Fraud’s long tail: Measles outbreak shows why it’s important to look downstream of retractions

Child with measles, via Wikipedia/CDC
Child with measles, via Wikipedia/CDC

As Retraction Watch readers know, public health officials are concerned about a U.S. measles outbreak. As The New York Times notes:

The United States has already had more cases of measles in the first month of 2015 than the number that is typically diagnosed in a full year. This follows a year in which the number of cases was several times more than the average since 2000, when the disease was declared eliminated in the United States.

As Retraction Watch readers also know, the discredited autism-vaccines link, fears of which lead some parents to skip their kids’ vaccations, rears its ugly head periodically. Much of the related anti-vaccine movement can be tied to a 1998 study in the Lancet by Andrew Wakefield and colleagues that was eventually retracted in 2010:

Following the judgment of the UK General Medical Council’s Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al1 are incorrect, contrary to the findings of an earlier investigation.2 In particular, the claims in the original paper that children were “consecutively referred” and that investigations were “approved” by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.

That study, as Retro Report explains this week in the video below, has continued to have a devastating impact on the public health:

It’s an excellent — and tragic — case study in how incorrect papers can have downstream effects, and why it’s important to follow up on such retractions.


4 thoughts on “Fraud’s long tail: Measles outbreak shows why it’s important to look downstream of retractions”

  1. It should be pointed out that according to the IOM, the MMR vaccine does have a small association with adverse events that dates back some 15 years; “The Immunization Safety Review committee concludes that the evidence favors rejection of a causal relationship at the population level between MMR vaccine and ASD (autism spectrum disorders). However, this conclusion does not exclude the possibility that MMR vaccine could contribute to ASD in a small number of children.” (2001) And in 2004, they concluded, “Considering molecular mimicry, bystander activation, and impaired immunoregulation collectively rather than individually, the committee concludes that there is weak evidence for these mechanisms as means by which multiple immunizations under the U.S. infant immunization schedule could possibly influence an individual’s risk of autoimmunity.” This from 2011: “Although it is also difficult to estimate rates for very rare conditions, the committee concluded that evidence supports the association of anaphylaxis with certain vaccines in certain circumstances, but the number of events related to each specific vaccine is not known.” While widespread public health efforts are to be lauded, and bvaccination is an important tool in public health, it should be ackowledge that certain at-risk populations are not reacting to poor science a la Wakefield, but to well-respected medical sources that point toward a need for caution in certain patient populations.

    1. I have followed the vaccine “debate” for years and have never encountered anyone on the pro-vaccination side who is not aware of the possibility of individual vaccine reactions in at-risk populations. Indeed, much of the argument for general vaccination relates to the fact that herd immunity levels are necessary to protect individuals who cannot be vaccinated for legitimate medical reasons.

      No one is accusing people who should not be vaccinated for documented medical reasons of “reacting to poor science” — the criticism is aimed at people whose children are not in high risk groups vis-à-vis vaccines and nevertheless choose not to vaccinate them.

      To say that this “should” be pointed out is to 1) ignore the fact that vaccine supporters are constantly pointing out that herd immunity is necessary *because* some patient populations cannot be vaccinated without taking in significant personal risks and 2) imply that declining immunity levels in certain communities are the result of at risk groups forgoing vaccination, rather than what is actually happening — parents declining to vaccinate their otherwise-healthy children.

      1. Points well taken; however what gets lost amongst highly polarized.discussions are the zebras. I am one. I am a healthcare worker and never refuse vaccination, nor am I anti-vaccination. However, six months ago I wS diagnosed with mastocytosis. As such, my complacency about the safety of vaccines has evaporated. I was over 50 before I was correctly diagnosed. I am the 1%. Things look different from my perspective.

    2. It should also be pointed out that “does not exclude” is not equivalent to “does prove.” That statement is not support for a link between vaccination and ASD; it’s merely an example of an organization trying to cover all their bases to avoid any kind of controversy or blame.

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