The decision by prestigious British journal The Lancet to publish a flawed study that sparked worldwide fears childhood vaccines could cause autism was the result of a "collective failure" that should never be repeated, according to the journal's editor.
The Lancet issued a formal retraction yesterday denouncing a 1998 study led by British gastroenterologist Andrew Wakefield that linked the measles, mumps and rubella vaccination with the onset of symptoms associated with autism.
"It's very clear that many statements in that paper are either dishonest or utterly misleading and so we were really very pleased we could retract the paper now," Lancet editor Richard Horton said in a telephone interview. "I think for me the major lesson is that there was a collective failure. There was a failure at the journal, there was a failure of government, there was a failure in the institutions, there was a failure amongst scientists, and everybody involved in this has lessons to learn from it."
The journal faced harsh criticism from members of the medical community who say editors should have retracted the paper years ago, after flawed research methods, serious conflicts of interest and ethics breaches came to light.
"It was a very poor study right from the start, even before these ethical allegations were first brought up," said Brian Ward, associate director of the Research Institute at McGill University Health Centre. "But the bottom line is they published a paper that never should have been published on its scientific merits because it was sexy."
In the study, Dr. Wakefield and researchers said they identified a group of children who were suffering chronic gastrointestinal problems in conjunction with behavioural problems, including loss of language skills after receiving the MMR vaccine. The hypothesis was that the vaccine led to gastrointestinal problems that somehow triggered autism.
The study seemed to lend scientific authority to those who claimed that vaccinations cause harm. But it was later revealed the parents of many of the children involved in the study were involved in a lawsuit against vaccine manufacturers. In addition, although research suggests children with autism may be more prone to gastrointestinal problems, no large, credible studies have been able to replicate Dr. Wakefield's findings.
The retraction comes days after a British panel, the General Medical Council, found that Dr. Wakefield conducted his research dishonestly and irresponsibly and lacked regard for children by performing invasive tests. The panel may decide on disciplinary actions in the months to come. In 2004, nearly all of Dr. Wakefield's collaborators distanced themselves from the findings.
But the paper and subsequent comments by Dr. Wakefield that parents should seek single vaccines for their children instead of the combined MMR vaccine resulted in a significant decline in the number of children being vaccinated, particularly in Britain and a subsequent spike in those childhood diseases.
While many members of the medical community hope the retraction could help end the debate over vaccines and autism and quell the growing anti-vaccination movement, Dr. Wakefield's work seems destined to live on.
The Autism Canada Foundation said The Lancet's retraction is a "tangential issue" in the larger picture of determining what role environmental elements, such as vaccines, could play in the development of symptoms.
"From Autism Canada's stance, no stone should be left unturned in understanding this disorder, which is affecting more children, youths and adults yearly," executive director Laurie Mawlam wrote in an e-mail.
Fiona Godlee, editor of the British Medical Journal, said in an interview yesterday (Tuesday) that "no good evidence" of an association between vaccines and autism exists.
Most medical experts agree Dr. Wakefield's paper, which helped to fuel the debate, was riddled with serious problems:
- The study group only involved 12 children
- It was later revealed that Dr. Wakefield was getting paid by lawyers mounting a lawsuit against vaccine manufacturers, and that some of the children involved in his study were also involved in the lawsuit.
- Researchers didn't find a link between MMR vaccine, gastrointestinal problems and behavioural problems. Rather, parents told the researchers they remember their child's symptoms emerging after they received the vaccine.