Review of Channel 4 investigation

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Dispatches. MMR: What They Didn't Tell You, Channel 4, Thursday 18 November at 9 pm

Dr Abi Berger, The British Medical Journal
Saturday November 27, 2004

Rating: ****

If you didn't see this programme, find someone who taped it. Not only will you learn something about the MMR (measles, mumps, rubella) health scare, but it will also give you the opportunity to watch one of the most exciting examples of investigative television journalism you will ever see. This episode of Dispatches was utterly compelling both in its presentation and in its lack of emotional blackmail.

Presenter and journalist Brian Deer seems to have singlehandedly eaten away at the MMR story. His clear and simple presentation of this, his latest chapter—describing an enormous clash and conflict of interest between science, business, huge egos, and the potential to make megabucks—belies the huge and prolonged efforts he has clearly gone to in trying to get to the bottom of the MMR tale of woe.

The story so far: following the publication of his paper in the Lancet ( Lancet 1998;351: 637[CrossRef][ISI][Medline]), Dr Andrew Wakefield held a press conference in February 1998, during which he raised concerns that the MMR vaccine might be causally linked to inflammatory bowel disease and the subsequent development of autism in young children. These concerns in turn led Dr Wakefield to offer his own personal opinion that giving single measles, mumps, and rubella shots might be safer for children. In one fell swoop he had undermined the MMR vaccination programme in the United Kingdom, and subsequently around the world.

As scientists and epidemiologists watched the unravelling of the MMR vaccination campaign, some questions cried out for an answer. Where was Andrew Wakefield coming from? What was the basis of his opinion that single shots might be safer? Large scale international epidemiological studies have repeatedly failed to find any indication for his advice to give single shots, or confirm the assertion of a causal link between the MMR vaccine and autism. While much time and money have been spent trying to find the answers in scientific study, Deer's documentary suggested that the answers might be found in the world of commerce.

Dispatches alleged that, nine months before the 1998 press conference, Dr Wakefield had filed patent applications at the London Patent Office for a new, alternative single measles vaccine and several potential treatments and even "cures" for inflammatory bowel disease and autism.

Nine months later, the MMR health scare was sparked by parties to those patent applications. As one commentator who was put on the spot by Deer said, on being made aware of this, not only did these patented "inventions" represent enormous claims, they also represented the potential of big money. Enough, it was agreed, to open a new medical school.

Deer dug further to find out exactly what had been patented. Members of the scientific community to whom he showed the applications unanimously agreed that the proposed technology behind the inventions (for example, injecting measles into mice, and then, after extracting and processing white cells, injecting the result into pregnant goats and using their colostrum to create capsules for children) lacked scientific credibility.

Cut to an interview with a hitherto unknown character called Dr Nick Chadwick, a scientist who was a PhD student in Wakefield's team in the late 1990s. Dr Chadwick was responsible for devising the scientific techniques that would later be used to detect the presence of the measles virus in the guts of children with autism. Dr Chadwick told Deer categorically that using these techniques he had not detected any live measles virus in the guts of any of the 40 children examined. Nor was any measles virus found in any of the cerebrospinal fluid samples obtained. And yet, despite this, these findings were not made public. Dr Wakefield claims that he subsequently published the fact that he considered the technology used by Dr Chadwick to be insufficiently sensitive.

When Deer asked Dr Chadwick why he had not divulged his findings at the time, his excuse was that he thought the story would simply die. At the time he was a student, and he felt he could not argue with Dr Wakefield, who was a charismatic supervisor.

Dr Wakefield now spends much of his time in the United States, where he is linked to a company that promotes products said to be of benefit to autistic children. He continues to address huge audiences at major conferences on autism. And he continues to refuse to be interviewed by Brian Deer.

He has also issued a statement on the internet stating that many of the claims made by Deer were "demonstrably false" and that because there had been "no objectivity in the manner of their intended portrayal, I declined to participate in any way in the making of the... programme".

Items reviewed are on a 4-star scale (4=excellent)

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