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What happens to doctors who don't play ...

Sun, 9 Dec 2001 21:26:08 -0800

MMR Vaccination - Andrew Wakefield, M.D.
What happens to doctors who don't play ...
"What matters most of all is what happens to these children."
Andrew Wakefield, M.D. -
Sunday 2 December 2001

Anti-MMR doctor is forced out By Lorraine Fraser, Medical Correspondent
(Filed: 02/12/2001)

THE specialist who first raised concerns about the safety of MMR vaccinations has been forced out of his job, The Telegraph can reveal. Andrew Wakefield, a consultant gastroenterologist whose research has linked the vaccine to autism and bowel disease in children, said last night that he had been asked to resign because of his work.

"I have been asked to go because my research results are unpopular," said Dr Wakefield, an academic at the Royal Free Hospital Medical School in London whose research into the triple measles, mumps and rubella vaccination has caused controversy.

"I did not wish to leave but I have agreed to stand down in the hope that my going will take the political pressure off my colleagues and allow them to get on with the job of looking after the many sick children we have seen. "They have not sacked me. They cannot; I have not done anything wrong. I have no intention of stopping my investigations."

He has been testing the theory that measles virus from MMR vaccine can colonise the bowel of susceptible children, producing inflammatory bowel disease, which then, via a disruption of the chemical balance in the body and the brain, leads to autism.

Although the specialist admits he has not published proof, he has infuriated ministers by suggesting that the three component vaccines should be given separately.

Dr Wakefield's departure comes a month after he was made a Fellow of the Royal College of Pathologists in recognition of his research work.

He left his �50,000 job on Friday after 14 years having been told that his ideas were "unwelcome" at University College London, which controls the Royal Free.

The news will please vaccination programme officials in the Public Health Laboratory Service. They have ridiculed his research and still insist that MMR, recommended officially for every child at around 13 months and again at four years, is safe.
He added last night: "I am very concerned that I have been unable to gain any guarantee from the hospital that the children we have already seen, and who need to be seen, will be looked after".

Parents of autistic children involved in his research expressed their anger last night. Some demanded reassurances that the Royal Free Hospital will continue treating their children. Dr Wakefield's research has made him a pariah of the medical establishment. As a result, the World Health Organisation felt obliged to announce its support of the MMR vaccine.

The Government has played down concerns since he published a paper in The Lancet in 1998, reporting that he and colleagues had identified a hitherto unknown combination of bowel damage and autism in children whose parents said their previously normal children fell ill after MMR. The row became a crisis last January when Dr Wakefield told The Telegraph that he had seen almost 170 children with a similar story and claimed that the Department of Health's contention that MMR had been proven to be safe did not "hold up".

That number, has now reached almost 200. Pressure on the children's gastroenterology unit is so great that it's waiting list risks breaking the NHS's 18-month limit. Parents have appealed to Tony Blair to give it more funds.

The Royal Free Hospital Medical School was unavailable for comment last night.

Parents left stunned as MMR doctor is forced out (Filed: 02/12/2001)

The specialist who linked autism and bowel disease with the combined vaccine has been treated shabbily, say his supporters. Lorraine Fraser reports.

THE departure from the Royal Free Hospital in London of Andrew Wakefield, the doctor who first raised doubts about the safety of the childhood MMR vaccination, will delight his opponents in the Department of Health, but it has devastated the parents of the 200 children he has studied. Rosemary Kessick, whose 13-year-old autistic son, William, was one of the first Dr Wakefield examined in his research into the links between autism, bowel disease and MMR, said: "What people fail to realise is that Andrew Wakefield did not go looking for us.

"We parents went looking for him because we were convinced, and we were right, that our children had bowel problems and these were somehow related to their autism. He has stood by us and as a result he has been treated very shabbily."

There are hundreds of children with symptoms of the new combined syndrome, such as severe abdominal pain, loss of language and extreme behaviour. In addition to the 200 being cared for by staff at the hospital's department of paediatric gastroenterology, another 150 are currently on a waiting list that stretches to 2003.

The service is so overwhelmed that some of the worried parents met officials from Tony Blair's office two months ago to beg him to intervene. Dr Wakefield was at that meeting, supporting the parents' plea, but last week he had finally to acknowledge that the hostility towards him inside the hospital and its medical school had made his position there untenable. He said: "I realise now that everything that has happened to me was inevitable from the beginning. If you offend the system, then the system will take its revenge."

Last night those who had heard the news were desperate for reassurance that their children would continue to be cared for by the unit, which was headed by Britain's most respected specialist in children's bowel disease, Prof John Walker-Smith, until his retirement last year.

It has an international reputation for excellence. In many cases the children's behavioural problems and learning difficulties have improved in consequence. The parents fear that without Dr Wakefield, there will be pressure on his former colleagues to stop this work.

Mrs Kessick, from Peterborough, Cambridgeshire, one of 250 parents taking legal action against the manufacturers of MMR vaccines, said: "In the end, I think, Andrew felt he had no choice but to fall on his sword to relieve the political pressure on his colleagues.

"I just hope he is correct in assuming that his absence will make it easier for the Royal Free to continue to care for all the children. My view is that there are some in positions of power there who do not want this to be the case."

Richard Miles, from west London, said that his 13-year-old son Robert's condition had improved greatly with the hospital's help. Mr Miles said: "The bottom line is that I think some of these children will die if the Royal Free stops looking after them. The team has done an absolutely tremendous job."

Ann Hewitt, from north London, whose son Thomas, eight, is severely affected and needs frequent hospital attention, said: "Irrespective of the causes of their problems these children are entitled to the best treatment and to the care and respect they deserve.

"They can shoot the messenger but these children are going to keep coming and it is essential that they continue to be looked after." When he started work at the Royal Free Hospital Medical School in 1987 Dr Wakefield was the man everyone wanted to know.

The doctor, who studied at St Mary's Hospital in west London and trained in bowel transplantation at the University of Toronto, arrived with plans to investigate the cause of two devastating inflammatory bowel diseases: Crohn's disease and ulcerative colitis.

Throughout the early 1990s his research was supported by grants worth millions from pharmaceutical companies and charities.

These began to fall away when, in 1995, he published a study suggesting that measles vaccination could be a risk factor for the bowel illnesses, the first warning that his research produced unpopular results.

He was unprepared, however, for the opprobrium that ensued when in 1998 he published a medical paper in The Lancet, reporting that he and his colleagues had identified a previously unknown combination of bowel disease and autism in 12 children. Bowel symptoms are common in autistic children but had until then been regarded as simply a manifestation of their behavioural problems.

The finding that these children had real and severe bowel disease was a groundbreaking discovery. Had the paper stuck to these facts alone Dr Wakefield might still be in a job. Against the advice of others in the team, however, he insisted that their joint paper record that eight parents said their previously normal child had fallen ill after receiving the MMR inoculation - a mixture of weakened but live measles, mumps and rubella virus given to a 1.5 million children a year.

The result was uproar and with each piece of research the doctor has announced since - including evidence of measles virus infection in damaged bowel tissue from some of the children - the louder the medical establishment's condemnation of him has grown.

When Dr Wakefield said in January that he had now seen 170 children with the bowel effects and autism, and that a majority of the parents involved had said their children fell ill after being given the MMR vaccine, the Department of Health's response was to launch a �3 million publicity campaign to reassure parents that it is safe.

The Department of Health said parents often first noticed signs of autism in their children around the time MMR is usually given but that did not mean the two were connected. A spokesman said: "Our view is that the triple vaccine is the safest way to protect children against three potentially serious diseases."

Yesterday Dr Wakefield said he still did not regret his decision to get involved in the MMR controversy. "Losing a London hospital teaching job doesn't do much for my CV but there are bigger issues at stake," he said. "What matters now most of all is what happens to these children."
Sunday 2 December 2001

"What matters most of all is what happens to these children."
Andrew Wakefield, M.D.