Andrew Wakefield, the doctor who suggested the MMR vaccine might cause autism, leading to a collapse in immunisation levels nationwide, "showed a callous disregard" for the suffering of children and "abused his position of trust" during the conduct of his research, a disciplinary panel ruled yesterday.
He took blood samples from children at his son's birthday party in return for payments of £5 and later joked about it in a presentation in the US in a manner that brought the medical profession "into disrepute", the panel found. The blood was used in research, published in The Lancet in February 1998, that suggested a link between the MMR vaccine, bowel disease and autism.
The verdict was delivered by the General Medical Council, the doctors' disciplinary body, after the longest hearing in its history lasting two and a half years. But it was rejected by supporters of Dr Wakefield, who heckled panel chairman Dr Surendra Kumar as he delivered the ruling at the GMC's headquarters in London.
One woman shouted: "These doctors have not failed our children. You are outrageous," and accused the GMC of being a "kangaroo court".
The GMC panel further found that Dr Wakefield acted "dishonestly" and was "misleading" and "irresponsible" in the way he described The Lancet study, which triggered the scare. He failed to state that the children were "part of a project to investigate a postulated new syndrome", many of whom he had "actively recruited." He also failed to disclose that he had applied for a patent on a single measles vaccine nine months before publication of The Lancet paper, which the panel found was "contrary to his duties" as its senior author.
The findings will not help to resolve the MMR controversy but are certain to generate renewed interest. The panel said it was "not concerned with whether there is or might be any link between the MMR vaccination and autism". It focused exclusively on the "conduct, duties and responsibility" of the doctors involved in the research.
Two colleagues of Dr Wakefield – Professors John Walker-Smith and Simon Murch – were also charged. All three were found to have subjected children to invasive investigations, including painful lumbar punctures (of the spinal cord) and colonoscopies (explorations of the bowel), which were "not clinically indicated" but which lacked Ethics Committee approval for research, because they did not meet the criteria for the trial.
Dr Wakefield was not present to hear the verdicts but later appeared outside the GMC, in front of placard-waving supporters. He said he was "extremely disappointed" at the findings and "dismayed" that two of his colleagues had been "dragged through this process". "The allegations against me and against my colleagues are both unfounded and unjust – and I invite anyone to examine the contents of these proceedings and come to their own conclusion."
The panel found that Dr Wakefield received £55,000 in funding from the Legal Aid Board but failed to disclose that some of the costs of conducting the study would have been met by the NHS, which it said was "dishonest". It added that he had "breached [his] duty in managing finances."
Following publication of The Lancet study, vaccination rates against MMR plunged and have never fully recovered. They stood at 91 per cent in 1997-98 and slipped to 79 per cent in 2003-4 and lower, to less than 50 per cent, in parts of London. National rates have since recovered to 85 per cent, but hundreds of thousands of children remain unprotected from the diseases and cases of measles have soared.
Delivering the GMC's findings, Dr Kumar said of Dr Wakefield's conduct in taking blood from his son's friends at a birthday party: "Despite your explanation that you did not consider it unethical to obtain blood in this way, the panel found that it was unethical and that you did not have ethical approval for such an undertaking."
Dr Evan Harris, Liberal MP whose complaint led to the GMC investigation, said yesterday: "That the GMC has found Wakefield guilty of unapproved and unnecessary invasive tests on young children is the most damning indictment possible. The findings of failure to declare financial interest are a secondary consideration."
The GMC will now consider whether the facts proved against Dr Wakefield and his colleagues amount to serious professional misconduct and what sanction, if any, to apply. The final verdict is expected in the spring.
Before the ruling, 12 organisations, including the Medical Research Council, the British Medical Association and the Faculty of Public Health, released a statement re-affirming their commitment to the triple MMR vaccine.
Timeline: From scare to disgrace
28 February 1998 Andrew Wakefield and 12 colleagues from the Royal Free Hospital, London, publish research in The Lancet linking the MMR vaccine with bowel disease and autism.
27 February 1998 The day before the Lancet paper is published, Dr Wakefield recommends parents give single vaccines for MMR to their children.
March 1998 A panel of 37 experts set up by the Medical Research Council says there is "no evidence to indicate any link" between the MMR vaccine and bowel disease or autism in children.
February 2001 The British Medical Journal says the MMR vaccine cannot account for the soaring rate of autism.
2001 Dr Wakefield moves to America with his wife and four children.
2003 National vaccination rates against MMR slump to 79 per cent (from 91 per cent before 1997) and to less than 50 per cent in parts of London.
2004 The Lancet announces a partial retraction of Wakefield's paper after discovering he had received £55,000 from the Legal Aid Board for research to support legal action by parents who claimed their children had been harmed by MMR. Ten of the 13 authors of the original paper disown it.
July 2007 The GMC case against Wakefield and two of his colleagues begins.
January 2010 Preliminary verdicts on the "facts" of the case are expected at the end of the month. Final verdicts are expected by June 2010.