Celebrating #WorldImmunizationWeek – The MMR-Andrew Wakefield Scandal

by Jeremy D. Bailoo, PhD

In our previous post, we highlighted how vaccines work and all of the effort that goes into ensuring safety and efficacy. So how did we get a point in our history where people fail to see the value of getting vaccinated?

As a thought exercise, imagine that you lived in the middle ages or the 1800s or the 1930s and were a doctor, parent, or teacher watching children become infected and die from diseases like measles. If a time traveler from 2019 came to you and said, “we now have medicines that could prevent that. The child doesn’t have to die. They can receive a quick injection, with low risk, and live without the terror of this disease”. You might ask this time traveler – is the disease eradicated? Now, imagine you are that time traveler from 2019. What would you say to explain that no, despite the fact that the vaccine exists, the disease is not eradicated. And, in fact, it has sprung up to infect and harm children. How did this happen?

It all began in 1993, when Andrew Wakefield published an article in the Journal of Medical Virology. He concluded that the measles virus may cause Crohn’s disease – an inflammatory bowel disease. This was followed by an article in the Lancet in 1995, claiming a causal link between the live attenuated measles vaccination and Crohn’s disease. This article was met with much disagreement by Wakefield’s scientific peers. These specific claims – that the live attenuated measles vaccination may cause Crohn’s disease — were abandoned by Wakefield and his co-authors, and were later discredited.

Wakefield subsequently published a paper in February of 1998 in The Lancet claiming a link between the combined measles, mumps, and rubella (MMR) vaccine to colitis and autism spectrum disorders. This paper was accompanied by a video news-release and a press conference.

“I can’t support the continued use of these three vaccines given in combination until this issue has been resolved.” Andrew Wakefield

These claims spread quickly, abetted by a sustained campaign by Wakefield. This was followed by a decrease in vaccinations rates in European countries, and resulting in deaths and severe and permanent injuries. For example, “confirmed cases of measles in England and Wales rose from 56 in 1998 to 971 in 2007. In the United Kingdom, coverage for MMR at 24 months is lower than for other vaccines (85% versus about 94%).”

How Andrew Wakefield, lawyers and clients drove down vaccine rates. Source.

A subsequent investigation and exposé by Brian Deer found that Andrew Wakefield had multiple undeclared conflicts of interest (detailed below). This exposé highlighted that Wakefield had a tremendous monetary incentive to discredit the MMR vaccine and to replace it with his patented variant.

  • In 1996, Wakefield is hired by a lawyer, Richard Barr, trying to prove that the MMR vaccine is unsafe. Paid over and 8-10 year period, it is later shown that Wakefield received £435,643 plus £3,910 in expenses by these lawyers. Additionally, Wakefield received an initial payment of £55,000 for the express purpose of conducting the research leading to the 1998 publication in the Lancet.
  • In 1997, Wakefield, applies for a patent titled “Pharmaceutical composition for treatment of IBD [irritable bowel syndrome] and RBD [regressive behavioral disorder; autism]
  • In 1998, four weeks before the publication of the paper in the Lancet, Wakefield files an application to the ethics committee at the hospital where he works to test a product (alternate vaccine) based on his 1997 patent application.
  • Wakefield publishes his paper in the Lancet, linking the MMR vaccine to autism, and recommends the use of single vaccinations rather than the three-in-one MMR. Unreported conflicts of interest include:
    • All of the children reported on had been pre-selected through anti?-MMR campaign groups
    • Most of the parents were clients of Richard Barr
    • None of the children lived in London, where Royal Free Hospital was located
  • About three months later, Wakefield files a patent titled, “Pharmaceutical composition for treatment of MMR virus mediated disease comprising a transfer factor obtained from the dialysis of virus-specific lymphocytes.” It states, “Such a composition may be used as a measles virus vaccine and for the treatment of inflammatory bowel disease and regressive behavioural disorder.”

Additionally, Deer’s investigation found that Wakefield had manipulated the evidence that he presented in his paper. Specifically, Wakefield reported that eight of twelve children that attended a routine clinic at the Royal Free Hospital, had developed autism within a few days — 2 weeks of the MMR vaccination. Wakefield also claimed that a novel intestinal lesion was associated with the children’s presentation of autism. However, Deer found that the described ailments of these children in the Lancet markedly differed from the hospital records – and in many of the children’s cases – medical concerns had been raised prior to vaccination. This investigation led to the eventual retraction of his paper in the Lancet in 2010 – twelve years after publication – but by then the damage was done.

Between July 2007 and May 2010, the UK General Medical Council (GMC) convened a tribunal, in light of emerging evidence of scientific misconduct, to evaluate these claims against Wakefield.  Wakefield continued to deny all charges, but in January 2010, the GMC ruled against Wakefield citing that he had: “failed in his duties as a responsible consultant”, acted against the interests of his patients, and “dishonestly and irresponsibly” engaged in his controversial research.

In May 2010, Andrew Wakefield was sanctioned by the GMC, effectively ending his career as a physician. In announcing the ruling, the GMC said that Wakefield had “brought the medical profession into disrepute”, and no sanction short of erasing his name from the register was appropriate for the “serious and wide-ranging findings” of misconduct.

In our next piece, we will explore some of the consequences of Andrew Wakefield’s actions.

External references for further reading
Brian Deer’s website
Andrew Wakefield’s page on Wikipedia