Dr Andrew Wakefield should not take all the blame for this scare
Friday, 29 January 2010
For a scientific paper which has been so utterly debunked, Dr Andrew Wakefield's 1998 study suggesting a link between the MMR vaccine and autism continues to exert a quite extraordinary influence over public life. The anger on display yesterday from Dr Wakefield's supporters when their champion was found guilty by the General Medical Council of professional misconduct in his research of 12 years ago underlines the enduring passions that surround this issue.
Dr Wakefield has accused the GMC of staging a sort of show trial, designed to punish him for daring to dissent from the views of the medical establishment regarding the safety of this vaccine. This seems a conspiracy theory too far. But, in a way, it is a pity there has not been a real inquest into the MMR debacle because there are many lessons from that affair that have still not been properly learned.
If there were such an investigation, Dr Wakefield would certainly need to accept a portion of the blame. His original 1998 research paper, co-authored with several colleagues from the Royal Free Hospital, was cautious and provisional in its conclusions. Yet at a subsequent press conference Dr Wakefield made the wild recommendation that parents should avoid giving their children the combined MMR jab on safety grounds. After that, he could have recognised his mistake and appealed for calm. But instead he chose to dig the hole deeper. And he has been blind ever since to the overwhelming evidence that has contradicted his theory.
That said, stubborn mavericks are hardly unknown. And the fact that Dr Wakefield's theories are unsupported by the evidence does not mean he ought to be silenced. Moreover, a single doctor, no matter how headstrong, cannot plausibly be held responsible for a health scare that has persisted for more than a decade.
Several other factors were necessary to set off this public health firestorm. The medical authorities need to accept some responsibility. In responding to the concerns of parents about the MMR jab, they got their tone wrong. Their public statements in support of the triple jab often came across as patronising and arrogant. They failed to take on board parents' deep anxieties over matters relating to their children's health.
The Government's response was inadequate too. Ministers were slow to react to public concerns and their refusal to countenance the idea of allowing parents to choose to have the three jabs administered to their children separately, though medically correct, probably stoked the panic. To some extent they also paid a price for previous misleading governmental assurances in the early 1990s over the health threat posed by BSE.
Finally, the media has lessons to learn. The press and television stations were perfectly justified in reporting Dr Wakefield's concerns in detail. But, too often, they failed to emphasise just how little evidence there was to support his assertions. In all likelihood, the MMR debacle would not have occured – and would certainly not have lasted so long – without a combination of all these factors.
Dr Wakefield is wrong to claim that he has been punished by a vengeful medical establishment. His misdemeanours in the conduct of his original research – though towards the milder end of the spectrum – were real. Yet this maverick should certainly not stand alone as a figure of vilification when we look back on the most damaging and persistent health scare of recent years.