overextrapolated from one study into absurdity, while studiously ignoring all reassuring data, and all subsequent refutations. They quoted ‘experts’ as authorities instead of explaining the science, they ignored the historical context, they set idiots to cover the facts, they pitched emotive stories from parents against bland academics (who they smeared), and most bizarrely of all, in some cases they simply made stuff up.
Now they claim that the original 1998 Wakefield research has been ‘debunked’ (it was never anything compelling in the first place), and you will be able to watch this year as they try to pin the whole scare onto one man. I’m a doctor too, and I don’t imagine for one moment that I could stand up and create a nine-year-long news story on a whim. It is because of the media’s blindness – and their unwillingness to accept their responsibility – that they will continue to commit the same crimes in the future. There is nothing you can do about that, so it might be worth paying attention now.
To remind ourselves, here is the story of MMR as it appeared in the British news media from 1998 onwards:
Autism is becoming more common, although nobody knows why.
A doctor called Andrew Wakefield has done scientific research showing a link between the MMR triple jab and autism.
Since then, more scientific research has been done confirming this link.
There is evidence that single jabs might be safer, but government doctors and those in the pay of the pharmaceutical industry have simply rubbished these claims.
Tony Blair probably didn’t give his young son the vaccine.
Measles isn’t so bad.
And vaccination didn’t prevent it very well anyway.
I think that’s pretty fair. The central claim for each of these bullet points was either misleading or downright untrue, as we will see.
Vaccine scares in context
Before we begin, it’s worth taking a moment to look at vaccine scares around the world, because I’m always struck by how circumscribed these panics are, and how poorly they propagate themselves in different soils. The MMR and autism scare, for example, is practically non-existent outside Britain, even in Europe and America. But throughout the 1990s France was in the grip of a scare that hepatitis B vaccine caused multiple sclerosis (it wouldn’t surprise me if I was the first person to tell you that).
In the US, the major vaccine fear has been around the use of a preservative called thiomersal, although somehow this hasn’t caught on here, even though that same preservative was used in Britain. And in the 1970s – since the past is another country too – there was a widespread concern in the UK, driven again by a single doctor, that whooping-cough vaccine was causing neurological damage.
Looking even further back, there was a strong anti-smallpox-vaccine movement in Leicester well into the 1930s, despite its demonstrable benefits, and in fact anti-inoculation sentiment goes right back to its origins: when James Jurin studied inoculation against smallpox (finding that it was associated with a lower death rate than the natural disease), his newfangled numbers and statistical ideas were treated with enormous suspicion. Indeed, smallpox inoculation remained illegal in France until 1769. Even when Edward Jenner introduced the much safer vaccination for protecting people against smallpox at the turn of the nineteenth century, he was strongly opposed by the London cognoscenti.
And in an article from
The success of the anti-vaccinationists has been aptly shown by the results in Zurich, Switzerland, where for a number of years, until 1883, a compulsory vaccination law obtained, and smallpox was wholly prevented – not a single case occurred in 1882. This result was seized upon the following year by the anti-vaccinationists and used against the necessity for any such law, and it seems they had sufficient influence to cause its repeal. The death returns for that year (1883) showed that for every 1,000 deaths two were caused by smallpox; In 1884 there were three; in 1885, 17, and in the first quarter of 1886, 85.
Meanwhile, WHO’s highly successful global polio eradication programme was on target to have eradicated this murderous disease from the face of the earth by now – a fate which has already befallen the smallpox virus, excepting a few glass vials – until local imams from a small province called Kano in northern Nigeria claimed that the vaccine was part of a US plot to spread AIDS and infertility in the Islamic world, and organised a boycott which rapidly spread to five other states in the country. This was followed by a large outbreak of polio in Nigeria and surrounding countries, and tragically even further afield. There have now been outbreaks in Yemen and Indonesia, causing lifelong paralysis in children, and laboratory analysis of the genetic code has shown that these outbreaks were caused by the same strain of the polio virus, exported from Kano.
After all, as any trendy MMR-dodging north-London middle-class humanities-graduate couple with children would agree, just because vaccination has almost eradicated polio – a debilitating disease which as recently as 1988 was endemic in 125 countries – that doesn’t necessarily mean it’s a good thing.
The diversity and isolation of these antivaccination panics helps to illustrate the way in which they reflect local political and social concerns more than a genuine appraisal of the risk data: because if the vaccine for hepatitis B, or MMR, or polio, is dangerous in one country, it should be equally dangerous everywhere on the planet; and if those concerns were genuinely grounded in the evidence, especially in an age of the rapid propagation of information, you would expect the concerns to be expressed by journalists everywhere. They’re not.
Andrew Wakefield and his Lancet paper
In February 1998 a group of researchers and doctors led by a surgeon called Andrew Wakefield from the Royal Free Hospital in London published a research paper in the
The paper described twelve children who had bowel problems and behavioural problems (mostly autism), and mentioned that the parents or doctors of eight of these children believed that their child’s problems had started within a few days of them being given the MMR vaccine. It also reported various blood tests, and tests on tissue samples taken from the children. The results of these were sometimes abnormal, but varied between children.
12 children, consecutively referred to the department of paediatric gastroenterology with a history of a pervasive developmental disorder with loss of acquired skills and intestinal symptoms (diarrhoea, abdominal pain, bloating and food intolerance), were investigated.
… In eight children, the onset of behavioural problems had been linked, either by the parents or by the child’s physician, with measles, mumps, and rubella vaccination … In these eight children the average interval from exposure to first behavioural symptoms was 6.3 days (range 1–14).
What can this kind of paper tell you about a link between something as common as MMR, and something as common as autism? Basically nothing, either way. It was a collection of twelve clinical anecdotes, a type of paper called a ‘case series’ – and a case series, by design, wouldn’t demonstrate such a relationship between an exposure and an outcome with any force. It did not take some children who were given MMR and some children who weren’t, and then compare the rates of autism between the two groups (this would have been a ‘cohort study’). It did not take some children with autism, and some children without autism, and then compare the rates of vaccination between the two groups (this would have been a ‘casecontrol study’).
Could anything else explain the apparent connection between MMR, bowel problems and autism in these eight children? Firstly, although they sound like rare things to come together, this was a specialist centre in a teaching hospital, and the children had only been referred there because they had bowel problems and behavioural problems (the circumstances of these referrals are currently being examined by the GMC, as we will see).
Out of an entire nation of millions of inhabitants, if some children with a combination of fairly common things (vaccination, autism, bowel problems) all come together in one place which is
