Andrew Wakefield Fights to Win Back Medical License

With all the attacks against de-licensed British doctor Andrew Wakefield by the scavengers of the media, one thing that gets lost is the fact that the findings on which the retraction of his paper and revocation of his medical license were based have been completely overturned. Wakefield is now looking to get his medical license back that the UK’s General Medical Council had taken from him over five years ago.

When faced with the fact that the findings used to justify the retraction were effectively disproved, the ombudsman of The Lancet – the journal that retracted Wakefield’s paper – Dr. Malcolm Molyneux admitted:

The retraction then mentions the enrolment [sic] procedure and ethical clearance, but implies that there remain other elements on which the decision was based.

The only accurate way to interpret Molyneux’s answer is that he tacitly acknowledges that the findings specifically mentioned to justify the paper’s retraction were overturned, but does not want to do anything about it or even revise the journal’s retraction statement. When pressed on what those “other elements” were that justified the paper’s retraction, Molyneux did not respond further.

Now that Andrew Wakefield is screening a film on the government’s cover-up of vaccines causing autism at the Tribeca Film Festival, I only wish he would include the unwarranted retraction of his paper in his Tribeca bio. I have been quite disappointed in Wakefield – from saying he insists on GMC’s witch trial against him and his colleagues to giving an interview with the pharma-conspiring New York Times, he has truly proven himself to be clueless about how to handle the scavengers’ attacks on him. Look at how pathetic his Tribeca film bio is:

Andrew Wakefield, MB.BS., is an academic gastroenterologist who practiced medicine at the Royal Free in the U.K. publishing over 140 scientific papers. In 1995, he was contacted by parents of autistic children with stomach issues; he learned that these conditions often occurred immediately following an MMR vaccine. In pursuit of this possible link, Dr. Wakefield led an initial study of twelve children with both stomach and developmental issues. The report, published in The Lancet, would catapult Wakefield into becoming one of the most controversial figures in the history of medicine. Vaxxed: From Cover-up to Controversy is his second film.

This is what it should really say:

Andrew Wakefield, MB.BS., is an academic gastroenterologist who practiced medicine at the Royal Free in the U.K. publishing over 140 scientific papers. In 1995, he was contacted by parents of autistic children with stomach issues; he learned that these conditions often occurred immediately following an MMR vaccine. His initial study of these children was retracted by The Lancet and his medical license was revoked because of disproved disciplinary findings that have now been completely overturned on appeal. Vaxxed: From Cover-up to Controversy is his second film.

Wakefield tells Autism Investigated that he is trying to get his medical license back, which is all the more appropriate now that the findings against him have been completely overturned by his colleague’s appeal. Yet he has never commented on whether he will even make a public statement about it. He most certainly should, especially now that his documentary on the CDC whistleblower story that he hijacked is being screened at Tribeca.

Update: Tribeca Film Festival pulled the documentary: “The Festival doesn’t seek to avoid or shy away from controversy. However, we have concerns with certain things in this film that we feel prevent us from presenting it in the Festival program. We have decided to remove it from our schedule.”

Footage from the film includes surreptitious recordings of Dr. William Thompson’s voice leaked by Wakefield as well as a silhouetted actor posing as Dr. Thompson.

Addendum: Last January, Autism Investigated sent the following question to the General Medical Council: “How do you justify keeping Dr. Andrew Wakefield de-licensed when all your findings against him have been overturned on appeal by his colleague, Prof. John Walker-Smith?”

The GMC replied with a signed letter that did not address the findings themselves, but did conclude: “a doctor can apply for restoration to the register in certain circumstances. We would then consider the doctor’s application, along with any further supporting evidence they provide, and determine whether to grant restoration to the register.”

More than five years has elapsed since Dr. Wakefield’s erasure, making him eligible to apply. Once he does, the GMC will have to consider his application along with “any further supporting evidence” he provides.

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46 Thoughts on “Andrew Wakefield Fights to Win Back Medical License

  1. Eddie Unwind on March 27, 2016 at 12:42 am said:

    However – as you would now be well aware – Wakefield’s film is not being screened at Tribeca, but I understand has just been pulled. Personally I have no clue as to what angle to take except to assume that De Niro and his crew simply bowed under the pressure of an avalanche of hostile attacks through social media, and perhaps also via ones that we don’t hear about.

    I would agree that, as others have noted, it is very difficult – given what we know (i.e. De Niro’s statement) – to imagine that De Niro hasn’t had a private screening of the film himself. Moreover he would have to be pretty out of touch to imagine that the screening of such a film for his Tribeca would not draw a mountain of hostility and criticism, so in other words, I’d have thought he’d have seen most of this coming, and was prepared to go through with it nonetheless.

    Surely many questions to be asked. Any thoughts, Jake?

    • This statement stood out to me:

      “The Festival doesn’t seek to avoid or shy away from controversy. However, we have concerns with certain things in this film that we feel prevent us from presenting it in the Festival program. We have decided to remove it from our schedule.”

      And what might those certain things be? Surreptitious recordings of Dr. Thompson’s voice? A silhouetted actor posing as him? I can only imagine…

      • Eddie Unwind on March 27, 2016 at 1:26 am said:

        By what you’re saying, are you implying that the film might, for example, have cut-and-pasted recordings of Thompson’s voice that were plainly misleading, as has been suggested? If so, I would have thought Wakefield to be much less foolish, since he presumably already has enough evidence to provide a solid argument? Moreover surely he’d ensure that such ‘edits’ were above board, particularly in view of his wanting to be reissued his medical licence? But perhaps you didn’t mean to imply any such thing. Please clarify?!

        • It’s not so much what the recordings themselves say, but rather that they were from recordings of Dr. Thompson without his permission that were leaked by Wakefield, also without Dr. Thompson’s permission. Not to mention the fact that dubbing them over a silhouetted actor would mislead viewers into thinking he was being interviewed for the film when he wasn’t.

          • Anne Harris on April 15, 2016 at 5:29 pm said:

            I watched an interview of the main people involved in making Vaxxed. They said that the recordings with Dr. Thompson were made by someone other than Wakefield (I forget the man’s name). That person went across the border from California (which does not allow recordings without both people’s permission) into Oregon (which only requires permission from 1 of the 2 people in the conversation to allow them to be recorded). So the conversations were legally recorded. The person who recorded them, not Wakefield, was the one who gave permission to release the recordings.

  2. Eddie Unwind on March 27, 2016 at 1:51 am said:

    If, on the other hand, the film-making itself appeared dodgy, then it would be just as well if Wakefield himself had pulled the film. A dodgy-looking production is the very last thing he needs at this point, regardless of whether it be of factual content. In the final analysis I am doubtful as to whether the content of any such film, no matter how well researched and engaging (or horrifying, for that matter), might do enough to persuade etc, especially given the current climate of tremendous hostility. After all, it is just a film.

    So perhaps this recent implosion is just as well, and Wakefield’s image as a man striving to bring the truth to light in the most adverse circumstances is not merely preserved, but greatly amplified?

    But I cannot imagine that these recent events would do any good at all to help him win back his medical licence..?

  3. Kathleen on March 27, 2016 at 2:34 am said:

    Jake, Why is it that you find Dr. Thompson so deserving of being the one to decide when, where and if his criminal behavior is/was disclosed? From where I stand, my son would have avoided injury all together had Thompson chosen to do the right thing at the time of writing the paper. Thompson, the adult, who was capable to making that choice. My son, not born yet, would have a life without pain, ridicule, therapy ALL THE TIME, anxiety, depression, FRIENDS…..I understand on one hand what your argument is, but it does not hold water when the bottom line is your throwing a man who has lost much under the bus in a weird belief that he wronged a coward that ultimately can be blamed for thousands if not hundreds of thousands of damaged children. You are unrelenting in your attacks on Wakefield. Please ask yourself what this “blog” accomplishes today? You don’t like his BIO, you think it could have been better? Ok. You have really changed.

    • Hans Litten on March 29, 2016 at 2:39 pm said:

      Kathleen , I agree with your sentiment entirely . and Barry has often said much the same here in the past about W.Thompson . But its been a long time since WT did speak out and the criminals have managed to keep the crime fully afloat, up & running in all that time relatively easily .
      My vaccine injured child would also fit within that time frame (post 2003\2004).

      This campaign (I don’t know if it is even that good to be able to call it that) is NOT about any individual like Andrew Wakefield or anyone else . It is about the Parents & the injured children.

      I have to stand up for Jake in this respect , there has definitely been some dirty double dealings occurring on our OWN side . infiltration . And I feel that sometimes that is what this site is about .

  4. Media Scholar on March 27, 2016 at 7:25 am said:

    Thompson’s material is fair use. There’s no basis to pull the film based upon material which is fair use.

    Just like secret recordings of the Ukrainian “Gas Princess” are fair use.

    https://youtu.be/Wkicw3EolCg

    She wants execute her political rival, and nuke 8 million Russian nationals residing in Ukraine.

    They call her the ‘Gas Princess’ for a reason. She was a oil exec-oligarch, who rode the Orange Revolution into power.

    She was busted for embezzling off gas contracts between Russia and Ukraine. It was an open and shut case. Even Yushchecko, the guy they tried to poison, testified against her. There was NO INDICATION her trial was politically-driven.

    She was crooked and got thrown in jail. It wasn’t until her daughter hired a German PR firm that she erroneously became this political prisoner suffering Soviet-style gulag abuse. Then her fellow crooked Big Oil politicians the world over raced to her aid.

    They could not get her out legally so they created mock protests A.K.A. Ukrainian “Star Wars” (https://youtu.be/xT9DZi5t5a8 ) and invoked U.N. law to trump the outcome of her guilty verdict.

    While the video seems humorous, hundreds died in the fraudulent process of jimmying her out of jail. Somewhere out there is a jpg of an old gal holding up a sign with a picture of the gas princess with a caption that read, “You died for this?”

    Eight million people is a lot of people. Obviously, the western leaders propping the gas princess up repeatedly don’t give a flip about human lives.

    The same can be said about the twenty-something Cyber-Marxists in America. Their social outcry against an untold number of vaccine-injured kids is disgusting to us, and maybe they are just ignorant fools following Hillary Clinton hoping their crony-ism lands them a big job, but the lives and the American families they are stepping on, including Robert DeNiro’s, shows their eyes are blind to social injustice.

    Chances are Clinton flaks are behind this “stampede”. They really don’t have a leg to stand on. Yet they disqualified DeNiro most likely because he has a conflict of interests not because of the illicit recordings of CDC whistle-blower William Thompson.

    Happy Easter!

    • Narad on March 29, 2016 at 3:17 am said:

      There’s no basis to pull the film based upon material which is fair use.

      No, there’s not, but that’s beccause “fair use” is a term of art referring to copyright law, which has nothing to do with the price of tea in China.

  5. Media Scholar on March 27, 2016 at 11:11 am said:

    Hillary Clinton may have lost three straight caucuses in the west, but in the east she scored big by sicking her Cyber Marxists on the ultra-lib Tribeca Film Festival. “Can’t have a Autism-vaccine flick.” That will put Comrade Hillary Clinton in a bad spot for pushing all these childhood vaccines; many of which have Thimerosal in them.”

    Perhaps Sponge Bob Wright will pop some popcorn and show re-runs of Katie Kouric’s colon to fill the void?

  6. Eddie Unwind on March 28, 2016 at 5:09 am said:

    Reflecting upon this and how it is likely to play out…

    Regardless of the reasons – of which there shall remain nothing beyond unsubstantiated rumours – De Niro has irrevocably damaged his reputation both on-screen and off-screen. A man so universally admired as he simply could not afford not to go through with his initial decision to screen Vaxxed, and, sadly for him, he will never live down the ignominy of his subsequent decision.

    Moreover De Niro’s backing down shall, after the initial euphoria, do substantial damage to the reputation of the medical establishment. The idea of a universally respected and much liked tough guy being obliged – in non-transparent circumstances – to surrender his initial, ‘personal’ convictions, cannot but suggest that coercion, bribe, threats etc were involved, even if this were not the case, for if there had been an above-board discussion, what’s to hide?

    Consequently, the actual film itself – regardless of content – will serve as a reminder for the events that preceded its screening (whenever that is); namely, the indelible impression of a world renowned tough-guy actor and suffering parent who, through attempting to put his foot forward in his child’s best interests as well as the autistic community at large, was pressured by unaccountable forces to step back.

    A very ugly incident.

    By comparison, Wakefield, no matter how shoddy a film-maker he may turn out to be, will be regarded as an infinitely braver figure than De Niro, and those who already despise him will now have cause to begrudge him his inadvertent show of courage (ultimately, to try and belittle an act of courage through mockery or wordplay is always seen as a cowardly act. Interestingly, 羡慕 means both ‘to envy’ and ‘to admire’).

    So we have a new, bloodshot-eyed, raging bull…

  7. Science Mom on March 28, 2016 at 6:21 pm said:

    I don’t see how Wakefield can get his licence back. He can’t use the appeals process and the restoration process requires good standing and not prohibited from practising. I of course welcome clarification on this.

      • Science Mom on March 28, 2016 at 8:05 pm said:

        No Jake, that isn’t the right venue as far as I can see; he would have to go directly through the GMC restoration process which he isn’t qualified to do. Again, if you have specific information for why you think the MPTS is the correct venue, I’ll gladly read it.

        • The information is on that site. I could care less about what you will read.

          • Narad on March 29, 2016 at 3:20 am said:

            The relevant information, I believe, is summarized in this PDF from the GMC.

            • I take it the key statement in that document that supposedly proves your point is this:

              “You cannot ask the tribunal to reconsider the facts proved against you that led to
              your erasure. You had a right of appeal immediately after the original hearing. If you
              did not appeal, or appealed unsuccessfully, that was the end of the matter.”

              -Except those same “facts” were appealed successfully by Wakefield’s colleague.

              • Narad on April 4, 2016 at 11:21 pm said:

                I take it the key statement in that document that supposedly proves your point is this

                Jake, my point was that neither Science Mom nor you appeared to have gotten things straight and that the linked document seems to clarify the process.

              • Narad on April 4, 2016 at 11:30 pm said:

                (Sorry about using two comments when one would have done.)

                Except those same “facts” were appealed successfully by Wakefield’s colleague.

                Right, but that was in a different venue. So, the path to being restored to the Register appears to be (1) losing before the GMC if its conditions are rejected and (2) then appealing to a higher legal body.

                • That’s ridiculous, it’s all the same system. Since the GMC’s findings were overturned by the High Court, the GMC will have to consider that reversal as it relates to Dr. Wakefield’s case. There’s no way around it.

                  • Narad on April 10, 2016 at 7:20 am said:

                    That’s ridiculous, it’s all the same system. Since the GMC’s findings were overturned by the High Court….

                    They weren’t, though. The Walker-Smith decision came from an administrative court, from which there was an appeal path.

                    I’m not at all familiar with British law, and the judgment in CO/7039/2010 doesn’t include the statutory and procedural references that one might expect when looking at a similar case in the U.S., but I think this scenario involves more than one appeal after the perfunctory step of being refused by the GMC.

                    • Did you see my addendum? I posted a letter from GMC which said they would consider Dr. Wakefield’s application and any further supporting evidence he provides.

  8. Chris Preston on March 29, 2016 at 1:34 am said:

    Jake, there appear to be a number of significant errors of fact in your post.

    1. Walker-Smith vs GMC was about Walker-Smith’s fitness to practice, not about the correctness or otherwise of the Lancet paper. Indeed in the court case considerable evidence was presented showing research fraud in the Lancet paper, such as the claim about the patients being consecutive presentations at the London Free. Indeed Walker-Smith’s evidence at the trial was to blame all of these on Andrew Wakefield. The Lancet paper remains retracted for good reason: it was fraudulent.

    2. Walker-Smith vs GMC did not address Andrew Wakefield’s fitness to practice. Therefore, it could not overturn Wakefield’s deregistration. Indeed on one of the key issues in the case of Walker-Smith; that he conducted research without an appropriate ethics approval, Justice Mitting found that it was absolutely Andrew Wakefield’s intention to conduct research and he did so without ethics approval. Walker-Smith claimed he was not conducting research, only Andrew Wakefield was, and Justice Mitting believed him.

    3. “Footage from the film includes surreptitious recordings of Dr. William Thompson’s voice leaked by Wakefield as well as a silhouetted actor posing as Dr. Thompson.”

    In fact the recordings of Thompson’s voice in the film trailer appear to have been doctored by Andrew Wakefiled by splicing two separate recordings together. This makes Thompson appear to say something that he likely did not say. This is likely to have been the key fact that led to the film being pulled from the festival.

    • Eddie Unwind on March 31, 2016 at 10:05 pm said:

      Chris, you’re a man who sounds as though he knows what he’s talking about. You should be an actor.

    • “Justice Mitting found that it was absolutely Andrew Wakefield’s intention” FALSE

      “showing research fraud in the Lancet paper, such as the claim about the patients being consecutive presentations at the London Free. Indeed Walker-Smith’s evidence at the trial was to blame all of these on Andrew Wakefield.” Also false.

    • Barry on April 2, 2016 at 2:45 am said:

      The Lancet paper remains retracted for good reason: it was fraudulent.

      ***********

      The Lancet paper was retracted for just one fraudulent reason???

      From what I recall, that retraction was based on a mountain of fraudulent reasoning.

    • “In fact the recordings of Thompson’s voice in the film trailer appear to have been doctored by Andrew Wakefiled by splicing two separate recordings together. This makes Thompson appear to say something that he likely did not say.”

      Maybe because *it was a trailer!* Do you have any evidence that the film itself had this “doctored” splicing? Or, did you just come to the conclusion that this was the entire movie based on one trailer?

      My goodness…anything to promote further hate-mongering…

      • Chris Preston on April 6, 2016 at 11:19 am said:

        It is my experience that almost all of the scenes in the trailer are highlights cut from the movie itself. As the trailer showcases a clearly spliced pair of audio recordings of William Thompson made by Brian Hooker, I am expecting that to turn up in the full movie as well.

        If this is the quality of the rest of the movie, then yes it is easy to see why it was pulled when these sorts of tricks in a documentary were pointed out.

        • Have you seen the movie?

          If not, then your assertion is merely speculation which you are using to drum up further hate, and my original comment still holds merit.

        • Eddie Unwind on April 8, 2016 at 6:51 am said:

          Chris, why not follow through on all the hype and boasting at Resentful Idiots and launch your allegations during the Q&A session following the movie? This is no place for such speculation – show us what you’re made of! Because I can tell you now, from here it all looks like a lot of posturing without any punch. I say you’re a coward. Prove me wrong!

          Go get to it Chris!! You can be a hero!!

  9. Eddie Unwind on March 29, 2016 at 1:40 am said:

    Just a thought – Despite that he has adopted an anti-vaccine route to gain publicity (for him at this stage there exists no other) I maintain that Wakefield is not anti-vaccine, and that he is sincere in advocating a single measles vaccine.

    More to the point, I think it is the likelihood of this that makes him such a despised and feared figure among those vehemently pro-vaccine. The pro-vaccine movement insists that such a moderated stance on vaccines is untenable. The reason for this is simply that the movement is one of extremism. Hence, their ultimate fear of having the film screened at Tribeca was simply that Wakefield might appear reasonable and not particularly anti-vaccine. This phenomenon we’re witnessing is summed up by Ortega y Gasset:

    ‘Unreasonableness is essential to extremism. To wish to be reasonable is to renounce extremism…The history of all forms of extremism has about it a monotony which is truly sad; it consists in having to go on making pacts with everything which the particular form of extremism under discussion had pretended to eliminate.’

  10. Eddie Unwind on March 29, 2016 at 9:37 am said:

    Along the same lines, here’s one further passage from Gasset:

    ‘In the fifteenth century such men as Agrippa, Paracelsus, and Savonarola moved about. What were those men? Humbugs? Sly rogues? Or authentic sages and heroes? The probability is that they were all of these things, and not by chance or out of some peculiar personal defect.’

    Gasset goes on to explain how such personalities cannot be considered in isolation from what were highly disoriented times, very much like our own. So, substitute Wakefield for Paracelsus and you begin to get a truer perspective.

  11. Hans Litten on March 29, 2016 at 9:59 am said:

    Was BlaxHill involved in the film Vaxxed in any capacity I wonder ?
    Things always go wrong when the BLAXMAN is involved .

  12. Hans Litten on April 4, 2016 at 9:31 am said:

    Did I hear it correctly ?
    The latest Stephanie Seneff Autism projection :
    By 2032 80% of all US males will be autistic .

    Did I hear this correctly ? Not Hg-enocide they say ?

  13. Hans Litten on April 4, 2016 at 10:31 am said:

    Did I hear it correctly ?
    The latest Stephanie Seneff (MIT) Autism projection :
    By 2032 80% of all US males will be autistic . (just 16 years away)
    Did I hear this correctly ? Not Hg-enocide they say ?

    powerpoint from Stephanie Seneff
    https://people.csail.mit.edu/seneff/2015/AutismOneMay21.pptx

  14. I’m going to start a new top-level comment just because the nested stuff becomes unreadable after a while, although nested block quotes may prove to be just as bad. Picking up from here,

    That’s ridiculous, it’s all the same system. Since the GMC’s findings were overturned by the High Court….

    They weren’t, though. The Walker-Smith decision came from an administrative court, from which there was an appeal path.

    I’m not at all familiar with British law, and the judgment in CO/7039/2010 doesn’t include the statutory and procedural references that one might expect when looking at a similar case in the U.S., but I think this scenario involves more than one appeal after the perfunctory step of being refused by the GMC.

    Did you see my addendum? I posted a letter from GMC which said they would consider Dr. Wakefield’s application and any further supporting evidence he provides.

    No, I hadn’t until now. I was thinking about this earlier though, and I don’t think it really changes much. What I was wondering about earlier was when the supporting evidence (i.e., the Walker-Smith decision) would have to be introduced in order for it to be a valid part of an appeal. (Again, I”m extrapolating from my understanding of U.S. court decisions.)

    The JWS appeal and the putative Wakefield appeal would be fundamentally different things, because the former followed directly upon the original decision, whereas the GMC would have a wholly different question before them – not the striking off, but reinstatement. Here are the steps that I originally had in mind:

    1. Wakefield applies for reinstatement and is refused for rejecting the validity of the striking off, per the letter of the requirements.

    2. An appeal ensues to the administrative arm of the High Court. I imagine two possibilities:

      (a) The appeals court finds that the GMC applied the GMC’s formal reinstatement rules correctly (that specific issue only), and a further appeal is necessary. This was my original idea; and it’s now clear that the JWS evidence would have to be introduced with step 1. Wakefield would have to appeal to a higher body.

      (b) If one reads the letter in the addendum genererously rather than as boilerplate, then the initial appeal could succeed on the basis of the GMC’s failure to properly consider the supporting evidence. The GMC would have to appeal to a higher body.

    3. Somebody appeals a second time.

    The magic question is whether the second appeal is possible either way. My guess is that it is, but I’m disinclined to really dig into British case law for the sake of something that seems facially implausible.

  15. Media Scholar on April 19, 2016 at 9:04 am said:

    http://www.nytimes.com/1994/08/23/us/health-care-debate-immunizations-clinton-s-plan-for-immunization-children.html

    THE HEALTH CARE DEBATE: IMMUNIZATIONS; Clinton’s Plan for Immunization Of Children Suffers a New Blow
    By ROBERT PEAR,
    Published: August 23, 1994

    WASHINGTON, Aug. 22— In a sudden reversal, the Clinton Administration has abandoned plans for a national vaccine warehouse, which was to store and distribute vaccine as part of a campaign to immunize children across the country starting Oct. 1.

    The demise of the warehouse is the latest in a series of setbacks to a Clinton initiative that, when first proposed in 1993, called for providing free, Government-subsidized vaccines to all children. The program has since been scaled back several times and, with cancellation of the plan for a vaccine warehouse, even less of the President’s proposal survives.

    Senator Dale Bumpers, Democrat of Arkansas, a close friend of President Clinton and his wife, Hillary, said the Administration’s plans for ordering, storing and distributing vaccine were “indescribably complicated.”

    “A fairly simple law, designed to benefit a relatively small group of uninsured children, was transformed into a bureaucratic nightmare that put the safety and availability of a third of our nation’s vaccine supply at risk,” Mr. Bumpers said. He asserted that the Administration’s plan “took us dangerously close to nationalizing the pediatric vaccine market,” a result he said Congress never intended.
    ————-

  16. Media Scholar on April 19, 2016 at 9:10 am said:

    It’s Mrs. Clinton’s shot at an inoculation cure –
    Hillary Rodham Clinton’s effort to supply childhood vaccines to
    every pre-school child

    Insight on the News, Feb 22, 1993 by Elena Neuman

    Summary: George Bush poured money into getting more preschoolers
    vaccinated, but the effort was criticized as meager, and some experts
    question whether greater spending is even the right prescription. Now
    Hillary Clinton will get her turn at a chronic national problem.

    In a little-publicized 1991 media event, Arkansas’s first lady
    blasted the Bush administration for its purported failure to pay for
    adequate supplies of childhood vaccines.

    “That has always been one of the most inexplicable positions taken by
    the administration over the years,” said Hillary Clinton from a
    podium she shared with Jocelyn Elders, who has been picked to become
    the new surgeon general. “Because if preventative health care is a
    positive thing, what better way than through immunization?” She
    revisited the subject at a Nov. 18 appearance before the Children’s
    Defense Fund, the advocacy group she once led. “We owe our children
    more than we’ve been giving them,” she declared. “What on earth could
    be more important than making sure that every child has the chance to
    be born healthy, to receive immunizations and health care as that
    child grows?”

    Now the nation’s first lady, appointed by her husband to lead his
    planned overhaul of the nation’s health care system, Mrs. Clinton is
    in a position to follow through on these complaints. And a plan to
    federally fund all childhood vaccines will reportedly be the
    administration’s first health care reform. If childhood immunization
    is less than universal because of neglect by penny-pinching
    Republicans in the White House, as the Clinton campaign charged, then
    giving children the medical attention they deserve is one campaign
    promise that should be easy to fulfill.

    According to the most quoted statistics, compiled by UNICEF and the
    Children’s Defense Fund, the United States ranks 17th in the world –
    behind countries like Albania, Poland, Mexico and Pakistan – for the
    percentage of 1-year-olds who have been vaccinated against polio.

    A Children’s Defense Fund survey this past summer found that most
    states report preschool vaccination coverage levels below 60 percent;
    in cities such as Los Angeles, Houston, Cleveland and Chicago, fewer
    than 50 percent of children under age 2 have received shots to
    prevent measles, mumps, rubella, diphtheria, pertussis (whooping
    cough) and other childhood diseases, the report said.

    Childhood immunization has been a hot issue since 1989, when it
    attracted national media attention because of an outbreak of measles –
    a disease all but wiped out in 1983. Infections of whooping cough
    also rose in the late eighties, primarily due to parents forgoing DTP
    (diphtheria, tetanus and pertussis) shots for their children after
    media reports that the vaccine caused serious adverse reactions, even
    death.

    The Bush record on children’s health was thus an open target for
    liberal criticism. In an opinion piece in the Washington Post less
    than a month before the election, commentator Michael Kinsley said
    the issue was a touchstone distinguishing Bush voters from Clinton
    voters. Describing the problem as an “aspect of the general decline
    of national wellbeing that snuck up on us while we were partying in
    the 1980s,” he laid the blame at the doorstep of “people with no
    faith in the power of government to do good.” What made him a
    Democrat, Kinsley offered, was his feeling that “as a citizen of the
    richest country in the world, this is a problem I shouldn’t have to
    worry about. And I wish we had a president who would take whatever
    action, and spend whatever money, is necessarry to solve it.”

    Samuel Katz, a professor of pediatrics at Duke University Medical
    Center and the chairman of the Federal Advisory Committee on
    Immunization Practices, echoed this analysis in late December and
    urged Bill Clinton to be the president Kinsley had wished for. “With
    the de-emphasis on federal support originating during the Reagan
    years and continuing through the Bush administration, problems have
    undermined the nation’s mandate to protect its children “he wrote in
    a Scripps Howard column. “Childhood vaccination must be a sure bet.
    President Bush’s health-care promises proved empty. They let down the
    innocent children among us. Let’s hope Bill Clinton’s medical agenda
    puts the nation’s future – its children – first and foremost.”

    Even Hollywood has thrown its weight behind the call for greater
    efforts at childhood immunization. In 1991, Steven Spielberg, Kate
    Capshaw, Henry Winkler, Bill Cosby and a host of entertainment
    executives and producers formed the Children’s Action Network, in
    association with the American Academy of Pediatrics, to launch a full-
    scale immunization awareness drive.

    Despite this seeming unanimity of liberal opinion, however, the
    Clintons may have a tough time living up to expectations. The
    indictment of the Bush administration for inaction on immunization
    left out two stubborn facts: Federal efforts have hardly been
    lacking; and the problem is more complicated than it has been
    portrayed.

    Advocates of a full federal offensive have emphasized the Bush
    administration’s failure to propose spending as much as Congress
    appropriated. Left out is the fact that spending on childhood
    preventive medicine may have been the fastest growing federal budget
    line in the Bush years – increasing by 250 percent.

    Federal spending on immunization in fiscal 1988 was $98 million; in
    fiscal 1992 it was $297 million; and for fiscal 1993, which began
    Oct. 1, Bush requested $349 million. During those years, funding for
    two new vaccines, hepatitis B and Haemophilus influenza type b, plus
    a booster shot for measles, mumps and rubella was added to the budget.
    Nor were federal efforts limited to increased funding. In 1991, Bush
    directed his top health officials to do a six-month study of six
    major urban centers to determine how the national immunization rate
    could be improved; upon receiving the panel’s suggestions to make
    public clinics more user-friendly, he approved an additional $46
    million to support vaccine distribution and education, quite apart
    from vaccine supply.

    Vaccine “one-stop shopping” centers and immunization “express lanes”
    were planned for inner cities; plans were drawn up to consolidate
    government aid centers with public clinics to make it easier for poor
    parents to have their preschool children immunized at the same time
    as and in the same office where they applied for food stamps or
    welfare benefits.

    These policy moves were “innovative and unusual. An important first
    step ” says Linda Talbott, executive director of Every Child by Two,
    an advocacy organization for children’s immunization founded by
    former first lady Rosalynn Carter and Betty Bumpers, wife of Arkansas
    Sen. Dale Bumpers. It was the first time since a federal immunization
    grant program was authorized in 1962 that money was allotted for
    functions other than the purchase of vaccines, and health care
    professionals applauded.

    Almost without exception, Democrats on Capitol Hill criticized the
    policy, not on its merits but as too little, too late, or as a Band-
    Aid approach. “We don’t need a six-city road show to study the
    problem”‘ said Sen. Edward Kennedy of Massachusetts. “We need a
    general federal commitment to see that every child is immunized” Katz
    told the Los Angeles Daily News that Bush had “finked out” on
    children.

    Now, former Bush health officials profess amazement at the way a
    massive budget increase, coupled with policy innovations, was turned
    into a political liability. “The notion that there haven’t been
    enormous increases in public health service funding, distribution and
    services during the Bush administration simply belies the fact of
    what’s happened – during a time when there was a great deal of
    constraint over the general federal spending,” says Kevin Moley,
    former deputy secretary of health and human services.

    Moley, like other Bush officials, ridicules the notion that the
    international rankings of UNICEF are reliable – that statistics from,
    say, Pakistan or Albania are reported accurately. “After all this
    talk, are [the Clinton people] prepared to match the percentage
    increases the Bush administration put through in such areas as
    immunization for children, Head Start and AIDS? … I don’t know
    where they’re going to get the money to do this unless they
    dramatically increase taxes or the deficit.” That may in fact be the
    plan. The Children’s Defense Fund advocates tripling spending – to $1
    billion – for a universal immunization purchase program in which all
    vaccines, for both public clinics and private physicians, would be
    federally funded.

    Given Mrs. Clinton’s close ties to the organization, it’s not
    surprising that the idea is being seriously considered. And although
    the Clinton administration says it has not quite figured out how to
    pay for the expensive federal program, higher taxes would in fact be
    consistent with a campaign speech that Clinton delivered to a
    convention of the American Association of Retired Persons in June in
    San Antonio, Texas. He said he planned to raise taxes on people
    making more than $200,000 to pay for specific programs – among them
    prenatal health care and immunization for all preschoolers.

    The problem is that with all the money that has been poured into the
    immunization program in the past four years and with the
    restructuring of the program, there has not been a corresponding
    improvement in rates at which preschoolers get their shots. While
    measles has been brought under control, some experts attribute its
    demise to the natural run of an epidemiological cycle rather than any
    Public Health Service action.

    Some immunization experts insist that to fully immunize the nation’s
    children, particularly children in poverty, the issue is less one of
    how much the federal government is willing to spend than of how
    willing the government is to be paternalistic when parents are
    irresponsible.

    According to Walter Orenstein, director of the department of
    immunization at the federal Centers for Disease Control in Atlanta,
    the chief cause of the measles resurgence “was not a problem with
    vaccine supply, but a problem with delivery of services and parents’
    lack of knowledge about the vaccine schedule.”

    But when William Roper, the Bush-appointed director of the Centers
    for Disease Control, suggested in 1991 that parents might share the
    blame for vaccination rates, he was denounced as being politically
    insensitive. His suggestion was to make welfare checks to mothers
    contingent upon immunization of their preschoolers, just as public
    school admission has since the 1970s required full vaccination. (It
    is for this reason that the immunization rate of schoolage children
    is nearly 100 percent.)

    “We all know that spending money and having coverage is not the only
    problem that we have to deal with, but we’re not allowed to say it”‘
    says Gail Wilensky, former special assistant to Bush for health
    care. “We need to get people to engage in more responsible behavior
    when it comes to their children. We need to stop pretending that this
    is just a financing health care problem.”

    Moley says, “You’ve got crack-addicted mothers trying to survive day
    by day whose last thought in the world is getting their children
    properly immunized. But God forbid anyone should suggest that
    parental irresponsibility and bad behavior are a factor here.”

    Joseph Liu, a senior associate and health care specialist at the
    Children’s Defense Fund, has been one of the most vocal opponents of
    this view. To him it’s more a matter of parental ignorance (and a
    large dose of Republican mishandling) than of irresponsibility.
    “You can go to almost any very concerned, very involved parent and
    ask them what’s the immunization schedule that their child needs from
    birth to age 4, and you won’t find single parent out of a hundred
    that has the ability to recite that schedule,” he says.

    In the past, pediatricians kept track of immunizations and informed
    parents of when to bring their children in. Today, says Liu, many
    families don’t have such a relationship with a pediatrician. Parents
    just don’t know what they’re supposed to be doing.

    In addition, points out Judith Shea of the National Association of
    Community Health Centers, the system of public immunization is too
    diffuse. “There isn’t a coordinated system throughout the states,”
    she says. “The communication among all the entities administering
    public vaccines is not as fluid as it should be.” Public clinics are
    often disorganized, require long waits and the scheduling of
    appointments weeks or months in advance, and aren’t open at hours
    that working parents can manage.

    Recent studies also have found clinics to be burdened by an ever-
    increasing clientele. A 1991 survey of Dallas-area pediatricians and
    family practitioners published in Pediatrics magazine found that more
    than 70 percent referred some of their patients to public clinics
    rather than administer the vaccines themselves. And a Milwaukee study
    found that children not covered by health insurance were far more
    likely to be sent by their doctors to public clinics. (Only half of
    private insurance plans cover the cost of immunization.) Although
    there hasn’t been a problem with vaccine supply in the clinics, the
    increased use has led to longer waits for appointments and in waiting
    rooms.

    The rectify these problems, a Bush-appointed group of federal, state,
    local and private organizations developed “Standards for Pediatric
    Immunization Practices” based on the recommendations of the Public
    Health Service’s National Vaccine Advisory Committee.

    The standards suggest keeping clinics open during off-hours and
    weekends; vaccinating children on a walk-in basis, thereby
    eliminating the need for scheduling appointments; forgoing the
    requirement of comprehensive physical examinations before
    administering vaccines; vaccinating children who come to a clinic for
    services other than a vaccine or who accompany other family members;
    and administering in a single visit all vaccinations for which a
    child is eligible.

    “We’re trying to do a better job of making our clinical services user-
    friendly,” says Orenstein of the CDC.

    “It’s very clear that we have to work with the public and private
    sector to do this. It isn’t simply a matter of just education. It’s
    an issue of trying to make the services as pleasant as possible, to
    reduce clinic waits and to not require appointments all the time.”
    Sen. Donald Riegle, a Michigan Democrat, is introducing legislation –
    the Comprehensive Child Health Immunization Act – that seeks to
    implement the standards as a matter of federal law.

    Optimism about the new standards is not unanimous, however. Jan
    Erickson, executive director of the National Vaccine Information
    Center, says the elimination of comprehensive physicals and the
    simultaneous inoculation of siblings would lead to an increase in
    adverse reactions to vaccines.

    “There are a host of reasons that we shouldn’t lessen the
    restrictions. We should, in fact, tighten them up,” she says. “The
    intent of the National Childhood Vaccine Injury Act was to make
    vaccines safer, so these standards really fly against Congress’s
    intent in passing that law, which still now should form the basis of
    any federal policy about immunization campaigns.”

    Erickson is referring to a law passed in 1986 in response to a number
    of serious neurological reactions and deaths from the whooping cough
    vaccine. A slew of lawsuits against the manufacturers of the vaccine
    threatened to put them out of business and jeopardized the nation’s
    vaccine supply. They also sent the prices of most vaccines
    skyrocketing. The price of the DTP vaccine, for example, has risen
    5,147 percent from its low of 19 cents a dose in 1977 to $9.97 in
    1992. The 1986 law partially rectified the crisis by legislating
    medical precautions for administering vaccines as well as a publicly
    financed vaccine injury compensation fund to eliminate the need for
    outside litigation against the companies.

    “The at-risk indicators for a vaccine adverse reaction are if there
    has been a history in that family among siblings or very close
    relatives of having had an adverse reaction,” says Erickson. “So the
    recommendation of giving siblings simultaneous vaccinations seems
    misguided. Having some sort of sequenced pattern to having siblings
    receive vaccinations makes a lot more sense. But really the most risk
    is introduced by not having competent medical professionals do the
    exams, the screening and admininistering of the vaccinations. Doctors
    are not well-trained enough to diagnose adverse reactions, and if
    doctors aren’t well-trained enough, you can certainly imagine that
    other persons without the professional training, what their
    deficiencies would be in recognizing adverse reactions,”

    The National Vaccine Information Center, an advocacy group for
    families of children injured by vaccines, has tracked 360 deaths and
    17,221 other serious adverse reactions due to vaccinations in the 20
    months leading up to July 1992. This, they say, represents only a
    fraction of the number of adverse reactions. (The CDC and many
    pediatricians and neurologists, on the other hand, question whether
    vaccines are the true cause of all these injuries and deaths.)

    Erickson, Orenstein and other immunization professionals further
    question the universal vaccine purchase program promoted by the
    Children’s Defense Fund, the American Association of Pediatrics and
    other heath care organizations. While Orenstein concedes that
    universal purchase would prevent fragmentation of care while also
    stopping the overuse of public clinics by children who are normally
    treated by private physicians, he says he wonders whether such an
    expensive solution would solve the problem of low vaccination rates
    in the inner cities.

    “We still will need to improve our health care delivery capacities in
    the inner cities,” he says. “We shouldn’t think that buying the
    vaccines will somehow get a kid in Harlem vaccinated. Moreover, will
    vaccine manufacturers drop out of the market as a result of universal
    purchase? That is a potential threat. Will they invest the same
    amount of money in research? That is not clear.” Vaccine
    manufacturers expressed just these concerns upon receiving word of
    Clinton’s universal purchase plans, and the CDC is currently funding
    a study to determine the benefits and risks of universal purchase.
    A recent study in the Journal of the American Medical Association,
    however, seems to suggest that universal purchase would not solve the
    nation’s preschool immunization problem.

    The study found that in caring for the uninsured and underinsured,
    expanded free or subsidized health care for low-income pregnant women
    was not associated with an improvement in access to prenatal care or
    in birth outcomes. Between 1984 and 1987, the study reported, the
    rate of Massachusetts women who received prenatal care declined, even
    as public care received increased funding.

    “The Clinton people have a lot to learn on this issue, and they’ve
    just been following a very knee-jerk kind of reaction”‘ says Erickson.
    “They think that universal immunization is a great thing to do for
    children, when in fact it really is a very poor effort at trying to
    safeguard children’s health.”

    Immunization of preschoolers may prove to be one of those problems
    that everyone – Democrat and Republican alike – would like to solve,
    but that can’t be solved by money alone.

    Bush tried his hand at it for four years. Now it’s Clinton’s turn.

    COPYRIGHT 1993 News World Communications, Inc.

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