The ''Lancet'' MMR autism fraud centered on the publication in February 1998 of a fraudulent research paper titled "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children" in ''
The Lancet
''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823.
The journal publishes original research articles, ...
''.
[ The paper, authored by now discredited and deregistered ]Andrew Wakefield
Andrew Jeremy Wakefield (born September 3, 1956) is a British anti-vaccine activist, former physician, and discredited academic who was struck off the medical register for his involvement in ''The Lancet'' MMR autism fraud, a 1998 study that ...
, and listing twelve coauthors, falsely claimed non-existent, causative links between the MMR vaccine
The MMR vaccine is a vaccine against measles, mumps, and rubella (German measles), abbreviated as ''MMR''. The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, ...
, colitis
Colitis is swelling or inflammation of the large intestine ( colon). Colitis may be acute and self-limited or long-term. It broadly fits into the category of digestive diseases.
In a medical context, the label ''colitis'' (without qualification) ...
, and autism
The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...
. The fraud was exposed in a lengthy ''Sunday Times
''The Sunday Times'' is a British newspaper whose circulation makes it the largest in Britain's quality press market category. It was founded in 1821 as ''The New Observer''. It is published by Times Newspapers Ltd, a subsidiary of News UK, whi ...
'' investigation by reporter Brian Deer
Brian Deer is a British investigative reporter, best known for inquiries into the drug industry, medicine and social issues for ''The Sunday Times''. Deer's investigative nonfiction book, ''The Doctor Who Fooled the World,'' was published in Se ...
, resulting in the paper's retraction in February 2010 and Wakefield being struck off
The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...
the UK medical register three months later. Wakefield reportedly stood to earn up to $43 million per year selling diagnostic kits for a non-existent syndrome he claimed to have discovered.[ He also held a patent to a rival vaccine at the time, and he had been employed by a lawyer representing parents in lawsuits against vaccine producers.
The scientific consensus on ]vaccines and autism
Extensive investigation into vaccines and autism has shown that there is no relationship between the two, causal or otherwise, and that the vaccine ingredients do not cause it. Vaccinologist Peter Hotez researched the growth of the false claim a ...
is that there is no causal connection between MMR, or any other vaccine, and autism.
1998 ''The Lancet'' paper
In February 1998, a group led by Andrew Wakefield
Andrew Jeremy Wakefield (born September 3, 1956) is a British anti-vaccine activist, former physician, and discredited academic who was struck off the medical register for his involvement in ''The Lancet'' MMR autism fraud, a 1998 study that ...
published a paper in the respected British medical journal ''The Lancet
''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823.
The journal publishes original research articles, ...
'', supported by a press conference at the Royal Free Hospital
The Royal Free Hospital (also known simply as the Royal Free) is a major teaching hospital in the Hampstead area of the London Borough of Camden. The hospital is part of the Royal Free London NHS Foundation Trust, which also runs services at Barn ...
in London, where the research was carried out. This paper reported on twelve children with developmental disorders referred to the hospital and described a constellation of bowel symptoms, as well as endoscopy
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ...
and biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a diseas ...
findings, that were said to be evidence of a new "syndrome" that Wakefield would later call "autistic enterocolitis". The paper described MMR vaccination as the "apparent precipitating event", tabulated the parents of eight of the twelve children as linking their developmental symptoms with MMR vaccination, suggested the connection between autism and the gastrointestinal
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...
pathologies was "real", and called for further research. But it admitted that the research did not "prove" an association between the MMR vaccine and autism.
At a press conference accompanying the paper's publication, later criticized as "science by press conference
Science by press conference or science by press release is the practice by which scientists put an unusual focus on publicizing results of research in the media, in the form of press conference events or press release statements. The term is usual ...
", Wakefield said that he thought it prudent to use single vaccines instead of the MMR triple vaccine until this could be ruled out as an environmental trigger. Wakefield said, "I can't support the continued use of these three vaccines given in combination until this issue has been resolved." In a video news release issued by the hospital to broadcasters in advance of the press conference, he called for MMR to be "suspended in favour of the single vaccines". In a BBC interview, Wakefield's mentor Roy Pounder
Roy Pounder (born 1944) is a British medical doctor and entrepreneur. He was Professor of Medicine at the Royal Free and University College Medical School in London and clinical vice president of the Royal College of Physicians of London. He is n ...
, who was not a coauthor, "admitted the study was controversial". He added "In hindsight it may be a better solution to give the vaccinations separately ... When the vaccinations were given individually there was no problem." These suggestions were not supported by Wakefield's coauthors nor by any scientific evidence.
British television coverage of the press conference was intense, but press interest was mixed. The ''Guardian'' and the ''Independent'' reported it on their front pages, while the ''Daily Mail'' only gave the story a minor mention in the middle of the paper, and the ''Sun'' did not cover it.[Alt URL]
/ref>
Controversy over MMR
Multiple subsequent studies failed to find any link between the MMR vaccine, colitis, and autism. In March 1998, a panel of 37 scientific experts set up by the Medical Research Council, headed by Professor Sir John Pattison found "no evidence to indicate any link" between the MMR vaccine and colitis or autism in children.
Public concern over Wakefield's claims of a possible link between MMR and autism gained momentum in 2001 and 2002, after he published further papers suggesting that the immunisation programme was not safe. These were a review paper with no new evidence, published in a minor journal, and two papers on laboratory work that he said showed that measles virus
''Measles morbillivirus'' (MeV), also called measles virus (MV), is a single-stranded, negative-sense, enveloped, non-segmented RNA virus of the genus ''Morbillivirus'' within the family ''Paramyxoviridae''. It is the cause of measles. Human ...
had been found in tissue samples taken from children who had autism and bowel problems. There was wide media coverage including distressing anecdotal evidence from parents, and political coverage attacking the health service and government peaked with unmet demands that Prime minister Tony Blair
Sir Anthony Charles Lynton Blair (born 6 May 1953) is a British former politician who served as Prime Minister of the United Kingdom from 1997 to 2007 and Leader of the Labour Party from 1994 to 2007. He previously served as Leader of th ...
reveal whether his infant son, Leo, had been given the vaccine. It was the biggest science story of 2002, with 1257 articles mostly written by non-expert commentators. In the period January to September 2002, 32% of the stories written about MMR mentioned Leo Blair, as opposed to only 25% that mentioned Wakefield. Less than a third of the stories mentioned the overwhelming evidence that MMR is safe.[ The paper, press conference and video sparked a major ]health scare
A health scare can be broadly defined as a social phenomenon whereby the public at large comes to fear some threat to health, based on suppositions which are nearly always not well-founded.
In 2009 an ABC News article listed "The Top 10 Health Sc ...
in the United Kingdom. As a result of the scare, full confidence in MMR fell from 59% to 41% after publication of the Wakefield research. In 2001, 26% of family doctors felt the government had failed to prove there was no link between MMR and autism and bowel disease. In his book '' Bad Science'', Ben Goldacre
Ben Michael Goldacre (born 20 May 1974) is a British physician, academic and science writer. He is the first Bennett Professor of Evidence-Based Medicine and director of the Bennett Institute for Applied Data Science at the University of Oxford ...
describes the MMR vaccine scare as one of the "three all-time classic bogus science stories" by the British newspapers (the other two are the Arpad Pusztai affair
The Pusztai affair is a controversy that began in 1998. Protein scientist Árpád Pusztai went public with the initial results of unpublished research he was conducting at the Rowett Institute in Aberdeen, Scotland, investigating the possible ef ...
about genetically modified crops
Genetically modified crops (GM crops) are plants used in agriculture, the DNA of which has been modified using genetic engineering methods. Plant genomes can be engineered by physical methods or by use of ''Agrobacterium'' for the delivery of ...
, and Chris Malyszewicz and the MRSA
Methicillin-resistant ''Staphylococcus aureus'' (MRSA) is a group of Gram-positive bacteria that are genetically distinct from other strains of ''Staphylococcus aureus''. MRSA is responsible for several difficult-to-treat infections in humans. ...
hoax).
A 2003 survey of 366 family doctors in the UK reported that 77% of them would advise giving the MMR vaccine to a child with a close family history of autism, and that 3% of them thought that autism could sometimes be caused by the MMR vaccine. A similar survey in 2004 found that these percentages changed to 82% and at most 2%, respectively, and that confidence in MMR had been increasing over the previous two years.
A factor in the controversy is that only the combined vaccine is available through the UK National Health Service
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
. As of 2010 there are no single vaccines for measles, mumps and rubella licensed for use in the UK. Prime Minister Tony Blair gave support to the programme, arguing that the vaccine was safe enough for his own son, Leo, but refusing on privacy grounds to state whether Leo had received the vaccine; in contrast, the subsequent Prime Minister, Gordon Brown
James Gordon Brown (born 20 February 1951) is a British former politician who served as Prime Minister of the United Kingdom and Leader of the Labour Party (UK), Leader of the Labour Party from 2007 to 2010. He previously served as Chance ...
, explicitly confirmed that his son has been immunised. Cherie Blair
Cherie, Lady Blair, (; born 23 September 1954), also known professionally as Cherie Booth, is an English barrister and writer. She is married to the former Prime Minister of the United Kingdom, Sir Tony Blair.
Early life and education
Booth ...
confirmed that Leo had been given the MMR vaccination when promoting her autobiography.[
The government stressed that administration of the combined vaccine instead of separate vaccines decreases the risk of children catching the disease while waiting for full immunisation coverage.] The combined vaccine's two injections results in less pain and distress to the child than the six injections required by separate vaccines, and the extra clinic visits required by separate vaccinations increases the likelihood of some being delayed or missed altogether;[MMR vs three separate vaccines:
*
*
*
*] vaccination uptake significantly increased in the UK when MMR was introduced in 1988.[ Health professionals have heavily criticized media coverage of the controversy for triggering a decline in vaccination rates. No scientific basis has been found for preferring separate vaccines, or for using any particular interval between them.]
In 2001, Mark Berelowitz, one of the co-authors of the paper, said "I am certainly not aware of any convincing evidence for the hypothesis of a link between MMR and autism". The Canadian Paediatric Society
The Canadian Paediatric Society (CPS) is a national association of paediatricians.
As a voluntary professional association, the CPS represents more than 3,000 paediatricians, paediatric subspecialists, paediatric residents, and other people wh ...
, the Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
, the Institute of Medicine
The National Academy of Medicine (NAM), formerly called the Institute of Medicine (IoM) until 2015, is an American nonprofit, non-governmental organization. The National Academy of Medicine is a part of the National Academies of Sciences, E ...
of the National Academy of Sciences
The National Academy of Sciences (NAS) is a United States nonprofit, non-governmental organization. NAS is part of the National Academies of Sciences, Engineering, and Medicine, along with the National Academy of Engineering (NAE) and the Nati ...
,
and the UK National Health Service
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
have all concluded that there is no link between the MMR vaccine and autism, and a 2011 journal article described the vaccine–autism connection as "the most damaging medical hoax of the last 100 years".
Newspaper investigation
Conflict of interest
Public understanding of the claims sharply changed in February 2004 with revelations by ''The Sunday Times'' of an undisclosed conflict of interest
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations i ...
on Wakefield's part in that, two years before the paper's publication, he had been approached by Richard Barr, a lawyer of Justice, Awareness and Basic Support
JABS (short for Justice, Awareness and Basic Support) is a British pressure group launched in Wigan in January 1994. Beginning as a support group for the parents of children they claim became ill after the MMR vaccine (which they claim gave t ...
, who was looking for an expert witness to start a planned class action
A class action, also known as a class-action lawsuit, class suit, or representative action, is a type of lawsuit where one of the parties is a group of people who are represented collectively by a member or members of that group. The class actio ...
regarding alleged "vaccine damage". Barr hired Wakefield at £150 per hour, plus expenses, and only then did they recruit the twelve children, actively seeking the parents of cases that might imply a connection between MMR and autism. Barr and Wakefield convinced the UK Legal Aid Board, a UK government organization to give financial support to people who could not afford access to justice, to assign £55,000 to fund the initial stage of the research. According to journalist Brian Deer, the project was intended to create evidence for the court case, but this only became publicly known six years after ''The Lancet'' report, with the newspaper's first disclosures.
Based on Deer's evidence, ''The Lancet'' editor-in-chief Richard Horton said Wakefield's paper should have never been published because its findings were "entirely flawed".[''The Sunday Times'' 2004:
*
*] Although Wakefield maintained that the legal aid funding was for a separate, unpublished study (a position later rejected by a panel of the UK General Medical Council
The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...
), the editors of ''The Lancet'' judged that the funding source should have been disclosed to them. Horton wrote, "It seems obvious now that had we appreciated the full context in which the work reported in the 1998 ''Lancet'' paper by Wakefield and colleagues was done, publication would not have taken place in the way that it did." Several of Wakefield's co-researchers also strongly criticized the lack of disclosure.[
]
No ethical approval
Among Deer's earliest reported allegations was that, contrary to a statement in the paper, Wakefield's research on the 12 children was conducted without any institutional review board authorization—a claim quickly denied in February 2004 by both the paper's authors and the ''Lancet''. The paper itself said, "Ethical approval and consent. Investigations were approved by the Ethical Practices Committee of the Royal Free Hospital NHS Trust, and parents gave informed consent." The dispute over this would remain unresolved, however, until settled in the English High Court in March 2012, where a senior judge vindicated Deer. Quoting the text, Justice Mitting ruled, "This statement was untrue and should not have been included in the paper."
Retraction of an interpretation
''The Lancet'' and many other medical journals require papers to include the authors' conclusions about their research, known as the "interpretation". The summary of the 1998 ''Lancet'' paper ended as follows:
In March 2004, immediately following the news of the conflict of interest allegations, ten of Wakefield's 12 coauthors retracted this interpretation, while insisting that the possibility of a distinctive gastrointestinal condition in children with autism merited further investigation. However, a separate study of children with gastrointestinal disturbances found no difference between those with autism spectrum
The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...
disorders and those without, with respect to the presence of measles virus RNA
Ribonucleic acid (RNA) is a polymeric molecule essential in various biological roles in coding, decoding, regulation and expression of genes. RNA and deoxyribonucleic acid ( DNA) are nucleic acids. Along with lipids, proteins, and carbohydra ...
in the bowel; it also found that gastrointestinal symptoms and the onset of autism were unrelated in time to the administration of MMR vaccine.
Later in 2004, the newspaper's investigation also found that Wakefield had a further conflict of interest
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations i ...
in the form of a patent
A patent is a type of intellectual property that gives its owner the legal right to exclude others from making, using, or selling an invention for a limited period of time in exchange for publishing an enabling disclosure of the invention."A p ...
for a single measles vaccines,[ had manipulated evidence,][ and had broken other ethical codes. The ''Lancet'' paper was partially retracted in 2004 and fully retracted in 2010, when ''Lancet''s editor-in-chief Richard Horton described it as "utterly false" and said that the journal had been deceived.] Wakefield was found guilty by the General Medical Council
The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...
of serious professional misconduct in May 2010 and was struck off the Medical Register
The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...
, meaning he could no longer practise as a doctor in the UK. In 2011, Deer provided further information on Wakefield's improper research practices to the ''British Medical Journal
''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
'', which in a signed editorial described the original paper as fraudulent.
Deer continued his reporting in a Channel 4
Channel 4 is a British free-to-air public broadcast television network operated by the state-owned enterprise, state-owned Channel Four Television Corporation. It began its transmission on 2 November 1982 and was established to provide a four ...
'' Dispatches'' television documentary, ''MMR: What They Didn't Tell You'', broadcast on 18 November 2004. This documentary reported that Wakefield had applied for patents on a single measles vaccine that claimed to be a potential rival of MMR, and that he knew of test results from his own laboratory at the Royal Free Hospital
The Royal Free Hospital (also known simply as the Royal Free) is a major teaching hospital in the Hampstead area of the London Borough of Camden. The hospital is part of the Royal Free London NHS Foundation Trust, which also runs services at Barn ...
that contradicted his own claims.[2004 BBC documentary:
*
*] Wakefield's patent application was also noted in Paul Offit
Paul Allan Offit (born March 27, 1951) is an American pediatrician specializing in infectious diseases, vaccines, immunology, and virology. He is the co-inventor of a rotavirus vaccine. Offit is the Maurice R. Hilleman Professor of Vaccinology, ...
's 2008 book, ''Autism's False Prophets
''Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure'' is a 2008 book by Paul Offit, a vaccine expert and chief of infectious diseases at Children's Hospital of Philadelphia. The book focuses on the controversy surro ...
''.
In January 2005, Wakefield sued Channel 4, 20/20 Productions, and the investigative reporter Brian Deer, who presented the Dispatches programme. However, after two years of litigation, and the revelation of more than £400,000 in undisclosed payments by lawyers to Wakefield, he discontinued his action and paid all the defendants' costs.
In 2006, Deer reported in ''The Sunday Times'' that Wakefield had been paid £435,643, plus expenses, by British trial lawyers attempting to prove that the vaccine was dangerous, with the undisclosed payments beginning two years before the ''Lancet'' paper's publication. This funding came from the UK legal aid fund, a fund intended to provide legal services to the poor.[
]
Support for Wakefield
Despite ''The Sunday Times'' disclosures, Wakefield continued to find support. Melanie Phillips
Melanie Phillips (born 4 June 1951) is a British journalist, author, and public commentator. She began her career writing for ''The Guardian'' and ''New Statesman''. During the 1990s, she came to identify with ideas more associated with the righ ...
, an influential columnist with the ''Daily Mail
The ''Daily Mail'' is a British daily middle-market tabloid newspaper and news websitePeter Wilb"Paul Dacre of the Daily Mail: The man who hates liberal Britain", ''New Statesman'', 19 December 2013 (online version: 2 January 2014) publish ...
'', called the reporting of Wakefield's contract with the solicitor Richard Barr "a smear whose timing should raise a few eyebrows," and Ben Goldacre
Ben Michael Goldacre (born 20 May 1974) is a British physician, academic and science writer. He is the first Bennett Professor of Evidence-Based Medicine and director of the Bennett Institute for Applied Data Science at the University of Oxford ...
, a doctor and writer, defended the 1998 ''Lancet'' report. Writing in ''The Guardian
''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Gu ...
'' in September 2005, he argued: "The paper always was and still remains a perfectly good small case series report, but it was systematically misrepresented as being more than that, by media that are incapable of interpreting and reporting scientific data."
Three years later, as Wakefield appeared at a General Medical Council hearing charged with "serious professional misconduct", Goldacre stepped up his support: "Journalists have convinced themselves that his £435,643 fee from legal aid proves that his research was flawed. I will now defend the heretic Dr Andrew Wakefield. The media are fingering the wrong man, and they know who should really take the blame: in MMR, journalists and editors have constructed their greatest hoax to date."
According to Deer writing in the ''BMJ'', the General Medical Council hearing was also criticized by Richard Horton, the ''Lancet'' editor: "My own view is that the GMC is no place to continue this debate. But the process has started and it will be impossible to stop."
Manipulation of data
Despite ongoing disagreement from Goldacre and others, ''The Sunday Times
''The Sunday Times'' is a British newspaper whose circulation makes it the largest in Britain's quality press market category. It was founded in 1821 as ''The New Observer''. It is published by Times Newspapers Ltd, a subsidiary of News UK, whi ...
'' continued the investigation, and on 8 February 2009, Brian Deer reported that Wakefield had "fixed" results and "manipulated" patient data in the ''Lancet,'' creating the appearance of a link with autism. Wakefield falsely denied these allegations, and even filed a complaint with the Press Complaints Commission
The Press Complaints Commission (PCC) was a voluntary regulatory body for British printed newspapers and magazines, consisting of representatives of the major publishers. The PCC closed on Monday 8 September 2014, and was replaced by the Indep ...
(PCC) over this article on 13 March 2009. The complaint was expanded by a 20 March 2009 addendum by Wakefield's publicist. In July 2009, the PCC stated that it was staying any investigation regarding the ''Times'' article, pending the conclusion of the GMC investigation. In the event, Wakefield did not pursue his complaint, which Deer published with a statement that he and ''The Sunday Times'' rejected it as "false and disingenuous in all material respects", and that the action had been suspended by the PCC in February 2010.
UK General Medical Council inquiry
Responding to the first ''Sunday Times'' reports, the General Medical Council
The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...
(GMC), which is responsible for licensing doctors and supervising medical ethics in the UK, launched an investigation into the affair. The GMC brought the case itself, not citing any specific complaints, claiming that an investigation was in the public interest. The then-secretary of state for health, John Reid, called for a GMC investigation, which Wakefield himself welcomed. During a debate in the House of Commons, on 15 Mar 2004, Dr. Evan Harris, a Liberal Democrat MP, called for a judicial inquiry into the ethical aspects of the case, even suggesting it might be conducted by the CPS. In June 2006 the GMC confirmed that they would hold a disciplinary hearing of Wakefield.
The GMC's Fitness to Practise Panel first met on 16 July 2007 to consider the cases of Wakefield, Professor John Angus Walker-Smith, and Professor Simon Harry Murch. All faced charges of serious professional misconduct. The GMC examined, among other ethical points, whether Wakefield and his colleagues obtained the required approvals for the tests they performed on the children; the data-manipulation charges reported in the ''Times'', which surfaced after the case was prepared, were not at question in the hearings. The GMC stressed that it would not be assessing the validity of competing scientific theories on MMR and autism. The GMC alleged that the trio acted unethically and dishonestly in preparing the research into the MMR vaccine. They denied the allegations. The case proceeded in front of a GMC Fitness to Practise panel of three medical and two lay members.
On 28 January 2010, the GMC panel delivered its decision on the facts of the case, finding four counts of dishonesty and 12 involving the abuse of developmentally disabled children. Wakefield was found to have acted "dishonestly and irresponsibly" and to have acted with "callous disregard" for the children involved in his study, conducting unnecessary and invasive tests. The panel found that the trial was improperly conducted without the approval of an independent ethics committee, and that Wakefield had multiple undeclared conflicts of interest
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations i ...
.
On 24 May 2010, the GMC panel ordered that he be struck off the medical register.[ John Walker-Smith was also found guilty of serious professional misconduct and struck off the medical register, but that decision was reversed on appeal to the High Court in 2012, because the GMC panel had failed to decide whether Walker-Smith actually thought he was doing research in the guise of clinical investigation and treatment. The High Court criticised "a number of" wrong conclusions by the disciplinary panel and its "inadequate and superficial reasoning". Simon Murch was found not guilty.]
In response to the GMC investigation and findings, the editors of ''The Lancet'' announced on 2 February 2010 that they "fully retract this paper from the published record".[
*] ''The Lancet''s editor-in-chief Richard Horton described it as "utterly false" and said that the journal had been deceived.
The ''Hansard
''Hansard'' is the traditional name of the transcripts of parliamentary debates in Britain and many Commonwealth countries. It is named after Thomas Curson Hansard (1776–1833), a London printer and publisher, who was the first official print ...
'' text for 16 March 2010 reported Lord McColl asking the Government whether it had plans to recover legal aid money paid to the experts in connection with the measles, mumps and rubella/measles and rubella vaccine litigation. Lord Bach, Ministry of Justice dismissed this possibility.
Full retraction and fraud revelations
In an April 2010 report in ''The BMJ
''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
'', Deer expanded on the laboratory aspects of his findings recounting how normal clinical histopathology
Histopathology (compound of three Greek words: ''histos'' "tissue", πάθος ''pathos'' "suffering", and -λογία '' -logia'' "study of") refers to the microscopic examination of tissue in order to study the manifestations of disease. Spe ...
results generated by the Royal Free Hospital
The Royal Free Hospital (also known simply as the Royal Free) is a major teaching hospital in the Hampstead area of the London Borough of Camden. The hospital is part of the Royal Free London NHS Foundation Trust, which also runs services at Barn ...
were later changed in the medical school to abnormal results, published in ''The Lancet''. Deer wrote an article in ''The BMJ'' casting doubt on the "autistic enterocolitis" that Wakefield claimed to have discovered.[ In the same edition, Deirdre Kelly, President of the European Society of Pediatric Gastroenterology and Nutrition and the Editor of the '']Journal of Pediatric Gastroenterology and Nutrition
The ''Journal of Pediatric Gastroenterology and Nutrition'' is a monthly peer-reviewed medical journal covering research on digestive diseases and nutrition in children. It is published by Lippincott Williams & Wilkins
Lippincott Williams & Wil ...
'' expressed some concern about ''The BMJ'' publishing this article while the GMC proceedings were underway.
On 5 January 2011, ''The BMJ'' published the first of a series of articles by Brian Deer, detailing how Wakefield and his colleagues had faked some of the data behind the 1998 Lancet article. By looking at the records and interviewing the parents, Deer found that for all 12 children in the Wakefield study, diagnoses had been tweaked or dates changed to fit the article's conclusion. Continuing ''BMJ'' series on 11 January 2011, Deer said that based upon documents he obtained under freedom of information legislation
Freedom of information laws allow access by the general public to data held by national governments and, where applicable, by state and local governments. The emergence of freedom of information legislation was a response to increasing dissatisfa ...
, Wakefield—in partnership with the father of one of the boys in the 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". ''The Washington Post'' reported that Deer said that Wakefield predicted he "could make more than $43 million a year from diagnostic kits" for the new condition, autistic enterocolitis
The ''Lancet'' MMR autism fraud centered on the publication in February 1998 of a fraudulent research paper titled "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children" in ''The Lancet''. T ...
.[ ]WebMD
WebMD is an American corporation known primarily as an online publisher of news and information pertaining to human health and well-being. The site includes information pertaining to drugs. It is one of the top healthcare websites.
It was foun ...
reported on Deer's ''BMJ'' report, saying that the $43 million predicted yearly profits would come from marketing kits for "diagnosing patients with autism" and "the initial market for the diagnostic will be litigation-driven testing of patients with AE utistic enterocolitis, an unproven condition concocted by Wakefieldfrom both the UK and the USA". According to WebMD, the ''BMJ'' article also claimed that the venture would succeed in marketing products and developing a replacement vaccine if "public confidence in the MMR vaccine was damaged".[
In an editorial accompanying Deer's 2011 series, ''The BMJ'' said, "it has taken the diligent scepticism of one man, standing outside medicine and science, to show that the paper was in fact an elaborate fraud," and asked:
Summarizing findings as of January 2011 in ''The BMJ'', Deer set out the following analysis of the cases reported in the study:]
In subsequent disclosures from the investigation, Deer obtained copies of unpublished gastrointestinal pathology reports on the children in the ''Lancet'' study that Wakefield had claimed showed "non-specific colitis" and "autistic enterocolitis". But expert analyses of these reports found bowel biopsies from the children to be overwhelmingly normal and with no evidence of any enterocolitis at all.
In September 2020, Johns Hopkins University Press
The Johns Hopkins University Press (also referred to as JHU Press or JHUP) is the publishing division of Johns Hopkins University. It was founded in 1878 and is the oldest continuously running university press in the United States. The press publi ...
published Deer's account of the fraud in his book ''The Doctor Who Fooled the World: Science, Deception, and the War on Vaccines.'' The book includes reporting of parents whose children were among the twelve recruited by Wakefield in ''The Lancet'' study. One described the paper as "fraudulent" while another complained of "outright fabrication".
Aftermath
Characterised as "perhaps the most damaging medical hoax of the 20th Century", ''The Lancet'' paper led to a sharp drop in vaccination rates in the UK and Ireland. Promotion of the claimed link, which continues in anti-vaccination propaganda despite being refuted, led to an increase in the incidence of measles
Measles is a highly contagious infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than , cough, ...
and mumps
MUMPS ("Massachusetts General Hospital Utility Multi-Programming System"), or M, is an imperative, high-level programming language with an integrated transaction processing key–value database. It was originally developed at Massachusetts Gener ...
, resulting in deaths and serious permanent injuries. Following the initial claims in 1998, multiple large epidemiologic
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evidenc ...
al studies were undertaken. Reviews of the evidence by the Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
,[ the ]American Academy of Pediatrics
The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C.
Background
The Academy was founded ...
, the Institute of Medicine
The National Academy of Medicine (NAM), formerly called the Institute of Medicine (IoM) until 2015, is an American nonprofit, non-governmental organization. The National Academy of Medicine is a part of the National Academies of Sciences, E ...
of the US National Academy of Sciences
The National Academy of Sciences (NAS) is a United States nonprofit, non-governmental organization. NAS is part of the National Academies of Sciences, Engineering, and Medicine, along with the National Academy of Engineering (NAE) and the Natio ...
,[ the UK ]National Health Service
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
,[ and the ]Cochrane Library
The Cochrane Library (named after Archie Cochrane) is a collection of databases in medicine and other healthcare specialties provided by Cochrane and other organizations. At its core is the collection of Cochrane Reviews, a database of system ...
all found no link between the MMR vaccine and autism. Physicians, medical journals, and editors have described Wakefield's actions as fraudulent and tied them to epidemics and deaths.
Among commentators drawing on Deer's investigation, academic Peter N. Steinmetz summarizes six fabrications and falsifications in the paper itself and in Wakefield's response in the areas of findings of non-specific colitis; behavioral symptoms; findings of regressive autism; ethics consent statement; conflict of interest statement; and methods of patient referral.
Wakefield has continued to defend his research and conclusions, saying there was no fraud, hoax or profit motive
In economics, the profit motive is the motivation of firms that operate so as to maximize their profits. Mainstream microeconomic theory posits that the ultimate goal of a business is "to make money" - not in the sense of increasing the firm's s ...
. He has subsequently become known for anti-vaccination
Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain abou ...
activism. In 2016, Wakefield directed the anti-vaccination film '' Vaxxed: From Cover-Up to Catastrophe''.
See also
* Vaccine hesitancy
Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain abou ...
* Folk epidemiology of autism
References
{{Disinformation
1998 hoaxes
Autism pseudoscience
MMR vaccine and autism
Medical-related conspiracy theories
Vaccine hesitancy
de:MMR-Impfstoff#Der Fall Wakefield