The Lancet retracts paper linking MMR vaccines and autism

This week, after receiving the conclusions of a multiyear ethics investigation of UK doctor Andrew Wakefield performed by the General Medical Counsel (GMC), the editors of British medical journal The Lancet formally retracted a study which purported to find a link between the childhood MMR vaccine, gastrointestinal disease, and autism. It was published in 1998 and has been a source of controversy ever since.

When I started at Nobel Intent, I found that there were five topics that were guaranteed to cause a flame-fest to erupt in the comments: evolution, circumcision, climate change, dark matter/energy, and vaccine-autism links. While people have issues with the scientific consensus for any number of reasons, much of the problems with the final topic can be traced to Wakefield’s study.

Wakefield was found to have acted unethically and conducted irresponsible research in coming to his—now thoroughly discredited—conclusions. According to Dr. Richard Horton, editor of The Lancet, “It’s the most appalling catalog and litany of some the most terrible behavior in any research and is therefore very clear that it has to be retracted.”

In this case, the actual paper contained no conclusive evidence, merely the suggestion that bowel leakage in children with gastrointestinal problems could cause the measles vaccine to spread into other parts of the body and affect the brain, possibly resulting in autism spectrum disorders.

It was in a subsequent press conference where Wakefield stated that he believed that the measles, mumps, and rubella (MMR) vaccines should not be given as a single shot, and instead be broken up into three shots given a year apart to reduce the chances of autism. The British media had a field day with this, and inaccurate reports spread across the pond to the US, where parents feared that the MMR vaccine could be the cause for the dramatic rise in autism cases.

As a result of Wakefield’s unscientific statements and the following media frenzy, vaccination levels dropped across Britain, and outbreaks of measles—and subsequent deaths—began occurring for the first time in decades. As other scientists began looking for a link between vaccines and autism, study after study found there was none. Yet the myth persisted in the popular mind, and people latched on to the belief that vaccines that protect against deadly diseases are not safe. In 2008, after numerous studies discredited the original work, researchers sought to put it to bed once and for all; using advanced technology that was developed in the intervening 10 years, they carried out the original research again and found no link.

While science was doing what it does best, other motives for Wakefield’s work came to light. In late 2006, investigative journalists in London found that Wakefield’s work was paid for by a legal team that was in the process of suing vaccine manufacturers, and that this same team represented some of the children who took part in the study. New evidence that came to life in the GMC ethics review found that a year before the study was published, Wakefield himself applied for a patent for a new vaccine that would eliminate both the measles virus and treat inflammatory bowel disease.

If the direct financial conflicts weren’t bad enough, the results of the GMC’s probe found numerous medical ethics violations as well. The panel found that 11 children were subjected to a host of unnecessary, invasive treatments such as lumbar punctures, colonoscopies, and barium meals. Wakefield even paid his son’s friends £5 each to for blood samples that were taken at his son’s birthday party. Children who did not fit the strict inclusion criteria for Wakefield’s work were also added to the study.

As allegations have continued to be brought into the public spotlight over the years since the publication, nine of the eleven original authors petitioned to have their names removed from it ahead of this final retraction.

It is difficult for the work to be more thoroughly discredited, but even with this retraction Wakefield’s supporters still believe that a link between the MMR vaccine and autism exists, and have been offering up comments to the media despite the recent findings. This is a case where people will believe what they want to, all other evidence be damned.

The act of publishing this paper has, for over a decade now, caused people to second-guess whether the MMR vaccine—and, by extension, many other vaccines—are safe and a responsible part of medical care. Not only has this created public health issues, but it has interfered with our ability to pursue more fruitful avenues of autism research and help those who are afflicted with this condition.

The Lancet, 2010. DOI: 10.1016/S0140-6736(10)60175-4.