We live in a world where a wealth of knowledge is readily available to many. Access to this is usually just a quick click away, but—almost ironically—this convenience means we are also more likely to be exposed to fraudulent information. A man once decided to make some quick cash by publishing an entirely falsified study, with no regard to the consequences. By falsely claiming that the MMR vaccine caused autism, this man single-handedly put the world on red alert, and millions of lives at risk.
The MMR vaccine
The MMR vaccine was first introduced in 1971, by the American pharmaceutical company Merck. An unprecedented triple vaccine, it provided protection against measles, mumps and rubella (MMR). The vaccine itself contains inactivated strains of the three types of virus and is, therefore, a form of active immunization. Vaccines ‘boost’ our immune system and allows our immune system to react to pathogens.
The three vaccines had already been readily available for several years, but the combination of all three for life-long protection led to convenience and increased rates of immunity among the population. Children are usually immunized at the age of 12 to 15 months and then once more between 4 to 6 years, just to ensure full immunity1.
Measles cases are reported in every part of the world, with the disease and complications arising from it responsible for a large number of fatalities. Right after its introduction, the impact of the MMR vaccine was immediate. In 1980, more than 4 million cases of measles were reported worldwide, in 2017 this number had fallen to just 170 000 – a decrease of 96%2. A similar drop in the number of mumps and rubella cases was seen. For a time after its introduction, all was well.
Wakefield Who?
However, not everybody approved of this new vaccine. One such man was British physician Andrew Wakefield. In 1998, Wakefield published a paper in the renowned medical journal The Lancet claiming that the MMR vaccine caused ‘behavioral changes’ and ‘intestinal abnormalities’3.
Wakefield and his team examined 12 children from age 3 to 10 that had all been immunized. According to the report, 8 of these children had been diagnosed with autism and all had gastrointestinal problems such as pain, diarrhea or bloating.
He suggested that there was a novel syndrome, that he coined ‘autistic enterocolitis’, establishing a link between changes to the structure of the gastrointestinal region of children to developmental disorders.
These symptoms started to manifest 24 hours to several months after receiving the MMR vaccine, according to the parents. Wakefield held a press conference to discuss these findings, which was an unusual scientific direction. Though he never openly linked the MMR vaccine with autism, he discussed the safety of the MMR triple vaccine compared to individual ones, explaining that when administered individually, these ‘symptoms’ did not manifest themselves.
Uncovering the Fraud
What occurred next was a global health scare, during which vaccination rates dropped sharply in the UK and abroad. Media attention toward the issue soared, many of which actually supported Wakefield and his claims. This gave rise to ‘anti-vaccine’ movements in which large numbers of people refused to vaccinate themselves and their children.
In a panic, investigations into Wakefield’s study were quickly conducted by multiple organizations. However, none of them ever managed to provide further evidence for his claims. The results from laboratory tests simply did not add up to the diagnosis Wakefield had coined ‘chronic non-specific colitis’. This indicated that there might have been tampering and falsification of the original data.
It was later found that Wakefield had also hand-picked the children who already had other symptoms (rash, fever, vomiting, etc.) present so that they fit his desired outcome4.
Furthermore, Wakefield had subjected the children to a series of rigorous tests and scans that would have been detrimental to the behavioral state of any child. A damning discovery was that he did not have approval from the Ethics Committee to perform certain tests on the children, but rather abused his position as a doctor to conduct to keep this information hidden5.
Lastly–and the most incriminating evidence that the study was a total fraud–was the discovery that Andrew Wakefield had been paid more than USD 400 000 for this study. What’s worse, he received this payment a whole 2 years before his paper was even published. All he had to do was connect the MMR vaccination with autism by the ‘discovery’ of a new symptom.
The man who paid him was Richard Barr, a lawyer who had plans to sue several pharmaceutical companies for manufacturing ‘defective’ MMR vaccines. At a dead end and in need of scientific evidence to succeed, he turned to Wakefield’s greed4.
Consequences For Wakefield
10 of the 13 scientists that worked on the study retracted their claim, and in 2010 the paper was retracted from The Lancet. Andrew Wakefield and two colleagues, however, were still of the opinion that they did nothing wrong when faced with charges before Britain’s General Medical Council. In 2010, Andrew Wakefield was struck off the medical register for being dishonest, misleading and downright unethical5,6.
But the damage to society had been done, resulting in serious outbreaks of measles and mumps—previously eradicated—sweeping through the United Kingdom and neighboring countries. In 2008, the incidence rate of measles was found to be many times greater than pre-1998 levels, enough for it to be relabeled ‘endemic’, or self-sustaining within the population7.
The incident serves as a reminder for us to remain critical, even when the information presented to us comes from experts and news outlets. Always question the evidence on offer; is it science-based? Is it replicable? Is it obtained from reliable sources? With coronavirus vaccines a popular topic in today’s conversation, it is more important than ever to be able to ask the right questions.
Reference
- Centers for Disease Controll and Prevention (2018). Measles, Mumps, and Rubella (MMR) Vaccination: What Everyone Should Know.
- World Health Organization (2018). WHO vaccine-preventable disease monitoring system, 2018 global summary: Global and regional immunization profile.
- Sabra, A., Bellanti, J. A., & Col?n, A. R. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, 352(9123), 234-235.
- Deer, B. (2011). How the case against the MMR vaccine was fixed. Bmj, 342, c5347.
- Deer, B. (2010). Wakefield?s ?autistic enterocolitis? under the microscope. Bmj, 340, c1127.
- General Medical Council (2010). Fitness to practise Panel Hearing 28 January 2010.
- EuroSurveillance Editorial Team. (2008). Measles once again endemic in the United Kingdom. Eurosurveillance, 13(7-9).
About the Author
Katharina was a science writer at FTLOScience from July 2018 to October 2019.
