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February 4th, 2010
09:58 AM ET

Autism study triggered parents’ fears

By Miriam Falco
CNN Medical Managing Editor

At 9:01am on Tuesday, journalists around the world got the news: The British medical journal Lancet had decided to "fully retract" a study it had published in 1998. The study was conducted by Dr. Andrew Wakefield and suggested that the combination vaccine against measles, mumps and rubella (aka German measles), also known as the MMR vaccine, triggers gastrointestinal problems, which may trigger autism.

It was a very small study – only 12 children were in it. But it was the study that was heard around world because it triggered a fear in parents that vaccines may cause autism. Consequently, many parents stopped vaccinating their children.

Wakefield has said his study didn't say vaccines cause autism. He wouldn't talk to the news media Tuesday, but in a written statement sent to CNN, Wakefield said "the Lancet paper does not claim to confirm a link between the MMR vaccine and autism."

Technically he is correct. In the 1998 study, Wakefield and his 12 co-authors write "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described." But the conclusion of his study says "We have identified a chronic enterocolitis [infection of the intestines] in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunization. Further investigations are needed to examine this syndrome and its possible relation to this vaccine."

So the study suggested that the MMR vaccine causes gut problems and these gut problems cause autism.

Suddenly many pediatricians and public health officials had to convince parents about the importance of utilizing the means to prevent some very deadly diseases.

Over the past decade, the repercussions of parents refusing to vaccinate their children because of the 1998 Wakefield study were big.

- In the United States, more cases of measles were reported in 2008 than 1997. The Centers for Disease Control and Prevention says "more than 90 percent of those infected had not been vaccinated, or their vaccination status was unknown."

- In Britain, where the study was conducted, the Health Protection Agency says 177 cases of measles were reported in 1997- in 2008 the nation had 1,370 cases.

- In Germany, the incidence among children under the age of 1 year was higher in 2006 than in 2001, according to the World Health Organization.

The latest CDC statistics tell us that an alarming 1 in 91 children in this country have some form of autism.

However, WHO statistics remind us that children are dying from the illnesses that vaccines are meant to prevent. For example, measles kills 164,000 children annually, noting that "measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available."

As a journalist who has covered autism stories for the past 10 years, I was surprised that it took so long for the Lancet to retract the study. That's because this particular study had been under fire for a long time.

Wakefield's suggested link between has been scrutinized many times in the past 12 years. In 2004, the Institute of Medicine reviewed existing research and found no evidence that the vaccine causes autism. But it wasn't the alleged link between vaccines and autism that lead to the retraction of the study this week.

Also in 2004, 10 of the 13 co-authors had their names removed from the study, when it became known that Wakefield hadn't disclosed information about a serious conflict of interest he had while running the study. He didn't disclose that he had had been paid by a law firm that intended to sue vaccine manufacturers.

Last week, a long investigation by the Britain's General Medical Council, the body that disciplines doctors, concluded that the way this study was conducted was "unethical," "dishonest" and "misleading." The board found that some of the children were given colonoscopies, MRIs and spinal taps that weren't needed from a medical standpoint. All these procedures come with some serious risks and should be done only when absolutely necessary.

Dr. Richard Horton, the editor-in-chief of the Lancet, told me that the journal had been waiting for the GMC's investigation to conclude and that after reading the 140-page report, he thought it was "the most appalling catalog and litany of some the most terrible behavior in any research" and is therefore very clear that it has to be retracted." The decision to retract the study was made the soon afterwards.

In his statement to CNN, Wakefield said, "The allegations against me and against my colleagues are both unfounded and unjust and I invite anyone to examine the contents of these proceedings and come to their own conclusion."

Does the removal of this study from the public record change your mind about a possible link between vaccines and autism?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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