Health and medicine
- What is the flu?
- Catching and spreading the flu
- When flu viruses attack!
- Three types of flu
- Naming the flu: H-something, N-something
- Testing for the flu
- Antiviral drugs for the flu
- Genetic shift in flu
- Flu vaccine efficacy
- Flu shift and drift
- Two flu vaccines (TIV and LAIV)
- Flu vaccine risks and benefits
- Making flu vaccine each year
- 5 common flu vaccine excuses
- Vaccines and the autism myth - part 1
- Vaccines and the autism myth - part 2
- Flu surveillance
The infamous Wakefield study kickstarted the Autism Myth, but many studies have since shown that there is no link between the MMR Vaccine and autism. Find out how it all got started. Rishi is a pediatric infectious disease physician and works at Khan Academy. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Rishi Desai.
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- This is a little off topic, but was Wakefield punished for what he did (financially, prison...)? If all said in this video is true, then he did a very dangerous thing here, people may have not vaccinated their kids because of this study, which may have caused a lot of health problems for them.(18 votes)
- Based on this study and proselytizing by the likes of Jenny McCarthy against vaccination there were many parents who thought they were doing the right thing in withholding vaccines from their kids and some of those kids were hurt as a result. As a physician this is one time I would encourage the tort lawyers to seek damages against McCarthy and Wakefield, although he is probably beyond the jurisdiction of US couts unless some of his shady business was conducted in the country.(13 votes)
- What I'm wondering about is how Lancet actually accepted Wakefield's article in the first place. Isn't it supposed to be a peer-reviewed journal?(5 votes)
- How was Wakefield able to get away with his lies for so long? ~10 years?(4 votes)
- It takes time to build up a case. As per the video, it took many groups to show the oposite of the report, and there several combinations and permutations. For an interesting read, check out "Bad Science" by Ben Goldacre.(3 votes)
- Now I'm a little confused.
1. How were these 13 authors assembled?
2. Why did only 10 authors retract? What about the other two? (The ones that weren't Wakefield, of course.)
3. Why would Wakefield do such a thing? Did he have a motive? (I know that the lawyers paid him, but wouldn't he be ethical and not choose to be bribed and harm innocent people, and cause rumors to be spread?)
4. How was he not caught before 2007?
5. Weren't the three parents concerned when he performed the unnecessary lumbar punctures?
6. Wait, what is a lumbar puncture?
You don't have to answer all six. Even one would be great.
Thanks in advance.(3 votes)
- 3) It seems like Wakefield did it so that he could undermine the MMR and then sell his own vaccine. Basically, to make money.
4) People assumed that he had done everything properly. It took a few years for the other studies to be completed that showed his original results didn't make any sense. Then Brian Deer did a brilliant investigation and discovered all the financial impropriety, and that many of his results had been faked.
5) It's hard to say. Likely, they just trusted Wakefield since he was a doctor. Maybe they were desperate for answers. Some of them really wanted to successfully sue the vaccine manufacturer, so maybe they were willing to do the tests to their kids for money.
6) "A lumbar puncture is a medical procedure where a needle is inserted into the lower part of the spine to test for conditions affecting the brain, spinal cord or other parts of the nervous system. During the procedure, pressure is measured and samples of cerebrospinal fluid (CSF) are taken from inside the spine." It's generally painful and can sometimes have serious side effects.
I would recommend googling "Brian Deer" and read his articles about Wakefield. It's a pretty amazing and scary story.(3 votes)
- What is autism?(2 votes)
- Autism is a term for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors.(4 votes)
- But what happened to Wakefield himself?
What is his situation today?(2 votes)
- His license to practice medicine was revoked. He lives near Austin, Texas with his wife and four children. He tried to sue Brian Deer from Texas, but it was thrown out of court and he had to pay all of the fees.(3 votes)
- Wow! What a scandal! I'm surprised Wakefield didn't get caught sooner. Did the lawyers have any grudge against the MMR vaccine developers or was it for them just a way to make money?(3 votes)
- Now you've got me wondering. What is the real cause for autism?(1 vote)
- Nobody knows the answer to this question, but many things have been implicated. Genetics and environmental toxins are some of the suspects.(2 votes)
- Can I know the reference of all this information?(1 vote)
- What you're hearing in this video is the voice of Rishi Desai, M. D. Rishi is a pediatric infectious disease physician and works at Khan Academy. He serves as the medical lead there (or here, whichever you call it). While Doctors of Medicine are usually a trustable source of information, these videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. (See description of video.)(1 vote)
So in the last video, we talked about how many, many studies have been done that show that there were no links between MMR vaccine and autism. And in fact, other studies have been done to kind of pick apart all of the individual parts of the mechanism that the Wakefield study laid out-- that there is no link between vaccine and gut inflammation, there's no link between gut inflammation and autism. And so at this point, people are pretty convinced that there really is no link between MMR vaccine and autism. But many families and a lot of parents still believe this myth. And so people wondered about this initial Wakefield study-- how the results even came about. Now, an interesting thing happened in 2004. And this is a very unusual thing for a research study of any sort. But basically, 10 of the authors-- remember, there are 13 authors on this study. 10 of them actually retracted, and said, you know, our conclusions were not appropriate. And we're going to retract. So three of the authors did not. But the fact that 10 of them actually retracted was really striking and kind of raised a lot of eyebrows. Why in the world would people retract their initial study? So that same year, because of this very odd thing to have happened, a guy by the name of Brian Deer, who was a reporter-- he was actually working for a British newspaper, investigative journalist-- began his investigation. He actually started looking into this stuff. And Brian Deer is a guy that had been kind of well known for investigations in the past. He had investigated the pharmaceutical industry and other kind of powerful organizations. And he thought that he would take on this Wakefield study and really get to the bottom of it, understand where these results came from. And what he found was really shocking in a lot of ways. Turns out back in 1996, about two years before the Wakefield study, a group of lawyers who were actually hoping to sue the MMR vaccine manufacturers, they decided to pay Wakefield a large sum of money. So they paid Wakefield thousands and thousands of pounds, which is converted to even more US dollars, to actually carry out this study. So they paid him directly. And this money was not used for the patients, because the patients were part of the National Health Service and got their care through that. This was actually money given directly to Wakefield. So this is obviously a huge conflict of interest, and this is not something that Wakefield had ever told anyone. He didn't mention this when he published this study. And another thing that actually came out was that a year later, in 1997, it turned out that Wakefield actually had filed a patent. So Wakefield had placed a patent on a vaccine, of all things. So Wakefield had a patent on a vaccine that would have competed with the MMR vaccine. It was kind of an alternative MMR vaccine. And so again, this is a major conflict of interest. Because if he's doing a study on one vaccine and showing that it's not a great vaccine, that it causes autism, then obviously that sets him up very nicely to actually put out his own alternative version of the vaccine. So these are two huge conflicts of interest that he did not mention when he was publishing his study. Now let me make a bit of space on this canvas, and we'll get into what happened next. It turns out, between the years of 2007 and 2010-- so for about 2 and 1/2 years, there was an investigation. And this was done by the General Medical Council. So this group is actually both doctors and community members. And they actually review any sort of unethical behavior done by a doctor and make a decision about whether that person can go back and practice medicine. So this GMC group, they reviewed all the documents that Brian Deer had investigated and other information they had kind of dug up themselves. And they basically found a number of things. They found that he was being dishonest, first of all. And you might be thinking, well, obviously he was being dishonest about some things. He didn't mention his financial interests. That was a second issue. They said that he had a few opportunities to mention them. Beyond just publishing the paper, he had also gone to meetings and conferences. And repeatedly, he had kind of lied about his financial interests. They said that he was negligent-- that he had actually done, specifically, things to autistic children in his study that were medically negligent, inappropriate. And finally, that he was unskilled. And specifically, what I mean is that he was not a pediatrician. He was a general physician-- surgeon, specifically-- and that he really didn't have any business working on kids. So with the first point, dishonesty, let me just go back to that briefly and give you a little bit more detail. They found that he had actually picked his patients. He had found them not randomly as they came into the hospital, which is what he had said, but that the lawyers that he was working with actually put him in touch with patients that were very interested in suing the MMR vaccine manufacturer. And obviously, if you have a group that's ready to sue another group, then that's not random. And maybe there's some bias in what they're going to say. He also didn't get any ethical clearance from the hospital. So he had said that the ethical board had cleared everything that he was doing, but that wasn't true. Now, with his financial interests, he actually-- in addition to having that patent on a vaccine, he also had a company that sold something called "transfer factor." And this product was basically marketed to people that were looking for an alternative to the MMR vaccine. So of course, if you can make the vaccine look really bad or unsafe, then your company selling an alternative is going to do really well. Now, on the negligence point, this is actually really unfortunate. He, among other things-- and so I'm just going to pick out one of the things they mentioned-- he performed three lumbar punctures on kids that did not need them. Now, think about that. Three lumbar punctures. This is a needle in the back, and you're getting fluid that kind of bathes the brain. You're doing this procedure on kids that just didn't need the procedure done at all. And so this is obviously completely inappropriate. And finally, he, as I said, was unskilled. He was not a pediatrician. And he should not have been making clinical decisions about pediatric patients. That was obviously something that you need skill and training to do, and he never received any of that. So they actually looked at all this evidence, and they said that they were going to remove him from the medical registry. So based on all this evidence, they actually removed him from the medical registry. And once you're removed from a medical registry in one country, it becomes very, very hard to work in any other country. And so he effectively was now unable to practice medicine or even surgery, which is what he was trained to do, anywhere in the world. So when all this information kind of came out, just a few days after he was removed from the medical registry, The Lancet actually decided that they would remove the article, or retract the article. So now The Lancet, the medical journal he had published it in, the initial Wakefield study, retracted it completely. And finally, one question kind of lingered in many people's minds, in my mind as well, is that even if you accept all this, that he kind of dishonestly found these patients and had a financial interest and was negligent, it seems so strange that 12 children had gut inflammation. Now, that just seems like a very odd thing to find. And it makes you wonder whether there was something to his study in the first place. Well, it turned out that finally, in 2011-- which is very, very recent, actually-- that the hospital records were released. So hospital records on these patients were released. And it turned out that the pathologists that had actually looked at these kids' intestines had said and written down something very different from what he reported. So basically, there was this huge disconnect between the hospital records and what he reported in his study. So this Wakefield study, essentially, did not reflect reality. For example, some of these kids had completely normal intestines. And yet, in his study he reported that they had inflammation. Other times, parents reported symptoms at a certain time point. But because that didn't fit with his overall idea, he changed the dates. So between changing dates and changing what the hospital records say about inflammation, it became very clear that basically this entire thing was fabricated. So going back to the beginning, where we had this one study on 12 children that showed this link between vaccine and autism, we've come a long way. I mean, now this study's been completely discredited because he's essentially been shown to have lied at different points. And also, many other studies have kind of looked at this link, or this connection, and shown that there really is no link between vaccines and autism. The one problem that remains is that a lot of families and parents still believe this autism myth. And that leads them to not vaccinate, and it creates a lot of confusion about the real cause of autism.