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Pressure mounts for inquiry into MMR furore

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7438.483-a (Published 26 February 2004) Cite this as: BMJ 2004;328:483

MMR and conflicts of interest

A few months ago, the BMJ used conflicts of interest as a theme. The
rapid responses showed that while some members of the profession
disapprove strongly of pharmaceutical industry bribery, others believed
there is no harm in it. Indeed, Simon Wessely, professor of psychiatry,
proudly proclaimed he currently holds 53 conflicts of interest and he
urged all to accept the situation for it is now a fact of life. How can
we argue with that when doctors who reach a target of MMR vaccinations,
are financially rewarded?

It seems to me that the current attack against Andrew Wakefield for a
conflict of interest, is not only hypocritical but typical of the manner
in which medical whistle-blowers have traditionally been treated.

The following rebuttal by Wakefield was published in "What Doctors
Don't Tell You". Permission to repost was given. I do hope the BMJ has a
sufficient sense of fair play to accept it for publication as a rapid
response.

DR WAKEFIELD: His side of the story

Many of you will know that Dr Andrew Wakefield, who pioneered
research into a link between autism and the MMR vaccine, was strongly
attacked in the London Sunday Times the other week, as reported in the
previous E-News. In particular he was criticised for receiving funds from
a legal aid charity that was representing parents of children who were
possibly injured by the vaccine. His statement follows in full...

"Serious allegations have been made against me and my colleagues in
relation to the provision of clinical care for children with autism and
bowel disease, and the subsequent reporting of their disease. These
allegations have been made by journalist Brian Deer who has expressed, in
front of witnesses, his aim of destroying me.

All but one of the allegations, which are grossly defamatory, have
been shown to be baseless. One allegation remains against me personally.
That is, that I did not disclose to the Lancet that a minority of the 12
children in the 1998 Lancet report were also part of a quite separate
study that was funded in part by the Legal Aid Board.

It is the Lancet's opinion but not mine that such a disclosure should
have been made since it may have been perceived as a conflict of interest.
This is despite that fact that the funding was provided for a separate
scientific study.

It needs to be made clear that the funds from the Legal Aid Board
were not used for the 1998 Lancet study, and therefore I perceived that no
financial conflict of interest existed.

The Lancet defines a conflict of interest as anything that might
embarrass the author if it were to be revealed later. I am not
embarrassed since it is a matter of fact that there was no conflict of
interest. I am, however, dismayed at the way these facts have been
misrepresented.

Whether or not the children's parents were pursuing, or intended to
pursue litigation against the vaccine manufacturers, had no bearing on any
clinical decision in relation to these children, or their inclusion in the
Lancet 1998 report.

It is a matter of fact that there was no conflict of interest at any
time in relation to the medical referral of these children, their clinical
investigation and care, and the subsequent reporting of their disease in
the Lancet.

As far as the 1998 Lancet report is concerned, it is a matter of fact
that we found and reported inflammation in the intestines of these
children.

The grant of £55,000 was paid not me but to the Royal Free Hospital
Special Trustees for my research group to conduct studies on behalf of the
Legal Aid Board. These research funds were properly administered through
the Royal Free Hospital Special Trustees.

The Legal Aid research grant to my group was used exclusively for the
purpose of conducting an examination of any possible connection between
the component viruses of the MMR - particularly measles virus - and the
bowel disease in these children. This is entirely in line with other
studies that have been funded by the Legal Aid Board (latterly the Legal
Services Commission) and reported in the BMJ. If and when this work is
finally published, due acknowledgement will be made of all sources of
funding.

It is unfortunate that, following full disclosure of these facts to
the editor of the Lancet, he stated that in retrospect he would not have
published facts pertinent to the parent's perceived association with MMR
vaccine in the 1998 Lancet report. Such a position has major implications
or the scientific investigation of injuries that might be caused by drugs
or vaccines, such as Gulf War Syndrome and autism, where possible victims
may be seeking medical help and also legal redress.

Health Secretary John Reid has called for a public enquiry. I
welcome this since I have already called for a public enquiry that
addresses the whole issue in relation vaccines and autism.

It has been proposed that my role in this matter should be
investigated by the General Medical Council (GMC). I not only welcome
this, I insist on it and I will be making contact with the GMC personally,
in the forthcoming week.

This whole unpleasant episode has been conflated to provide those
opposed to addressing genuine concerns about vaccine safety with an
opportunity of attacking me - an attack that is out of all proportion to
the facts of the matter.

I stand by everything that I have done in relation to the care,
investigation and reporting of the disease that I and my colleagues have
discovered in these desperately ill children.

My family and I have suffered many setbacks as a direct consequence
of this work. As a family, we consider that our problems are nothing
compared with the suffering of these children and their families. For the
sake of these children, this work will continue."

* To search the WDDTY database - where every word from the last 14
years of research can be found – click on
http://www.wddty.co.uk/search/infodatabase.asp

Competing interests:
None declared

Competing interests: No competing interests

06 March 2004
Gurli Bagnall
Independent Patients' Rights Campaigner
Marlborough Sounds, 7372, New Zealand