The doctor who triggered an international scare over the MMR vaccine, contributing to a resurgence of measles cases in Britain, has admitted that his claims are “not proved”.
Andrew Wakefield, who is the subject of a disciplinary inquiry by the General Medical Council, told The Times that he was unrepentant about his theory linking the combined MMR vaccine to bowel disorder s and autism.
But he appeared to distance himself from his infamous Lancet paper on MMR, instead suggesting that his theory stemmed from his own analysis of “safety studies” – a review that has never been peer-reviewed or published.
Speaking to The Times from the Thoughtful House autism centre in Austin, Texas, where he now works, Dr Wakefield said that he had no regrets about conducting the case study of 12 children at the Royal Free Hospital, Hampstead, that ignited the MMR scare in 1998.
Dr Wakefield moved across the Atlantic to help to set up the centre five years ago after meeting the founders – a former Dell Inc executive, Charlie Ball, and his wife, Troylyn, who have a child with development problems – while giving a speech on autism in Austin.
In 2006, only months before the Department of Health announced that he would face GMC charges, he sold his house in Kew, London, for just over £1 million and bought a retreat in an exclusive suburb of Austin for $905,000 (£629,000).
Dr Wakefield, a gastroenterologist, told The Times that he was not practising medicine in the United States, where he does not have a licence, but was working on research as executive director of the clinic. His salary is understood to be almost £200,000 a year.
However, parents at Thoughtful House told The Times that Dr Wakefield had been present as colleagues examined and treated their children, which may constitute a breach of medical regulations.
Speaking of his MMR claims, Dr Wakefield said: “It’s under investigation. I would absolutely agree it’s not proved. Nor have I ever claimed that it’s proved.”
Several large-scale studies, involving millions of children, have found no evidence that the combined MMR vaccine is harmful, while a landmark legal judgment in America this week strongly rejected the Wakefield hypothesis, adding that it had failed to gain acceptance in the medical community.
Dr Wakefield and two former colleagues at the Royal Free are charged by the GMC with serious professional misconduct in relation to the 1998Lancetpaper and a press briefing. In the briefing he suggested that the combined MMR jab could be linked to bowel disorders and autism.
Dr Wakefield denies the charges, but hanging on the wall near his office in Thoughtful House is a poster spelling out the “Wakefield Hypothesis”, which stemmed from the contested research.
“The suggestion that parents should have the option of single vaccines was based on a review of all of the safety studies that were conducted on all of the vaccines from the single vaccine through to the MMR,” he said. “It was not based upon a case report of 12 children with a possible new syndrome. This was made explicit in a communication to my colleagues in advance of the press briefing. Based upon my review of the literature, the safety studies were totally inadequate.”
Dr Wakefield claims no responsiblity for the fact that one in four children still does not receive the recommended two doses of MMR, adding: “The reemergence of measles is not the consequence of a hypothesis. We did not cause a scare. We responded to parents’ legitimate concerns. They were uncertain about the vaccine. We responded to that, as we should have done, and did, in a professional and ethical manner. Not to have done so would have been negligent.”
This week the US Court of Claims rejected a test case brought by the parents of 14-year-old Michelle Cedillo, on behalf of the families of thousands of children with autism, who sought compensation from the US Government on the grounds that the illness was attributed to vaccines.
Experts say the 183-page ruling, based on testimony of 16 expert witnesses and a review of 658 medical articles, could mark a turning point in the row over the hypothesis.
George Hastings, the “special master” in the case, wrote: “The evidence that I have reviewed makes it appear extremely unlikely that the MMR vaccine can contribute to the causation of autism.”
The judge went out of his way to denounce a key colleague of Dr Wakefield at Thoughtful House, Dr Arthur Krigsman, who treated Michelle, for offering medical advice that was “very wrong” and suggested it amounted to “gross medical misjudgment”.
The UK Department of Health and the vast majority of doctors and scientists say that the facts in favour of routine MMR vaccination for children aged 12 to 15 months are already indisputable, with more than 500 million doses of the vaccine having been given in 90 countries since the 1970s.
But the ensuing fears about the jab sent vaccination rates plummeting, which is now blamed for causing a rapid increase in measles. There were 1,350 cases in England and Wales last year; the disease was almost nonexistent in the early 1990s.
The Health Protection Agency said yesterday that public confidence in the MMR vaccine was returning, despite not yet reaching pre1997 levels. “But . . . children who weren’t vaccinated many years ago are at real risk,” a spokesman added.
With a rise in autism cases in recent years – the causes of which remain poorly understood – the centre has benefited from celebrity backers. Members of the country rock group the Dixie Chicks sit on its board, while Jenny McCarthy, a former Playboy model and MTV presenter, who blames MMR for her autistic son’s condition, attended the centre’s charity softball game four years ago and is counted by Dr Wakefield as a friend.
Thoughtful House received nearly $2.4 million in donations in 2007, the latest year for which its tax forms have been released, and had net assets of $4.5 million.
Parents of autistic children treated at Thoughtful House brush off the criticisms of Dr Wakefield. Mara LaViola, a qualified lawyer who now lives in New York, is among those convinced that the MMR vaccine was the “tipping point” for her autistic son Zachary, now 6. “I could not find any answers. I could not get any help. I heard about the vaccine-autism connection. At first, I did not believe it. I come from a family of mainstream doctors and everyone dismissed it.” Ms LaViola thinks Dr Wakefield has been “treated abysmally”.
“We are 100 per cent behind him,” said Jennifer Keefe, a Dallas lawyer, whose four-year-old autistic son, Kevin, has been treated at the centre.
Dr Wakefield is not allowed to treat patients, although according to Ms LaViola he was present at least once when she was seeing Dr Krigsman, The Texas Medical Board said that Dr Wakefield had not applied for a licence to practise medicine in the US, and was free to carry out research, but that it would investigate any complaints if he had treated patients inappropriately.
It could not say whether any complaints had been lodged or were being investigated.
