How Wakefield misled UK and US lawmakers - and BBC flagship show hardly noticed

This page is research from an investigation by Brian Deer for The Sunday Times of London and the UK's Channel 4 Television into a campaign linking the MMR children's vaccine with autism. | Go to part I: The Lancet scandal | Go to part II: The Wakefield factor

On 3 February 2002, the BBC's flagship investigative programme, Panorama, broadcast what was described as the result of a year-long inquiry into Wakefield's claims. The reporter was Sarah Barclay, sister-in-law of Nick Lander, chair of Visceral, a body set up by Wakefield in June 2000, and of which he is a salaried director. Barclay says this relationship was notified to BBC managers

The programme was called "Every parent's choice", which was practically a campaigning slogan for calls to make single shots available - Wakefield's demand - and effectively editorializes by ending on a parent making that demand. However, a greater interest lies in the production crew's discovery that Wakefield had given evidence to UK parliamentary and US congressional committees on a child he had never seen and who turned out not to appear to have the syndrome Wakefield alleged was evidence of vaccine damage

The more extraordinary passages in this programme are highlighted below

[Media 3 Feb 2002] PANORAMA MMR Every Parent's Choice

NB: THIS TRANSCRIPT WAS TYPED FROM A TRANSCRIPTION UNIT RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT: BECAUSE OF THE POSSIBILITY OF MIS- HEARING AND THE DIFFICULTY, IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS ACCURACY.

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[Media 3 Feb 2002] PANORAMA MMR Every Parent's Choice
RECORDED FROM TRANSMISSION: BBC-1 DATE: 3:02:02
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ADAM MORRISH: (Playing) Do not switch it off. You see, I am the first man to conquer Mount Everest. Cut.

SARAH BARCLAY: This is Adam Morrish as a healthy 9 year old. Adam's only serious childhood illness had been measles. His family had no idea of what might follow years later.

DAVID MORRISH: Over the period of really I guess February to April, May time in 1993 Adam neurologically disintegrated before our very eyes. By October of 1993 Adam had moved through not being able to balance, falling over a lot, being in a wheelchair, not being able to eat. By the middle of the summer he had spoken his last word. By the end of the summer he was blind. By October Adam was in a waking coma and that's pretty much as we see him today.

BARCLAY: Adam caught measles as a baby from an unvaccinated child. The virus lay dormant for almost ten years before triggering an extremely rare and fatal condition known as SSPE.

DAVID MORRISH Adam did come into contact with the mild measles virus just on a bus while we were on holiday, sitting next to a small girl who had measles. We didn't know she had measles then, but we do now. And that's of course the thing which I often think back to and I think.. I mean I can't help.. you won't be surprised that we have thought on many occasions that if that child had been vaccinated, Adam may not be in the condition he's in today.

BARCLAY: These parents know measles can be dangerous, but they don't want their child to have MMR, the triple vaccine which protects them from measles, mumps and rubella. They'd rather pay for single vaccines at £60 a shot, even though the government insists MMR is safe.

MOTHER: And all they say is the research shows that MMR is safe Well what about the other side, what about the research that shows it's not safe?

INTERVIEWER: Can I just ask you why you've brought your child here for a single vaccine?

2nd MOTHER: Because my other son was damaged by the MMR.

INTERVIEWER: What happened?

2nd MOTHER: He had the MMR and he's autistic, so there was no way he was having it. He's just had the measles today.

INTERVIEWER: What happened to your other son?

2nd MOTHER: Overnight he had the fever, the high temperature..

INTERVIEWER: Literally? 2nd MOTHER: Literally overnight. He was never the same again. He stopped talking and his behaviour was bizarre.

3rd MOTHER: I think their position is now untenable and that they need to change their mind and not see it as a U-turn but see it as actually responding to the people who, let's face it, put them in their jobs.

BARCLAY: At the Department of Health in London they're not interested in U-turns. They're planning a £3 million campaign to restore confidence in MMR.

MEETING: Yes, and I want to see.. I want to see the sort of ten myths, ten facts, provides information, it's doing what we keep hearing people want. They want information, it provides information. It's not judgmental....

BARCLAY: The Government is convinced it's better to try and persuade parents MMR is safe rather than allow the choice of single vaccines.

Dr PAT TROOP Deputy Chief Medical Officer If we were to offer single vaccines, it would suggest to parents that there was a problem with the vaccine, we would end up with fewer children vaccinated rather than more. There may be some who might come forward for single vaccines but I think many more parents would just turn away from the vaccine and I think we would have many more children exposed to serious diseases. I don't think it would actually improve the situation, I think it would make it worse. Royal Free Hospital Press Conference 1998 This is a battle the Government has been fighting for the last 4 years. Andrew Wakefield ignited the debate over MMR by announcing the findings of research into a group of children with autism and bowel disease. He said some parents had linked the condition with MMR, a defining moment for the vaccine programme.

ANDREW WAKEFIELD: (speaking at conference) my concerns are that one more case of this is too many and that we put children at no greater risk if we dissociated those vaccines into three, but we may be averting the possibility of this problem, and.....

BARCLAY: He'd urged the Government to split MMR into separate vaccines, but the research was based on just 12 children and hadn't proved a link with MMR.

Interviewed in 1998

ANDREW WAKEFIELD There is sufficient anxiety in my own mind that it would be sensible to divide them into separate doses, that is, give them individually as measles vaccine, mumps vaccine and rubella vaccine until this issue has been resolved.

[NEWS REPORT] What should parents do after a report linking the measles, mumps and rubella vaccines with autism.

BARCLAY: MMR, a vaccine promoted by the Government as safe, became a source of confusion and fear among an increasing number of parents. Whatever the official evidence which rejected a link between MMR and autism, fewer parents were prepared to take a risk. When the experts were reviewing the evidence on MMR they didn't examine the evidence which had prompted Andrew Wakefield to raise such public concern about the vaccine - the children whose parents believe they've been irreparably damaged by MMR. This family is one of a thousand now taking legal action against the makers of the vaccine.

Dorset MARK & HEATHER ADAMS What I do remember is about a month after the vaccine, ringing up a new GP in floods of tears saying "My son does not understand a word I say".

BARCLAY: Rory Adams is severely autistic. The symptoms started to appear when he was two, soon after he had his MMR. This is the age at which autism usually develops, but his parents don't believe it's coincidence.

HEATHER: We've got a big problem out there, and while there is a possibility that it may be linked to MMR....

MARK: Exactly, when there are enough cases to bring into serious doubt..

HEATHER: There is reasonable doubt.. I mean any other medical issue, if there was this amount of reasonable doubt it would be pulled. If we were talking about a can of beans in Sainsbury's that might possibly be contaminated, the whole lot would have been withdrawn by now, and we're talking about kids' lives here.

SARAH BARCLAY At the beginning of last year a new study by Andrew Wakefield analysed the clinical trials that had been done before MMR was introduced. He said that children hadn't been monitored for long enough to pick up side-effects like autism or bowel disease, and that a vaccine containing three live viruses should have been tested for much longer. These were serious accusations.

ANDREW WAKEFIELD You do not combine three live viruses into one vaccine and assume that that is a benign process, that you can follow those children for 3, 4, 5 weeks and get away with it. These are viruses that are live, they are capable of establishing long-term infection and they are capable of producing long-term adverse events.

Department of Health Press Conference 22nd January 2001

LIAM DONALDSON: People are entitled to make claims, and when those claims cause anxiety to parents then we have a responsibility to respond to parents' concerns and look at the evidence again and continue looking at it every time that a claim is made.

BARCLAY: This time the Government was determined to win the war of words with Andrew Wakefield. They assembled a team of medical experts, called a press conference and launched a concerted attack on the work of the man they held responsible for the loss of public confidence in MMR.

CHAIR: If I could just start with Dr Miller.

Dr ELIZABETH MILLER Public Health Laboratory Service The issues and allegations about MMR vaccine safety have been looked at extremely carefully by a number of independent research groups. The conclusion time and time again is that there are no grounds for suspecting that MMR vaccine causes autism.

SARAH BARCLAY: Just because there is no evidence now, doesn't necessarily mean that there won't be evidence in the future. What happens if you've got it wrong?

Prof LIAM DONALDSON Chief Medical Officer This isn't a situation where we're in the dark with no evidence whatsoever, but you're choosing to focus on one, or a small group, of people's claims against a wide range of other researchers who've not been able to replicate their work, who are prepared to come out publicly and sign up to unequivocal endorsements of the effectiveness and the safety profile of MMR.

BARCLAY: MMR was launched in Britain in 1988, but it had been used in other countries for more than 10 years. It was this experience British experts relied on when they licensed the vaccine.

[TV Promotion] IMMUNISATION SEE YOUR DOCTOR OR LOCAL CLINIC HEALTH EDUCATION AUTHORITY "Immunisation, the safest way to protect your child"

Prof Sir WILLIAM ASSCHER Cttee on Safety of Medicines, 1986-92 We had a huge database on which that decision was made, more so than with most vaccines because the history of the triple vaccine goes back to 1979 I think in the States, 1982 in Scandinavia. So when we licensed it in '88 we had information on about 5 million vaccinations.

"Until they catch it, you'll most likely have forgotten just how miserable measles can be."

BARCLAY: MMR was promoted for another reason too, take up of single measles vaccine was slow. Combining three vaccines in a singe jab was thought to be the most efficient way of banishing three childhood diseases forever.

EDWINA CURRIE Health Minister, 1986-88 We'd had 47,000 cases of measles the year before, we were heading for 80,000 cases in 1988. Measles is a killer. In fact in 1988 we lost 15 children who were killed by measles, all of whom were preventable, and we felt that the case was overwhelming for having a go.

BARCLAY: But could the combination of three live viruses be causing long-term problems no one could have predicted. Rory's parents have listened to everything the Government said about the safety of MMR but they're not prepared to accept the official reassurance.

MARK ADAMS: I think there is a greater questioning of authority and I think affairs such as the BSE fiasco has certainly had an effect on people's perception of what they're being told and when the Department of Health vilifies and denigrates the only people who are looking into the problem that our son and thousands of other children have, we find it deeply distressing.

BARCLAY: Today Rory's on his way to the Royal Free Hospital in London. As well as autism he also has a type of bowel disease. The research here is controversial because of it's connection with MMR and the doctor at the centre of the debate about it's safety.

ANDREW WAKEFIELD The parents have proven that they were absolutely correct when they said their child had a bowel disease. The medical profession had said no they haven't. The medical profession was wrong. So when the parents said to us I think this started after the MMR vaccine, as indeed parents are saying all around the world now, we were obliged to investigate that. We could not.. I could not walk away from that. That's what I signed up to in medicine and however uncomfortable it might get for me, that was the deal.

BARCLAY: When doctors at the Royal Free examined what was going on inside the bowels of children with Rory's symptoms, a procedure called 'scoping', they found swelling and inflammation, evidence of a new condition which seemed to be affecting some autistic children. Simon Murch, a specialist in children's bowel disease, tries to examine Rory to see if his condition has improved. He believes Rory and the other children could be suffering from a disease trigged by defects in their immune system. Even though he hasn't linked it with MMR, he's found himself drawn into the controversy.

Dr SIMON MURCH Paediatric Gastroenterologist: I've been advised by colleagues that it is better to accept that a very few children can have adverse events than to continue investigating that if it's going to have an impact on the vaccine uptake internationally.

BARCLAY: Concerns about MMR have had an impact on many families including the Wakefields. Andrew Wakefield and his wife Carmel, also a doctor, have had to make their own choices about whether to vaccinate their children.

Dr CARMEL O'DONOVAN Andy has never ever, ever advocated not vaccinating, and indeed our first two children, who were born.. well the first was born as MMR was introduced so he was one of the children who had MMR as would be normal and accepted practice at that time, as was our second child. As Andy's work was unfolding and the potential link between MMR and problems began to unfold then we had to reappraise our policy on vaccinating our own children, so our second two children have not had MMR vaccination.

BARCLAY: When Andrew Wakefield first raised concerns about MMR he had no proof that the vaccine could cause autism, but he believed it was possible that a harmful, live virus was persisting in the bodies of some autistic children. Over the last year we followed Andrew Wakefield's search for the virus which could prove a possible link between MMR and autism.

Coldspring Harbor, Long Island February 2001

BARCLAY: The setting for a prestigious medical conference. To help in his search for the measles virus Andrew Wakefield has turned to Professor John O'Leary, a man internationally renowned for being able to detect minute particles of virus in human tissue. They're here to discuss the possible causes of autism, including MMR.

WAKEFIELD: The question we've been asking, is measles virus present in the intestine of these children. The diseased intestine looks like a disease that could be caused by a virus. Previous research has shown that the protein of the virus is in the lymph glands but the gold standard now is to find the gene of the virus in there.

BARCLAY: Meetings here take place far away from public scrutiny. Unpublished research is revealed and discussed. That's why we weren't allowed to record the presentation made by John O'Leary, but the evidence he was presenting seemed significant. He'd found measles virus in most of the samples he'd tested from children with autism and bowel disease.

Prof JOHN O'LEARY Trinity College, Dublin We have found measles virus, we've quantitative, we've localised it and the next thing people want to know is.. you know.. what's the sequence strain of it. I'm sure there are multiple wild type strains existing out there, there are multiple strains in vaccines, so it's a very difficult job.

BARCLAY: No one at the meeting disputed these findings, but until they're published in a respected medical journal, neither the Government nor the wider scientific community, will take any notice of them. While scientists argue about the many possible causes of autism the experience of hundreds of parents like Vicky Hill raises questions about whether the measles virus could be lingering in some children long after they've been vaccinated with MMR.

VICKY HILL I'd delayed taking them for it because they'd had colds and flu and I took them in and pretty much straight after they'd had the vaccine when I brought them home they developed high temperatures. After that they were both ill with rashes to their face and the trunk of their body. Their whole demeanour changed basically overnight.

BARCLAY: Two years later both twins were diagnosed autistic.

VICKY: I was just so bereaved and felt so utterly devastated that the two little boys that I'd brought into the world that had seemed to be to all intents and purposes normal had suddenly gone.

BARCLAY: The likelihood of non-identical twins like Connell and Alexander both being autistic is about 1 in 50. No one knows what causes autism. The question is whether MMR could act as a trigger in susceptible children.

WAKEFIELD: We have found that it's children who have a strong family history of autoimmune disease, particularly in the mother, of thyroid disease, diabetes, arthritis, children who are vaccinated with MMR when they're unwell, children who are on antibiotics or who've recently been on antibiotics, children who have for example food allergies, milk allergic children, and children who are maybe given multiple vaccines at the same time.

BARCLAY: Though unproved scientifically, that observation provides Vicky with a plausible explanation for what happened to her two boys.

VICKY: If I'd known then what I know now, there would be no way they would have had the vaccine. Their health has suffered ever since, they've never been right, and as I said, Alexander keeps developing this measles rash on his body whenever he's ill, so it's obvious that somewhere inside him lurking there's a virus.

Irish Committee on Health & Children March 2001

BARCLAY: In Ireland where the debate over MMR has been fuelled still further by a measles outbreak which killed three children, a special committee has been convened to investigate the potential link between MMR and autism. Andrew Wakefield has been asked to give evidence.

WAKEFIELD: .. but my anxiety is this, and I've just been given the latest data from the United States of America from the Education Department on the prevalence of autism in children between 6 and 18 years, and in some states it's as high as 1 in 32 children and I do not want that to be the future for this country or for the United Kingdom.

BARCLAY: But Wakefield's collaborator is becoming increasingly concerned about the way the public debate over autism and MMR is threatening to undermine the science.

O'LEARY: I am in the middle of what is a very difficult and emotive situation here. I will again appeal to everybody that we must not fight this in the press. This has got to be fought in the scientific peer reviewed press and we must respect that.

BARCLAY: Did you think when you started working with him that you'd suddenly find yourself in the middle of a fairly major public health controversy?

Prof JOHN O'LEARY Trinity College, Dublin No. (laughs) No I did not, no.

BARCLAY: The problem with the whole debate about MMR is the way claims about the vaccine have been made without scientific proof. One prestigious medical journal turned down the paper Andrew Wakefield and his colleagues were working on because it failed to prove that the measles virus came from the vaccine. But by then a new theory had emerged, the double hit, another potential missing link between autism and MMR. Andrew Wakefield has been asked to speak to a parliamentary committee investigating autism. He highlights the case of a child who's had two doses of MMR.

Parliamentary Committee on Autism March 2001

WAKEFIELD: And you can see this interesting double hit phenomenon that occurs in many children. Here is a child who did not receive his first MMR until he was four years and three months of age, after which he became autistic. In fact what this child has developed is what we call.. what the paediatric psychiatrists call disintegrative disorder.

BARCLAY: This is Christopher Walker, the child Andrew Wakefield was talking about.

MARK & TINA WALKER TINA: He used to say 'daddy' when his dad came home from work, but it was 'addy, 'addy. And he'd point to his shoes and say 'oes for shoes.

MARK: He could read before he went to school, just slightly.. you know.. cat and dog and apple and things, he could read them out of the books and he used to love books.

TINA: He never ever had a tantrum. He never did anything out of place. He was just a normal 3 year old right up until just before he started school.

Leeds

TINA: Do you want to get yourself a biscuit Christopher?

BARCLAY: This is Christopher Walker today. Now 16 he suffers from disintegrative disorder, similar to autism. But Christopher is not like the other children in this film. His symptoms did appear soon after he'd had the MMR, but he wasn't a baby when he had the jab, he was nearly 4. Christopher had a single measles jab when he was a year old with no apparent side-effects. Then he was given MMR just before he started school.

TINA: Almost immediately there were concerns about his behaviour and about his development. At the same time he developed problems with walking, tip toe walking and rocking sideways. His speech became less clear.

MARK: It was like losing him. It was very upsetting but I mean we didn't associate with anything to do with the injection at all.

TINA: No. No.

BARCLAY: When Christopher was 9 he had a booster jab of measles and rubella. Within months he'd regressed dramatically. Recently his parents checked the vaccination records.

TINA: I was really stunned at the dates and how it tied in. It seemed like it was an explanation for the way he is.

MARK: All these things have stepped up in severity after the injections that he's had so to us it's very obvious.

BARCLAY: The little boy who never had a tantrum has now become an unpredictable stranger.

MARK: He's pulled lumps out of Tina's hair. The other day he tipped the table over. He'll sit down for his meal and his plate, food and everything, knife and fork will go flying across the room.

TINA: We've taken to hardly speaking to him at all just to keep a nice atmosphere.

BARCLAY: Are you frightened of him?

TINA: Yes.

BARCLAY: That must be very hard.

TINA: Yes. Yes it is hard, yes.

BARCLAY: Completely baffled by the apparent link between Christopher's injections and the dramatic change in his behaviour, his parents were advised to contact Andrew Wakefield.

TINA: Dr Wakefield rung me up and said that Christopher really does need to be treated.

BARCLAY: Were you surprised to get a call from him?

TINA: Yes, yes, I was very surprised because I didn't.. I'm so used to doctors not being able to help through no fault of their own, so it's given us some hope.

Congressional Hearings 25th April 2001

Andrew Wakefield is to appear before a congressional committee investigating the potential link between autism and MMR. In America autism appears to be increasing at an extraordinary rate. Here Wakefield is seen as something of a hero. This time the British Government representative is the one under attack.

Dr ELIZABETH MILLER Public Health Laboratory Service There is no evidence that the onset of autistic symptoms is more likely shortly after MMR vaccine than at any other time. Indeed new evidence which is shortly to appear from my colleagues and myself in a vaccine journal is that there is no evidence that MMR vaccine increases the likelihood of autism at any time after vaccination.

AMERICAN SPEAKER: You know the hypothesis is not that MMR causes all forms of autism, and if you are operating under the assumption....

MILLER: No, I haven't implied that it does.

AMERICAN SPEAKER: ... that MMR causes a small percentage of cases of autism then that may be very, very difficult to detect in an epidemiological study, and if the British Government is at all concerned about vaccination rates declining because of Wakefield's finding, why don't they just scope 50 kids? What's the problem?

MILLER: I think you have accepted that the evidence has already excluded MMR as a common cause of autism.

AMERICAN SPEAKER: If I could just interrupt you because these kids have florid inflammatory bowel disease. Why can't somebody duplicate this study. I mean we've got this poor lone guy coming here constantly year in year out and you know Doctor O'Leary, might I say, is a very, very reputable scientist, why can't we repeat O'Leary's data?

MILLER: Well first of all we have to wait to see the findings.. biological findings published in a peer reviewed journal and we have not yet seen those.

BARCLAY: While his critics wait for one piece of evidence, Andrew Wakefield presents another, the double hit, Christopher Walker's case.

WAKEFIELD: .. these children received not one dose but three doses of the MMR vaccine, and what we see in many of these children is a double hit phenomenon. They regress after the first dose and then they regress further after the second dose. This child did not receive his first MMR vaccine until he was 4 years 3 months of age. He then deteriorated into autism, a disintegrative disorder. He then received his second dose at 9 years of age and disintegrated catastrophically. He became incontinent of faeces and urine and he lost all his residual skills. This is not coincidence.

BARCLAY: Five days later, the boy who Andrew Wakefield has been discussing in Washington arrives in London for his first appointment at the Royal Free.

MURCH: Tell me what actually happened around that time. Was it a bit more sudden?

TINA: It was more serious in that he actually did lose all his skills.

BARCLAY: Simon Murch starts to take a detailed medical history from Christopher's parents. But when Andrew Wakefield arrives, it becomes clear that the boy whose case is linked so clearly with MMR isn't someone he's seen before, in fact, it's the first time they've met. There's only one way to find out what's wrong with Christopher and that's to look inside his throat and gut. What they're looking for is evidence of the chronic inflammation which is typical of the new disease. But if it's there, it's not immediately obvious.

MURCH: It's not.. it's borderline. You may well see this sort of pattern in children who were being scoped for a variety of reasons, and it's not diagnostic of any condition, nothing that you would get too excited about.

BARCLAY: Andrew Wakefield has made a very clear connection between the vaccine and the condition. From what you saw of Christopher Walker, do you think there was a connection?

Dr SIMON MURCH Paediatric Gastroenterologist I think that's absolutely impossible to say. Throughout this whole episode I and our department have tried to separate the two issues. I think, as a paediatrician, it's immensely uncomfortable to be in any way associated with research that is seen to impact on vaccine uptake rates. I think it's quite an improper area for any of us to pronounce on without hard evidence.

BARCLAY: Andrew Wakefield is one of the few doctors to listen to parents who believe their children were damaged by MMR, but is he a rigorous scientist?

Prof BRENT TAYLOR Royal Free Hospital I think he's misled himself. I think he really hasn't used proper scientific methodology repeatedly. It's interesting that when he's reported something and he's tried to reproduce it using better scientific methods he hasn't been able to in various aspects of this research, particularly in relation to inflammatory bowel disease, and the fact that no one anywhere in the world has been able to reproduce any of his findings. It makes one wonder about their validity.

BARCLAY: Last November Andrew Wakefield left the Royal Free Hospital by mutual agreement. He may be right that MMR damages a particular group of children. But after four years he's failed to provide the evidence to justify the alarm his claims have caused. Shouldn't you have proved it before you said it?

WAKEFIELD: As I say, proof may be 10-15 years away in terms of definitive scientific proof.

BARCLAY: So shouldn't you have waited?

WAKEFIELD: No.

BARCLAY: Why?

ANDREW WAKEFIELD Because the proof was there that the questions that the parents had raised were valid, and the parents would keep coming to us and saying "What would you recommend".

BARCLAY: But science demands more than that, doesn't it. Obviously you have to do your duty as a doctor, obviously you have to listen to the parents and observe and investigate. But isn't your duty as a scientist different? Doesn't it require more rigorous proof?

WAKEFIELD: I think that is a valid argument, but we were much further ahead by that stage in terms of identifying the virus, putting the pieces of the jigsaw together to demonstrate that that was the case.

BARCLAY: Back in Leeds Christopher Walker has just been expelled from school for being violent. His condition continues to decline. For weeks he's been spending most of the time in his bedroom staring at the floor. He no longer even plays with his video game. Last week he was admitted to hospital.

MARK WALKER: He doesn't have a future.

TINA WALKER: He doesn't, no future. And now he doesn't eat any solid food at all. He doesn't eat nothing.

MARK: Everything that happens to him is just a further set back. He's weaker now than he ever was. He's 16 and he's just over 7 stone.

TINA: I just wish that we could go back in time.

[MMR Promotion] No parent wants to expose their children to unnecessary danger, yet measles, mumps and rubella can still be a serious threat.

BARCLAY: At the Department of Health they're watching the latest edition to the campaign they hope will convince parents MMR is safe. The man in charge of the government's immunisation programme pours scorn on the doctor he holds responsible for destroying trust in MMR. [Department of Health] There was a new hypothesis coming from the Royal Free Group, you know.. it's like Sherlock Holmes, it's the case of the shifting hypothesis.

BARCLAY: Andrew Wakefield and Professor O'Leary's virus research is about to be published in a respected medical journal. It reveals that measles virus was found in more than 80% of the children with autism and bowel disease they tested, but in just 7% of those without. After months of research it hasn't been possible to identify any proven link with MMR.

Prof JOHN CROCKER Editor, Journal of Molecular Pathology It tells us that parts of measles virus has been found in the bowel specimens from children with a rare condition which is not fully understood. The virus has been found not to be in it's full active or dividing form and therefore the significance of this finding is very uncertain.

BARCLAY: If the Department of Health turns round when this paper is published and says it doesn't change anything at all, it doesn't advance the argument about MMR would they be right?

CROCKER: Yes they would, yes.

BARCLAY: In some parts of the country there is now so much confusion over MMR that uptake of the vaccine has fallen dramatically. In Lewisham where Anne Nesbitt works, uptake is just 63%, well below the level needed to ensure everyone in the community is protected.

Dr ANNE NESBITT Community Paediatrician I think that parents' anxieties have been fuelled by the fact that many of them now know a child who has autism, but relatively few parents these days know a child who's had measles, and I think you worry about things you know about, but it's harder to worry about things that you haven't experienced.

[NEWS] On 92 to 95 FM at 810 medium wave, this is BBC Radio Scotland. Now there's been an outbreak of measles at two nurseries in South London. Three children under five have contracted the virus, 22 other suspected cases are being investigated. You might not have expected that to make the news but for the fact health officials have warned children are at greater risk from measles because too few parents are allowing them to have the controversial MMR vaccine.

DAVID MORRISH I think it's very important that people take those decisions and think about it at two levels: one as a parent safeguarding their own child, and that's of course the one that we'll probably find the most easy. But if a number of us are choosing not to vaccinate our children, and taking measles for an example, then we will simply get more cases of complications from that disease, and in very rare and very unfortunate cases you'll have complications like SSPE.

BARCLAY: There are now more than half a million autistic children in Britain. Science has yet to identify the causes but the consequences can be devastating. When we revisited the twins we discovered that one of them had recently set fire to the kitchen causing extensive damage. Funding for the twins' intensive therapy is also under threat. It will take more than information campaigns and official reassurance to convince many parents that MMR is not responsible for autism.

VICKY HILL Research should be done and should be funded so that we can look at it and say well these are the facts, it's up to you. You can either have it three in one, you can have it separately or you can choose not to, but it's your choice because they're your children. And if I'd been given that information and that opportunity I would have chosen obviously differently. But I wasn't, and I think other people should be given that right that my sons and myself were denied.

BARCLAY: Andrew Wakefield is going to work in America. He leaves behind him many parents confused about which risk to take with their children.
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www.bbc.co.uk/panorama

CREDITS Reporter Sarah Barclay Film Camera Peter George Neil Higginson Sound Recordist Tony Pasfield Dubbing Mixer Bradley Mason VT Editor Boyd Nagle Graphic Design Kaye Huddy Julie Tritton Film Research Kate Redman Eamonn Walsh Production Team Ben Peachey Kath Posner Anita Rice Karen Sadler Giovanni Ullevi Production Manager Martha Estcourt Unit Manager Maria Ellis Film Editor Toe Trevill Assistant Producers Shabnam Grewal Joanna Lee Producers Stephen Scott Gary Horne Deputy Editor Andrew Bell Editor Mark Robinson 14