Critical Analysis: MMR Vaccine Paper and Public Health Concerns

This report provides a critical analysis of the paper by Wakefield (1998) published in The Lancet, which falsely linked the MMR vaccine to autism. The analysis examines the paper's methodology, including its small sample size, uncontrolled design, and speculative conclusions, highlighting its limitations. It details how the paper led to a significant drop in vaccination rates in the UK, resulting in increased measles and mumps outbreaks, and the widespread public health consequences. The report explores the paper's strengths, such as its ethical approvals, while also focusing on the deliberate attempts to establish a link between autism and the MMR vaccine without proper evidence. The report also discusses the importance of MMR vaccines, their effectiveness, and the lack of evidence to support the association of thimerosal with cognitive and behavioral functions. The conclusion emphasizes the lack of strong evidence supporting Wakefield's claims and the devastating impact of the paper on public health, necessitating revaccination campaigns to counter the misinformation.

Running head: CRITICAL ANALYSIS
CRITICAL ANALYSIS
Name of the Student
Name of the university
Author’s note

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Introduction
This paper provides a critical analysis of the paper (Wakefield 1998) discussing about the
relation between the mumps measles and rubella vaccine and deterioration in the cognitive
development of child. The paper will evaluate all the methods and the findings from the paper
and will finally draw a succinct conclusion from the results and the findings. Since the concerned
article had been proven to be fraudulent, this paper aims to focus on the implications that the
article had on the public health of UK.
Background of the paper
Andrew Wakefield and his colleagues published this paper in the Lancet that suggested
that measles, mumps and rubella vaccine (MMR) may influence Andrew Wakefield and his
colleagues published this paper in the Lancet that suggested that measles, mumps and rubella
vaccine (MMR) may influence pervasive developmental disorder and behavioral regression in
patients (Harrison 2013).
Despite of the uncontrolled design of the study, small sample size and speculative nature
of the conclusion drawn, the paper gained a wide publicity, which lead to a drastic drop in the
vaccination procedure, as the parents were concerned about the risk of autism (Calvert et al.
2013).

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This paper aims to investigate a group of children suffering from chronic enterocholitis,
and developmental disorder. Lymphoid hyperplasia can be followed by chronic enterocholitis
due to the inflammation of the digestive tract (Demichelli et al. 2013). The paper discusses about
the relation between the three given clinical conditions by carrying out a randomized control
trial.
Limitations of the paper
The population studied was not appropriate in the context. The methodology used in this
case was a randomized control trial. All the families of the children were not accounted with all
the information regarding the study (Wakefield et al.1998).
It can be seen from the retracted paper that the authors took history regarding the
immunization details and their exposure to the infectious disease. In spite of all the investigations
the author made incorrect association between the MMR vaccines and the onset of autism. The
paper provided with the result that out of eight children, five had adverse reaction with the
immunization with the MMR vaccine (Wakefield et al.1998).
The reports provided with the fact that the child receiving monovalent muscles vaccine
showed slower growth. The findings show that the child that received a dose of vaccine at the
age of 4.5 years showed behavioral deterioration and at the 18th month the child developed Otitis
media, which he directly linked with the vaccination (Brown et al. 2012).

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The author linked the disintegrative psychosis with the measles encephalitis, although
there are no evidences to these facts. According to the author, rubella virus is associated with
autistic disorders, which again inks autism to the rubella vaccines. As per the findings of the
author, 15 out of 20 autistic children showed their first symptoms within the weeks of
vaccination (Wakefield et al.1998). He also looked for the relation between the MMR vaccines
and the deteriorated behavioral symptoms in the children with autism. No further researches
could prove the authenticity of his research. The evidences were insufficient to prove his
statement. One of the most negative points of this paper is that, throughout the paper the author
had deliberately tried to establish the link between autism and MMR vaccine without any proper
evidences (Patient.info, 2017).
The sample population used for the control study was not appropriate. The patient's family, the
health care workers were not blind to the study. The ages and the other variables used in the
study were not clearly defined. The outcome of the study is not clinically relevant as no other
evidences could support the facts raised in the study (Wakefield et al.1998).
The patients have not been selected in an appropriate way. In this study more number of
children should have been taken into account. The people evaluating the outcomes were not
acquainted with the predictor variables (Brown et al.2012). The statistical methods were also not
clearly defined. Although the author believed that the result would benefit the greater population
but the actual result lead to something else.
Strengths of the paper
The positive sides of this article are that it has been written with excellent scientific
knowledge which depicts in-depth knowledge about the matter. The structure of the paper is

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good and it is commendable the names have kept anonymous (Brown et al.2012). Ethical
approval has been received from the Ethical practices committee of the Royal Free hospital with
consent from the families of the patients (Aluwihare-Samaranayake 2012). The paper is
supported by many references. A properly referred paper increases the chance of acceptance.
MMR vaccine and its uses
The Centers for Disease Control and Prevention (CDC) has confirmed the use of the
MMR vaccines to be effective in preventing measles. According to CDC, two doses of MMR
vaccine are 97% effective in preventing measles (Demichelli et al. 2013). Children can take the
MMV vaccine as it can efficiently give protection against mumps, measles and rubella and
varicella. The vaccines mainly contained thimerosal, which is a mercury based preservative that
is used to prevent contamination of the vials that are multidosed. There are no such solid
evidences to prove the association of thimerosal with the despaired cognitive and behavioral
functions (Nicholson and Leask 2012).
Studies have shown that there is no link between vaccination and autism (Autism.org.uk, 2017).
The study (DeStefano and Thompson 2004) showed that the total amount of the antigen received
from the vaccines was same among the child with autism and without Autism.
Impact of the experiment on public health
After the publication of the paper in the Lancet, there was a drastic drop in the
vaccination rates across UK, which in turn increased the occurrence of the measles and mumps
worldwide. Since both are contagious, the disease spread to a larger population (Patient.info,
2017). This in turn caused a wide spread mortality and permanent injuries. Wakefield's paper has

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been considered as one of the most damaging hoax in the field of medical science. The author
can be held responsible for the epidemics and the deaths (Anderberg et al.2012).
Conclusion
The information provided in the paper linking the MMR vaccine did not have any strong
evidence. In fact most of the reports published after that showed some alternate result and did not
find any adversities related to the MMR vaccine. Although the report was decorated with rich
scientific terms, and got ethically certified, the paper created fear and confusion among the
population which ultimately took the life of many people. To break this hoax, the government
had to take up the revaccination campaign. MMR vaccine had been considered as a safe vaccine
and can be also administered to children.

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