By Jeremy Laurance
London - The doctor who sparked an international scare over the safety of MMR vaccine is to be charged with serious professional misconduct by the General Medical Council in a final attempt by the medical establishment to lay the controversy to rest.
Andrew Wakefield, who published a research paper in 1998 purporting to show a link between MMR vaccine and autism, is accused in preliminary charges of publishing "inadequately founded" research, failing to obtain ethical committee approval, obtaining funding "improperly" and of subjecting children to "unnecessary and invasive investigations", The Independent has learnt.
The research, which appeared in The Lancet, is said to have done more damage than anything published in a scientific journal in living memory.
It caused widespread alarm about MMR vaccine, immunisation rates slumped and cases of measles, mumps and rubella soared.
Detailed charges are being formulated by the GMC's lawyers for presentation in the autumn and a public hearing is expected next year. If found guilty Dr Wakefield, 50, could be struck off the medical register.
Unusually the GMC has brought the case itself in the public interest. There is no complainant. The investigation has taken two years and lawyers for Dr Wakefield complain he and his family are suffering distress caused by the delay in bringing charges.
The research was carried out at the Royal Free Hospital, north London by Dr Wakefield and 12 other doctors and published in The Lancet in February 1998.
The warning about MMR was amplified by Dr Wakefield at a press conference - to the disquiet of his colleagues present - and the subsequent scare led tens of thousands of parents to boycott the vaccine.
Immunisation rates fell over the next five years from well over 90 percent nationally to a low of 78,9 per cent in early 2003. In parts of London they fell below 60 percent.
There was a resurgence in cases of measles, mumps and rubella (German measles), according to the Health Protection Agency. The number of cases of mumps soared from 4 204 cases in 2003 to 16 436 in 2004 and to 56 390 cases last year.
Since 2003 the MMR vaccination rate has increased slightly and in mid-2005 stood at 83 percent. A spokesperson for the agency said: "The fear of Wakefield has dissipated a bit. The figures are coming back up."
In 2004 it emerged that at the time he was preparing The Lancet paper, Dr Wakefield was being paid by lawyers for parents of allegedly MMR vaccine damaged children to look for evidence that could be used to help sue manufacturers of the vaccine.
He received £55 000 from the Legal Aid Board which was paid into his research fund but which he had not disclosed to his co-researchers. At least four of the 12 children in the Lancet study were also in the Legal Aid Board funded study.
He was accused by The Lancet of failing to declare a conflict of interest that could have influenced his findings. Richard Horton, the editor, declared the paper "fatally flawed" and said if he had known in 1998 about the conflict of interest he would never have published it.
The journal partially withdrew the paper in February 2004 and the following month ten of the 12 authors, withdrew the claim of a link with autism. John Reid, health secretary at the time, called on the GMC to hold an inquiry.
In a High Court hearing listed for this month, the GMC will seek disclosure of papers from the lawyers for whom Dr Wakefield was working, which are relevant to the case.
The GMC is also considering bringing charges against two other doctors who were members of Dr Wakefield's research team, Professor John Walker-Smith, former head of paediatric gastroenterology at the Royal Free, and Professor Simon Murch. It is understood that the case against Professor Murch is considered weaker.
Dr Wakefield, a consultant gastroenterologist, left the Royal Free hospital in 2001 "by mutual agreement." He has since worked mainly in America where he has business interests and continues to carry out research on autistic children.
His claims about the link between MMR and autism have been repudiated by a series of scientific studies but captured the imagination of a public primed to be sceptical of government claims of safety by the debacle over mad cow disease and variant CJD.
The Government's chief medical officer, Sir Liam Donaldson, accused Dr Wakefield of mixing "spin and science" and blamed his research paper for a loss of confidence in MMR vaccine which had saved millions of children's lives.
Simon Dinnick, of lawyers Radcliffeslebrasseur representing Dr Wakefield, said: "He strongly contests the allegations. The delay in bringing the case to a conclusion is causing great distress to him and his family."
All of the doctors are believed to have denied any professional misconduct.