Andrew Wakefield is the lead author of the 1998 paper, “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children”. Wakefield claimed that his study had shown a link between the measles mumps and rubella (MMR) vaccine and autism in children. The British media latched onto this and filled the air-ways with news of how the MMR vaccine had been shown to cause autism.
The study itself did not actually prove any link between autism and MMR. It asked parents to think back and remember when their child had started exhibiting slowed development. In 8 of the 12 cases it was thought to have been within 2 weeks of the MMR vaccine and in 3 of these, within 48hrs. There are a number of problems with stating that this shows a causal link between the MMR vaccine and autism. Firstly, as the parents were aware that the study looked to link MMR and autism, this exposed them to 'recall bias' (remembering a closer connection between two events then what actually occurred). Secondly the MMR vaccine is normally administered before a child begins school (where the likely hood of exposure to infectious diseases increases) and it is also around this time that autistic children begin to develop signs of autism. Therefore it is probable, but not relevant, that in the months following the MMR vaccine that an autistic child might first begin to display signs of autism. Lastly, the notion that these children's autism rapidly onset within days of the vaccine is scientifically unsubstantiated. Autistic children will display behaviour that is of slight concern but not clearly abnormal for weeks or months before beginning to display clearly abnormal behaviour. They are not simply normal children one day and autistic the next.
The paper itself actually states as much in its discussion section; "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described”. Yet Wakefield unrepentantly publicised the notion that a link had been shown. The large media hype that surrounded this controversy has led to vaccination rates dropping substantially. In the UK MMR vaccination rates dropped from 92% in 1996 down to 84% in 2002. Currently in Australia only around 83% of children aged five are fully vaccinated. These are both under the 90 - 95% needed to create herd immunity within a community. This appalling rate of vaccination has led to a massive increase in measles outbreaks worldwide, as well as several deaths. These deaths are absurd for a civilisation in which we have all the tools to eradicate such diseases.
The proposition that there is a link between the MMR vaccine and autism has been thoroughly debunked, with studies having been carried out all around the world.
The 2009 paper "Lack of Association between measles-mumps-rubella vaccination and autism in children : A case-Control Study" looked at 96 children with autism and 192 control children (matched for age, sex and general practitioners) and concluded that it provided "evidence against the association of autism with either MMR or a single measles vaccine".
A Finnish study "No evidence for measles, mumps, and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study" also concluded that there was no link between the MMR vaccine and autism.
"A population-based study of measles, mumps and rubella vaccination and autism" was published in 2002 and provided "strong evidence against the hypothesis that MMR vaccination causes autism", after looking at over 500,000 children and comparing incidences of autism between those who were vaccinated and those who weren't.
In 2002 the study "Neurologic disorders after measles-mumps-rubella vaccination" was published. It was a retrospective study looking at 535, 544 children. Among many results it showed no clustering of hospitalizations for autism following vaccination, It again concluded that "We did not identify any association between MMR vaccination and encephalitis, aseptic meningitis, or autism".
A Japanese study "No effec of MMR withdrawal on the incidence of autism :a total population study" looked at autism rates in Yokohama, a city in which no MMR vaccinations took place after 1992. It concluded that the "MMR vaccination is most unlikely to be a main cause of ASD (autism spectrum disorder)" and that the withdrawal of the MMR vaccine cannot be expected to reduce the incidence of ASD.
Recently Andrew Wakefield’s methods have come under review. Investigative journalist Brian Deer found that before the study was conducted Wakefield had been awarded £55,000 by Richard Barr, a lawyer trying to raise a lawsuit against drug companies manufacturing the MMR vaccine. This money was to go towards the study, but Wakefield also personally received over £400,000 from Barr for his work. Of the 12 children involved in the study, most of their parents were either clients or contacts of Richard Barr’s. Obviously these circumstances would have biased both the parents and Andrew Wakefield, further discrediting his original study.
For the past two-and-a-half years the General Medical Council (GMC) have been investigating Andrew Wakefield and in January 2010 ruled that he acted dishonestly, irresponsibly, unethically and callously. These rulings followed the findings that he did not have ethics approval for the invasive testing he carried out on the test subjects (3-10 year old children), including lumber punctures. It was also found that the control blood samples were gathered at his son’s birthday party where the children were paid £5 for their blood sample. The GMC commented that he acted in disregard for the pain and distress it would have caused the children. The GMC have yet to decide whether he will have his medical licence revoked.
Following these findings The Lancet has retracted the original paper.
By acting so unethically, conducting a study with an undisclosed conflict of interest, and by drawing unsubstantiated and misleading conclusions, Andrew Wakefield has become responsible for a global decline in vaccination rates. Although his study has now been discredited, the damage has been done. The idea that the MMR vaccine causes autism has been popularised and is firmly seeded in society. The truth needs to be spread and people need to be shown how much damage is being done due to the declining rates of immunisation.
References
http://press.thelancet.com/wakefieldpaper.pdf
http://briandeer.com/mmr/lancet-greenhalgh.htm
http://briandeer.com/mmr/lancet-summary.htm
http://news.bbc.co.uk/2/hi/health/8483865.stm
http://journals.lww.com/pidj/Abstract/publishahead
/Lack_of_Association_Between_Measles_Mumps_Rubella.99421.aspx
http://www.ncbi.nlm.nih.gov/pubmed/9643797
http://content.nejm.org/cgi/content/short/347/19/1477
http://www.ncbi.nlm.nih.gov/pubmed/12415036
http://www.ingentaconnect.com/content/bpl/jcpp/2005/00000046/00000006/art00003
http://www.medicareaustralia.gov.au/provider/patients/acir/statistics.jsp
The study itself did not actually prove any link between autism and MMR. It asked parents to think back and remember when their child had started exhibiting slowed development. In 8 of the 12 cases it was thought to have been within 2 weeks of the MMR vaccine and in 3 of these, within 48hrs. There are a number of problems with stating that this shows a causal link between the MMR vaccine and autism. Firstly, as the parents were aware that the study looked to link MMR and autism, this exposed them to 'recall bias' (remembering a closer connection between two events then what actually occurred). Secondly the MMR vaccine is normally administered before a child begins school (where the likely hood of exposure to infectious diseases increases) and it is also around this time that autistic children begin to develop signs of autism. Therefore it is probable, but not relevant, that in the months following the MMR vaccine that an autistic child might first begin to display signs of autism. Lastly, the notion that these children's autism rapidly onset within days of the vaccine is scientifically unsubstantiated. Autistic children will display behaviour that is of slight concern but not clearly abnormal for weeks or months before beginning to display clearly abnormal behaviour. They are not simply normal children one day and autistic the next.
The paper itself actually states as much in its discussion section; "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described”. Yet Wakefield unrepentantly publicised the notion that a link had been shown. The large media hype that surrounded this controversy has led to vaccination rates dropping substantially. In the UK MMR vaccination rates dropped from 92% in 1996 down to 84% in 2002. Currently in Australia only around 83% of children aged five are fully vaccinated. These are both under the 90 - 95% needed to create herd immunity within a community. This appalling rate of vaccination has led to a massive increase in measles outbreaks worldwide, as well as several deaths. These deaths are absurd for a civilisation in which we have all the tools to eradicate such diseases.
The proposition that there is a link between the MMR vaccine and autism has been thoroughly debunked, with studies having been carried out all around the world.
The 2009 paper "Lack of Association between measles-mumps-rubella vaccination and autism in children : A case-Control Study" looked at 96 children with autism and 192 control children (matched for age, sex and general practitioners) and concluded that it provided "evidence against the association of autism with either MMR or a single measles vaccine".
A Finnish study "No evidence for measles, mumps, and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study" also concluded that there was no link between the MMR vaccine and autism.
"A population-based study of measles, mumps and rubella vaccination and autism" was published in 2002 and provided "strong evidence against the hypothesis that MMR vaccination causes autism", after looking at over 500,000 children and comparing incidences of autism between those who were vaccinated and those who weren't.
In 2002 the study "Neurologic disorders after measles-mumps-rubella vaccination" was published. It was a retrospective study looking at 535, 544 children. Among many results it showed no clustering of hospitalizations for autism following vaccination, It again concluded that "We did not identify any association between MMR vaccination and encephalitis, aseptic meningitis, or autism".
A Japanese study "No effec of MMR withdrawal on the incidence of autism :a total population study" looked at autism rates in Yokohama, a city in which no MMR vaccinations took place after 1992. It concluded that the "MMR vaccination is most unlikely to be a main cause of ASD (autism spectrum disorder)" and that the withdrawal of the MMR vaccine cannot be expected to reduce the incidence of ASD.
Recently Andrew Wakefield’s methods have come under review. Investigative journalist Brian Deer found that before the study was conducted Wakefield had been awarded £55,000 by Richard Barr, a lawyer trying to raise a lawsuit against drug companies manufacturing the MMR vaccine. This money was to go towards the study, but Wakefield also personally received over £400,000 from Barr for his work. Of the 12 children involved in the study, most of their parents were either clients or contacts of Richard Barr’s. Obviously these circumstances would have biased both the parents and Andrew Wakefield, further discrediting his original study.
For the past two-and-a-half years the General Medical Council (GMC) have been investigating Andrew Wakefield and in January 2010 ruled that he acted dishonestly, irresponsibly, unethically and callously. These rulings followed the findings that he did not have ethics approval for the invasive testing he carried out on the test subjects (3-10 year old children), including lumber punctures. It was also found that the control blood samples were gathered at his son’s birthday party where the children were paid £5 for their blood sample. The GMC commented that he acted in disregard for the pain and distress it would have caused the children. The GMC have yet to decide whether he will have his medical licence revoked.
Following these findings The Lancet has retracted the original paper.
By acting so unethically, conducting a study with an undisclosed conflict of interest, and by drawing unsubstantiated and misleading conclusions, Andrew Wakefield has become responsible for a global decline in vaccination rates. Although his study has now been discredited, the damage has been done. The idea that the MMR vaccine causes autism has been popularised and is firmly seeded in society. The truth needs to be spread and people need to be shown how much damage is being done due to the declining rates of immunisation.
References
http://press.thelancet.com/wakefieldpaper.pdf
http://briandeer.com/mmr/lancet-greenhalgh.htm
http://briandeer.com/mmr/lancet-summary.htm
http://news.bbc.co.uk/2/hi/health/8483865.stm
http://journals.lww.com/pidj/Abstract/publishahead
/Lack_of_Association_Between_Measles_Mumps_Rubella.99421.aspx
http://www.ncbi.nlm.nih.gov/pubmed/9643797
http://content.nejm.org/cgi/content/short/347/19/1477
http://www.ncbi.nlm.nih.gov/pubmed/12415036
http://www.ingentaconnect.com/content/bpl/jcpp/2005/00000046/00000006/art00003
http://www.medicareaustralia.gov.au/provider/patients/acir/statistics.jsp
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