Andrew Wakefield, the disgraced figure behind the MMR scandal, certainly has plenty to answer for. This became all-too-apparent last week, as the first measles fatality was reported in Wales – the first in the UK for five years. Gareth Williams was found dead in his Swansea flat on the 18th April; the post mortem confirmed that the 25 year-old had contracted measles and this was the likely cause of death.
This news comes as a wave of impromptu vaccination clinics continue to open across Wales; 808 people are estimated to have contracted measles in the epidemic so far and around ten percent of these have required hospitalisation. 2000 children will be given the MMR jab in schools, as the campaign to protect the Welsh population from the disease continues. But why is there this spike in cases, when full vaccination gives 99% protection? The answer lies in Wakefield’s deception, which rapidly spread from a small study report to popular belief.
The MMR vaccination protects against measles, mumps and rubella; these conditions are extremely infectious and can cause complications that include deafness and meningitis, even permanent brain damage. Measles remains a major killer worldwide; WHO estimates that over 400 children die each day from the condition unnecessarily. The introduction of an effective vaccination to the UK in 1988 was a landmark in tackling childhood disease rates.
In 1998 the then-practitioner Andrew Wakefield published research that suggested a link between the MMR vaccine and an increased risk of contracting autism. His paper was published in the Lancet; news of the ‘link’ rapidly spread. The ensuing media hysteria resulted in thousands of people choosing not to vaccinate their children with the triple vaccine. The ramifications of Wakefield’s claims were far-reaching; some Japanese hospitals chose to change their vaccination programme on the strength of this Lancet ‘research’.
The British Medical Journal refers to Wakefield’s research as ‘an elaborate fraud’. The study involved twelve children with autism. With his co-authors Wakefield claimed to have discovered a new condition, termed ‘autistic enterocolitis’; the implication was that eight of the children had developed autism because of their MMR vaccine, and that they also suffered from a range of gastrointestinal conditions. The press took hold of the story and it hit headlines; BBC News termed the resultant outcry ‘science by press conference’. In fact, the study was inherently flawed; there were no controls, the sample size was tiny, results were non-replicable…to add insult to injury journalists revealed how the discredited former doctor had carefully tweaked his patients’ medical histories to substantiate his shaky claims. In short, this ‘scientific’ work was an utter sham.
Subsequent digging by the journalist Brian Deer uncovered the motivation behind this study. Wakefield was heavily financially motivated to find the link between triple MMR vaccine and autism; the implication was that he stood to gain through publicising uptake of the single-dose vaccine as a ‘safer’ alternative. The Lancet retracted Wakefield’s falsified study when he was struck off the medical register in 2010. However, the damage was done. It is estimated that half of London’s children have missed their vaccinations due to the myths peddled by the original 1998 piece.
Other than the obvious repercussions of Wakefield’s actions, there is the other less immediately apparent problem of how public perception of medical research may have been tarnished. It is generally accepted that the press seizure of the study, which garnered sensationalist headlines and caused such widespread parental panic, was largely responsible for the fact that two million British children have not been vaccinated and are now at risk. The original Lancet piece would probably have been largely ignored without the media feeding frenzy. Parents expected that the information they were receiving would be substantiated and credible; the stereotypical image of scientists, white-coated and respectable, meant that the challenge posed to Wakefield’s findings took rather longer than it should have done. It’s to be hoped that such blind acceptance would now be tempered, as most media organisations now have dedicated science journalists to spot bad science!