An editorial that examines the link between receipt of the combined measles, mumps, and rubella (MMR) vaccine and the development of autism, in the wake of a recent journal retraction.
This admission came as no surprise to 10 of the study's original investigators, who, in 2004, had issued a "retraction of interpretation" in The Lancet, stating: "We wish to make it clear that in this paper no causal link was established between MMR vaccine and autism as the data were insufficient. However, the possibility of such a link was raised and consequent events have had major implications for public health." Data from the Health Protection Agency (HPA) of the United Kingdom bear out their concern. There were 1,348 cases of measles in England and Wales in 2008-the highest number of cases since current monitoring was introduced in 1995-and most of the cases could have been prevented with vaccination.1
This month's retraction of the Wakefield article no doubt seems anticlimactic to most pediatricians-it certainly does to me. In the 12 years since the publication of Wakefield's paper, his findings have been discredited, and studies from around the world have found no link between MMR and autism. The proposed MMR-autism link has been eclipsed, however, by fears regarding thimerosal and other vaccine components, and pediatricians have been challenged to convince parents of the safety and benefits of vaccines-arguably the most effective public health intervention in the past century (see the article in this issue by Dr Michael J Smith, "Parental vaccine refusal").
Dr McMillan, editor-in-chief of Contemporary Pediatrics, is professor of pediatrics, vice chair for pediatric education, and director of the pediatric residency training program, Johns Hopkins University School of Medicine, Baltimore.
1. Health Protection Agency. Agency published annual measles figures for 2008. http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1233822584984?p=1231252394302/. Accessed February 8, 2010.
2. Offit PA. Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. New York: Columbia University Press; 2008.