MMR Controversy

Abstract 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’.