EXHIBIT 1
EXHIBIT 2
CURRICULUM VITAE
DR ANDREW J WAKEFIELD MB. BS.
EXHIBIT 3
CURRICULUM VITAE –written in 2008 and amended in 2012 by CW
NAME:
Andrew Jeremy WAKEFIELD
ADDRESS:
802 Crystal Creek Drive Austin Texas 78746 Tel: 512 923 4277 wakersaj@live.com
DATE OF BIRTH:
3 September 1956
NATIONALITY:
British
VISA STATUS:
Permanent Resident
MARITAL STATUS:
Married
CURRENT POSITION
Executive Director, Strategic Autism Initiative, Austin Texas, 78746.
PRIZES:
1987: Toronto General Hospital Resident's Research Prize. 1988: First Prize: Basic Science, Mount Sinai Hospital Department of Medicine, Toronto. 1992-3: Department of Trade and Industry. SMART I Award for Research and Technology. 1993-4: Department of Trade and Industry. SMART II Award for Research Technology.
MEDICAL EDUCATION:
and
St Mary's Hospital Medical School, London 1976-1981 3
A.J.WAKEFIELD
QUALIFICATIONS GAINED:
MB BS, University of London Primary Fellowship, Royal College of Surgeons (London)
APPOINTMENTS:
1981 1983
Final Fellowship, Royal College of Surgeons (London)
1985
Fellowship of the Royal College of Pathologists (UK)
2001
House Surgeon to Mr DC Britton, Royal United Hospitals, Bath, Avon Aug 1981 - Feb 1982 House Physician to Dr JG Walker, Dr R Elkeles, Dr C Coulter and Professor Wickramasinghe, St Mary's Hospital, London, W2 Feb 1982 - Aug 1982 Two year appointment to St George's Hospital, General Surgical Senior House Officer Rotation Casualty Officer, St George's Hospital, Tooting (Mr A Barker) Aug 1982 - Feb 1983 The Royal Marsden Hospital, Sutton. Mr J-C Gazet, Mr N Breech, Dr J Ford, Dr J GleesFeb 1983 - Aug 1983 Frimley Park Hospital, Surrey. Mr AH Amery, Mr H Hills, Mr KPR Rutter, Mr MJ Solan, Mr RC Lallemand Aug 1983 - Aug 1984 Two year appointment to Queen Mary's University Hospital, Roehampton, Surgical Registrar Rotation: Registrar to Mr RAD Booth, General and Colo-rectal surgery Sep 1984 - May 1985 Registrar to Mr KP Robinson, General and Vascular surgery May 1985 - Jan 1986 Registrar to Mr J McLean-Singleton, General and Urological surgery Jan 1986 - Apr 1986
2
A.J.WAKEFIELD Appointment to St George's Surgical Registrar Rotation:
Hospital,
Tooting,
Registrar to Miss EM Gordon, Paediatric surgery Apr 1986 - Nov 1986 Appointment as Wellcome Research Fellow to the Surgical Unit, Toronto General Hospital and the Faculty of Medicine of the University of Toronto, Toronto, Ontario, Canada: Dr Z Cohen and Professor B Langer Nov 1986 - Nov 1988 Appointment as Wellcome Research Fellow, Royal Free School of Medicine Nov 1988 – Sept 1990 Senior Lecturer in Experimental Gastroenterology, Departments of Medicine & Histopathology, Royal Free School of Medicine Jan 1993 – Sept 1997 Reader in Experimental Gastroenterology, Department of Medicine & Histopathology Oct 1997 – Nov 2001 Royal Free & University College Medical School, London. Honorary Consultant in Experimental Gastroenterology to Royal Free Hampstead NHS Trust, London. Jan 1994 - Nov 2001 Director of Research and Chairman, Inflammatory Bowel Disease Study Group, RFHSM. Senior Medical Adviser to the UK registered Charity VISCERAL Dec 2001 -Dec 2004 Executive Director, Thoughtful House Center for Children, Austin Texas Feb 2005 – Feb 2010
HONOURS, SCHOLARSHIPS AND AWARDS: Wellcome Trust Travelling Fellowship
1986-9
Runcorn Travelling Scholarship Westminster Medical School Research Trust 1986
3
A.J.WAKEFIELD
AMI Travelling Scholarship Royal College of Surgeons, England
1986
Ethicon Foundation Scholarship, Ethicon Foundation Fund, Royal College of Surgeons, England
1986
Anglo-Canadian Scientific Exchange Scholarship, The Royal Society and the Natural Sciences and Engineering Research Council, Canada 19861987 Wellcome Trust Travelling Fellowship, The Wellcome Trust, London 1986-1989 Curie Foundation Travelling Scholarship
1989
Three-year extension of Wellcome Trust Fellowship 1990-1993 Membre D'Honneur Etranger de la Societe Royal Belge de Gastro-Enterologie
Fellow of the Royal College 2001 by publication. (withdrawn)
of
1995
Pathologists.
AUTISM COMMUNITY AWARDS September 2000: NVIC Courage in Science April 2002: Autism 2002 “The Angel of Autism” from S.A.F.E November 21 2003: The 2003 Harold Harper Lecture – update on vaccines and autism April 18 2004: Defeat Autism Now! Veritas Praevalebit April 2
nd
2006: 1st Annual Elizabeth Birt “Never Give Up” Memorial
November 2008: National Autism Association “The Believe” award December 2008: Age of Autism Awards 2008 Galileo Award Dr. Andrew Wakefield By Mark Blaxill (http://www.whale.to/vaccines/blaxill4.html)
4
A.J.WAKEFIELD
May
2009:
{March 2012 quote from Teri Arranga, director of AutismOne: "The 'Dr. Andrew J. Wakefield Courage in Medicine Award,' given annually at the AutismOne conference since May 2009, was named after Dr. Wakefield because he exemplifies the pinnacle of courage, integrity, and honesty in medicine. With the CDC's March 29, 2012, declaration of the rate of autism at 1 child in 88, it is more vital than ever to support Dr. Wakefield's visionary work that truly addresses the roots of the epidemic of autism and other neurological disabilities in the nation's youths. The award named after Dr. Wakefield honors those doctors and researchers who have, with self-sacrifice and compassion, withstood the perils of protecting children at the expense of being unpopular with the mainstream medical establishment. Will our nation have a legacy of health ‌.. or will we have no legacy at all?"}
October 2009: NVIC Humanitarian Award
"for his compassion, brave spirit and
uncompromising commitment to improving the health of children and the biological integrity of future generations, for his love for his fellow man, for inspiring others to stand strong in the face of adversity, for dedicating his life to healing the sick and making the world a better place to live." November 2010: The Autism Trust Richard Barber Award – National Autism Association
5
A.J.WAKEFIELD
May 2011: Man of the Year Award - AutismOne Conference September 2011: The Michael Ziff DDS Memorial Award – The International Academy of Oral Medicine and Toxicology
6
A.J.WAKEFIELD
Reviewer to Scientific Journals Lancet American Journal of Gastroenterology Gastroenterology Gut Digestive Diseases and Sciences European Journal of Gastroenterology and Hepatology Alimentary Pharmacology and Therapeutics Supervisor to Higher Degree students Dr Nicholas Thompson (MD) Dr Mark Hamilton (MD) Dr Javaid Subhani (MD) Dr Nicholas Chadwick (PhD) Dr Martin Osbourne (MS) Dr Andrew Anthony (MRCPath) Dr Russell Walmsley (MD) Dr David Kelly (PhD)
7
A.J.WAKEFIELD
PUBLICATIONS 1.
Mant TG, Lewis JL, Mattoo TK, Rigden SP, Volans GN, House IM, Wakefield AJ, Cole RS. Mercury poisoning after disc-battery ingestion. Hum Toxicol. 1987:6:179-81.
2.
Silverman R, Cohen Z, Craig M, Wakefield A, Kim P, Langer B, Levy G. Monocyte/macrophage procoagulant activity (PCA) as a measure of immune responsiveness in Lewis and Brown Norway inbred rats: discordance with lymphocyte proliferative assays. Transplantation 1989; 47: 542-548.
3.
Wakefield AJ, Gordon EM. A huge renal cyst presenting in childhood. Case report and review of the literature. Journal of the Royal Society of Medicine 1989; 82: 443-445.
4.
Wakefield AJ, Cohen Z, Kim P, Craig M, Levy G. The reversal of cyclosporine mediated suppression of alloantigen induced monocyte procoagulant activity by H2 antagonists cimetidine and ranitidine in vitro. Transplantation Proceedings 1989; 21: 844-847
5.
Kim P, Wakefield AJ, Cohen Z, Craig M, Levy G. The reversal of cyclosporine mediated suppression of monocyte procoagulantactivity by H2 antagonists in the rat model of small intestinal transplantation. Transplantation Proceedings 1989: 21; 2900-2902
6.
Wakefield AJ, Cohen Z, Craig M, Jeejeebhoy KN, Levy GA. The thrombogenicity of total parenteral nutrition solutions. I: Effect on induction of monocyte macrophage procoagulant activity. Gastroenterology 1989; 97: 12101219
7.
Wakefield AJ, Cohen Z, Craig M, Rosenthal A, Gotleib A, Jeejeebhoy KN, Levy GA. The thrombogenicity of total parenteral nutrition solutions. II: Effect on induction of endothelial cell procoagulant activity. Gastroenterology 1989; 97: 1220-1228
8.
Wakefield AJ, Sawyerr AM, Dhillon AP, Pittilo RM, Rowles PM, Lewis AAM, Pounder RE. Pathogenesis of Crohn's disease: multifocal gastrointestinal infarction. Lancet 1989; ii: 1057-1062
9.
Sinclair S, Wakefield AJ, Levy GA Fulminant hepatic failure. Springer Seminars in Immunopathology, (ed) Thomas HC 1990; 12: 33-45
10.
Wakefield AJ, Cohen Z, Levy GA. Procoagulant activity in Gastroenterology. Gut 1990; 31: 239-242
11.
Sawyerr AM, Wakefield AJ, Hudson M, Dhillon AP, Pounder RE. The pharmacological implications of leucocyte-endothelial cell interactions in Crohn's disease. Alimentary Pharmacology & Therapeutics 1990; 1: 1-14
12.
Wakefield AJ, Dhillon AP, Sawyerr AM, Sankey E, More, L, Sim R, Pittilo RM, Rowles PM, Hudson M, Lewis AAM, Pounder RE. Granulomatous vasculitis in Crohn's disease. Gastroenterology 1991; 100: 1279-1287
8
A.J.WAKEFIELD
13.
Wakefield AJ, Sawyerr AM, Hudson M, Dhillon AP, Pounder RE. Smoking, the oral contraceptive pill and Crohn's disease. Digestive Diseases & Sciences 1991; 36: 1147-1150
14.
Kelleher J, Wakefield AJ, Gordon I, Ransley P. Renal injury in complete ureteric obstruction: a functional and morphological study. Urological Research 1991; 19: 245-248
15.
Pounder RE, Wakefield AJ, Sawyerr AM, Hudson M, Dhillon AP. Pathogenesis of Crohn's disease: granulomatous vasculitis and multifocal gastrointestinal infarction Proceedings of the Falk Symposium on Inflammatory Bowel Disease 1991; 5: 33-38
16.
Kelleher JP, Shah V, Godley M, Wakefield AJ, Gordon I, Ransley PG, Snell ME, Risdon RA. Urinary endothelium (ET-1) in complete ureteric obstruction in the miniature pig. Urological Research 1992; 20: 63-65
17.
Wakefield AJ, Fox JD, Sawyerr AM, Taylor JE, Sweenie CH, Smith M, Emery V, Hudson M, Tedder RS, Pounder RE. Detection of herpesvirus DNA in the large intestine of patients with ulcerative colitis and Crohn's disease using the nested polymerase chain reaction. Journal of Medical Virology 1992; 38: 183-190
18.
Wakefield AJ, Hudson M, Pounder RE. Crohn's Conflict (Invited article). Medical Laboratory World 1992; 5: 9-13
19.
Hudson M, Piasecki C, Sankey EA, Sim R, Wakefield AJ, More LJ, Sawyerr AM, Dhillon AP, Pounder RE. A ferret model of acute multifocal gastrointestinal infarction. Gastroenterology 1992; 102: 1591-1596.
20.
Dhillon AP, Anthony A, Sim R, Wakefield AJ, Sankey EA, Hudson M, Allison MC, Pounder RE. Mucosal capillary thrombi in rectal biopsies. Histopathology 1992; 21: 127-133.
21.
Hudson M, Hutton R, Wakefield AJ, Sawyerr AM, Pounder RE. Evidence for activation of coagulation in Crohn's disease. Blood Coagulation and Fibrinolysis 1992; 3: 773-778.
22.
Hudson M, Wakefield AJ, Hutton RA, Sankey EA, Dhillon AP, More L, Sim R, Pounder RE Factor XIIIa subunit and Crohn's disease. Gut 1993; 34: 75-79.
23.
Wakefield AJ, Hudson M, More L. Procoagulant activity in gastroenterology. In: Procoagulant Activity in Health and Disease. Eds: Levy GA; Cole EH. CRC Press: Ann Arbor, USA. 1993; 5: 87-110.
24.
Sankey EA, Dhillon AP, Anthony A, Wakefield AJ, Sim R, More L, Hudson M, Sawyerr AAM, Pounder RE. Early mucosal changes in Crohn's disease. Gut 1993; 34: 375-381
25.
Osborne M, Hudson M, Piasecki C, Dhillon AP, Lewis AAM, Pounder RE, Wakefield AJ. Crohn's disease and anastomotic recurrence: microvascular ischaemia and anastomotic healing in an animal model. British Journal of Surgery 1993; 80: 226-229
9
A.J.WAKEFIELD 26.
Anthony A, Dhillon AP, Nyg책rd G, Hudson M, Piasecki C, Strong P, Trevethick MA, Clayton NM, Jordan CC, Pounder RE, Wakefield AJ. Early histological features of small intestinal injury induced by indomethacin. Alimentary Pharmacology &.Therapeutics.1993; 7: 29-39
27.
Wakefield AJ, Pittilo RM, Sim R, Cosby SL, Stephenson JR, Dhillon AP, Pounder RE. Evidence of persistent measles virus infection in Crohn's disease. Journal of Medical Virology. 1993; 39: 345-353
28.
Smith M, Wakefield AJ. Viral association with Crohn's disease: Invited article. Annals of Medicine 1993; 25: 557-561
29.
More L, Sim R, Hudson M, Dhillon AP, Pounder RE, Wakefield AJ. Immunohistochemical study of tissue factor expression in normal intestine and idiopathic inflammatory bowel disease. Journal of Clinical Pathology 1993;46:703-708
30.
Wakefield AJ, More L, Difford J, McLaughlin JE. Immunohistochemical study of vascular injury in acute multiple sclerosis. Journal of Clinical Pathology 1994; 47: 129-133
31.
Hudson M, Piasecki C, Wakefield AJ, Sankey EA, Dhillon AP, Osborne M, Sim R, Pounder RE. A vascular hypersensitivity model of acute multifocal intestinal infarction. Digestive Diseases & Sciences 1994; 39: 534-539
32.
Nyg책rd G, Anthony A, Piasecki C, Trevethick MA, Hudson M, Dhillon AP, Pounder RE, Wakefield AJ. Acute indomethacin-induced jejunal injury in the rat: early morphological and biochemical changes. Gastroenterology 1994; 106: 567575.
33.
Mazure G, Grundy JE, Nyg책rd G, Hudson M, Khan K, Srai K, Dhillon AP, Pounder RE, Wakefield AJ. Measles virus induction of human endothelial cell tissue factor procoagulant activity in vitro. Journal of General Virology 1994; 75: 2863-2871
34.
Hamilton MI, Wakefield AJ. Inflammatory bowel disease. Recent Advances in Gastroenterology. Vol.10 Ed. RE Pounder. Churchill Livingstone. London 1994. Vol. 10 9.pp 161-180
35.
Thompson NP, Wakefield AJ. Infective agents -Vascular factors Inflammatory Bowel Disease. Ed. Allan RN, Keighley MRB, Rhodes J. Alexander Williams J. 1994;17:133-142
36.
Ekbom A, Wakefield AJ, Zack M, Adami H-O. Perinatal measles infection and subsequent Crohn's disease. Lancet 1994; 344: 508-510.
37.
Sawyerr AM, Pottinger BE, Savage CO, Bradley NJ, Hudson M, Wakefield AJ, Pearson JD, Pounder RE. Serum immunoglobulin G reactive with endothelial cells in inflammatory bowel disease. Digestive Diseases & Sciences 1994; 39: 1909-1917
10
A.J.WAKEFIELD
38.
Anthony A, Dhillon AP, Sim R, Pounder RE, Wakefield AJ. Dexamethasone promotes ulcer plugging in experimental enteritis. Alimentary Pharmacol & Therapeutics 1994; 8: 597-602
39.
Smith M, Wakefield AJ. Crohn's disease: ancient and modern. Invited article. Journal of Postgraduate Medicine. 1994; 70: 149-153
40.
Anthony A, Dhillon AP, Sim R, Nygård G, Pounder RE, Wakefield AJ. Ulceration, fibrosis and diaphragm-like lesions in the caecum of rats treated with Indomethacin Alimentary Pharmacology & Therapeutics 1994; 8: 417-424.
41.
Wakefield AJ. The pathogenesis of Crohn's disease. Chronic Inflammatory Bowel Disease. Stangë E F (Ed), Kluwer Academic Publishers, London, 1994, pp 22-29
42.
Wakefield AJ, Hudson M, Pounder RE Leukocyte-endothelial cell interactions in Crohn's disease: potential targets for mesalazine in Crohn's disease.Advances in Experimental Medicine and Biology 1995. Ed: McGhee JR and Mestecky J. Plenum Press, New York:1307-1311
43.
Ray RA, Smith M, Sim R, Nystrom M, Pounder R E, Wakefield AJ. The intracellular polymerase chain reaction for small CMV genomic sequences within heavily infected cellular sections. Journal of Pathology 1995; 177:171-180
44.
Ray RA, Smith M, Sim R, Bruce I, Wakefield AJ. In situ hybridisation detection of short viral amplicon sequences within cultured cells and body fluids after the in situ polymerase chain reaction. Journal of Virological Methods 1995; 52: 247-263
45.
Nygård G, Hudson M, Mazure G, Anthony A, Dhillon AP, Pounder RE, Wakefield AJ Procoagulant and prothrombotic response of human endothelium to indomethacin and endotoxin in vitro: relevance to non-steroidal inflammatory drug enteropathy. Scandinavian Journal of Gastroenterol. 1995; 30: 25-32
46.
Nygård G, Anthony A, Khan K, Bounds SV, Dhillon AP, Pounder RE, Wakefield AJ. Intestinal site-dependent susceptibility to chronic indomethacin in the rat: a morphological and biochemical study. Alimentary Pharmacology & Therapeutics 1995; 9: 403-410
47.
Wakefield AJ, Ekbom A, Dhillon AP, Pittilo RM, Pounder RE. Crohn's disease: pathogenesis and persistent measles virus infection. Gastroenterology 1995; 108: 911-916
48.
Thompson N, Wakefield AJ, Pounder RE. Inherited disorders of coagulation appears to protect against inflammatory bowel disease. Gastroenterology 1995; 108: 1011-1015
49.
Hamilton MI, Dick R, Crawford L, Thompson NP, Pounder RE, Wakefield AJ. Is proximal demarcation of ulcerative colitis determined by the territory of the inferior mesenteric artery? Lancet 1995; 345: 688-690
50.
Hamilton MI, Bradley NJ, Srai SKS, Thrasivoulou C, Pounder RE, Wakefield AJ. Autoimmunity in ulcerative colitis: tropomyosin is not the major antigenic
11
A.J.WAKEFIELD determinant of the Das monoclonal antibody, 7E12H12. Clinical & Experimental Immunology.1995; 99: 404-411. 51.
Thompson NP, Wakefield AJ, Pounder RE. Prognosis and prognostic risk factors in inflammatory bowel disease. Special article. Saudi Journal of Gastroenterology. 1995;1:129-137
52.
Lewin J, Dhillon AP, Sim R, Pounder RE, Wakefield AJ. Persistent measles virus infection of the intestine: confirmation by immunogold electron microscopy. Rapid publication. Gut 1995; 36: 564-569
53.
Thompson NP, Montgomery SM, Pounder RE, Wakefield AJ. Is measles vaccination a risk factor for inflammatory bowel disease? Lancet 1995; 345: 1071-1074
54.
Anthony A, Dhillon AP, Thrasivoulou C, Pounder RE, Wakefield AJ. Preulcerative villus contraction and microvascular occlusion induced by indomethacin in the rat jejunum: a detailed morphological study. Alimentary Pharmacology & Therapeutics. 1995;9:605-613
55.
Anthony A, Dhillon AP, Fidler H, McFadden JJ, Billington O, Nyg책rd G, Pounder RE, Wakefield AJ. Mycobacterial granulomatous inflammation in the ulcerated caecum of indomethacin-treated rats. International Journal of Experimental Pathology. 1995; 76: 149-155
56.
Smith MS, Warren BF, Fox JD, Watkins PE, Hudson M, Pounder RE, Wakefield AJ. Detection of herpesvirus DNA in cotton-top tamarins: no association with colitis. International Journal of Experimental Pathology. 1995;76:201-203
57.
Sawyerr AM, Smith MS, Hall A, Hudson M, Hay CR, Wakefield AJ, Brook MG, Tomura H, Pounder RE. Serum concentrations of von Willebrand factor and soluble thrombomodulin indicate alteration of endothelial function in inflammatory bowel diseases. Digestive Diseases & Sciences. 1995; 40: 793-799
58.
Wakefield AJ. Vasculitis and Crohn's disease: a novel and debated concept. Research and Clinical Forums. 1995; 17: 53-56
59.
Wakefield AJ. Crohn's disease - the pathogenesis of a granulomatous vasculitis: A hypothesis. Canadian Journal of Gastroenterology 1995; 9: 199-202
60.
Ray R, Cooper PJ, Wakefield AJ. The era of intracellular nucleic acid technology. Biotechnology. 1995; 13: 445-447
61.
Thompson NP, Pounder RE, Wakefield AJ. Perinatal and childhood risk factors for inflammatory bowel disease: a case-control study. European Journal of Gastroenterology and Hepatology. 1995; 7: 385-390
62.
Wakefield AJ, Pounder RE. Measles virus in Crohn's disease (letter). Lancet 1995;345;660
63.
Anthony A, Sim R, Dhillon AP, Pounder RE, Wakefield AJ. Gastric mucosal contraction and vascular injury induced by indomethacin precede neutrophil infiltration in the rat. Gut 1996; 39: 363-368
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A.J.WAKEFIELD
64.
Ekbom A, Daszak PS, Kraaz W, Wakefield AJ. Crohn's disease following measles virus exposure in utero: risk estimates and clinical characteristics. Lancet 1996; 344: 508-509
65.
Ray R, Cooper PJ, Sim R, Chadwick N, Earle P, Dhillon AP, Pounder RE, Wakefield AJ. Direct in situ reverse transcriptase polymerase chain reaction for detection of measles virus. Journal of Virological Methods 1996;60:1-17
66.
Anthony A, Bahl A, Oakley IG, Spraggs CF, Dhillon AP, Trevethick MA, Piasecki C, Pounder RE, Wakefield AJ. The beta-3 adrenoceptor agonist CL316243 prevents indomethacin-induced jejunal ulceration in the rat by reversing early villous shortening. Journal of Pathology 1996:179:340-346
67.
Hudson M, Chitolie A, Hutton RA, Smith MS, Pounder RE, Wakefield AJ. Thrombotic vascular risk factors in inflammatory bowel disease. Gut 1996;38:733-737
68.
Ray R, Sim R, Khan K, Dhillon AP, Pounder RE, Wakefield AJ. Direct in situ nucleic acid amplification: control of artifact and use of labelled primers. Clinical Molecular Pathology 1996; 49: 345-350
69.
Thompson N, Driscoll R, Pounder RE, Wakefield AJ. Genetics versus environment in inflammatory bowel disease: results of a British twin study. British Medical Journal 1996; 312: 95-96
70.
Thompson NP, Fleming DM, Pounder RE, Wakefield AJ. Crohn's disease, measles and measles vaccination: a case-control failure (letter). Lancet 1996;347:263
71.
Walmsley RS, Zhao MH, Hamilton MI, Brownlee A, Chapman P, Pounder RE, Wakefield AJ, Lockwood CM. Antineutrophil cytoplasm autoantibodies against bactericidal/permeability increasing protein in inflammatory bowel disease. Gut 1997;40:105-109
72.
Daszak P, Purcell M, Lewin J, Dhillon AP, Pounder RE, Wakefield AJ. Detection and comparative analysis of persistent measles virus infection in Crohn's disease by immunogold electron microscopy. Journal of Clinical Pathology 1997;50:299304
73.
Wakefield AJ, Sim R, Akbar AN, Pounder RE, Dhillon AP. In situ immune responses in Crohn's disease: a comparison with acute and persistent measles virus infection. Journal of Medical Virology. 1997;51:90-100
74.
Anthony A, Dhillon AP, Pounder RE, Wakefield AJ. Ulceration of the ileum in Crohn’s disease: correlation with vascular anatomy. Journal of Clinical Pathology.1997;50:1013-1017
75.
Anthony A, Pounder RE, Dhillon AP, Wakefield AJ. Vascular anatomy defines sites of indomethacin-induced jejunal ulceration along the mesenteric margin. Gut 1997;41:763-770
76.
Montgomery SM & Wakefield AJ. Measles vaccine and neurological events. Lancet 1997; 349: 1625 (letter) 13
A.J.WAKEFIELD
77.
Montgomery SM, Pounder RE, Wakefield AJ. Infant mortality and the incidence of inflammatory bowel disease. Lancet 1997; 349: 472-473
78.
Montgomery SM, Morris DL, Pounder RE, Wakefield AJ. Measles vaccination and inflammatory bowel disease (letter). Lancet 1997;350:1774
79.
Tiwana H, Wilson C, Walmsley RS, Wakefield AJ, Smith MSH, Cox NL, Hudson MJ, Ebringer A. Antibody responses to gut bacteria in ankylosing spondylitis, rheumatoid arthritis, Crohn's disease and ulcerative colitis. Rheumatology International. 1997; 17: 11-16
80.
Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA. Ileal lymphoid nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children. Lancet 1998;351:637-641 (retracted: appealed)
81.
Kelly DA, Piasecki C, Anthony A, Dhillon AP, Pounder RE, Wakefield AJ. Focal reduction of villous blood flow in early indomethacin enteropathy: a dynamic vascular study in the rat. Gut 1998;42:366-373
82.
Montgomery SM, Morris DL, Thompson NP, Subhani J, Pounder RE, Wakefield AJ. Prevalence of inflammatory bowel disease in British 26-year olds. British Medical Journal 1998;7137:1058-1059
83.
Balzola F, Khan K, Pera, A, Bonino F, Pounder RE, Wakefield AJ. Measles IgM immunoreactivity in patients inflammatory bowel disease. Italian Journal of Gastroenterol. 1998;30:4,378-382
84.
Tiwana H, Walmsley RS, Wilson C, Yiannakou JY, Ciclitira PJ, Wakefield AJ, Ebringer A. Characterisation of the Humoral Immune Response to Klebsiella Species in Inflammatory Bowel Disease and Ankylosing Spondylitis. British Journal of Rheumatology. 1998:37;525-531
85.
Anthony A, Schepelmann S, Guillaume J-L, Strosberg AD, Dhillon AP, Pounder RE, Wakefield AJ. Localisation of the beta3-adrenoceptor in the human gastrointestinal tract: an immunohistochemical study. Alimentary Pharmacology & Therapeutics. 1998;12:579-526
86.
Chadwick N, Bruce I, Davies M, van Gemen B, Schukkink R, Khan K, Pounder RE, Wakefield AJ. A sensitive and robust method for measles RNA detection. Journal of Virological Methods. 1998,70:59-67
87.
Chadwick N, Bruce IJ, Schepelmann S, Pounder RE, Wakefield AJ. Measles virus RNA is not detected in inflammatory bowel disease using hybrid capture and reverse transcription followed by the polymerase chain reaction. Journal of Medical Virology, 1998;55:305-311
88.
Walmsley RS, Anthony A, Sim R, Pounder RE, Wakefield AJ. Absence of E. Coli, Listeria and Klebsiella pneumoniae within inflammatory bowel disease tissues. Journal of Clinical Pathology. 1998;51:657-661
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A.J.WAKEFIELD
89.
Kelly D, Piaseki C, Anthony, A, Dhillon AP, Ponder RE, Wakefield AJ. Reversal and protection against indomethacin-induced blood stasis and mucosal damage in the rat jejunum by a B-3 adrenoceptor agonist. Alimentary Pharmacology & Therapeutics. 1998; 12:1121-1129
90.
Wakefield AJ & Montgomery SM. Crohn’s disease: the case for measles virus (Invited article) Italian Journal of Gastroenterology 1999;31:247-254
91.
Chadwick N, Wakefield AJ, Pounder RE, Bruce I. A comparison of three nucleic acid amplification methods as a source for DNA sequencing. BioTechniques 1998;25:818-822
92.
Montgomery SM, Morris DL, Pounder RE, Wakefield AJ. Paramyxivorus infections in childhood and subsequent inflammatory bowel disease. Gastroenterology 1999;116:796-803
93.
Tompson NP, Fleming DM, Charlton J, Pounder RE, Wakefield AJ. Patients Consulting with Crohn's disease in primary care in England and Wales. European Journal of Gastroenterology & Hepatology. 1998;10:1007-1012
94.
Anthony A, Dhillon AP, Pounder RE, Wakefield AJ. The colonic mesenteric margin is most susceptible to injury in an experimental model of colonic ulceration. Alimentary Pharmacology & Therapeutics. 1999;13:531-535
95.
Anthony A, Sim R, Pounder RE, Dhillon AP, Wakefield AJ. Similarities between Crohn's disease and indomethacin experimental ulcers in the rat. Alimentary Pharmacology and Therpeutics. 2000;14:241-245
96.
Subhani J, Montgomery SM, Thompson N, Ebrahim S, Wakefield AJ, Pounder RE. Childhood risk factors for inflammatory bowel disease: a twin case-control study. Submitted for publication
97.
Montgomery SM, Twamley SI, Murch SH, Pounder RE, Wakefield AJ Contact with soil in infancy does not protect against atopy. Immunology Today 1999;20:289-290
98.
Montgomery SM, Morris DL, Pounder RE, Wakefield AJ. Asian ethnic origin and the risk of inflammatory bowel disease. European.Journal of Gastroenterology and Hepatology.1999;11:543-546
99.
Montgomery SM, Pounder RE, Wakefield AJ. Smoking in adults and passive smoking in children are associated with acute appendicitis. Lancet 1999;353:379
100.
Montgomery SM, Wakefield AJ, Morris DL, Pounder RE, Murch SH. The initial care of newborn infants and subsequent hay fever. Allergy. 2000;;55:916-22.
101.
Orteu CH, McGregor JM, Whittaker SJ, Balzola F, Wakefield AJ. Erythema elevatum diutinum and Crohn disease: a common pathogenic role for measles virus? Arch Dermatol. 1996;32:1523-5.
102.
Wakefield AJ, Anthony A, Murch SH, Thomson M, Montgomery SM, Davies S, Walker-Smith JA. Enterocolitis in children with developmental disorder.
15
A.J.WAKEFIELD American Journal appealed)
of
Gastroenterology
2000;95:2285-2295
(retracted:
103.
Furlano RI, Anthony A, Day R, Brown A, McGavery L, Thomson MA, Davies SE, Berelowitz M, Forbes A, Wakefield AJ, Walker-Smith JA, Murch SH. Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. Journal of Pediatrics 2001;138:366-72.
104.
Wakefield AJ and Montgomery SM. Autism, viral infection and measles mumps rubella vaccination. Israeli Medical Association Journal 1999;1:183-187
105.
Dunn AC, Walmsley RS, Dedrick RL, Wakefield AJ, Lockwood CM. Antineutrophil cytoplasmic autoantibodies (ANCA) to bactericidal/permeabilityincreasing (BPI) protein recognize the carboxyl terminal domain. Journal of Infection. 1999;39:81-7
106.
Thompson NP., Montgomery SM., Wadsworth MEJ., Pounder RE., Wakefield AJ. Early determinants of inflammatory bowel disease: use of two longitudinal birth cohorts. European Journal of Gastroenterology & Hepatology. 2000;12:2530
107.
Kawashima H., Takayuki M., Kashiwagi Y., Takekuma K., Hoshika A., Wakefield AJ. Detection and sequencing of measles virus from peripheral blood mononuclear cells from patients with inflammatory bowel disease and autism. Digestive Diseases and Sciences. 2000;45:723-729
108.
Wakefield AJ and Montgomery SM. Measles, mumps, rubella vaccine: through a glass, darkly. Adverse Drug Reactions & Toxicological Reviews 2000;19:265283
109.
Anthony A., Dhillon AP., Pounder RE., Wakefield AJ. Granulomatous vasculitis in Crohn’s disease: association with the extra-mural vasculature. 2001 (Submitted for publication)
110.
Morris DL, Montgomery SM, Galloway ML, Pounder RE, Wakefield AJ. Inflammatory bowel disease and laterality: is left handedness a risk? Gut. 2001;49:199-202
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Wakefield AJ, Montgomery SM. Immunohistochemical analysis of measles related antigen in Inflammatory bowel disease. Gut. 2001;48:136-7
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Morris DL, Montgomery SM, Thompson NP, Ebrahim S, Pounder RE, Wakefield AJ. Measles vaccination and inflammatory bowel disease: a national British Cohort Study. American Journal of Gastroenterology. 2000;95:3507-12
113.
O'Leary JJ, Uhlmann V, Wakefield AJ. Measles virus and autism. Lancet. 2000;356:772 (letter)
114.
Wakefield AJ, Montgomery SM. Measles virus as a risk for inflammatory bowel disease: an unusually tolerant approach. American Journal of Gastroenterology. 2000;95:1389-92. (Editorial)
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Anthony A, Sim R, Guillaume JL, Strosberg AD, Dhillon AP, Pounder RE, Wakefield AJ. Beta (beta)3-adrenergic receptors in human pancreatic islet and duodenal somatostatin neuroendocrine cells. Alimentary Pharmacology and Therapeutics. 2000;14:579-8
116.
Kelly D, Anthony A, Piasecki C, Lewin J, Pounder RE, Wakefield AJ. Endothelial changes precede mucosal ulceration induced by indomethacin: an experimental study in the rat. Alimentary Pharmacology and Therapeutics. 2000;14:489-96
117.
Wakefield AJ. MMR vaccination and autism. Lancet. 1999;354:949-50 (letter)
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Wakefield AJ. The New Autism (Invited Article) Clinical Child Psychology & Psychiatry 2002;7:518-528
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Uhlmann V., Martin C, Shiels, Wakefield AJ, O.Leary JJ. Possible viral pathogenesis of a novel paediatric inflammatory bowel disease. Molecular Pathology 2002;55:84-90
120.
Wakefield AJ., Puleston J. Montgomery SM., Anthony A., O’Leary J.J., Murch SH Entero-colonic encephalopathy, autism and opioid receptor ligands. Alimentary Pharmacology & Therapeutics. 2002;16:663-674
121.
Torrente F., Machado N., Perez-Machado M., Furlano R., Thomson M., Davies S., Wakefield AJ, Walker-Smith JA, Murch SH. Enteropathy with T cell infiltration and epithelial IgG deposition in autism. Molecular Psychiatry. 2002;7:375-382
122.
Ehlin GGC, Montgomery SM, Ekbom A, Pounder RE, Wakefield AJ. The prevalence of gastrointestinal diseases in two British birth cohorts 2002
123.
Montgomery SM, Wakefield AJ, Ekbom A. Pertussis infection in childhood and type I diabetes 2002 Diabet. Med. 2002;19: 986–993
124.
Montgomery SM., Lambe M., Wakefield AJ., Pounder RE., Ekbom A. Siblings and the risk of Inflammatory Bowel Disease. Scandinavian Journal of Gastroenterology 2002;37:1301-1308
125.
Wakefield AJ. The Gut-Brain Axis in Childhood developmental Disorders. Journal of Pediatric Gastroenterology and Nutrition. 2002;34:S14-S17
126.
Wakefield AJ. Entero-colitis, Autism and Measles Virus. Consensus in Child Neurology. 2002;6:74-77
127.
Ashwood P, Anthony A, Pellicer AA, Torrente F, Wakefield AJ. Intestinal lymphocyte populations in children with regressive autism: Evidence for extensive mucosal immunopathology. Journal of Clinical Immunology, 2003;23:504-517.
128.
Wakefield AJ. Enterocolitis, autism and measles virus. Molecular Psychiatry. 2002;7:S44-46
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129. Ashwood P, Anthony A, Torrente F, Wakefield AJ., Spontaneous mucosal lymphocyte cytokine profiles in children with regressive autism and gastrointestinal symptoms: Mucosal immune activation and reduced counter regulatory interleukin-10. Journal of Clinical Immunology. 2004:24:664-673 130. Anthony A, Ashwood P., Wakefield AJ. The significance of ileo-colonic lymphoid nodular hyperplasia in children with autistic spectrum disorder. European Journal of Gastroenterology and Hepatology 2005 Aug;17(8):827-36 131. Bradstreet JJ., ,El Dahr J., Anthony A., Kartzinel J., Wakefield AJ, Detection of Measles Virus Genomic RNA in Cerebrospinal Fluid of Children with Regressive Autism: a Report of Three Cases Journal of American Physicians and Surgeons. 2004.9:39-45 132. Stott C., Blaxill M., Wakefield AJ. MMR and Autism in Perspective: the Denmark Story. Journal of American Physicians and Surgeons 2004;9:89-91 133. The Gut-Brain Axis in Childhood Developmental Disorders: Viruses and Vaccines. Wakefield AJ., Collins I., Ashwood P. Invited chapter in Infectious Disease and Neuropsychiatric Disorders Chapter 21, pp 198-206 134. Ashwood P, Wakefield AJ. Ileal and peripheral blood CD3+ cytokine profiles in children with regressive autism and gastrointestinal symptoms: Mucosal immune activation and reduced counter regulatory interleukin-10. Journal of Neuroimmunology. 2006 ;73:126-34. 135. Wakefield AJ., Stott C., Limb K. Gastrointestinal co-morbidity, autistic regression and Measles-containing vaccines: positive re-challenge and biological gradient effects. Medical Veritas 2006;3:796-802 136.
Wakefield AJ. The significance of ileocolonic lymphoid nodular hyperplasia in children with autistic spectrum disorder. (letter) Eur J Gastro Hep 2006;18:571574.
137.
Wakefield AJ. Autistic enterocolitis: Histopathology 2006;50:380-384
138.
Russo AJ, Krigsman A, Jepson B, Wakefield AJ. Anti-PR3 and Anti-MPO IgG ANCA in Autistic Children With Chronic GI Disease. Immunology and Immunogenetics Insights 2009:2:21-28
139.
Russo AJ, Krigsman A, Jepson B, Wakefield A. Low serum alpha-1 antitrypsin associated with anti-PR-3 ANCA in autistic children with GI disease. - Genomics Insights, 2009 2009;2:1–9.
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140.
Russo AJ, Krigsman A, Jepson B, Wakefield AJ. Decreased Serum Hepatocyte Growth Factor (HGF) in Autistic Children with Severe Gastrointestinal Disease. Biomarker Insights. 2009; 4: 181–190.
141.
Russo AJ, Krigsman A, Jepson B, Wakefield AJ. Generalized Autoimmunity of ANCA and ASCA Related to Severity of Disease in Autistic Children with GI Disease. Immunology and Immunogenetics Insights 2009:1 37–47
142.
Wakefield AJ. Callous Disregard. Autism and Vaccines – The Truth Behind a Tragedy. New York (2010) Skyhorse Publishing.
143.
Wakefield AJ. Waging war on the Autistic Child. The Arizona 5 and the Legacy of Baron von Munchausen. New York (2012) Skyhorse Publishing.
144.
Russo AJ, Krigsman A, Jepson B, Wakefield AJ. Low serum myeloperoxidase in autistic children with gastrointestinal disease. Clin Exp Gastroenterol. 2009; 2: 85–94.
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Journal: Controversial autism study was 'elaborate fraud'
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Journal: Controversial autism study was 'elaborate fraud' Study linking childhood vaccine to autism was based on doctored information, report says. ASSOCIATED PRESS
Published: 8:58 p.m. Wednesday, Jan. 5, 2011
The first study to link a childhood vaccine to autism was based on doctored information about the children involved, according to a new report in a British medical journal on the widely discredited research. The conclusions of the 1998 paper by Andrew Wakefield and colleagues was renounced by 10 of its 13 authors and later retracted by the medical journal Lancet, where it first ran. A new examination found, by comparing the reported diagnoses in the paper to hospital records, that Wakefield and colleagues altered facts about patients in their study. The analysis, by British journalist Brian Deer, found that despite the claim in Wakefield's paper that the 12 children studied were normal until they had the measles, mumps and rubella shot, five had previously documented developmental problems. Deer also found that all the cases were somehow misrepresented when he compared data from medical records and the children's parents. Wakefield, who had moved to Austin was executive director of the local Thoughtful House Center for Children before resigning in February, couldn't be reached for comment by The Associated Press. In an accompanying editorial, BMJ editor Fiona Godlee and colleagues called Wakefield's study "an elaborate fraud." They said Wakefield's work in other journals should be examined to see if it should be retracted.
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4/4/2012 2:34 PM
No sign Abilene parents not vaccinating kids : Abilene Reporter-News
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No sign Abilene parents not vaccinating kids British doc’s findings are renounced Mike Roark roarkm@reporternews.com / 325-676-6776 Thursday, January 6, 2011
Abilene public health and school district officials say they have not seen signs locally that parents stepped back from vaccinating their children over the past few years after a now-bogus health report indicated a childhood vaccine could lead to autism. The conclusions of a 1998 paper by British doctor Andrew Wakefield and colleagues linking a childhood vaccine to autism has been renounced by 10 of its 13 authors and later retracted by the medical journal Lancet, where it was published. And even though the study’s findings that the measles, mumps and rubella shot was connected to autism has been proven to have been fabricated, it prompted some parents worldwide to not vaccinate their children for the diseases. However, that hasn’t been the trend in Abilene and Taylor County, said Kay Durilla a registered nurse with the Abilene-Taylor County Health District. “That’s not something that we’ve seen,” Durilla said Thursday. Durilla said each child needs to be vaccinated at two, four and six months for a variety of diseases. It also is important children get the MMR shot at 12 months old. She added that other childhood vaccinations are received when a child is 15 to 18 months old, and between the ages of 4 and 6. “It is very important to get these vaccinations,” she said. “These are some of the most important discoveries in medical history.” Linda Langston, the head registered nurse in the Abilene school district, said school records don’t indicate more students than normal are seeking waivers to avoid childhood vaccinations. “No, we have not seen that it has increased in any way,” Langston said. Langston agreed with Durilla that getting all childhood vaccinations is the best way to protect a child’s heath. The Texas Department of Health Services said there have been few waivers granted to students in Taylor County in recent years whose families object to their children receiving vaccinations.
EXHIBIT 4-B
4/4/2012 2:42 PM
No sign Abilene parents not vaccinating kids : Abilene Reporter-News
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The latest figures, from the 2008-09 school year shows that just 22 students, or 0.10 percent, of all students in the county, received a waiver from the state saying they didn’t have to have the vaccinations. In 2007-08, there were 33 exemptions, or 0.15 percent; in 2006-07 there were 23 exemptions, or 0.10 percent; and in 2005-06 there were 20 exemptions, or 0.09 percent. A new examination of Wakefield’s study found, by comparing the reported diagnoses in the paper to hospital records, that Wakefield and colleagues altered facts about patients in their study. The analysis, by British journalist Brian Deer, found that despite the claim in Wakefield’s paper that the 12 children studied were normal until they had the MMR shot, five had previously documented developmental problems. Deer also found that all the cases were somehow misrepresented when he compared data from medical records and the children’s parents. Last May, Wakefield was stripped of his right to practice medicine in Britain. Many other published studies have shown no connection between the MMR vaccination and autism. Reported cases of measles have surged since Wakefield’s paper was published and there are sporadic outbreaks in Europe and the U.S. In 2008, measles was deemed endemic in England and Wales. Wakefield now lives in the U.S. where he enjoys a vocal following including celebrity supporters. The Associated Press contributed to this story.
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4/4/2012 2:42 PM
Journal: Study linking vaccine to autism was fraud
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Journal: Study linking vaccine to autism was fraud THE ASSOCIATED PRESS
Updated: 11:20 p.m. Wednesday, Jan. 5, 2011 Published: 6:07 p.m. Wednesday, Jan. 5, 2011
The first study to link a childhood vaccine to autism was based on doctored information about the children involved, according to a new report on the widely discredited research. The conclusions of the 1998 paper by Andrew Wakefield and colleagues was renounced by 10 of its 13 authors and later retracted by the medical journal Lancet, where it was published. Still, the suggestion the MMR shot was connected to autism spooked parents worldwide and immunization rates for measles, mumps and rubella have never fully recovered. A new examination found, by comparing the reported diagnoses in the paper to hospital records, that Wakefield and colleagues altered facts about patients in their study. The analysis, by British journalist Brian Deer, found that despite the claim in Wakefield's paper that the 12 children studied were normal until they had the MMR shot, five had previously documented developmental problems. Deer also found that all the cases were somehow misrepresented when he compared data from medical records and the children's parents. Wakefield could not be reached for comment despite repeated calls and requests to the publisher of his recent book, which claims there is a connection between vaccines and autism that has been ignored by the medical establishment. Wakefield now lives in the U.S. where he enjoys a vocal following including celebrity supporters like Jenny McCarthy. Deer's article was paid for by the Sunday Times of London and Britain's Channel 4 television network. It was published online Thursday in the medical journal, BMJ. In an accompanying editorial, BMJ editor Fiona Godlee and colleagues called Wakefield's study "an elaborate fraud." They said Wakefield's work in other journals should be examined to see if it should be retracted. Last May, Wakefield was stripped of his right to practice medicine in Britain. Many other published studies have shown no connection between the MMR vaccination and autism. But measles has surged since Wakefield's paper was published and there are sporadic outbreaks in Europe and the U.S. In 2008, measles was deemed endemic in England and Wales. ___ Online: www.bmj.com ___ January 06, 2011 12:20 AM EST Copyright 2011, The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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EXHIBIT 4-C
4/4/2012 2:38 PM
Journal: Study linking vaccine to autism was fraud
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4/4/2012 2:38 PM
Journal: Study linking vaccine to autism was fraud - San Antonio Express...
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Journal: Study linking vaccine to autism was fraud Associated Press Published 11:56 a.m., Thursday, January 6, 2011
LONDON -- The first study to link a childhood vaccine to autism was based on doctored information about the children involved, according to a new report on the widely discredited research. The conclusions of the 1998 paper by Andrew Wakefield and colleagues was renounced by 10 of its 13 authors and later retracted by the medical journal Lancet, where it was published. Still, the suggestion the MMR shot was connected to autism spooked parents worldwide and immunization rates for measles, mumps and rubella have never fully recovered. A new examination found, by comparing the reported diagnoses in the paper to hospital records, that Wakefield and colleagues altered facts about patients in their study. The analysis, by British journalist Brian Deer, found that despite the claim in Wakefield's paper that the 12 children studied were normal until they had the MMR shot, five had previously documented developmental problems. Deer also found that all the cases were somehow misrepresented when he compared data from medical records and the children's parents. Wakefield could not be reached for comment despite repeated calls and requests to the publisher of his recent book, which claims there is a connection between vaccines and autism that has been ignored by the medical establishment. Wakefield now lives in the U.S. where he enjoys a vocal following including celebrity supporters like Jenny McCarthy. Deer's article was paid for by the Sunday Times of London and Britain's Channel 4 television network. It was published online Thursday in the medical journal, BMJ. In an accompanying editorial, BMJ editor Fiona Godlee and colleagues called Wakefield's study "an elaborate fraud." They said Wakefield's work in other journals should be examined to see if it should be retracted. Last May, Wakefield was stripped of his right to practice medicine in Britain. Many other published studies have shown no connection between the MMR vaccination and autism. But measles has surged since Wakefield's paper was published and there are sporadic outbreaks in Europe and the U.S. In 2008, measles was deemed endemic in England and Wales.
EXHIBIT 4-E
4/4/2012 2:45 PM
Journal: Study linking vaccine to autism was fraud - San Antonio Express...
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4/4/2012 2:45 PM
Fear and vaccine: It's a public health disaster - Houston Chronicle
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Fear and vaccine: It's a public health disaster Copyright 2011, HOUSTON CHRONICLE Published 06:30 a.m., Tuesday, January 11, 2011
The work of a British researcher purporting to link increased likelihood of autism with childhood vaccinations has been debunked. Again. Since Dr. Andrew Wakefield’s study linking autism with vaccines was published 12 years ago in the leading British medical journal, The Lancet, it has caused little more than grief. In 2009, The Lancet retracted the Wakefield paper. Over the years, no less than 18 controlled epidemiological studies have been conducted to investigate the possible link between autism and vaccines. And? “They have all come back showing the same thing,” says Alison Singer, the founder and president of Autism Science Foundation, a nonprofit that advocates scientific rigor in evaluating the causes of autism. “There is no link between vaccines and autism,” Singer told CNN.com. The consequences have been ugly: The incidence of measles has surged as tens of thousands of parents in this country and Europe have decided to forgo the vaccinations. The latest examination of Wakefield’s work, conducted by a British journalist, found that the researchers had altered the facts about patients in their study. The investigation by journalist Brian Deer, paid for and published by The Sunday Times newspaper of London and a British television network, found that contrary to documentation in Wakefield’s paper, five of the children had developmental problems prior to their vaccinations for measles, mumps and rubella with the MMR vaccine. The paper claimed all 12 children were normal until they had the shot. In an editorial in the British medical journal BMJ, editor Fiona Godlee and her colleagues pulled no punches. The editors called it “an elaborate fraud.” We hope that all these pedigreed critiques will at last put this topic to rest.The effectiveness of vaccinations relies in large part on the willingness of most members of a potentially affected population group to be vaccinated. Since Wakefield’s study was released in 1998, vaccination rates have dropped noticeably, a phenomenon widely attributed to fears of exposure to autism from the MMR shots. As many as 25 percent of parents may be scared away from having their children vaccinated by the Wakefield study. That’s too many. Measles can kill. The best way to avoid catching them is for children to be vaccinated. Let’s not be
EXHIBIT 4-F
4/4/2012 2:47 PM
Fear and vaccine: It's a public health disaster - Houston Chronicle
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4/4/2012 2:47 PM
Wakefield, autism researcher, subject of 3-part expose | Salud
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Home > Salud > Archives > 2011 > January > 21 > Entry
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Wakefield, autism researcher, subject of 65 3-part expose Share
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By Mary Ann Roser | Friday, January 21, 2011, 11:53 AM An autism researcher in Austin who was stripped of his British medical license last year for misconduct in his research on children in England, is the topic of a three-part expose that recently wrapped up in the British Medical Journal.
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The Statesman published a report about the first article that said Andrew Wakefield’s research that launched a worldwide scare linking vaccines to autism was built on “an elaborate fraud.” Children in the 1998 study were said to have autism symptoms emerge soon after vaccination with the measles-mumps-rubella vaccine. That is disputed by the author of the article, Brian Deer, a British journalist who has written extensively on the Wakefield saga.
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The 1998 study was retracted by The Lancet, the journal that published it, last year.
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Wakefield, right, denies the allegations in the articles and came out with a book last year to defend himself when his license was taken called “Callous Disregard.” He is continuing his research into autism at a clinic in Austin with Dr. Arthur Krigsman, a pediatric gastroenterologist, on Cameron Road. Both resigned last year from the Thoughtful House Center for Children.
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Deer’s second article in the medical journal says that in 1995 Wakefield sought a patent for a test that would look for the measles virus in bowel tissue, furthering an autism theory Wakefield has long championed. Use of the proposed test in Britain and the U.S. would generate up to £72.5 million a year, Deer wrote, or $116 million in today’s dollars. Deer also writes about Wakefield’s work aiding an attorney suing the vaccine manufacturer.
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The third article says that editors of the Lancet allowed the public to be misled about Wakefield’s research for six years. That’s how long Deer said it took editors of The Lancet to retract Wakefield’s paper after Deer first complained about it. Wakefield issued a statement disputing Deer’s articles last week. “I want to make one thing crystal clear for the record - my research and the serious medical problems found in those children were not a hoax and there was no fraud whatsoever. Nor did I seek to profit from our findings,” he wrote. “I stand by the Lancet paper’s methodology and the results which call for more research into whether environmental triggers cause gastrointestinal disease and developmental regression in children.” He said Friday that he planned to issue documents that refute Deer’s articles. “There’s absolutely no question they committed serious defamation,” he said. “I will be dealing with this over the next several months.” Permalink | Comments (32) | Post your comment Categories: Autism Comments When commenting, we ask that you keep things civil and abide by our Visitor Agreement. To report comment abuse, click here. By EM January 21, 2011 5:42 PM | Link to this
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4/4/2012 2:49 PM
Wakefield, autism researcher, subject of 3-part expose | Salud
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What a gigantic sleazebucket. This guy belongs in a prison. By Jake Crosby January 21, 2011 5:52 PM | Link to this You’re right, Brian Deer does belong in a prison. By Ed January 21, 2011 6:23 PM | Link to this Those reviewing Wakefield’s research were able to document that he committed fraud wit regard to the characteristics of those in the study. In the world of medicine and academia, that is fraud and totally cancels the findings of the study. Anyone who falsifies data to get a paper published or to promote a theory is a sleazebucket.
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By AustinDude January 21, 2011 7:49 PM | Link to this Andrew Wakefield and his cohorts at “Thoughtful House” in Austin have been bilking concerned parents for years. The parents’ hard-earned money has been sucked up to the tune of over $400/hour just to listen to their crazy theories, that when repeated enough times, tends to become fact by assertion (as opposed to by proof). It is shameful for a place calling themselves “Thoughtful House” (and don’t be fooled by Wakefield’s “resignation” because that outfit still preaches the same garbage) collects piles of money from parents who are too scared for their child to not try everything imaginable to find a cure. Doesn’t sound very thoughtful, does it?
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By bpatient January 21, 2011 9:43 PM | Link to this Wakefield’s Lancet paper was rejected by four of the six reviewers. That should have ended it right there, but the editor of the Lancet apparently hoped that, shaky as it was, the article would attract attention—he could not have known what the editors of the BMJ know now, which led them to write: “Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.”
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By todd January 21, 2011 10:44 PM | Link to this It’s amazing how many people still believe that his research is true, especially in Austin where many don’t like to vaccinate. By Jackie January 22, 2011 10:09 AM | Link to this The whining voices of mothers of autistics!!!! Clearly you have not been affected by autism. How very insensitive and ignorant! You should update your research and learn that autism is in fact an epidemic and that these children need pioneers who are brave enough to speak for them when they cannot.
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By bpatient January 22, 2011 10:47 AM | Link to this Jackie, you responded to a troll who tried to provoke people like you while posing as a prominent pediatrician and vaccine expert. By Katie Wright January 22, 2011 1:45 PM | Link to this It is very sad to see journalists advocating censorship. I am a Mom of a vaccine injured child who has been censored- he has literally lost his ability to speak as a result of autism. I am the only voice he has. Like many Moms I have been researching autism non stop since the day my son regressed- 7 years. I am not trying to sell anyone anything. I get nothing out of this and only hope to advocate for research done that could help my child. He does not have a psychiatric condition - he has a chronic autoimmune disease. When NO doctor in the country (believe me we looked) could help my son we went to Thoughtful House. Their doctors recognized and treated my son’s severe and disabling GI disease. His quality of life dramatically improved. I cannot understand why anyone would want children to live in pain. By Chris January 22, 2011 2:02 PM | Link to this The Offit and Mnookin comments were done by an impostor trying to get people angy. That is what trolls like to do. Ignore them. By bpatient January 22, 2011 2:29 PM | Link to this Katie Wright, as Chris noted the comment from “Seth Mnookin” which advocated censorship was a fraud, but it took you in, just as you’ve been fooled by Wakefield’s fraud. By Retrack January 22, 2011 2:40 PM | Link to this Katie also thinks that “retrack” is a word. By Joe January 22, 2011 4:59 PM | Link to this Andrew Wakefield’s thank you to parents
4/4/2012 2:49 PM
Wakefield, autism researcher, subject of 3-part expose | Salud
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http://www.statesman.com/blogs/content/shared-gen/blogs/austin/health/en...
To all parents: “I am immensely grateful to you for your wonderful support. Your voices are being heard around the world and that is precisely why our opponents have become so vicious. The only hope of victory for those who oppose the recognition of what has happened to your children for what it is and a Safety-First vaccine policy, is to divide us. Together we have come too far, for too long, for good reason, to be divided. Each attack makes us stronger and more determined. Science and safety must be the new language of vaccine policy. Solidarity will ensure this happens.” -Andy “Do not judge me too harshly Dr. Wakefield, but when I die I am taking my son with me. You see, I’m all he has. I’m the only one who loves him.” A mother’s plea in 1997 That got Wakefield involved with autism By TRUTH January 22, 2011 5:31 PM | Link to this As a parent of an autisitc, vaccine injured child who is now almost recovered because of the treatments that have healed her gut and immune system——I say—-complete education of the issue is key to understanding the TRUTH. I am also a writer/reporter and understand the power of the pen. Just because someone is allowed to write their interpretation of something doesn’t make it true. It’s important for the writer to provide COMPLETE information. Did Mr. Deer bother to contact the countless number of families who are CERTAIN their children are vaccine injured. I have 2 friends who’s children became autistic the moment they received the MMR. The red hering is Dr. Wakefied. The true investigation is the impact on the human body by metals, toxins, perservatives, and viruses that are contained in the vaccinations. AND the number of vaccinations given. I would be interested to know who signs Mr. Deer’s checks…….. By bpatient January 22, 2011 5:32 PM | Link to this Since he can’t practice medicine and he threw away his research career, I suppose that all Wakefield can do is to continue to extract money from vulnerable parents. I wonder what Jim Jones said to inspire his followers at Jonestown. By Jenny Allan January 22, 2011 5:51 PM | Link to this Dr Paul Offit states above:- ‘Even if he (Dr Wakefield) is right, it’s a small price to pay. At the most 40,000 children suffer a vaccine injury that will affect them the rest of their lives’. So that’s OK them. The smug Dr Offit’s questionable moral standards are revealed here. Well, he is not exactly a disinterested party. He has made millions from, guess what, a vaccine!! Parents have always been told the MMR vaccine is completely SAFE by medical establishment personnel. By advocating the notion that vaccine damage is a small price to pay for the ‘dubious’ concept of ‘herd immunity’ a term invented to pressurise doubting parents into vaccinating their children, Dr Offit has revealed his ‘true colours’. I don’t know know where Dr Offit gets his 40,000 figure from, but if it is true that vaccines cause autism, (and this has NEVER been disproved),the real figure is far far higher; in the UK one child in 64 is autistic. Vaccine damage also includes sometimes fatal seizures, and severe brain damage. Wakefield’s hypothesis of MMR linked bowel damage has also never been disproved. Even so 40,000 children sounds like a lot of ruined lives to me. Why do we ‘accept’ these human sacrifices on the alter of rich interested parties like Dr offit?? By Orac January 22, 2011 6:37 PM | Link to this Mothers and fathers refusing to vaccinate their world choking population of babies should be put in prison and their children taken away from them. In fact they should be sterilized as well. Millions of children die every year in impoverished countries from starvation and disease. Bill Gates and Ted Turner have given away billions to see to it worm infested children receive oral polio vaccines. Wakefield is a false profit just like Galileo Galilei and should be tried for sedition. By bpatient January 22, 2011 7:53 PM | Link to this Jenny Allen (like Jackie) repeated the nonsense written above by a troll who pretended to be Dr. Paul Offit, just as Katie Wright, swallowed the bait from an antivaccine troll pretending to be author Seth Mnookin. Really, it’s already clear that antivaxxers believe anything at all, no matter how nonsensical, that seems to support their anti-scienctific views, but this is getting ridiculous—there’s no need to keep proving it in this thread—just believing Wakefield is sufficient evidence. By bpatient January 22, 2011 9:41 PM | Link to this It would be useful if people (such as “Paul Offit” and “Seth Mnookin”) would stop playing rude sock puppet. That makes it difficult to tell if posters like “Jake Crosby” are imposters or simply examples of Poe’s Law. By Erwin Alber January 23, 2011 2:26 AM | Link to this I highly recommend that parents of vaccine-injured children investigate Dr Tinus Smits’ homeopathic CEASE therapy: Autism - homeopathy, vaccination and autism website Dr. Tinus Smits a way to cure serious side effects of vaccinations and autism by homeopathy and a new long-term homeopathic treatment called CEASE/Inspiring Homeopathy. www.cease-
4/4/2012 2:49 PM
Wakefield, autism researcher, subject of 3-part expose | Salud
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http://www.statesman.com/blogs/content/shared-gen/blogs/austin/health/en...
autism.com/ His wonderful book ‘Autism - Beyond Despair’ s a must-read. I also highly recommend Martin Walker’s eye-opening book ‘Silenced Witnesses Volume 2’ (Slingshot Publications) concerning the MMR/autism/Wakefield controversy. When I was reading this book, a very clear picture emerged in my mind as to who the criminals in this sorry saga are, and it isn’t Dr Wakefield and his colleagues. By Bill January 23, 2011 8:09 AM | Link to this Most flu shots contain a preservative called “Thimerosal”, which is 1/2 ethyl mercury. Mercury is extremely neurotoxic (brain damaging).[13] Aluminum and formaldehyde are also in many vaccines and are extremely neurotoxic, especially when combined. These substances have been linked to Alzheimer’s in adults and autism in children. See VacTruth.com; VaccinationDebate.com; the National Vaccine Information Center, NVIC.org, VacLib.org, NaturalNews.com, RussellBlaylockMD.com, and Tetrahedron.org By AutismNewsEat January 23, 2011 8:12 AM | Link to this What would Jim Jones say to his followers, “trust me, these 70 vaccine injections are safe”. Also, very good for my bonus salary plan. By Bill January 23, 2011 8:13 AM | Link to this Not that long ago the rate of autism was 1 in 2,500, but more recent CDC figures say that autism now afflicts 1 in 91 U.S. children and 1 in 58 boys. Many more are afflicted with the related ADD and ADHD disorders.[21] Between 1992-2002 the rate of autism rose 1,000 %, even as the number of so-called “required” childhood vaccines rose from 8 to nearly 40 (see Exemptions below). The more vaccines and thimerosal injected, the more autism, ADD and ADHD that result. By Bill January 23, 2011 8:16 AM | Link to this A recent study conducted by the University of Calgary showed that mercury ions alter the cell-membrane of developing neurons in babies and young children, directly contributing to autism.[16] Amish children are almost NEVER vaccinated and almost NEVER get autism – the ones who do have almost all been vaccinated. People who take three to five flu shots are ten times more likely to develop Alzheimers. [11][12][13][www.vactruth.com] By Bill January 23, 2011 8:20 AM | Link to this The vaccine makers attitude about protecting the public from cancer-causing substances is well illustrated by the following quote: “Carcinogenicity, we (Dr. Deborah Novicki of Novartis, another pharmaceutical company) have done no testing for the carcinogenicity of MF59 adjuvant or any of our preventive vaccines. We haven’t done it and we don’t plan to.” This information is found on a “Workshop on Adjuvants and Adjuvanted Preventative and Therapeutic Vaccines” hosted by the FDA. This gem of a quote is on page 391. [3][19] [www.vactruth.com; www.fda.gov; www.fluscam.org] By Bill January 23, 2011 8:24 AM | Link to this Your children DO NOT have to get ANY vaccinations, nor should they (see websites above). You can get an EXEMPTION by calling the Dept. of State Health Services at 512-458-7200 or 800-345-8647 or FAX 512-458-7544. They just need the child’s name, address and date of birth. You can request an exemption for reasons of conscience that will last for two years, or a medical exemption that will last for one year and requires a doctor’s signature. They may try to dissuade you, but DEMAND a general exemption form for ALL vaccines. By Broadway January 23, 2011 11:15 AM | Link to this The British Medical Journal apparently thinks enough of Mr. Deer’s work to stand behind it despite the onslaught of criticism from Dr Wakefield’s supporters. You have to give the Medical Journal credit for realizing they made a mistake backing Dr Wakefield’s findings and being big enough to admit it instead of digging in their heels. I look forward to seeing the evidence Dr Wakefield says is forthcoming. By Father of an 8-Year Old with Autism January 23, 2011 11:31 PM | Link to this I see a lot of rash comments on this board condemning parents of Autistic kids for seeking help for their children and for those who are not getting their kids vaccinated due to the concerns of shot safety. To this end I will state a few items: 1) We went to the Thoughtful House and solved our leaky gut issues. We finally got him out of diapers at age 6. Quacks or not the regular Dr.’s did not help. 2) I do not think all vaccines are unsafe. They affect some more than others and 1 in 100 is not acceptable. It changed my son’s life! They could space them, give them at a later age, test the need for them (titters testing) or eliminate some all together. 3) I have a 22 month old. It was a surprise, but no sign of Autism…Also no shots up to now. I will stay this course as a 1-100 chance of Autism worries me more than serious injury of 1 in a million with the measles. 4) If you cannot tell me what causes Autism.. then you cannot rule out the vacinations in certain kids. Just watch a TV ad for a basic drug. The ad has 75 % of
4/4/2012 2:49 PM
Wakefield, autism researcher, subject of 3-part expose | Salud
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http://www.statesman.com/blogs/content/shared-gen/blogs/austin/health/en...
its time telling you how your head could fall off or die in your sleep (exaggeration but you get the point) vaccines are typically live virus’s administered to young children… And you can claim they are 100% safe. Who are the ones with their head in the sand? I am a good dad. I love my kids. If you are a nasty poster. Get off the computer and hug your neurotypical child and be thankful. I won’t tell you how to raise them. By AutismNewsBeat January 24, 2011 11:16 AM | Link to this Broadway, the BMJ never backed Wakefield’s 1998 study. That was The Lancet, a totally different publication. By SR January 24, 2011 11:39 AM | Link to this In Europe, a cohort study of 467,450 Danish children found no association between TCVs and autism or autism spectrum disorders (ASDs), nor any dose-response relationship between thiomersal and ASDs that would be suggestive of toxic exposure. A retrospective cohort study on 109,863 children in the United Kingdom found no association between TCVs and autism, but a possible increased risk for tics. Another UK study based on a prospective cohort of 13,617 children likewise found more associated benefits than risks from thiomersal exposure with respect to developmental disorders. In North America, a Canadian study of 27,749 children in Quebec showed that thiomersal was unrelated to the increasing trend in pervasive developmental disorders (PDDs). A study performed in the US which analyzed data from 78,829 children enrolled in HMOs taken from the Vaccine Safety Datalink (VSD) did not show any consistent association between TCVs and neurodevelopmental outcomes, noting different results from data in different HMOs. It goes on and on. By Lou January 27, 2011 7:22 AM | Link to this It appears that Vitamin D Council may have figured out the root cause to autism. Check out its website and go to Autism section and read the theory of autism and vitamin D. Case reports too. Apparently, it has to do with vitamin D deficiency beginning in the mother’s womb and vitamin D is crucial for proper brain development. It is quite possible that the kids were already born with autism but remained unnoticed till vaccines making the symptoms worse where parents happened to noticed it. It seems to be always during 2nd or 3rd year. My guess is that their already low vitamin D level dipped even lower where immune system cannot function properly (very highly dependent on vitamin D for proper function). Virtually all autistic kids and their mothers tested very low so that’s much stronger link than vaccines as a possible root cause. High dose vitamin D treatment for autistic kids seemed remarkable. It’s so cheap yet they made major improvement after a month or so. Much cheaper than what Dr. Wakefield offers. By Lou January 27, 2011 7:41 AM | Link to this It appears that there’s more information about the alleged dirty plays by Deer and whoever is involved at Natural News website (naturalnews.com/031116DrAndrewWakefieldBritishMedicalJournal.html) Post a comment Commenting guidelines Name:
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Wakefield, autism researcher, subject of 3-part expose | Salud
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4/4/2012 2:49 PM
Vaccine-autism myth should be laid to rest - San Antonio Express-News
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http://www.mysanantonio.com/opinion/editorials/article/Vaccine-autism-...
Vaccine-autism myth should be laid to rest Beyond bad science, a study purporting to show link was a fraud. Express-News Editorial Board Published 12:00 a.m., Friday, January 21, 2011
The development of vaccinations that prevent the spread of communicable diseases was one of the greatest medical advances of the 20th century. Literally millions of people are alive today or living without the crippling effects of serious illness because of vaccines. Three of the biggest child killers — smallpox, diphtheria and polio — no longer exist in the United States. In 1998, however, the British medical journal Lancet published a study by Dr. Andrew Wakefield that purported to show a link between the measles-mumps-rubella vaccine and autism. Wakefield now runs an autism center in Austin. The study, however, was deeply flawed. Ten of the study's 13 authors renounced its conclusions. Last year, Lancet belatedly retracted the study, conceding it should not have been published. Now the British Medical Journal has gone a step further, publishing a report claiming that beyond being faulty, the Wakefield report was a deliberate fraud. According to the report, Wakefield received six-figure payments to falsify data from attorneys who hoped to cash in on lawsuits against pharmaceutical companies. Wakefield has denied allegations of wrongdoing and defended his work, according to numerous reports. Whether the flawed findings were intentional or not, this should be the end of the story. Unfortunately, the vaccines-cause-autism myth has gained a large and passionate following, aided in part by misguided endorsements from celebrities such as Jenny McCarthy. The science is clear — vaccines save lives. Failing to vaccinate children leaves them susceptible to debilitating and potentially fatal diseases. Aside from the damage this myth has done to public health, it has also preyed on the parents of children with autism. Worse, it has diverted scientists and funding from valuable research on autism to a fruitless search for the nonexistent links between vaccines and the disorder.
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4/4/2012 2:52 PM
Vaccine-autism myth should be laid to rest - San Antonio Express-News
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http://www.mysanantonio.com/opinion/editorials/article/Vaccine-autism-...
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4/4/2012 2:52 PM
When scientific research is flawed: Autism and vaccines | Baker Institute ...
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Baker Institute Blog Insight and analysis from the James A. Baker III Institute for Public Policy at Rice University
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When scientific research is flawed: Autism and vaccines
In 1998, Andrew Wakefield — a British surgeon and medical researcher — published a study that he claimed linked the measles, mumps, and rubella (MMR) vaccine to autism in children. This claim attracted widespread media attention and led many parents to regard the vaccines as too great a health risk for their children. Wakefield’s findings made him look, to some, like a hero. Unfortunately for Wakefield and his reputation, no other reputable study has found the same correlation between the vaccine and autism. Last month, the British Medical Journal published its own findings, and asserted that Wakefield had falsified data to support his hypothesis. If the data was indeed falsified or used in a selective manner that lacked scientific and ethical integrity, then Wakefield is guilty not only of bad science but also of public endangerment. In the years since Wakefield’s claim, others have taken his message to heart and spread it further. Almost like a rumor in high school, advocates and celebrities — public figures who believed it to be true — discussed it with almost anyone who would listen. Since 2000, measles and mumps outbreaks have been reported in western countries that had been well equipped to stave off infection through the use of the MMR vaccine. In July 2007, among other occasions, an outbreak of measles in the UK led to some fatalities. Vaccination rates in some parts of the UK dropped to 70 percent, well below previous rates of 85 percent and higher, causing unnecessary exposure to the risk of disease. The ramifications of Wakefield’s study may have also crossed the Atlantic. Just last year, the American Association of Family Physicians reported an outbreak of the mumps in New York and New Jersey. While it is entirely possible or even likely that Wakefield truly believed, or believes still, in the correlation between the vaccine and autism, no circumstance can justify the compromise of research ethics and integrity to prove a hypothesis. The general public must be able to trust every facet of a study to believe its conclusions; any amount of dishonesty calls all results into question. Though Wakefield’s research may be rightly criticized, the multiple journals and studies that have refuted his claims through honest and thorough research should be commended. They deserve praise not only for disagreeing with Wakefield’s results, but also for thoroughly retesting his data and independently concluding that his study was flawed.
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4/4/2012 3:22 PM
When scientific research is flawed: Autism and vaccines | Baker Institute ...
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http://blog.chron.com/bakerblog/2011/02/when-scientific-research-is-fla...
© 2011 Hearst Communications Inc.
The process of peer review is the best defense for misleading or incomplete research. The scientific community owes the public (which, in many cases, is its source for funding) integrity and ethical behavior in its own studies — and the scrupulous process of reviewing and questioning studies such as Wakefield’s that have ramifications to the health and well-being of society. Anything less is not science, but opinion. Greg Shipman is a graduate student at Rice University studying subsurface geoscience. He is on the professional science master’s track in the School of Natural Sciences and a student of Kirstin Matthews, Baker Institute fellow in science and technology policy. Share
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Posted by Baker Institute on February 10, 2011 at 7:32 am | Permalink | 22 Comments Categories: Science and Technology Policy, Students
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22 Responses to When scientific research is flawed: Autism and vaccines Black Lung says: February 10, 2011 at 9:12 am Mr. Shipman, I suppose that holds true for climate change research and valsified data as well?
Diogenes says: February 10, 2011 at 9:38 am
4/4/2012 3:22 PM
When scientific research is flawed: Autism and vaccines | Baker Institute ...
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http://blog.chron.com/bakerblog/2011/02/when-scientific-research-is-fla...
Flawed scientific research? You mean like Human-caused Global Warming?
Festus says: February 10, 2011 at 9:45 am Why has “journalist” Brian Deer since 2004 made a cottage industry out of attacking Andrew Wakefield? Who is paying Brian Deer’s salary? http://www.ageofautism.com/2011/01/keeping-anderson-cooper-honest-is-brian-deer-the-fraud.html
JohnGalt says: February 10, 2011 at 9:47 am Whoa, Greg, Wakefield’s research wasn’t flawed, it was outright fraudulent. Flawed is when a poor study design, or oversights, or honest mistakes make the results and conclusions questionable. What Wakefield did was premeditated: he included patients that would support his preconceived conclusion and excluded others that would not. His willful fraud has provided reasons for many parents to refuse to vaccinate their children. Children, literally, have died as a result of this fraud. It should not be classified as merely flawed.
NoEnvironuts4me says: February 10, 2011 at 10:11 am “Peer review” means generally that a paper or study has been reviewed by someone with the background/credentials to understand the method(s) used to reach the conclusions. Peer review probably would not immediately catch outright fraud. Peer review would also likely fail to catch errors/omissions if all or most of the reviewers fully agreed with the premise in the first place. (As is the case with climate researchers).
PayAttention says: February 10, 2011 at 10:19 am For those blithering on about Climate Change, note the difference: The evidence for man-made climate change is not limited to one study, and has not lacked peer review. To put it in perspective, among those who actually make their living studying climatoloty, there are more of them named “Steve” that have found the evidence compelling for man-made climate change than all of those who do not put together. There is money to be made in generating greenhouse gases, however, so these few, and a bunch of TV weather jocks who love the camera more than actual competence, get a lot of press sponsored by fossil fuel producers and power companies vested in coal.
Kelly says: February 10, 2011 at 10:42 am Andrew Wakefield is a hack and a fraud of the highest order, anyone who has taken a single course in research methods knows this. I am a social worker and practice in the autism field and it is flabbergasting how many parents hold on to these types of falsehoods instead of getting serious about their child’s needs as an adult. Society needs to spend less time and money searching for a “cure” (is there a “cure” for Down’s Syndrome or Bipolar Disorder?) and put more resources into effective service delivery programs for teens & adults on the spectrum. Yes, they DO grow up at some point!
HDad says: February 10, 2011 at 11:07 am Hold it, D. Just because you don’t like the implications of Human-Caused Global Warming doesn’t mean that the research is flawed. Multiple valid studies, peer reviews and knowledgeable consensus point to the inescapable impact of human practices on current global warming trends. Mankind is not the only source of greenhouse gases; we’re just adding such quantities and destroying the mediating systems to such a degree that we are pushing the ecosystem across a brink that threatens not the planet, which will recover, but the survival of many of the life forms (including us) currently living on the planet.
4/4/2012 3:22 PM
When scientific research is flawed: Autism and vaccines | Baker Institute ...
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Eric Berger says: February 10, 2011 at 11:32 am Welcome to the world of blogging, Greg! I would encourage you to jump right in and answer some of the questions posed here. Eric
chris says: February 10, 2011 at 11:48 am What about all the celebrities who spouted this every time they got on air? Its not like someone asked jenny mccarthy her opinion and she responded. She went out of her way to spread this gossip without verifying it, and as a result people are dead. If we are to accept that intentions don’t affect legal liability, Jenny McCarthy is no better than a pillip morris exec.
Whatever... says: February 10, 2011 at 11:58 am You’re only repeating same old stuff for a long time. Did you even bother to do a comprehensive research from both sides? Did you ever talk to Dr. Wakefield to get his side of the story? I can name a couple major screw ups by mainstream medical/science establishment… like Cholesterol and saturated fat causing heart disease myth. They never could prove conclusively that they cause heart disease even after 50 years. Read The Great Cholesterol Con by Colpo. And there’s vitamin D screw up by gov’t… we have now a widespread vitamin D deficiency that could cost us 4 trillion dollars in medical expense over the next 10 years because of badly flawed studies. Even if Dr. Wakefield turn out to be a fraud, he’s nothing compared to the examples I listed above. Get over it. Quit beating dead horse. There’s much more important things to worry about.
YOS says: February 10, 2011 at 12:02 pm the british should file criminal charges against wakefield
Lizard says: February 10, 2011 at 12:02 pm Good posts, PayAttention and HDad! By the way, Black Lung, in the case of the e-mail controversy you’re talking about surrounding the Climatic Research Unit in England, that matter has been thoroughly investigated and the investigations found that the science concerning human-caused climate change had not been altered. See: http://en.wikipedia.org/wiki/Climatic_Research_Unit_email_controversy
Kirstin Matthews says: February 10, 2011 at 12:33 pm I would disagree with previous comments that Wakefield’s research has not impacted people significantly. In our own state, the number of people who do not vaccinate their children is increasing as is the number of people getting preventable diseases such as whopping cough. While some do not have access to healthcare (which is another issue entirely), others decide to avoid vaccinations because of Wakefield’s claims (which have not held up under further scientific scrutiny) that they cause Autism in children. They are relying on others to vaccinate their children to avoid these diseases–which are severe and can even be deadly. But as the unvaccinated increase this no longer is valid. Those who are affected are our most vulnerable poputations: infants and the elderly. And as the disease spreads, it increases the chance that it will mutate or become more severe requiring new vaccines.
4/4/2012 3:22 PM
When scientific research is flawed: Autism and vaccines | Baker Institute ...
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As for the pharmacuetical companies, they do not make appreciable money for these common vaccines and are asked to sell them at a low cost so they can be used universally. Many stopped creating vaccines for fear of litigation consequences.
Whatever... says: February 10, 2011 at 12:34 pm By the way, I wouldn’t be surprised if they found a link between vaccines and autism but not the way you and others look at it. Vitamin D is gaining steam over the cause of autism. What if vitamin D deficiency is the root cause and vaccines simply aggravated unseen symptoms of autism? Vitamin D is crucial for proper brain development in the womb and also crucial for proper immune system function. What if undiagnosed autistic kids already had very low (confirmed by studies; look for it in pubmed) and you gave vaccines to them but their immune system could not handle it? Go read Vitamin D and Autism theory at this link -http://www.vitamindcouncil.org/health/autism/autism-information.shtml. “Current research has implicated vitamin D deficiency as a major factor in the pathology of at least 17 varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal disease, and more.” – http://www.vitamindcouncil.org/ Talk about hypocrisy by mainstream medical establishment. They can’t figure out when a minority group could. Not looking good on you, fella.
David says: February 10, 2011 at 12:36 pm Not only was he a fraud, he was a con man. He had a financial interest in trying to link vaccines to austism that has subsequently been discovered.
David says: February 10, 2011 at 12:38 pm Not only was he a fraud, he was a con man. He had a financial interest in trying to link vaccines to austism that has subsequently been discovered. from cnn: According to BMJ, Wakefield received more than 435,000 pounds ($674,000) from the lawyers. Godlee said the study shows that of the 12 cases Wakefield examined in his paper, five showed developmental problems before receiving the MMR vaccine and three never had autism
Greg says: February 10, 2011 at 12:41 pm First, thank you all for taking the time to read the piece. I did not expect the response. Some have mentioned other areas of study and ask my opinion on whether my sentiments on flawed and/or fraudulent research extend to them or not. I would say absolutely they do. Though I am not thoroughly versed in the “ClimateGate” case that some cited above, I would point to that as an example of why flawed (or in more severe cases outright fraudulent) research is so dangerous. The alleged selective use of data in that case potentially calls into question not only the results of that study, but in the eye of the public many more studies that may in fact be sound. This in effect is a sort of ‘boy who cried wolf’ scenario. The public hears ‘wolf’ and it turns out that single case of research is possibly not a ‘wolf’. Members of the public therefore no longer listen to any one else, some of which may actually see a ‘wolf’. This is another reason that research owes the community the utmost integrity. Studies don’t need to be questionable in reality to cause damage to the public or scientific community. They only need be questionable in perception. This I would argue holds true in all areas of research, but much more so in hot-button issues such as healthcare and climate-change. Others asked if celebrities are liable for their repeating of Wakefield’s ‘findings’. I would argue yes, but not nearly to the degree of Wakefield himself. These celebrities may have offered their opinions as if they were experts, but that did not in fact give them the credentials of an expert. If a victim (for lack of perfect wording) of this situation acted due to the words of Jenny McCarthy they have no more case against her than if someone asked a butcher, a baker, or a candlestick maker for medical advice that backfired. In other words, it is not a reasonable assumption that someone would turn to her in the first place, as it is with a medical researcher. Wakefield, however, had better credentials to gain public
4/4/2012 3:22 PM
When scientific research is flawed: Autism and vaccines | Baker Institute ...
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credibility on the issue, and as such Wakefield’s bad advice held more weight (and liability) than a celebrity’s.
JohnD says: February 10, 2011 at 12:47 pm Those interested in examining the evidence for anthropogenic climate change are encouraged to look at the series of blog posts that Dr. Nielsen-Gammon has put together explaining the topic in simple but accurate terms. In short, the effect has a good basis in both empirical and theoretical science, and has been used with great success to predict climate changes.
lil ol me says: February 10, 2011 at 12:58 pm Lizard: Wikipedia is not a valid source for anything scientific. Even people like you can edit it…. The CRU was hardly vindicated, the investigation was a total whitewash by the University who, if they had found fraud, would have lost millions of research $$. It is widely held as a scam and coverup. HDad: mankind’s contribution to atmospheric CO2 is approx 0.3%. And go understand how peer-reviewing really works before you claim any validity based on it. PayAttention: approx 100 times as much money has already been made by the promoters of AGW than by those who doubt it. Follow the money and for once, Pay Attention.
Laura says: February 11, 2011 at 6:47 am Dear Greg, If you had read Dr. Wakefield’s paper ( it was a “paper” or “case study” rather than an all out planned “study”, you would KNOW that Dr. Wakefield never claimed there was a definitive link, but that there was POSSIBLE link and it warranted further research. That’s it! Secondly, his findings of live, vaccine strain measles virus in the guts of autistic children ( but not the non-autistic controls) has been independantly replicated in 5 other studies around the world. They are listed on the website http://www.callous-disregard.com/research.htm along with other studies connecting gut disease to autism. I suggest you come down off your ivory tower and actually read what was said/researched instead of being a parrot of fashionable media who have not done their homework. Unthinking respect for Authority is the greatest enemy of TRUTH. A. Einstein Sincerely, Laura Mother to autistic child who is nearly recovered due to treating him accordingly for his medical illness, caused by vaccinosis.
JohnD says: February 11, 2011 at 9:32 am Dear Laura, If you had read anything other than Wakefield’s self-promotion, you would understand that his paper was fraudulent and his ehtics are lacking. He has experimented on children without informed consent. He has used his fraudulent research to make money. And his lies have killed people. If you are truly commited to reading the research, then look at all of it, not just the bits that agree with your world-view. There is no link between autism and vaccines, despite many many attempts by various sceintists to find one.
4/4/2012 3:22 PM
When scientific research is flawed: Autism and vaccines | Baker Institute ...
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And please remember that vaccines save lives. If we stopped using the MMR vaccine, then we could expect to see roughly 30,000 children die each year, and to have another 1,000 suffer long-term debilitating injuries (deafness, blindness, cognitive problems), and to see another 1,700,000 children sick with the diseases that the MMR vaccine prevents. Are you in favor of killing 30,000 children each year?
4/4/2012 3:22 PM
Journal editor strives to increase disease awareness - Houston Chronicle
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Journal editor strives to increase disease awareness Sunday Q&A Editor strives to increase understanding of disease ERIC BERGER , HOUSTON CHRONICLE Published 06:30 a.m., Sunday, February 13, 2011
Last week Dr. Jeffrey Drazen, editor of the New England Journal of Medicine, presented the Selma & Lois DeBakey Lecture in Biomedical Communications at The Methodist Hospital Grand Rounds. Prior to his talk, the editor of arguably the world's most influential medical journal spoke with science writer Eric Berger about the changing nature of medical publishing. Q. How selective is the journal? A. It works out that we publish about 4 or 5 percent of what's submitted. We try to find stuff that makes a big difference in understanding the biology of disease, and it turns out that's about a third of what we publish. Another third is epidemiology (the study of patterns of illness), descriptive stuff. I'm not a big fan of epidemiology — it has its place. And clinical trials makes up the other third. Clinical trials are really useful because sometimes they can inform you about the biology of a disease. Q. Andrew Wakefield, the researcher who got a fraudulent study published in The Lancet that claimed a link between autism and vaccines, recently spoke in Houston. How do you protect against those kinds of publications as an editor? A. There are two sides of Wakefield. The part where he's fabricating data, it's impossible to protect against. Nobody has the resources to go into someone's lab book to find the primary data, and depending on how hard someone wants to cheat, they can go back and fake the primary data. So unless you were there at every primary examination, how are you going to know? Q. And the other side? A. We take a very hard look at things overall. When a scientist is successful they have to pour their heart and soul into their data, and they are so passionate about this, it's more important than their kids. Our job is to look at what they really have got. With Wakefield there weren't many cases, it was a small series, the implications of the work were big. If you put your name on something people are going to believe it. What we do in our editorial process is ask, "Is it likely to be true?" And if we think it's likely to be true, "What is the implication of our publishing it?" We'll quite often not publish something which may be true, but we're not sure they're true, and the implications would be so great if it turned out to be true. So we'll step back and say we want more evidence. Q. From an East Coast perspective, what's the perception of medical research in Houston? A. There's world-class stuff going on here. There are really good people doing good work. What identifies good work is you have people who try to use the best technology to answer important questions. It doesn't require the world's best medical center to do that, it requires people who are dedicated to whatever the question is, whether it's a genetics question, a cancer question or a cardiovascular question, who mobilize the tools to do it. We try to take stuff on its merits, wherever it's from. Interestingly, if you look at the numbers, when I started 10 years ago, 70 percent of our submissions and half of our publications were from the United States exclusively. Now it's about 40 percent of our submissions and less than half of our publications are from the Untied States exclusively. Q. John Ioannidis, a respected epidemiologist, has made the claim that most published research is false. What do you think about this? A. Good medical research is on the cutting edge, right? When things are really sharply in focus it's no longer the cutting edge. So when researchers are working with things that are out of focus they're trying to see the new idea through the fog of what we believe in our head, which might be wrong, and it's not going to be right 100 percent of the time. If we waited for things to be so clear we would make much slower progress. At the same time we can't be rash about adopting stuff before it's well established. So we have to find a balance. Q. One of the ways I've noticed your journal has changed with the Internet is that you have really rushed to get studies online quickly. Is this a difficult transition for medical journals? A. For us to survive and succeed we've got to change the way people get information. I teach a course for Harvard medical students, and 15 years ago the students wouldn't have begun to think about getting all of their information on the Web. Now at the beginning of class I'll ask who wants their information on paper, and who would prefer links to the course material on a website, and that's what they want. People are changing. So we need to convey information in a way that's open and readily available. eric.berger@chron.com 53-Year-Old Mom Looks 27 Follow this 1 weird tip and remove 20 years of wrinkles in
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Journal editor strives to increase disease awareness - Houston Chronicle
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4/4/2012 3:24 PM
Levine: Wakefield was costly detour for autism research, treatment
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Levine: Wakefield was costly detour for autism research, treatment Steve Levine, Local Contributor Published: 7:54 p.m. Monday, March 7, 2011
The sad story of the fraud Dr. Andrew Wakefield perpetrated on the world's autism community lies at the intersection of my personal and professional lives. Could the latest revelations be the final chapter? As chief of communications at the Texas Medical Association, I promote the fact that physicians rely on good, hard, peer-reviewed science to make medical decisions. We endorse immunizations as safe and effective public health tools that save lives. We publicize the repeated scientific findings that find no relationship between immunizations and autism. TMA and other medical organizations have spent far too much effort combating Wakefield's fraudulent "research findings." His well-publicized but poorly documented study linked the measles-mumps-rubella (MMR) vaccine to a new pathology he called "autistic enterocolitis." Frightened that "the triple jab" would impose the horrors of autism on their normal toddlers, parents first in Britain, then around the globe, began refusing the MMR vaccine. Then all childhood vaccinations became circumspect. Infectious diseases we once had on the run are returning. Polio is back in Asia, and we have an epidemic of pertussis right here in the Austin metropolitan area. Globally, we've spent millions of dollars trying to replicate or repudiate Wakefield's findings. Those millions could have been so much better spent on finding new therapies or on furthering the promising research into other causes of autism. How many thousands of children could have been spared if scientists hadn't been forced to follow Wakefield down his deceptive rabbit hole? That's my professional role. As a father, I have a different perspective. My three children include a 21-year-old son with severe autism. Thankfully, he has a good job. But he never learned to speak, and his disability will significantly limit him for the rest of his life. Like most other parents of people with autism, I desperately want someone or something to blame for what's happened to my son. "Desperately" is the operative word. Autism has no cure. There is little that science can offer other than intensive, individualized education. That works, but it's hard work. We've run an applied behavior analysis program for our son for 15 years. He's made tremendous progress — did I say he has a job? — but he still has autism and always will. For some parents, especially young parents with once-healthy children now afflicted by an unknown evil, that prognosis is just too much to accept. They are desperate for a miracle. They desperately want a villain to blame. As King Claudius said to Rosencrantz in Hamlet, "Diseases desperate grown by desperate appliance are relieved, or not at all." And that's the tragedy of what the British Medical Journal called Wakefield's "deliberate fraud." It led desperate parents to seek those desperate appliances. Since my son was diagnosed, I've heard about so many desperate interventions for the disease. I've seen the rise and fall of facilitated communication, which claimed to unlock autistic brains through the power of the keyboard. I've seen severely restrictive diets. I've become angry at physicians who traded on parents'
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4/4/2012 3:27 PM
Levine: Wakefield was costly detour for autism research, treatment
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desperation by prescribing expensive quack cures like secretin injections. So many parents I know have spent thousands having their sons' and daughters' hair and blood analyzed for so-called micro-toxins and rare mineral imbalances. As most, but not all, of these "treatments" cause no damage, you might ask, "Where's the harm?" Just look at the waste of these children's precious time and the parents' hard-earned money. Every month squandered on these unproven, or disproven, treatments is a month of delayed applied behavior analysis. Every dollar wasted on these unproven treatments is a dollar that could have been spent on therapists who could help turn these children's lives around. I've met and spoken with Wakefield. He's a personable, charismatic man. I can see how desperate parents would fall for this pied piper. I'd like to think he didn't intentionally cause so much damage. Like so many other people with autism, my son has a hard time discerning intent. But he can see consequences. And so can I. Levine lives in Bee Cave.
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4/4/2012 3:27 PM
Letter: Vaccine, autism myths clarified : Abilene Reporter-News
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Letter: Vaccine, autism myths clarified Staff Reports Monday, August 29, 2011
Melissa Richardson, Abilene I would like to provide clarification on a recent article concerning autism in an effort to prevent any misunderstanding. The study referenced in the article was a 1998 study on vaccines conducted by Dr. Andrew Wakefield. The research was proven to be fraudulent and was retracted from the British journal in which it was published. Nevertheless, some parents continue to believe that there is a correlation between vaccines and their child's autism. Other people believe that with the discrediting of the Wakefield study, the door on research regarding vaccines and autism has been forever closed. The Interagency Autism Coordinating Committee coordinates efforts within the Department of Health and Human Services concerning autism, including drafting a strategic plan for autism research. Their Strategic Plan has approved 38 research objectives, including the following: Study the effect of vaccines, vaccine components and multiple vaccine administration in autism causation and severity through a variety of approaches including cell and animal studies and understand whether and how certain subpopulations in humans may be more susceptible to adverse effects of vaccines. Determine design and feasibility of addressing different health outcomes in vaccinated, unvaccinated and alternatively-vaccinated groups. Further information on the IACC is available at http://iacc.hhs.gov/. West Texas has taken an active role in supporting autism research. While the quest to find a cause and a cure continues, there are presently effective interventions that have been scientifically proven to impact the lives of students with autism in a positive way. In spite of budget cuts and other challenges facing our schools, students with autism will continue to benefit from these research findings, regardless of what scientists someday determine to be the cause.
Š 2012 Scripps Newspaper Group — Online
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4/4/2012 3:43 PM
Dvorak: Diseases of the past coming back, thanks to distrust of vaccines
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Dvorak: Diseases of the past coming back, thanks to distrust of vaccines Petula Dvorak, The Washington Post Published: 9:19 p.m. Saturday, Oct. 22, 2011
WASHINGTON Tents, signs, protests and chants are all the rage these days for showing our growing distrust of government and big corporations. Want to know another way that distrust is manifesting in America? Through whooping cough, measles and diphtheria. Yep. Statistics from the Centers for Disease Control and Prevention have gone totally retro, with old-school diseases coming back stronger than pencil skirts. Why? Our nation's parents have a growing distrust of vaccinations, one of medicine's greatest advances. And we're not just talking about 2 or 3 percent anymore. The fringe who didn't believe in medicine for religious and other reasons has exploded into a 10 percent, largely yuppie epidemic. A report this month in the medical journal Pediatrics says that one in 10 parents are avoiding or delaying vaccines in their children because of safety concerns. So now places such as San Diego and Minneapolis are the backdrops for mini-epidemics of deadly diseases not seen in generations. GOP presidential hopeful Rep. Michele Bachmann, R-Minn., gave wind to more anti-vaccine hysteria last month when she reported one woman's alleged horror story with the HPV vaccine, which is designed to protect girls from cervical cancer. "I will tell you that I had a mother last night come up to me here in Tampa, Fla., after the debate. She told me that her little daughter took that vaccine, that injection, and she suffered from mental retardation thereafter," Bachmann said. That's just ridiculous. The anti-vaccine movement began gaining momentum about a decade ago, when folks started to allege a link between immunization and autism, fueled by studies from a British doctor, Andrew Wakefield. It was seized on by parents desperate to find an explanation for the sharp rise in diagnoses of autism in children. The embrace of everything eco- and bio- and whole and organic also drove the rejection of stuff manufactured in a lab that is injected into your babies. And then the cause was famously taken up by actress Jenny McCarthy, who loudly went on Oprah's show and concluded that "the University of Google" confirmed that a vaccine caused her son's autism. "That woman. With the swinging blond hair and spray tan. People listened to her. They still listen to her," lamented Alexandra Stewart, who teaches health policy at George Washington University. Numerous medical studies have debunked the connection between vaccines and autism, but parental resistance keeps rising anyway. "You have someone like McCarthy out there, and then you have CDC scientists," a frustrated Stewart said.
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4/4/2012 3:47 PM
Dvorak: Diseases of the past coming back, thanks to distrust of vaccines
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http://www.statesman.com/opinion/dvorak-diseases-of-the-past-coming-b...
I asked her whether a more glamorous spokesperson would do the trick. There was a moment of silence before we both agreed on an answer: "CDC Barbie!" Barbie could put on a tiny lab coat and little white high heels to go with her pro-immunization message. That's not a far-fetched idea, given the overwhelming data parents ignore. Earlier this year, Wakefield's study was at last retracted by the British medical journal Lancet because some of the data turned out to be bogus. Still, the number of parents who won't trust shots keeps rising, primarily, Stewart said, among "white, educated populations of people with computers." Ordinarily, their kids would have to be immunized to attend school, that petri dish of boogers, drool and various germs that children produce. If you have a strong religious opposition to vaccination, or it is proved that your child would medically be harmed by a vaccine, you can opt out. In some states — California and Washington, for instance — there is also a "philosophical exemption" that allows the children of Google-educated worriers into school without shots. "We don't have that. And not allowing that philosophical exemption really helps us with our rates," said Greg Reed, who runs Maryland's Center for Immunization. Only about 1 percent of Maryland schoolchildren aren't immunized based on the limited exemption, Reed said. And the state hasn't experienced any of the old-school disease outbreaks plaguing California, Washington and other Western states. In nearby Virginia, the rates of religious exemptions have been trending upward over the past few years and now account for 1.36 percent of children who aren't immunized, said Sandra Sommer, the quality assurance and policy manager for that state's Division of Immunization. "We've been seeing a lot of vaccine hesitancy lately," Sommer said. "And part of it is that vaccines are victims of their own success." Not a lot of folks have seen kids die of diphtheria. For now, the three measles cases that Virginia had last year — "We hadn't seen that many in a long time," Sommer said — didn't become 30 or 300 because so many other children were immunized. Paging CDC Barbie ...
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4/4/2012 3:47 PM
EARLY REPORT
Early report
Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children A J Wakefield, S H Murch, A Anthony, J Linnell, D M Casson, M Malik, M Berelowitz, A P Dhillon, M A Thomson, P Harvey, A Valentine, S E Davies, J A Walker-Smith
Summary
Introduction
Background We investigated a consecutive series of children with chronic enterocolitis and regressive developmental disorder. Methods 12 children (mean age 6 years [range 3–10], 11 boys) were referred to a paediatric gastroenterology unit with a history of normal development followed by loss of acquired skills, including language, together with diarrhoea and abdominal pain. Children underwent gastroenterological, neurological, and developmental assessment and review of developmental records. Ileocolonoscopy and biopsy sampling, magnetic-resonance imaging (MRI), electroencephalography (EEG), and lumbar puncture were done under sedation. Barium follow-through radiography was done where possible. Biochemical, haematological, and immunological profiles were examined. Findings 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. All 12 children had intestinal abnormalities, ranging from lymphoid nodular hyperplasia to aphthoid ulceration. Histology showed patchy chronic inflammation in the colon in 11 children and reactive ileal lymphoid hyperplasia in seven, but no granulomas. Behavioural disorders included autism (nine), disintegrative psychosis (one), and possible postviral or vaccinal encephalitis (two). There were no focal neurological abnormalities and MRI and EEG tests were normal. Abnormal laboratory results were significantly raised urinary methylmalonic acid compared with agematched controls (p=0·003), low haemoglobin in four children, and a low serum IgA in four children. Interpretation 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.
Lancet 1998; 351: 637–41 See Commentary page Inflammatory Bowel Disease Study Group, University Departments of Medicine and Histopathology (A J Wakefield FRCS, A Anthony MB, J Linnell PhD, A P Dhillon MRCPath, S E Davies MRCPath) and the University Departments of Paediatric Gastroenterology (S H Murch MB, D M Casson MRCP, M Malik MRCP, M A Thomson FRCP, J A Walker-Smith FRCP,), Child and Adolescent Psychiatry (M Berelowitz FRCPsych), Neurology (P Harvey FRCP), and Radiology (A Valentine FRCR), Royal Free Hospital and School of Medicine, London NW3 2QG, UK Correspondence to: Dr A J Wakefield
We saw several children who, after a period of apparent normality, lost acquired skills, including communication. They all had gastrointestinal symptoms, including abdominal pain, diarrhoea, and bloating and, in some cases, food intolerance. We describe the clinical findings, and gastrointestinal features of these children.
Patients and methods 12 children, consecutively referred to the department of paediatric gastroenterology with a history of a pervasive developmental disorder with loss of acquired skills and intestinal symptoms (diarrhoea, abdominal pain, bloating and food intolerance), were investigated. All children were admitted to the ward for 1 week, accompanied by their parents.
Clinical investigations We took histories, including details of immunisations and exposure to infectious diseases, and assessed the children. In 11 cases the history was obtained by the senior clinician (JW-S). Neurological and psychiatric assessments were done by consultant staff (PH, MB) with HMS-4 criteria.1 Developmental histories included a review of prospective developmental records from parents, health visitors, and general practitioners. Four children did not undergo psychiatric assessment in hospital; all had been assessed professionally elsewhere, so these assessments were used as the basis for their behavioural diagnosis. After bowel preparation, ileocolonoscopy was performed by SHM or MAT under sedation with midazolam and pethidine. Paired frozen and formalin-fixed mucosal biopsy samples were taken from the terminal ileum; ascending, transverse, descending, and sigmoid colons, and from the rectum. The procedure was recorded by video or still images, and were compared with images of the previous seven consecutive paediatric colonoscopies (four normal colonoscopies and three on children with ulcerative colitis), in which the physician reported normal appearances in the terminal ileum. Barium follow-through radiography was possible in some cases. Also under sedation, cerebral magnetic-resonance imaging (MRI), electroencephalography (EEG) including visual, brain stem auditory, and sensory evoked potentials (where compliance made these possible), and lumbar puncture were done.
Laboratory investigations Thyroid function, serum long-chain fatty acids, and cerebrospinal-fluid lactate were measured to exclude known causes of childhood neurodegenerative disease. Urinary methylmalonic acid was measured in random urine samples from eight of the 12 children and 14 age-matched and sex-matched normal controls, by a modification of a technique described previously.2 Chromatograms were scanned digitally on computer, to analyse the methylmalonic-acid zones from cases and controls. Urinary methylmalonic-acid concentrations in patients and controls were compared by a two-sample t test. Urinary creatinine was estimated by routine spectrophotometric assay. Children were screened for antiendomyseal antibodies and boys were screened for fragile-X if this had not been done
637
THE LANCET • Vol 351 • February 28, 1998
EXHIBIT 5
EARLY REPORT
Child
Age (years) Sex
Abnormal laboratory tests
Endoscopic findings
Histological findings
1
4
M
2
9·5
M
Hb 10·8, PCV 0·36, WBC 16·6 (neutrophilia), lymphocytes 1·8, ALP 166 Hb 10·7
3
7
M
Ileum not intubated; aphthoid ulcer in rectum LNH of T ileum and colon; patchy loss of vascular pattern; caecal aphthoid ulcer LNH of T ileum
4
10
M
5
8
M
6
5
M
Platelets 480, ALP 207
7 8
3 3·5
M F
Hb 9·4, WBC 17·2 (neutrophilia), ESR 16, IgA 0·7 IgA 0·5, IgG 7
LNH of T ileum; loss of vascular pattern in rectum LNH of T lieum; proctitis with loss of vascular pattern LNH of T ileum; loss of colonic vascular pattern LNH of T ileum Prominent ileal lymph nodes
9
6
M
10
4
M
IgG1 9·0
LNH of T ileum; patchy erythema at hepatic flexure LNH of T ileum and colon
11 12
6 7
M M
Hb 11·2, IgA 0·26, IgM 3·4 IgA 0·7
Acute caecal cryptitis and chronic non-specific colitis Acute and chronic non-specific colitis: reactive ileal lymphoid hyperplasia Acute and chronic non-specific colitis: reactive ileal and colonic lymphoid hyperplasia Chronic non-specific colitis: reactive ileal and colonic lymphoid hyperplasia Chronic non-specific colitis: reactive ileal lymphoid hyperplasia Acute and chronic non-specific colitis: reactive ileal lymphoid hyperplasia Normal Acute and chronic non-specific colitis: reactive ileal lymphoid hyperplasia Chronic non-specific colitis: reactive ileal and colonic lymphoid hyperplasia Chronic non-specific colitis: reactive ileal lymphoid hyperplasia Chronic non-specific colitis Chronic non-specific colitis: reactive colonic lymphoid hyperplasia
MCV 74, platelets 474, eosinophils 2·68, IgE 114, IgG1 8·4 IgE 69, IgG1 8·25, IgG4 1·006, ALP 474, AST 50
LNH of T ileum LNH on barium follow-through; colonoscopy normal; ileum not intubated
LNH=lymphoid nodular hyperplasia; T ileum=terminal ileum. Normal ranges and units: Hb=haemoglobin 11·5–14·5 g/dL; PCV=packed cell volume 0·37–0·45; MCV=mean cell volume 76–100 pg/dL; platelets 140–400 109/L; WBC=white cell count 5·0–15·5 109/L; lymphocytes 2·2–8·6 109/L; eosinophils 0–0·4 109/L; ESR=erythrocyte sedimentation rate 0–15 mm/h; IgG 8–18 g/L; IgG1 3·53–7·25 g/L; IgG4 0·1–0·99 g/L; IgA 0·9–4·5 g/L; IgM 0·6–2·8 g/L; IgE 0–62 g/L; ALP=alkaline phosphatase 35–130 U/L; AST=aspartate transaminase 5–40 U/L.
Table 1: Clinical details and laboratory, endoscopic, and histological findings
Histology Formalin-fixed biopsy samples of ileum and colon were assessed and reported by a pathologist (SED). Five ileocolonic biopsy series from age-matched and site-matched controls whose reports showed histologically normal mucosa were obtained for comparison. All tissues were assessed by three other clinical and experimental pathologists (APD, AA, AJW).
Ethical approval and consent Investigations were approved by the Ethical Practices Committee of the Royal Free Hospital NHS Trust, and parents gave informed consent.
Results Clinical details of the children are shown in tables 1 and 2. None had neurological abnormalities on clinical examination; MRI scans, EEGs, and cerebrospinal-fluid profiles were normal; and fragile X was negative. Prospective developmental records showed satisfactory achievement of early milestones in all children. The only girl (child number eight) was noted to be a slow developer compared with her older sister. She was subsequently found to have coarctation of the aorta. After surgical repair of the aorta at the age of 14 months, she progressed rapidly, and learnt to talk. Speech was lost later. Child four was kept under review for the first year of life because of wide bridging of the nose. He was discharged from follow-up as developmentally normal at age 1 year. In eight children, the onset of behavioural problems had been linked, either by the parents or by the child’s physician, with measles, mumps, and rubella vaccination. Five had had an early adverse reaction to immunisation (rash, fever, delirium; and, in three cases, convulsions). In these eight children the average interval from exposure to first behavioural symptoms was 6·3 days (range 1–14). Parents were less clear about the timing of onset of abdominal symptoms because children were not toilet 638
trained at the time or because behavioural features made children unable to communicate symptoms. One child (child four) had received monovalent measles vaccine at 15 months, after which his development slowed (confirmed by professional assessors). No association was made with the vaccine at this time. He received a dose of measles, mumps, and rubella vaccine at age 4·5 years, the day after which his mother described a striking deterioration in his behaviour that she did link with the immunisation. Child nine received measles, mumps, and rubella vaccine at 16 months. At 18 months he developed recurrent antibioticresistant otitis media and the first behavioural symptoms, including disinterest in his sibling and lack of play. Table 2 summarises the neuropsychiatric diagnoses; the apparent precipitating events; onset of behavioural features; and age of onset of both behaviour and bowel symptoms.
Laboratory tests All children were antiendomyseal-antibody negative and common enteric pathogens were not identified by culture, microscopy, or serology. Urinary methylmalonic-acid excretion was significantly raised in all eight children who Metuylmalanic acid (mg/mmol) creatinine
before. Stool samples were cultured for Campylobacter spp, Salmonella spp, and Shigella spp and assessed by microscopy for ova and parasites. Sera were screened for antibodies to Yersinia enterocolitica.
15
10
5
p=0·003
0 Patients
Controls
Figure 1: Urinary methylmalonic-acid excretion in patients and controls p=Significance of mean excretion in patients compared with controls.
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EARLY REPORT
Child
Behavioural diagnosis
Exposure identified by parents or doctor
Interval from exposure to first behavioural symptom
Features associated with exposure
1 2 3 4
Autism Autism Autism Autism? Disintegrative disorder?
MMR MMR MMR MMR
Fever/delirium Self injury Rash and fever Repetitive behaviour, self injury, loss of self-help
5
Autism
6
Autism
None—MMR at 16 months MMR
1 week 2 weeks 48 h Measles vaccine at 15 months followed by slowing in development. Dramatic deterioration in behaviour immediately after MMR at 4·5 years Self-injurious behaviour started at 18 months 1 week
7 8
MMR MMR
24 h 2 weeks
Recurrent otitis media
11
Autism Post-vaccinial encephalitis? Autistic spectrum disorder Post-viral encephalitis? Autism
Measles (previously vaccinated with MMR) MMR
12
Autism
None—MMR at 15 months
9 10
Age at onset of first symptom Behaviour
Bowel
12 months 13 months 14 months 4·5 years
Not known 20 months Not known 18 months
4 years 15 months
18 months
21 months 19 months
2 years 19 months
1 week (MMR 2 months previously)
Rash & convulsion; gaze avoidance & self injury Convulsion, gaze avoidance Fever, convulsion, rash & diarrhoea Disinterest; lack of play
18 months
2·5 years
24 h
Fever, rash & vomiting
15 months
Not known
1 week
Recurrent “viral pneumonia” for 8 weeks following MMR
15 months
Not known
Loss of speech development and deterioration in language skills noted at 16 months
Not known
MMR=measles, mumps, and rubella vaccine.
Table 2: Neuropsychiatric diagnosis
were tested, compared with age-matched controls (p=0·003; figure 1). Abnormal laboratory tests are shown in table 1.
Endoscopic findings The caecum was seen in all cases, and the ileum in all but two cases. Endoscopic findings are shown in table 1. Macroscopic colonic appearances were reported as normal in four children. The remaining eight had colonic and rectal mucosal abnormalities including granularity, loss of vascular pattern, patchy erythema, lymphoid nodular hyperplasia, and in two cases, aphthoid ulceration. Four cases showed the “red halo” sign around swollen caecal lymphoid follicles, an early endoscopic feature of Crohn’s disease.3 The most striking and consistent feature was lymphoid nodular hyperplasia of the terminal ileum which was seen in nine children (figure 2), and identified by barium follow-through in one other child in whom the ileum was not reached at endoscopy. The normal endoscopic appearance of the terminal ileum (figure 2) was seen in the seven children whose images were available for comparison. Histological findings Histological findings are summarised in table 1. Terminal ileum A reactive lymphoid follicular hyperplasia was present in the ileal biopsies of seven children. In each case, more than three expanded and confluent lymphoid follicles with reactive germinal centres were identified within the tissue section (figure 3). There was no neutrophil infiltrate and granulomas were not present. Colon The lamina propria was infiltrated by mononuclear cells (mainly lymphocytes and macrophages) in the colonic-biopsy samples. The extent ranged in severity from scattered focal collections of cells beneath the surface epithelium (five cases) to diffuse infiltration of the mucosa (six cases). There was no increase in intraepithelial lymphocytes, except in one case, in which numerous lymphocytes had infiltrated the surface epithelium in the proximal colonic biopsies. Lymphoid follicles in the vicinity of mononuclear-cell infiltrates
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showed enlarged germinal centres with reactive changes that included an excess of tingible body macrophages. There was no clear correlation between the endoscopic appearances and the histological findings; chronic inflammatory changes were apparent histologically in endoscopically normal areas of the colon. In five cases there was focal acute inflammation with infiltration of the lamina propria by neutrophils; in three of these, neutrophils infiltrated the caecal (figure 3) and rectalcrypt epithelium. There were no crypt abscesses. Occasional bifid crypts were noted but overall crypt architecture was normal. There was no goblet-cell depletion but occasional collections of eosinophils were seen in the mucosa. There were no granulomata. Parasites and organisms were not seen. None of the changes described above were seen in any of the normal biopsy specimens.
Discussion We describe a pattern of colitis and ileal-lymphoidnodular hyperplasia in children with developmental disorders. Intestinal and behavioural pathologies may have occurred together by chance, reflecting a selection bias in a self-referred group; however, the uniformity of the intestinal pathological changes and the fact that previous studies have found intestinal dysfunction in children with autistic-spectrum disorders, suggests that the connection is real and reflects a unique disease process. Asperger first recorded the link between coeliac disease and behavioural psychoses.4 Walker-Smith and colleagues5 detected low concentrations of alpha-1 antitrypsin in children with typical autism, and D’Eufemia and colleagues6 identified abnormal intestinal permeability, a feature of small intestinal enteropathy, in 43% of a group of autistic children with no gastrointestinal symptoms, but not in matched controls. These studies, together with our own, including evidence of anaemia and IgA deficiency in some children, would support the hypothesis that the consequences of an inflamed or dysfunctional intestine may play a part in behavioural changes in some children. 639
EARLY REPORT
Figure 2: Endoscopic view of terminal ilium in child three and in a child with endoscopically and histologically normal ileum and colon Greatly enlarged lymphoid nodule in right-hand field of view. A and B=child three; C=normal ileum. Remainder of mucosal surface of` terminal ileum is a carpet of enlarged lymphoid nodules.
The “opioid excess” theory of autism, put forward first by Panksepp and colleagues7 and later by Reichelt and colleagues8 and Shattock and colleagues9 proposes that autistic disorders result from the incomplete breakdown and excessive absorption of gut-derived peptides from foods, including barley, rye, oats, and caesin from milk and dairy produce. These peptides may exert centralopioid effects, directly or through the formation of ligands with peptidase enzymes required for breakdown of endogenous central-nervous-system opioids,9 leading to disruption of normal neuroregulation and brain development by endogenous encephalins and endorphins. One aspect of impaired intestinal function that could permit increased permeability to exogenous peptides is deficiency of the phenyl-sulphur-transferase systems, as described by Waring.10 The normally sulphated glycoprotein matrix of the gut wall acts to regulate cell and molecular trafficking.11 Disruption of this matrix and increased intestinal permeability, both features of inflammatory bowel disease,17 may cause both intestinal and neuropsychiatric dysfunction. Impaired enterohepatic sulphation and consequent detoxification of compounds such as the phenolic amines (dopamine, tyramine, and serotonin)12 may also contribute. Both the presence of intestinal inflammation and absence of detectable neurological abnormality in our children are consistent with an exogenous influence upon cerebral function. Lucarelli’s observation that after removal of a provocative 640
Figure 3: Biopsy sample from terminal ileum (top) and from colon (bottom) A=child three; lymphoid hyperplasia with extensive, confluent lymphoid nodules. B=child three; dense infiltration of the lamina propria crypt epithelium by neutrophils and mononuclear cells. Stained with haematoxylin and eosin.
enteric antigen children achieved symptomatic behavioural improvement, suggests a reversible element in this condition.13 Despite consistent gastrointestinal findings, behavioural changes in these children were more heterogeneous. In some cases the onset and course of behavioural regression was precipitous, with children losing all communication skills over a few weeks to months. This regression is consistent with a disintegrative psychosis (Heller’s disease), which typically occurs when normally developing children show striking behaviour changes and developmental regression, commonly in association with some loss of coordination and bowel or bladder function.14 Disintegrative psychosis is typically described as occurring in children after at least 2–3 years of apparently normal development. Disintegrative psychosis is recognised as a sequel to measles encephalitis, although in most cases no cause is ever identified.14 Viral encephalitis can give rise to autistic disorders, particularly when it occurs early in life.15 Rubella virus is associated with autism and the combined measles, mumps, and rubella vaccine (rather than monovalent measles vaccine) has also been implicated. Fudenberg16 noted that for 15 of 20 autistic children, the first symptoms developed within a week of vaccination. Gupta17 commented on the striking association between measles, mumps, and rubella vaccination and the onset of behavioural symptoms in all the children that he had investigated for regressive autism. Measles virus18,19 and measles vaccination20 have both been implicated as risk
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EARLY REPORT
factors for Crohn’s disease and persistent measles vaccine-strain virus infection has been found in children with autoimmune hepatitis.21 We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described. Virological studies are underway that may help to resolve this issue. If there is a causal link between measles, mumps, and rubella vaccine and this syndrome, a rising incidence might be anticipated after the introduction of this vaccine in the UK in 1988. Published evidence is inadequate to show whether there is a change in incidence22 or a link with measles, mumps, and rubella vaccine.23 A genetic predisposition to autistic-spectrum disorders is suggested by over-representation in boys and a greater concordance rate in monozygotic than in dizygotic twins.15 In the context of susceptibility to infection, a genetic association with autism, linked to a null allele of the complement (C) 4B gene located in the class III region of the majorhistocompatibility complex, has been recorded by Warren and colleagues.24 C4B-gene products are crucial for the activation of the complement pathway and protection against infection: individuals inheriting one or two C4B null alleles may not handle certain viruses appropriately, possibly including attenuated strains. Urinary methylmalonic-acid concentrations were raised in most of the children, a finding indicative of a functional vitamin B12 deficiency. Although vitamin B12 concentrations were normal, serum B12 is not a good Urinary measure of functional B12 status.25 methylmalonic-acid excretion is increased in disorders such as Crohn’s disease, in which cobalamin excreted in bile is not reabsorbed. A similar problem may have occurred in the children in our study. Vitamin B12 is essential for myelinogenesis in the developing central nervous system, a process that is not complete until around the age of 10 years. B12 deficiency may, therefore, be a contributory factor in the developmental regression.26 We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunisation. Further investigations are needed to examine this syndrome and its possible relation to this vaccine.
References 1 2
3
4 5 6
7 8
9
10
11
12
13 14 15 16 17 18
19 20
Addendum: Up to Jan 28, a further 40 patients have been assessed; 39 with the syndrome.
21
Contributors A J Wakefield was the senior scientific investigator. S H Murch and M A Thomson did the colonoscopies. A Anthony, A P Dhillon, and S E Davies carried out the histopathology. J Linnell did the B12 studies. D M Casson and M Malik did the clinical assessment. M Berelowitz did the psychiatric assessment. P Harvey did the neurological assessment. A Valentine did the radiological assessment. JW-S was the senior clinical investigator.
22 23 24
Acknowledgments This study was supported by the Special Trustees of Royal Free Hampstead NHS Trust and the Children’s Medical Charity. We thank Francis Moll and the nursing staff of Malcolm Ward for their patience and expertise; the parents for providing the impetus for these studies; and Paula Domizo, Royal London NHS Trust, for providing control tissue samples.
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