Lancet withdraws study linking autism to vaccination

Lancet withdraws discredited, controversial MMR study

The research suggesting a link between the measles-mumps-rubella vaccine (MMR) and autistic spectrum disorders has been issued a full retraction from the medical journal which originally published it in 1998.

The Lancet says it now accepts that some claims made in the report were “false”.

The report, originally submitted by lead author Dr. Andrew Wakefield, a British born and trained physician, fueled an already smoldering anti-vaccination movement. His findings directly led to a significant decrease in the administration of MMR vaccines in Great Britain and the spread of measles in particular. But the effects are even greater than that when considering the evolution of the anti-vaccine movement and where it is today. As a result of questioning the side effects of vaccinations, investigation of thimerosal and mercury in vaccines was begun and the dialogue for pediatric preventive medicine was changed forever.

The 1998 study reported intestinal inflammation in a dozen children diagnosed with autism and linked them to the MMR vaccine. The authors of the study noted that parents of eight of the 12 children reported behavioral changes within two weeks of receiving the MMR vaccine. The controversy was ignited in the Lancet summary: “We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.” It was speculated that the trigger in question was the MMR vaccine in eight cases and measles infection in one other. Although his findings stated that no causal connection between the MMR vaccination and autism, Wakefield recommended separating the three components of the vaccine as a future protocol.

The findings were so controversial that new studies were immediately begun to recreate Wakefield’s results. One study in Japan contradicted the findings after examining children who showed no greater incidence of autism without the MMR vaccine which had been dropped in that country in 1993. In 2005, the BBC reported on research involving 300 children which could not recreate or substantiate the findings of the 1998 Wakefield report.

In 2004, Wakefield was accused of conflict of interest when it was revealed that he and the hospital where the research had been conducted had been paid in 1998 by lawyers acting on behalf of parents who believed their children had been harmed by the MMR vaccine. They were preparing a lawsuit against the manufacturers of the vaccine and were seeking evidence to support their case.

At the same time, ten of the twelve doctors involved in the original study retracted their support of the interpretation of the findings. A news report in 2004 also revealed that Wakefield had the patent for a single measles vaccine, the very remedy he recommended during his initial press conference. That same year, The Lancet backed off its support of the research but continued to stand by the report stating that it helped “raise new ideas.”

Allegations brought before the General Medical Council (GMC) disciplinary panel in 2007 revealed a list of unprofessional and reckless practices: that Wakefield and his hospital had been paid by biased parties, that he ordered investigations without qualification, that he acted dishonestly by failing to disclose how patients were recruited and that some of them were paid, that he performed unnecessary and dangerous procedures on children without approval, that he conducted research not approved by the hospital’s ethics committee and finally that he purchased blood samples from children at his own son’s birthday party - an event he laughed about in a video tape shown at a medical conference.

Yesterday, February 2, 2010, the GMC concluded that Wakefield and two of his colleagues acted “dishonestly and irresponsibly” in conducting their research. They found a callous disregard for the suffering of children and abuse of his position of trust. The next step for the GMC is determining whether Wakefield and his colleagues will lose their medical licenses for the egregious misconduct. Not surprisingly, Dr. Wakefield denies any wrongdoing. He stated, “The allegations against me and against my colleagues are both unfounded and unjust.”

The Lancet withdrew its support of the article, something it has only done 10 or 15 times in its 186 year history.

The furor starting in 1998 was one of the first times that a publication in a medical journal reached the general population and stirred a controversy which impacted social norms with regard to accepted medical practices. No one, The Lancet included, anticipated the impact.

Source: The Lancet, Peter Russell, New Scientist, BBC, GMC Press Release

photo by Paul de Bruin