Interview:
Dr Andrew Wakefield,
research
team leader,
Royal Free
Hospital School of Medicine
INTERVIEWER:
Dr Wakefield, what exactly have
you found?
DR ANDREW
WAKEFIELD: Well this
work started just over a year ago
when we were contacted by a group
of mothers who complained that
their children had been
developing perfectly normally
until they had encountered an
environmental insult, in many
cases they claimed it was the
measles, mumps and rubella
vaccine, and then had lost their
… all their acquired skills,
such as speech, language,
developmental milestones. And at
the time we were not sure of the
implications of that. But what
was interesting is that those
children had also suffered
gastrointestinal symptoms,
diarrhoea, alternating
constipation and diarrhoea,
sometimes blood loss. And it
became evident to us that after
five calls in two days we had to
look at this very seriously to
(investigate) these
gastrointestinal side effects in
particular. Now one of the
questions that had been raised
before … the claims had been
rather put to one side of
gastrointestinal disturbances,
these were just a function of the
behavioural problems, but we felt
they merited taking a little more
seriously and so that we
investigated them.
Interestingly, we set out a
study, ten children, we thought
we might find inflammation
perhaps in one or two based upon
the history -- we’ve now
looked at 40 children and 39 of
those have exactly the same
findings. And that’s
been intriguing. The children
have a patchy inflammation of the
colon, rather like colitis as we
recognise it historically. And
they also have great big swollen
lymph glands in the terminal
ileum, that is the end of the
small intestine. And that
combination, as we call it
‘ileo hyperplasia’,
follicular hyperplasia of the
terminal ileum and colitis, is
the, is the core of the
gastrointestinal syndrome.
Interestingly, they also have all
undergone developmental
regression after a period of
normal development.
INTERVIEWER:
There has been concern recently
over any long term effects as a
result of the MMR vaccine, are
you saying now then that there
does appear to be a proven link
between the vaccine and the side
effects?
DR ANDREW
WAKEFIELD: No, the work
certainly raises a question mark
over MMR vaccine, but it is,
there is no proven link as such
and we are seeking to establish
whether there is a genuine causal
association between the MMR and
this syndrome or not. It is our
suspicion that there may well be
but that is far from being a
causal association that is proven
beyond doubt.
INTERVIEWER:
But if you say there’s at
least a question mark over it
now, should the vaccine continue
to be administered while
you’re investigating?
DR ANDREW
WAKEFIELD: I think if
you asked members of the team
that have investigated this they
would give you different answers.
And I have to say that there is
sufficient anxiety in my own mind
of the safety, the long term
safety of the polyvalent, that is
the MMR vaccination in
combination, that I think that it
should be suspended in favour of
the single vaccines, that is
continued use of the individual
measles, mumps and rubella
components.
INTERVIEWER:
Because that begs the question
that you know, are the … do
the advantages of continuing with
the vaccines outweigh the
disadvantages of a problem
developing if you, if you
continue to have them?
DR ANDREW
WAKEFIELD: Well I think
it’s a very complex
question. Certainly if you
continue, as I would recommend to
use the single vaccine, you do
not incur a greater risk of those
diseases in the children, so that
you do not lose the benefits of
vaccination if you space them
over time.
INTERVIEWER:
(CUTS) So even measles?
DR ANDREW
WAKEFIELD: Well as yet
we don’t know, but there is
no doubt that if you give three
viruses together, three live
viruses, then you potentially
increase the risk of an adverse
event occurring, particularly
when one of those viruses
influences the immune system in
the way that measles does. And it
may be, and studies will show
this or not, that giving the
measles on its own reduces the
risk of this particular syndrome
developing.
INTERVIEWER:
So you’re saying that a
parent should still ensure that
their child is inoculated but
perhaps not with the MMR combined
vaccine?
DR ANDREW
WAKEFIELD: Again, this
was very contentious and you
would not get consensus from all
members of the group on this, but
that is my feeling, that the, the
risk of this particular syndrome
developing is related to the
combined vaccine, the MMR, rather
than the single vaccines.
INTERVIEWER:
Now what you seem to be
indicating is that there’s
… the effects are on this
intestinal disease of the gut and
also autism which is a
personality disorder. What’s
the link there? How can there be
a link?
DR ANDREW
WAKEFIELD: Well this is
intriguing of course. We’ve
been looking for the cause of
autism in the brain for many many
years and yet have failed to
define it. People have been
saying for some time, people on
the periphery of autism, have
been saying for some time that
this may well be related to bowel
damage. The Italians for example
have found that children who are
autistic have in many cases a
leaky intestine. Others,
biochemists, have been saying
that it may be a toxic state that
absorption of chemicals such as
opioid, peptides, morphine like
substances from the gut that you
and I produce in our diet from
milk and wheat, are actually
getting access through that leaky
gut into the developing brain.
And perhaps if that occurs at a
particular time of life, when the
brain is rapidly developing, then
it is susceptible to long term
damage. And that is intriguing
again, because many parents
report that certain foodstuffs
make their children’s
behaviour much worse, and that
withholding that food, those
foods, improves their behaviour.
What we’ve been able to do
here, by directly visualising and
biopsying the bowel, is to
confirm, at least in this group
of children, that there is a
link, it may well be a link
between gut inflammation and
behavioural abnormalities.
INTERVIEWER:
Is this likely to be permanent
damage or can, can it be treated?
DR ANDREW
WAKEFIELD: We simply
don’t know at this stage. We
have … We entered this as
a pilot study to look at ten
children, we’ve now looked
at 40 children,we’ve
been going for a year; we
sincerely hope that we can (CUTS)
something to ameliorate the
damage that has been done, but we
do not yet know whether
that’s the case.
INTERVIEWER:
Of course there’ll be many
parents whose children have had
this MMR vaccine who will now be
concerned about what may happen
to their children. What advice
would you give to them?
DR ANDREW
WAKEFIELD: Well, the
interesting thing is that the
damage, the behavioural or
developmental change tends to
occur quite soon after
administration, and this is
where, why parents or GPs or
paediatricians have been able to
make the link, the association
with MMR. So if that hasn’t
happened then it is extremely
unlikely to happen.
INTERVIEWER:
But there are going to be parents
now whose children are about to
have the vaccination, and
they’re gonna say: I’m
not gonna risk it. What would you
say to them?
DR ANDREW
WAKEFIELD: Well, my
message is for the Department of
Health and the regulatory
authorities, and that is that
this needs urgent investigation;
it needs funding and it needs the
appropriate level of commitment
in terms of basic scientific
research and clinical research to
answer the question. And until
that time we cannot offer any
definitive evident, any
definitive message to parents
about this.
INTERVIEWER:
Sounds to be saying, you seem to
be saying perhaps don’t?
DR ANDREW
WAKEFIELD: My opinion,
again, is that the monovalent,
the single vaccines, measles,
mumps and rubella, are likely in
this context to be safer than the
polyvalent vaccine.
INTERVIEWER:
That’s the MMR vaccine?
(INTERVIEW ENDS)