Andrew Wakefield tried to connect the MMR vaccine to Crohn's before implicating it in autism.

Health and medicine explained.
June 2 2010 12:32 PM

Wakefield's First Try

Before the disgraced doctor Andrew Wakefield said that the MMR vaccine caused autism, he thought that it led to Crohn's disease.

Andrew Wakefield. Click image to expand.
Andrew Wakefield

Last week, Andrew Wakefield, the man who is associated with proposing the highly controversial link between the MMR vaccine and autism, was struck off the U.K. medical register —essentially, he lost his license. The author of the infamous 1998 Lancet paper retracted earlier this year by the publication, Wakefield is also known for his inappropriate attempts to prove his hypothesis: At one time, he even bragged about subjecting children at his son's birthday party to blood tests and paying them 5 pounds a pop. He is also said to have conducted other invasive procedures on children that he wasn't qualified to perform, without proper ethical approval. The General Medical Council said that he had "callous disregard for the distress and pain the children might suffer."

Over the last decade, Wakefield has been named a hero by several autism groups and endorsed by former Playboy Playmate Jenny McCarthy. But rather than making him a pariah, last week's decision seems only to serve as further fuel for him to plug his conspiracy stories as he travels around the United States promoting his new book Callous Disregard. The man is said to be responsible for a sharp reduction in the number of children being inoculated for MMR, allowing the number of measles cases in the United Kingdom to soar to more than 1,300 in 2008, compared with 56 in 1998. It is deeply troubling that Wakefield's new book rocketed into Amazon's list of best-selling parenting titles.

But although it made him famous, the MMR-autism link was not Wakefield's first attempt to connect the vaccine with chronic health problems. Since 1989, he has tried desperately to convince the world of several theories involving the measles virus, measles vaccine, and the MMR vaccine—all of which have now been scientifically disproven.

So where did it all begin? After qualifying from St. Mary's Hospital at the University of London in 1981, Wakefield specialized in surgery and worked in intestine transplant surgery for a few years. However, he decided to move into research and focused on Crohn's disease, a chronic and severe inflammatory disorder of the bowel. Its cause remains a mystery, but in the late 1980s, Wakefield announced he had discovered that the root of Crohn's disease was the measles virus.

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In 1993, in a paper published in the Journal of Medical Virology, Wakefield said that his analysis showed that 13 out of 15 histological intestinal tissue samples from patients with Crohn's were positive for the RNA of the measles virus. From this he proposed that the measles virus may have caused Crohn's in those patients. Wakefield continued to publish papers to this effect in the Lancet and elsewhere. By 1995, his claims had evolved. He now argued that the measles virus and measles vaccinations were associated with not only Crohn's but also ulcerative colitis, another serious and chronic inflammatory disease of the large intestine and rectum.

Karel Geboes, a professor in pathology from Belgium, was never convinced by the strength of Wakefield's studies in this field and said that he "over-interpreted" his findings: "He is not a pathologist but a surgeon. … His claim was too rigorous, and there was no real proof for the hypothesis. It is not enough to find viral material—there are plenty of studies showing the presence of microorganisms." Finding microorganisms doesn't mean that they caused the disease in question.

Meanwhile, Wakefield seemed to have become a regular at the patent office. In 1996, he filed for a patent for a method of diagnosing Crohn's or ulcerative colitis by detection of the measles virus—and he applied for the patent under his home address rather than his institute's address. That is just "bizarre behavior," says Tom MacDonald, dean of research and professor of immunology at Barts and the London School of Medicine and Dentistry.

A year later he would patent a "safer" measles vaccine; though this was just a year before his MMR-autism paper was published in the Lancet, he did not declare this patent in his conflicts of interest to the editors of the publication. By this point, Wakefield had begun to propose that the MMR vaccine and its three virus strains put pressure on the body's immune system, which resulted in the development of Crohn's or ulcerative colitis. If the Department of Health listened to him and took MMR off the shelves, his new patent and vaccine could have been very profitable.

Wakefield kept quite busy in addition to his studies on Crohn's. In two decades, his work has been published in gastroenterology, rheumatology virology, dermatology, and urology journals. His studies included ferret, pig, and rat models. He conducted biotechnology studies, liver studies, and even looked at the effects of smoking and the contraceptive pill on Crohn's disease; an unusual array of work for one researcher. Wakefield was desperately trying to make his name in research, and it didn't seem to matter what field it was in.

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