MMR Controversy

Michael Fitzpatrick, Barton House Health Centre, London, UK

Published online: May 2011

DOI: 10.1002/9780470015902.a0023271

Full Article on Wiley Online Library

The measles, mumps and rubella (MMR) controversy erupted in 1998 when Andrew Wakefield, a medical researcher at a London teaching hospital, suggested that the MMR vaccine, given routinely in the second year of life, caused inflammatory bowel disease and autism. Though the MMR-autism theory was scientifically discredited by studies in epidemiology and virology, the campaign against MMR was taken up by parents and lawyers, politicians and journalists. It resulted in a fall in the uptake of MMR and outbreaks of measles as well as imposing a new burden of guilt and blame on parents of children with autism. A decade later Wakefield was found guilty by the General Medical Council of serious professional misconduct in relation to the conduct and publication of his research and struck off the medical register. His work was subsequently shown to be fraudulent.

Key Concepts:

The Andrew Wakefield theory that the MMR vaccine caused inflammatory bowel disease and autism provoked a major controversy between 1998 and 2010.
Epidemiological studies in different populations, using different methods, failed to confirm a causal link between MMR and autism.
Virological studies failed to confirm persistent measles infection in children with autism.
The notion of a distinctive inflammatory bowel condition in children with autism – ‘autistic enterocolitis’ – has not been generally accepted by gastroenterologists.
Litigation based on claims of a link between MMR and autism collapsed in the UK in 2003, in the USA in 2009.
Influential journalists promoted Wakefield as a scientific maverick, as a champion of autistic children and as a victim of the medical establishment.
The exposure of ethical violations and other forms of malpractice in the Wakefield research by the journalist Brian Deer led to his disgrace.
In 2010 Wakefield was found guilty of serious professional misconduct and struck off the medical register.
In 2011 the BMJ concluded that the Wakefield campaign against MMR ‘was based not on bad science but on a deliberate fraud’.

Keywords: MMR; measles; inflammatory bowel disease; autism; autistic enterocolitis; epidemiology; virology; litigation

References
	Afzal MA, Ozoemenal LC, O'Hare A et al. (2006) Absence of detectable measles virus genome sequence in blood of autistic children who have had their MMR vaccination during the routine childhood immunization schedule of UK. Journal of Medical Virology 78: 623–630.
	Baird G, Pickles A, Simonoff E et al. (2008) Measles vaccination and antibody response in autism spectrum disorders. Archives of Disease in Childhood 93: 832–837. doi: 10.1136/adc.2007.122937.
	book Barr R and Limb K (1998) Measles, Mumps, Rubella Vaccines (MMR or MR): Information Pack. London: Hodge Jones and Allen.
	Buie T, Campbell DB, Fuchs GJ et al. (2010) Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics 125(suppl. January) S1–S18. doi:10.1542/peds.2009-1878C.
	Chen RT and DeStefano F (1998) Vaccine adverse events: causal or co-incidental? Lancet 351: 611–612.
	other Deer B (2004) MMR: the truth behind the crisis, Sunday Times, 22 February.
	Deer B (2011) How the case against the MMR vaccine was fixed. British Medical Journal 342: c5347.
	Demicheli V, Jefferson T, Rivetti A et al. (2005) Vaccines for measles, mumps and rubella in children. Cochrane Database of Systematic Reviews (Issue 4. Art. No.: CD004407, doi:10.1002/14651858.CD004407.pub2).
	D'Souza Y, Fombonne E and Ward BJ (2006) No evidence of persisting measles virus in peripheral blood mononuclear cells from children with autism spectrum disorder. Pediatrics 118(4): 1664–1675. doi:10.1542/peds.2006–1262.
	Elliman D and Bedford H (2007) MMR – where are we now? Archives of Disease in Childhood 92: 1055–1057. doi:10.1136/adc.2006.103531.
	Fitzpatrick M (2007a) The anti-MMR gravy train derailed. Spiked-Online, 12 January.
	other Fitzpatrick M (2007b) The MMR-autism theory? There's nothing in it, Spiked-Online, 4 July.
	other Fitzpatrick M (2009) MMR-autism scare: the truth is out at last, Spiked-Online, 23 February.
	ePath General Medical Council (GMC) (2010a) Fitness to practise panel. Findings of fact. 28 January 2010. www.gmc-uk.org/static/documents/content/Wakefield__Smith_Murch.pdf
	ePath General Medical Council (GMC) (2010b) Dr Andrew Wakefield: determinations on serious professional misconduct and sanctions. 24 May 2010. www.gmc-uk.org/Wakefield_SPM_and_SANCTION.pdf_32595267.pdf; Professor John Walker-Smith: determinations on serious professional misconduct and sanctions, 24 May 2010. www.gmc-uk.org/Professor_Walker_Smith_SPM.pdf_32595970.pdf
	Godlee F (2011) The fraud behind the MMR scare. Editor's choice. British Medical Journal 342: d22.
	Godlee F, Smith J and Marcovitch H (2011) Wakefield's article linking MMR vaccine and autism was fraudulent. British Medical Journal 342: c7452.
	Hornig M, Briese T, Buie T et al. (2008) Lack of association between measles virus vaccine and autism with enteropathy: a case-control study. PLoS ONE 3(9): e3140. doi:10.1371/journal.pone.0003140.
	book Institute of Medicine (2004) Immunisation Safety Review: Vaccines and Autism. Washington, DC: National Academies Press.
	other Joint Committee on Vaccination and Immunisation (JCVI) (1995) Measles and Crohn's Disease. Minutes of the meeting held on Friday 5th May 1995, JCVI (95) 64:14.
	ePath Legal Services Commission (LSC) (2003) Decision to remove funding for MMR litigation. Transcript. 6 October. www.mmrthefacts.nhs.uk/news
	Lindley KJ and Milla PJ (1998) Autism, inflammatory bowel disease and MMR. Correspondence. Lancet 351: 907.
	MacDonald TT and Domizio P (2007) Autistic enterocolitis: is it a histopathological entity. Histopathology 50(3): 371–379.
	Metcalf J (1998) Is measles infection associated with Crohn's disease? The current evidence does not support a causal link. British Medical Journal 316: 166.
	Miller E, Andrews N, Waight P et al. (2003) Bacterial infections, immune overload, and MMR vaccine. Archives of Disease in Childhood 88: 222–223.
	book Mills H (2002) MMR: The Story So Far. Special Report. London: Private Eye.
	ePath NHS Information Centre (2010) NHS Immunisation Statistics. England 2009-10. http://www.ic.nhs.uk/webfiles/publications/003_Health_Lifestyles/immstats0910/Immunisations_Bulletin_2009-10.pdf
	ePath Offit PA (2002) Vaccines and Autism. Immunisation Action Coalition, www.immunize.org/catg.d/p2065.pdf
	other Roberts Y (1995) A shot in the dark. Sunday Times Magazine, 17 December.
	Taylor B, Miller E, Farrington P et al. (1999) Autism and MMR vaccine: no epidemiological evidence for a causal association. Lancet 353: 2026–2029.
	ePath US Court of Federal Claims (USFC) (2009) Autism decisions and background information. http://www.uscfc.uscourts.gov/node/5026
	Wakefield AJ, Murch SH, Anthony A et al. (1998) Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 351: 637–641.
	World Health Organisation (WHO) (1998) Expanded programme on immunisation (EPI) – association between measles infection and the occurrence of chronic inflammatory bowel disease (IBD). Weekly Epidemiological Record 73: 33–40.
	Wright N (2010) Does autistic enterocolitis exist? Editorial British Medical Journal 340: c1807. doi: 10.1136/bmj.c1807.
Further Reading
	book Allen A (2008) Vaccine: The Controversial Story of Medicine's Greatest Lifesaver. New York: WW Norton.
	book Boyce T (2007) Health, Risk and News: The MMR Vaccine and the Media. London: Peter Lang.
	book Fitzpatrick M (2004) MMR and Autism: What Parents Need to Know. London: Routledge.
	book Fitzpatrick M (2010) Defeating Autism: A Damaging Delusion. London: Routledge.
	book Furedi F (2002) Culture of Fear: Risk-Taking and the Morality of Low Expectations. London/New York: Continuum.
	book Mnookin S (2011) The Panic Virus: A True Story of Medicine, Science and Fear. New York: Simon and Shuster.
	book Offit P (2010) Autism's False Prophets: Bad Science, Risky Medicine and the Search for a Cure. New York: Columbia University Press.
	book Offit P (2011) Deadly Choices: How the Anti-Vaccine Movement Threatens Us All. New York: Basic.

Article Title:	MMR Controversy
* Name:
* E-mail:
* Note:

MMR Controversy

Key Concepts:

Related Sub-Topics: