On 21 November 1953, what is now Britain\u2019s Natural History Museum stunned both science and the public by calling the fraud in the case of \u201cPiltdown Man.\u201d\u00a0Fragments of fossilized jaw, skull, and tooth, unearthed shortly before World War I from gravel beds, 45 miles south of London, were not, as had been believed, the remains of an aberrant part-human, part-ape \u201cmissing link.\u201d They were an elaborate, highly motivated hoax.<\/p>\n
Today, the BMJ<\/em> calls the fraud over medicine\u2019s missing link: the research linking MMR with autism. Published in a five-page Lancet paper in February 1998, it triggered media campaigns which sent vaccination rates plummeting,\u00a0 and caused the most intractable health alarm in a generation. The paper claimed that in two thirds of 12 consecutive child patients with \u201cregressive developmental disorder\u201d and enterocolitis, attending one London hospital\u2019s paediatric gastroentreology clinic, the \u201capparent precipitating event\u201d was a measles, mumps, and rubella vaccine, with a temporal link between shot and symptoms of 14 days.<\/p>\n At first, the comparison may feel disconcerting. The Piltdown scandal lay in fossils, while the MMR scare rested on the status of young children.\u00a0 But the parallels are striking.\u00a0 The modus operandi was essentially the same: the dishonest representation of pre-assembled artifacts.\u00a0 The dramatis personae, meanwhile, were similar in their conduct: they contrived, or they were duped, or they failed to act.<\/p>\n This week, the BMJ<\/em> begins a series which lays bare the MMR scandal in detail never published before.\u00a0 Drawing on interviews, documents, and properly obtained data, collected during seven years of inquiries,\u00a0we show how one man, former gastroenterology researcher Andrew Wakefield, was able to manufacture the appearance of a purported medical syndrome, whilst not only in receipt of large sums of money, but also scheming businesses that promised him more.\u00a0 His was a fraud, moreover, of more than academic vanity.\u00a0 It unleashed fear, parental guilt, costly government intervention, and outbreaks of infectious disease.<\/p>\n The Piltdown contrivance involved the pre-arranged \u201cdiscovery\u201d of features brought together to be sensationally \u201cfound.\u201d A piece of skullcap was human, a partial jaw was an orangutan\u2019s, and a tooth was a chimpanzee\u2019s, filed down.\u00a0They were stained with chemicals and, to fabricate a temporal link, were buried with flint tools in datable gravel near the tiny village of Piltdown, East Sussex.<\/p>\n Some would suggest that their proximity was a matter of chance, but the odds of this would have taxed an astronomer.\u00a0\u201cThat two different individuals were present,\u201d one of the scientists who unmasked the fraud explained later, \u201ca fossil man, represented by a cranium without a jaw, and a fossil ape, represented by a jaw without a cranium, within a few feet of each other and so similar in colour and preservation, would be a coincidence, amazing beyond belief.\u201d<\/p>\n And so it was with Wakefield, eight decades after the Piltdown discoveries.\u00a0Amazing beyond belief.\u00a0 For skullcap read \u201cdevelopmental disorders,\u201d for the jaw \u201centerocolitis,\u201d and for the tooth \u201cparental complaints about MMR.\u201d\u00a0Bring them together at one hospital, with a 14-day temporal link, and another assemblage was \u201cfound.\u201d<\/p>\n \u201cOnset of behavioural symptoms was associated by the parents with measles, mumps, and rubella vaccination in eight of the 12 children,\u201d declared the Lancet paper\u2019s \u201cfindings\u201d section. \u201cIn these eight children the average interval from exposure to first behavioural symptoms was 6.3 days (range 1-14),\u201d added a \u201cresults\u201d narrative, which adopted the \u201cfindings\u201d as fact.\u00a0 \u201cInterpretation. We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.\u201d<\/p>\n So how was it done?\u00a0 For a decade this remained hidden in the children\u2019s hospital and general practice records.\u00a0 Only when public uproar over my first Sunday Times MMR reports led to the retraction of the paper\u2019s \u201cinterpretation\u201d section in March 2004,\u00a0 and the UK General Medical Council invoked its formidable powers under the 1983 Medical Act, were they brought to light at a fitness to practise hearing. That hearing was the longest ever, running 217 days between July 2007 and May 2010.<\/p>\n Some elements behind the scam were already known, as a result of\u00a0 my continuing investigation.\u00a0 Two years before the paper, Wakefield had been retained by a high street solicitor, hoping to raise a \u201cclass action\u201d lawsuit over MMR.\u00a0 The doctor was contracted to be paid at the extraordinary rate of \u00a3150 an hour, grossing him \u00a3435,643, plus expenses.\u00a0 This was six times his reported annual salary as a non-clinical researcher at the Royal Free medical school, London.<\/p>\n I also revealed – years after the paper\u2019s publication – that the children\u2019s parents were seeking compensation.\u00a0 They were mostly clients and contacts of the solicitor, based in Norfolk, and had come to the Royal Free precisely to blame MMR, wanting Wakefield to help their children and their claims.\u00a0 This was not, as the profession and the public had thought, merely a snapshot from a large hospital\u2019s case load.\u00a0 The \u201cfinding\u201d of complaints about the vaccine was pre-ordained.<\/p>\n And this was only the start of the fix.<\/p>\n It took the GMC\u2019s lawyers to drill deeper into the material.\u00a0 Who were these 12 families? What was wrong with these children? Why were they admitted to the Royal Free? The answers tumbled out over 197 days of open sessions, focused on Wakefield and his senior colleague, John Walker-Smith.\u00a0 In the end, they were struck off,\u00a0 but only after the laying down of bitter truths, in immense detail, for the public record.<\/p>\n None of the families were from anywhere near London, and one\u00a0 had flown in from California.\u00a0 They had been targeted, pre-selected for the children\u2019s symptoms.\u00a0 And when Wakefield\u2019s research failed to show the \u201cnew syndrome\u201d he was contracted by the solicitor to find, the results were \u201creviewed,\u201d changed, and misreported in the Lancet – such that in not one of the 12 children\u2019s cases can the Royal Free\u2019s paper be reconciled with National Health Service records.<\/p>\n Scholars still debate the identity of the Piltdown cheat, although most agree it was an amateur fossil hunter, Charles Dawson. In the MMR case, it was plainly Wakefield, with no evidence that even the lawyer knew what was happening.\u00a0 As reported in my feature this week<\/a>, Wakefield took clinical records and reinterpreted them to suit himself, chiseling histories and reaching clinical diagnoses not in the files.\u00a0 He reported unremarkable bowel histology as \u201cnon-specific colitis.\u201d And he concealed the source and status of the children.<\/p>\n “In reaching its decision,\u201d the five-member GMC tribunal ruled in January 2010, among dozens of proven findings, \u201cthe panel notes that the project reported in the Lancet paper was established with the purpose to investigate a postulated new syndrome and yet the Lancet paper did not describe this fact at all. Because you [Wakefield] drafted and wrote the final version of the paper, and omitted correct information about the purpose of the study or the patient population, the panel is satisfied that your conduct was irresponsible and dishonest.”<\/p>\n This was one of four charges of dishonesty found proven – to an onerous criminal standard of sureness.\u00a0 Another was dishonest misuse of legal aid money obtained by Wakefield to pay for the study. Two more were counts of dishonesty when responding to doctors, including a Medical Research Council panel, who asked the critical questions: what were the sources of his funding and patients?<\/p>\n None of Wakefield\u2019s colleagues knew what was really going on, although some knew enough to be concerned.\u00a0But it would not be fair to say that he acted alone, or that the scandal was merely due to one man.\u00a0During the life of the MMR crisis, he was aided or supported by many – who themselves were generally duped. These included clinicians, research scientists, journalists, Lancet editors, hospital and medical school managers, and even the academic institution which eventually fired him.<\/p>\n Again, the anthropological hoax involved a similar story.\u00a0 The findings had rested on the most credible reputations.\u00a0 At a breathless Geological Society meeting at Burlington House, Piccadilly, in December 1912, for instance, it was the distinguished keeper of geology at the British Museum, Arthur Smith Woodward, who vouched for Piltdown Man.\u00a0 In the company of Dawson, he would personally recover fragments of the purported hominid and reputedly coined the popular phrase \u201cmissing link.\u201d<\/p>\n In the MMR fraud, the big name to be misled was Walker-Smith, professor of paediatric gastroenterology. Although he slipped off on holiday when Wakefield\u2019s findings were unveiled at a now-notorious press conference at the Royal Free, it was in part his reputation that got them published.\u00a0 \u201cHe was an important mentor in my career,\u201d David Candy, professor of paediatric gastroenterology in Chichester, who peer-reviewed the paper, told the GMC panel.\u00a0 \u201cIn a way I knew it was going to be a good paper, I knew it was going to be well written, and I knew it was going to be data that could be believed in.\u201d<\/p>\n But Walker-Smith and 11 other co-authors did not even know which child was which in the patient-anonymised text and tables of the paper.\u00a0 In February 2004, as the Lancet moved to head off my investigation – rushing out still-unretracted statements\u00a0 denying what the GMC would later prove – Walker-Smith and\u00a0 fellow co-author Simon Murch\u00a0 had to wait on Wakefield to fax them the children\u2019s names so they could pull the records in order to frame the Lancet\u2019s rebuttals.<\/p>\n And yet the Wakefield fraud had sat in plain view for six years before serious challenge.\u00a0 Journals, the BMJ<\/em> included, had fretted over epidemiology and viral studies without giving pause to the remarkable, now fully retracted,\u00a0 fundamentals.\u00a0 Did the scientific community ever really believe that 12 families had turned up consecutively at one hospital, with no reputation for developmental disorders, and make the same highly specific allegations – with a time-link of just days – and that there was not something\u00a0 fishy going on?<\/p>\n Piltdown Man offers the salutary lesson.\u00a0 Polite society could not harbour such thoughts.\u00a0 Even as the skullcap, jaw, and tooth were first laid out for public inspection before the Great War\u2019s outbreak, some among the audience were muttering fraud.\u00a0 But they were urged not to rock the establishment\u2019s boat with the implication that a gentleman could not be trusted.\u00a0 \u201cHe was a delightful colleague in scientific research,\u201d Woodward said later of the fossil-hunter Dawson.<\/p>\n \u201cWe all rely on trust,\u201d Walker-Smith told the GMC panel, in words for which he will be remembered.\u00a0 \u201cI trusted Dr Wakefield.\u201d<\/p>\n Did we all?<\/p>\n Brian Deer<\/strong> is an investigative journalist.<\/em>See also On 21 November 1953, what is now Britain\u2019s Natural History Museum stunned both science and the public by calling the fraud in the case of \u201cPiltdown Man.\u201d\u00a0Fragments of fossilized jaw, […]<\/p>\n
\nEditorial: Wakefield\u2019s article linking MMR vaccine and autism was fraudulent
\n<\/a>Feature:Secrets of the MMR scare: how the case against the MMR vaccine was fixed<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"