Pressure mounts for inquiry into MMR furore

Pressure was mounting this week for a full inquiry after the revelation that the lead investigator in a controversial UK study on alleged links between autism, bowel disease, and the measles, mumps, and rubella (MMR) vaccine had failed to disclose that he was also carrying out investigations for lawyers hoping to sue over vaccine damage.

Andrew Wakefield's study of 12 children, published in the Lancet (1998;351: 637), provoked a huge media controversy that was followed by a substantial fall-off in the percentage of children given the triple vaccine.

Last week the Lancet's editor, Richard Horton, said he would not have published the paper had he known that Dr Wakefield had a contract for up to £55 000 ($102 700; €81 800) from the legal aid board (now the legal services commission) to carry out tests on 10 children for a group action against vaccine manufacturers. Dr Wakefield admitted that at least four, possibly five, of the children featured in both studies.

Dr Wakefield said in a statement that the two studies had been quite separate. The Lancet study was a clinical investigation; only the study funded by the legal aid board—looking at whether the measles virus was present in the children's intestinal tissue—had been designed to explore the issue of causation.

The health secretary, John Reid, called for an inquiry by the General Medical Council “as a matter of urgency.” A GMC spokeswoman said the council had spoken to Dr Wakefield, who was happy to cooperate with any investigation.

But Evan Harris, a liberal democrat MP who sits on both the BMA's ethics committee and the House of Commons science and technology committee, said that a GMC inquiry would not go far enough. “There needs to be a wider inquiry. The GMC can only hear existing allegations against medically qualified people. There may be people who have made errors who are not legally qualified and there may need to be recommendations as to research ethics in the future.”

The furore was sparked by a Sunday Times investigation (22 February, pp 1, 12, 13) which also cast doubt on whether research ethics approval had been properly granted for the study, carried out at the Royal Free Hospital in London, which subjected autistic children to such invasive procedures as lumbar puncture and ileocolonoscopy.

The Royal Free and University College Medical School and the Royal Free Hampstead NHS Trust said in a statement: “We are entirely satisfied that the investigations performed on the children reported in the Lancet paper had been subjected to appropriate and rigorous ethical scrutiny.”

The chief medical officer for England, Professor Liam Donaldson, told BBC radio's Today programme that Dr Wakefield's research had led to a loss of confidence in a vaccine that had saved millions of children's lives.

“We have always thought that Dr Wakefield's original study was poor science, but it is not just us that thought that. Individual experts and individual medical bodies around the world criticised it,” he added.

The legal services commission withdrew funding for the MMR group action last year (BMJ 2003;327: 640), announcing at the same time that it would no longer fund research for litigation purposes. (See p 528.)

Correspondence about research ethics approval at the Royal Free Hospital is on the website of Brian Deer, who wrote the Sunday Times article, at http://briandeer.com/mmr/royal-free-index.htm