- REVEALED:
MMR RESEARCH SCANDAL
The
Sunday Times (London) February 22 2004
Brian
Deer
FULL details are disclosed today of the four-month
Sunday Times investigation that has uncovered a
medical scandal at the heart of the worldwide scare
over MMR.
Andrew
Wakefield, the doctor who champions the alleged link
between measles, mumps and rubella vaccine and autism
in young children, stands discredited for misleading
his medical colleagues and The Lancet, the
professional journal that published his findings.
The
investigation has found that when he warned parents
to avoid MMR, and published research claiming a link
with autism, he did not disclose he was being funded
through solicitors seeking evidence to use against
vaccine manufacturers.
The
Lancet said yesterday that The Sunday Times's
evidence meant that the finding linking MMR and
autism was "entirely flawed" and should
never have been published. Last night, John Reid, the
health secretary, called for an inquiry by the
General Medical Council (GMC) "as a matter of
urgency".
Evan
Harris, a Liberal Democrat MP who sits on the British
Medical Association's ethics committee, said the GMC
had inadequate powers and pressed the government for
a full independent inquiry.After reviewing The Sunday
Times's findings, Richard Horton, the editor of The
Lancet, said he should never have published
Wakefield's article linking MMR to autism. It was
"fatally" flawed.
Wakefield
was not contactable yesterday, but he said last week
when confronted with the investigation findings that
he was unrepentant. He denied misleading his
colleagues or The Lancet.The scandal arises from the
journal's publication in February 1998 of a
scientific report on the "findings" in the
cases of 12 autistic children, apparently admitted
routinely to the Royal Free hospital in north London
in 1996-97.
Wakefield
was the lead author of the report. He wrote that the
parents of eight of the 12 children blamed MMR: they
said symptoms of autism had set in within days of
vaccination. The Sunday Times has now established
that four, probably five, of these children were
covered by the legal aid study. And Wakefield himself
had been awarded up to £55,000 to assist their case
by finding scientific evidence of the link.
Wakefield
did not tell his colleagues or medical authorities of
this conflict of interest either during or after the
research.The children were subjected to a battery of
invasive procedures, including colonoscopies and
lumbar punctures.
In
the months that followed the examination of the first
children, many more were channelled through the
hospital. The parents of many were clients of one
solicitor, Richard Barr, of King's Lynn, Norfolk, who
was leading the legal attack and had organised
Wakefield's funding from the Legal Aid Board (now the
Legal Services Commission).
The
research paper published in The Lancet contained no
scientific evidence of a link with MMR, only the
"association" made by parents. But at the
unprecedented press conference to launch the report,
attacked the three-in-one jab as posing risks of
causing autism and bowel problems.
"It's
a moral issue for me and I can't support the
continued use of these three vaccines given in
combination until this issue has been resolved,"
he said. Neither in the report nor at the conference
did he disclose the legally-funded work he was doing
for Barr's clients. Asked his opinion of this
non-disclosure last month, Barr said: "I
remember noting at the time that the funding
acknowledgment wasn't there, but it didn't see to be
a big deal . . . things have moved on since
then."
Barr
added yesterday: "My role is to do the best for
my clients. Clients came to me and told me what was
happening to their children."
In
March 1998, as public alarm took off over the safety
of MMR, a meeting of the Medical Research Council
squarely asked Wakefield about the source of the
children he had analysed in the Lancet report.
Wakefield failed to take the opportunity to reveal
his interest.Six weeks later he was faced with a
letter in The Lancet raising the question of
litigation. All children, Wakefield claimed, came
through "formal channels" and that "no
conflict of interest exists".
The
medical establishment has long rejected Wakefield's
claims about MMR, and in 2001 he left the Royal Free.
He now travels between Britain and America, lecturing
about the dangers of the vaccine.
Last
weekend, aware of The Sunday Times's investigation,
he flew back to Britain. He was represented by Abel
Hadden, a top PR man at Sir Tim Bell's Bell Pottinger
company. At a tense confrontation on Wednesday at
Bell Pottinger's headquarters in Mayfair, a red-eyed
Wakefield denied any wrongdoing. He said any conflict
of interest in his work was "a matter of
opinion"."I believe that this paper was
conducted in good faith," he said. "It
reported the findings. There was no conflict of
interest. Do we have any reasons [now] to change our
opinion? No, but then again it's a debate."
As he
was speaking, the findings of the investigation were
also being shown to Horton at The Lancet. Shocked,
Horton later called in Wakefield and visited the
Royal Free on Thursday to talk to Wakefield's former
colleagues and inspect records.By Friday, Horton and
his fellow editors were faced with a dilemma: should
they respect The Sunday Times's confidence and wait
for the storm to break today? Or rush out a press
release criticising Wakefield and taking credit for
Disclosing his fatal conflict of interest? They chose
the latter.
Simon
Murch, one of the leading doctors involved with
Wakefield's research at the Royal Free, said
yesterday that news of the £55,000 legal funding was
"a very unpleasant surprise"."We
didn't know. We were pretty taken aback. The timing
of it before the paper is something we have all been
shocked by. If you have a colleague who has not told
you, if you have not been informed you are going to
be taken aback."
He
went on: "I am not going to join the queue of
people rushing up to kick Andy. But it is right that
this has come out: there has been a complete conflict
of interest."
Murch
said it was never made clear that the payment was in
place before the report was published. "We never
knew anything about the £55,000 — he had his
own separate research fund," said Murch.
"All of us were surprised . . . We are pretty
angry."
He
added: "This is not personal corruption. But
there was a clear conflict of interest — it was
not declared to us and it was not declared to the
journal, and it should have been." Murch said he
believed that if Wakefield had made clear his
interest, The Lancet would have asked for the report
to be rewritten to focus on hard fact and to
"leave the speculation, leave the measles story
out of there".
Another
of Wakefield's 12 co-workers in the study said:
"I am very, very angry. I would never have put
my name to the study if I had known there was this
conflict of interest, and had I not done so it would
never have got published."
Another
author, Dr Peter Harvey, a board member of Visceral,
a registered charity set up to support Wakefield,
spoke out in his defence. Harvey said he did not
think the funding was relevant and he would have
still have put his name to the study if he had known.
"I don't think there was any conflict of
interest," he said.
Dr
Richard Smith, editor of the British Medical Journal,
said, however: "That MMR paper is the best
example there has ever been of a very, very dodgy
paper that has created a lot of discomfort and
misery."
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Brian Deer. All rights reserved. No portion of this
article on MMR, the Lancet and Andrew Wakefield may
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