Earlier this month, in the small coastal city of Swansea, Wales, a 25-year-old man with measles was found dead in his flat. It was the first measles fatality in Britain in five years, and a bleak development in an epidemic caused by a health scare that began here more than a decade and a half ago.
Almost 900 people, mostly children and adolescents, have contracted the disease in recent weeks. Health officials say it’s the result of a “lost generation” of children, now roughly 10-18 years old, who did not receive their vaccinations as infants in the 1990s. Back then, there were widely publicized concerns about a link between bowel disease, the MMR vaccine—which protects children against measles, mumps and rubella—and autism. While the link was later disproved and the 1998 paper that promoted it exposed as fraudulent, many parents, particularly in the Swansea area where the local media took up the story, still failed to get their children immunized. Why this legacy of mistrust took hold in south Wales more strongly than the rest of the country is not entirely known, though most put it down to those early reports, combined with a relatively inward-looking culture. What’s certain is that consequences could be dire.
The Swansea epidemic shows no signs of ending; 121 new cases appeared in the last week. Epidemiologists expect the outbreak could last until the summer holidays and beyond. And there are serious concerns it could spread to other parts of Wales, due to low vaccination rates across that region—as well as across the entire country. It is estimated at least 40,000 children across Wales are currently not vaccinated.
The former surgeon and medical researcher at the centre of the controversy is Andrew Wakefield, who was a senior lecturer and honorary consultant in experimental gastroenterology at the Royal Free Hospital School of Medicine. In 1998, he published a now-infamous paper in the medical journal The Lancet that linked “behavioural symptoms” with MMR, reporting that the onset of autism began two weeks after infants received their first round of jabs. (His theory was that the measles portion of the vaccine damaged the children’s intestines and eventually their brains.) The paper claimed to have identified a new syndrome, which Wakefield and his co-authors dubbed “autistic enterocolitis”—a behavioural disorder supposedly brought on by MMR and linked to bowel disease.
Many parents of autistic children hailed the research as a breakthrough; not only did it offer a cause for a mysterious and debilitating disorder, it offered a solution, too: a gluten- and dairy-free diet that proponents claimed alleviated symptoms.
Celebrity proponents of the MMR-autism link, most notably Jenny McCarthy, went public promoting the research. But despite 14 major public health studies in countries such as the U.K., U.S., Denmark and Finland, which studied more than 600,000 autistic children, no researchers were able to replicate the link. In fact, the rate of autism was exactly the same in children who had received MMR as those who had not. Wakefield’s theory was obliterated.
The U.K.’s General Medical Council launched an inquiry into allegations of misconduct and, in 2010, found that Wakefield had “failed in his duties as a responsible consultant.” He was struck off the Medical Register and barred from practising medicine. The Lancet, which published the original paper, issued a full and immediate retraction, and the Sunday Times declared Wakefield’s autism link “an elaborate fraud” perpetrated for the personal gain of Andrew Wakefield himself.
Amazingly, none of this has given Wakefield a moment of pause. He has consistently maintained his innocence and the veracity of his findings and continues to promote the idea of an MMR link to autism. Indeed, he took to YouTube earlier this month to defend himself against the latest claims that the outbreak in south Wales was his fault. His bizarre argument is that the government was actually to blame, as it showed more interest in protecting the MMR vaccine than at-risk children and did not heed his advice to administer separate vaccines. The Independent newspaper ran a link to Wakefield’s screed on the front page of its website and was roundly excoriated for giving him a platform.
Meanwhile, as the media focus on Wakefield, public health workers in south Wales are desperately trying to make sure all unvaccinated children receive their jabs. The “lost generation” is still at risk. As one Welsh epidemiologist told the BBC, “Nowhere in Wales is safe from measles, and I think that is true of the U.K. as a whole.” Unrepentant though he is, Andrew Wakefield has a lot to answer for.