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Johann Hari: Don't let emotion steamroller science

For five lethal years the press manufactured a controversy over the link between MMR and autism

Tuesday, 25 October 2005

At last! The three-in-one vaccination programme is complete, and millions of British people are immune, immune, immune. There's only one problem: the contagions we are now resistant to are not Measles, Mumps and Rubella (MMR). They are science, rationality and evidence.

As the prospect of a mass vaccination of the British people against avian flu hovers over us like a flock of sickly seagulls, we can't pretend the past five years haven't happened. We have just lived through an unscientific (and potentially deadly) backlash against one of the safest and simplest vaccinations in medicine. For five long, lethal years, the British press manufactured a controversy about whether there is a link between MMR and autism. They were armed with nothing more than the views of one maverick doctor who is now facing misconduct charges before the General Medical Council, and a horde of confused, grieving mothers pining for a meaning to their pain. But with these weapons, they gave the bogus impression of there being a fierce debate. The result was that more than 400,000 children who should have been given the jabs were not, and Professor Raymond Tallis says only "extreme luck" will prevent a measles outbreak and a cemetery-full of dead children now.

Last week, yet another scientific study found definitively that the link is a myth - but the headlines reporting this soothing truth lasted for a day. For anybody who cared to see, it was always clear from the very first day of the "row" that the link was unproven and probably fictitious. In 1998, Dr Andrew Wakefield launched the question when he wrote an article in The Lancet. It was based on a tiny pool of infants, most of whom were in the study because their parents believed in the link and wanted to sue for compensation.

The article was - by its own admission - speculative: that's why The Lancet ran a responsible editorial stressing the need for much more detailed study before any conclusions at all were drawn. But Wakefield rushed to a press conference that day, calling for the complete abandonment of MMR. The rest of the medical profession was astonished he would draw such a drastic conclusion from such anorexic evidence, but it was too late: the "controversy" had begun.

Studies conclusively disproving Wakefield's speculations came quickly: a study of 1.8 million randomly-chosen children in Finland (as opposed to Wakefield's hand-picked 12) found that autism rates remained stable after the introduction of MMR. Even more startlingly, it was found that when MMR was suspended in Japan due to production problems, autism rates held steady - but 90 extra children died of measles. This evidence was waved away by much of the press as difficult and indigestible; they preferred to focus instead on brain-dead trivia such as whether Leo Blair was given the jab.

There's an old, obvious lesson here about the press having - as Stanley Baldwin put it - "power without responsibility". But there was a darker, less obvious trend revealed by the anti-MMR scandal: a populist contempt for basic science and evidence.

During the MMR row, the British public were encouraged to be suspicious of a distant, arrogant "medical establishment". Instead of arid studies, parents were prompted to fall back on their "common sense": in your gut, does it feel right to inject your baby with three vaccines at once? Similar appeals to non-rational instincts have also been behind the surging popularity of witchdoctor potions marketed as "alternative medicine".

This softening of the brain can only happen if you wilfully suspend the lesson of the past three centuries of human progress. Before the 1750s, everybody relied on instinct, intuition and superstition - the things that prevented you from giving your child the MMR - to guide their health care. All medicine was "alternative". The result? They were all dead before the age of 40.

The rise of modern medicine - the greatest achievement in human history - has been based on the destruction of common sense as a way of understanding illness, and its replacement with a commitment to rational, evidence-based study.

Ever since modern medicine was born, there has always been a strong counter-movement claiming to defend The People and their innate wisdom from its supposedly cold and impersonal rationality. When the British government introduced compulsory vaccinations to eradicate diphtheria, polio and smallpox from this island in the 1860s, thousand of populist anti-vaccination leagues sprang up. They claimed germ theory was "unproven" and waved placards of the children "murdered" by the vaccines. They even said it defied (you guessed it) "common sense" to inject small children with a small amount of a disease to ensure their immunity against it. Hundreds of thousands of parents agreed, relied on their gut - and buried their children as a result. If they had prevailed, those diseases would still be scything through our population today.

We shouldn't feel smugly superior. The MMR row showed once again how emotion and fear can steamroller scientific fact. Mothers of autistic children who blamed MMR for their children's plight were repeatedly wheeled into the news studios to attack the "medical establishment" and praise the "heroic" Dr Wakefield. I saw one mother shout down an MMR defender on TV before being asked - softly, politely - if she knew anything about science. "I don't need scientific qualifications. I am a mother and I know my son," she replied. She was clearly distraught and looking for something - anything - that would turn her child's disability from being a meaningless twist of nature into a crusade for justice. But against her - and because of people like her - there may soon be hundreds of mothers who have needlessly lost their child to measles.

We could engage in a grisly Grief Olympics, with people hurling their damaged or dead children into the field to justify their competing claims. But it would be smarter to admit that there is no equality between emotional instincts, however intense, and science.

In the MMR row, it is not the "medical establishment" that has behaved with arrogance. The arrogance has come from the handful of grieving parents who put their need for a heroic narrative above the public's health, from the lone doctor who pandered to their grief in defiance of the facts, and - most of all - from a sensationalist right-wing press who took them seriously.

If a measles epidemic comes, they will have to answer for their actions. In the meantime, we may all have to depend on medics to protect us from avian flu. This time, we should respect the scientific method, not drown it out with our panicked screams.