How a zealot's word led us astray on autism
Opinion: Tiny, flawed vaccine study: a case study in biased medicine
By Arthur Caplan, Ph.D.
updated 12:49 p.m. ET, Wed., Feb. 3, 2010
A dozen years ago, a British physician named Dr. Andrew Wakefield published a paper in the prestigious medical journal The Lancet that did immeasurable harm to children.
Wakefield, who back in 1998 was working at London's Royal Free Hospital, claimed in the article that the vaccination of 12 children with measles/mumps/rubella (MMR) vaccine had caused a reaction in their bowels that caused autism.
At a press conference shortly after the paper came out, Wakefield urged parents not to give their children the combination vaccine.
The British press went crazy over the report. The word and the fear quickly spread around the world.
Since the controversial paper was published, British parents abandoned the vaccine in droves, leading to a resurgence of measles. Vaccination rates for measles have never recovered, and there are outbreaks of the disease in the U.K. every year.
And across the globe, millions of parents who choose to follow their own doctors' advice and vaccinate their children have had to face the anxiety of an alleged link to a dread disease.
All this despite the fact that no scientists were ever able to replicate Wakefield's findings.
Yesterday, The Lancet, after years of investigations, lawsuits, press complaints and accusations, took the unprecedented step of withdrawing this 12-year-old article as misleading and false.
Why did The Lancet finally act? Because the British board that licenses doctors recently concluded that Wakefield had "shown callous disregard" for the children in his study and had "abused his position of trust" in doing his research. In language I have almost never seen from a disciplinary body, the General Medical Council added that Wakefield acted "dishonestly," was "misleading" and "irresponsible" in the way he described the findings of his tiny study about the danger of MMR vaccine in The Lancet.
As it turns out, for the study Wakefield took blood samples from children at his son's birthday party, paying them 5 pounds each.
The language was probably not strong enough. The Wakefield paper killed children and left others deaf and disabled from preventable diseases as their parents, in an effort to avoid autism, left them unvaccinated.
Vaccination has always had its critics. Using needles to put things into children's bodies has always left some parents uneasy. And the epidemic of autism has left other parents searching for some cause, some agent, some substance that might be to blame.
Vaccination became a prime suspect because it occurs so close to the time at which autism used to be first diagnosed. And Wakefield's paper was all the ammunition anti-vaccinators needed.
Wakefield's study was both tiny and flawed. Nearly all of his 13 other co-authors eventually bailed out on the article. Still, the press could not resist from spreading the scary news over and over again, even though no one could get the same findings as Wakefield did. And Wakefield himself, supported by a fanatical anti-vaccine lobby that to this day cannot let go of the vaccine-autism connection, continued to spread fear of vaccines right up to the time of his disciplinary hearing.
Some will try to portray Wakefield as a martyr, sacrificed for the profits pharmaceutical companies make from vaccines. But the profit from childhood vaccination has always been a very small part of Big Pharma's big profits. The companies still in the childhood vaccine business generally stay there from a sense of duty to the public health not greed.
Wakefield is no martyr. He is a scientist who would not give up on his theory no matter how much evidence accumulated that vaccines are not linked to autism. And that makes him guilty of letting his zealotry blind him to the harm avoiding effective vaccines did to many vulnerable children.
The bitter lessons of the decision to expunge the Wakefield paper from medical history are clear. No single, small study should ever be taken as the basis for a massive change in anyone's behavior when it comes to your health and that of your family. And the desire to find some reason, any reason, for the plague of autism should not blind us to the fact that the evidence clearly shows that vaccination is not the culprit.
Arthur Caplan is director of the Center for Bioethics at the University of Pennsylvania.
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