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The doctor who, for whatever reasons, nurtured the myth that the MMR vaccine causes autism has been struck off by the General Medical Council making it impossible for him to practice medicine in the United Kingdom.

North & South June edition

North & South June edition

But the decision by the GMC to dismantle Andrew Wakefield’s career once and for all is unlikely to convince of their folly those parents who refuse to vaccinate their children. Experts disproved Wakefield’s claims years ago, long before the GMC began investigating him, yet a hardcore of parents continue to opt out of vaccination programmes around the world, thwarting the herd immunity so crucial to disease spreading among children.

Anyone looking for an insight into the thinking of such parents should read Joanna Wane’s excellent cover story in North & South this month, “The Case for Vaccination”. The cover (pictured left) shows seven year-old Charlotte Cleverley-Bisman, who missed out on the meningococcal B (MeNZB) vaccine by a few weeks back in 2004.

Aged just six months, she was struck down with meningococcol septicaemia, which claimed all of her limbs. If time had been on her side she would have got her jab and life would be very different for this brave young girl today.

Wane interviews everyone from immunisation experts to housewives in her piece. Virtually all agree vaccinating children is worth the small risk of them suffering an adverse reaction. One voice stands out however, that of Huia Minogue, a 34 year-old part-time marketing consultant and mother of a four year old boy, Roman. Huia has an erratic approach towards vaccination – she had Roman vaccinated for whooping cough and tetanus, but not Hepatitis or Hib (haemophilus influenzae type b). She does her own research on vaccination and explains:

“I was breastfeeding, using cotton nappies, making sure there was no lead in our paint and no colouring in his food. You’re creating this wholesome, natural little environment. Why would you want to inject terrible viruses into a small infant?”

Huia, as much as she loves little Roman, doesn’t understand how vaccines work and as she weighs up whether to give him his MMR shot which is due, I doubt Wakefield’s thorough discrediting and banning will factor into her decision-making. She also told Wane, apparently close to tears:

“Times have changed. People don’t want to be told ‘Just do this’. They’re asking ‘Where’s the proof?’”

The GMC decision comes 12 years after Wakefield and colleagues published their dodgy paper in The Lancet triggering a wave of anti-vaccine sentiment that led to plummeting vaccination rates and a resurgence of diseases like measles. Over a decade on, Wakefield’s legacy is a lingering suspicion of vaccinations among parents the world over.

Here’s what scientists approached by the Science Media Centre in London had to say about Wakefield’s professional demise:

Dr Jennifer M Best, Emeritus Reader in Virology at King’s College London, said:

“I hope that this ruling will finally persuade the public and some misguided journalists that Dr Wakefield behaved irresponsibly in suggesting that there might be a link between the MMR vaccine and gastrointestinal disease and autism. Many studies have shown that MMR is a safe vaccine. It is important that the uptake of MMR is improved, to ensure that measles and rubella do not recur in the UK.”

Professor Terence Stephenson, President of the Royal College of Paediatrics and Child Health (RCPCH), said:

’Measles, mumps and rubella vaccines have all been shown to be safe and UK families are fortunate to have free access to these which is not true of many parts of the world. The false suggestion of a link between autism and the MMR vaccine has done untold damage to the UK vaccination programme.

’We cannot stress too strongly that all children and young people should have the MMR vaccine. Overwhelming scientific evidence shows that it is safe.”

And this also courtesy of the SMC from Dr Evan Harris, the former MP and medical doctor who originally urged the GMC to investigate the case:

“Today’s decision, while welcome, does not close this matter because it is about more than one man.  There needs to be an enquiry as to how these unacceptable invasive tests came to be done on so many vulnerable children despite the existence of ethics committees designed to prevent this sort of abuse, and the medical establishment needs to ask itself whether there are any other published papers, based on the same flawed research, that need to be retracted as the Lancet paper eventually was.

“It took a determined journalist to expose what happened to these children and to public funding and I am not satisfied that something similar could not happen again.  Medical journals need to review their systems of checks and hospitals must ensure their ethical oversight is fit for purpose.”

SMC timeline on the MMR scandal

MMR Timeline

1988 — MMR introduced in UK, for the first time boys are immunised against rubella, there is a chance of getting wider measles vaccine coverage and mumps vaccination is included for the first time.

1993 onwards — Andrew Wakefield proposes measles jab causes Crohn’s disease, this is later disproved

1995 — Uptake rate of vaccine is 95% enough for herd immunity for mumps, measles and rubella.

1998 — Andrew Wakefield suggests MMR and autism link at press briefing to launch research published in the Lancet

1998 — 14 year study suggests no problems with MMR vaccine published in Lancet.

1999 — Research published in the Lancet from the Royal Free, where Wakefield did his research, finds no evidence for MMR and autism link.

2000 — Andrew Wakefield and John O’Leary present evidence to US congress suggesting link between MMR and autism.

2000 — Another large scale study suggests benefits of MMR vastly outweigh risks.

2001 — BMJ study using GP Research Database suggests no link between MMR and autism.

2001 — Andrew Wakefield resigns from the Royal Free and University College Medical School

2002 — John O’Leary and colleagues suggest measles are present in guts of patients with austim in a paper in the Journal of Clinical Pathology: Molecular pathology. Scientists question methods and later a US legal case says methods unreliable.

2002-2004 — A large number of scientific studies find no link between MMR and autism including research published in British Medical Journal, New England Journal of Medicine, Pediatrics and Lancet

2004 — 10 co-authors on the 1998 Wakefield Lancet paper issue a retraction and editor of the Lancet says, with hindsight, they shouldn’t have published the paper.

2004-2005 — Uptake of MMR vaccine falls to 81%.

2005 — Large scale Japanese study shows MMR not linked to autism; Japan withdrew MMR and cases of autism continue to increase.

2005-2006 Uptake of MMR vaccine at 84%.

2006 April – 13 year old boy becomes the first person in the UK to die from measles in 14 years.

2006 June – It is announced that Andrew Wakefield is to face the General Medical Council over charges of professional misconduct.

2007 – Uptake of MMR vaccine increased to 85%. Department of Health would like the vaccine uptake to rise to 95% — a level that would give herd immunity.

July 2007 – GMC starts hearings against Wakefield and two of his colleagues.

January 2010 – GMC issues preliminary verdicts and finds Wakefield to have been ‘irresponsible’ in conducting unnecessary and invasive tests on children. The Lancet retracts Wakefield’s original paper a couple of days later.

May 2010 – Wakefield is found guilty of serious professional misconduct and is struck off the medical register.

More on Sciblogs from Grant Jacobs