BMJ Declares Vaccine-Autism Study ‘an Elaborate Fraud


Jan. 6, 2011 — The medical journal BMJ has declared the 1998 Lancet study that implied a link between the MMR vaccine and autism “an elaborate fraud.”

Fiona Godlee, MD, BMJ’s editor in chief, says in a news release, “The MMR scare was based not on bad science but on a deliberate fraud” and that such “clear evidence of falsification of data should now close the door on this damaging vaccine scare.”

MMR-Autism Study

In 1998, the Lancet published a research paper by Andrew Wakefield, MD, and colleagues suggesting a connection between the MMR (measles, mumps, and rubella) vaccine and bowel disease and autism. It received worldwide media coverage and led many people, especially parents, to question the safety of the vaccine.

In 2004, 10 of the 13 authors of the research paper retracted their interpretation of their findings.

In January 2010, the UK’s General Medical Council (GMC) ruled that Wakefield had acted “dishonestly and irresponsibly.”

The Lancet retracted the paper in February 2010, accepting that the claims made in it were false.

In May 2010, Wakefield was found guilty of serious professional misconduct by the GMC and was struck off the medical register.

Accusations of Fraud

In a series of three articles, the BMJ reveals what it says is the true extent of the scam behind the scare. The series is based on interviews, documents, and data collected during seven years of inquiries by award-winning investigative journalist Brian Deer.

Thanks to the recent publication of the General Medical Council’s hearings transcript, the BMJ was able to peer-review and check Deer’s findings and confirm extensive falsification in the Lancet paper.

Seven years after  he first looked into the MMR scare, Deer shows how Wakefield was able to manufacture the appearance of a medical syndrome, while not only in receipt of large sums of money, but also scheming businesses that promised him more.

The first of the BMJ articles says Wakefield’s fraud “unleashed fear, parental guilt, costly government intervention, and outbreaks of infectious disease.”

Vaccination Levels

MMR vaccination rates in the United States were at 90% in 2009, according to the most current statistics from the CDC. These rates are still below the 95% level recommended by the World Health Organization.

Diverted Resources

In an editorial, Godlee, BMJ Deputy Editor Jane Smith, and leading pediatrician and Associate Editor Harvey Marcovitch conclude that there is “no doubt” that it was Wakefield who perpetrated this fraud. They say: “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.”

Yet he has repeatedly denied doing anything wrong, they add. “Instead, although now disgraced and stripped of his clinical and academic credentials, he continues to push his views. Meanwhile the damage to public health continues.”

But they say perhaps as important as the scare’s effect on infectious disease is the energy, emotion, and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it.

Wakefield Responds

Wakefield told CNN his work has been “grossly distorted” and claims he’s been the target of “a ruthless, pragmatic attempt to crush any attempt to investigate valid vaccine safety concerns.”

An Antibiotic for Irritable Bowel Syndrome?


Symptom relief was better with rifaximin than with placebo.

Antibiotic use has been suggested to treat patients with irritable bowel syndrome (IBS), particularly for cases that are difficult to treat or are accompanied by bloating. One antibiotic that has shown efficacy in small IBS studies is rifaximin (JW Gastroenterol Oct 16 2006), a minimally absorbed, oral agent that has activity against gram-positive and gram-negative bacteria, anaerobes, and Clostridium difficile and is indicated for Escherichia coli–related travelers’ diarrhea and reduction of risk for hepatic encephalopathy.

To further test whether rifaximin can relieve IBS symptoms, investigators conducted two industry-supported, identically designed, double-blind, randomized, placebo-controlled trials involving a total of 1260 patients who had IBS without constipation. Patients received either rifaximin (550 mg 3 times daily) or placebo for 2 weeks and were followed for an additional 10 weeks. The primary endpoint was adequate relief of global IBS symptoms (patient-reported relief of symptoms for at least 2 of the first 4 weeks after initiation of treatment). A secondary endpoint was adequate relief of IBS-related bloating.

In the two studies combined, a higher proportion of participants in the rifaximin groups than in the placebo groups experienced adequate relief of global IBS symptoms (40.7% vs. 31.7%; P<0.001) and adequate relief of bloating (40.2% vs. 30.3%; P<0.001). Similar therapeutic gains were achieved in reducing IBS-related abdominal pain and loose or watery stools. Responses to rifaximin were sustained throughout follow-up for adequate relief of both global IBS symptoms and IBS-related bloating.

Comment: These two studies provide strong evidence that rifaximin improves symptoms in IBS patients who do not experience constipation. The principal downsides of rifaximin therapy would be its high cost and the unknown consequences of using an effective nonabsorbable antibiotic in large numbers of patients. Many other approaches are used for IBS patients who do not have constipation — including fiber supplementation, antimotility drugs, antispasmodics, probiotics, and, in more-severe cases, agents that alter visceral sensitivity (such as tricyclics and selective serotonin reuptake inhibitors). Responsible clinicians will likely balance these factors, together with consideration of the symptom complex and severity of symptoms, in deciding when rifaximin treatment is warranted.

Douglas K. Rex, MD

Published in Journal Watch Gastroenterology January 7, 2011