A series of denials and a failure to formally investigate allegations of misconduct in Andrew Wakefield's MMR research meant the public
was misled for six years about the credibility of the 1998 Lancet paper by Wakefield and colleagues.
Dr Fiona Godlee, BMJ Editor in Chief, says the UK has
consistently failed to take research misconduct seriously. She calls on the UK government to establish mandatory oversight
of clinical research integrity within the NHS, as happens for publicly funded
research in the USA.
In the third and final part of a special BMJ series,
"Secrets of the MMR scare", investigative journalist Brian Deer reveals how the
medical establishment closed ranks to protect Wakefield after he raised concerns with the
Lancet in 2004.
Deer's allegations included possible research fraud,
unethical treatment of vulnerable children, and Wakefield's conflict of interest through his
involvement with a lawsuit against vaccine manufacturers.
Deer thought the editor, Richard Horton, would say that an
investigation was needed. Instead he reports that "within 48 hours, and working
with the paper's three senior authors, the journal was to publish 5000 words of
denials, in statements, unretracted to this day."
The statements said that an investigation was undertaken by
the Royal Free
Hospital that "cleared Wakefield of wrongdoing."
But documents, emails, and replies obtained under the
Freedom of Information Act reveal no formal investigation. "What emerges is
merely a scramble to discredit my claims during the 48 hours after I disclosed
the information," writes Deer. In short, "the accused were investigating
It took a further six years for the General Medical Council
(GMC) to prove Deer's allegations, and for the Lancet paper to be retracted.
During this time, public alarm over MMR continued, measles outbreaks occurred,
and two UK
children died from the disease.
"Were it not for the GMC case, which cost a rumoured £6m
(Ä7m; $9m), the fraud by which Wakefield
concocted fear of MMR would forever have been denied and covered up," argues
Deer. The Royal Free
Hospital and Medical School
have since confirmed that they carried out no formal investigation. No doctor
was interviewed, and no documents were generated.
In a written response to the BMJ last week, Professor Sir
John Tooke, Vice-Provost at University College London said: "UCL takes any
allegation of research misconduct very seriously, and we will certainly
investigate those raised in the BMJ. This process will be subject to external
scrutiny, in line with our procedures in this area." He added: "We
are determined to learn from the mistakes made in relation to this case ... Our
objective is to continue refining a structure and processes which provide all
reasonable safeguards whilst also facilitating the highest quality research for
"This case reveals major flaws in pre and
post-publication peer review," says Dr Godlee. "Allegations of
research misconduct must be independently investigated in the public interest.
But it's still too easy for institutions to avoid external scrutiny, and
editors can fail to adequately distance themselves from work they have
published and then defended."
An accompanying editorial by researchers in Seattle says Deer's
articles reveal the urgent need "to fix a system that failed to protect
human subjects and the public from the consequences of fraudulent