January 06, 2011
How the case against the MMR vaccine was fixed
Some of you may be aware that many parents are not giving their children the MMR (measles, mumps, rubella) vaccine out of fears that it may cause autism. These fears were generated by a paper published in 1998 by the British medical journal Lancet by Andrew Wakefield and others suggesting such a link. The findings were challenged but the journal only withdrew the paper in 2010.
The British Medical Journal has now published a detailed investigation and concludes that all of the twelve original cases reported had had their data misreported or altered in order to make the link.
The Lancet paper was a case series of 12 child patients; it reported a proposed "new syndrome" of enterocolitis and regressive autism and associated this with MMR as an "apparent precipitating event." But in fact:
- Three of nine children reported with regressive autism did not have autism diagnosed at all. Only one child clearly had regressive autism
- Despite the paper claiming that all 12 children were "previously normal," five had documented pre-existing developmental concerns
- Some children were reported to have experienced first behavioural symptoms within days of MMR, but the records documented these as starting some months after vaccination
- In nine cases, unremarkable colonic histopathology results—noting no or minimal fluctuations in inflammatory cell populations—were changed after a medical school "research review" to "non-specific colitis"
- The parents of eight children were reported as blaming MMR, but 11 families made this allegation at the hospital. The exclusion of three allegations—all giving times to onset of problems in months—helped to create the appearance of a 14 day temporal link
- Patients were recruited through anti-MMR campaigners, and the study was commissioned and funded for planned litigation
None of the families of the children were aware that Wakefield was involved in a lawsuit that would benefit from showing the link he purportedly discovered..
As the editors of the BMJ say:
Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children's cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross.
Meanwhile the damage to public health continues, fuelled by unbalanced media reporting and an ineffective response from government, researchers, journals, and the medical profession. Although vaccination rates in the United Kingdom have recovered slightly from their 80% low in 2003 they are still below the 95% level recommended by the World Health Organization to ensure herd immunity. In 2008, for the first time in 14 years, measles was declared endemic in England and Wales. Hundreds of thousands of children in the UK are currently unprotected as a result of the scare, and the battle to restore parents’ trust in the vaccine is ongoing.
What Wakefield set in motion was a monstrous crime, playing on the great fear of parents that some well-meaning action on their part may cause harm to their children and for which they will never forgive themselves. Fortunately for me, my own children were vaccinated well before this scare arose otherwise I too would have agonized over what to do.
Due to so many not giving their children the vaccines because of these fears, all children have been put at risk, while many have suffered from each of these diseases and some have died. Despite this new report, it will be hard to convince die-hard vaccine skeptics to change their minds.