Do Vaccines Cause Autism?

Many parents today are convinced that vaccines for children, such as MMR (measles, mumps and rubella vaccine), are an irrefutable cause of autism. The origin of this theory goes back to  February 1998. That’s more than 25 years ago! Since then, a lot has happened. Today, we will investigate and establish a timeline of events that will help parents and other readers determine whether vaccines cause autism.

The Lancet, Andrew Wakefield and His Major “Breakthrough”

The Lancet is a prestigious peer-reviewed medical journal founded in 1823. The journal has one of the highest impact factors. The Lancet is published weekly. There are more than 10,000 volumes over the two centuries of its existence. A February 1998 volume published, “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children.” The research paper received wide publicity. Andrew Wakefield and twelve others published this paper.

The paper claimed that families of 8 out of 12 children blamed the MMR vaccine for their autism and reported that children began showing symptoms of autism within days of receiving the shot. The research paper also suggested a link between the MMR vaccine, a novel form of bowel disease and autism. The study was based on twelve children with autism. The paper postulated that the vaccine might predispose children to behavioural regression and pervasive developmental disorder. The authors also proposed the existence of “autistic enterocolitis” – a new syndrome.

The Aftermath of the Research Paper

Wakefield’s paper generated mass media attention and triggered widespread fear across the globe over the MMR vaccine. Panic-stricken parents besieged medical professionals about vaccine safety. Following the paper’s publication, by 2003, only 78.9% of British 2-year-olds were being vaccinated. This was well below the required rate of 95% to protect the population. Subsequently, there was an outbreak of measles. Fear spread across the globe at an alarming rate¹.

The paper also caused waves in research and medical fraternity. Several researchers began their epidemiological studies: Taylor et al, 1999, DeStefano & Chen, 1999. The Lancet published both. These two studies and other research elsewhere failed to establish whether or not MMR vaccines cause autism. Andrew Wakefield criticized the research by Taylor et al. in 1999, accusing them of ignoring rules and calling their methods weak², which is ironic because of the events that unfolded in subsequent years.

Researchers were perplexed. They also investigated whether the link between MMR vaccine and autism could be temporal – autism red flags start showing around the same age a child receives their vaccination.

Scandal

It was in 2004 that an exposé published in the Sunday Times uncovered a shocking scandal. The investigative journalist Brian Deer carried out a four-month investigation. The first article was published in 2004, followed by numerous other articles over the years.

The front-page article caused a scandal. According to the investigation, Wakefield did not disclose that he was being funded through solicitors searching for evidence to use against pharmaceuticals producing vaccines. The Times’ investigation established that legal aid covered four or five children. Wakefield was awarded £55,000 to support their cause and provide scientific evidence. There was an apparent conflict of interest. Some of the Co-authors (total 13) of the study were shocked to discover this. They were kept in the dark about Wakefield’s dealings. One co-author stated that if he had known about this conflict of interest, he would never have been a part of the research.

Parents of children in the study were also approached. The paper also shocked the parents. After reading the five-page article, the parent stated that the information had been distorted³. It was also discovered that some parents were clients of one solicitor, Richard Barr, who led the legal attack on vaccine manufacturers. This was the same solicitor who had organised Wakefield’s funding from the Legal Aid Board.

This story has many twists. And perhaps Netflix can turn this into a fascinating 4-part documentary. Several years before the much-publicized research paper, Wakefield had drafted a business plan of molecular viral diagnostic tests with a predicted turnover of £72.5m from Britain and America. Wakefield also had to include a London medical school at University College London (UCL) in the plan to get it rolling. The catch:  a diagnostic test also required a condition that needed to be diagnosed.

A press conference followed the publication of the article. But before the press conference, Wakefield, and the hospital (the venue where research was conducted) distributed a video to broadcasters. Wakefield appeared in the tapes and says, “the MMR vaccination in combination—that I think it should be suspended in favour of the single vaccines“. The article, the press conference, the video and the ensuing media frenzy worked together to boost Wakefield’s business plan. Behind the scenes, unknown to many, Wakefield held a patent of “safe” single measles shot (the patent was filed in 1995 and granted in 1997, 8 months before the paper in the Lancet).

Both, the publication of the article and the media hype it generated breathed life into Wakefield’s business plan. Of course, the subsequent vaccine scare may have derailed the plans for Wakefield’s single vaccine. The proposed syndrome in the paper would be Wakefield’s masterstroke. The plans for investment began to roll out soon after the paper’s publication and the press conference. It turned out that one of the parents from the study was also roped in for investment.

The Unraveling of the Plan

In the months that followed, Wakefield courted investors, set up his company to carry out business, and promised a series of papers that never materialised. The grand launch was planned for 2000. However, everything started unraveling before then. The thread that unraveled was the medical school onboard with the plan. In 1999, a new head of medicine arrived, and he saw right through Wakefield’s plan and all the conflicts of interest. A letter addressed to Wakefield held the following comment:

“This concern arose originally because the company’s business plan appears to depend on premature, scientifically unjustified publication of results, which do not conform to the rigorous academic and scientific standards that are generally expected.”

The letter marked the end of the commercial deal. While the medical school withdrew, they still offered support. The same letter also asked Wakefield to corroborate the results from the Lancet paper and volunteered 150 children. An excerpt is reproduced below:

“Good scientific practice now demands that you and others seek to confirm or refute robustly, reliably, and above all reproducibly, the possible causal relationships between MMR vaccination and autism/“autistic enterocolitis”/inflammatory bowel disease that you have postulated.”  

At the time, Wakefield agreed to continue his research. However, this produced no result even though the school sent Wakefield several reminders, which bore no fruit. By October 2001, Wakefield was terminated from the school.

The Verdict

In 2003, journalist Brian Deer investigated the case. He uncovered the controversy of mammoth proportions. There was deceit and subterfuge. The journalist pieced the story together brick by brick. The findings were shocking. Wakefield’s research received secret funding to create evidence against the MMR vaccine, while he planned his business. In the course of things, there was misreporting and manipulation of children’s information so that the results could lean in his favour.  Even those who worked closely on the paper didn’t know what was happening.

Not one of the 12 cases reported in the paper was free from manipulation when developmental histories of the children were considered. Some children were already at high-risk of having autism before vaccination, other were deemed “normal” several months after vaccination. Some children weren’t even diagnosed with autism. And then, the undisclosed funding proved to be another nail in the coffin. Combined with Wakefield’s business plan and patent, all the evidence was damning.

Brian Deer’s report led to a huge public outcry in the country. Subsequently, the longest medical disciplinary inquiry in history began in 2007. It ran for over 200 days and concluded in 2010. Wakefield and one of the co-author of the paper were struck off from the medical register – meaning that they could not practice medicine again. The panel that gave the verdict found Wakefield guilty of 30 charges. These included dishonesty and 12 charges of causing children to be subjected to clinically unjustified invasive procedures.

In 2011, the Lancet retracted the controversial paper, citing that no cause-based link could be established between the MMR vaccine and autism. They also highlighted the fact that Wakefiled had failed to disclose financial interests, which included funding by solicitors as well as his own commercial interests.

Anti-Vaxxers Still at Large

Numerous parents still believe that vaccines cause autism, even though a large body of research could not establish the link. In Pakistan, a country whose people love conspiracy theories, have gone the extra mile to discredit ALL vaccines, not just MMR (this applies to anti-vaccination parents).

Professionals with dubious credentials still hoodwink parents into believing Wakefield’s discredited theories. They lead parents to believe that vaccination causes autism. Several of the practitioners also tutored parents about the relation between autism and bowel issues – Wakefield’s proposed syndrome. Some professionals have robbed parents of hundreds of thousands of rupees in the name of testing and providing medicine for treating autism (remember, no such medicine has been produced to date. If there had been, the developed countries would have “eradicated” autism by now). However, the burden not only lies with the professionals but also with parents. It is 2023. Research and information is only a click away. Ignorance is unforgivable. And when children with autism are factored in, ignorance, manipulation and deceit can be considered criminal negligence.

Related to this topic:

Autism Myths Debunked

References

1. https://www.thetimes.co.uk/article/mmr-doctor-andrew-wakefield-fixed-data-on-autism-mgj82qsk50g
2. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)75696-8/fulltext
3. https://www.bmj.com/content/342/bmj.c5347.full