Researcher says choice of injection essential

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Andrew Wakefield, the doctor at the centre of the controversy over the MMR vaccine, broke his recent silence yesterday to say it was "untenable" for the Government not to offer parents a choice of jabs.

Dr Wakefield said the form of vaccination – single or triple jab – should be the choice of parents. "I strongly advocate protection of children against these diseases," he said. "It's a question of what is the safest way to do that, and my preference is for the single vaccines."

It was, he said, "untenable" to offer only the triple MMR vaccine "in the face of all the evidence".

He made the comments on the day the chief medical officer, Professor Sir Liam Donaldson, launched a fierce defence of the Government's policy of recommending the combined MMR vaccine.

Part of Dr Wakefield's evidence consists of papers co-authored by him showing that children with autism and gut disorders frequently have the measles virus in their gut. One hypothesis used to explain autism is that measles and other infections weaken the gut wall, allowing dangerous products into the blood and then to the brain, where they trigger the developmental disorder.

But Dr Wakefield added that there was still no data showing a direct link between measles, bowel disorders and autism. "This is just one part of the evidence. It will be some years before we have absolute proof, but there are reasons for anxiety," he said.

Dr Wakefield sparked the MMR controversy with a paper in The Lancet in 1998 which focused on 12 children who had gut disorders. Nine were autistic, and of those eight started to show a loss of developmental skills after the MMR jab, and one after catching measles. He suggested there might be a link and said research was needed. Instead the study and its authors attracted criticism from the medical profession – but parents picked up on it and MMR take-up began to fall.

Dr Wakefield was asked to leave his job at the Royal Free Hospital in London in March last year. At the time he said he did not want to go, but agreed to in the interest of his colleagues. Since then he has continued his research with private funding, including money from parents of autistic children and a charity called Visceral.

His latest paper, co-written with Professor John O'Leary and published in the Journal of Molecular Pathology, expanded on the initial study. It found measles DNA in the gut of 75 out of 91 children with bowel disorders, compared to five out of 44 control subjects.

Yesterday the Department of Health said it had "picked up a number of serious inconsistencies and problems in the methodology" of the paper, and a team of scientists would publish a response in a couple of weeks.

Dr Wakefield replied: "This was a proper peer-reviewed paper, independently, rigorously reviewed. They [the DoH] can send it out to their mates and get any sort of answer they like, but that doesn't change the fact that this was peer-reviewed and properly published."

Dr Wakefield was unrepentant over the furore that has developed over the triple vaccine. "There should be no discussion of measles epidemics, of deaths, because we have an alternative to the MMR," he said. "It is unsustainable on the part of the Department of Health not to offer a choice."

He said the latest research was "genuine grounds for parental concern".

"We were responding to the concerns of parents – several thousand parents saw their children develop problems, they felt, after having the vaccine – we think their fears have been substantiated, Dr Wakefield said. "The study was designed to detect the measles virus and whether it was present in the diseased intestinal tissue of children with inflammatory bowel disorder. There was a highly significant difference in the rate of measles in these children compared with the control group. The only exposure these children had had to the measles virus was in the vaccine. Most had the MMR; a few had had the single vaccine."

Asked if the single measles vaccine might also cause the disorder, he said: "Theoretically, yes, however the trend in the dramatic rise of autism in developed countries since MMR was introduced raises concerns that the combination might make the measles component behave differently."

Friends of Dr Wakefield supported him. "He's had hostility and bile from the medical, though not scientific, professions," said Dr Paul Sharrock of the autism research unit at the University of Sunderland. "They made it impossible for him to keep his job. The medical profession isn't very keen on people who break ranks."

Since leaving the Royal Free, Dr Wakefield has continued to work with former colleagues, and also with the International Child Development Research Centre in Florida, Trinity College Dublin and the Karolinska Institute in Stockholm.