SUNDAY FEBRUARY 10 2002
MMR: Dr Maverick sticks to his guns
The man behind the autism scare tells Rosie Waterhouse why he still
believes MMR is a threat
To the parents of the autistic children he treats, Dr Andrew Wakefield
is a hero. To the medical establishment, he is an irresponsible maverick.
Wakefield is the man responsible for prompting the nationwide fears about
MMR, the measles, mumps and rubella vaccine. As increasing numbers of
anxious parents refuse to let their children have the triple jab, outbreaks
of measles are spreading, and the government is blaming Wakefield.
He is the focus of the increasingly polarised debate about the NHS's
refusal to provide an alternative to MMR, which Wakefield has linked to
autism and a form of bowel disease in some children. The row has reached
such proportions - embroiling the prime minister's son Leo - that Wakefield
feels "enormous anxiety" about whether his fears about MMR will ultimately
be proved correct or not.
"Sometimes I feel like the person who put an axe into the Rokeby Venus
in the National Gallery," he confessed.
At the age of 45, he has had to walk away from his post at the Royal
Free hospital, in north London, although he insists he will continue to work
on research on the hundreds of children being treated there. Officially, his
work was "no longer in line with the department of medicine's research
This summer he will uproot his family - his wife Carmel, who trained
as a physician and now works as an adviser to NHS trusts on medical
negligence and risk, and their four children aged five, seven, 11 and 13 -
to live in Florida. He plans to continue his research work there, based at a
private clinic partly funded by Visceral, a UK charity.
Wakefield, a former surgeon and consultant gastroenterologist, says
the past few years have taken their toll. "I've lost my job, and my standing
in the medical and scientific community is at an all-time low. There's no
way I'm going to work again in this country. Nobody will want to employ me."
He added: "What keeps me going is that I have to be able to face
parents and say we did our best and we did not walk away from this because
it was uncomfortable. And these parents at every stage so far have been
shown to be right and therefore one is enormously reassured that this is the
right course to pursue."
So, what is Wakefield's case against MMR? In Britain and the United
States the number of children diagnosed with autism has risen dramatically
in recent years. Some of the increase is likely to be accounted for by
better awareness and increased diagnosis rather than solely a rise in
incidence. But many parents, and a small but vocal number of researchers,
believe the increase is genuine and that vaccines including MMR are to
The MMR controversy has surfaced periodically since Wakefield and
colleagues at the Royal Free published research in 1998, the first to
suggest the MMR jab could be a possible cause of autism and a new type of
bowel disease in children.
Wakefield told a press conference launching the study - which then
included only 12 children - that as a parent he could only advocate giving
separate vaccines for measles, mumps and rubella and that the government
should allow parents this choice.
What led him to such an unequivocal position on the basis of
apparently scant evidence? By the time the paper was published, Wakefield
says, they had examined about 60 children in Britain and America all sharing
the same conditions of autism and bowel disease.
Wakefield cites three further factors. First, he had analysed all the
safety data since MMR's introduction and had concluded that tests were
inadequate. Second, he had already published research that he says showed
that measles and mumps vaccines may cause inflammatory bowel disease. This
work had led some parents of autistic children with bowel problems to
consult him. Finally, the research on these children "observed a novel form
of inflammatory bowel disease was occurring in children who had developed
symptoms shortly after the MMR vaccine".
The most recent review of evidence by the Medical Research Council
concluded that epidemiological studies failed to prove or disprove any link
between MMR and autism. But last Monday Wakefield and colleagues published
their latest research.
It revealed the presence of the measles virus in the gut of 75 of 91
autistic children with the variant form of bowel disease. Measles was found
in the gut of only 5 out of 70 healthy children tested.
The researchers conceded that these results were not proof of a causal
link between MMR, autism and bowel disease. But they concluded: "These data
confirm an association between the presence of measles virus and gut
pathology in children with developmental disorder."
Wakefield believes the findings are "consistent with the hypothesis
that MMR is a contributory cause of autism and bowel disease in some
When MMR was introduced in 1988, doctors were told officially that
parents who rejected it should be allowed single vaccines for their
children. Labour reversed this advice after coming to power in 1997,
decreeing that the single vaccines should not be used by the NHS. It
insisted that MMR was the best protection against measles, a potential
Wakefield describes the government's handling of the whole issue, and
the Blairs' refusal to say whether or not their baby has had MMR, as a
At prime minister's questions in the Commons last week Tony Blair,
while still refusing to state whether or not Leo had had the jab, insisted
the vaccine was safe.
Next day a rattled Sir Liam Donaldson, the chief medical officer,
suggested that he and other vaccine advisers at the Department of Health
would have to resign if ministers caved in and made the single vaccines
available on the NHS for those parents who wanted them. This would be like
playing Russian roulette with children's lives, he said.
Wakefield claims the vaccine advisers are blinkered. "I think the
problem comes because the politicians are driven by the mandarins at the
Department of Health who have an almost evangelical belief in the rightness
of their course of action. And the danger with that is that, because it's a
complex issue, the politicians rely very much on the information they get
and decisions are taken according to that information. The problem is that
it is not objective."
Meryl W. Dorey,
The Australian Vaccination Network, Inc.
PO Box 177 02 6687 1699 Phone
Bangalow NSW 2479 02 6687 2032 FAX
"All truth goes through three stages. First it is ridiculed. Then it is
violently opposed. Finally, it is accepted as self-evident." (Schopenhauer)
advice. The decision to vaccinate and how you implement that decision is
yours and yours alone.
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