February 7, 2010

Retraction of the MMR Paper — Not What It Seems

Early last week, The Lancet (a medical journal) retracted the 1998 paper that allegedly linked the MMR vaccine to autism. This is actually a very interesting story with more to it than you might initially suspect.

The lead author in the Lancet study is not an "anti-vaccine quack." On the contrary, he had earlier filed for a patent for a vaccine. (Note: He may be a quack — I can't judge this very well either way — but he wasn't anti-vaccine.)

The paper, by Dr. Andrew Wakefield and others, stated very clearly that while they found a correlation of the MMR vaccine with autism, their study "did not prove an association between [the vaccine] and the syndrome described." So where did the MMR-autism link come from?

Dr. Wakefield made a statement during a press conference that he thought measles, mumps, and rubella vaccinations should be done separately. The media — gotta love 'em — ran with the story.

This all came to a head this week because at the end of January, England's General Medical Council (as far as I can tell, it is a national form of America's individual state medical boards) concluded a hearing on Dr. Wakefield's conduct during the study.

They found some serious breeches of ethics. If true, I have a hard time condoning his actions, as they involved putting disabled children through some unnecessary and painful treatments and tests.

So what's so interesting? First —  it took 10+ years for the government to "protect" it's citizens. Second — there is nothing in the paper itself that made an outrageous claim, and, even Wakefields remarks are tame, so I'm not sure one can blame him for the public reaction and media frenzy. (On this, I think the medical and scientific community would do well to learn that they shouldn't treat the public like children.) Third — officially, the paper was retracted because of the ethical violations undertaken during the study, not because of any false data. Yet, there's this quote from the editor of The Lancet:

"It was utterly clear, without any ambiguity at all, that the statements in the paper were utterly false," he said. "I feel I was deceived."

So it seems that no lessons were learned by the scientific/medical community and the pendulum will swing the other way. Headlines abound with the likes of "MMR vaccine-autism paper retracted" and "Lancet study false." There you have it: vaccines are proven safe always and forever, and you are a heretic to question this wisdom. (Just imagine doctors saying "Because I said so" and sending their patients' parents to their room without supper.)

Another interesting side story is one that also came up during the Ivins tragedy: the motive of profit by patent. Assuming this is a reasonable motive, it makes one wonder whether all of this supposed innovation that is stimulated by patents is worth the victimization that allegedly results from time to time. Oh wait...you can't ever know the answer to this because the prices of these abstractions are unknowable.

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