An injection of reality in the hysteria over vaccine

WITH tousled brown hair and sporting a check shirt, Dr Andrew Wakefield, 52, cuts an unassuming figure. It is hard to imagine that he almost single-handedly sparked one of the world’s biggest health scares.

Twelve years ago he caused a worldwide panic over the combined measles, mumps and rubella vaccine when he and colleagues at the Royal Free Hospital in London had a paper published in the medical journal The Lancet. It suggested a link between the vaccine, autism and bowel disorders and, although the study involved just 12 children, it generated huge interest.

During a press conference after publication, Wakefield suggested that giving children the vaccines in three separate doses would be safer than a single vaccination. This suggestion was not supported by the paper but, in the media frenzy that followed, his comments made headline news.

Millions of parents in Britain and Ireland boycotted MMR vaccines as a result. Uptake of the vaccine dropped to under 80% in Britain and in some places fewer than 50% of children had the recommended two doses. In Ireland the national figure also dropped to under 80% while in parts of Dublin the uptake of the vaccine was less than 60%.

The infamous research paper has now been resoundingly discredited and on Thursday the governing body of doctors in Britain, the General Medical Council, condemned Wakefield on a number of grounds.

In the first instance, it says he manipulated patient data and misreported results in his 1998 paper. He also gained financially, receiving funding from litigants against vaccine manufacturers without informing colleagues or medical authorities of his conflict of interest. In 2004, 10 of the 13 authors dissociated themselves from the 1998 paper which the editor of the Lancet, Richard Horton, described as “fatally flawed”.

The GMC also found that Wakefield had been “dishonest, irresponsible and showed callous disregard for the distress and pain” after performing colonoscopies and lumbar punctures on children.

A toxic mixture of arrogance, megalomania and greed combined to cause a worldwide panic over a combination vaccine that has been credited with saving millions of lives.

Yet this publicity-loving pseudo-scientist refuses to accept he is wrong. Summoning his usual bravado, he dismissed the GMC findings in a manner that borders on the psychotic.

“I still had a naive belief in justice, I didn’t believe it could be quite like this,” he told the Daily Telegraph. “I feel so sorry for the children and their parents; it’s desperate for them. But the struggle goes on. The chap who discovered thalidomide said this always happens and 50 years later he received an apology.”

Yet he cannot find it within himself to apologise for abusing children in a most insidious fashion. It was revealed during the GMC investigation that he even paid children £5 to take blood samples from them at his son’s birthday party.

Wakefield was supported by some parents who felt he was the first doctor to take their children’s problems seriously. They say he has been pursued by the medical and political establishment in a campaign to destroy him.

But there is little doubt that their hero is a liar and a cheat. He is now peddling his particular brand of fear in the United States, where he has established a clinic in Texas funded by the parents of autistic children.

Already health experts in the US are worried about the effect he is beginning to have on parents there. Paul Offit, professor of paediatrics at the University of Pennsylvania, warned: “Wakefield’s malign influence is spreading across the United States, where we have seen vaccination rates drop and unprecedented chains of measles infections in the last year.”

Failure to immunise can have devastating effects. Mumps reached epidemic levels in Britain in 2005, while cases of measles also rose. In 2006 Britain saw its first death from the disease for 14 years when an Irish-born Traveller boy of 13 succumbed to measles.

It has been much the same story here. From late 1999 until the summer of 2000, there was a measles outbreak in north Dublin. At the time, the national immunisation level had fallen below 80%, and in part of north Dublin the level was around 60%. There were more than 100 hospital admissions from more than 300 cases. Three children died and several more were gravely ill, some requiring mechanical ventilation to recover.

Ireland experienced its last major measles outbreak in 2000, with more than 1,600 cases and three deaths.

There has been a significant increase in cases of measles in Ireland in recent years, with 165 cases recorded in 2009 compared with 55 for 2008.

The increase has been most noticeable in Cork and Kerry, where the number of cases jumped from just five in 2008 to 53 in 2009.

There were 26 cases in the region in the first two weeks of 2010 alone – 15 in Cork and 11 in Kerry.

Despite the widespread availability of measles vaccine for nearly 40 years, measles remains a major cause of childhood mortality. There were an estimated 30 to 40 million cases of measles in 2000, causing some 777,000 deaths. Although it is widely believed that measles has been eradicated in the developed world, a substantial number of people still catch it. In 2004 France had 4,448 cases and Germany had 121.

Two hundred years after the discovery of vaccine by the English physician Edward Jenner, immunisation is credited with saving nine million lives a year worldwide. According to UNICEF, a further 16 million deaths a year could be prevented if effective vaccines were deployed against all potentially vaccine-preventable diseases.