How my son’s autism led me to take on the anti-vaxxers
My campaign against dangerous misinformation in the world of vaccinations began almost 20 years ago, built on the publication in 1998 of a now-notorious and withdrawn paper in the medical journal the Lancet.
This paper, written by Andrew Wakefield, first raised the now-discredited possibility of a link between MMR and autism.
As a GP at a busy inner-London practice, I soon found myself having long discussions with worried parents who wanted to delay or refuse vaccination – or to opt for expensive, separate measles, mumps and rubella jabs offered by sleazy private clinics.
And I had reasons of my own for taking a particularly close interest in this debate.
Our son James, born in 1992, had followed a course of apparently normal development before regression into autism at the age of 18 months – a common story for autistic children and also, wrongly, said to be typical of the children supposedly affected by MMR.
On digging out James’s baby clinic book, we discovered that he had the jab without any apparent adverse effects about four months before we first noticed the signs of what doctors call his ‘autistic withdrawal’.
I carefully read the Lancet paper. Although Wakefield and his coauthors admitted that they ‘did not
prove a causal relationship’ – my italics – between MMR and autism, it would be more accurate to say that they did not present any evidence of a causal relationship. They simply reported that the parents of eight of the 12 children in the study believed there was such a link.
What’s more, the four- stage mechanism through which MMR was supposed to produce both autism and inflammatory bowel disease seemed, to me, entirely speculative.
Putting all this together, I was swiftly unconvinced by the theory that the MMR jab had been a factor in causing autism in James or in any child. Other parents, of course, were not so sure.
Given that the MMR jab is usually administered at around the time features of autism often first appear, it was understandable that some parents would suspect a causative link – especially when this was suggested by what seemed to be a reputable doctor.
I knew immediately that Wakefield and his supporters should be called to account.
The impact of his paper, revealed more than 20 years ago, is still being felt today. Britain has recently lost its measles-free status amid a growing barrage of online propaganda from ‘ antivaxxers’ while the Government has seemed to take its eye off the ball on the subject.
Wakefield, though disgraced in the medical community and rightly struck off, is now enjoying a second life in America, paid well for peddling his discredited, shadowy conspiracy theories in the world of quack autism therapists – and, indeed, enjoying a relationship with supermodel Elle Macpherson.
But back to the early 2000s. By then, our family was struggling with James’s increasingly challenging behaviour and the difficulties of finding a school that could cope with him. Wakefield’s campaign, however, seemed to be going from strength to strength.
It frustrated me that the medical authorities seemed to think it was enough to expose the lack of serious evidence for Wakefield’s and other anti-vaxxers’ claims at scientific conferences and in specialist journals. What was needed – and what is still needed today – is a proper countering of these claims in the public sphere.
To our discredit, many of us doctors have been too slow to realise that anti-vaxxers do not truly operate in the world of scientific research. Wakefield is a perfect example of this: Though his scientific talents are negligible, his PR skills are formidable.
I have since come to know several parents who found themselves dragged into ill-fated litigation against vaccination companies based on Wakefield’s claims, and many more who were afflicted with guilt and anxiety over giving their children the MMR jab.
By 2004, thanks to the efforts of a spectrum of campaigners including doctors, journalists and others, the tide began to turn against the Wakefield campaign.
As a result of his failure to come up with evidence that convinced anybody but himself of the MM Rautism link, the Legal Services Commission withdrew funding for the litigation – effectively bringing it to an end.
The lawyers and their expert witnesses shared £15million among themselves – and 1,500 families ended up with nothing but bitterly disappointed hopes. If only that had spelled an end to the matter.
But the myths about vaccination did not die down. At the end of 2004, I pulled together numerous criticisms of the anti-MMR campaign I had written in both the medical and popular press over the preceding five years.
I wrote a book, MMR and Autism: What Parents Need To Know, to expose the pseudo-science of these claims. My aim as a doctor and as a campaigner on this issue has always been to reassure parents worried about vaccination, and to relieve the anxieties of parents of autistic children.
My last encounter with Wakefield took place at a conference organised by a parents’ anti-vaccination group in Bournemouth in 2007.
He was greeted with a standing ovation and delivered a highly technical presentation which would not have persuaded his scientific peers, but clearly impressed this lay audience.
When it came to the Q&A after the talk, I asked Wakefield how he explained the fact that, in nearly a decade since he had first advanced his MMR-autism hypothesis, this had failed to win the endorsement of a single British scientist or practising specialist in autism, gastroenterology or paediatrics.
He refused to answer – and the security guards were summoned to remove me from the hall.
My application to attend a subsequent conference by the same group was refused.
These heavy-handed tactics are typical of the hypocrisy of an antivaxxer movement that spurns free enquiry and open debate.
SO, now that Britain has lost its measles-free status, what should we – as doctors and as parents – be doing?
Some call to ban anti-vaxxer websites and online forums, or to make vaccination mandatory for school entry. I think that while the information war must be played out on the web, compulsory vaccinations are a step too far.
But as a GP, I see that the real challenge is to improve the organisation of Britain’s baby clinics.
We need to address shortages of the key professionals involved – health visitors, practice nurses and GPs. We need to improve systems to alert parents when vaccinations are due, to ensure clinics are at convenient times and that staff have sufficient time – and adequate training – to deal with parental concerns.
We need better IT systems to cope with a more tech-savvy population, and for keeping accurate vaccination records.
None of these measures will change the past, of course.
The fact that our son James is now 27 gives us a ready reminder of how long this controversy has been running – and how much more we need to do.
Dr Michael Fitzpatrick is the author of MMR and Autism: What Parents Need to Know