Andrew Wakefield

Autism: Revisiting the MMR Myth

Last June I wrote an Article about the MMR vaccine and the unfounded claims that it is linked to Autism. Since then I have had numerous questions from concerned parents on the topic and I just wanted to clarify the situation. I think the easiest way to do this is to run through a step by step account of what has actually happened in the seventeen years.

1994

Richard Barr

A solicitor called Richard Barr succeeds in winning legal aid for the pursuit of a class action against the manufacturers of MMR based on the claim that the MMR vaccine is a defective product, which has been widely used since 1988. Due to legal complexities, the class action must be filed and argued within ten years of the initial date that the drug was released, leaving less than four years to prepare a case. At this point, publications written by Dr Andrew Wakefield, which proposed the possibility that the Measles virus, may play a role in the development of Inflammatory Bowel Disease and Crohn’s disease. Barr contacted Dr Wakefield for his expertise on the Measles Virus.

1998

Dr Andrew Wakefield

A paper is released by Doctor Wakefield and twelve other Doctors. The paper is based on twelve children with Autistic Spectrum Disorders. The paper is published by The Lancet – a small, but respected medical journal. The paper states that the parents of eight out of the twelve children believed that their children developed “behavioural symptoms” shortly after being given the second dose of MMR vaccine, which is typically given to children at around four years of age, with the first dosage around 13 to 14 months. The paper also states that although these findings were interesting, no casual link had actually been established between the vaccine and Autistic Spectrum Disorders.

Doctor Wakefield takes it upon himself to call for the suspension of the MMR vaccine at a press conference and via a video statement, which were quickly picked up by the media, and so the MMR scare began.

As an interesting side note, Doctor Wakefield suggested that parents should opt for separate Measles, Mumps and Rubella vaccines, separated by at least a year. However, the media seemed to miss this point and many parents were unaware of this option still existed. Separate vaccines were also unpopular with the UK’s National Health Service due to increased costs.

Now before we continue, I feel it is important to point out that in 1993, Japan had a similar scare and after the suspension of the vaccine, in-depth research found no evidence of a link between ASD’s and MMR.

2001

Doctor Wakefield resigns from his post at the Royal Free Hospital, stating that he has been asked to leave due to the unpopular nature of his research and irreconcilable differences with senior staff at the hospital. By this time, Doctor Wakefield has by now gained significant support from concerned parents whose children have some form of ASD and have also had the MMR Vaccine, as most children by this stage have. For many in the media, the idea that the link between ASD and MMR exists is now unequivocal, despite ongoing research which appears to point to the contrary and objections from many respected medical professionals. There are rumours of cover-ups and conspiracies and the media again fans the flames of this particular scare – going so far as to demand to know if the UK Prime minister at the time (Tony Blair) has allowed his youngest son to have the vaccine.

2002

The story has now taken on a life of its own, becoming one of the leading debates of the year. Media confidence is shaken however, when co-author of Dr Wakefield’s original paper, Dr. John Walker-Smith comes releases a paper that finds the MMR vaccine to be safe in the vast majority of children. He adds the caveat that although no direct link between Autism and MMR is obvious, epidemiology is a blunt tool, and it is possible that a sub-group of children may exist who have a slightly increased risk of developing autism from the MMR vaccine. He also states that no evidence can be found that the MMR vaccine is damaging to the immune system, and if anything the reverse appears to be true.

Another co-author of the original paper, Dr Berelowitz comes forward, stating: “I am certainly not aware of any convincing evidence for the hypothesis of a link between MMR and autism”.

By December, several independent studies using much larger research groups have been carried out by Canadian Paediatric Society, the American Centers for Disease Control and Prevention, the American Institute of Medicine of the National Academy of Sciences and the UK National Health Service. All of their studies reach the same conclusion – that there is no apparent link between the MMR vaccine and Autism.

2004

An investigative reporter named Brian Deer discovers that Dr. Wakefield received £55,000 funding from the legal Aid Board via Richard Barr shortly prior to the release of the original paper for producing evidence to use against vaccine manufacturers. This is deemed a conflict of interest as neither the Royal Free Hospital, nor the Lancet had been made aware of this payment. Dr Wakefield, claims that the payment was for an unrelated paper which was never published (a claim which later is rejected by the Medical Council).

Brian Deer goes on to create a televised documentary, exposing the shocking fact that Dr. Wakefield had applied for a patent on a vaccine that would be in direct competition with the MMR vaccine.

During a debate, a Member of Parliament, Dr Evan Harris calls for a Judicial Enquiry into Dr. Wakefield’s ethics and suggests the Crown Prosecution Service works in Conjunction with the General Medical Council to conduct a formal investigation into the situation.

In May, The Lancet formally retracts the original paper and criticises Dr. Wakefield and his co-authors for lack of disclosure and issues a formal apology.

2005

Dr. Wakefield brings legal action against Channel 4 productions and Brian Deer, however Wakefield quickly drops the case and pays the defendants legal costs shortly after revelations that undisclosed payments totalling more than £400,000 had been made to Dr Wakefield, at or around the time of the original paper had been released, by lawyers.

2006

Brian Deer releases formal documentation, clarifying the financial situation. Dr. Wakefield had been paid several payments totalling £435,643 by solicitor’s legal aid, via Richard Barr. The payments had started in 1996, two years prior to the paper being released.

The General Medical Council, after investigation, confirms that it will hold a formal disciplinary hearing of Dr. Wakefield and his involvement with the affair, including claims that Dr. Wakefield manipulated data for his own benefit.

2007

The General Medical Council begins formal hearings of Dr. Wakefield, Professor John Angus Walker-Smith, and Professor Simon Harry Murch, under allegations of Serious Professional Misconduct.  The allegations where that these three individuals had acted unethically and dishonestly. Further to this, it was alleged that they had conducted a study on children without seeking the appropriate approvals.

2010

After much consideration, the General Medical Council reaches its formal conclusion. The panel found that the trio had acted “dishonestly and irresponsibly” and that Wakefield had treated the children involved with his study with “callous regard” and had conducted unnecessary and invasive tests. Wakefield was found to have numerous and undeclared conflicts of interest.

Wakefield was found guilty of serious professional misconduct on four counts of dishonesty and 12 involving the abuse of developmentally challenged children, and was ordered to be struck off the medical register.

John Walker-Smith was also found guilty of serious professional misconduct and struck off the medical register. Simon Murch was found not guilty, despite having previously been found to not have ethical approvals for the study.

2011

Earlier this month Brian Deer published more articles, showing exactly how Wakefield manipulated the data in his study. After interviewing the parents of the children involved in the study, it appears Wakefield manipulated the dates, so that it appeared the children became symptomatic at or just after their second MMR vaccine.

A few days ago, the Deer revealed that based upon documents he obtained under Freedom of information legislation, Wakefield—in partnership with the father of one of the boys in the original study—had planned to launch a venture on the back of an MMR vaccination scare that would profit from new medical tests and “litigation driven testing” and due to patents that Wakefield holds, would earn as much as £26 million per year for the diagnosis of “Autistic enterocolitis”, a term coined by Wakefield, referring to a controversial and unproven condition.

My View:

Let’s forget the controversy for a moment and look at the facts. Many parents still believe the MMR vaccine is dangerous and many still believe there is a link to Autism. The truth is that Autism in any form is a complicated condition. If there is anything positive to take away from the above controversy, it is that research has been extremely popular over the past ten years or so on the subject of Autism. The latest findings point to the fact that Autism has two elements. It appears that people with Autistic Spectrum Disorders have certain common genetic factors, but that doesn’t cause Autism on its own. There is a missing piece to the puzzle – an environmental cause. Could that factor be the MMR Vaccine? Research studies have thoroughly ruled that out. In fact it is now thought that whatever environmental trigger combines with these genetic factors almost certainly happens before your birth – in the womb.

The whole point of this post was to address the myth devised by Wakefield about a link between MMR and Autism and I believe that the facts speak for themselves – there is no link.

However, Wakefield’s research caused an unprecedented public outcry, and well meaning parents left their children unvaccinated. In 2008 the number of deaths caused by the Measles was 90% higher than ten years earlier. Due to the high fever and temperature caused by these diseases, an alarming number of children suffered irreversible brain damage and lung conditions.

There are risks with Vaccination – it would be irresponsible of me to say there aren’t. Some children react badly to them, some children very badly, but what we need to look at here is which risk worse? As a parent, that is up to you to decide and you must simply follow your conscience and hope it is the better choice.

If you have any comments or further questions, please feel free to ask or to email me.

Best wishes

ZenEmu X