The Lancet retracted Wakefield's study on Tuesday after Britain's General Medical Council ruled that he had carried out his research "dishonestly" and "irresponsibly." But the damage caused by the paper and the subsequent anti-MMR campaign can't be so easily undone. Two British children have died from measles in the past five years, and many more are believed to have been left with long-term health problems after catching that preventable infection.
Jeff J Mitchell, Getty Images
One in 15 measles cases results in serious complications, including fits, pneumonia and ear infections. Here, a young boy receives an immunization shot in Glasgow, Scotland, in 2007.
Not so long ago, many Britons regarded measles as a mostly dead disease. In 1998, only 56 people in England and Wales caught the virus, compared with 460,000 (99 of who died) in 1967, the year before the single measles jab was introduced. (It was replaced by the MMR injection in '88.)
But following the publication of Wakefield's paper, and the media furor it provoked, incidents of the disease soared, hitting a high of 1,370 confirmed cases in 2008. The cause was clear: Parents were frightened that their kids would develop autism and so opted out of the MMR program. While in 1997 92 percent of all children under 2 received the injection, only 80 percent were vaccinated in 2004.
"Measles spreads faster than mumps or rubella," explains Dr. Helen Bedford, senior lecturer in children's health at London's Institute of Child Health. "So if there's a modest decrease in vaccine uptake, you'll see instant results."
Part of the reason why parents were so willing to skip MMR is the vaccination program's huge success in suppressing those childhood infections. When suggestions of a link between autism and the jab first appeared, says Bedford, people everywhere were talking about the apparent rise in numbers of autistic children. By contrast, measles wasn't a hot topic, as the MMR jab had reduced incidents to a record low. Parents weighed the risks and decided autism was a bigger threat than measles, mumps or rubella.
They were wrong. Although the vast majority of people who catch measles suffer only minor symptoms, such as rashes and fevers, one in 15 cases results in serious complications, including fits, pneumonia and ear infections.
Worse still, roughly one in 1,000 infections triggers encephalitis, or inflammation of the brain. "It's thought that about 25 percent of people who suffer encephalitis will have permanent problems [such as brain damage]," says Bedford. With well over 1,000 cases of measles being reported in England and Wales each year, it doesn't take a math genius to realize that at least one child every 12 months is at serious risk of suffering this terrible condition.
Other complications might take a decade to emerge. "SSP -- subacute sclerosing panencephalitis -- is quite rare but really horrible," says Bedford. "Often somebody has an attack of measles and recovers completely, but then about seven to 10 years later develops this fatal degenerative disorder of the central nervous system."
SSP occurs in four out of every 100,000 cases. That risk level climbs to 18 in 100,000 cases for children under 1, who can't be vaccinated against measles.
As diseases spread more easily in populations with low vaccination rates, parents who refuse MMR don't just endanger their own kids. They also raise the risks to those who are either too young for the jab -- like babies up to 13 months old -- or who can't receive it because of a pre-existing health condition. In 2006, the U.K. saw its first measles death in 14 years: a 13-year-old unvaccinated boy who suffered from an underlying lung disorder. Two years later, a 17-year-old boy from northern England, born with a lowered immune system, died from the same preventable disease. Both children lived in communities with low vaccination rates.
The World Health Organization notes that the probability of deaths like these occurring can be slashed if 95 percent of people are immunized against measles. At that point, the population achieves "herd immunity," meaning unvaccinated people are few and far between, and so unlikely to give each other the disease.
"But you can't have herd immunity without everybody getting their children immunized, and it's difficult to persuade everyone that it's important," says Bedford. "Some people's main concern is their own child; they're not thinking about the rest of the community. Other people feel it's an important duty."
There is some evidence, though, that after a dangerous decade of doubt, Brits are once again willing to take on that responsibility. Uptake of MMR has slowly increased in the past five years and today stands at about 85 percent.
