The General Medical Council's decision to pursue
Andrew Wakefield is a huge gamble. The scare over
MMR vaccine that began in 1998 has seen hundreds of
thousands of parents reject one of the most basic
safeguards for children.
In the eight years since, experience has shown
that any publicity about MMR, even that which has
undermined the credibility of the author of the
scare, has damaged confidence in the the combined
vaccine against measles, mumps and rubella and led
to a further fall in immunisation rates. Bringing a
disciplinary case against Dr Wakefield risks
re-enforcing the view that there is a conspiracy by
the Government and medical establishment to promote
MMR. If the GMC wins, it could turn Dr Wakefield
into a martyr. If it loses, it may reignite debate
about the safety of the vaccine.
The case has been through the GMC's screening
procedure and, despite initial scepticism as to
whether it could be made to stick, lawyers on both
sides now accept that he will be charged with
serious professional misconduct.
His defenders say that his research may be open
to criticism, like any research, but academic
disagreement does not add up to serious professional
misconduct. Even his failure to disclose a conflict
of interest - that he was being paid by the Legal
Aid Board - has been described by at least one
senior GMC member as "foolish" but not unprecedented
and not sufficient to justify charges by the GMC.
The question now is what effect a public hearing
before the GMC will have on MMR vaccination rates.
In the tentative view of the Health Protection
Agency, public confidence in the vaccine is just
beginning to return and immunisation rates are on
the rise. It would be tragic if that were to be
damaged.
The really surprising feature of the MMR scare
has been not how it started but how it has been
sustained for so long in the face of overwhelming
evidence that the vaccine is safe.
The safety record of the combined triple vaccine
is vastly superior to that for the single vaccines.
Yet many parents have opted for single vaccines in
preference to the triple MMR in the belief that they
are protecting their children from a greater harm.
Why have intelligent people chosen to reject
mainstream science and listen to far less
authoritative sources? Unlike most scientific
controversies which flare up and die away, this one
has simmered on for eight years. It has been
sustained by a mix of public anxiety, public
mistrust of government assurances on health
following the BSE debacle and sympathy for a lone
doctor.
Growing environmental concerns about pollution,
additives in the diet and genetically modified crops
have conspired to undermine faith in science. Tony
Blair's refusal to say whether his son Leo had
received the MMR vaccine heightened anxiety.
Richard Horton, editor of The Lancet, which
published the offending paper, has said the
controversy over MMR revealed a society "unable to
come to terms with dissent" and called it "a crisis
of rationality." Whatever the outcome of the GMC
case, rebuilding public confidence in science must
be a priority in an age facing unquantifiable
threats as diverse as those from global warming and
avian flu.
But in the field of children's health, a constant
source of anxiety for parents, nothing can compete
with the power of anecdote. So it is worth recording
that Professor John Walker-Smith, the distinguished
paediatric gastroenterologist who was the senior
author on Dr Wakefield's 1998 Lancet paper,
disclosed in 2002 that he continued to support MMR -
as have all the Royal Free paediatricians from the
beginning - and that three of his own grandsons had
had the triple MMR vaccination.
The General Medical Council's decision to pursue
Andrew Wakefield is a huge gamble. The scare over
MMR vaccine that began in 1998 has seen hundreds of
thousands of parents reject one of the most basic
safeguards for children.
In the eight years since, experience has shown
that any publicity about MMR, even that which has
undermined the credibility of the author of the
scare, has damaged confidence in the the combined
vaccine against measles, mumps and rubella and led
to a further fall in immunisation rates. Bringing a
disciplinary case against Dr Wakefield risks
re-enforcing the view that there is a conspiracy by
the Government and medical establishment to promote
MMR. If the GMC wins, it could turn Dr Wakefield
into a martyr. If it loses, it may reignite debate
about the safety of the vaccine.
The case has been through the GMC's screening
procedure and, despite initial scepticism as to
whether it could be made to stick, lawyers on both
sides now accept that he will be charged with
serious professional misconduct.
His defenders say that his research may be open
to criticism, like any research, but academic
disagreement does not add up to serious professional
misconduct. Even his failure to disclose a conflict
of interest - that he was being paid by the Legal
Aid Board - has been described by at least one
senior GMC member as "foolish" but not unprecedented
and not sufficient to justify charges by the GMC.
The question now is what effect a public hearing
before the GMC will have on MMR vaccination rates.
In the tentative view of the Health Protection
Agency, public confidence in the vaccine is just
beginning to return and immunisation rates are on
the rise. It would be tragic if that were to be
damaged.
The really surprising feature of the MMR scare
has been not how it started but how it has been
sustained for so long in the face of overwhelming
evidence that the vaccine is safe.
The safety record of the combined triple vaccine is
vastly superior to that for the single vaccines. Yet
many parents have opted for single vaccines in
preference to the triple MMR in the belief that they
are protecting their children from a greater harm.
Why have intelligent people chosen to reject
mainstream science and listen to far less
authoritative sources? Unlike most scientific
controversies which flare up and die away, this one
has simmered on for eight years. It has been
sustained by a mix of public anxiety, public
mistrust of government assurances on health
following the BSE debacle and sympathy for a lone
doctor.
Growing environmental concerns about pollution,
additives in the diet and genetically modified crops
have conspired to undermine faith in science. Tony
Blair's refusal to say whether his son Leo had
received the MMR vaccine heightened anxiety.
Richard Horton, editor of The Lancet, which
published the offending paper, has said the
controversy over MMR revealed a society "unable to
come to terms with dissent" and called it "a crisis
of rationality." Whatever the outcome of the GMC
case, rebuilding public confidence in science must
be a priority in an age facing unquantifiable
threats as diverse as those from global warming and
avian flu.
But in the field of children's health, a constant
source of anxiety for parents, nothing can compete
with the power of anecdote. So it is worth recording
that Professor John Walker-Smith, the distinguished
paediatric gastroenterologist who was the senior
author on Dr Wakefield's 1998 Lancet paper,
disclosed in 2002 that he continued to support MMR -
as have all the Royal Free paediatricians from the
beginning - and that three of his own grandsons had
had the triple MMR vaccination.