Charismatic Doctor at Vortex of Vaccine Dispute

"This is where one's career starts to go downhill," he said in a recent interview. "It's one thing to describe a new disease. But this is a case where the medical profession was wrong and the parents were right. What was I supposed to say when the parents pointed to the MMR -- 'Look, I'm terribly sorry but that's inconvenient so please go find another doctor'? "

But while Wakefield's credibility with his medical colleagues plummeted, his popularity with parents and the media continued to rise. The medical writer for the Sunday Telegraph newspaper won a British Press Award in 2002 for her coverage of Wakefield's work. Each positive story about him was promptly posted on the growing network of web sites of autism support groups.

"The media kept presenting this as a 50-50 proposition, claiming that the medical community was split down the middle on the MMR, when in fact almost all the science was on one side," said Fiona Fox, director of the Science Media Centre, which works with journalists reporting on science-related stories. "I think the public were ill-served by the media in this debate."

The government's case was not helped when Prime Minister Tony Blair, citing privacy considerations, refused to reveal whether his own son Leo, born in 2000, had received the triple jab. Blair insisted that the vaccine was safe, but parents continued to shy away.

Last December Britain's Channel Five television aired "Hear the Silence," a 90-minute docudrama that depicted the harrowing experiences of Kessick and other parents of autistic children and celebrated Wakefield's campaign on their behalf. The network organized a discussion program afterward and invited representatives from both sides to appear. Public health officials pulled out at the last minute, arguing that a debate would only lend credibility to the anti-MMR side. "We felt we'd be giving respectability to a program that was not respectable," Salisbury said.

The pullout left a handful of non-experts to make the pro-MMR argument, led by Michael Fitzpatrick, a general practitioner whose son is autistic. He says he got involved in the controversy after the mother of an autistic child told him she blamed herself for allowing her child to receive the triple jab. "What really annoyed me was Andy Wakefield setting himself up as spokesman for the parents when in fact what he was doing was visiting guilt upon many parents," said Fitzpatrick, who has just published a book, "MMR and Autism: What Parents Need to Know."

"People are anxious, they're frightened and so it's easy for many to adopt the default position and do nothing," Fitzpatrick said.

This is exactly how one mother reacted. Michelle Ellis, who was invited to listen to the arguments at the discussion program, said afterward she respected the case of the pro-MMR team but was still not willing to vaccinate her two young sons. "Statistics don't work for me here," she said.

The broadcast in many ways marked the apex of Wakefield's popularity. But while one part of the media was building him up, another was preparing to pull him down.

Last November a Sunday Times journalist who identified himself as Brian Lawrence paid a visit to Kessick's home north of London. He spent nearly six hours questioning her about William's autism, Wakefield and the entire MMR controversy. Afterward, she said, she felt like she had been grilled like a witness under cross-examination. She said that Lawrence didn't seem to believe anything she told him.

Her suspicion was not far off. "Brian Lawrence" was actually Brian Deer, a prize-winning investigative journalist with a reputation for breaking stories about the pharmaceutical industry. Deer said he used a false name -- Lawrence is actually his middle name -- because he didn't want Kessick to check his web site and find out that one of his specialties was tracking down false claims of damage from vaccines.

Parents' Court Case Suspended

Deer said he had planned to attend the trial of a major MMR lawsuit due to begin in April. When it was suspended indefinitely, he decided to launch his own probe. He found Kessick, like many of the plaintiffs, to be sympathetic people but less than reliable witnesses. He concluded that they wanted to believe MMR had caused their children's autism and that they may have bent the truth to prove it.

"I took her through her evidence as she would be asked in court," he recalls. After about several hours, he says, he told her she and the other plaintiffs could never win their case.

Wading into the huge volume of records in the case, Deer discovered something Wakefield had neglected to tell the Lancet: that the Royal Free Hospital had received some $90,000 in funding from the plaintiffs for Wakefield's help in doing a study of 10 of the victims. Four of the plaintiffs, including William Kessick, were among the dozen patients included in the Lancet article.

Rather than showing up at the Royal Free as consecutive referrals from disinterested general practitioners, Deer alleged, the Lancet 12 had been carefully chosen to prove Wakefield's theory and help lend credence to the lawsuit.

Wakefield insisted he had done nothing wrong -- that the Lancet study and the legal case had been kept entirely separate. But Lancet editor Horton said his former colleague should have disclosed the potential conflict before the original study was published. "If we had known the conflict of interest Dr. Wakefield had in this work, in my judgment it would have been rejected," Horton told the BBC.

A few weeks later, 10 of the 13 doctors on the original study issued a "Retraction of an interpretation" in which they declared that "no causal link was established between MMR vaccine and autism." Wakefield refused to sign.

The retraction was "absolute nonsense, just spin," he says. "There's absolutely no doubt they've been under huge pressure and it's very sad. We did discuss this in detail and I said, 'Guys, I can't sign up to this'."

Wakefield lost other allies as well. John O'Leary, an Irish microbiologist who has been one of his key collaborators, pronounced himself "shocked and disappointed" that Wakefield had not declared the potential conflict.

But Wakefield's core supporters, such as Rosemary Kessick, continue to believe in him. Robert Sawyer, chief executive of Visceral, Wakefield's research group, says donations are still coming in. But he expects to move Wakefield's research unit to Texas over the next few years. The United States, with its privatized health care system and entrepreneurial spirit is much more fertile ground than Britain for a medical pioneer like Wakefield, Sawyer said.