Anatomy of a Scare

Like many people in London on that bleak February day in 1998, biochemist Nicholas Chadwick was eager to hear what the scientists would say. The Royal Free Hospital, where he was a graduate student in the lab of gastroenterologist Andrew Wakefield, had called a press conference to unveil the results of a new study. With flashbulbs popping, Wakefield stepped up to the bank of microphones: he and his colleagues, he said, had discovered a new syndrome that they believed was triggered by the MMR (measles, mumps, rubella) vaccine. In eight of the 12 children in their study, being published that day in the respected journal The Lancet, they had found severe intestinal inflammation, with the symptoms striking six days, on average, after the children received the MMR. But hospitals don't hold elaborate press conferences for studies of gut problems. The reason for all the hoopla was that nine of the children in the study also had autism, and the tragic disease had seized them between one and 14 days after their MMR jab. The vaccine, Wakefield suggested, had damaged the intestine—in particular, the measles part had caused serious inflammation—allowing harmful proteins to leak from the gut into the bloodstream and from there to the brain, where they damaged neurons in a way that triggered autism. Although in their paper the scientists noted that "we did not prove an association" between the MMR and autism, Wakefield was adamant. "It's a moral issue for me," he said, "and I can't support the continued use of [the MMR] until this issue has been resolved."

That's strange, thought Chadwick. For months he had been extracting genetic material from children's gut biopsies, looking for evidence of measles from the MMR. That was the crucial first link in the chain of argument connecting the MMR to autism: the measles virus infects the gut, causing inflammation and leakage, then gut leakage lets neurotoxic compounds into the blood and brain. Yet Chadwick kept coming up empty-handed. "There were a few cases of false positives, [but] essentially all the samples tested were negative," he later told a judicial hearing. When he explained the negative results, he told NEWSWEEK, Wakefield "tended to shrug his shoulders. Even in lab meetings he would only talk about data that supported his hypothesis. Once he had his theory, he stuck to it no matter what." Chadwick was more disappointed than upset, figuring little would come from the Lancet study. "Not many people thought [Wakefield] would be taken that seriously," Chadwick recalls. "We thought most people would see the Lancet paper for what it was—a very preliminary collection of [only 12] case reports. How wrong we were."

The next day, headlines in the British press screamed, DOCTORS LINK AUTISM TO MMR VACCINE AND BAN THREE-IN-ONE JAB, URGE DOCTORS AFTER NEW FEARS. That was mild compared with what followed. Hysteria over childhood vaccinations built to such a crescendo that Wakefield's nuanced warning—that it was specifically the triple vaccine, not single-disease vaccines (even measles), that posed a threat—was drowned out. In 2001, Prime Minister Tony Blair and his wife, Cherie, refused to say whether their son, then 19 months old, had received the MMR; rumors swirled that they had gone to France so the child could receive the measles vaccine alone. In 2003, a docudrama about Wakefield ran on British TV, depicting him as having his files stolen and his phone tapped by evil pharmaceutical companies intent on protecting their vaccines. As one reviewer described the show: "The MMR vaccine is coming to get our kids."

The MMR vaccine is the same on both sides of the Atlantic, so fears of childhood vaccines (of which U.S. health officials recommend 35 by age 6) started a backlash in the United States, too, fueled in no small part by the fact that the incidence of autism was rising for reasons scientists could not fully explain. In California, for instance, the incidence of autism had risen from 6.2 per 10,000 births in 1990 to 42.5 in 2001. Groups of parents began refusing vaccines for their children. Within a few years of Wakefield's announcement, rates of MMR vaccinations in Britain fell from 92 percent to below 80 percent. Although there was no comparable nationwide decrease in the United States, pockets of resistance to vaccination appeared throughout the country, laying the groundwork for a sevenfold increase in measles outbreaks. Looking back from the perspective of 11 years, the panic seems both inevitable and inexplicable. Inevitable, because legitimate scientists publishing in respected journals produced evidence of a link between vaccines and autism, and because the press as well as politicians and even public-health officials stoked the mounting hysteria. Inexplicable because, by the early 2000s, scientific support for that link had evaporated as completely as the red dot on a baby's vaccinated thigh.

Scientists and government officials who defended the safety of childhood vaccines were not shy about attributing the fears to the science illiteracy of the public and the fearmongering of the press. In truth, however, after Wakefield's announcement there was a steady drumbeat of studies—not from kooks in basement labs but from real scientists working at real institutions and publishing in real, peer-reviewed journals—that backed him up. In 2002, pathologist John O'Leary of Coombe Women's Hospital in Dublin reported that he had found RNA from the measles virus in 7 percent of normal children—but in 82 percent of those with autism, suggesting that some children are unable to clear the vaccinated virus from their systems, resulting in autism. That same year, a Utah State University biologist reported finding high levels of antibodies against the measles virus in the blood and spinal fluid of autistic children; the MMR, he postulated, had triggered a hyperimmune response that attacked the children's brains. In 2003, gastroenterologist Arthur Krigsman, then at New York University School of Medicine, reported finding what Wakefield had: that the guts of 40 autistic children were severely inflamed, lending support to the idea that leaks allowed pernicious compounds to make a beeline for the brain.

But these studies and others supporting the link between autism and the MMR were nothing compared with an extraordinary step that had been taken by the U.S. government and by one of the country's leading medical organizations. On July 7, 1999, the American Academy of Pediatrics (AAP) and the U.S. Public Health Service issued a warning about the preservative in many vaccines. Called thimerosal, it contains 49.6 percent ethylmercury by weight and had been used in vaccines since the 1930s, including the diphtheria/tetanus/pertussis (DTP) and Haemophilus influenzae (Hib) vaccines (but not the MMR). The experts tried to be reassuring, saying in a statement there are "no data or evidence of any harm" from thimerosal. But, they continued, children's cumulative exposure to mercury from vaccines "exceeds one of the federal safety guidelines" for mercury. (By 2003, most childhood vaccines did not contain thimerosal, though flu vaccines still did.) The AAP statement did not mention autism.