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Andrew WakefieldDr. Andrew Wakefield (born 1957 in the United Kingdom) is a Canadian trained gastroenterologist best known as the lead author of the controversial 1998 clinical research study, published in the Lancet, which suggested measles may trigger the onset of autism and bowel disease in a small proportion of children. Early career After qualifying as a surgeonin 1981, Dr. Wakefield began his professional career in Canada specializing in bowel resection surgery. Wakefield became a fellow of the Royal College of Surgeons in 1985, and returned to the UK in the late 1980s. As his career turned toward research in the late 1980s, Wakefield began to notice the significant increase of irritable bowel disease among children. During this period he published a number of studies which, he believed, suggested a link between measles and Crohn's disease, a form of inflammatory bowel disease (IBD). This led him to criticise early versions of the MMR, which contains live measles virus, on UK television in 1995 and 1996. Meanwhile, Wakefield became a senior lecturer at the Royal Free Medical School in north London. During the mid-1990s, while conducting research associated with his practice of medicine at the Royal Free Hospital in London, Dr. Wakefield began to consider whether there was any connection between measles and the onset of autism and bowel disease. In February of 1998, Wakefield's research team published its soon-to-be controversial study involving 12 autistic children who had been referred to Wakefield at the Royal Free Hospital in Hampstead for gastrointestinal problems. The report was published in the Lancet medical journal. http://briandeer.com/mmr/lancet-paper.htm Rather than a relatively formal scientific paper, the study findings were published as a clinical report, in the classical mode. Although the authors stressed that a causal connection was not proven, the report did focus on the description of a possible new syndrome, involving a potential link between bowel disease and autism. The report also pointed out that parents of eight of the twelve children said that behavioral problems began within two weeks of vaccination with MMR. In any case, the study was not about the triple jab for the measles, mumps and rubella (MMR) vaccine, as it later was commonly believed. Only later did the MMR vaccine, which contains attenuated doses of the measles Moraten strain, the mumps Jeryl Lynn strain, and the rubella RA27/3 strain, become the only choice available within the UK health care system. The MMR controversy In February 1998, at a press conference and in a video news release http://briandeer.com/wakefield/royal-video.htm issued by the hospital, Wakefield said "(T)here is no doubt that if you give three viruses together, three live viruses, then you potentially increase the risk of an adverse event occurring, particularly when one of those viruses influences the immune system in the way that measles does. And it may be, and studies will show this or not, that giving the measles on its own reduces the risk of this particular syndrome developing." He suggested that parents should opt for single jabs against mumps, measles and rubella instead, separated by gaps of one year. Despite Wakefield's warning, the British government decided to adopt use of a new version of MMR the next year. In 1999, a newly introduced vaccine intended to protect against rotavirus was suspended, following reports that 23 infants suffered collapsed bowels soon after they received that immunization. Even so, British and international medical authorities united to dismiss Dr. Wakefield's warnings about the MMR's association with bowel disease, scorning his research as worthless while insisting the triple vaccine was quite safe. In early 2001, based on concerns over the newly recognized syndrome linking measles with autism and bowel disorders, Dr. Wakefield was prompted to reiterate his warning that that the MMR would increase potential risks, since the the government blocked access to single jab alternatives. Dr Wakefield again suggested that parents should opt for single jabs against mumps, measles and rubella instead - echoing the sentiment of the Hippocratic oath, which begins, "First, do no harm." His repeated warnings, and the media attention they received, led to a drop in the number of children receiving the live strain MMR, as had been predicted in a letter to the government by Wakefield's chief at the hospital http://briandeer.com/wakefield/roy-pounder.htm. In retrospect, Wakefield later lamented, "What precipitated this crisis was the removal of the single vaccine, the removal of choice, and that is what has caused the furor - because the doctors, the gurus, are treating the public as though they are some kind of moronic mass who cannot make an informed decision for themselves." In December of 2001, Wakefield resigned under pressure just a month after becoming a fellow of the Royal College of Pathologists in recognition of his research work. Wakefield responded by saying "I have been asked to go because my research results are unpopular." One day before Wakefield's departure, a study that began the process of confirming his findings hit the news. A team of researchers in the US, led by Dr. Vijendra Singh, had analyzed blood samples from 125 autistic children and 92 children who did not have autism. Dr Singh's team found a protein band, as analyzed with monoclonal antibodies, that was immunopositive for measles hemagglutinin (HA) protein, in 75 of the 125 (60%) of the autistic children. Singh had found antibodies showing an abnormal reaction to the measles component of the MMR vaccine. None (0%) of the non-autistic children showed the unusual antibody response. However, Peter Lachmann, Emeritus Professor of Immunology at Cambridge, and other vaccine proponents have said the conclusions drawn by Dr. Singh and his team did not constitute a direct link between MMR and autism. The abnormal immune response found by Singh appeared to establish a link between measles antibodies and autism, suggesting the antibodies produced an autoimmune response that prevented nerves from developing properly, thereby affecting brain functions. A separate study by another research team found evidence of measles virus in the spinal fluid of 19 out of 28 children with autism compared with one out of 37 children in a control group. Since Singh's study, there have been several more studies replicating Wakefield's seminal findings, and other researchers have come forward to confirm their own findings of high incidence rates of measles in the gut of children with Crohn's. Aftermath In February of 2004, controversy resurfaced. Wakefield was accused of a conflict of interest. The Sunday Times reported that four or five of the 12 children in the Lancet study were part of an ongoing legal action involving another concurrent, legal aid-funded, study in which Wakefield had participated. The Times implied the children were selected for the Lancet study because they were litigants with a financial interest in the results of the clinical examinations conducted for the second study http://briandeer.com/mmr/lancet-deer-1.htm. The Legal Services Commission subsequently cut off legal aid funding for the parents, derailing the litigation. Actually, it was the litigants who had sought treatment for their children from Wakefield, because of his reputation, well before any of them decided to join the suit. Following publication of the allegations, 10 of Wakefield's 12 co-authors of the Lancet paper published a "retraction of an interpretation". Critics of the retraction point out that their reversal stemmed from the disproven conflict of interest allegations, and was a reflection of political pressure, rather than any dispute with the essential findings of their report. The UK's Channel 4 Television aired further allegations made by Sunday Times writer Brian Deer, that before the Lancet paper was published, Wakefield had filed a patent application http://briandeer.com/wakefield/vaccine-patent.htm for a single measles vaccine, and that Wakefield's laboratory had failed to find measles virus in the children. http://briandeer.com/wakefield/nick-chadwick.htm The UK's General Medical Council is investigating the allegations.http://briandeer.com/wakefield/gmc-announce.htm Meanwhile, increasing numbers of parents with autistic children have come forward to tell of how their children were progressing normally, until administration of the MMR, and of how afterwards their development promptly regressed while they also suffered digestive problems and food intolerances. Wakefield's critics point out that such an association is merely coincidental, as autism is commonly diagnosed early in the second year of life, when administration of the MMR vaccination is routine. The Institutes of Medicine (IOM) along with the CDC, NIH, and FDA (and their British counterparts) continue to deny any link exists between vaccines and autism. The NIH has not funded studies to replicate the clinical science of Dr. Singh and Dr. Wakefield. None of the agencies have offered an explanation for why children with autism have elevated measles antibody titers, measles in the gut, measles in the spinal fluid or positive test results for myelin basic protein antibodies. The governments' case rests on epidemiological evidence. Rather than examining individual children possibly harmed by MMR, such evidence is based on patterns of disease in the general population. All epidemiological analysis reports have concluded there is no evidence of any link between MMR and autism or bowel disease. Despite this, the new syndrome identified by Wakefield has gained wider acknowledgement. Wakefield has recently commented on a new epidemiological report from Japan that concluded no correlation between vaccines and autism was evidenced. However, the Japanese data shows a striking dip in autism rates when public confidence in vaccines, especially in MMR, fell. Autism rates had risen 85.9 per 10,000 for children born in 1990 in Japan, but then dropped to 55.8 per 10,000 for children born in 1991 when MMR uptake was falling before its total withdrawal from the Japanese market. Autism rates soon rose again, when the Japanese public started to accept three separate vaccines. Wakefield suggested that, since the separate vaccines were given four weeks apart, or less, it was the same as being given MMR. Thus, the "dip" in autism rates happened when the children were not receiving the vaccines in any form, indicating the opposite of the conclusion suggested in the paper. See also External links Wakefield, Andrew Wakefield, Andrew [[Category:British scientists|Wakefield, An
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