Wakefield's retracted MMR paper

The paper appeared in The Lancet in February 1998 under the names of Andrew Wakefield and 12 colleagues. It described 12 children, 11 of them boys, aged 3 to 10, who had been referred to the Royal Free Hospital and School of Medicine with bowel symptoms and a loss of skills such as language after normal early development. All 12 had intestinal abnormalities. In eight, the parents linked the start of behavioural symptoms to the measles, mumps and rubella (MMR) vaccine.

The study had 12 patients and no control group. Rao and Andrade later pointed out that a link in time was almost bound to appear, since MMR vaccination and the first signs of autism both fall in early childhood. Still, the paper drew wide publicity, Wakefield recommended single vaccines in place of the combined MMR in speeches and public appearances, and vaccination rates fell. Epidemiological studies followed. A Danish cohort of 537,303 children born from 1991 to 1998, reported in 2002, found no raised risk of autistic disorder among the 82% who had been vaccinated (relative risk 0.92).

In 2004 the Lancet acknowledged that Wakefield had been funded by lawyers acting for parents in lawsuits against vaccine makers, which the paper had not disclosed. Ten of the 12 co-authors withdrew the interpretation linking the vaccine to autism. The Royal Free Hampstead NHS Trust and the medical school said the children had received proper ethical scrutiny, and the journal kept the paper, citing public interest.

The General Medical Council ruled in January 2010. It found that the children had been carefully selected, although the paper called them a consecutive series, and that invasive tests had been done without the necessary ethical approval; it judged Wakefield dishonest and irresponsible. The Lancet retracted the paper on 2 February 2010, and in May the council struck him off the medical register for serious professional misconduct. In January 2011 the BMJ published an investigation by the journalist Brian Deer, with an editorial that called the paper fraudulent.

The Health Protection Agency attributed a large measles outbreak in the United Kingdom in 2008 and 2009 to the fall in the number of children receiving MMR. Pockets of measles in Canada and the United States were also attributed to parents' refusal to vaccinate.