Editors of the British medical journal Lancet announced they would retract a controversial 1998 study which sought to establish a connection between child vaccinations and autism in the wake of findings the primary author fabricated data.
In the 12 years since the article by Dr. Andrew Wakefield and two colleagues was published, concerns over a supposed connection between vaccines for mumps, measles and rubella (MMR), and autism led fewer parents to seek vaccines for their children, causing a rise in the illnesses, particularly in Europe.
“This false link between MMR vaccines and autism resulted in a tenfold increase in measles in the United Kingdom alone,” said Roger Bate, London-based Legatum Fellow in Global Prosperity at the American Enterprise Institute. “Wakefield mainly, and the Lancet to a certain extent, deserve criticism here.”
Journalist Exposed Falsehoods
Brian Deer, a journalist at the Sunday Times, is credited with exposing the flaws in Dr. Wakefield’s approach, which resulted in the UK’s General Medical Council January 28th ruling that he participated in “dishonesty and misleading conduct” while doing the research in 1998.
“The hero of this story is Brian Deer, who persevered for years even after the Lancet editors had apparently done their investigation. Increasingly the knowledge to nail people like Wakefield is in the public domain, so journalists can play the ‘free market’ to their advantage,” said Trisha Greenhalgh, professor of primary health care at University College of London.
Media Scare Tactics
Rae Sonnenmeier, a clinical associate professor at the University of New Hampshire, said the fallout from the exposure of Wakefield’s study signals the responsibility of the media to report scientific issues without bias toward frightening headlines.
“When an idea becomes widely popularized, it can often seem as if it is considered fact, when in reality it was just an idea. And then, when that frightening idea is later shown to be false, it can take a long time for the general public to accept that the idea is not fact,” Sonnenmeier said.
“The media plays an important role in the process of disseminating new ideas and information. It has been reported since 2004 that vaccines are safe and do not cause autism, yet many parents of young children still have concerns. It is important for health care professionals from all fields to be well-informed about the current state of knowledge so that they can provide appropriate advice.”
Parents Reacted to Connection
Children ultimately suffered the consequences of this study, even if Dr. Wakefield did not intend them to, said William Schaffner, MD, professor and chair of the Department of Preventive Medicine at Vanderbilt University.
“The cause of autism still is unknown, and the disease is often devastating to the child as well as to the family. Parents want an explanation for this tragedy, and because vaccines are given to young children just during that time in life when autism first is diagnosed, this relationship in timing appears to be a cause-and-effect relationship,” said Schaffner.
“Those circumstances combined to produce a firm persistence of belief, despite an accumulation of contrary scientific information. This is the true tragedy: the fallacious and unethical publication in the Lancet has led to children suffering disease, hospitalizations, and deaths that were entirely preventable.”
Persistence of Quackery
Steven L. Salzberg, director of the Center for Bioinformatics and Computational Biology at the University of Maryland, says certain forms of false connections will always emerge in the health care universe.
“We have been plagued by quackery in the marketplace for centuries, in part because there are always people happy to profit from the ignorance of others. They offer ‘cures’ that don’t work, and as long as people will buy them, someone will sell them,” said Salzberg.
In an environment where many people get medical information from unreliable sources, the importance of transparency and openness is paramount, says Schaffner.
“First, we must do good science to provide solid information. Second, we must become more skilled in bringing this information to the public in convincing ways. It is the free marketplace of ideas, and within it we must be transparent, clear, empathetic, and helpful. And very persistent about the truth,” Schaffner said.
The best way to avoid such incidents in the future is to stress the importance of finding the best information, Sonnenmeier says.
“Those in the free market must have the best information available and some guidance about how to interpret the available information. The free market can play a role in posing questions about ideas as they emerge from the scientific community,” Sonnenmeier said. “Then professionals, parents, and individuals can make decisions that make sense to them.”
Lessons to Be Learned
“Asking ‘why is autism increasing?’ is a legitimate question, and Dr. Wakefield tried to answer this question, but he did not obey the guidelines of a good epidemiological study,” said Bate. “This study should not have passed peer review, and never should have been published.”
According to Greenhalgh, the lesson from this controversy is that people should question what they hear, even if it comes from a source they’re inclined to trust.
“We can learn that just because something is published in a top-quality medical journal doesn’t mean it’s good science,” said Greenhalgh.
Tabassum Rahmani ([email protected]) writes from Dublin, California.
