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MMR doctor 'to face GMC charges'

Mr Wakefield stands by his findings

The doctor who first suggested a link between the MMR vaccine and autism is to be charged with serious professional misconduct, it is reported. 12 June 2006

The Independent newspaper reports that the General Medical Council will accuse Mr Andrew Wakefield of carrying out "inadequately founded" research.

Vaccination rates fell sharply after Dr Wakefield questioned the safety of MMR, raising fears of a measles epidemic.

His initial Lancet paper has since been disowned by the journal.

The editor admitted he would not have published the 1998 paper if he had known about what he called a "fatal conflict of interest".

Mr Wakefield was being paid to see if there was any evidence to support possible legal action by a group of parents who claimed their children were damaged by the vaccine. Some children were involved in both studies.

In addition ten doctors who co-authored the paper issued a statement in 2004 arguing there was insufficient evidence to draw the conclusion that the MMR vaccine was not safe.

The main thrust of the paper was that MMR was linked not only to autism, but also to the bowel disorder Crohn's disease.

No corroboration

But a host of major studies has since failed to find any evidence of a link between MMR and autism.

However, the uptake rate for MMR - a triple jab which protects against measles, mumps and rubella - slumped in the wake of the controversy.

The rate has since picked up again, but remains low in some areas of the country, most notably London.

The Independent reports that Mr Wakefield will face four charges: that he published inadequately founded research, failed to obtain ethical committee approval for the work, obtained funding for it improperly, and subjected children to "unnecessary and invasive investigations".

Mr Wakefield carried out his initial study while working at London's Royal Free Hospital.

He has since moved to the US.

A General Medical Council spokesman refused to confirm details, but said: "An investigation is ongoing."

http://news.bbc.co.uk/1/hi/health/5070670.stm

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In the dock: the man who caused the great MMR scare

By Jeremy Laurance, Health Editor

Published: 12 June 2006

http://news.independent.co.uk/uk/health_medical/article799541.ece

The doctor who sparked an international scare over the safety of MMR vaccine is to be charged with serious professional misconduct by the General Medical Council in an attempt by the medical establishment finally to lay the controversy to rest.

Andrew Wakefield, who published a research paper in 1998 purporting to show a link between the MMR vaccine and autism, is accused in preliminary charges of publishing "inadequately founded" research, failing to obtain ethical committee approval, obtaining funding "improperly" and of subjecting children to "unnecessary and invasive investigations", The Independent has learnt. The research is said to have caused immunisation rates to slump and cases of measles, mumps and rubella to soar. The research, which appeared in The Lancet, is said to have done more damage than anything published in a scientific journal in living memory.

Detailed charges are being formulated by the GMC's lawyers for presentation in the autumn and a public hearing is expected next year. If found guilty Dr Wakefield, 50, could be struck off the medical register.

The GMC has brought the case itself in the public interest. There is no complainant. The investigation has taken two years and lawyers for Dr Wakefield say he and his family are suffering distress caused by the delay in bringing charges.

The research was carried out at the Royal Free Hospital, north London, by Dr Wakefield and 12 other doctors and published in The Lancet in February 1998. The warning about the combined vaccine was amplified by Dr Wakefield at a press conference - to the disquiet of his colleagues present - and the subsequent scare led tens of thousands of parents to boycott the vaccine.

Immunisation rates fell over the next five years from more than 90 per cent nationally to a low of 78.9 per cent in early 2003. In parts of London rates fell below 60 per cent. There was a resurgence in cases of the three diseases, including rubella (German measles), according to the Health Protection Agency. The number of cases of mumps soared from 4,204 cases in 2003 to 16,436 in 2004 and to 56,390 cases last year.

Since 2003 the MMR vaccination rate has increased slightly and in mid-2005 stood at 83 per cent. A spokeswoman for the agency said: "The fear of Wakefield has dissipated a bit. The figures are coming back up."

In 2004 it emerged that at the time he was preparing The Lancet paper, Dr Wakefield was being paid by lawyers for parents of children allegedly damaged by the MMR vaccine to look for evidence that could be used to help take legal action against manufacturers of the vaccine.

He received £55,000 from the Legal Aid Board, which was paid into his research fund but which he had not disclosed to his co-researchers. At least four of the 12 children in the Lancet study were also in the Legal Aid Board funded study. He was accused by The Lancet of failing to declare a conflict of interest that could have influenced his findings.

Richard Horton, the editor, declared the paper "fatally flawed" and said if he had known in 1998 about the conflict of interest he would never have published it. The journal partially withdrew the paper in February 2004 and the following month 10 of the 12 authors withdrew the claim of a link with autism. John Reid, the Health Secretary at the time, called on the GMC to hold an inquiry. Dr Wakefield, a consultant gastroenterologist, left the Royal Free Hospital in 2001 "by mutual agreement". He has since worked mainly in America.

The Government's chief medical officer, Sir Liam Donaldson, accused Dr Wakefield of mixing "spin and science". But Jackie Flether of the support group Jabs, representing parents concerned about vaccination, said: "The GMC charges are totally unfounded and seem to be a total witch hunt against Andrew Wakefield and the research team. All the researchers did was raise a red flag [about MMR] and say more research was needed." All the doctors are believed to have denied professional misconduct.

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Leading article: A risky move that may revive parents' fears

Published: 12 June 2006

One has to hope the General Medical Council knew what it was doing when it decided to bring charges against the doctor behind the boycott of the MMR vaccine, as this newspaper reveals today. Serious professional misconduct is about as bad a charge as its gets, and if the charges are made to stick Andrew Wakefield may well be struck off.

Many members of the medical profession, not to mention parents who were appalled by the panic he generated, might cheer such an outcome to the rafters.

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Jeremy Laurance: A gamble that risks turning a maverick into a martyr

Published: 12 June 2006

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.

Doctor who sparked MMR scare could face misconduct charges
By Nic Fleming, Medical Correspondent
(Filed: 13/06/2006)  http://www.telegraph.co.uk/news/main.jhtml;jsessionid=NHWL1KIVQYJOZQFIQMGCFFWAVCBQUIV0?xml=/news/2006/06/13/nmmr13.xml&sSheet=/news/2006/06/13/ixuknews.html

Is this doctor a hero or a health risk?
By Tom Leonard
(Filed: 13/06/2006)
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/06/13/nmmr213.xml

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