Published online 23 February 2004 | Nature | doi:10.1038/news040223-1


Link between vaccine and autism "entirely flawed"

Medical journal says it regrets publishing Wakefield's research on MMR.

The MMR vaccine has protected millions of children from life-threatening diseases.The MMR vaccine has protected millions of children from life-threatening diseases.© SPL

A series of allegations have been brought against Andrew Wakefield, the physician whose research and press statements first brought into the public eye a possible link between the combined measles, mumps, rubella (MMR) vaccine and autism.

One allegation points out that Wakefield had been given £55,000 (US$103,000) for a legal-aid project to investigate a possible link between MMR and autism, after several parents suspected the vaccine had negatively affected their children. Wakefield did not declare the existence of this project when he published a paper on a similar topic in The Lancet in February 1998.

Richard Horton, editor of The Lancet, says this is in violation of his journal's policy regarding conflict of interest.

In light of this, Horton now says that he would have asked Wakefield to remove the suggestion of a link between the vaccine and autism before the paper was published. "My belief is that that aspect of his work is entirely flawed and this conflict of interest shows how it was flawed," Horton told the BBC.

The UK government's chief medical officer, Liam Donaldson, today added his voice to calls for an independent investigation by the General Medical Council into the claims against Wakefield.

Wakefield denies that any of his actions were improper, and insists that a possible connection between the vaccine and autism deserves further study. He says he welcomes any inquiry into his work.

Loss of faith

Wakefield's initial study showed only that some children with unusual symptoms of bowel disease and autism were reported by their parents to have recently had the MMR jab. It did not show a causal link between the two, and included only 12 children, as both Wakefield and other scientists pointed out. But Wakefield added in public remarks that the link was worrying and deserved precautionary actions.

This caused a serious decline in the public's faith in the triple vaccine, and a reduction in the number of children receiving protective coverage against measles. Coverage has dropped to 79% of children in 2002-03, from 91% in 1997-98.

The British investigation into Wakefield's work, led by a reporter for The Sunday Times newspaper, came up with six allegations of scientific misconduct. This includes the suggestion that Wakefield's work for legal aid should have been disclosed to The Lancet, a conclusion with which the journal agrees.

"Editors and reviewers should have had an opportunity to take his dual role into consideration when assessing this paper for publication," says a press statement from the journal. "This information would have been material to our decision-making about the paper's suitability, credibility and validity for publication."

The The Sunday Times also suggested to The Lancet that Wakefield had not had proper ethical clearance for some of the invasive medical procedures carried out on children in the study, and that the procedure for selecting children in the study was biased because Wakefield had invited some of them to apply. But The Lancet says the evidence does not support these allegations.

Wakefield continues to investigate the possible link between MMR and autism, although most scientists now agree that there is no persuasive evidence for any such link.