In 1998, a landmark study was published in the medical journal The Lancet. It was the first major research that suggested a link between the measles-mumps-rubella (MMR) vaccine and autism. Almost immediately following publication, the rates of vaccination plummeted and the incidence of measles escalated among children. Since then, the subject has been the source of much controversy, and much of the science has been disproved in other research. Now, the original journal admits it may have made a mistake in publishing the research in the first place.

Recently, the United Kingdom’s General Medical Council (GMC) determined that several elements of the original publication “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children,” authored by Dr. Andrew Wakefield, are incorrect. Specifically, the GMC found evidence that the authors did not receive the necessary ethical approval for the investigation and they misrepresented the children’s diseases. The GMC issued a startling reprimand that asserted Dr. Wakefield and colleagues showed a “callous disregard” for children and acted “dishonestly” when conducting the research. It turns out that Dr. Wakefield was being paid by a group of parents who believed their children had been harmed by the MMR vaccine. Dr. Wakefield insists that he was motivated by a genuine concern for the welfare of the children.

The original research involved 12 children ranging in age from 3 to 10 years. Eleven of them were boys. Parents of 8 of the children linked the MMR vaccine to the onset of behavioral symptoms associated with autism, psychosis, or encephalitis. The authors concluded that the exposure to the MMR vaccine could not be ruled out as a cause for developmental regression in previously normal children. In 2004, The Lancet issued a partial retraction of the research, but argued they were right to publish the research to promote new ideas and new ways of thinking. In doing so, they sparked a decade of intense controversy and a decline in vaccination rates around the developed world. Now, The Lancet goes further and fully retracts the paper from its published record. Hindsight has led them to rethink their original motives.

No one yet knows exactly what causes autism, or any of the related spectrum of disorders. There is strong evidence for a genetic link, but environmental exposure to toxins cannot be ruled out. New reports of exposure to known mutagens and environmental risk factors before conception appear to be related to an increased risk for autism. A new hypothesis claims that living in urban areas, at higher altitudes, or with high levels of precipitation may decrease sun exposure, increase risk for Vitamin D deficiency, and, therefore, increase the risk for autism. Until large-scale, ethically-compliant, scientifically-sound research in confirmed, the causes and implications of autism will never be known. Until then, everyone should take heed not to believe everything they read — even in prestigious medical journals.

References

Herbert MR (2010). Contributions of the environment and environmentally vulnerable physiology to autism spectrum disorders. Current opinion in neurology PMID: 20087183

Kinney, D., Barch, D., Chayka, B., Napoleon, S., & Munir, K. (2010). Environmental risk factors for autism: Do they help cause de novo genetic mutations that contribute to the disorder? Medical Hypotheses, 74 (1), 102-106 DOI: 10.1016/j.mehy.2009.07.052

WAKEFIELD, A., MURCH, S., ANTHONY, A., LINNELL, J., CASSON, D., MALIK, M., BERELOWITZ, M., DHILLON, A., THOMSON, M., & HARVEY, P. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children The Lancet, 351 (9103), 637-641 DOI: 10.1016/S0140-6736(97)11096-0

Retraction – Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet.

WAKEFIELD, A., MURCH, S., ANTHONY, A., LINNELL, J., CASSON, D., MALIK, M., BERELOWITZ, M., DHILLON, A., THOMSON, M., & HARVEY, P. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children The Lancet, 351 (9103), 637-641 DOI: 10.1016/S0140-6736(97)11096-0