MMR doctor, ‘unethical, callous and dishonest’

wake_01One of the poster boys of the global anti-vaccination movement, Dr Andrew Wakefield, has been found guilty of being dishonest, irresponsible and misleading, with the possibility of being struck off the medical register.

Wakefield was a senior lecturer in the Departments of Medicine and Histopathology at the Royal Free Hospital and a reader in experimental gastroenterology. He was an honorary consultant in experimental Gastroenterology with a stipulation in his contract that he had no involvement in the clinical management of patients.

He and others had a paper published in The Lancet in 1998 outlining research which supposedly found a link between the childhood MMR (measles-mumps-rubella) vaccine and autism. This finding was immediately picked up by anti-vaccination groups as evidence of the dangers of vaccination. That this research was not duplicated by others, and that most of the co-authors of the paper subsequently disassociated themselves from it seemed to be of no consideration to the movement – their case, as far as they were concerned, was proved; end of story.

The upshot of the release of Wakefield’s findings was a great deal of media coverage outlining the supposed dangers of MMR vaccine leading to autism in patients. What has been described as ‘panic’ ensued, with vaccination rates immediately dropping in the UK. This lead to an increase in diseases that the MMR vaccination was designed to prevent. Vaccination rates have apparently still not fully recovered to the levels before the scare.

Quickly, however, there were suggestions that Wakefield’s own research methods and protocols – apart from the dubious nature of the findings regarding a link between MMR and autism – were faulty, with the result that he and two other researchers were brought before the UK’s General Medical Council.

The Panel said the case was ‘complex’, hearing evidence and submissions for 148 days over a period of two and a half years followed by 45 days of deliberation. The Panel made it clear that the case was not concerned with whether there is or might be any link between the MMR vaccination and autism. However, it did find Wakefield’s conduct in relation to his research and the presentation of the paper to The Lancet was “dishonest … irresponsible … [and] resulted in a misleading description of the patient population in the Lancet paper”.

The selection of the subjects of research was biased, the Council said. Wakefield deliberately “omitted necessary and relevant information” and he did not have Ethical Practices Committee approval for his research project.

Wakefield also failed to disclose a conflict of interest in that he was in the process of patenting a vaccine that would “eliminate” MMR and measles virus, and that the father of one of the children involved in the study would be CEO of a company set up to produce his alternative treatment. The greatest conflict of interest, however, was that the research itself had been, at least in part, funded by the Legal Aid Board. The implication of this is that it might have had a bearing on any findings adverse to the manufacturers of MMR vaccine.

Conduct in many of his dealings with the children involved in the project “was contrary to [their] clinical interests”, putting them through painful and unnecessary tests. Disturbingly, Wakefield arranged that blood was taken from some children involved in the research at his own son’s birthday party, and he gave each child five pounds “as a reward at the end of the party”.

There have been suggestions that Wakefield may face serious charges regarding his fitness to practice. The GMC Panel “concluded that [its] findings, which include those of dishonesty and misleading conduct, would not be insufficient to support a finding of serious professional misconduct.”

True to form, the anti-vaccination movement has come out in defence of Wakefield, describing him as a martyr to the cause, and Wakefield has been quoted as saying he had “no regrets” over his work. One correspondent on a forum described the GMC panel as “evil judges from the garden of Stalin”.

Anti-vaccination proponents ignore the extremely serious irregularities in the way he achieved his results, preferring to concentrate on their belief that those results support their case. That those same findings are also likely to be wrong – Wakefield only studied 12 children while other subsequent studies have looked at many thousands of subjects and have not replicated and have indeed challenge his findings – seems to go unnoticed by the anti-vaxers.

But acknowledgement of facts that contradict their views has never been a strength of that movement.