Vaccinated (19 page)

Parents in England and Ireland responded by refusing to give their children the MMR vaccine. In the months following Wakefield's announcement, one hundred thousand parents chose not to vaccinate their children. As a consequence, the incidence of measles in England and Ireland skyrocketed. “After the study first came out we were struggling just to get parents to immunize their children,” said Michele Hamilton-Ayers, a pediatrician in Cheltenham, England. “Things got terribly bad.” Measles, a disease that vaccines had easily controlled, was back. Within months, one small children's hospital just outside of Dublin admitted a hundred children with measles, three of whom died. One was a fourteen-month-old girl, Naomi. “I couldn't believe that this could happen,” said her mother, Marie. “We used to hear about measles, but I never thought that it could be this bad.” Suffering from high fever and with difficulty breathing, Naomi had been admitted to the hospital's intensive care ward with measles pneumonia. After three weeks she went home, but she wasn't better. “She started twitching with her eye,” said Marie. “I couldn't believe that there was something wrong with her again.” Having infected Naomi's lungs, measles virus now infected her brain. Naomi went back to the hospital. “By the time we got up to the ward she was dead. They were taking all the tubes out of her. When she first got sick, the nurse said that it was only the measles. Only?”

The allegation that MMR vaccine might be causing autism spread quickly to the United States. Several politicians took up the cause. On April 12, 2000, Dan Burton, chairman of the House Committee on Government Reform, brought together scientists, public health officials, doctors, and parents to get at the truth, to sort out what was behind this epidemic of autism. He began the congressional investigation with a statement: “I'm very proud of that picture,” he said, pointing to a photograph, projected onto a large screen at the front of the room, of his granddaughter Alexandra and his grandson Christian. “The one on the left is my granddaughter. She almost died after receiving the hepatitis B shot. Within a short period of time she quit breathing and they had to rush her to the hospital. My grandson—who you see there with his head on her shoulder—according to the doctors was going to be about six feet ten. We anticipated having him support the family by being an NBA star. But unfortunately, after receiving nine shots on one day, the MMR and the DTaP and the hepatitis B, within a very short period of time he quit speaking, ran around banging his head against the wall, screaming and hollering and waving his hands, and became totally a different child. And we found out that he was autistic. He was born healthy. He was beautiful and tall. He was outgoing and talkative. He enjoyed company and going places. Then he had those shots and our lives changed and his life changed.” Burton stopped, trying to compose himself. “I don't want to read all of the things that happened to Christian,” said Burton, “because I don't believe that I could make it through it. But I can't believe that this is just a coincidence. That the shot is given and that within a very short period of time instead of being the normal child that we played with and talked to, he was running around banging his head and flailing his arms. And when people tell me that that's just a genetic problem I'm telling you that they're just nuts. That's not the way it was.”

Burton, with the help of antivaccine activists, had called several people to testify in front of his committee. Andrew Wakefield talked about children who had recently been vaccinated with MMR vaccine and had become autistic. John O'Leary, a molecular biologist from Ireland, showed pictures of measles virus proteins in the intestines of Wakefield's autistic children. O'Leary failed to mention that other investigators evaluating those same samples couldn't find what he had found, some questioning whether O'Leary had made up his data. Burton watched slide after slide as Wakefield and O'Leary described polymerase chain reactions, fusion proteins, hybridization analyses, and the importance of follicular dendritic cells. Clearly in over his head, Burton later remarked that perhaps these results could be explained in simpler terms.

Not all who testified were willing to line up behind Burton. Brent Taylor, an epidemiologist also working at the Royal Free Hospital in London (where Wakefield had performed his study), testified that the rates of autism in children who did or did not receive MMR vaccine were the same. This wasn't how Burton wanted the meeting to go. Reading a statement prepared for him by antivaccine groups as a rebuttal to Taylor's arguments, Burton asked whether Taylor had arbitrarily excluded some cases of autism. When Taylor responded that he had included every case of autism that he had identified, Burton was stuck. He hadn't read either Wakefield's or Taylor's papers.

Henry Waxman, the ranking Democrat on the committee, questioned the venue for such a discussion. “I'm troubled by this meeting,” said Waxman. “This hearing was called and structured to establish a point of view. And that's the point of view of the chairman [Burton].” Waxman suggested that Burton had stacked the deck by excluding groups that had asked to testify at the hearing—among them the American Medical Association, the American Public Health Association, the Infectious Diseases Society of America, the American Nurses' Association, Britain's Medical Research Council, the WHO, and Louis Sullivan, the former head of the Department of Health and Human Services. “I think hearings like this have a real danger,” said Waxman. Later in the hearing, Waxman again questioned the validity of Congress as the place to determine scientific truths. He asked that scientific studies be performed and evaluated by scientists and that congressmen defer to the scientific process. “Let's let the scientists find where the truth may be,” he said. To Waxman, having politicians judge the science of vaccines in Congress made about as much sense as having scientists legislate voters' rights in their laboratories.

Burton wasn't the only politician who supported the notion that MMR caused autism. Congressman Dave Weldon wrote a letter to Louis Cooper, then president of the American Academy of Pediatrics: “I am compelled to urge the Academy to recommend to pediatricians that they inform parents of their option of separating the MMR for their children. I am also contacting public health officials to urge that they examine their policies as well.”

The American media loved the story. The
New York Times
,
CNN
,
USA Today
, the
Washington Post
, and almost every major newspaper, magazine, and radio and television station in the United States elevated Wakefield's hypothesis to fact: MMR caused autism. On November 12, 2000, the television program
60 Minutes
produced a segment titled “The MMR Vaccine.” Ed Bradley was the correspondent. The segment began with Bradley interviewing Dave and Mary Wildman, the parents of an autistic son, from Evans City, Pennsylvania. Bradley said that the boy “appeared perfectly normal until just after his first birthday, when he received the MMR vaccine. Within a few weeks, according to his parents, things began to change.” “He started to not look at me anymore when I would call his name,” said Mary. “And do you know why?” asked Bradley. “Because of the MMR vaccine,” she said, tears streaming down her face. “I should never have had him have that vaccine.” Bradley also interviewed Andrew Wakefield during the segment. “My concern comes initially from the story the parents tell,” said Wakefield. “They have a normally developing child who upon receipt of the MMR vaccine develops a complex syndrome of behavioral and developmental regression, loss of speech, loss of language, loss of acquired skills, loss of socialization with siblings or peers.” “Do you have children?” asked Bradley. “I have four children,” Wakefield replied. “Knowing what you know now,” said Bradley, “would you give them the MMR vaccine?” Wakefield leaned toward the camera: calm, certain. “No, I wouldn't,” he said. “I would most certainly vaccinate them. I would give them [separate shots of] measles, mumps, and rubella vaccines.” After watching the program, Marie Lynch, a thirty-two-year-old event planner from Chicago, said, “I did permit my two-year-old daughter, Tess, to be vaccinated with MMR. However, I crossed my fingers and prayed for days.”

Dr. Richard Buchta (left) inoculates Jeryl Hilleman's son Colin with the MMR vaccine, 1991.

In response to the growing controversy, epidemiologists, researchers, and public health officials in the United States, Denmark, the United Kingdom, Finland, and other countries sorted through medical records, trying to determine whether children who had received the MMR vaccine were at greater risk of autism than were those who hadn't. During the next few years, fourteen separate groups of investigators evaluated the records of more than six hundred thousand children. The results were clear, consistent, and reproducible: the incidence of autism was the same in both groups. MMR vaccine didn't cause autism. Parents choosing not to immunize their children weren't reducing their risk of autism; they were only increasing their risk of catching potentially fatal infections. Andrew Wakefield's conjecture hadn't stood up to further scrutiny.

In February 2004 Brian Deer, an investigative reporter in London, found that Andrew Wakefield wasn't exactly what he appeared to be. Writing for the
Sunday Times
of London, Deer found that Wakefield's
Lancet
paper contained several errors. In its acknowledgments the paper stated that “this study was supported by the Special Trustees of Royal Free Hampstead NHS Trust and the Children's Medical Charity.” But Wakefield had omitted the study's largest supporter. Two years before his paper was published, Wakefield had signed a contract worth £55,000 with a personal injury lawyer named Richard Barr. Five of the eight autistic children in Wakefield's study were Barr's clients. Wakefield knew that the parents of the children in his study had a financial interest in finding a link between the MMR vaccine and autism. If Wakefield was successful in establishing that link, these parents could successfully sue for compensation. Wakefield chose not to disclose his financial ties to Barr, either to the editor of the
Lancet
or to his fellow investigators.

The acknowledgments weren't the only part of Wakefield's paper that were misleading. Wakefield claimed that he had first encountered children during their routine admissions to the hospital, when in fact he had been alerted to their existence by Barr. He had then laundered the parents' claims about their children's histories into clinical findings to fit a medical publication, grossly misleading the public. In the wake of the
Lancet
study, seven hundred families banded together in London to sue pharmaceutical companies on behalf of their autistic children; many of these families were clients of Richard Barr.

Finally, Wakefield claimed that “investigations were approved by the Ethical Practices Committee.” But the ethics committee had never approved the study. Further, Wakefield later reassured the committee that all of the invasive tests performed on these children—including blood collections, spinal taps, colonoscopies, and intestinal biopsies—would have been carried out even if these children weren't being studied. This was clearly untrue. The fact that young children with autism were being subjected to biopsies and spinal taps for the purpose of generating evidence for a lawsuit caused many to wonder exactly who was looking out for their well-being.

Looking for a response to Deer's allegations, reporters cornered Wakefield during a press conference. Wakefield admitted that “four, perhaps five” of the children in the
Lancet
study were clients of Richard Barr. “Was it four or five?” they asked. “Let's make it five,” he said. “Were they litigants?” “Yes,” replied Wakefield. “Were you being paid to help them build their case?” Again Wakefield said yes. “Did you tell your colleagues that these children were part of the study?” “I don't recall,” said Wakefield. “Did you tell the
Lancet
about these conflicts prior to the publication?” Wakefield said that he hadn't. “Why not?” “I believe that this paper was conducted in good faith,” said Wakefield. “It reported the findings. There was no conflict of interest.” “Do you have any reasons now to change your opinion?” “No,” said Wakefield.

Sir Liam Donaldson, the British government's chief medical officer, saw Wakefield's report for what it was: bad science. By failing to examine the incidence of autism in vaccinated
and
unvaccinated groups, Wakefield hadn't studied anything; he'd merely advanced a hypothesis based on a few children. Donaldson felt that Wakefield's paper should never have been published, not because of conflicts of interest but because it failed to shed any light on the cause or causes of autism. He recognized that Wakefield's pronouncements came at great cost. Speaking on BBC's
Today
program, Donaldson said, “If the paper had never been published, then we wouldn't have caused a completely false loss of confidence in a vaccine that has saved millions of children's lives around the world.”