Lancet Backtracks

In 1998, Andrew Wakefield, MD, published an article in the prestigious British medical journal Lancet, allegedly claiming there was a connection between the Measles-Mumps-Rubella (MMR) vaccine for children, and the occurrence of autism.  Twelve years later, Lancet has retracted this article.

I have long been skeptical of any connection between vaccinations and autism.  It would be fairly simple to look back and find it, if it existed.  In the so-called developed countries, adequate records are kept that would make it possible to identify a statistical connection.

Dr. Wakefield's article may have made such a statistical connection.  I don't have access to the article, so I can't say.  Assuming that it did make such a connection, it remained an isolated claim that, to my knowledge, was not verified by other researchers.

As might have been expected, Dr. Wakefield's article touched off a furor.  The medical profession tended to dismiss the paper.  The lay public accepted Dr. Wakefield' claim, and hailed him as a courageous dissenter.  Millions of parents agonized over whether to get the vaccine; many decided it wasn't work the risk.

I'd never have entertained the possibility that MMR vaccine was related to autism, had Lancet not retracted the article.  It is common for some research to remain unverified.  Mistakes are made all the time.  Promising initial results are found not to be confirmed by other researchers.  Retractions are rarely made because of this.

Now that Lancet has retracted this article, I have to ask myself, "why?"  Surely this is not the only mistaken article they've published over the years. There must have been dozens, perhaps hundreds of other articles that turned out to be unverified, since Dr. Wakefield's.   Why was his chosen for retraction, over all the others?  What makes his so special?

Could it be that the drug companies "got" to Lancet, persuading them to retract the article?  After all, vaccine sales dropped precipitously when the article came out.  Drug companies were hurt - or at least, their unconscionable profits were slightly decreased.  Maybe they "encouraged" Lancet to retract the article.  While this vaccine represented a trivial percentage of total drug profits, the companies may have feared a "slippery slope".  If one drug can be criticized, why not others?  That could set a bad precedent.

I wonder how much of Lancet's revenue comes from ads placed by drug companies.  If they're like other medical publications, their very existence probably relies on these ads.  I could not rule out the possibility that Lancet caved in to pressure from the drug companies, perhaps threatening to stop advertising in their journal.  That would likely be a disaster.

I hasten to add that it is entirely possible that Lancet is a wholly ethical, objective publication that cannot be subverted by drug companies or anyone else.  Lancet is considered one of the most prestigious medical publications in the world - perhaps the most prestigious.  They would likely stand firm against pressures that might cause a lesser publication to fold.

The problem isn't that we know Lancet has been bought.  The problem is that we don't know that it hasn't.  How objective can a publication be, when its existence relies upon the same drug companies that are being discussed in the articles?

In many professions, being paid by those you are evaluating is considered a conflict of interests.  If Big Oil is paying for research, your results are likely be more favorable to Big Oil, than if Greenpeace is signing your checks.   If you continue to find flaws with Big Oil, they'll stop paying you.

As long as Lancet - and the other medical publications - survive primarily on ads by pharmaceutical companies, there will remain a serious question of whether these journals are objective.