One of the world’s most prestigious medical journals has gone to startling lengths to demonstrate, supposedly once and for all, that there is no connection between the MMR (measles, mumps and rubella) vaccine and autism.
On Tuesday, The Lancet formally retracted the 1998 paper by Dr. Andrew Wakefield that first suggested the link. The study has long been the source of public concern over the safety of vaccines and is often cited as the reason for a sharp drop in vaccination rates that continues, even today, in Britain, the U.S. and Canada.
For two years, the U.K. General Medical Council’s Fitness to Practice Panel examined the study’s methodology and, last week, it concluded that Wakefield was a dishonest and irresponsible doctor who had provided false information and acted with “callous disregard” for the children in his study. As a result, The Lancet pulled the paper from its published record and Dr. Wakefield must go before the panel in April to determine if he (and two of his colleagues) will lose their licence to practise medicine.
Indeed, there were multiple problems with the study, ranging from methodology to a conflict of interest. But there is plenty of blame to go around and, while Dr. Wakefield should gain entrance to the Hall of Fame for Bad and Unethical Science, I’m not convinced that he is the only one who should be publicly pilloried for perpetuating the claims of a link between the MMR vaccine and autism.
The study was based on the case studies of just 12 children, suggesting the paper was more anecdotal than statistically significant. Wakefield was cited for conducting invasive tests on the children, including painful lumbar punctures and colonoscopies that were not in their best medical interests. Blood samples were obtained by offering money to children at a birthday party.
More important to the legitimacy of the study, however, was an obvious conflict of interest. Wakefield’s research was funded by $90,000 he received from lawyers who were searching for evidence to sue the vaccine makers. Further, he was also developing his own vaccine for measles and, in June 1997, he filed for a patent for the vaccine. That was a full year before the paper was published.
The conflict of interest was never declared, but the peer review process at The Lancet obviously failed to pick up on, or investigate, the questionable methodology or source of funding.
The paper also openly states that the parents of eight of the children associated the onset of behavioural problems with the MMR vaccine—it doesn’t say the authors make the association. Instead, the authors write, “We do not prove an association between measles, mumps and rubella vaccine and the syndrome described” and, “Further investigations are needed to examine this syndrome and its possible relation to this vaccine.”
So where are Wakefield’s claims of a link between MMR vaccine and autism? Not in the published paper. Rather, any claims of this association appear to stem from media coverage of the paper and a press conference by Wakefield.
Wakefield is obviously guilty of conducting bad and highly unethical science. But I don’t believe he should be pilloried for single-handedly undermining vaccination programs around the world. He never stated that children shouldn’t be vaccinated—he only encouraged parents to give their children separate vaccinations for each disease and to do so at one-year intervals.
Journalists are the ones who created the story and widely reported it out of its proper context or without the necessary caveats. They are the ones who implied a direct, causal link—not Wakefield. In 2004, three of Wakefield’s co-authors issued a partial retraction stating that they “formally retract the interpretation placed upon these findings.” Again, the problem isn’t the findings so much as the interpretations that have been “placed upon these findings.” The diagnosis, as it were, has been seriously distorted. The overall message of Wakefield’s study seems to have been magnified and sensationalized at the expense of accuracy. Wakefield may well have played along and enjoyed the media ride, but he’s not the only one responsible for perpetuating the vaccine debate.
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