On January 5, 2011, The British Medical Journal declared fraudulent the published medical study that launched a global vaccine scare thirteen years ago.1
How the MMR Vaccine Scare Began
In 1998, a major medical journal based in the UK, The Lancet, published a report2 headed by Andrew Wakefield, who was at that time a gastroenterological surgeon and medical researcher.The report implied a causal link between the measles, mumps, and rubella (MMR) vaccine and the development of autism combined with IBD in children, which Wakefield described as a new syndrome he named “autistic entercolitis”. For more than a decade, the media has widely reported on the study, leading tens of thousands of people to believe that the suggestion about the MMR vaccine must be true. As a result of this global vaccine scare, immunization rates dropped in the UK3 and North America4. This of course has also lead to an increase in recent years of cases of measles, which the vaccine could have prevented.5
Credible medical journals publish many hundreds of research studies each year. Reports are peer reviewed by the journals’ medical panels, a rigorous process that can take months or years before a study sees publication. Despite these painstaking procedures, mistakes still happen; all research reports have the potential for bias and, on occasion, a flawed, mistaken, or even outright fraudulent paper somehow gets through.
Immediately after The Lancet published the paper in 1998, the medical community quickly rose up to refute the study for some obvious issues. For example, the study only included twelve children, and much of the “data” used came from what the children’s parents themselves observed and what they believed had caused the developmental and gastrointestinal issues. This kind of data is always questionable, particularly in a medical journal, as it is not what one would normally consider scientifically reliable. Wakefield nonetheless found strong supporters, including high-profile celebrities, such as Jenny McCarthy, an American model (Playboy), comedian, actor, author, and activist, who used her public status to campaign against the MMR vaccine, based on Wakefield’s research.
Other researchers have conducted similar studies, diverting thousands of research dollars toward this particular issue, but no similar autism/IBD syndrome has been found, nor any verifiable link between autism and the MMR vaccine, nor any link between IBD and the MMR vaccine.6
Conflict of Interest and Research Don’t Mix
In 2004, a UK journalist named Brian Deer helped to expose the fact that Wakefield had a financial conflict of interest related to the study.7 Firstly, the Wakefield study’s funding sources included a lawyer who was working on an anti-vaccine lawsuit for people who believed that the vaccines caused their children’s medical conditions. Secondly, the lawyer paid Wakefield to assist with the lawsuit. Ten of the thirteen co-authors then withdrew their support of the Lancet paper’s interpretation section. Their retraction read, “We wish to make it clear that in this paper no causal link was established between (the) vaccine and autism, as the data were insufficient. However, the possibility of such a link was raised, and consequent events have had major implications for public health. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon these findings in the paper, according to precedent.”8
Despite that partial retraction and the mounting criticism of the original paper that so powerfully ignited the MMR vaccine scare, Wakefield continued to find supporters among other researchers and thousands of parents of developmentally delayed and/or IBD children. In 2004, Wakefield founded “Thoughtful House Center for Children” in Texas, where even though he did not hold a medical licence, he led the clinic’s research program. The organization was technically not-for-profit, but Wakefield received an annual salary of nearly US$300,000.3
Profiting From Parents’ Fears
IBD and autism each affect young children and have debilitating effects on their lives. There is no known cause or cure for either disease. It is hard to conceive of a more vulnerable group of patients and concerned parents, particularly if a child appears to have symptoms of both diseases at once. Wakefield’s message to those parents was clear: We know the cause of these diseases and we know exactly how to prevent them. A further implication was that parents themselves were to blame for their children’s suffering. They were claims that would be difficult for any desperate parent, feeling guilty and helpless by a child’s confusing, debilitating illness, to resist. Despite the fact that no researchers independent of Wakefield and his associates have been able to replicate the results of the 1998 paper, or that Wakefield had an obviously unethical financial interest in the study, parents still found it difficult to accept that the medical community has no known cause or cure for autism or IBD. Many parents were also – and perhaps still are – afraid to give their children the MMR vaccine.
If research papers can contain such immense mistakes, how does a non medical professional know which “evidence” to believe? What if people still believe Wakefield’s research, even if it’s proven fraudulent?
“The oldest and strongest emotion of mankind,” wrote famous horror writer H.P. Lovecraft, “is fear.”
Serious Professional Misconduct
Soon after The Sunday Times published another damning investigative report by UK journalist Brian Deer on December 31, 20069, the UK General Medical Council (GMC) launched what would be the longest Fitness to Practice hearing in its history. Announcing its findings on January 28, 2010, the GMC found more than a few biases in Wakefield’s study and research practices:10
- Wakefield did not conduct the 1998 study according to ethical standards for research.
- Wakefield lied in the Lancet paper when he wrote that the participating children were referred independently after being diagnosed with IBD or other major gastrointestinal issues. In fact, many of the children were chosen specifically by Wakefield, and others were recruited with the help of the same lawyer who was paying him to conduct the study.
- Wakefield subjected vulnerable autistic and other developmentally challenged children to a variety of difficult GI tests, including colonoscopy and lumbar puncture (i.e., spinal tap), without any medical indication to benefit the children.
- Even before publication of the study, Wakefield was working on patenting his own version of a measles vaccine, which he would sell at a great profit as a supposedly “safe” alternative to the MMR vaccine. The father of one of the children in Wakefield’s study was a cofounder of the planned business that would market this product.
- Unrelated to the particular paper in question, the GMC panel also found that Wakefield had paid children at his own son’s birthday party £5 each so he could draw their blood for use in his research. He later joked about this during a lecture.
The findings of Brian Deer’s many years of investigative journalism, published as a series in The British Medical Journal in 201111, also revealed that the medical records of the children in Wakefield’s article showed that many of them suffered from chronic constipation – the opposite of the diarrhea normally associated with IBD – but Wakefield omitted this information from thestudy. Deer also found that medical tests on the study’s children that came back negative for any IBD were altered in the study to read “non-specific colitis”. In addition to the vaccine patent, Wakefield was also developing a number of businesses to market new diagnostic tools and medications for the mythical syndrome “autistic entercolitis” that he had fabricated. If he had not been stopped, there would eventually have been a wide demand for such tools because of the MMR scare, which Wakefield also created.
On February 2, 2010 – just four days after the release of the GMC’s findings – the editors of The Lancet finally retracted the original 1998 study.3 On May 24, 2010, the GMC panel found Wakefield guilty of serious professional misconduct, concluding that “Dr. Wakefield’s name should be erased from the medical register” in order “to protect patients and
It is only natural that a researcher would dream of making a major new medical discovery, but, dreams aside, breakthrough advances in medical knowledge normally happen through years of dedicated research conducted by many researchers across numerous studies. A single published study usually contributes to a body of research to shape the critical thinking in a particular area. We may not always be sure that a specific study is entirely free of error or bias, but, as in this case, it is sometimes possible to know when a study’s claim cannot and should not be trusted. Conducting studies that replicate, disprove, strengthen, or weaken someone else’s findings may be less exciting, but it is that very process of testing and cross-testing – and of testing again and again – that is crucial to advancing good medical research. No subsequent study has come up with corroborating results for Wakefield’s paper.
A good study will include many participants, and Wakefield’s study included only twelve children. Also, a study will normally focus on one particular disease, disorder, or condition, in order to make the data manageable and to allow for reasonable interpretations from the results. Wakefield, to the contrary, attempted to analyse two major and dissimilar illnesses (autism and IBD) and to study their possible relation to a medical procedure (MMR vaccine) used to prevent yet another dissimilar illness (the measles virus) all in the same study.
Most obvious of all, good researchers will tell the truth, even if their findings are not as they had anticipated or hoped. Wakefield practically hand-picked the twelve children in his study, based on how well their particular symptoms and circumstances fit with the outcome that he – and the lawyer who was paying him nearly half a million pounds – desired. He also omitted undesirable data about the participants and included additional, fabricated data.
With Wakefield’s study exposed as a fraud and resoundingly discredited by the international medical community, researchers can now get back to the arduous business of determining the real causes and possible cures for developmental disabilities like autism and devastating gastrointestinal diseases like Crohn’s and ulcerative colitis. In the meantime, please continue to follow your physician’s advice regarding immunization.
A research report published in 2010 in The Journal of Medical Ethics found that medical reports retracted from journals due to data fabrication were more likely to be associated with a “calculated effort to deceive” rather than an accidental or unintentional falsification.13