In the dock: the man who caused the great MMR scare
Monday, 12 June 2006
The doctor who sparked an international scare over the safety of MMR vaccine is to be charged with serious professional misconduct by the General Medical Council in an attempt by the medical establishment finally to lay the controversy to rest.
Andrew Wakefield, who published a research paper in 1998 purporting to show a link between the MMR vaccine and autism, is accused in preliminary charges of publishing "inadequately founded" research, failing to obtain ethical committee approval, obtaining funding "improperly" and of subjecting children to "unnecessary and invasive investigations", The Independent has learnt. The research is said to have caused immunisation rates to slump and cases of measles, mumps and rubella to soar. The research, which appeared in The Lancet, is said to have done more damage than anything published in a scientific journal in living memory.
Detailed charges are being formulated by the GMC's lawyers for presentation in the autumn and a public hearing is expected next year. If found guilty Dr Wakefield, 50, could be struck off the medical register.
The GMC has brought the case itself in the public interest. There is no complainant. The investigation has taken two years and lawyers for Dr Wakefield say he and his family are suffering distress caused by the delay in bringing charges.
The research was carried out at the Royal Free Hospital, north London, by Dr Wakefield and 12 other doctors and published in The Lancet in February 1998. The warning about the combined vaccine was amplified by Dr Wakefield at a press conference - to the disquiet of his colleagues present - and the subsequent scare led tens of thousands of parents to boycott the vaccine.
Immunisation rates fell over the next five years from more than 90 per cent nationally to a low of 78.9 per cent in early 2003. In parts of London rates fell below 60 per cent. There was a resurgence in cases of the three diseases, including rubella (German measles), according to the Health Protection Agency. The number of cases of mumps soared from 4,204 cases in 2003 to 16,436 in 2004 and to 56,390 cases last year.
Since 2003 the MMR vaccination rate has increased slightly and in mid-2005 stood at 83 per cent. A spokeswoman for the agency said: "The fear of Wakefield has dissipated a bit. The figures are coming back up."
In 2004 it emerged that at the time he was preparing The Lancet paper, Dr Wakefield was being paid by lawyers for parents of children allegedly damaged by the MMR vaccine to look for evidence that could be used to help take legal action against manufacturers of the vaccine.
He received £55,000 from the Legal Aid Board, which was paid into his research fund but which he had not disclosed to his co-researchers. At least four of the 12 children in the Lancet study were also in the Legal Aid Board funded study. He was accused by The Lancet of failing to declare a conflict of interest that could have influenced his findings.
Richard Horton, the editor, declared the paper "fatally flawed" and said if he had known in 1998 about the conflict of interest he would never have published it. The journal partially withdrew the paper in February 2004 and the following month 10 of the 12 authors withdrew the claim of a link with autism. John Reid, the Health Secretary at the time, called on the GMC to hold an inquiry. Dr Wakefield, a consultant gastroenterologist, left the Royal Free Hospital in 2001 "by mutual agreement". He has since worked mainly in America.
The Government's chief medical officer, Sir Liam Donaldson, accused Dr Wakefield of mixing "spin and science". But Jackie Flether of the support group Jabs, representing parents concerned about vaccination, said: "The GMC charges are totally unfounded and seem to be a total witch hunt against Andrew Wakefield and the research team. All the researchers did was raise a red flag [about MMR] and say more research was needed." All the doctors are believed to have denied professional misconduct.
The spread of a contagion of fear
By Geneviève Roberts
* FEBRUARY 1998: Andrew Wakefield's paper is published in The Lancet, linking the MMR triple vaccine with autism
* 2000: Demand for single vaccines rises
* JANUARY 2001: The Government rejects calls for a single measles vaccine on the NHS
* 2001: MMR vaccinations fall to 84.2 per cent of children, down from 92 per cent in 1996
* EARLY 2003: Immunisation rates reach low of 78.9 per cent
* NOVEMBER 2003: Dr Simon Murch says there is "unequivocal evidence that MMR is not a risk factor for autism"
* 2004: It emerges that while preparing his Lancet paper, Dr Wakefield was being paid by lawyers for parents of children allegedly damaged by MMR
* 2004: Immunisation rates rise to 81 per cent
* 2004: Number of cases of mumps: 16,436, up from 4,204 the previous year. In 2005 the number is up to 56,390
* MID-2005: Immunisation rates rise to 85 per cent
* OCTOBER 2005: Cochrane Library says there is no credible evidence that MMR harms
* APRIL 2006: A boy, 13, who had not received the MMR vaccine, becomes the first person to die of measles in 14 years