Thursday, January 06, 2011

Bad Science Kills Babies

When Pre-Schooler Anonymous was born, nearly four years ago, we at the Egg spent a lot of time talking to other newish parents. One of the hot subjects, in our baby-mad neighborhood, was the choice of a pediatrician. This was treated with the level of intensity that in our experience rarely accompanies the choice of a college or a spouse. Both in person and on the interwebs, parents would grill each other on Dr. So-and-So's perceived style and competence. "Which hospitals is she connected to? Does she have separate waiting rooms for healthy children and sick ones? Does she listen when you talk?" That sort of thing.

These are all reasonable questions. But then, very quietly, there was the other question: How does she feel about ... vaccinations?

It turned out that quite a number of our friends -- including some exceptionally smart, loving and otherwise responsible parents -- were dead set against providing their children with the usual gantlet of shots in the bottom. Since these shots are required by the school system, this meant finding doctors who would follow the old proposal to "let's not, and say we did." In other words, they needed doctors who would fake the paperwork.

We didn't choose one of those doctors. Quite the contrary. When we delicately broached the subject with out pediatrician, he gave us a long and very unhappy speech on why Phil Donahue was killing babies. (As older parents, we had some idea who Phil Donahue had been, but we wondered whether he shouldn't update his speech to include Jenny McCarthy or Robert Kennedy Jr). The key thing was that he also mentioned something we had come across ourselves, a massive study in Denmark which disproved the supposed link between MMR vaccines and autism.

As we looked into the question, two important points came through to us: (1) that the anti-vaccine crowd was passionate, but seemed to have more anecdotal than statistical evidence; and (2) that, as in most matters of public health, it is important that everybody take part in the preventive measures. To really keep a neighborhood safe from measles, mumps or rubella, it isn't enough to just give your own kid the (partial) protection of a vaccine; everybody else has to do likewise. Which means that the anti-vaccine types, and the doctors who enable their fraud, are not just putting their own kids at risk, but everybody else's, too.

Comes now this series of articles in the British Medical Journal, which for some irritating reason prefers to call itself merely BMJ. It's disturbing stuff.

One of the main scientific supports of the anti-vaccine movement was a 1998 Lancet paper by Andrew Wakefield and numerous other authors. It claimed to find strong evidence of a correlation between vaccines and developmental disabilities, and "triggered a decade-long public health scare." It was based on a small group -- 12 patients, versus the half-million in the Danish study. But still, it was science. And in the Lancet.

It was also completely bogus. Fake, phony, fraudulent.

Reporter Brian Deer describes his investigation into the paper, which resulted in its retraction by the Lancet and disavowal by 1o of the 12 authors. To make a long story short, he found that the evidence was reported selectively and inaccurately. As the BMJ editors describe it:

Deer unearthed clear evidence of falsification. He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal.

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. Moreover, ... [an investigating] panel found him guilty of dishonesty concerning the study’s admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards.

Prince of a guy, right? And yet he keeps going: "... although now disgraced and stripped of his clinical and academic credentials, he continues to push his views." And some people still listen. We imagine it's analogous to the occasional clergyman who, caught in some massive indiscretion, simply denies any guilt and counts on the irrational confidence placed in him by his well-conditioned followers.

Here's why it matters:
Although vaccination rates in the United Kingdom have recovered slightly from their 80% low in 2003-4, they are still below the 95% level recommended by the World Health Organization to ensure herd immunity. In 2008, for the first time in 14 years, measles was declared endemic in England and Wales. Hundreds of thousands of children in the UK are currently unprotected as a result of the scare, and the battle to restore parents’ trust in the vaccine is ongoing.
The situation in the US may be different, but experience makes us wonder how different. And when the coverage isn't adequate, kids get sick. Measles, mumps and rubella are all serious. They can lead to pneumonia, brain damage, birth defects, even death. The CDC reports hundreds of preventable deaths and thousands of preventable illnesses every year because parents have been frightened by bad science.


Pastor Joelle said...

Sometimes I think we share a mind...I was going to blog on this...drives me CRAZY. There was a parent on CNN they interviewed "Well I feel that vaccine causes autism and this doesn't change anything."

WELL I FEEL LIKE THE MOON IS MADE OUT OF CHEESE AND EVERYONE SHOULD PAY ME RENT FOR IT!!! I feel it so I don't have to pay any attention to anything that proves otherwise ARGH!!!!!!!!!!!!!!!!!!!

Kate the Great said...

Not vaccinating your kids is one thing, but finding a doctor to fake the paperwork so you can have your cake and eat it, too? HORRENDOUS. I'm giving every parent in Astoria the side-eye from now on.

Mark said...

Unfortunately, it's not just the MMR vaccination that's been falling behind. The hysteria caused by this fraud often simply rejects vaccinations of any sort. And it seems for some it had/has become like an article of faith.

Several years ago at a precinct caucus, an anti-vaccine resolution was brought forward. This was in a precinct with a heavy population of professionals and other well educated people (including many who worked in academia). The most cogent responses of people who could argue from facts and with sound reasoning had basically no impact on those who thought this was a serious thing and who believed this was firmly established. The discussion got heated. Anti-intellectualism abounded. (You can guess which side.) Ultimately, and thankfully, the resolution was soundly defeated. Still, it was a strange thing.

What makes me particularly upset about this anti-vaccine crankery, is that it has real and dangers affects for themselves, their children, and for others.