Summary of
Brian Deer's investigation
into a threat to children's
health
With
a series of stories spread over six
years, Brian Deer has pursued a
landmark public interest
investigation for The Sunday Times of London and
the United Kingdom's Channel 4 Television network into
allegations - first made in Britain -
linking the three-in-one measles,
mumps and rubella vaccine (MMR) with
claims of a terrifying new syndrome
of bowel and brain damage in
children. These allegations led to a
decade-long health crisis in the UK,
and sparked epidemics of fear, guilt
and infectious diseases, which have
been exported to the United States
and other developed countries,
spawning every kind of concern over
vaccinations.
Almost
incredibly, the trigger for what is
now a worldwide controversy was a
single scientific research paper published in
a medical journal, the Lancet, in
February 1998. Written by a
41-year-old laboratory researcher, Dr
Andrew Wakefield, and co-authored by
a dozen other doctors, it reported on
the cases of 12 anonymous children
with developmental disorders, who
were admitted to a paediatric bowel
unit at the Royal Free hospital in
Hampstead, north London, between July
1996 and February 1997.
Backed
by a press conference and a video news-release, the
five-page paper’s claims
received huge media attention, and
were followed by a sustained attack
on the vaccine. This included further
publications by Wakefield,
criticising MMR, and led to an
unprecedented collapse in public
confidence in the shot, which, since
the late 1980s in the UK and the
early 1970s in the US, has been given
almost universally to children, soon
after they are one year old, almost
eradicating measles and rubella.
The
prime cause of the alarm was findings
in the paper claiming that the
parents of two thirds of the 12
children blamed MMR for the sudden
onset of what was described as a
combination of both an inflammatory
bowel disease and "regressive
autism", in which language and
basic skills are lost. Most
disturbingly, the first behavioural
symptoms were said to have appeared
within only 14 days of the shot.
Although
the research involved only a dozen
children, and its results were never
replicated, many medical
breakthroughs have begun with
small-scale observations, and, if
true, Wakefield's findings might have
been the first snapshot of a hidden
epidemic of devastating injuries.
"It's a moral issue for
me," he said at the 1998 press
conference, where he called for a
boycott of the triple MMR, in favour
of breaking it up into single shots,
to be given at yearly intervals.
"I can't support the continued
use of these three vaccines, given in
combination, until this issue has
been resolved."
As
the doctor campaigned, UK vaccination
rates slumped: below the level needed
to keep measles at bay. Even Tony
Blair became embroiled in the
controversy when Wakefield supporters
suggested, wrongly, that the prime
minister’s youngest son was not
vaccinated with MMR. Meanwhile, in
America, a ferocious anti-vaccine
movement took off, after Wakefield
appeared on the CBS network's 60
Minutes programme in November 2000,
speaking of an "epidemic of
autism". This was followed by
claims that all vaccines are suspect:
either due to their content, or
because of an increase in the number
given to children.
"In
1983 the shot schedule was ten.
That's when autism was one in 10,000.
Now there's 36, and autism is one in
150," argued American actress
Jenny McCarthy, who blamed MMR for
her own son’s autism, and gained
the highest profile in the US
movement. "All arrows point to
one direction."
Andrew
Wakefield's role unmasked
But,
as journalists queued to report on
parents' fears, Brian Deer was
assigned to investigate the crisis,
and unearthed a scandal of astounding
proportions. He discovered that, far
from being based on any findings, the
public alarm had no scientific basis
whatsoever. Rather, Wakefield had
been payrolled to create evidence
against the shot, and, while planning
extraordinary business schemes, meant
to profit from the scare, he had
changed and misreported data on the
anonymous children to fix the results
in the prestigious journal.
Before
Deer’s inquiries, Wakefield had
appeared to all the world to be an
independent, if controversial,
researcher. Tall and square-headed,
with hooded eyes and a booming voice,
he was the son of doctors (a
neurologist and a family
practitioner), had grown up in Bath,
a prosperous, west-of-England spa
town, and joined the Royal Free in
November 1988, after training in
Toronto, Canada. His demeanour was
languid - he was privately educated -
and, born in 1956, he was a lingering
example of the presumed honour of the
upper middle class.
But
the investigation discovered that,
while Wakefield held himself out to
be a dispassionate scientist, two years before the
Lancet paper was published - and
before any of the 12 children were
even referred to the hospital - he
had been hired by a lawyer, Richard Barr: a jobbing
solicitor in the small eastern
English town of King's Lynn, who
hoped to raise a speculative class
action lawsuit against drug companies
which manufactured MMR.
Unlike
expert witnesses, who give
professional advice and opinions,
Wakefield had negotiated a lucrative
contract with Barr, then 48, to
conduct clinical and scientific
research. The goal was to find
evidence of what the two men called
"a new syndrome", intended
to be the centrepiece of (later
failed) litigation on behalf of an
eventual 1,600 families, mostly
recruited through media stories.
This, publicly undisclosed, role for
Wakefield created the grossest
conflict of interest, and the
exposure of it by Deer, in February
2004, led to public uproar in
Britain, the retraction of the Lancet
report's conclusions section, and,
from July 2007, the longest-ever professional
misconduct hearing by
the UK's General Medical Council.
The
money came through Barr [audio] from the UK
legal aid fund: run by the government
to give poorer people access to
justice. Wakefield charged for his
time at the extraordinary rate of
£150 an hour - billed through a
company of his wife's - eventually
totalling, for generic work alone,
what the UK Legal Services
Commission, pressed under the freedom
of information act, said was £435,643 (about
$750,000 US), plus expenses. These
hourly fees - revealed in The Sunday
Times in December 2006 - amounted to
more than eight times the doctor's
reported annual salary, and created a
financial incentive not only for him
to launch the alarm but to keep it
going for as long as possible.
In
addition to the personal payments was
an initial award of £55,000, applied
for by Wakefield in June 1996 - but
never declared to the Lancet, as it
should have been - for the express
purpose of conducting the research later
submitted to the journal. This
start-up funding was part of a
staggering £18m of taxpayers' money
eventually shared among a group of doctors and lawyers,
working under Barr's and Wakefield's
direction, to try to prove that MMR
caused the previously unheard-of
"syndrome". Yet more
surprising, Wakefield had predicted the existence
of such a syndrome - which he would
later dub "autistic
enterocolitis" - before he
carried out the research.
This
Barr-Wakefield deal was the
foundation of the vaccine crisis,
both in Britain and throughout the
world. "I have mentioned to you
before that the prime objective is to
produce unassailable evidence in
court so as to convince a court that
these vaccines are dangerous,"
the lawyer reminded the doctor in a
confidential letter, six months
before the Lancet report.
And,
if this was not enough to cast doubt
on the research's objectivity, The
Sunday Times and Channel 4
investigation unearthed another
shocking conflict of interest. In
June 1997 - nearly nine months before
the press conference at which
Wakefield called for single vaccines
- he had filed a patent on products,
including his own supposedly
"safer" single measles
vaccine, which only stood any
prospect of success if confidence in
MMR was damaged. Wakefield denied any vaccine
plans, but his proposed shot, and a
network of companies intended to
raise venture capital from purported
inventions - including a vaccine,
testing methods, and strange
potential miracle cures for autism -
were set out in confidential
documents. One business was later
awarded £800,000 from the legal aid
fund, on the strength of
now-discredited data which he had
supplied.
Behind
the veil of confidentiality
As
with the researcher, so too with his
subjects. They also were not what
they appeared to be. In the Lancet,
the 12 children (11 boys and one
girl) were held out to be merely a
routine series of kids with
developmental disorders and digestive
symptoms, needing care from the
London hospital. That so many of
their parents blamed problems on one
common vaccine struck an
understandable chord of concern. But
Deer discovered that the children
(aged between 2½ and 9½) had been
recruited through MMR campaign
groups, and that, at the time of
their admission, most of their
parents were clients and contacts of
the lawyer, Barr. None of the 12
lived in London. Two were brothers.
Two attended the same doctor's
office, 280 miles from the Royal
Free. Three were patients at another
hospital clinic. One was flown in
from the United States.
The
investigation revealed, moreover,
that the paper's incredible finding
of a sudden onset of autism after
vaccination was a sham: laundering
into medical literature, as apparent
facts, the unverified, often vague,
memories and assertions of a group of
unnamed parents who, unknown to the
journal and its readers, were bound
to blame MMR when they came to the
hospital, because that was why they
had been brought there. Wakefield, a
former trainee gut surgeon, denied
this. But the true number of families
accusing MMR wasn't eight, as the
paper said: it was 11 of the 12
(later all 12) and, in some cases,
records noted the children's legal
involvement before they were even
referred.
"Mum
taking her to Dr Wakefield, Royal
Free hospital, for CT scan, gut
biopsies," wrote one family
doctor in the north-east of England,
for example, before referring the
only little girl in the project.
"Will need ref letter. Dr
Wakefield to phone me. Funded
through legal aid."
In
the light of these discoveries, the
case was overwhelming to dig deeper
into Wakefield's findings. In an
exercise never before accomplished by
a journalist, Deer was able to go
behind the face of the 1998 paper,
identify the subjects, and access
their original patient data.
Penetrating veils of medical
confidentiality, he discovered that
the hospital's clinicians and
pathology service had found nothing
to implicate MMR, but that Wakefield
had repeatedly changed and
misreported diagnoses,
histories and descriptions of the
children, which made it appear that
the syndrome had been discovered.
As
revealed in The Sunday Times in
February 2009, the effect was to give
the impression of a link between MMR,
bowel disease and the sudden onset of
regressive autism, when otherwise
none was evident. The hospital's
pathology service had repeatedly
declared bowel biopsies from the
children to be normal, and not one of
the 12 cases was free of critical
mismatches between the paper which
launched the vaccine crisis and the
kids' contemporaneous clinical
records. Some children showed signs
of autism before vaccination. Some
were deemed normal months afterwards.
Some did not have autism at all.
"From
the information you provided me on
our son, who I was shocked to hear
had been included in their published
study," said the father of a boy
from northern California, who was
admitted, at age 5, to
Wakefield’s research, "the
data clearly appeared to be
distorted."
Children's
protections sidelined
In
addition to finding that the Lancet
paper had been fixed, the
investigation uncovered a raft of
other issues: starting with
irregularities in ethical
supervision. Research on patients is
governed by national and
international standards -
particularly the Helsinki declaration - and no
reputable hospital review board would
have endorsed the kind of fishing
expedition Wakefield embarked on for
Barr. Without that endorsement,
moreover, no major medical journal
would have published any resulting
paper. Nevertheless, to satisfy the
Lancet's stringent patient-protection
requirements, Wakefield reported that
a gruelling five-day
battery of invasive and
distressing procedures performed on
the kids, including anaesthesia,
ileocolonoscopies, lumbar punctures,
brain scans, EEGs, radioactive drinks
and x-rays, proposed for the lawsuit,
was approved by the Royal Free's
ethics committee.
But
Deer revealed that, despite the
research being executed on the
uniquely vulnerable, developmentally
challenged children of sometimes
desperate parents, the ethics
committee was not told the truth
about the project, and had given no such approval. Wakefield
and his key associates issued a formal statement denying this
explosive discovery, but later
changed their story and admitted it
during the General Medical Council hearing, where -
despite clear rules - they now
argued they needed no approval.
Wakefield's
basic science was also probed. The
story was much the same. He had
obtained the legal money and planned
his business ventures against a
theory of his own that the culprit
for both inflammatory bowel disease
and autism was persistent infection
with measles virus, which is found
live as a normal part of MMR. But
Deer revealed on Channel 4 that
sophisticated, unreported, molecular tests carried out
in Wakefield's own lab had found no
trace of measles in the children's
guts and blood. Those tests were
among a string which found no
evidence of the virus. The Sunday
Times also disclosed critical
flaws in one apparently positive
study, which involved materials
supplied by Wakefield. This had
misled thousands of families affected
by autism, both in the UK and US,
ensnared for years in hopeless
litigation based almost entirely on
his measles theory.
Deer
(who in April 2006 reported the first
British measles death in 14 years)
took no view on whether vaccines may
or may not cause autism, but he never
found any scientific material which
repeated the Lancet findings.
Although all kinds of children
suffer from digestive issues, helearnt
of a mass of authoritative research
which overwhelmingly rebutted
Wakefield's claims.
"Specifically, numerous studies
have refuted Andrew Wakefield’s
theory that MMR vaccine is linked to
bowel disorders and autism," was
how the American Academy of
Pediatrics summarised the position in
an August 2009 statement to NBC News
for a Dateline programme which
featured both Wakefield and Deer.
"Every aspect of Dr
Wakefield’s theory has been
disproven."
The
impact of the investigation has been
felt around the world, with media
coverage from New Zealand to Canada.
In the UK, the revelations prompted a
statement by the prime minister, a collapse
in the anti-MMR campaign, and a rebound in
vaccination levels. In the US - where
the Barr-Wakefield deal was joined by
allegations marshalled by American
attorneys that a mercury-based
vaccine preservative, thimerosal, was
also at fault - findings by Deer were
presented by the Department of
Justice in federal court, followed in
February 2009 by scathing judgments. After
hearing a test case of petitions from
some 5,000 families, one presiding
judge said:
"Therefore, it is a noteworthy
point that not only has that
'autistic enterocolitis' theory notbeen accepted into
gastroenterology textbooks, but that
theory, and Dr Wakefield’s role
in its development, have been
strongly criticized as constituting
defective or fraudulent
science."
Wakefield
campaign denies everything
In
response to Deer's findings, Wakefield supporters denied that he
received money for research, and,
amid a barrage of sometimes paid-for attacks and crank abuse,
insisted that the doctor was a
champion of children’s
interests. But the father-of-four had
not only baselessly triggered the
resurgence of sometimes fatal or
brain-disabling measles outbreaks,
plunged countless parents into the
hell of believing it was their own fault for agreeing
to vaccination that a son or daughter
had developed autism, and misled an
ethics committee over child rights
and safety, but it was discovered
that he had gone as far as to buy blood samples from children
as young as four years old, attending
a birthday party, and then to joke
about them crying, fainting and
vomiting.
Meanwhile,
Wakefield bizarrely argued that he
neversaid that MMR caused
autism at all. But documents -
including patents - evidence
the doctor's claims, and he published
a string of further misleading
reports to undermine the vaccine.
Even when he knew that his
allegations had been proven baseless,
he was found promoting them from a
controversial business in Austin,
Texas, called Thoughtful House, where, after
being fired from the Royal Free in
October 2001, he now holds a
$280,000-a-year post, spun from his
campaign against the shot.
Throughout
the investigation, Wakefield refused to
co-operate, filed complaints, and issued public statements denying every
aspect. He also initiated, and then abandoned with some
£1.3m ($2m) costs, a two-year libel lawsuit, financed by
the wealthy Medical Protection
Society, which defends doctors
against complaints from patients. The
conduct of this lawsuit was
criticised by a High Court judge, who said
that Wakefield "wished to
extract whatever advantage he could
from the existence of the proceedings
while not wishing to progress
them", and that the doctor was
using them as "a weapon in his
attempts to close down discussion and
debate over an important public
issue".
Andrew
Wakefield says that he has done
nothing wrong. "The notion that
any researcher can cook such data in
any fashion that can be slipped past
the medical community for his
personal benefit is patent
nonsense," he argued in a March
2009 statement. "Scientific
rigor requires repeatability for
verification of any research and Mr
Deer's implications of fraud against
me are claims that a trained
physician and researcher of good
standing had suddenly decided he was
going to fake data for his own
enrichment."
Postscript:
investigation vindicated
On 28
January 2010, a General Medical
Council panel handed down rulings on
Wakefield's conduct, following a
197-day inquiry, arising from Brian
Deer's investigation. The inquiry was
the longest-ever by the medical
regulator. The panel, of three
doctors and two lay members, branded
Wakefield "dishonest",
"unethical",
"irresponsible" and
"callous". His 1998 Lancet
research was found to be dishonest,
and performed without ethical
approval. Five days later, the Lancet
fully retracted the paper
from the scientific literature. After
further proceedings, Wakefield's
license to practise medicine is
expected to be revoked.
A
selection of Brian Deer's
stories
which exposed Andrew
Wakefield
and shattered a
decade-long scare
Left & first below:
22 February 2004
Second below: 14 November
2004
Above
left: 18 June 2006
Above right: 31 December
2006
Left & below: 8
February 2009
Left:
11 September 2005
Below: 2 April 2006
Above
left: 25 April 2004
Above right: 21 May 2006
Left: 7 March 2004
Below: 22 February 2004
(turn from splash)
Expounded
and exposed: the rise and
fall of the MMR crisis
October 1988:
MMR triple vaccine,
containing attenuated
live measles, mumps and
rubella viruses, is
launched in the United
Kingdom, after successful
use in America since 1971
February 1996: A
solicitor, Richard Barr,
hires Andrew Wakefield at
£150 an hour to support
a planned legal attack on
MMR jab manufacturers.
Not publicly disclosed
June 1996:
Wakefield and Barr ask
the UK Legal Aid Board
for money to show a link
between MMR and a
"new syndrome"
of autism and bowel
disease. Not publicly
disclosed
July 1996: First
autistic child admitted
to Royal Free hospital
for research project. Of
the 12 in the study, most
are Barr and campaign
contacts, and 11 will
turn out to be litigants
June 1997:
Wakefield files for a
patent on his own
supposedly
“safer” single
measles jab, and for
miracle products to treat
autism and bowel disease.
Not publicly disclosed
February 1998:
The Lancet publishes
paper proposing link
between MMR, and a
"syndrome" of
autism and bowel disease.
Wakefield makes no
disclosure of his
interests
January 2001:
The Daily Mail and other
newspapers launch
campaigns backing
Wakefield after he
publishes a
“review” of his
evidence and [repeats]
calls for single vaccines
December 2001: Prime
minister Tony Blair is
ambushed by Wakefield
supporters with
allegations that his
youngest son, Leo, did
not have MMR. The
claim turns out to be
untrue
January 2003:
Vaccination among
two-year-olds falls to
78.9%: below the 92%
needed to protect the
population. Figures in
parts of inner London are
half the national rates
February 2004:
The Sunday Times reveals
Andrew Wakefield’s
legal funding and the
children’s litigant
status. The revelations
are greeted by a media
firestorm and public
anger
February 2004:
Dr Richard Horton, editor
of The Lancet, describes
the original February
1998 paper as
“fatally
flawed” and
apologises for publishing
it in the journal
March 2004: Ten
of the 1998 Lancet
paper’s 13 authors,
excluding Wakefield,
retract their previous
claim of possible
MMR-autism link set out
in its conclusions, or
"interpretation"
November 2004:
Brian Deer's Channel 4
investigation reveals
Wakefield’s single
vaccine patent claims and
commercial interests, and
that measles was not
found in the children
March 2005: Scientists
reveal that, after MMR
was discontinued in
Japan, the incidence of
reported autism continued
to rise at a similar rate
to countries using the
three-in-one
April 2006: The
Sunday Times reports that
a 13-year-old boy had
become the first person
in the UK in 14 years to
die from measles.
Meanwhile, measles
outbreaks rage
December
2006: The Sunday
Times reveals details of
Wakefield's personal
funding from the lawyer -
£435,643, plus expenses,
or £150 an hour - to
sustain a speculative
lawsuit
July 2007: GMC
opens professional
misconduct case against
Wakefield and two other
Royal Free colleagues
concerning ethical issues
over the treatment of the
Lancet children
February 2009:
The Sunday Times reveals
data fixing behind the
Lancet paper. Wakefield
denies research fraudand files a
complaint with the UK
Press Complaints
Commission
February 2009:
Three test case judgments
for 5,000 claims are
handed down in US federal
court rejecting the
allegation that MMR can
cause autism, and
lambasting Wakefield
January 2010:
GMC gives devastating
findings from its
professional misconduct
hearing for Wakefield,
John Walker-Smith and
Simon Murch over ethical
and publication issues
February 2010:
The Lancet retracts
Wakefield's 1998
MMR-autism research
paper. The journal's
editor describes aspects
of it as "utterly
false", and said he
"felt deceived"
Selected
resources from the Andrew
Wakefield investigation
More of The
Sunday Times of London
stories from Brian Deer's
investigation into the
MMR vaccine controversy
and Andrew Wakefield's
research activities are
listed at this
page
Andrew
Wakefield's patent
application for a
"new
vaccine/immunisationfor the
prevention and/or
prophylaxis against
measles virus
infection", the
existence of which he
denies
The agreed
meanings of Brian Deer's
Channel 4 documentary,
pleaded in Andrew
Wakefield's abandoned
"gagging writ"
lawsuit, Wakefield v
Channel 4 & Ors, is here
Read
the allegations of data
fixing in the 1998 Lancet
paper on MMR, autism and
bowel disease, put by
Deer to Andrew Wakefield
in February 2009, and his
lawyers' response
The UK General Medical
Council's January 2010 findings
on the misconduct of
Wakefield and two
co-defendants, professors
John Walker-Smith and
Simon Murch
Brian
Deer is interviewed by
Matt Lauer on the NBC
News Dateline program, in
August 2009, concerning
the first part of the
vaccine investigation
Another clip, here,
from the special Dateline
edition includes
Wakefield's response. He
says of the 12 children:
"Now let's be clear.
They were admitted to the
Royal Free for
investigation of their
symptoms. Nothing to do
with research, nothing to
do with class action,
nothing to do with
vaccines." These documents,
revealed by Deer, say
otherwise
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