Debunked

5 minute read
Claudia Wallis

More than any other research, it was a study published in the British medical journal the Lancet in 1998 that helped foster the persisting notion that childhood vaccines can cause autism. On Feb. 2, that flawed study, led by gastroenterologist Dr. Andrew Wakefield, was officially retracted by the journal’s editors–a serious slap and a rare move in the world of medicine. “It has become clear that several elements of the 1998 paper by Wakefield et al. are incorrect, contrary to the findings of an earlier investigation,” wrote the Lancet editors in a statement issued online.

Wakefield’s methods were the subject of what was almost certainly the longest medical-misconduct inquiry in British history. The General Medical Council, which licenses British doctors, ruled on Jan. 28 that Wakefield and two of his co-investigators had acted dishonestly and irresponsibly and shown “callous disregard” for the 12 children in the study, which suggested that symptoms of autism in eight of the children and gastrointestinal trouble in all 12 were somehow linked with exposure to the MMR (measles, mumps and rubella) vaccine.

Among other failures, Wakefield neglected to disclose that he was a paid adviser in legal cases involving families suing vaccine manufacturers for harm to their children. It appears that he also handpicked children for his research rather than including patients he encountered at his clinic–another deception cited by the Lancet editors.

And there were other lapses in the way Wakefield recruited research participants: in one instance, he paid children about $8 apiece at his son’s birthday party to give blood. The General Medical Council also concluded that Wakefield had unnecessarily carried out invasive procedures on some of the children in the 1998 study, including spinal taps and colonoscopies, without ethical approval.

Wakefield and the other two doctors cited by the Medical Council may be stripped of their right to practice medicine in Britain. But the conclusion of the investigation comes several years after the 1998 study had already been widely discredited and after the other 10 co-authors had publicly rejected its findings.

Now, with the Lancet’s formal retraction of Wakefield’s paper, the question is whether the vaccine theory of autism may finally be put to rest. But that seems unlikely. Since 1998, numerous studies have found no link between vaccines and autism, yet parents’ fears have endured. Indeed, vaccination rates in the U.K., which dropped after the publication of Wakefield’s paper, never fully rebounded, and measles cases later took off. The number of cases has also risen in the U.S.

The vaccine fears persist in part because parents often notice the first autism symptoms around age 2, when many childhood vaccines are given. Most autism experts believe this is purely coincidental and that in many cases, parents have missed subtle signs of autism–like a baby’s failure to point or use other gestures to communicate–that may have emerged before vaccination.

The vaccine theory also offers an appealingly simple explanation for a devastating and confusing ailment that seems to arrive like a thief in the night. It has been diagnosed with ever greater frequency, and the number of vaccines given in childhood has also grown in the past 20 years, making them an easy target for blame. Experts believe much of the increase in autism-spectrum-disorder diagnoses stems from better detection, less stigma and broader definitions of autism, but this explanation fails to satisfy many afflicted families.

Another reason that Wakefield’s spurious conclusions had so much staying power was that his study focused on gastrointestinal symptoms in children with autism. Many autistic children have chronic constipation, diarrhea, stomach pain and feeding issues–problems that remain poorly understood. Says autism advocate and blogger Katie Wright, a Wakefield loyalist: “He was the first doctor to take this concern seriously and research why so many autistic children develop severe GI disease.”

Wakefield, who is associated with the Thoughtful House Center for Children, an autism center in Austin, Texas, could not be reached for comment. He maintains a devoted circle of supporters, several of whom appeared with him on Jan. 28 in London for the General Medical Council ruling. The formal repudiation of his 1998 paper may only reinforce their belief that there’s a conspiracy on the part of the medical establishment to suppress his work.

It’s hard to say how many families cling to the belief that vaccines cause autism, but they are likely a minority. Dr. Paul Offit, chief of the infectious-diseases division at the Children’s Hospital of Philadelphia and author of Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure, says he has received hundreds of grateful letters from parents of autistic children thanking him for debunking the autism-vaccine connection. But he has also received death threats, as recently as a month ago. “It’s easy to scare people,” says Offit. “But it’s extremely hard to unscare them.”

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