Measles has gripped the UK and Europe, and is threatening to spread to the US. There are already more than 120 confirmed cases across the UK, with an outbreak on the continent striking down more than 10,000 people. Around 34 people, including eight in Ukraine, have tragically died from the disease.
Most of the victims are children and young people, with many experts putting its rapid spread down to false claims linking the MMR (measles, mumps and rubella) vaccine to autism, as well as a general mistrust of vaccinations among so-called anti-vaxxers. Many parents are afraid of the ingredients in vaccines, a fear exacerbated by a combination of ignorance and the spread of false information.
Contrary to many people’s early expectations of an ‘information superhighway’ – expectations that are now long left in the dust – the internet has become a breeding ground for inaccurate pseudoscience, false claims and an apparent contempt for experts. The anti-vaccination movement, far from dying out once the claims upon which it is based were disproved, is going from strength to strength thanks to persistent social media campaigns that prey on people’s fears and innate desire to do what they think is the best for their children.
This is particularly notable given that the ‘science’ upon which anti-vaxxer claims are based has been repeatedly, conclusively, feverishly disproven. One of the most notorious examples of this is the study that originally linked the MMR jab to autism in the 1990s – authored by the now-former doctor, Andrew Wakefield.
In 1993, Wakefield first published studies drawing a positive link between the MMR vaccine and the gastrointestinal disease Crohn’s. While conducting further research into Crohn’s in 1995, he was approached by the mother of a child with autism asking for help with her son’s bowel problems. The following year, Wakefield started focusing on finding a link between the MMR vaccine and autism.
In 1998 Wakefield’s claims about Crohn’s disease were disproven by a number of experts who were reviewing peer-reviewed studies – they found that measles didn’t cause Crohn’s disease, and neither did the MMR jab. However, in February that same year Wakefield published his paper in respected medical journal The Lancet linking the MMR vaccine to both gastrointestinal disease and autism. In subsequent campaigns, Wakefield pushed for the reintroduction of the single-jab vaccine.
The controversial claims were immediately treated with suspicion by members of the medical community – but even so, they led to a widespread international resurgence of the anti-vax movement, with many parents terrified that the jab could, perversely, end up harming their children more than it helped them.
But six years later, in 2004, reporter Brian Deer uncovered a number of issues and concerns with Wakefield’s research in an episode of Channel 4’s Dispatches. Among these issues was that Wakefield had applied for a patent on a single-jab measles vaccine before his campaign against MMR – a significant conflict of interest, leading to suspicions that he was planning to produce his own vaccine to rival the MMR.
Disturbingly, it was also claimed that Wakefield had ‘gravely abused’ the children in his care by unethically carrying out extensive invasive procedures, which had required three people holding a child down while he carried out his research. This drove nurses to leave, and raised serious concerns among his medical colleagues.
But things really took a turn when damning evidence of a series of payments made to Wakefield by the Legal Services Commission for the purpose of building a case against the MMR jab. The payments, which amounted to a substantial £435,643, began two years before Wakefield’s study was published in The Lancet. Details of the payments were published in The Sunday Times in December 2006, after being obtained by Deer from the LSC.
At around the same time, independent researchers carried out similar research to check Wakefield’s claims – and concluded that there was actually no evidence of a link between the MMR and autism. This was then confirmed by the Institute of Medicine, the US National Academy of Sciences, the CDC and the NHS. Later studies of more than a million children dismissed Wakefield’s claims for good.
It was also revealed that Nicholas Chadwick, a researcher working under Wakefield’s supervision, had failed to find the measles virus in the children in the study. A later report in The Sunday Times, published in 2009, revealed that Wakefield had ‘changed and misreported results in his research, creating the appearance of a possible link with autism’. A report in the BMJ the following year, written by Deer, detailed exactly how Wakefield had falsified data in The Lancet in order to support his desired results.
As a result, between 2017 and 2010, the General Medical Council (GMC) brought professional misconduct charges against Wakefield and two colleagues with whom he’d worked on the paper.
What were the GMC’s charges against Andrew Wakefield?
Was ‘being paid to conduct the study by solicitors representing patients who believed their children had been harmed by MMR’
Ordered invasive diagnostic investigations ‘without the requisite paediatric qualifications’, including colonoscopies and colon biopsies, on the children in his care – going against his department’s ethics board and ignoring the children’s clinical interests
‘Acted “dishonestly and irresponsibly” in failing to disclose… how patients were recruited for the study’
‘Conducted the study on a basis not approved by the hospital’s ethics committee’
Purchased blood samples, for £5 each, from children who went to his son’s birthday party (Wakefield later joked about doing this during a presentation)
‘Showed callous disregard for any distress or pain the children might suffer’
Although Wakefield denied the charges, the GMC ruled against him in January 2010, stating that he had ‘failed in his duties as a responsible consultant’, went against the best interests of his patients, and that he had acted ‘dishonestly and irresponsibly’ in order to carry out his research. Announcing their findings, the council said that Wakefield had ‘brought the medical profession into disrepute’. As a result of the ‘serious and wide-ranging findings’ of misconduct in the hearing, the GMC permanently removed him from the medical register, thus banning him from practicing medicine.
That same year, The Lancet retracted his 1998 report.
‘Clear evidence of the falsification of data should now close the door on this damaging vaccine scare,’ an editorial in the BMJ in 2011 said. ‘Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No.
‘A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. Moreover, although the scale of the GMC’s 217-day hearing precluded additional charges focused directly on the fraud, the panel found him guilty of dishonesty concerning the study’s admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards.’
But despite the mountains of evidence against it, the door is far from closed on the anti-vaccination movement.
One Facebook page, The Truth About Vaccines, has attracted more than 124,000 followers with its steady stream of anti-vax memes and videos that take advantage of people’s paranoia. Other similar pages have up to 10,000 followers each. One meme, which shows a sheep declaring ‘Let’s all get flu shots and make ourselves sick… So we don’t get sick’, betrays a lack of understanding of how vaccinations, and the human immune system, work. Other posts incorrectly claim that vaccinations can cause food allergies and autoimmune diseases. A number of them simply express libertarian, anti-Government sentiments – with immunisation presented as a mysterious chemical administered by the authorities for nefarious purposes.
But it’s not all about memes. A recent study by Emma’s Diary, which works with the NHS, the Royal College of GPs and the Royal College of Midwives to produce a pregnancy healthcare guide for new mothers, found that as many as 44% of pregnant women were avoiding the flu and whooping cough vaccinations due to health concerns, and another 11% said they actively didn’t agree with or believe in vaccinations – despite a third-trimester flu jab being considered essential for a healthy childbirth.
‘I think there are a number of things that our findings have shown,’ Sunil Singh, healthcare director at Emma’s Diary, told Metro.co.uk. ‘Especially with first-time mums there’s an uncertainty about safety of vaccinations during pregnancy – they wonder “is it safe, is it going to harm the baby, is it going to harm me, will it impact on their well-being”.’
And the anti-vax movement isn’t just confined to the UK and US.
In Pakistan and Afghanistan, Islamist militants say that vaccination is a Western conspiracy to sterilise Pakistani children – often targeting vaccination centres with deadly gun and bomb attacks. These attacks are one of the reasons that these two countries are the last in the world where polio remains endemic – having been eradicated from around 125 countries since 1988 through effective polio eradication programmes.
In Japan, the rates of women getting the HPV vaccine – which protects against cervical cancer – plummeted from around 70% in 2013 to less than 1% last year. The fall happened after a preliminary (and, allegedly, fraudulent) study claimed there was a link between the vaccine and brain damage in mice. The study was seized upon by Japanese media, spreading online with unconfirmed videos of girls in wheelchairs and suffering from seizures after apparently getting immunised. This is despite a number of studies, published in the BMJ and the Paediatric Infectious Disease Journal and looking at more than a million girls, found absolutely no link between the vaccine and autoimmune, cardiovascular or neurological disorders.
So how dangerous is the movement?
One of the most insidious claims by the anti-vax community is that the diseases against which we immunise children are not as harmful as the medical community warns. It goes without saying, in light of the tragic recent child deaths in Europe, that these claims are false.
Dr David Elliman, a consultant in community child health at Great Ormond Street Hospital, told Metro.co.uk that the risk of a British child developing a disease like polio is extremely low, whether or not they are vaccinated – but the same cannot be said for other conditions.
‘The chances of a child getting polio in this country are remote – so unless they or a member of the family goes and visits someone in Pakistan or Afghanistan, the chances are they’ll get away with it,’ he said. ‘But if it’s something like whooping cough, where there’s still quite a lot around, or measles or mumps, or some of the causes of meningitis, if the individual child is not immunised then of course they run the risk of getting that disease. Most of the diseases we immunise against, we immunise against because they are severe diseases.
‘So the meningitis vaccines are against a disease that can kill you or leave you with a disability. Whooping cough kills young babies – unfortunately we are still seeing a few deaths each year from whooping cough in young babies. Tetanus and diphtheria, as a young child they are unlikely to get, but we do still see cases in this country and we do still have some deaths in this country.
‘The last child to die of [serious respiratory illness] diphtheria was an eight-year-old who wasn’t immunised. They in fact hadn’t gone abroad, but a relative had, and probably brought back the diphtheria and gave it to her.
‘If you get immunised and you’re exposed to the disease, then chances are you won’t get it – but even if you do get the disease, because no immunisation is 100% perfect, then you will get it much less severely.’
He added: ‘If an unimmunised child is in a nursery where everyone else is immunised, then the risk to them is very low. But if they’re in a nursery where lots of people agree with those parents’ views and have their children not immunised, then they have a much greater risk of getting the disease – because you can get one case in and it’ll spread around. If you’re in a nursery where the majority are immunised, you can get one case but it will just die out.
‘When I do a clinic I still see occasional patients where I talk to the parents, I often say quite seriously, “choose your friends carefully – because if they all agree with you and don’t have their children immunised, then there is a much greater risk of something spreading within the community”.
‘There are some, even now, who are worried about either immunisations in general or about specific immunisations.’
Dr Elliman explained that even if you make it through your childhood years unvaccinated, many diseases are worse when caught in adulthood. If an adult gets mumps, for example, they are much more likely to get meningitis with it. If you get rubella as a child it’s usually ‘mild’, but if you get it when you’re pregnant, it could be a ‘disaster’ because it seriously damages the unborn baby.
Singh, from Emma’s Diary, also said the legacy of vaccination scares could lead mums-to-be to put their unborn children at risk, or even to make risky decisions once they’re born.
‘It’s really important for mums to understand the importance of vaccinations during pregnancy, not just because of the risks during childbirth, but also for once the baby is born – because in the first five years of the baby arriving, in line with the Red Book [Personal Child Health Record], babies have to be immunised a number of times,’ he said.
‘So you have the first set of immunisations at eight weeks, then the second lot at 12 weeks, then the third lot at 16 weeks, and then you’re going to have another set at 12 months for MMR, and then the booster immunisations, then at three years you’re going to be giving them the MMR and a pre-school boost.’
So how do doctors and midwives allay parents’ fears about the vaccinations, and make it clear how vital they are for the health of both their kids and the community?
Dr Elliman said: ‘There are two things, I suppose. The approach I would use is finding out what they are worried about, why they are worried about it, and what they have read or seen on the topic.
‘A parent may come to you and say “I’m worried about a particular vaccine”, but they may have different worries from someone else – so one needs to find out what their concerns are, rather than just pressing a button and giving a routine answer, if you like. It’s not always appropriate.
‘One has to recognise that, however much I might disagree with their views, their views are formed on what they think is the best for their child. In a sense, we’re both starting from the same place – the aim is to ensure their child remains healthy.’