Paediatrics and politics
In 1798 Edward Jenner first described “vaccination.” The British government awarded Jenner £30 000 in recompense for his time, the equivalent of £1m (€1.2m; $1.5m) today. Exactly 200 years later in 1998 Andrew Wakefield claimed a link between MMR (measles, mumps, rubella) vaccination and autism. From early experimental medicine, as we would now describe Jenner’s observational study, and then his “first in man, proof of principle” experiment on a child; through some of the largest efficacy studies ever conducted in the 20th century; to a case series that involved selection bias, non-reproducible results, and fraud, evidence based medicine has come through two centuries, the past 25 years of which I witnessed at close quarters.
In 1986, as a young paediatrician, I shared an office with another trainee undertaking a study of MMR. Before the introduction of MMR in 1988, about half a million children caught measles each year, of whom 100