Britain’s leading medical journal, the BMJ, is calling on MPs to launch a parliamentary inquiry into research which claimed that the MMR vaccine causes autism and bowel disease, following extraordinary new disclosures about what it calls the “elaborate fraud” behind the work of Andrew Wakefield.
In an editorial in the journal, BMJ editor-in-chief Dr Fiona Godlee says that at least six further research papers by Wakefield require independent investigation and that at least six former senior figures at the London medical school where the work was carried out may have a case to answer over their involvement.
In a letter sent to Andrew Miller MP, chair of the House of Commons committee on science and technology, Dr Godlee says that if University College London, where Wakefield worked, does not immediately convene an independent inquiry into the Wakefield affair, then parliament must intervene.
"Institutional misconduct is too important to be left to the institutions themselves," she says.
In May 2010, Wakefield, formerly a researcher at the Royal Free medical school in Hampstead, north London, was struck off the medical register over a raft of charges, including dishonesty in research published in the Lancet in 1998. And last January, the BMJ concluded that his claims linking MMR vaccine with autism and bowel disease were “an elaborate fraud.”
Now, the journal publishes further revelations about the research, removing any remaining credibility to the claim that Wakefield and his co-authors had discovered a new inflammatory bowel disease associated with MMR. Experts studying unpublished raw data submitted to the BMJ with a view to exonerating Wakefield say it provides no evidence of such disease and that almost entirely normal findings were misreported in the Lancet paper.
Published in February 1998, the paper claimed that 8 of 12 children with brain problems seen at the Royal Free hospital developed autism within days of MMR, and that 11 of the 12 had colitis. The paper triggered a decade-long storm of public anxiety, plummeting levels of vaccination, and the re-emergence of measles as an endemic disease in Britain and elsewhere.
This new information does nothing to exonerate Wakefield of fraud but nor does it reflect well on his 12 authors, says Godlee. "It is impossible to reconcile [the new data] with what was published in the Lancet. The paper talks of enterocolitis and a new bowel disease involving a putative “unique disease process.” How could two consultant histopathologists have reported healthy biopsies and then put their names to such a text?"
The BMJ has been at the forefront of investigating the MMR scare, and earlier this year Dr Godlee wrote to University College London reporting six more papers involving Wakefield which have aroused concerns. She believes that a continuing failure to get to the bottom of the vaccine scandal raises serious questions about the prevailing culture of our academic institutions and attitudes to the integrity of their output. Given the extent of involvement of senior personnel at the highest level, only an independent inquiry will be credible, she says.
"This is not a call to debate whether MMR causes autism," says Godlee. "Science has asked that question and answered it. We need to know what happened in this inglorious chapter in medicine. Who did what, and why?"
In an accompanying feature article published on bmj.com today, investigative journalist Brian Deer explains what the latest revelations add to our knowledge of the Wakefield saga. He also reveals that UCL included Wakefield’s claims - not once but twice - in its submission to the UK’s research assessment exercise as part of a bid for money.
"If UCL does not immediately initiate an externally-led review of its role in the vaccine scare, we believe that parliament should do it," concludes Godlee. "After the effort and time it has taken to crack the secrets of the MMR scare, and the enormous harm it has caused to public health, it would compound the scandal not to heed the warnings from this catastrophic example of wrongdoing."
Fiona Godlee, Editor-in-Chief, BMJ, London, UK
via Emma Dickinson, press officer
Brian Deer, Journalist, London, UK