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An investigation and articles published this week in the British Medical Journal make it clear once and for all that the research on which Dr. Andrew Wakefield based his controversial vaccine-autism link was not only faulty, but fraudulent.
Wakefield's 1998 study, published in medical journal The Lancet (which officially retracted the study about a year ago), didn't actually claim that the Measles-Mumps-Rubella vaccine caused autism, though clearly said that Wakefield and his colleagues thought a link was possible. The work was riddled with red flags: The study involved just 12 children, Wakefield-a gastroenterologist-was neither ethically cleared nor qualified to perform invasive tests (like spinal taps) on his subjects, he paid children at his son's birthday party to provide blood samples, and he failed to disclose that "he had been paid to advise solicitors acting for parents who believed their children had been harmed by the MMR," according to a BBC report.
Nevertheless, Wakefield's work became the cornerstone of the anti-vaccine movement, the findings of his flawed study extrapolated by many to include all vaccinations, not just the MMR. After it was published in 1998, cases of measles in England skyrocketed and, even now, vaccination rates there have never recovered.
Brian Deer, a journalist whose 2004 research into Wakefield's methods became the basis of England's General Medical Council's investigation and decision to strip the doctor of his medical license last year, has written a series of articles for the British Medical Journal after pouring over interviews, documents, and data made public during the GMC's hearings. The first article was published this week; in it, he interviews parents of some of Wakefield's test subjects and finds huge discrepancies between Wakefield's study, hospital records, and the parents' recollections.
In a Jan. 5 editorial, the editors of the British Medical Journal wrote: "Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children's cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross."
Wakefield appeared (via Skype) on CNN's "Anderson Cooper 360," Jan. 6, where he said of Deer: "I've had to put up with this man's false allegations for many, many years.... he is a hit man, he's been brought in to take me down, because they are very very concerned about the adverse reactions to vaccines that are occurring in children."
Wakefield also insisted that his 1998 study "is not a lie" and added: "The findings that we made have been replicated in five countries around the world."
Wakefield has never replicated his own study. In an interview with him last year, I asked him about the countries that he's often said have replicated it; he changed the subject, claimed that the GMC and others were trying to discredit him, and vowed to continue his research into vaccines and autism. "My concern is for vaccine safety, for a safety-first vaccine policy," Wakefield told me. "I have every intention of continuing to serve this population of children for as long as I can."
No one knows for sure what causes autism, though the rates continue to rise. A Department of Health and Human Services report released in October 2009 said that about 1 in 100 children have an Autism Spectrum Disorder (ASD), up from the previous estimate of 1 in 150. The odds for boys are even more startling; according to the report, which appeared in the American Academy of Pediatrics' journal, Pediatrics, boys have a 1 in 58 chance of being diagnosed with autism.
If you have a child on the spectrum (and I do), this latest twist in the vaccine-autism controversy may seem to close off an avenue to research and treatment. But it actually doesn't; not knowing a definitive cause leaves plenty of room for research. There is scientific evidence that vaccines can act as a trigger for children with certain medical issues, like mitochondrial disease. Other research suggests that environmental toxicity is to blame. Still other scientists and doctors point out the possibility of a genetic link, possibly involving Alzheimer's. While delaying or avoiding vaccines may seem like an answer for some, a May 2010 study in Pediatrics shows that doing so doesn't make a difference in brain development (which means that you aren't necessarily protecting your neuro-typical child by avoiding shots, most of which are mercury-free now anyhow).
Where do you stand on the vaccine-autism debate? Given this new development, are you more or less likely to vaccinate your child?
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