a closer investigation of possible causes in the environment of these children, so e.g. in respect to the MMR vaccine. The publication suggested a connection between stomach-bowel symptoms and developmental disorders found in these children which was perceived as ostensibly related to the MMR vaccination. A causal connection of MMR vaccines leading to autism, however, was not established. In a press conference prior to the publication, Wakefield said he recommended the use of single vaccines instead of the triple MMR until clarification was obtained. He further stated that eight of the twelve parents considered the vaccination a possible cause, as vaccination and first symptoms occured within days. He stated he could not support the further use of MMR vaccine without detailed investigation. In a video recording prepared for TV in advance he demanded to stop the use of MMR and replace them with single vaccines  instead.<ref>[http://briandeer.com/wakefield/royal-video.htm Video des Wakefield-Interviews]</ref>
  
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Nichtsdestotrotz werden seine längst widerlegten Thesen insbesondere von esoterisch inspirierten Kreisen immer wieder aufgegriffen, so z.B. von [[Andreas Bachmair]]&nbsp;[http://www.impfschaden.info/masern_impfung.htm].
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===The resulting dispute===
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Report, press conference, and video unsettled the Britisch public. A heated debate followed, in which both sides used Wakefield's research as arguments. He was publicly criticized, with his critics expressing doubts regarding correctness as well as ethics of his research. Government and National Health Service (NHS) emphasized that extensive epidemiological data showed no correlation between MMR vaccination and developmental disorders. Many parents refused to believe this, since official information had been discredited earlier, as in the case of BSE. Government was accused that their true motif for rejecting single vaccinations was the higher cost of these. As a result, MMR vaccination rates decreased from&nbsp;92% (1996) to&nbsp;84% (2002). It was suspected that only&nbsp;60% of neccessary MMR vaccinations were performed in some districts of London which is substantially below what is needed for herd immunity of measles. Although no measles epidemic occured so far, physicians warned that epidemics were possible since the number of infections was increasing.
  
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==Der Artikel in ''The Lancet'' im Jahr 1998==
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One issue in the dispute was that only the combined vaccine is available via NHS. Parents rejecting this vaccine can either pay for single vaccinations out of their own pockets or not vaccinate at all. Although Prime Minister Tony Blair publically defended the MMR vaccine, he refused to comment the vaccination status of his youngest son Leo at the same time.
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Im Februar 1998 veröffentlichte eine Gruppe um Andrew Wakefield einen Bericht mit dem Titel "''Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children''" in der angesehenen medizinischen Fachzeitschrift ''The Lancet''.<ref name=Wakefield98>AJ Wakefield et al.: ''Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children''. Lancet. 351(9103), 1998, S. 637-41 PMID 9500320 [http://www.healthprotection.org.uk/ncbugs/ACROBATS/Wakefield98.pdf PDF]</ref> Der Bericht analysierte die Fälle von zwölf autistischen Kindern, welche 1996-1997 im Royal Free Hospital im Norden Londons behandelt wurden. Beschrieben werden den Darm betreffende Symptome, welche gemäß Wakefield der Beweis eines vollständig neuen Syndroms waren. Dieses bezeichnete er später als autistische Enterocolitis. Wakefield empfahl eine nähere Untersuchung von möglichen Ursachen in der Umwelt der Kinder, unter anderem des MMR-Impfstoffes. In der Arbeit werden Verbindungen zwischen Magen-Darm-Symptomen und Entwicklungsstörungen dieser Kinder vermutet, welche angeblich mit der MMR-Impfung verbunden waren. Die kausale Verknüpfung, die MMR-Impfstoffe führten zu Autismus, wurde indes nicht erreicht. In einer Pressekonferenz vor Veröffentlichung der Arbeit gab Wakefield jedoch an, er würde es für sinnvoll halten, bis zur Klärung Einzelimpfstoffe statt des Dreifach-MMR zu nutzen. Weiterhin gab er an, dass acht der zwölf Eltern die Impfung für eine wahrscheinliche Ursache hielten, da Impfung und Beginn der Symptome nur Tage auseinander lagen. Er erklärte, die weitere Verwendung des Kombinationsimpfstoffs ohne detaillierte Prüfung der Sachlage nicht mehr unterstützen zu können. In einer vorher für das Fernsehen erstellten Videoaufzeichnung forderte er, die Nutzung von MMR zugunsten der Einzelimpfstoffe auszusetzen.<ref>[http://briandeer.com/wakefield/royal-video.htm Video des Wakefield-Interviews]</ref>
 
  
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===Die folgende Kontroverse===
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The majority of paediatricians prefer the combined vaccine, as it is less strenuous for the child, and many parents rather have one vaccination done instead of three.
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Bericht, Pressekonferenz und Video verunsicherten die britische Bevölkerung. Die folgende Debatte wurde polarisiert, wobei beide Seiten Wakefields Forschung argumentativ nutzten. Er wurde öffentlich angegriffen, seine Kritiker bezweifelten sowohl die Korrektheit als auch die Ethik seiner Forschungen. Die Regierung und die medizinischen Ämter, wie der National Health Service (NHS), betonten ausführliche, epidemiologische Daten würden keinerlei Zusammenhang zwischen den MMR-Impfungen und Entwicklungsstörungen aufzeigen. Manche Eltern weigerten sich, diesen Dementis Glauben zu schenken, da bereits zuvor staatliche Angaben zur Sicherheit diskreditiert wurden, wie im Fall des BSE-Skandals. Die Regierung wurde beschuldigt, die höheren Kosten der Einzelimpfungen seien der Grund für deren Ablehnung. Als Ergebnis brach die Impfung mit MMR von&nbsp;92% (1996) auf&nbsp;84% (2002) ein. Von Teilen Londons wurde vermutet, dass nur noch&nbsp;60% der Impfungen mit MMR durchgeführt wurden, was drastisch unterhalb des für Herdenimmunität vor Masern notwendigen Schwellenwerts liegt. Auch wenn bisher keine Masernepidemie auftrat, haben Ärzte aufgrund der ansteigenden Zahl von Infektionen bereits vor einer solchen gewarnt.
 
  
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Ein Faktor der Kontroverse ist, dass nur der Kombinationsimpfstoff über das NHS verfügbar ist. Eltern, die diesen Impfstoff ablehnen, haben so nur die Wahl entweder die separaten Impfungen privat vornehmen zu lassen, oder aber ihre Kinder gar nicht zu impfen. Premierminister Tony Blair hat den MMR-Impfstoff zwar öffentlich verteidigt, gibt jedoch keine Auskunft darüber, welche Impfung sein Sohn Leo bekam.
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Epidemiological research on hundreds of thousands of children in numerous studies failed to indicate a link between MMR vaccination and autism. Critics of these studies, like the retired intern John Walker-Smith, although a supporter of the triple vaccine, labelled epidemiology a 'blunt tool' which does not necessarily expose such connections.<ref>http://www.vaccinationnews.com/DailyNews/February2002/AutBowMeas.htm</ref> As an example, it is difficult to find to populations differing in vaccination status only.
  
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Die Mehrheit der Ärzte bevorzugt den Kombinationsimpfstoff, da er weniger belastend für das Kind ist und Eltern eher eine als drei Impfungen vornehmen lassen.
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Dr.&nbsp;Wakefield gave up his position at the Royal Free Hospital in 2001 and now works for a controversial private hospital in the USA. His continued studies include research on possible immunological, metabolical, and pathological changes caused by "Autistic Enterocolitis", as well as connections between bowel diseases and neurological disorders in children and a possible connection between these disorders and influences like vaccines<ref>[http://www.thoughtfulhouse.org/bio_awakefield.htm A.&nbsp;Wakefield at his new employer]</ref>
  
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Epidemiologische Forschung an hunderttausenden Kindern in zahlreichen Studien zeigt weiterhin keine Verbindung zwischen MMR-Impfung und Autismus. Kritiker dieser Studien, wie der im Ruhestand lebende Kliniker John Walker-Smith, obwohl ein Unterstützer des Dreifachimpfstoffs, bezeichneten die Epidemiologie als 'stumpfes Werkzeug', welche derartige Kausalzusammenhänge nicht notwendigerweise aufzeigt.<ref>http://www.vaccinationnews.com/DailyNews/February2002/AutBowMeas.htm</ref> So ist es beispielsweise schwierig, zwei Populationen hinreichender Größe zu finden, welche sich nur durch die Impfung unterscheiden.
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In an article published 2011 in "health affairs" on the topic of vaccine opposition in the USA the authors (Kennedy et. al) come to the conclusion:
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:''"Andrew Wakefield's report, which ran in the Lancet, may have been be "the flimsiest, most underpowered study supporting a conclusion of monumental importance to appear in a leading peer-reviewed journal in the past fifty years."''<ref>Kennedy A et al. ''Confidence about vaccines in the United States: understanding parents' perceptions''. Health Affairs 30:1151-1159, 2011. [http://content.healthaffairs.org/content/30/6/1151.abstract]</ref>
  
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Dr.&nbsp;Wakefield gab seinen Job im Royal Free Hospital 2001 auf und arbeitet nun für eine umstrittene Privatklinik in den USA. Seine fortgesetzten Studien beinhalten die Arbeit an möglichen immunologischen, metabolischen und pathologischen Veränderungen durch die "autistische Enterocolitis", sowie Verbindungen zwischen Darmerkrankungen und neurologischen Störungen bei Kindern und dem möglichen Zusammenhang zwischen diesen Störungen und Einflüssen wie Impfstoffen.<ref>[http://www.thoughtfulhouse.org/bio_awakefield.htm A.&nbsp;Wakefield bei seinem neuen Arbeitgeber]</ref>
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===Conflict of interest===
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In February 2004, journalist Brian Deer exposed information that Wakefield had recieved £&nbsp;55.000 in third-party funds prior to publishing the ''Lancet'' report, with the money paid by lawyers looking for a connection between autism and MMR vaccination.<ref>[http://briandeer.com/mmr/lancet-deer-1.htm B ''Deer: Revealed: MMR Research Scandal'']. The Sunday Times, London, February&nbsp;22, 2004</ref> According to the ''Sunday Times'', several of the parents quoted were involved in law suits against manufacturers of MMR vaccines. Although Wakefield stated that these third-party funds had been public from the beginning, the fact that this was known neither to the ''Lancet'' nor to his co-authors raised much criticism. On February 20, 2004, the ''Lancet'' rated Wakefield's study ''flawed'' due to a ''fatal conflict of interest'' and concluded it should have never been published. Several of Wakefield's co-authors also criticized the lack of information about these third-party funds in explicit ways.<ref>[http://www.staffnurse.com/nursing-news-articles/mmr-autism-link-study-476.html]</ref> The General Medical Council, responsible for issuing medical licences and surveillance of medical ethics in Great Britain, began investigations.<ref>[http://briandeer.com/wakefield/gmc-alleges.htm]</ref>
  
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===Vorwurf eines Interessenskonfliktes===
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Furthermore, nine months before the incriminated report caused world-wide anxiety and uncertainty regarding the MMR vaccines, a series of patents protecting several potentially very profitable products happened to be submitted by Wakefield and the Royal Free Hospital Medical School in London. Obviously, such products would enjoy a much larger chance on the market if and when the MMR vaccines experienced a damage in reputation. The patents e.g. covered an allegedly safe measles vaccine and medication for the treatment of bowel diseases and autism which were all based on the assumption these conditions were caused by MMR vaccination.<ref>http://briandeer.com/wakefield-deer.htm</ref>
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Im Februar 2004 deckte der Journalist Brian Deer auf, dass Wakefield zum Zeitpunkt der Veröffentlichung des ''Lancet''-Berichtes £&nbsp;55.000 an Drittmitteln von Anwälten erhielt, welche zwischen Autismus und dem MMR-Impfstoff Verbindungen suchten.<ref>[http://briandeer.com/mmr/lancet-deer-1.htm B ''Deer: Revealed: MMR Research Scandal'']. The Sunday Times, London, 22.&nbsp;Februar 2004</ref> Gemäß des Artikels in der ''Sunday Times'' waren einige der zitierten Eltern an Prozessen gegen Hersteller des MMR-Impfstoffes beteiligt. Obwohl Wakefield angab, die Drittmittel seien von Anfang an veröffentlicht worden, wurde bemängelt, dass diese weder dem ''Lancet'', noch den Co-Forschern bekannt gemacht wurden. Am 20.&nbsp;Februar 2004 bezeichnete ''Lancet'' Wakefields Studie aufgrund eines "fatalen Interessenskonfliktes" als "fehlerhaft" und gab an, dass diese niemals hätte veröffentlicht werden dürfen. Mehrere von Wakefields Co-Forschern bemängelten ebenfalls deutlich die fehlenden Angaben zu den Drittmitteln.<ref>[http://www.staffnurse.com/nursing-news-articles/mmr-autism-link-study-476.html]</ref> Das General Medical Council, welches in Großbritannien für die Vergabe von Lizenzen für Doktoren und die Überwachung der medizinischen Ethik zuständig ist, hat Ermittlungen aufgenommen.<ref>[http://briandeer.com/wakefield/gmc-alleges.htm]</ref>
 
  
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Ferner haben Wakefield und die Royal Free Hospital Medical School in London bereits 9&nbsp;Monate bevor sie mit dem inkriminierten Artikel weltweit Angst und Unsicherheit bezüglich des MMR-Impfstoffs erzeugten, das erste einer Serie von Patenten eingereicht, mit denen eine Reihe theoretisch hochprofitabler Produkte geschützt werden sollten, welche aber am Markt nur Erfolg haben konnten, wenn der Ruf des MMR-Impfstoffs beschädigt würde. Dabei handelte es sich u.a. um einen angeblich sichereren Masern-Impfstoff und Medikamente zur Behandlung von Darmkrankheiten und Autismus, die alle darauf basierten, dass diese Krankheiten durch den MMR-Impfstoff ausgelöst würden.<ref>http://briandeer.com/wakefield-deer.htm</ref>
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===''Lancet'' report retracted===
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As a consequence of Brian Deer's article, ten of altogether thirteen authors of the report formally renounced the claim of having found a connection between autism and MMR.<ref>Murch SH et al.: Retraction of an interpretation. Lancet. 2004;363(9411):750 PMID 15016483</ref> Deer continued investigations in a documentation on British TV titled ''MMR: What They Didn't Tell You'', which was broadcast Nov.&nbsp;18, 2004. The report accused Wakefield of owning patents on a product competitive to MMR, and of being aware of test results from his own laboratories in definite contradiction to his claims.<ref>B Deer: [http://briandeer.com/wakefield-deer.htm Further accusations]</ref> On February 2, 2010, ''The Lancet'' announced to have the 1998 article removed completely from their list of publications.<ref name="retraction"/><ref>http://news.bbc.co.uk/2/hi/health/8493753.stm Lancet accepts MMR study 'false'</ref>
  
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===Rückzug des ''Lancet''-Berichts===
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===Anti-Vaccination lawyers paid 3.5&nbsp;million Pound===
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In Folge des Artikels von Brian Deer traten zehn der dreizehn Autoren des Berichtes formal von der Behauptung zurück, eine Verbindung zwischen Autismus und MMR gefunden zu haben.<ref>Murch SH et al.: Retraction of an interpretation. Lancet. 2004;363(9411):750 PMID 15016483</ref> Deer setzte seine Ermittlung in einer Dokumentation des britischen Fernsehens ''MMR: What They Didn't Tell You'' fort, welche am 18.&nbsp;November 2004 ausgestrahlt wurde. Hierin wird Wakefield beschuldigt, Patente für ein Konkurrenzprodukt zu MMR zu besitzen und von Testergebnissen seines eigenen Labors zu wissen, welche seine Behauptungen klar widerlegten.<ref>B Deer: [http://briandeer.com/wakefield-deer.htm Weitere Anschuldigungen von Wakefield]</ref> Am 2.&nbsp;Februar 2010 gab ''The Lancet'' bekannt, den Artikel aus dem Jahr 1998 vollständig aus der Publikationsliste zu streichen.<ref name="retraction"/><ref>http://news.bbc.co.uk/2/hi/health/8493753.stm Lancet accepts MMR study 'false'</ref>
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Further investigation by the English newspaper ''Sunday Times'' established that Wakefield and others, prior to the publication, received up to 3.5&nbsp;million British Pound from a law firm which represented the parents of children allegedly affected. Andrew Wakefield apparently received 500,000 pound, with first payments already having been made two years prior to the controversial publication. Five of Wakefield's co-authors and one reviewer who checked the publication for ''The Lancet'' had also received personal payments. <ref>H. Kaulen: [http://www.faz.net/s/Rub9D1EE68AC11C4C50AC3F3509F354677D/Doc~EC63B7196515B464D9C345BA3990C6991~ATpl~Ecommon~Scontent.html Artikel in der FAZ], 8. Januar 2007</ref>
  
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===Anwälte der Impfgegner zahlten 3,5&nbsp;Millionen Pfund===
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As a consequence, the Gerneral Medical Council prepared legal steps to have Wakefield's medical licence revoked.<ref>Reiner Luyken: ''[http://www.zeit.de/2007/17/M-Anti-Impfkampagne?page=all Panik vor dem Piks]''. Die Zeit, 19.&nbsp;April 2007, Nr.&nbsp;17</ref>
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Weitere Nachforschungen der englischen Zeitung ''Sunday Times'' ergaben, dass im Vorfeld zu der bewussten Publikation Wakefield und weitere Protagonisten bis zu 3,5&nbsp;Millionen britische Pfund von einer Anwaltskanzlei erhalten haben, welche die Eltern der vermeintlich geschädigten Kinder vertrat. Andrew Wakefield selber soll sich mit einer halben Million Pfund bereichert und schon zwei Jahre vor dem Erscheinen des strittigen Beitrags die ersten Zahlungen erhalten haben. Weiterhin hatten fünf weitere Autoren der Publikation und auch ein Gutachter, der seinerzeit die Veröffentlichung für ''The Lancet'' prüfte, persönliche Zahlungen von der Anwaltskanzlei erhalten.<ref>H. Kaulen: [http://www.faz.net/s/Rub9D1EE68AC11C4C50AC3F3509F354677D/Doc~EC63B7196515B464D9C345BA3990C6991~ATpl~Ecommon~Scontent.html Artikel in der FAZ], 8. Januar 2007</ref>
 
  
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Inzwischen bereitet die britische Ärztekammer einen Ausschluss von Andrew Wakefield vor.<ref>Reiner Luyken: ''[http://www.zeit.de/2007/17/M-Anti-Impfkampagne?page=all Panik vor dem Piks]''. Die Zeit, 19.&nbsp;April 2007, Nr.&nbsp;17</ref>
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==New studies on autism==
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Epidemiological research shows an upward trend for autism in recent years. The cause is uncertain; however, a change in diagnostics and census is more likely  than an increase in actual numbers.<ref>B Taylor et al.: ''Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study''. British Medical Journal, Vol 324, Feb. 16 2002, p. 393-396 [http://bmj.bmjjournals.com/cgi/reprint/324/7334/393?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&author1=taylor%2C+b&author2=miller%2C+e&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1113249908936_21240&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1,2,3,4 PDF]</ref><ref>[http://bmj.bmjjournals.com/cgi/eletters/330/7483/112-d# BMJJournals.com] - 'Rapid Responses to: Increase in autism due to change in definition, not MMR vaccine' ''British Medical Journal'' (Meinungsaustausch der ''BMJ''-Website)</ref><ref name="Barbar">WJ Barbaresi et al.: ''The incidence of autism in Olmsted County, Minnesota, 1976-1997: results from a population-based study''. Arch Pediatr Adolesc Med. Jan. 2005, 159(1), p. 37-44 PMID 15630056</ref> Diagnosis of autism has intensified in recent years, with children being examined more efficiently and at an earlier age than before. A causal link between MMR and autism can be excluded with utmost probability, as is shown by the studies quoted below which also happen to be far more comprehensive than Wakefield's. Science today assumes that the different forms of autism are essentially coined by genetic factors. The importance of genetics in this field is emphasized by studies including twins: Whereas identical twins show a correlation of 80% to 90%, this risk is much lower for fraternal twins.
  
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==Neuere Studien zum Thema Autismus==
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* Following Wakefield's publication, many studies researched a connection between MMR and autism. <ref>List of 17 studies on a MMR-Autism link, Immunization Action Coalition [http://www.immunize.org/catg.d/p4026.pdf]</ref> In October 2003, a EU-funded meta-study was published, reviewing the results of 120 previous studies, summarizing and analyzing the adverse effects of MMR-vaccine<ref>T Jefferson: ''Unintended events following immunization with MMR: a systematic review''. Vaccine. 2003 Sep 8;21(25-26), p. 3954-60 PMID 12922131</ref>. The authors concluded:
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Epidemiologische Forschungen zeigen für die vergangenen Jahrzehnte einen Anstieg bei Autismus. Die Ursache ist unklar, vielfach wird allerdings weniger ein realer Anstieg als die Veränderung der Diagnose- und Erhebungsmethodik als Grund vermutet.<ref>B Taylor et al.: ''Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study''. British Medical Journal, Vol 324, 16. Feb. 2002, S. 393-396 [http://bmj.bmjjournals.com/cgi/reprint/324/7334/393?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&author1=taylor%2C+b&author2=miller%2C+e&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1113249908936_21240&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1,2,3,4 PDF]</ref><ref>[http://bmj.bmjjournals.com/cgi/eletters/330/7483/112-d# BMJJournals.com] - 'Rapid Responses to: Increase in autism due to change in definition, not MMR vaccine' ''British Medical Journal'' (Meinungsaustausch der ''BMJ''-Website)</ref><ref name="Barbar">WJ Barbaresi et al.: ''The incidence of autism in Olmsted County, Minnesota, 1976-1997: results from a population-based study''. Arch Pediatr Adolesc Med. Jan. 2005, 159(1), S. 37-44 PMID 15630056</ref> So ist die Diagnose für Autismus in den vergangenen Jahren ausgeweitet worden und Kinder werden heute intensiver und eher als früher diagnostisch untersucht. Ein kausaler Zusammenhang zwischen MMR und Autismus kann dagegen inzwischen als so gut wie ausgeschlossen gelten, wie die im Folgenden zitierten, im Unterschied zu Wakefields Arbeit sehr umfangreichen, Studien gezeigt haben. Die Forschung geht heute davon aus, dass die verschiedenen Erscheinungsformen des Autismus ganz entscheidend von genetischen Faktoren mitbestimmt werden. Welch großen Stellenwert die Genetik bei der Entstehung von Autismus hat, zeigen unter anderem Zwillingsstudien: Während eineiige Zwillinge eine Konkordanz von&nbsp;80% bis 90% aufweisen, ist die Wahrscheinlichkeit, dass beide Kinder erkranken, bei zweieiigen Zwillingen wesentlich geringer.
+
**The vaccine has both positive and adverse effects
 +
**A connection between MMR and autism is ''highly unlikely''
 +
**Design and report of results relevant for security in MMR vaccine studies are mostly inadequate
  
−
* In der Folge von Wakefields Veröffentlichung folgten viele Studien, die den Zusammenhang zwischen MMR und Autismus untersuchten.<ref>Auflistung von 17&nbsp;Studien zum möglichen Zusammenhang MMR-Autismus, Immunization Action Coalition [http://www.immunize.org/catg.d/p4026.pdf]</ref> Im Oktober 2003 wurde eine von der Europäischen Union finanzierte Übersichtsarbeit veröffentlicht, welche die Ergebnisse aus 120&nbsp;anderen Studien und Nebenwirkungen des MMR-Impfstoffs zusammenfasste und näher analysierte.<ref>T Jefferson: ''Unintended events following immunization with MMR: a systematic review''. Vaccine. 2003 Sep 8;21(25-26), S. 3954-60 PMID 12922131</ref> Die Autoren schlossen:
+
* In January 2005, an intensive research in one county in Minnesota reported an eightfold increase in autism. Research covered a time span from the early 1980ies to the late 1990ies. No connection to MMR was established. Authors suspect that a change in both diagnostics and definitions is responsible for this increase.<ref name="Barbar"/>
−
**Der Impfstoff ist mit einigen positiven und einigen negativen Wirkungen assoziiert.
 
−
**Es ist 'unwahrscheinlich', dass es eine Verbindung zwischen MMR und Autismus gab.
 
−
**'Das Design und der Bericht von sicherheitsrelevanten Ergebnissen in MMR-Impfstoff-Studien [...] sind überwiegend inadäquat.'
 
  
−
* Im Januar 2005 wurde nach intensiver Forschung in einer einzelnen Grafschaft in Minnesota von einer Verachtfachung des Auftretens von Autismus berichtet. Der untersuchte Zeitraum umfasst die frühen 1980er Jahre und endet in den späten 1990ern. Bei der Forschung wurde kein Zusammenhang mit MMR entdeckt. Die Autoren vermuten, dass der Anstieg mit verbesserter Diagnostik der Störung und sich wandelnden Definitionen zu erklären ist.<ref name="Barbar"/>
+
* In March 2005, a study on 30,000 children born in a district of Yokohama concluded that autism is on the rise (from 46-86 cases in 10,000 children to 97-161 cases in 10,000 children), despite the fact that MMR vaccines were no longer used in Japan since April 1993. The authors concluded ''"The relevance of these results is that MMR is most likely not a cause of ASD, as the rise in ASD cannot be explained, and a withdrawal of MMR in countries where it is still in use will not lead to a decline in ASD."''.<ref>H Honda, Y Shimizu, M Rutter: ''No effect of MMR withdrawal on the incidence of autism: a total population study''. J Child Psychol Psychiatry. 2005 Jun;46(6):572-9. PMID 15877763</ref> Wakefield claims, however, the rise in autism backed by data obtained supported his hypothesis.<ref>''Japanese Study Is The Strongest Evidence Yet For A Link Between MMR And Autism''. The Red Flag, March&nbsp;6, 2005 [http://www.redflagsweekly.com/articles/2005_mar06_2.html]</ref> His point of view was met with little support, however.<ref>I Sample: ''Lingering fears of MMR-autism link dispelled''. The Guardian, 3.&nbsp;März 2005&nbsp;[http://www.guardian.co.uk/uk_news/story/0%2C3604%2C1429115%2C00.html]</ref>
  
−
* Im März 2005 schloss eine an 30.000 in einem Distrikt von Yokohama geborenen Kindern durchgeführte Studie, dass das Auftreten von Autismus weiterhin anstieg (von 46-86&nbsp;Fällen auf 10.000&nbsp;Kinder zu&nbsp;97-161 auf&nbsp;10.000), obwohl die Nutzung des MMR-Impfstoffs in Japan im April 1993 eingestellt wurde. Die Schlussfolgerung der Autoren lautet. ''"Die Bedeutung dieser Ergebnisse ist, dass MMR-Impfung höchst wahrscheinlich keine Hauptursache von ASD ist, da sich hiermit der Anstieg des Auftretens von ASD über die Zeit nicht erklären lässt und dass von einem Rückzug des MMR-Impfstoffs in denjenigen Ländern, die ihn noch verwenden, kein Rückgang im Auftreten von ASD zu erwarten ist"''.<ref>H Honda, Y Shimizu, M Rutter: ''No effect of MMR withdrawal on the incidence of autism: a total population study''. J Child Psychol Psychiatry. 2005 Jun;46(6):572-9. PMID 15877763</ref> Wakefield behauptet indes, der Anstieg von Autismus, welchen die Daten belegen, würde seine Hypothese stützen.<ref>''Japanese Study Is The Strongest Evidence Yet For A Link Between MMR And Autism''. The Red Flag, 6.&nbsp;März 2005 [http://www.redflagsweekly.com/articles/2005_mar06_2.html]</ref> Seine Ansichten fanden jedoch wenig Unterstützung.<ref>I Sample: ''Lingering fears of MMR-autism link dispelled''. The Guardian, 3.&nbsp;März 2005&nbsp;[http://www.guardian.co.uk/uk_news/story/0%2C3604%2C1429115%2C00.html]</ref>
+
* In October 2005, the ''Cochrane Library'' published a summary of scientific studies and concluded: ''"There is no plausible proof for the harmfulness of MMR vaccine"''. On the other hand, these authors, too, criticized the design and the reporting of security-relevant results in MMR studies as largely inadequate.<ref name= Demicheli2005>V Demicheli,T Jefferson, A Rivetti, D Price: ''Vaccines for measles, mumps and rubella in children''. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD004407. [http://www.cochrane.org/press/MMR_final.pdf PDF]</ref> Cochrane - situated in Oxford, England - is seen as the highest independent control for medical publications and as a guardian of evidence-based medicine by many scientists.
  
−
* Im Oktober 2005 veröffentlichte die ''Cochrane Library'' eine Überprüfung von 31&nbsp;wissenschaftlichen Studien und schloss: ''"Es gibt keinen glaubwürdigen Beweis hinter den Behauptungen der Schadhaftigkeit des MMR-Impfstoffs"''. Allerdings bemängelten auch diese Autoren, das Design und der Bericht von sicherheitsrelevanten Ergebnissen in MMR-Impfstoffstudien sei überwiegend inadäquat.<ref name= Demicheli2005>V Demicheli,T Jefferson, A Rivetti, D Price: ''Vaccines for measles, mumps and rubella in children''. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD004407. [http://www.cochrane.org/press/MMR_final.pdf PDF]</ref> Cochrane, in Oxford, England, wird von Wissenschaftlern weithin als die höchste unabhängige Prüfinstanz medizinischer Literatur angesehen und als Küster der "beweisgeführten Medizin".
+
* A case-control study dated 2008 renders a connection between MMR and autism highly improbable.<ref>Hornig M, Briese T, Buie T, Bauman ML, Lauwers G, et al. 2008 Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study. PLoS ONE 3(9): e3140 doi:10.1371/journal.pone.0003140</ref>
  
−
* Ein Fall-Kontrollstudie von 2008 lässt es als sehr unwahrscheinlich erscheinen, dass eine Masernimpfung ursächlich mit Autismus in Zusammenhang gebracht werden kann.<ref>Hornig M, Briese T, Buie T, Bauman ML, Lauwers G, et al. 2008 Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study. PLoS ONE 3(9): e3140 doi:10.1371/journal.pone.0003140</ref>
+
==Revocation of medical licence==
 +
In May 2010, Wakefield lost his medical licence for Great Britain due to inappropriate conduct. The General Medical Council did not review the scientific basis for his research, but its realization. One issue was that Wakefield e.g. included a blood sample obtained from friends of his son's on the occasion of his son's birthday party, and of also having made payments for the samples. The Council stated this was not in accordance with an appropriate conduct and caused damage to the medical profession.
  
−
==Berufsverbot==
+
Wakefield migrated to the USA where he founded a non-profit autism center in 2005. Despite the occupational ban in Great Britain he can practise medicine legally in the USA.<ref name='NIH'/>.
−
Wakefield wurde im Mai 2010 von der britischen Ärztekammer seine Zulassung  für Großbritannien wegen standeswidrigen Verhaltens entzogen. Das General Medical Council beschäftigte sich allerdings nicht mit den wissenschaftlichen Grundlagen der Untersuchung, sondern mit ihrer Durchführung. So soll Wakefield beim Kindergeburtstag seines Sohnes Blutproben von dessen Freunden entnommen und ihnen dafür Geld gegeben haben. Damit hat er den Arztberuf in Verruf gebracht, begründetet die Kammer ihre Entscheidung.
 
  
−
Wakefield wanderte vor einigen Jahren in die USA aus, wo er 2005 ein gemeinnütziges Autismus-Zentrum gründete. Ungeachtet des Berufsverbots in Großbritannien darf er dort weiter praktizieren<ref name='NIH'></ref>.
+
{{OtherLang|ge=Andrew Wakefield|en=Andrew Wakefield}}
  
−
==Literatur==
+
==Literature==
 
*Parker, S.J., Schwartz, B., Todd, J., and L.K. Pickering. 2004. Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original Data. Pediatrics, 114(3): Seiten 793-804
 
*Parker, S.J., Schwartz, B., Todd, J., and L.K. Pickering. 2004. Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original Data. Pediatrics, 114(3): Seiten 793-804
 +
*Gerber JS, Offit PA. ''Vaccines and autism: A tale of shifting hypotheses''. Clinical Infectious Diseases 48:456-461, 2009. http://cid.oxfordjournals.org/content/48/4/456.full
  
 
==Weblinks==
 
==Weblinks==
 +
* http://scienceblogs.com/insolence/2011/01/piltdown_medicine_andrew_wakefields_scie.php
 
*[http://news.bbc.co.uk/1/hi/health/3513365.stm BBC Profile: Dr. Andrew Wakefield]
 
*[http://news.bbc.co.uk/1/hi/health/3513365.stm BBC Profile: Dr. Andrew Wakefield]
 
* http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece
 
* http://www.timesonline.co.uk/tol/life_and_style/health/article5683671.ece
Line 68: Line 72:
 
* http://www.guardian.co.uk/society/2009/sep/22/autism-rate-mmr-vaccine
 
* http://www.guardian.co.uk/society/2009/sep/22/autism-rate-mmr-vaccine
 
*[http://news.scotsman.com/news/Andrew-Wakefield--doctor-who.6024512.jp News.scotsman.com, 28.&nbsp;Januar 2010] Andrew Wakefield - doctor who linked MMR to autism - is damned by General Medical Council.
 
*[http://news.scotsman.com/news/Andrew-Wakefield--doctor-who.6024512.jp News.scotsman.com, 28.&nbsp;Januar 2010] Andrew Wakefield - doctor who linked MMR to autism - is damned by General Medical Council.
−
*[http://www.spiegel.de/wissenschaft/medizin/0,1518,675592,00.html Spiegel Online, 3.&nbsp;Februar 2010] Zurückgezogene Studie: Das offizielle Ende eines Impf-Skandals.
 
−
*[http://www.scienceblogs.de/zoonpolitikon/2010/02/ist-der-zusammenhang-zwischen-impfungen-und-autismus-nun-endgultig-vom-tisch.php Ist der Zusammenhang zwischen Impfungen und Autismus nun endgültig vom Tisch?] Ali Arbia in ScienceBlogs 4.&nbsp;Februar 2010
 
−
*http://www.impfblog.de/2010/02/der-tiefe-fall-des-andrew-wakefield/
 
−
*http://www.zeit.de/2010/07/M-Medizinlegenden?page=all
 
  
 
==Quellennachweise==
 
==Quellennachweise==
 
<references/>
 
<references/>
  
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{{Wikipedia|Wikititel=Andrew_Wakefield|Jahr=2008|Monat=7}}
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{{Wikipedia|Wikititle=Andrew_Wakefield|Year=2008|Month=7}}
 
{{DEFAULTSORT:Wakefield, Andrew}}
 
{{DEFAULTSORT:Wakefield, Andrew}}
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[[category:Chirurg]]
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[[category:Surgeon]]
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[[category:Pseudowissenschaftler]]
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[[category:Pseudoscientist]]

Latest revision as of 19:18, 14 June 2011

Wakefield.jpg

Andrew Jeremy Wakefield (born 1957) is a British surgeon who received a lot of attention with a 1998 publication in The Lancet, both among experts and in public. The article titled Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children[1] correlates MMR vaccination with autism. As a consequence, vaccination rates dropped, especially in Great Britain.

In 2004, it became public that Wakefield had received 55,000 £ from lawyers representing parents of autistic children prior to the publication of his article.[2]. Lawyers were looking for connections between autism and vaccination in order to sue manufacturers of vaccines. This was known neither to Wakefield's co-authors nor to The Lancet. As a consequence, ten of thirteen authors stepped back.[3] In February 2010, the article was retracted by The Lancet.[4]

Wakefield resigned from his position in the Royal Free Hospital in London 2001, and now works for a private hospital in the USA. In 2007, he had to face charges by the British Medical Association.[5]In May 2010 he received an occupational ban[6].

His long refuted theories nonetheless are still accepted by esoteric or CAM inspired circles and persons, e.g. Christopher Maloney.

The Lancet article in 1998

In February 1998, a group around Andrew Wakefield published a report titled "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children" in the renowned medical publication The Lancet.[1] The report analysed the cases of twelve autistic children who were treated in the Royal Free Hospital in the north of London in 1996-1997. The report described bowel related symptoms which, according to Wakefield, were to be seen as proof of a completely new syndrome which he later called Autistic Enterocolitis. Wakefield recommended a closer investigation of possible causes in the environment of these children, so e.g. in respect to the MMR vaccine. The publication suggested a connection between stomach-bowel symptoms and developmental disorders found in these children which was perceived as ostensibly related to the MMR vaccination. A causal connection of MMR vaccines leading to autism, however, was not established. In a press conference prior to the publication, Wakefield said he recommended the use of single vaccines instead of the triple MMR until clarification was obtained. He further stated that eight of the twelve parents considered the vaccination a possible cause, as vaccination and first symptoms occured within days. He stated he could not support the further use of MMR vaccine without detailed investigation. In a video recording prepared for TV in advance he demanded to stop the use of MMR and replace them with single vaccines instead.[7]

The resulting dispute

Report, press conference, and video unsettled the Britisch public. A heated debate followed, in which both sides used Wakefield's research as arguments. He was publicly criticized, with his critics expressing doubts regarding correctness as well as ethics of his research. Government and National Health Service (NHS) emphasized that extensive epidemiological data showed no correlation between MMR vaccination and developmental disorders. Many parents refused to believe this, since official information had been discredited earlier, as in the case of BSE. Government was accused that their true motif for rejecting single vaccinations was the higher cost of these. As a result, MMR vaccination rates decreased from 92% (1996) to 84% (2002). It was suspected that only 60% of neccessary MMR vaccinations were performed in some districts of London which is substantially below what is needed for herd immunity of measles. Although no measles epidemic occured so far, physicians warned that epidemics were possible since the number of infections was increasing.

One issue in the dispute was that only the combined vaccine is available via NHS. Parents rejecting this vaccine can either pay for single vaccinations out of their own pockets or not vaccinate at all. Although Prime Minister Tony Blair publically defended the MMR vaccine, he refused to comment the vaccination status of his youngest son Leo at the same time.

The majority of paediatricians prefer the combined vaccine, as it is less strenuous for the child, and many parents rather have one vaccination done instead of three.

Epidemiological research on hundreds of thousands of children in numerous studies failed to indicate a link between MMR vaccination and autism. Critics of these studies, like the retired intern John Walker-Smith, although a supporter of the triple vaccine, labelled epidemiology a 'blunt tool' which does not necessarily expose such connections.[8] As an example, it is difficult to find to populations differing in vaccination status only.

Dr. Wakefield gave up his position at the Royal Free Hospital in 2001 and now works for a controversial private hospital in the USA. His continued studies include research on possible immunological, metabolical, and pathological changes caused by "Autistic Enterocolitis", as well as connections between bowel diseases and neurological disorders in children and a possible connection between these disorders and influences like vaccines[9]

In an article published 2011 in "health affairs" on the topic of vaccine opposition in the USA the authors (Kennedy et. al) come to the conclusion:

"Andrew Wakefield's report, which ran in the Lancet, may have been be "the flimsiest, most underpowered study supporting a conclusion of monumental importance to appear in a leading peer-reviewed journal in the past fifty years."[10]

Conflict of interest

In February 2004, journalist Brian Deer exposed information that Wakefield had recieved £ 55.000 in third-party funds prior to publishing the Lancet report, with the money paid by lawyers looking for a connection between autism and MMR vaccination.[11] According to the Sunday Times, several of the parents quoted were involved in law suits against manufacturers of MMR vaccines. Although Wakefield stated that these third-party funds had been public from the beginning, the fact that this was known neither to the Lancet nor to his co-authors raised much criticism. On February 20, 2004, the Lancet rated Wakefield's study flawed due to a fatal conflict of interest and concluded it should have never been published. Several of Wakefield's co-authors also criticized the lack of information about these third-party funds in explicit ways.[12] The General Medical Council, responsible for issuing medical licences and surveillance of medical ethics in Great Britain, began investigations.[13]

Furthermore, nine months before the incriminated report caused world-wide anxiety and uncertainty regarding the MMR vaccines, a series of patents protecting several potentially very profitable products happened to be submitted by Wakefield and the Royal Free Hospital Medical School in London. Obviously, such products would enjoy a much larger chance on the market if and when the MMR vaccines experienced a damage in reputation. The patents e.g. covered an allegedly safe measles vaccine and medication for the treatment of bowel diseases and autism which were all based on the assumption these conditions were caused by MMR vaccination.[14]

Lancet report retracted

As a consequence of Brian Deer's article, ten of altogether thirteen authors of the report formally renounced the claim of having found a connection between autism and MMR.[15] Deer continued investigations in a documentation on British TV titled MMR: What They Didn't Tell You, which was broadcast Nov. 18, 2004. The report accused Wakefield of owning patents on a product competitive to MMR, and of being aware of test results from his own laboratories in definite contradiction to his claims.[16] On February 2, 2010, The Lancet announced to have the 1998 article removed completely from their list of publications.[4][17]

Anti-Vaccination lawyers paid 3.5 million Pound

Further investigation by the English newspaper Sunday Times established that Wakefield and others, prior to the publication, received up to 3.5 million British Pound from a law firm which represented the parents of children allegedly affected. Andrew Wakefield apparently received 500,000 pound, with first payments already having been made two years prior to the controversial publication. Five of Wakefield's co-authors and one reviewer who checked the publication for The Lancet had also received personal payments. [18]

As a consequence, the Gerneral Medical Council prepared legal steps to have Wakefield's medical licence revoked.[19]

New studies on autism

Epidemiological research shows an upward trend for autism in recent years. The cause is uncertain; however, a change in diagnostics and census is more likely than an increase in actual numbers.[20][21][22] Diagnosis of autism has intensified in recent years, with children being examined more efficiently and at an earlier age than before. A causal link between MMR and autism can be excluded with utmost probability, as is shown by the studies quoted below which also happen to be far more comprehensive than Wakefield's. Science today assumes that the different forms of autism are essentially coined by genetic factors. The importance of genetics in this field is emphasized by studies including twins: Whereas identical twins show a correlation of 80% to 90%, this risk is much lower for fraternal twins.

  • Following Wakefield's publication, many studies researched a connection between MMR and autism. [23] In October 2003, a EU-funded meta-study was published, reviewing the results of 120 previous studies, summarizing and analyzing the adverse effects of MMR-vaccine[24]. The authors concluded:
    • The vaccine has both positive and adverse effects
    • A connection between MMR and autism is highly unlikely
    • Design and report of results relevant for security in MMR vaccine studies are mostly inadequate
  • In January 2005, an intensive research in one county in Minnesota reported an eightfold increase in autism. Research covered a time span from the early 1980ies to the late 1990ies. No connection to MMR was established. Authors suspect that a change in both diagnostics and definitions is responsible for this increase.[22]
  • In March 2005, a study on 30,000 children born in a district of Yokohama concluded that autism is on the rise (from 46-86 cases in 10,000 children to 97-161 cases in 10,000 children), despite the fact that MMR vaccines were no longer used in Japan since April 1993. The authors concluded "The relevance of these results is that MMR is most likely not a cause of ASD, as the rise in ASD cannot be explained, and a withdrawal of MMR in countries where it is still in use will not lead to a decline in ASD.".[25] Wakefield claims, however, the rise in autism backed by data obtained supported his hypothesis.[26] His point of view was met with little support, however.[27]
  • In October 2005, the Cochrane Library published a summary of scientific studies and concluded: "There is no plausible proof for the harmfulness of MMR vaccine". On the other hand, these authors, too, criticized the design and the reporting of security-relevant results in MMR studies as largely inadequate.[28] Cochrane - situated in Oxford, England - is seen as the highest independent control for medical publications and as a guardian of evidence-based medicine by many scientists.
  • A case-control study dated 2008 renders a connection between MMR and autism highly improbable.[29]

Revocation of medical licence

In May 2010, Wakefield lost his medical licence for Great Britain due to inappropriate conduct. The General Medical Council did not review the scientific basis for his research, but its realization. One issue was that Wakefield e.g. included a blood sample obtained from friends of his son's on the occasion of his son's birthday party, and of also having made payments for the samples. The Council stated this was not in accordance with an appropriate conduct and caused damage to the medical profession.

Wakefield migrated to the USA where he founded a non-profit autism center in 2005. Despite the occupational ban in Great Britain he can practise medicine legally in the USA.[6].

Versions of this article in other languages

Literature

  • Parker, S.J., Schwartz, B., Todd, J., and L.K. Pickering. 2004. Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original Data. Pediatrics, 114(3): Seiten 793-804
  • Gerber JS, Offit PA. Vaccines and autism: A tale of shifting hypotheses. Clinical Infectious Diseases 48:456-461, 2009. http://cid.oxfordjournals.org/content/48/4/456.full

Weblinks

Quellennachweise

  1. ↑ 1.0 1.1 Wakefield AJ et al.: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 351(9103), 1998, S. 637-41 PMID 9500320 (PDF, 592 kB) Cite error: Invalid <ref> tag; name "Wakefield98" defined multiple times with different content
  2. ↑ Brian Deer: Revealed: MMR Research Scandal The Sunday Times (London) February 22 2004
  3. ↑ Murch SH et al.: Retraction of an interpretation. Lancet. 2004;363(9411):750 PMID 15016483
  4. ↑ 4.0 4.1 The Editors of The Lancet: Retraction – Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, Early Online Publication, 2 February 2010. doi:10.1016/S0140-6736(10)60175-7
  5. ↑ Reiner Luyken: Panik vor dem Piks. DIE ZEIT, 19.04.2007, 17/2007
  6. ↑ 6.0 6.1 http://www.spiegel.de/wissenschaft/medizin/0,1518,696472,00.html
  7. ↑ Video des Wakefield-Interviews
  8. ↑ http://www.vaccinationnews.com/DailyNews/February2002/AutBowMeas.htm
  9. ↑ A. Wakefield at his new employer
  10. ↑ Kennedy A et al. Confidence about vaccines in the United States: understanding parents' perceptions. Health Affairs 30:1151-1159, 2011. [1]
  11. ↑ B Deer: Revealed: MMR Research Scandal. The Sunday Times, London, February 22, 2004
  12. ↑ [2]
  13. ↑ [3]
  14. ↑ http://briandeer.com/wakefield-deer.htm
  15. ↑ Murch SH et al.: Retraction of an interpretation. Lancet. 2004;363(9411):750 PMID 15016483
  16. ↑ B Deer: Further accusations
  17. ↑ http://news.bbc.co.uk/2/hi/health/8493753.stm Lancet accepts MMR study 'false'
  18. ↑ H. Kaulen: Artikel in der FAZ, 8. Januar 2007
  19. ↑ Reiner Luyken: Panik vor dem Piks. Die Zeit, 19. April 2007, Nr. 17
  20. ↑ B Taylor et al.: Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. British Medical Journal, Vol 324, Feb. 16 2002, p. 393-396 PDF
  21. ↑ BMJJournals.com - 'Rapid Responses to: Increase in autism due to change in definition, not MMR vaccine' British Medical Journal (Meinungsaustausch der BMJ-Website)
  22. ↑ 22.0 22.1 WJ Barbaresi et al.: The incidence of autism in Olmsted County, Minnesota, 1976-1997: results from a population-based study. Arch Pediatr Adolesc Med. Jan. 2005, 159(1), p. 37-44 PMID 15630056
  23. ↑ List of 17 studies on a MMR-Autism link, Immunization Action Coalition [4]
  24. ↑ T Jefferson: Unintended events following immunization with MMR: a systematic review. Vaccine. 2003 Sep 8;21(25-26), p. 3954-60 PMID 12922131
  25. ↑ H Honda, Y Shimizu, M Rutter: No effect of MMR withdrawal on the incidence of autism: a total population study. J Child Psychol Psychiatry. 2005 Jun;46(6):572-9. PMID 15877763
  26. ↑ Japanese Study Is The Strongest Evidence Yet For A Link Between MMR And Autism. The Red Flag, March 6, 2005 [5]
  27. ↑ I Sample: Lingering fears of MMR-autism link dispelled. The Guardian, 3. März 2005 [6]
  28. ↑ V Demicheli,T Jefferson, A Rivetti, D Price: Vaccines for measles, mumps and rubella in children. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD004407. PDF
  29. ↑ Hornig M, Briese T, Buie T, Bauman ML, Lauwers G, et al. 2008 Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study. PLoS ONE 3(9): e3140 doi:10.1371/journal.pone.0003140 


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