Charismatic Doctor at Vortex of Vaccine Dispute

Wakefield ran a battery of tests on William and concluded that Kessick might well be right about the MMR. He persuaded his colleagues at the Royal Free to launch a study of William and 11 other autistic children with similar disorders.

They published their findings in the Lancet in February 1998. In the article, they noted that most of the parents claimed their children's development had regressed within days or weeks of receiving the triple jab. The study itself drew no conclusion except that further investigation was needed. Still, Horton, the editor, was sufficiently uncertain about the findings that he commissioned a critical commentary that ran in the same issue.

But at a press conference announcing the report, Wakefield went a major step beyond what the study said. Asked about the MMR, he told reporters there was "sufficient concern in my own mind" that he would recommend children only receive individual vaccine injections -- not triple jabs -- until the matter was resolved.

One of his colleagues on the paper, pediatric gastroenterologist Simon Murch, immediately jumped in to insist that Wakefield was mistaken. "If this precipitates a scare and immunization rates go down," Murch warned, "as sure as night follows day, measles will return and children will die."

Murch proved to be right. Wakefield's remarks were highlighted in front-page headlines here the next day. The British public, which has grown increasingly suspicious of the medical establishment and the government after outbreaks of mad cow and foot-and-mouth disease, took notice.

By 2003 the MMR vaccination rate had fallen to 79 percent -- well below the 95 percent level experts say is needed to eradicate measles in the general population. Last year, British health officials reported 442 cases of measles, more than three times the number in 1996.

Career Turning Point

Wakefield went on to publish a series of papers seeking to reinforce his thesis and saying that he and other researchers had discovered measles viruses in the bowels of autism victims. In 2001 he co-authored a paper called "Through a Glass Darkly" contending that the MMR vaccine had been introduced without thorough safety tests.

But other researchers were failing to reproduce his results and various epidemiological studies of large, controlled populations failed to uncover a link between MMR and autism. The Institute of Medicine in Washington, part of the National Academy of Sciences, has compiled 14 large-scale studies in the United States, Canada and Europe that all exonerate the vaccine. Wakefield suggests each study has been flawed either because of its methodology or because its authors massaged the findings to get the answers they sought.

David Salisbury, head of Britain's national immunization program, said he understands why Wakefield's views gained traction with the public. "Unfortunately we have a long tradition of vaccine scares in this country," he said in an interview, "and people no longer accept the rather patronizing 'Do as I say because I'm the doctor.'"

Still, says Salisbury, the MMR has passed every test. "It's now been looked at by studies from numerous industrialized countries conducted in many different ways and they all come to the same conclusion -- we can find no evidence of an MMR-autism link," he said.

Britain's health service has refused to provide the more expensive single jabs Wakefield had recommended, arguing there was no reason to believe single vaccines would be less likely to cause an adverse reaction than the triple jab, and that by dragging out vaccinations over two years, fewer children would get the full series and many would be left exposed for longer periods. Those who want single jabs must go to private doctors and pay up to $300 per shot, whereas the MMR is free.

Sometimes the authorities have been heavy-handed. Some children whose parents refused to have them vaccinated have been struck off patients' lists at local clinics. When one local general practitioner started offering patients single jabs, the authorities hauled him before the General Medical Council and threatened to take away his license. The council dismissed the case.

Last fall the quasi-official Legal Services Commission pulled the plug on funding the legal case of Kessick and nearly 1,000 other plaintiffs on grounds the case was likely to fail. After spending about $26 million on research and other preparation, the commission declared, "There remains no acceptance within the worldwide medical authorities that MMR causes the symptoms seen in the children involved in this action."

Wakefield said his funding and responsibilities were curtailed to the point that in 2001 he left the Royal Free. He now gets most of his funding from Visceral, a nonprofit research group he set up in 1994.