...The cut-throatism and backstabbing in the medical establishment, as depicted in this book, is rather frightening!....It is difficult not to feel sorry for Wakefield and Horton.....One cannot help feeling that Horton enjoyed romping in the woods until he discovered that the woods were full of big bad wolves....a good, thought provoking read...
MMR Science & Fiction, Exploring the vaccine crisis by Richard Horton. Softcover, 7.6" x 5.1" x 0.8".
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Granta Publications, 2/3 Hanover Yard, Noel Road, London N1 8BE, United Kingdom. Tel: +44 (0) 207 704 9776. Fax: +44 (0) 207 704 0474. Email: firstname.lastname@example.org. Publication Date Sep 16, 2004. 160 pages, ISBN-10: 1862077649. ISBN-13: 978-1862077645. Retail Price: £7.99. Web Price: £6.39 (20% off)
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To understand what this book is about it is necessary to understand the background of the so-called MMR vaccination scandal. It is also important to know that Richard Horton is the editor of the prestigious medical journal, The Lancet .
On February 28, 1998, a five-page research paper by Dr Andrew Wakefield and 12 other doctors from the Royal Free Hospital London was published in The Lancet, apparently linking the measles, mumps and rubella vaccine (MMR) with autism.1 This one paper triggered a world-wide "scare" over the vaccine's safety and resulted in falls in children's immunisations.
On the 6th of March 2004 the Lancet (vol 363, no 9411) published a retraction written by 10 of the original 13 authors2 (two authors - Andrew Wakefield and Peter Harvey declined to retract, while John Linnell could not be contacted), which caused considerable discomfort to the proponents of the MMR vaccine-autism link. The following is an extract from the letter of retraction.
"We wish to make it clear that in this paper no causal link was established between MMR vaccine and autism as the data were insufficient. However, the possibility of such a link was raised and consequent events have had major implications for public health. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon these findings in the paper, according to precedent."
What triggered this retraction?
Ten days before, The Sunday Times, a prestigious British newspaper, had exposed what appeared to be a conflict of interest on the part of Andrew Wakefield. An investigative journalist by the name of Brian Deer wrote the piece.
The newspaper revealed that Wakefield had received funding from the Legal Aid Board, several years previously, to conduct his research on behalf of parents who believed that their children had been damaged by MMR and who were seeking compensation. Wakefield had not declared this conflict of interest when he submitted the paper, although it is clear editorial policy that all interests should be declared.
The Lancet correctly anticipated that it would be in the firing line: "A press statement from the Lancet, issued the Thursday before Deer's article was published and making no mention of the Sunday Times, expressed "regret" that this funding was not disclosed." (BMJ)
According to Deer he had discussed the matter in confidence with Dr. Richard Horton, the editor of The Lancet and Horton's jumping the gun was just not cricket! (In journalistic terms Horton's action could be described as a "spoiler" which should have been familiar to Deer.)
Since the memorable retraction, Wakefield's career at the Royal Free Hospital has been ruined. Richard Horton took a certain amount of flak but survived to write this book. The cut-throatism and backstabbing in the medical establishment, as depicted in this book, is rather frightening!
As might be expected, and under the circumstances, this is Richard Horton's views on the whole sad episode. Horton of course blames everyone but himself, but to be fair to him, he analyses Wakefield's paper in a manner in which was never analysed. For instance Wakefield never actually wrote that there was a link between MMR vaccine and autism but merely mentioned this at the press conference. There is also no firm evidence that Wakefield selected his subjects with bias.
In fact what the original paper attempted to say was that 'measles virus may play a part' in causing inflammatory bowel disease. This message was of course lost in the press treatment of the paper.
One good thing to come out the whole sorry business 'was the enormous public interest generated about financial conflicts of interest in science' says Horton in his book. In this at least he is probably correct. He goes on to analyse the malign influence of financial conflicts of interest in medical research today.
It is difficult not to feel sorry for Wakefield and Horton. There is no doubt Horton was doing his best for The Lancet . However, one cannot help feeling that Horton enjoyed romping in the woods until he discovered that the woods were full of big bad wolves.
The book has no doubt been hurriedly brought out in the wake of the retraction of Wakefield's paper. It is nevertheless a good, thought provoking read.
Readers are informed that the royalties from the book are to be donated to the Autism Intervention Research Trust.
(1) 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 Feb 28;351(9103):637-41. Partial retraction in: Murch SH, Anthony A, Casson DH, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Valentine A, Davies SE, Walker-Smith JA. Lancet. 2004 Mar 6;363(9411):750. (Back to [citation] in text)
(2) Murch SH, Anthony A, Casson DH, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Valentine A, Davies SE, Walker-Smith JA. Retraction of an interpretation. Lancet. 2004 Mar 6;363(9411):750. Partial retraction of: 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. Lancet. 1998 Feb 28;351(9103):637-41. (Back to [citation] in text)
-Review by Gyan Fernando
Gyan Fernando is a forensic pathologist in Devon UK and has experience of clinical forensic medicine in his younger days having once worked as an FME for a Scottish police force. He has avidly followed the MMR controversy right from the beginning. Dr. Gyan Fernando may be contacted via Email by clicking here
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