Medical practice

Ruling on doctor in MMR scare

The doctor who sparked the MMR controversy was “dishonest, irresponsible and showed callous disregard for the distress and pain” of children, the General Medical Council (GMC) has ruled. The ruling has been reported by many newspapers.

The GMC said Dr Andrew Wakefield “abused his position of trust” when conducting research into a proposed link between the MMR vaccine, autism and bowel disorders. He carried out clinically unnecessary and invasive tests on children without ethical approval or appropriate qualifications.

Wakefield also failed to disclose conflicts of interest to The Lancet medical journal, which in 1998 published the research paper that sparked the MMR scare. The paper has since been withdrawn by The Lancet and discredited. The scare nonetheless led to a dramatic drop in MMR vaccination rates and a rise in cases of measles.

The ruling comes after a two-and-a-half-year investigation by the GMC.

Why did The Lancet publish the flawed research in the first place?

Wakefield failed to declare a number of conflicting interests when submitting the paper for publication. These included the fact that he and several of the children in the study were involved in a lawsuit attempting to show that MMR was linked to autism.

The Lancet withdrew the paper after this was revealed by a Sunday Times investigation in February 2004. The journal said Wakefield’s undisclosed interests affected the study’s “suitability, credibility, and validity for publication”. Subsequently 11 of its 13 authors also withdrew their support for the research.

Is there any evidence that MMR causes autism?

Absolutely none. There has not been a single credible study that has shown a risk of MMR causing autism, despite tens of millions of children around the world receiving the vaccine.

On the contrary, numerous high-quality research studies support the safety of MMR.

The latest systematic review, conducted by the Cochrane Collaboration, analysed evidence from 31 studies and concluded that there was no evidence for a link between MMR and autism.
In 2003, following an extensive review, the World Health Organization stated there was no evidence to suggest MMR caused autism

All results of published vaccine trials reaffirm the safety and efficacy of the MMR vaccine. Rates of autism have not increased since the MMR vaccination was introduced.

Why did a single flawed study trigger such a huge health scare? 

The Lancet is a revered medical journal and, despite Wakefield’s study being small and scientifically weak, it received widespread high-profile media coverage.

Unusually, the findings were first revealed at a televised press conference and Wakefield - a charismatic individual - was outspoken in promoting the idea of a link between MMR and autism.

The scientific and medical establishment understood that Wakefield’s single small study proved nothing but it failed to get its message across. It also failed to investigate and uncover the facts about how Wakefield had conducted his research.
This allowed the story to run for more than five years until the investigative journalist Brian Deer  published his expose in 2004.

Why has it taken the GMC more than five years to rule on Wakefield's actions?

This has been the longest hearing held by the General Medical Council. A panel of three GPs and two lay members has sat for a total of 187 days since the hearing was first launched. They had to consider and hear evidence from 36 witnesses on dozens of allegations. The charge sheet (PDF) runs to 95 pages - 34 of them devoted to Dr Wakefield alone. These range from Wakefield’s undisclosed conflicts of interest when publishing the research, to unethical treatment of autistic children, including the use of unnecessary and invasive tests.

What was its verdict?

The GMC said Dr Wakefield had acted “dishonestly and irresponsibly”. Among the allegations levelled against him were the use of unethical medical techniques and the failure to disclose his role as a paid adviser in a lawsuit claiming MMR had harmed children. Two other authors of the Lancet paper, Prof John Walker-Smith and Prof Simon Murch, also breached rules of conduct. Read the full verdict (PDF).

A GMC panel will meet in April to rule on the doctors’ fitness to practise. If they are found guilty of serious professional misconduct, they could be struck off the medical register.

How much damage has the MMR scare done? 

The scare caused MMR vaccination rates to fall sharply. This in turn led to a sharp rise in cases of measles, putting children’s lives at risk. Vaccination rates have climbed again in recent years but have yet to recover to pre-scare levels.

Should I get my child vaccinated?

Absolutely. MMR vaccination has an exceptional safety record and is the best way to protect children from measles, a potentially serious condition that can blind, cause brain damage or even kill. MMR also protects against mumps and rubella, two serious but preventable diseases that can cause major complications.

Where can I find out more?

There are a number of evidence-based resources to help parents understand MMR and vaccination:

NHS Choices Health A-Z: MMR vaccination

NHS Choices Health A-Z: vaccinations

NHS Choices Birth to Five: reviews, tests and vaccinations

Health Protection Agency: vaccinations for measles, mumps and rubella

The National Autistic Society: statement on MMR

NHS Attribution