A January 5, 2011 report in the BMJ investigated the 1998 paper that first alleged a link between the MMR vaccine and autism. The author, Brian Deer, presents evidence that the paper resulted from research fraud. The History of Vaccines blog looks at the history of the paper and how it has profoundly affected research, public health, and the public perception of vaccines over the last 12 years.
In the wake of a paper published in the Lancet in 1998, vaccination rates in Britain plummeted. The lead author of the paper, Andrew Wakefield, rose to prominence as a result of his claims that the combination measles, mumps, and rubella (MMR) vaccine had caused autism in the 12 children in the study, and frightened parents began to delay or completely refuse vaccination for their children, both in Britain and the United States. Since then, outbreaks of previously eliminated diseases have sickened and killed children in both countries.
Over the next twelve years, the possibility of a link between MMR and autism was studied exhaustively. No reputable, relevant study confirmed Wakefield’s findings; instead, many well-designed studies have found no link between MMR and autism.
In 2004, the Lancet stated that it should not have published Wakefield’s paper, with then-editor Dr. Richard Horton noting that Wakefield had a “fatal conflict of interest” when conducting the research. The majority of the co-authors of the study subsequently retracted the findings in the paper, and in 2010, the Lancet formally retracted the paper itself.
Three months later, in May 2010, Britain’s General Medical Council banned Wakefield from practicing medicine in Britain, stating that he had shown “callous disregard” for children in the course of his research. The council also cited previously uncovered information about Wakefield’s research being partially funded by lawyers hoping to sue vaccine manufacturers on behalf of parents of children with autism.
On Wednesday, January 5, the BMJ published a report by Brian Deer, a British journalist who had previously reported on flaws in Wakefield’s work. For this new report, Deer spoke with parents of children from the retracted study and found evidence that Wakefield committed research fraud by falsifying data about the children’s conditions.
Specifically, Deer reports that while the paper claimed that eight of the study’s 12 children showed either gastrointestinal or autism-like symptoms days after vaccination, records instead show that at most two children experienced these symptoms in this time frame. Additionally, while the paper claimed that all 12 of the children were “previously normal” before vaccination with MMR, at least two had developmental delays that were noted in their records before the vaccination took place.
After examining the records for all 12 children, Deer noted that the statements made in the paper did not match numbers from the records in any category: the children having regressive autism; non-specific colitis; or first symptoms within days after receiving the MMR vaccine. The Lancet paper claimed that six of the children had all three of these conditions; according to the records, not a single child actually did. (See a table that breaks down the comparison between the Lancet numbers and the medical records here.)
In an accompanying editorial, BMJ editor in chief Fiona Godlee and co-authors Jane Smith and Harvey Marcovitch examine the damage to public health caused by a tiny study based on parental recall with no control group – a study that turned out to be almost entirely fraudulent, but whose impact continues to this day.
Although the findings of Wakefield’s paper have long been discredited by scientists, the evidence that the data itself was falsified makes this report by the BMJ a landmark moment in the history of vaccines. Evidence is strong that this study should not have been published not merely because it was poorly conducted, but instead because it was a product of research fraud. After more than 12 years of panic, fear, and confusion over the possibility of autism being linked to vaccines, this “MMR scare” chapter of vaccine history may finally draw to a close.
In addition to the BMJ’s report and accompanying editorial, news outlets worldwide have devoted time to coverage of this story. Links to some of this coverage are provided below.
Brian Deer’s report at the British Medical Journal, “How the case against the MMR vaccine was fixed” — http://www.bmj.com/content/342/bmj.c5347.full
Accompanying editorial by Fiona Godlee, Jane Smith, and Harvey Marcovitch, “Wakefield’s article linking MMR vaccine and autism was fraudulent” — http://www.bmj.com/content/342/bmj.c7452.full
MedPage Today’s coverage of the BMJ report by John Gever, “BMJ Lifts Curtain on MMR-Autism Fraud” — http://www.medpagetoday.com/Pediatrics/Autism/24203
CNN’s coverage via Anderson Cooper 360:
- Video: Cooper introducing the story and interviewing Andrew Wakefield
- Video: CNN’s Dr. Sanjay Gupta interviewing Andrew Wakefield
- Video: Cooper discussing the report with Seth Mnookin, author of the forthcoming book about the MMR scare, The Panic Virus
- Video: Vaccines for Children Proven Not to Cause Autism (Note: this headline is not accurate – you don’t “prove” that something doesn’t cause something else.)
- Video: The Vaccine Scare: Anecdotes vs. Data (Brief clip with Dr. Richard Besser and Seth Mnookin)
- Lara Salahi’s article, “Report Linking Vaccine to Autism ‘Fraudulent,’ Says British Medical Journal” — http://abcnews.go.com/Health/Autism/link-vaccine-autism-link-fraud-british-medical-journal/story?id=12547823