2

To: Dean of Research, University of Wollongong

Re: Allegation of Academic Misconduct

Summary - This report concerns the Thesis entitled An analysis of the Federal Government’s pertussis

immunisation policy submitted for a Masters of Science in 2007 by Ms Judy Wilyman, and

available at http://tinyurl.com/Wilymanthesis

- The authors of the following report believe that there exists within that Thesis a Prima Facie

case of academic misconduct evident, and feel obliged to make this report. They make this

allegation in good faith.

- This report outlines false and misleading claims made within this thesis (which is publically

available), which may contribute to members of the public making health decisions leading to

serious adverse outcomes.

- This report is to be considered together with the University of Wollongong Research

Misconduct Policy, especially but not limited to parts 6.4 and 10.1.b, available at

http://www.uow.edu.au/about/policy/UOW058715.html and the “Misrepresentation” section

of Table 5.1 available at http://www.uow.edu.au/about/policy/UOW058635.html#P124_6224

This report specifically excludes discussion of the contentious issue of the subject matter of the thesis

and the beliefs of the author. This report does not examine, reference or cite any other works by the

author. This report is made regarding specific alleged academic misconduct such as false attribution,

misrepresentation, false citation, manipulation of data, and the omission of information demonstrated

as part of this thesis.

ATTACHMENT 2

3

Introduction

This report will not focus on elements of the thesis, which appear to be solely due to poor scholarship

(such as an in-text citation not appearing in the bibliography or spelling/grammatical errors).

This report is not an overall analysis of the entire thesis, but examines in depth three examples from

within the thesis that represent, in my opinion, cases of academic misconduct. The three examples of

misconduct include the unedited text from the thesis (including all figures and tables referred to

within the text) to assist investigators with their assessment. The three examples are taken from three

separate chapters (3, 5 and 6) and include over 1600 words, two tables and two figures from the

thesis.

The author of the thesis does not appear to fit the University of Wollongong’s criteria for “poor

academic practice or scholarship rather than academic misconduct”. That is, she is not one of the

following;

a. The student is at an early stage of an undergraduate program of study

• The author had been awarded a undergraduate degree in science previously and this

thesis was for the completion of a Master of Science degree

b. The student is undertaking study at an Australian University for the first time

• The author gained her Bachelor of Science degree from the University of New South

Wales

c. The conduct represents a minor contravention of acknowledgement practice or other

academic standards or requirements

• This report includes several examples of misrepresentation (e.g. representing data or

information incorrectly, improperly or falsely) that the University of Wollongong

classifies as medium to high level of outcome.

d. There is other compelling evidence that the conduct arose from a genuine lack of

understanding of acknowledgement practice or other academic standards or requirements.

• It is difficult to envisage a set of circumstances in which someone (successfully)

submitting a Master’s thesis (which is second only to a PhD in academic

achievement) could be considered as lacking an understanding of acknowledgement

practice or other academic standards or requirements.

ATTACHMENT 2

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Example 1: Figures 1 and 2 of the Thesis and explanatory material

Summary

• Incomplete Figure 2 omits showing reduction in pertussis cases in children observed post-

1997. Description of information included in Figure 2 does not match Figure 2

• Explanation of Figure 2 incorrectly overstates pertussis notifications in children. Pertussis

was only made a national notifiable disease in 1991, which is stated in the text and can be

observed clearly in Figure 1. As such only pertussis notifications post 1991 can be compared

due to systematic differences in notification data collection.

• The thesis does not refer at any point to the change in diagnostic tools that occurred between

1991 and 2005 (the time period covered by the description of Figure 2.) The introduction of

serological testing in the mid-1990’s and PCR testing in 2001 could be seen as factors in

increasing levels of pertussis notifications. In isolation this point may be viewed as poor

scholarship but when placed into the context of the other misrepresentations in this (and

other) sections it suggests that this information may have been omitted so as not to contradict

the author’s contention.

Thesis page 30-1 including Figures 1 and 2. Entirety of text included and italicised

Pertussis became a nationally notifiable disease in 1991 and Figure 1 below illustrates the change in

notifications from the eighties to the nineties. It also illustrates the increasing incidence of pertussis in

the nineties with a large peak in 1997-8 and another large peak in 2001 and 2005. Vaccination rates

also increased in the nineties.

ATTACHMENT 2

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Reference: Commonwealth Department of Community Services and Health, The Official

Commonwealth Yearbook of Australia, 1989: Department of Health and Aging, NNDSS, 2006.

Figure 2 below shows particularly high notifications in the 0-4 years and 5-9 year age groups from

1993 – 1998. Notifications remain high in the 0-4 age group from 1999 - 2005 and this is the age

group of highest mortality and vaccination rates. Figure 2 also shows an increase in notifications in

the 10-14 year age group from 1999-2004.”

ATTACHMENT 2

6

Analysis

National Notifiable Diseases Surveillance System (NNDSS) data from 1991–2005 is clearly

referenced by the author in this section and as such is the only data set used to examine her claims.

The other reference in this section, Andrews et al., 1997 (Andrews et al., 1997) used the NNDSS data

from 1991-1996. Figure 1 also includes data from 2006 but as this was not mentioned. In reference

to Figure 2 this additional year has been excluded. Pertussis became a nationally notifiable disease in

1991 and as such only data from years with full year reporting of pertussis notifications, 1992–2005

have been included for the calculation of long-term notifications yearly averages.

Figure 2 is based on a figure (Figure A) from Andrews et al., which only included data from 1991 to

1996. Even though the author created this original figure and had access to data until at least 2005,

Figure 2 does not show data beyond 1997.

Figure A: From Andrews at al., 1997 (Andrews et al., 1997)

The author chose to finish plotting data at 1997, which was the year with highest pertussis

notifications. There is no explanation or scientific validation for why the graph finishes in 1997,

whilst the accompanying descriptions include data to 2005. The NNDSS data plotted in Graphs A

and B clearly show that pertussis notifications in children were in decline from 2001 to 2005.

ATTACHMENT 2

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Figure 2 additionally does not show the notification rate (per 100,000) for the 0 – 4 age group but

instead shows the 0-<1 and 1-4 age groups. The claims made by the author, “0-4 age group”, are

therefore impossible to assess based on the graphical representation of data presented as Figure 2.

Two graphs have been included in this report to allow comparison of the claims within this section of

the thesis.

Graph A is from a presentation made by Dr Peter McIntyre from the National Centre for

Immunisation Research and Surveillance (NCIRS) in 2011 (http://tinyurl.com/m9ar39q). Please note

grey area is data that would not have been available to the author of the thesis prior to submission of

the thesis and has been deliberately obscured.

ATTACHMENT 2

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Graph B is our own graphical representation of the pertussis notification data 1991–2005 from

NNDSS (http://tinyurl.com/lryow7q), that is how Figure 2 of the thesis should have appeared had it

been made accurately and using all available data at the time of the composition.

The data presented in Figure 2 of the thesis is clearly not an accurate depiction of Australian pertussis

notifications during the period 1991–2005.

The author also makes specific claims (based on the 1991–2005 NNDSS data), which are not

representative of that data:

“… particularly high notifications in the 0 – 4 years and 5 – 9 year age groups from 1993-1998”

As discussed, 1997 was a very high year for pertussis notifications and as a result all age group

notifications for 1997 (except 2001 for the 10-14 age group) were the highest in the timespan

examined in Figure 2. However, all notifications (except 1997) were within one standard deviation

(SD) of the long-term yearly pertussis notification average for 1992-2005 and in fact 1996 was below

average. For the 5-9 age group, all notifications (except 1997) were also within one SD of average.

There is nothing to suggest that these figures are “particularly high” and the author provides no form

of statistical analysis with which to support her conclusions.

“Notifications remain high in the 0-4 age group from 1999 – 2005”

This claim is also not supported by the data. All points except 2001 and 2004 were below average.

Notifications for 1999 were between one and two SD below average, which suggests it was actually a

year of very low notifications. The notifications for both 2001 and 2004 were less than one SD above

average. Average annual notifications for 1999-2005, while not statistically different, were lower

than the 1992-2005 average (42 vs. 48.4 per 100,000).

0!20!40!60!80!

100!120!140!160!180!200!

Not

ifica

tions

/ 100

,000

pop

ulat

ion!

Pertussis age specific notification rate 1991- 2005!

0 - 4 yrs!5 - 9 yrs!10 - 14 yrs!

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“Figure 2 also shows an increase in notifications in the 10-14 year age group from 1999-2004.”

The years 2000 and 2001 were certainly years of high notifications for the 10-14 age group with both

figures being over one SD higher average. However all other years were within one SD and in fact

1999 and 2003 were below average.

10

Example 2: Section 6.1 The Vaccine Ingredients

Summary

• Out of 47 citations in this section none were to peer-reviewed scientific publications

• No information about the safe/toxic levels of vaccines ingredients, and how this related to the

amounts found in (pertussis) vaccines. In fact this section never actually lists the specific

ingredients (and doses) of the any of the Australian pertussis vaccines.

• Omission of key pieces of information about the pertussis vaccine in Australia such as the

removal of mercury in 2000 or the switch from whole cell to acellular pertussis vaccines in

1999, but which the author stated did not occur until 2004

• Numerous claims about vaccine ingredients which are not supported by scientific citation

such as stating that “neurodevelopment disorders such as autism have similar symptoms to

those of mercury poisoning”

• Citations used to support statements are in fact unrelated to the statements made.

Thesis pages 52 to 54. Entirety of text included and italicised.

6.1 THE VACCINE INGREDIENTS

Parents are told that the chemicals and virus’s/bacteria in vaccines will not overload a baby’s

immature immune system nor will it harm their developing neurological systems (Immunise Australia

Program, 2004: Ada and Isaacs, 2000). This is not the evidence from animal studies and adverse

reactions to the vaccines. Refer Appendix 5.

The Australian whole-cell DTP vaccine is made using heat inactivated B.pertussis bacteria and then

strengthened with the adjuvant, aluminium phosphate and other stabilisers (CDI, 1997: Informed

Choice, 2005). All vaccines contain quantities of preservatives, antibiotics and stabilisers and

examples of these found in the DTP vaccine include thimerosal (a mercury compound), sodium

chloride, sodium hydroxide, aluminium hydroxide, aluminium hydrochloride, sorbitol, hydrolyzed

gelatin and formaldehyde (Informed Choice, 2006). Aluminium and mercury are heavy metals linked

with neurological damage (Needleman H, 2000: Kirby D, 2005) and formaldehyde is a brain

carcinogen (FDA as cited in Kirby D, 2005: Miller NZ, 1995).

Prior to 2003 government documents did not present the ingredients in vaccines. The synergistic and

cumulative effect of the chemicals in each vaccine needs to be considered as new vaccines are added

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to the childhood schedule. It is known that toxicity of mercury is increased when combined with other

ingredients such as aluminium and formaldehyde (Informed Choice, 2006: Kirby D, 2005). The

manufacturing processes of different brands of pertussis vaccines will result in variations in the

efficacy and safety of these vaccines between countries.

Thimerosal is a mercury compound that has been used as a preservative in vaccines since 1939 (Cook

M, 2006: Kirby D, 2005). It contains nearly 50% ethylmercury by weight and is a nerve cell poison

causing death and brain damage (FDA and CDC as cited in Kirby D, 2005). It is present in the DPTw

vaccine, which is given to children before the age of six months.

The infant blood-brain barrier is not developed until six months of age so its possible that even

miniscule amounts of toxin can cause harm if injected before this age (Cook M, 2006: Kirby D, 2005).

Each dose of the whole-cell DTP vaccine contains approximately twenty-five micrograms of

ethylmercury (Kirby D, 2005, p.81). This may vary between brands.

Prior to 1987 this was the only vaccine containing mercury given to children. In 1987 the Hepatitis B

vaccine was introduced for infants in Australia and the Hib vaccine in 1992 (Vic Dept. Health, 2006).

Both of these vaccines also contain ethylmercury - approximately twelve micrograms in the hepatitis

B vaccine and twenty-five micrograms in the Hib vaccine (Kirby D, 2005, p.81). Other sources of

mercury in infants include the Rho (D) immunoglobulin injection (65 micrograms of mercury) which

is administered to mothers prenatally and also the flu vaccine (Kirby D, 2005, p.65).

Governments first became concerned about the cumulative effects of mercury in vaccines in 1999,

when parents (who had observed their infants development change after vaccination) linked the

symptoms of autism to mercury poisoning (Kirby D, 2005). The Environmental Protection Agency’s

(EPA) daily standard for mercury in adults is 0.1 micrograms per kilogram (Kirby D, 2005). Mercury

is known to be more toxic in infants than in adults (Kirby, 2005, p.311). It is estimated that children in

the nineties were receiving many times more than the daily limit of mercury with each vaccination

(Kirby D, 2005, p.82).

There is evidence from America and Australia that doctors were not informed of the amount of

mercury in vaccines (Kirby D, 2005). Halsey N, (1999) the Director of Vaccine Safety in America, is

quoted as saying in an American Academy of Pediatrics (AAP) committee report “doctors should be

told soon about the amount of mercury in vaccines and the conflict with a federal health guideline.”

(Kirby D, 2005, p.70). Halsey N, (1999) also stated “no-one knows what dose of mercury, if any is

safe, and we can claim there is no evidence of harm but the truth is no-one has looked.” (Kirby D,

2005, p.71).

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It is a scientific fact that neurodevelopment disorders such as autism have similar symptoms to those

of mercury poisoning (Coulter H., 1990: Kirby D, 2005, p. 73). The Institute of Medicine (IOM)

stated in 1999 that an association between mercury and autistic behaviours is biologically plausible

(Kirby D, 2005). Researchers have linked heavy metals with affecting the neurotransmitters –

chemical substances needed for the proper functioning of the nervous system (Needleman H, 2000).

Alteration of the prefrontal lobes affects decision-making, choices, resisting impulses and behaviour

(Needleman H, 2000).

This is consistent with research on the causes of autism, which indicates autism is a result of

immature development and organization of the brain, in particular of the frontal and temporal lobes

(Coulter, 1990, p.25: Kirby D, 2005). Mercury and Aluminium are examples of heavy metals and

these with other metals are found in vaccines.

There are several causes of Autism of which one is genetics (Autism Association NSW). The rate of

autism spectrum disorders in developed countries was 1 in 10,000 a decade ago, today they are 1 in

166 (Autism Association NSW). As it is unlikely there has been an increase in the percentage of

people with the autism gene in such a short time period, it is plausible to suggest that an

environmental toxin is causing the observed increase in autism (Kirby D, 2005)

Children with autism have very different immune profiles from normal children. They are found to

have increased autoimmunity and an imbalance of the normal immune response (Kirby D, 2005,

p.465). Environmental triggers can cause the immune system to dysfunction (Behrman et al, 1998).

An FDA memo in the American Register in 1982, claimed thimerosal was among the most toxic of

mercury compounds and an unreliable preservative (Kirby D, 2005, p.83). It is also highly allergenic

with symptoms often not appearing until well after exposure (Kirby D, 2005, p.83). Evidence suggests

some children have a genetic problem with expelling mercury from the body and these predisposed

children are more at risk of permanent neurological damage particularly when exposed to the live-

virus MMR vaccine at eighteen months of age (Kirby D, 2005). This genetic predisposition appears to

be four times more common in boys than girls (Kirby D, 2005, p.143). Refer Appendix 6.

The neurological theory of autism is described in Coulter H, (1990, p.1-51). It illustrates the

relationship between autism, palsies and vaccine-induced encephalitis as well as the link with Sudden

Infant Death syndrome (SIDS). Coulter H, (1990) also states that the medical profession has known

for a long time that “encephalitis, especially from vaccination can give rise to an allergic state, while

conversely the existence of an allergic state predisposes to the development of encephalitis after

vaccination.” (p. 152-155).

In the NHMRC 1994 guidelines doctors are informed that pertussis vaccine does not cause infantile

spasms, epilepsy, or Sudden Infant Death syndrome. Yet vaccine induced brain injuries in children

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are on a scale from those who completely recover to mild forms of ADD or ADHD, learning

difficulties to autism, seizures and death (Fisher B, 2004). Coulter and Fisher (1985) noted that

allergic children react more strongly to the DPT shot and that vaccines seem to heighten existing

allergic sensitivities (Coulter, 1990, p151).

Analysis

Judging from the name of this section in the context of a thesis called “An analysis of the Federal

Government’s pertussis immunisation policy” it is entirely reasonable to expect that this section

would contain some, if not all of the following information in relation to pertussis immunisation in

Australia;

1. The vaccine ingredients, particularly for the pertussis containing vaccines

2. The function of the vaccine ingredients

3. The dose of the vaccine ingredients

4. The safety profile of the vaccine ingredients

5. Whether the vaccine ingredients have changed over time

6. Citation of published peer reviewed scientific studies to support claims and statements,

particularly involving safety

Unfortunately Section 6.1 The Vaccine Ingredients does not address any of these topics using a

scientific approach. However these topics do provide a framework with which to place and examine

the contents of Section 6.1 of the thesis

The vaccine ingredients, particularly for the pertussis containing vaccines

This section begins with the sentence “Parents are told that the chemicals and virus’s/bacteria in

vaccines will not overload a baby’s immature immune system nor will it harm their developing

neurological systems.” This statement infers that vaccines contain “chemicals and virus’s/bacteria”.

No vaccines contain living bacteria; whole cell pertussis vaccines do contain bacteria, which have

been heat inactivated, and are therefore no longer a living or viable organism but a collection of

antigens and proteins. The acellular pertussis vaccine, which has been used in Australia since 1999,

contains only 3 proteins from B.pertussis. The phrasing employed can only be viewed as being

designed to scare the reader.

The other ingredients the author lists include “thimerosal (a mercury compound), sodium chloride,

sodium hydroxide, aluminium hydroxide, aluminium hydrochloride, sorbitol, hydrolyzed gelatin and

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formaldehyde.” The author also refers to “aluminium phosphate and other stabilisers”. The only

reference given is to a website “Informed Choice” (http://www.informedchoice.info/cocktail.html).

Unfortunately the data on this site do not support the author’s claims. The website cited makes no

mention of sodium chloride (also commonly known as ‘salt’) or sodium hydroxide in any of the three

pertussis containing vaccines. At no time in either this section, or in fact during the entire thesis does

the author state which pertussis vaccine is used within Australia, or from what period of time.

The function of the vaccine ingredients

The thesis gives some information on the possible functions of these ingredients. However, the

information about the actual vaccine ingredients of pertussis containing vaccines used in Australia

was incomplete and contradicts the references used, There is no information about the function or

rationale for inclusion of the vaccine ingredients apart from the vague reference to “preservatives,

antibiotics and stabilisers”.

However the thesis does choose to state “Aluminium and mercury are heavy metals linked with

neurological damage”. A citation used to support this claim, “Needleman, 2000”, is a website link to

where Dr Herbert Needleman received an award for his work on lead poisoning in children. There is

no mention of mercury or aluminium in this reference. While Dr Needleman has written over 100

scientific articles on lead toxicity he does not appear to have ever even mentioned aluminium. These

false attributions of statements about mercury and/or aluminium toxicity to a well-known and

respected scientist to bolster claims by the author of the thesis appear to support a case of academic

misconduct.

This paragraph also states “formaldehyde is a brain carcinogen”. The author produces no scientific

links to support this claim. The doses at which formaldehyde, mercury or aluminium are likely to

have these affects is not mentioned. The only references to support these statements are from key

critics of vaccination. David Kirby is a journalist and the author of a 2005 book entitled “Evidence of

Harm: Mercury in Vaccines and the Autism Epidemic”. Kirby writes about mercury in vaccines and

focuses on the early work of the anti-vaccination organisation “Safe Minds”. A review of this book in

the British Medical Journal concluded that “The only value of this woefully one sided account of the

mercury and autism controversy is the insight it offers into the way that credulous journalists have

contributed to the public nuisance and private distress caused by antivaccine campaigns.” (Fitzpatrick,

2005). The other reference is to a book by Neil Z Miller, Director of the Think Twice Global Vaccine

Institute, another prominent anti-vaccination organisation. Neither of these references is published in

peer-reviewed scientific journals.

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The dose of the vaccine ingredients

One of the key tenets of pharmacology is that the dose makes the poison. As such a critical factor in

the assessment of the safety of any ingredient present in a vaccine must surely include how much of

that ingredient is present. The author makes a single reference to a whole cell pertussis (DTPw)

vaccine containing 25 µg of ethylmercury. This is incorrect. It actually contains 25 µg of thimerosal

of which mercury is a component). There is no information on how much aluminium, formaldehyde

or any of the other vaccine ingredients is contained in any pertussis vaccine.

Thimerosal/mercury was removed from the Australian childhood vaccine schedule in 2000. The

author makes no mention of this crucial point within the vaccine ingredients section or in fact at any

point during the thesis. The author does refer, in Table 2 (page 19 of the thesis), to a recommendation

by the US-based Institute of Medicine to phase out the use of thimerosal/mercury in 1999 but neglects

to mention that it occurred in Australia only a year later. The author repeatedly states that the pertussis

vaccine contains mercury (which in turn is referred to as a “nerve poison” and agent of “neurological

damage”) when in fact the vaccine used in Australia had been mercury-free for at least six years prior

to the submission of the thesis.

The statements “It is present in the DPTw vaccine, which is given to children before the age of six

months” and “Each dose of the whole-cell DTP vaccine contains approximately twenty-five

micrograms of ethylmercury (Kirby D, 2005, p.81). This may vary between brands.” imply that the

whole cell pertussis vaccine is still in use, even though the author states elsewhere in the thesis that it

was phased out in Australia in 2004. Even this 2004 date is incorrect as the whole cell pertussis

vaccine was completely removed from the Australian vaccination schedule in 1999, a full five years

before this date (http://tinyurl.com/jvkth2k).

The safety profile of the vaccine ingredients

The author includes the statement “The Environmental Protection Agency’s (EPA) daily standard for

mercury in adults is 0.1 micrograms per kilogram (Kirby D, 2005)”. A direct reference to the EPA

was not used. While this standard is used for chronic exposure it is relevant only for methylmercury,

not ethylmercury. There is a large body of evidence that demonstrates that ethylmercury is far less

toxic than methylmercury. To be more specific, a study in the Lancet journal in 2002 (Pichichero et

al., 2002) looked at the effect of giving infants vaccinations containing ethylmercury (thimerosal).

This study concluded that, “Administration of vaccines containing thiomersal does not seem to raise

blood concentrations of mercury above safe values in infants. Ethylmercury seems to be eliminated

from blood rapidly via the stools after parenteral administration of thiomersal in vaccines.” This study

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was published in a major journal 5 years before the thesis was submitted. It is reasonable to assume

that the author had access to this article as a paper from the same journal was cited in the thesis

bibliography (Moxen, 1990)

Have the vaccine ingredients changed over time?

Throughout the thesis the author never specifies which DTPw/DTPa vaccine is being discussed.

Vaccines are made by a wide variety of companies and this varies both by location and time (which

the author herself alludes to in paragraph 3 of Section 6.1, “The manufacturing processes of different

brands of pertussis vaccines will result in variations in the efficacy and safety of these vaccines

between countries.”). Any examination or explanation of the differences between DTP vaccines is

absent and as such it is difficult to assess many of the claims in this section.

Citation of published peer reviewed scientific studies to support claims and statements,

particularly involving safety

Section 6.1 of the thesis contains over 1000 words and 47 references but does not cite a single

published peer-reviewed scientific study. This is a section that it could be assumed would rely heavily

on the published scientific literature in terms of ingredient toxicity or clinical trials of vaccine safety.

In fact this analysis has already included two peer-reviewed scientific studies on the topic of vaccine

ingredients. However, in the absence of citing scientific papers, the book “Evidence of Harm:

Mercury in Vaccines and the Autism Epidemic” was cited 26 times. Additionally books, websites

and magazine articles by other prominent vaccine critics, including Neil Z Miller (see above), Barbara

Loe Fisher (President of the powerful US anti-vaccination organisation National Vaccination

Information Center), and Harris Coulter (a “leading homeopathic historian”) account for 11 citations.

79% of the citations in this section were from authors with well-known anti-vaccine views.

Additionally three citations of Needleman, as discussed above, were unrelated to the statements in the

thesis.

In addition to the points raised previously this section is littered with statements that have no

supporting scientific references, and in fact go against the current scientific consensus including, but

not limited to;

“It is known that toxicity of mercury is increased when combined with other ingredients such as

aluminium and formaldehyde (Informed Choice, 2006: Kirby D, 2005).”

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“It is a scientific fact that neurodevelopment disorders such as autism have similar symptoms to those

of mercury poisoning (Coulter H., 1990: Kirby D, 2005, p. 73).”

“As it is unlikely there has been an increase in the percentage of people with the autism gene in such

a short time period, it is plausible to suggest that an environmental toxin is causing the observed

increase in autism (Kirby D, 2005).”

The author also overlooks many references that would have contradicted the case that vaccine

ingredients are safe at the levels at which they are used. An example of the scientific literature

available to the author but not utilised is the peer reviewed paper “Vaccine components and

constituents: responding to consumer concerns” (Eldred et al., 2006). This paper was published in the

Medical Journal of Australia and examined over 10 different vaccine ingredients from the Australia

vaccination schedule. This paper was published a year before the thesis was submitted, and in a

journal which the author has already demonstrated she had access to (she cited 11 papers from that

journal in her bibliography).

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Example 3: Tables 6 and 7

Summary

• The author has chosen a very old paper (1966) to demonstrate pertussis vaccine efficacy when

more recent (2004) studies examining the same parameters in more depth were available. The

whole cell pertussis vaccine used in 1966 had been replaced nearly a decade before the thesis

was submitted.

• The author has changed the names/descriptions of the categories of immunisation status

without acknowledgement and has then further manipulated data without any clear scientific

rationale.

• The author has made several claims that are incorrect, and could be viewed as dangerous, if

taken at face value by a member of the public.

Thesis pages 39-40 including Tables 6 and 7. Entirety of text included and italicised.

In 1966, Adams I. and Barron A, reported “Pertussis is a disease which in the public mind does not

carry with it a fear of high mortality or lifelong morbidity. The vaccine, which gives a high degree of

protection, (although not complete) has been in use for many years. It is therefore of interest to note

that pertussis epidemics continue to occur in Australian communities with considerable regularity.”

Pertussis was considered at this time to be a disease of low morbidity and mortality despite the

epidemics. Table 1 (Part 1) indicates that mortality due to pertussis in 1966 was 4 deaths per year.

This article reports that pertussis was occurring largely in unimmunised children in the Sydney

community. The information to support this statement is given in Table 6.

Reference: Adams I. and Barron A, 1966, MJA, Vol. 1, No.2.

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The authors concluded from the information in Table 6, that the majority of patients had received no

immunisation or if they had commenced their immunisation, they had failed to complete it (Adams I.

and Barron A, 1966).

It is interesting to examine this table from a different perspective. It is possible to say 41% of these

children were fully or partially immunised and 59% of them were unimmunised. If the 6.5% fewer

than two months are not included because they are ineligible for immunisation, this leaves 52.5% of

the cases unimmunised. These figures are compared in Table 7.

Nearly half of the children who got pertussis had some immunisation status. The reason for

immunizing is to gain some protection from the disease. The statistics indicate that one-third of fully

vaccinated children still got infected with pertussis. This does not support the earlier statement that

‘the vaccine gives a high degree of protection.’ The ACP (1991) agrees that two doses are inadequate

yet infants are vaccinated at two months of age.

Analysis

The author has chosen to use an obscure (and previously uncited) article to demonstrate efficacy of

the pertussis vaccine. This article was 41 years old at the time of thesis submission. The study by

Adams and Barron (Adams and Barron, 1966) examines the vaccination status of 137 hospitalisations

from Sydney Metropolitan hospitals in 1964. While age does not necessarily reduce the validity of

research, the fact that this was a study involving whole cell pertussis vaccines, which had not been

used in Australia for nearly a decade at the time that the thesis was submitted, raises questions about

the appropriateness of this reference. No other figures or tables apart from those based on Adams and

Barron were used in this section of the Thesis (5.2 The efficacy of the pertussis vaccine).

Our own search of the scientific literature revealed a more relevant and up to date paper by Elliott and

colleagues (Elliott et al., 2004) that studied infant hospitalisations in Australia in 2004. The

nationwide study looked at vaccination status (even as far as number of injections of the acellular

vaccine) and was published three years before the thesis was submitted. The author had already cited

20

a paper from this journal (Kimura et al, 1990) and three other articles by one of the co-authors Peter

McIntyre, so clearly the author was familiar with the journal and the co-authors of the paper.

One possible reason that the author did not cite this highly relevant paper was that it demonstrated

that 97/140 (69%) infant hospitalisations for pertussis were in unvaccinated children, and that only 4

cases were in fully vaccinated children (2.9%). This contribution of unvaccinated children to

hospitalisations found by Elliott et al. actually closely mirrors the data produced by Adams and

Barron (unimmunised children were responsible for 69% and 59% of hospitalisation for pertussis

respectively). However Elliott et al. did a more detailed analysis and their work investigated a cohort

of children vaccinated with the current acellular pertussis vaccine.

Adams and Barron found that only 27% of hospitalisations were children whose “immunisations

(were) up to date” whereas 59% were in children who had “failed to obtain any immunisation”.

Additionally, 14% of hospitalised children were classed as “failed to keep immunisations up to date.”

Interestingly when the figure from Adams and Barron was reproduced in this thesis the categories had

been subtly modified, e.g. “immunisation up to date” had become “Immunised”. In fact through this

section of the thesis the author refers to children in the “immunisation up to date”/”immunised”

category as “fully immunised”. This subtle yet crucial manipulation of the category titles changes the

context of Table 6, and the following analysis within the thesis significantly. For example, a young

child who has had a single immunisation shot of a three shot protocol would still be categorised as

“immunisation up to date”, but would certainly not be classed as “fully immunised” by other authors

in this field. Table 6 was referenced as “Adams I. and Barron A, 1966, MJA, Vol. 1, No.2.” yet the

author never acknowledges the changes that were made to the categories relating to immunisation

status.

Table 7 is also highly manipulated although the author acknowledges the changes - pooling the

groups she has re-classified as “fully” and “partially” immunised, and removing the 9 unvaccinated

infants under 2 months of age. There is no scientific reason offered for removing the 9 infants under

2 months of age from the data. They were clearly hospitalised with pertussis and had not received a

pertussis vaccination. The author appears to undertake several rounds of manipulation of the data in

order to be able to draw the following conclusion “Nearly half of the children who got pertussis had

some immunisation status”. This conclusion is not supported by the Adams and Barron study.

The author then uses the manipulated data to make the dangerous claim that “The statistics indicate

that one-third of fully vaccinated children still got infected with pertussis”. There are several errors

with this statement. Firstly, Adams and Barron examined children hospitalised with pertussis infection

rather than simply children with pertussis infections. Secondly, it is simple to assess the authors’

claim. The author characterised 37 children as “fully immunised”. If these 37 children constituted

one third of the fully vaccinated children in Sydney then only 111 children in Sydney were fully

21

vaccinated. It can be roughly estimated, based on the Australian Commonwealth Yearbook data, that

there were approximately 230,000 children in Sydney less than 5 years of age in 1965

(http://tinyurl.com/m6l8rly).

Additionally a 1964 paper by Douglas and colleagues (Douglas et al., 1964) in 1964 examined the

rate of diphtheria immunisation status in school children in Sydney. While this report does not give us

directly the number of children who were vaccinated against pertussis, because the diphtheria and

pertussis vaccines were combined it does provide an indication of vaccination rates in Sydney in

1964. This paper concluded that between 82 – 96% of the schoolchildren tested were immunised

against diphtheria.

22

Conclusions

The authors of this report are concerned that the three sections of the thesis discussed represent a

prima facie case of academic misconduct.

• Claims were made that were not supported by the data produced

• Claims were made that were not supported by the citations given

• References were ignored that the author would be reasonably expected to have access to, but which

did not support her claims.

• Tables and figures were presented and modified in a manner which misrepresents the data.

• Critical pieces of information about the pertussis vaccine in Australia such as the removal of

mercury in 2000 or the switch from whole cell to acellular pertussis vaccines in 1999 were omitted

from the thesis.

The thesis presents a highly exaggerated view of the risks of pertussis vaccination in Australia, which

is not supported by evidence while concurrently down playing any benefits of the pertussis vaccine. In

fact there is no information of the efficacy of the current (post-1999) acellular pertussis vaccine

within the thesis in spite of multiple studies, including a systematic review by the Cochrane

Collaboration being available prior to submission.

We respectfully request that the University processes this allegation according to its policies. We

wish to remain anonymous to the author of the thesis in question, and to her supervisors, current and

previous.

23

Additional Bibliography

ADAMS, A. I. & BARRON, A. O. 1966. Pertussis in Sydney: an indicator of the problem facing health educators. Medical Journal of Australia, 1, 41-5.

ANDREWS, R., HERCEG, A. & ROBERTS, C. 1997. Pertussis notifications in Australia, 1991 to 1997. Communicable Diseases Intelligence, 21, 145-8.

DOUGLAS, A., WOOLARD, T. J. & BOGER, J. R. 1964. Immunization State of School Children in the Sydney Area as Determined by the Schick Test. Medical Journal of Australia, 2, 1017-8.

ELDRED, B. E., DEAN, A. J., MCGUIRE, T. M. & NASH, A. L. 2006. Vaccine components and constituents: responding to consumer concerns. Medical Journal of Australia, 184, 170-5.

ELLIOTT, E., MCINTYRE, P., RIDLEY, G., MORRIS, A., MASSIE, J., MCENIERY, J. & KNIGHT, G. 2004. National study of infants hospitalized with pertussis in the acellular vaccine era. Pediatric Infectious Disease Journal, 23, 246-52.

FITZPATRICK, M. 2005. Evidence of Harm. Mercury in Vaccines and the Autism Epidemic: Medical Controversy. BMJ, 330.

PICHICHERO, M. E., CERNICHIARI, E., LOPREIATO, J. & TREANOR, J. 2002. Mercury concentrations and metabolism in infants receiving vaccines containing thiomersal: a descriptive study. Lancet, 360, 1737-41.