Dr Abi
Berger, The British Medical Journal
Saturday November 27, 2004
Dispatches.
MMR: What They Didn't Tell You, Channel 4, Thursday
18 November at 9 pm
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".
aberger@bmj.com
Items reviewed are
on a 4-star scale (4=excellent)
