Friday, Sept 25th, 2009
Controversy has erupted over the revelation that a standardized test given to U.K. high-schoolers in 2008 contained a question painting a study raising concerns over the safety of the measles mumps and rubella (MMR) vaccine.
The General Certificate of Secondary Education (GCSE) test is the most widely taken academic qualification exam among 14- to 16-year-olds in England, Wales and Northern Ireland. The test questions are designed by the United Kingdom’s Assessment and Qualifications Alliance (AQA).
Question 5 on the Science portion of the January 2008 test concerned the 1998 study that first raised concerns between the MMR vaccine and autism. In that study, published in the prestigious journal The Lancet, Andrew Wakefield and colleagues examined 12 autistic children after their parents raised concern that their conditions might have been caused by the MMR shot. Although the study did not find any causal relationship between the vaccine and autism, the authors concluded there was enough concern to recommend that parents instead give their children individual vaccines for each of the three diseases, spaced a year apart each.
The Lancet paper caused a huge upswing in public concern about vaccines, particularly the MMR shot, and rates of vaccination dropped significantly.
The GCSE test question was split into two parts. In the first part, students were asked to explain how the MMR vaccine functions to protect children from the three diseases. The second part briefly described Wakefield’s study, concluding by saying, “Dr Wakefield’s research was being funded through solicitors for the twelve children. The lawyers wanted evidence to use against vaccine manufacturers.”
The students were then asked, “(i) Was Dr Wakefield’s report based on reliable scientific evidence? … (ii) Might Dr Wakefield’s report have been biased?”
Students were given points for part (i) only if they criticized the study for having a small sample size and for relying on parents’ anecdotal reports as evidence. They were given points for part (ii) only if they agreed that Wakefield might have been biased by being paid by parents/lawyers.
Wakefield accused the test writers of making false claims about him and his research.
“The thought police appear to be saying, ‘To pass this exam you have to adopt this particular point of view,'” he said. “We didn’t make any claims that MMR was the cause of anything. The exam question completely misrepresents what we said. The Lancet study received no funding whatsoever.”
Vaccine critics, meanwhile, accused the test of attempting to bias children toward one side of a controversial issue.
“This is an insidious way of shaping young people’s opinions,” said Jackie Fletcher of Jabs.
Although the students were only being tested on their analysis of the scientific merit of the study, the question volunteered the following information: “Some newspapers used parts of the report in scare stories about the MMR vaccine. As a result, many parents refused to have their children vaccinated.”
After the controversy emerged, the AQA issued an apology for any “misunderstanding” regarding the question, and removed the January 2008 Science test from its Web site.
Wakefield has been a controversial figure ever since the publication the 1998 Lancet study. In 2004, Lancet editor Richard Horton made the first conflict-of-interest allegations against Wakefield, which was followed up by accusations in the Sunday Times that he had breached ethical rules. These accusations led Minister of Parliament Evan Harris and Health Secretary John Reid to call for Wakefield to be investigated by the General Medical Council (GMC) as “a matter of urgency.”
But Horton reports in his book MMR Science & Fiction: Exploring the Vaccine Crisis that the GMC “had not a clue where to begin,” and that one medical regulator questioned him on possible ways to proceed.
“He seemed keen to pursue Wakefield,” Horton writes, “especially given ministerial interest.”
In a letter published on its Web site, Jabs notes that the investigation into Wakefield appears to be more of a fishing expedition than a concern over an actual breach of medical ethics.