Update: The discredited scientific paper in 1998 linking the measles, mumps and rubella vaccine with autism has been retracted by The Lancet (pdf). The journal cited falsehoods in the paper exposed by the UK General Medical Council following a lengthy investigation of the lead author, Andrew Wakefield, then of London’s Royal Free Hospital, and two of his co-authors.

Twelve years after his now discredited claim in The Lancet that injections of the MMR vaccine against measles, mumps and rubella might cause autism and bowel disorders in children, Andrew Wakefield is closer than ever to being banned from practising as a doctor.

Publication of his claims panicked parents into abandoning the shots, which had peaked in uptake at 92 per cent of UK children in 1995, falling to a trough of just 81 per cent in 2004.

A panel appointed by the UK General Medical Council – which regulates and monitors British doctors – concluded today that there’s now no factual impediment to Wakefield and two of the co-authors on his paper facing charges of professional misconduct.


Professional failings

This was not about rebutting, once again, the autism claims. The panel made it clear that its report was not an exploration of whether the link existed or not. Rather, “it has concerned itself exclusively with the conduct, duties and responsibilities of each doctor”, it says. In other words, it investigated the facts of whether Wakefield and his colleagues failed to uphold their professional duties to patients.

That said, the findings are damning, and look like they could spell the end for the three. Reached after 148 days of hearings spread over two-and-a-half years, they mean that Wakefield, a practitioner at the Royal Free Hospital in London when his infamous paper appeared, will learn whether he’ll be struck off following hearings starting 7 April that will decide his fate. So too will two co-authors of the paper who were also at the Royal Free at the time: John Walker-Smith and Simon Murch.

Painstakingly laid out in a 143-page document, the GMC panel’s findings are strewn with the words “dishonest”, “irresponsible” and “misleading”. The panel resurrected and upheld most, if not all, of the main charges against Wakefield, such as his undeclared conflict of interest in having filed a patent relating to treatments for bowel conditions a year before his Lancet study appeared. “The panel therefore rejects the proposition put forward by your [Wakefield’s] counsel that third-party perceived conflicts of interest did not fall within the relevant definition at the time,” it concludes.

The Lancet itself said in 2004 that in hindsight it shouldn’t have published the paper, following publication of a retraction by 10 co-authors on the paper.

£5 for blood

The GMC panel also affirmed irregularities in the way Wakefield recruited and managed the 12 children involved in the study.

At least four of the 12 lacked the history of gastrointestinal symptoms and so did not constitute the “routine referrals to the gastroenterology department” that had been stated in the paper. “The panel concluded that your description of the referral process as ‘routine’, when it was not, was irresponsible and misleading and contrary to your duty as a senior author,” it says. “The panel is satisfied that your conduct in this regard was dishonest and irresponsible.”

On another occasion, at his own son’s birthday party in 1999, he took blood from children who were there as guests and paid them each £5 for agreeing to this. He was accused by the panel of showing “callous disregard for the distress and pain that you knew, or ought to have known, the children would suffer.”

And so it goes on, for page after page. There’s no doubt that a minority of parents continue to believe there was something in what Wakefield reported, despite scores of scientific studies clearing the vaccine of any link with autism. One showed that autism was still on the rise even in children who’d never received the vaccine because it had been withdrawn. Wakefield supporters outside the GMC’s headquarters in London claimed he’d been made a scapegoat by the medical profession.

Nor will the findings dampen concerns in the US that thimerosal, a mercury-based preservative added to vaccines, causes autism. The US government fuelled the allegations in 2008 by agreeing compensation for some parents who claimed vaccines had damaged their children, although a US court last year ruled once again that there was no link with autism.

The fate of Wakefield will be decided in April. Meanwhile in the UK the uptake of the vaccine has recovered to 85 per cent. Not exactly the 95 per cent the government wants, but it is slowly getting there.