More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
David Ropeik

David Ropeik

Posted: January 10, 2011 12:10 PM

Last May British medical authorities stripped Dr. Andrew Wakefield of his license to practice medicine. In case the name isn't familiar, Wakefield was the lead author of the 1998 paper published in The Lancet (and later retracted) that set off worldwide fear of vaccines. Now the British Medical Journal has jumped in, publishing an investigative report calling the Wakefield study "an elaborate hoax," suggesting that he manipulated his findings to help him get rich by suing drug companies.

The press will give this latest aspect of the story its 15 minutes of fame. But the coverage will mostly be about Wakefield. Little attention will be paid to the larger lesson here. Thousands of people are now getting all sorts of diseases that had been nearly eradicated, diseases which are resurgent now that people around the world have become fearful of vaccines, thanks both to Dr. Wakefield and to the innate way the human animals perceives and responds to risk. The lesson is that sometimes what we do to protect ourselves feels safe, but makes things worse. Examining how the psychology of risk perception played out in the Wakefield affair, and continues to play out in public concern about vaccines, can tell us a lot about how to avoid this risk in the future -- the huge risk that arises when we get risk wrong.

Wakefield et.al. looked for a link between autism and the MMR (measles, mumps, rubella) vaccine. In their now retracted paper the authors said "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described." But in the news conference announcing the paper, Wakefield suggested taking the vaccines one at a time rather than together, just in case. The parents of the autistic kids who were studied -- all 12 of them -- desperate for an explanation for their tragedy, jumped at that hint, and 12 years later fear of vaccines of all sorts has spread worldwide. Vaccination rates are down. Herd immunity to some diseases has dropped so low those diseases are spreading again, in the U.S. and around the world.

As surely as we now know that vaccines do not cause autism, we also know from research on risk perception that several specific psychological characteristics played (and still play) a huge role in people's fear of vaccines.

  • We know that human-made risks are scarier than those that are natural. Vaccines are human-made.

  • We know that a risk will seem more threatening if it comes with little benefit, and vaccines protect us from diseases that are mostly gone, so their benefits are perceived as minimal (even though the risk remains).

  • We know that a risk imposed on us feels scarier than one we choose to take on our own, and vaccination is imposed by government (though one can opt out).

  • We are more afraid if we don't trust the people in charge of our health and safety, and many people don't trust vaccine makers or the government health agencies overseeing vaccine programs.

  • Finally, we know that any risk to kids evokes more fear than the same risk to adults, and the whole fear of vaccines movement got started, and still largely focuses on autistic children.

It is not at all unreasonable to respond to risk this way. When it comes to the perception of potential danger, which is ultimately about survival, we have developed these affective characteristics -- trust, choice, kids, risk vs. benefit, among others -- as tools with which to judge a situation quickly, instinctively, subconsciously, for its riskiness. This is neither rational or irrational. It's just how we do it.

But this affective risk response can lead to what in my book I call The Perception Gap, a dangerous gap between our feelings and the facts that can be a risk in and of itself. Sometimes we're more afraid than the facts say we need to be (vaccines). With many of the bigger threats, we're not afraid enough (infectious disease). The gap between our fears and the facts can be dangerous all by itself. Just ask the parents of the thousands of kids worldwide now getting, or dying of diseases that vaccines had pretty much controlled.

We need to start paying more attention to what the psychology of risk perception has to teach us about why we react to risk the way we do. We need to be honest with ourselves and recognize that, as right as our feelings about a given risk may be, those feelings may raise new dangers. We do have to fear fear itself, too much or too little. As we have studied risks like vaccines and autism, so we have studied the psychology of risk perception, and identified its pitfalls. We can use that knowledge for wiser overall risk management in the choices we make as individuals and as a society.

And we need to do this proactively, as risk-related issues arise, before our feelings become too deeply set. Because we also know from risk perception studies that, once we've made our interpretations of what's safe and what's not, it's very hard to get those interpretations to change. One American parent in four is worried about the danger of vaccines to their kids and hundreds of thousands now refuse to have their kids vaccinated. This latest investigation against Dr. Wakefield won't change that. The harm he and others have done will persist for a long time, and will continue to serve as a reminder of the risk we face if we don't recognize that the way we perceive risk can be a huge risk in and of itself.

David Ropeik is an Instructor at the Harvard Extension School and author of "How Risky Is It, Really? Why Our Fears Don't Always Match the Facts"

(This post originally ran as a Guest Blog on Scientific American)

 
 
 

Follow David Ropeik on Twitter: www.twitter.com/dropeik

 
 
  • Comments
  • 50
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Recency  | 
Popularity
09:40 PM on 02/10/2011
Anyone prepared to comment on this
http://www.ncbi.nlm.nih.gov/pubmed/8741307
After you read this and maybe follow a few more leads you will be able to comment on MMR.
How can studies PROVE anything when we don't even know what vaccine they are talking about. The MMR vaccine Wakefield suggested MIGHT be - due to parents comments- related to autism was (I found this out somewhere else - but read the link first) exchanged for the American vaccine which was shown to be safer.
Vaccines might be wonderful - but I'd be more likely to believe it if we could hear the truth. Certainly it doesn't take much knowledge to realise just how much wool Deer is pulling. Has pulled. He's such a health advocate - telling us all about terrible drugs that HAVE ALREADY BEEN taken off the market. So much money is involved the courts are ? the newsmedia is ?
American studies that back up Wakefield's claims have been pulled - Wake Forest Universities. He says a group may be more prone to damage - If say that is coeliacs - let's find them and figure out a safer option. Vaccines have almost certainly saved lives, but they have also killed people. Risk benefit is hard to ascertain, and long term damage impossible with no studies to prove it. So it's your job medical community PROVE IT, don't stop studies from happening because you are afraid of what they might find out.
02:48 PM on 01/18/2011
Being that the judicial system has awarded MILLIONS to people for austim from MMR and other vaccines isnt it pretty obvious that vaccines are dangerous. Google it! http://www.cbsnews.com/8301-31727_162-20015982-10391695.html
03:29 PM on 01/17/2011
A good step in eliminating vaccine fear would be to stop putting thimerosal, which is 49.6% mercury, one of the most toxic substances known, in adult vaccines. Use of thimerosal in pediatric vaccines was finally discontinued around 2003. I'll pay the extra 25 cents per dose for a single-use vaccine vial that does not need thimerosal and that minimizes my risk of infection relative to vials that are used for multiple patients. We know how incredibly toxic minuscule amounts of mercury are. We know how medical studies on the risk of various substances yo-yo back and forth over the years. Why take any chances in the meantime when there is a cheap risk-free alternative.
12:36 PM on 01/17/2011
BOTTOMLINE: does the hypothesis that ASD with GI complaints before or after MMR exposure deserve further research?
if not, why not
does the possibility that measles virus from the MMR appears in the gut of these children problematic?
Are corp. and stockholder profits corrupting influences?

Does Dr. Gallo derive any profits from the HIV test?
(read the disclaimer on the label)

What researcher would dare to do this research given the "media" inspired hysteria.
05:25 PM on 01/12/2011
The truth is a valuable thing. So, before any other articles about this subject are written, please, anyone, find the truth about Dr. Wakefield first. It might surprise you. It can be found easily on the internet. Then investigate, as J.B. Handley (see below) did, who Brian Deer is. J.B. Handley wrote a great article about the subject. Lies have legs. Let's hope they don't keep marching on with impunity.
10:06 PM on 01/12/2011
Or, you could skip both Handley and Deer's writing and just look at the actual documents that Deer refers to. The evidence is there. It's not a matter of opinion, Gigi C. Andrew Wakefield concocted a vaccine scare to make a LOT of money. He wanted to BE "Big Pharma". He is the enemy of our children. The facts are there. Go ahead and look.
11:16 AM on 01/11/2011
Sadly, although you seem competent to copy and paste a list of articles that you apparently have not read, you don't seem to understand what it means to "replicate" a study.

One of Wakefield’s colleagues and former business partners co-authored a study that was a rigorous and explicit attempt to replicate Wakefield’s findings; the authors concluded: “The work reported here eliminates the remaining support for the hypothesis that ASD with GI complaints is related to MMR exposure. We found no relationship between the timing of MMR and the onset of either GI complaints or autism.” [Lack of association between measles virus vaccine and autism with enteropathy: a case-control study. PLoS One. 2008 Sep 4;3(9):e3140.]
11:49 PM on 01/10/2011
MMR STUDIES REPLICATING WAKEFIELD et al.:

Furlano R, Anthony A, Day R, Brown A, Mc Garvey L, Thomson M, et al. “Colonic CD8 and T cell filtration with epithelial damage in children with autism.“ J Pediatr 2001;138:366-72.

Sabra S, Bellanti JA, Colon AR. “Ileal lymphoid hyperplasia, non-specific colitis and pervasive developmental disorder in children”. The Lancet 1998;352:234-5.

Torrente F., Machado N., Perez-Machado M., Furlano R., Thomson M., Davies S., Walker-Smith JA, Murch SH. “Enteropathy with T cell infiltration and epithelial IgG deposition in autism.” Molecular Psychiatry. 2002;7:375-382

Ashwood P, Anthony A, Pellicer AA, Torrente F. “Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology.” Journal of Clinical Immunology, 2003;23:504-517.

Gonzalez, L. et al., “Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms“. Arch Venez Pueric Pediatr, 2005;69:19-25.

Balzola, F., et al., “Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsule enteroscopy: Another piece in the jig-saw of the gut-brain syndrome?” American Journal of Gastroenterology, 2005. 100(4): p. 979- 981.

S. Walker, K. Hepner, J. Segal, A. Krigsman “Persistent Ileal Measles Virus in a Large Cohort of Regressive Autistic Children with Ileocolitis and Lymphonodular Hyperplasia: Revisitation of an Earlier Study”

Balzola F et al . “Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients.” Gastroenterology 2005;128(Suppl. 2);A-303.
04:59 PM on 01/10/2011
Dr. Wakefield is innocent of these ridiculous charges. No patient or their families have ever complained about their treatment - it was this reporter, Brian Deer who filed the complaint with the GMC, then "followed" the story. All the families have the highest regard for Dr. Wakefield.

And Dr. Wakefield has never said you shouldn't vaccinate. He said he recommended further research into the matter.
06:14 PM on 01/10/2011
The People's Temple members who committed suicide at Jonestown didn't complain, either--they just kept on believing and drank the Kool-Aid.
The editors of the BMJ have concluded that Wakefield is a fraud. Wakefield can sue the BMJ, Deer, and his employers under the notoriously slanted UK libel laws if he likes. He has already abandoned one suit against Deer and Deer received a check for his legal expenses. Perhaps Wakefield can try again--who knows, he might use his time wisely to become a good jailhouse lawyer if, in fact, he is imprisoned for fraudulent use of about three-quarters of a million dollars in public (legal aid) funds.
09:01 PM on 01/10/2011
Read Wakefield's side in his book "Callous Disregard". You might change your mind about who is drinking the Kool-aide.
photo
HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
08:58 PM on 01/10/2011
Wrong.

The father of child complained and that complaint is found at the beginning of the BMJ article.

In 2004, the story of the paper became public on a Friday. On Sunday, Brian Deer published his story. On Monday, the GMC contacted Deer asking for information for the investigation they were undertaking. On Wednesday, Brian Deer gave the GMC information. As well, let us not forget that Wakefield called upon the GMC to investigate the charges.
02:18 AM on 01/11/2011
Actually, Sheldon, Brian Deer contacted the GMC and asked permission to show them evidence of misconduct at the Royal Free:
http://www.rescuepost.com/files/deer1st_complaint1.pdf
03:11 PM on 01/10/2011
http://www.ageofautism.com/2011/01/keeping-anderson-cooper-honest-is-brian-deer-the-fraud.html

Parents of affected children are fully vested in this matter. We've been lied to before, we're being lied to again by Brian Deer. Dr. Wakefield is an honest man who has stood by our children from the beginning. Please read the other side before jumping to the conclusion that mainstream media has done it's due dilligence in looking at the facts themselves.
http://www.ageofautism.com/2011/01/the-big-lie-wakefield-lancet-paper-alleged-fraud-was-not-possible-for-anyone-to-commit.html

Pharm doesn't want anyone to look at vaccines. The testing and studies have NOT been done.
photo
HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
12:30 PM on 01/11/2011
I like pointing to child 11 in the article. It is so simple.

The admission and discharge information at the Royal Free hospital has the child having his first autistic symptom a month before MMR vaccination. And a week after vaccination, the kid got a chest infection.

Wakefield reported that the kid had the first behavioral signs of regressive autism a week after MMR vaccination.
10:18 PM on 01/12/2011
Wakefield was trying to BECOME "Big Pharma". The documents are clear. The timeline is obvious. He committed fraud and his motive was money. You're on the wrong side of this.

Ask yourself - is there any evidence at all that would convince you Wakefield is guilty as charged? If the answer is "no", then you're too invested, too committed, and almost religious in your support of Wakefield.

It is time to reflect, it is time to pray, and it is time to objectively look at the documents that Wakefield himself signed. And it is time to change your mind. It's ok, we've all been wrong about big important stuff before.

An honest, thoughtful and brave person can admit a mistake, learn from it, and move on.
HUFFPOST SUPER USER
SingaporeAutismDad
02:05 PM on 01/10/2011
Keeping Anderson Cooper Honest: Is Brian Deer The Fraud?

By J.B. Handley

"It is quite clear that you do not understand English. Brian Deer is not a member of the Sunday Times staff. He is a freelance journalist who runs his own website and blog and is not under the control or direction of the Sunday Times. Mr. Deer should not represent himself as a Sunday Times journalist. He is not a member of staff, does NOT have a regular salary from us, is not on our pension scheme and pays his own tax as a freelance. If he says that he writes for the Sunday Times that would be correct. He is a contributor to The Sunday Times on an occasional basis but again we have no control over him ..."

- Alaistair Brett, Legal Manager, Sunday Times

I watched Brian Deer’s appearance on Anderson Cooper 360, the one where he closed his eyes for extended periods of time when Anderson asked him certain tough questions, and kept wondering to myself, “Who IS this guy?”

The answers are coming in fast and hard as to who Brian Deer really is, and I must say I am thoroughly astonished at how badly many major news outlets...

http://www.ageofautism.com/2011/01/keeping-anderson-cooper-honest-is-brian-deer-the-fraud.html
photo
HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
04:41 PM on 01/10/2011
I invite everyone to visit Brian Deer's website, www.briandeer.com. His specialty is investigative reporting on health issues. He hasn't been very kind to Big Pharma.

When it comes to the recent article, it was commissioned by the BMJ. It is clearly defames Wakefield and in language that is blunt and explicit. The UK is very friendly to plaintiffs who sue for libel. So you can be sure that the BMJ carefully vetted every word of the article. So the article is by Deer with the backing of the BMJ.

Separately, there is the GMC hearing that ended up erasing Wakefield from the medical registry. Brian Deer certainly supplied information to the GMC, but the GMC acted independently and found that Wakefield, beyond a reasonable doubt, was unfit to be a doctor because he had acted unethically and dishonestly.
04:52 PM on 01/10/2011
Sheldon101, Maybe you should read Dr. Wakefield's book "Callous Disregard" for a clearer understanding of how the the case against him was manipulated and contrived in order to assert a claim of misconduct. http://www.amazon.com/Callous-Disregard-Autism-Vaccines-Tragedy/dp/1616081694/ref=sr_1_1?ie=UTF8&s=books&qid=1294696315&sr=8-1
HUFFPOST SUPER USER
SingaporeAutismDad
05:13 PM on 01/10/2011
Sheldon:

Here's more on this Brian Deer chap:

http://www.ageofautism.com/2011/01/keeping-anderson-cooper-honest-is-brian-deer-the-fraud.html
01:47 PM on 01/10/2011
Nonsense. Our children are receiving more than 36 innoculations before the age of five. At the same time autism has increased by over 800%. This "new" information is just propaganda to mask a recent study that indicated that primates who are unvaccinated lead a much more healthy life than vaccinated ones.

It's all about making billions of dollars for the major pharmaceutical companies. They are the ones that led the charge to crucify Dr Wakefielf and are fueling this latest smear. Dr Wakefield wrote a seven page article in the British Medical Journal Lancet calling for studies on the safety of vaccines. He did not reach any conclusions. For that he was run out of England.

The Amish do not vaccinate their children and have a zero rate of autism. Drugs are not the answer nor are mass innoculations with untested chemicals. Let'sw hear both sides of the evidence.
photo
HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
04:45 PM on 01/10/2011
So a UK medical journal's publishing an article about Wakefield is "It's all about making billions of dollars for the major pharmaceut­ical companies."

Go read the article. As well, go read the GMC decision. And in case you don't know, when Deer published his investigations in 2004, Wakefield actually called upon the GMC to investigate.

There is a copy of the GMC decision at https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=0B7TTKX7laEzvMzk2Y2Q4ZGUtZDA5Mi00NGY3LTg5MjAtZDQ1NzE4ODg0ZTQz&hl=en
09:07 PM on 01/10/2011
Sheldon, I would highly suggest you research and find out just WHAT the BMJ is, what kind of organization do you think it is?

I would love for you to share how/where they get their revenue from as well as what percentages of the revenue are from what areas of business?

Also, by reading the original complaints issued to the GMC you can easily see who/what and the intent behind the complaing that Deer sent to the GMC...its facts are black and white, and why Deer, a freelance reporter would have interest in excessive/unessacary/or dangerous testing/care/etc that Deer 'alledges' Dr. Wakefield and others did to these kids, then why do you think NONE of the kids themselves or their parents, or their full medical records ever reveiwed by the GMC?Well, other than the medical records that Deer illegally obtained? I mean, isnt it AT ALL concerning to you that none of the parents/kids were interviewed by GMC?
And another big question? Why would the GMC, a governmental body, EVER take 'hearsay' as evidence? Because that is what they did, they took all 'papers/etc' that Deer gave them and instead of using it as hearsay like it IS, they used it as gospel, as FACT. That is dangerous, and if ANY judge/government body here did that, it would be DISASTEROUS and very WORRISOME!
Can you find ONE GMC case that also decided based on HEARSAY? plz share it.
12:08 AM on 01/11/2011
Sheldon you keep mentioning the GMC hearing and Brian Deer's article in the BMJ. Given your conclusions, one has to wonder if this is ALL you have read about this issue.
photo
HUFFPOST SUPER USER
Eric Mann
Do you want to be on the opposite side of Progress
12:58 PM on 01/17/2011
20 years ago, children received almost as many, how come Autism did not pop up like this then?
Why didn't Autism make a real huge increase when the MMR vaccine was introduced?

The Amish/Autism thing is a total myth. Though they have lower rates, the fact that they have such different social ordering than other people is a much more plausible explanation. That and a lot of Amish do vaccinate their children.
02:43 PM on 01/18/2011
Amish have different social ordering?? You make no sense sir. The Amish have NEVER had a case of autism. The ONLY Amish that have autism are adopted into the sects and were vaccinated before adoption. Do your research.
12:48 PM on 01/10/2011
It's not that Wakefield's science was wrong or there was an error but it's that it was a blatant lie. At the very least he should be charged with manslaughter in EVERY case where a child died from a disease that was preventable with a vaccine.

And americans need to quit being scientifically lazy. Oprah is not a scientist. She is an entertainer. You are socially irresponsible if you know no further science then what you learned in Jr. High School.http://www.huffingtonpost.com/david-ropeik/wakefield-debunked-but-va_b_805826.html#
11:17 AM on 01/12/2011
Well, it's looking more and more crystal clear that Dr. Wakefield did NOT lie - but brian deer DOES - please make sure you are not being 'lazy' and read this article:
http://www.ageofautism.com/2011/01/keeping-anderson-cooper-honest-is-brian-deer-the-fraud.html
For the sake of all of our children we need to really know the truth about this issue, don't we?!
photo
HUFFPOST SUPER USER
AutismNewsBeat
12:28 PM on 01/10/2011
"But in the news conference announcing the paper, Wakefield suggested taking the vaccines one at a time rather than together, just in case."

And just by coincidence, Wakefield applied for a patent on a measles vaccines in 1997!
01:49 PM on 01/10/2011
The vaccine patent he applied for was an adult vaccine and would never have competed with the childhood MMR vaccine.
06:00 PM on 01/10/2011
From my understanding, the Transfer Vector was not viable, and was deemed so before the Lancet article was ever released. So these allegations of a competing vaccine (that wasn't really a vaccine) are not accurate.
08:20 PM on 01/10/2011
ANB, still getting the facts wrong. Wakefield's patent application on behalf of Royal Free Hospital was not for a vaccine but transfer factor which is not what he recommended people use.

Details, ANB, details.