NEWS FOCUS:Controversial study suggesting link between vaccination and autism led to sharp drop in immunisations against infectious diseases
A 12-YEAR saga with major ramifications for public health came to an end yesterday when the General Medical Council (GMC) in Britain found Dr Andrew Wakefield guilty of serious professional misconduct over the way he carried out controversial research into the MMR vaccine.
It all started when the gastroenterologist published a paper in the Lancetmedical journal in 1998, suggesting a link between MMR vaccination and the subsequent development of autism in young children.
When the study was published, Wakefield joined others who had been involved in the research at a press conference at the Royal Free Hospital. While most of the researchers present suggested that parents continue to have their children vaccinated with the MMR vaccine pending further research, Wakefield advised they opt for single jabs against mumps, measles and rubella.
These comments and a resulting media campaign led to a sharp drop in the numbers immunised against the infectious diseases.
The controversial study looked at 12 children with developmental and bowel problems. Eight of the children had autism, which their parents reported began soon after their vaccination with MMR. The authors proposed that MMR caused a leaky bowel, which allowed a toxin to enter the body, travel to the brain and cause autism. But the research was open to criticism on a number of fronts: the number of patients was small, there was no control group for comparison, and as it was carried out retrospectively, some parents were surveyed up to eight years after their children’s vaccination, leaving the study open to the possibility of faulty recall.
It was Wakefield’s research methods that the GMC focused on during its two-and-a-half year inquiry. He was accused of carrying out invasive tests on vulnerable children without ethical approval, including colonoscopies, lumbar punctures and brain scans.
During the hearings, it emerged he had collected blood samples from children attending his son’s birthday party, paying each of them £5.
The disciplinary panel also found fault with his failure to disclose that he had been paid to advise solicitors acting for the parents of children suspected of being harmed by the MMR jab.
In striking Wakefield from the UK medical register, Dr Surendra Kumar, the panel’s chairman, said he had “brought the medical profession into disrepute”. Overall, the GMC found him guilty of more than 30 charges.
However, Wakefield continued to maintain his innocence yesterday, saying, “Efforts to discredit and silence me through the GMC process have provided a screen to shield the government from exposure on the MMR vaccine scandal.”
Wakefield originally worked as a transplant surgeon before switching to gastrointestinal research, becoming a senior lecturer at the Royal Free Hospital at the time of the controversial study.
He subsequently left the UK and now works with the International Child Development Resource Center in Florida. He continues to see patients at the Thoughtful House, a centre for autistic children in Texas.
How badly did the controversy affect childhood immunisation rates? Prior to Wakefield’s intervention, MMR uptake rates were above 90 per cent. However, five years later, rates had fallen to 70 per cent and below in some areas. In tandem with this fall, measles rates have gone up, including in the Republic, when an outbreak in 2000 resulted in more than 1,600 cases of the disease and three deaths.
Research here confirmed parents remain wary of childhood vaccination, although most follow medical advice and have their children immunised. The survey of 72 parents attending a Co Galway practice found almost a half had some reservations about the MMR vaccine.
Early this year, the Lancetformally retracted the controversial paper from the public record. It said that claims in the paper that the children had been consecutively referred and that investigations were approved by the local research ethics committee had been proven to be false.
A number of large well-designed studies carried out subsequent to 1998 have found absolutely no scientific evidence that the MMR induces autism in infant children. The vaccination has reduced deaths from measles and also reduced complications from the viral infection, including pneumonia and encephalitis (inflammation of the brain). MMR vaccination rates here have climbed back slowly towards 90 per cent.