Who is Andrew Wakefield and what did the disgraced MMR doctor do?

What part did his, now retracted, 1998 study on the link between autism and vaccines play on measles outbreaks and the modern anti-vaccination movement?

Who is Andrew Wakefield?

Andrew Wakefield is a former British doctor and researcher, who birthed the modern anti-vaccination movement with widely discredited research, since withdrawn by The Lancet medical journal and renounced by its co-authors.

He received his medical degree in 1985 and trained as a gastrointestinal surgeon with an interest in inflammatory bowel disease.

But his licence to practise was revoked and he was erased from the medical register in 2010 after the UK’s General Medical Council found him guilty of dishonesty, the "abuse" of developmentally delayed children by giving them unnecessary and invasive medical procedures, and acting without ethical approval for his research.

Two of his co-authors, Professors John Walker-Smith and Simon Murch were also found guilty by the panel.

What he did?

In 1995 Wakefield claims he was approached by parents of an autistic child with stomach issues. He then encountered other families in a similar position who claim their child had first shown signs of the developmental disabilities after receiving the childhood immunisation for measles, mumps and rubella (MMR).

The three-in-one jab had been introduced in 1988, replacing the single jabs for each disease that had been given previously, two forms of the MMR jab were withdrawn in 1992 after signs they caused mild mumps meningitis.

Wakefield and 12 co-authors published research in The Lancet in 1998, based on the cases of 12 patients, which proposed a link between the MMR jab and autism and bowel disease.

At a press conference for the paper’s release Wakefield called for the return to three single jabs.

What happened next?

Mistrust of vaccines was stoked by campaigns in the Daily Mail and other papers backing Wakefield, the absence of other scientific voices challenging the link, and PR gaffes like UK prime minister Tony Blair refusing to comment on claims his son, Leo, had not received the vaccine.

MMR vaccination rates in the UK collapsed from above 90 per cent to 79 per cent in January 2003.

In 1987, the year before the MMR jab was introduced, there were 86,000 cases reported.

In 2006 a 13-year-old boy from Manchester became the first UK death from measles for 14 years, and that year in England and Wales there were more than 450 measles cases, the highest levels for 20 years.

Another measles outbreak in south Wales in 2013 infected more than 1,000 people, mainly children, and led to the emergency distribution of 50,000 MMR vaccines to prevent the disease spreading.

Why did the view of him change?

In 2004 a Sunday Times journalist, Brian Deer, published an investigation into Wakefield’s undisclosed financial interests.

It alleged many of the families in his case study were part of legal action against the MMR jab manufacturer, and he had been funded by the solicitors for these cases to provide evidence in support.

In the wake of the revelations 10 of the co-authors of The Lancet paper withdrew their support for the interpretation section, which was the area that had claimed a link with autism.

In 2007 the GMC opened its investigation into the allegations of serious professional misconduct against Wakefield and two co-authors, which would eventually lead to him being struck off.

Twelve years on from the original study, and a month before the GMC panel found Dr Wakefield guilty The Lancet withdrew its paper, with editor Richard Horton describing aspects of it as “utterly false” and saying he “felt deceived”.

What is stoking these fears now?

Wakefield moved to America where he has become a documentary producer and campaigner on the issue.

He points to a rise in autism diagnosis since the jab was introduced, however critics say this has also coincided with more awareness of disorders like autism, which is playing into higher diagnosis rates.

Concerned parents and interest groups are major propagators of myths about vaccines, and these can spread rapidly online and has transcended even Wakefield’s original concerns, extending to issues like “canine autism” in vaccinated pets.

Much of the concern lies in theories about the ingredients of the vaccines themselves.

Mercury?

The bulk of any vaccine will be water and other ingredients are often found in the body in varying amounts already.

The British Immunology Society (BIS) told The Independent that mercury (thiomersal), an often worried about ingredient, is no longer used in UK vaccines. However extensive research has failed to find any link with brain damage in children.

Aluminium?

Another common ingredient, is added to vaccines to increase the response of the body’s immune system to the inactivated virus. However the BIS adds that Aluminium is, again, only a trace amount at a level much lower than safe amounts in breast milk, formula and foods.

The triple jab itself?

Some parents fear that the combined effect of all three can overload the immune system and affect brain development. But the BIS stresses the immune system comes into contact with thousands of bacteria and viruses each day with no ill effect. A major study, of 500,000 infants followed up over 12 years found no risk of extra infection risk from the multiple versus single jabs.

So what causes autism?

The National Autistic Society in the UK says this picture is still complex. Autism is a spectrum of developmental disorders and people can have huge variety in how they’re affected.

Fundamentally autism affects how someone interacts with other people and their environment.

It is driven by a mix of genetic and environmental factors, which can include medications, which affect the development of the brain.

However there has been no reputable evidence to link autism to the MMR jab and at least 17 major trials have looked at Wakefield’s findings and found no effect.

There are drugs which can cause autism and autism like disorders. For example, sodium valproate antidepressants and anti-epileptic medicines were recently banned in the UK for all women who have the potential to get pregnant, and the European Union is also reviewing its use.

If taken in pregnancy four in 10 children is born with some form of developmental disability and one in 10 with a serious physical deformity, such as spina bifida.