Editorials

Wakefield’s article linking MMR vaccine and autism was fraudulent

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.c7452 (Published 06 January 2011) Cite this as: BMJ 2011;342:c7452

BMJ response to emails from readers of Age of Autism

Since we published the first of three articles by Brian Deer on the
secrets of the MMR scare [1] and a linked editorial [2] on 5 January 2011,
the BMJ has been the subject of an orchestrated campaign of emails. In
response to questions raised in these emails, we make the following
statement.

The BMJ stands by the article and the editorial. The article, which
was subjected to peer review and editorial checking, was based on
enquiries carried out over some seven years, involving, among other
things, interviews with parents of children enrolled in Andrew Wakefield's
research. Four such parents are quoted in the article. As made clear in
the article, the core data on which the findings were based were
evidenced, except in the case of one child, by the transcript of a General
Medical Council fitness to practise hearing which sat between July 2007
and May 2010.

In many of the emails we have been sent, it is suggested that Andrew
Wakefield did not have access to GP records and therefore could not be
responsible for discrepancies between those records and what was published
in the Lancet in February 1998. The case we presented against Andrew
Wakefield that the 1998 Lancet paper was intended to mislead is not
critically reliant on GP records. It is primarily based on Royal Free
hospital records, including histories taken by clinicians, and letters and
other documents received at the Royal Free from GPs and consultants.

We draw attention to the finding of the fitness to practise panel, on
which we are entitled to rely, that "the project reported in the Lancet
paper was established with the purpose to investigate a postulated new
syndrome and yet the Lancet paper did not describe this fact at all.
Because you [Wakefield] drafted and wrote the final version of the paper,
and omitted correct information about the purpose of the study or the
patient population, the panel is satisfied that your conduct was
irresponsible and dishonest."

Contrary to other suggestions contained in the emails, we made no
allegation of dishonesty against Andrew Wakefield's co-authors, or indeed
against anybody else. As the GMC panel heard, it was Andrew Wakefield who
wrote the Lancet paper, using data which he anonymised, with little
oversight by other authors. We confirm that under the uniform requirements
for manuscripts submitted to biomedical journals all authors should be in
a position to speak to data, but the evidence is that in this case they
were not.

We are aware of recent claims made by Andrew Wakefield that "new
documents have come to light" purportedly confirming his claims in the
Lancet. The material he cites was presented to the GMC panel two and a
half years ago. Andrew Wakefield was last year erased from the medical
register and he has chosen not to appeal that decision. As indicated, the
very many charges proven against him include dishonesty in his research.

We are unaware of any peer reviewed paper replicating Andrew
Wakefield's research or confirming his claims to have identified a new
syndrome of regressive autism and inflammatory bowel disease associated
with MMR vaccination. With respect to gastrointestinal issues, we draw
attention to an authoritative consensus statement published last year by
experienced specialists in this field [3] and particularly to statement 4:
"The existence of a gastrointestinal disturbance specific to persons with
ASDs (eg 'autistic enterocolitis') has not been established."

Fiona Godlee, Editor in Chief, BMJ

References

1. Deer B. How the case against the MMR vaccine was fixed. BMJ 2011;
342:c5347 doi: 10.1136/bmj.c5347

2. Godlee F, Smith J, Marcovitch H. Wakefield's article linking MMR
vaccine and autism was fraudulent. BMJ 342:doi:10.1136/bmj.c7452

3. Buie P, Campbell DB, Fuchs GJ, et al. Evaluation, diagnosis, and
treatment of gastrointestinal disorders in individuals with ASDs: a
consensus statement. Pediatrics 2010;125;S1-S18.

Competing interests: FG is editor in chief of the BMJ and responsible for all it contains.

07 February 2011
Fiona Godlee
Editor in Chief
BMJ
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