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Health and medicine
Course: Health and medicine > Unit 18
Lesson 3: Influenza- 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
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Vaccines and the autism myth - part 2
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.
Want to join the conversation?
- 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)
- We're any of these lawyers disbarred ? It seems to be only right if they initiated the problem.(1 vote)
Video transcript
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.