This is part 2 of a series of blog posts about Andrew Wakefield's 1998 Lancet paper (now retracted), which turned out to be a hoax. The fatally flawed paper claiming vaccines cause autism was retracted in 2010, 12 years later.
What was even the point?
The primary goal of the tests ordered by Wakefield was apparently to find evidence of measles vaccine contained in the children's gut. The idea was that the children suffered from invisible, persistent measles infections inside their digestive system that was causing their autistic tendencies to manifest. He further posited that this measles infection was caused by administration of childhood vaccines. In the MMR (Measles, Mumps, Rubella) vaccine, a live but weakened form of the measles virus is administered. Wakefield's idea was that this weakened measles virus was wreaking havoc on the children and he sought to prove his theory correct.
An Invasive, Traumatic Testing Regime
From July 1996 to February 1997, twelve autistic children underwent testing for what ended up being Andrew Wakefield's 1998 Lancet paper (now retracted). Eleven of his subjects were boys. The children ranged in age from two to nine years old. Bear in mind that these are autistic kids so any disruption of routine is traumatic. The children were brought to London. None lived in London. They came from all over the U.K., including an island in the English Channel. One child came from the bay area in the U.S.
Here is a summary of the unnecessary, terrifying and painful tests they were submitted to:
1. Fluid extraction (spinal fluid, blood, urine). The autistic children were forced to give multiple blood, urine and spinal fluid samples. According to reporter Brian Deer (see video below), the blood testing required three people to hold the child down so that blood could be drawn. Imagine the resultant screaming of these autistic children echoing through the hospital.
2. Orifice probing. Each of the autistic children was rendered unconscious and subjected to extensive, invasive digestive system scoping, including ileocolonoscopy (a deeper, more risky version of the standard colonoscopy) and upper endoscopy (where the tube is fed down through the mouth/esophagus). Tissues were removed for testing at each diagnostic procedure.
3. Forced feeding. As part of the series of tests, autistic children were forced to ingest (a) barium meal, a white salt that shows up on x-rays, (b) vitamin B12 mixed with a radioactive substance.
4. Fear and boredom. The autistic children were somehow forced to submit to numerous scans, including x-rays of the digestive system, MRI scans of the brain and EEG testing of brain activity.
Here's just a bit of an example of what Child 4 (age 9) went through: The child cried unconsolably and fought with nurses throughout the battery of tests ordered by Wakefield. Blood was found in his stool. When Child 4 refused to drink the chalky drink required for a barium meal, they tried holding him down and using a syringe but the child fought it. A nose tube also proved fruitless. They decided to sedate the child but then changed their minds and gave up. Child 4 had to do EEG and MRI under sedation. (this is all summarized from Deer, 2020, page 72-3).
See Brian Deer, the reporter who exposed Andrew Wakefield, discuss the terrible testing regime these children underwent:
Andrew Wakefield's License to Practice Medicine Revoked
A panel was convened by the General Medical Council (GMC) to investigate misconduct by Wakefield and two of his associates (Professor John Walker-Smith and Professor Simon Murch). The panel heard evidence for an astonishing 148 days over a 2.5 year period. Evidence in the case came from 36 witnesses as well as examination and cross-examination of the three doctors under investigation. During this time the panel sought to avoid being influenced by the press and they ignored any information about whether vaccines cause autism. They were instead focused on the professional conduct of the three doctors.
The GMC finding was that Andrew Wakefield acted in an irresponsible and dishonest way. They found that Wakefield lacked both the credentials and the proper approvals to carry out such tests. Additionally, they found that Andrew Wakefield consistently acted against the best interests of the children being studied. As a result, the GMC revoked Andrew Wakefield's license to practice medicine.
Parting thoughts
Andrew Wakefield got away this horrendous testing in large part because no one was watching. There was no adult in the room. Going forward, research institutions must be more sensitive to the cost for participants in terms of time, trauma, risk, etc. In this case, all of the tests ordered were fairly standard but they became extreme because of (a) the sheer number of them and (b) the young age and mental condition (autism) of the participants. All of these factors must be taken into account. The Royal Free Hospital in London may say that Wakefield deviated from the approved protocol but the reality they must face is that they allowed it to occur. All of the resources used were theirs. Wakefield was their doctor. The hospital itself is also culpable.
About the author
Aaron Charlton, PhD is a science and medical blogger and entrepreneur. He writes for Away Clinic and other medical clients. He also maintains a website called OpenMKT.org that is aimed at improving transparency and quality of scientific research within the field of marketing. He is sometimes quoted by the media on matters of scientific integrity.