TCA, vol. 40: Do you think MMR causes autism?
Deep down? Maybe just a little?
You’re not alone. A recent survey revealed that 24% of Americans still believe (falsely) that the measles, mumps and rubella vaccine can cause autism. To be more precise:
In April of 2024, 1,500 people were given the statement “The CDC has said that there is no evidence of a link between measles vaccine and getting autism”. 41% said that was very accurate. 32% said that was somewhat accurate. 18% said that was somewhat inaccurate. 6% said that was very inaccurate. 3% were not sure.
How did the MMR get associated with autism?
Back in 1998 when Mariah Carey wore ruched mini dresses and Titanic was #1 in the box office, Andrew Wakefield published a 5-page paper titled “Ilial-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children” in the prestigious scientific journal The Lancet.
This paper followed 12 children (11 boys and 1 girl) who were supposedly referred by their physician to a pediatric gastroentrology unit in England where Wakefield worked. These children all had gastrointestinal symptoms and developmental delays or personality changes. Many intestinal scans and tests were performed and the paper published evidence that many of the children had colitis (inflammation of the colon) or nodules in the intestine. The parents of 8 out of 12 children noted that they had personality changes that happened shortly after receiving the MMR vaccine.
Here is my analysis of the paper, on face value alone (we’ll get to some deeper issues later).
This is a case series-type of study. While there is nothing wrong with a case-series, it is one of the weakest types of scientific studies in that the sample size is small (12 here) and there is no control group. Case-series studies are often done as a type of anecdote to say “Hey, something is weird here. It deserves more attention and a follow up study”. Case-series are NOT meant to be instructive or as a final say in the matter.
Much of the data comes from the parents not doctors. Parent reports are often inaccurate (quick tell me exactly what your child had to eat last Friday for lunch). Parents often are biased in favor of their child, or in favor of their belief system. Parents are usually not scientifically or medically trained, leading to inaccurate reporting (however well intentioned).
Wakefield continues to bring up measles and MMR in the paper even though there is no actual evidence that it is connected to anything. He writes this in the discussion of the paper: “We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described.” The paper itself concedes that there is no association between MMR and these childrens’ symptoms. And yet, the paper continues to raise the spectre as if it’s associated.
Folks, this is the paper that started the “MMR causes autism” belief.
This. Stupid. Paper.
You may be asking yourself … “if the paper proved no association, how could this have caused the fear that the vaccine is dangerous?”. I can’t explain it other than this.
Maybe people didn’t read all the way to the end to the discussion?
Maybe non-scientists were unable to accurately interpret this paper and its weaknesses?
Maybe because Wakefield went on an interview spree after it was published saying things like this?
INTERVIEWER: But if you say there’s at least a question mark over it now, should the vaccine continue to be administered while you’re investigating?
DR ANDREW WAKEFIELD: I think if you asked members of the team that have investigated this they would give you different answers. And I have to say that there is sufficient anxiety in my own mind of the safety, the long term safety of the polyvalent, that is the MMR vaccination in combination, that I think that it should be suspended in favour of the single vaccines, that is continued use of the individual measles, mumps and rubella components.
(The bolded part is important. Remember that for later).
Wakefield has been cagey since. He continued to promote his hypothesis and expanded it into a theory that the combination of autism-like disorders and intestinal dysfunction after MMR vaccination is its own thing called “autistic enterocolitis”.
But in later interview like with Sanjay Gupta, he claims that he was just responding to parental complaints and not making any associations whatsoever.
I see that the paper was “retracted”. What does that mean and why was it?
Science is a self-correcting process, it’s one of the reasons I love it. When a scientist wants to publish their data, they send it to a journal. That journal has an editorial board of experts in that field which reviews the paper (or should, things have gotten shady now-a-days) for things like: Are these data new? Relevant? Important? Is the experiment well done? Is there something missing? Is the analysis or the statistics done accurately? Is there plagiarism or obvious data manipulation?
If the paper fails any one of these questions, it can either be denied or sent back to the scientist for fixing. If it passes, then it is published. After that, other scientists in the same field often will repeat the experiment in order to confirm it.
If, at any point, the data in the paper fails to hold up, it may be retracted from the literature in part, or in full. Retractions happen and the journal gives a reason why. Often they are pretty innocuous and it doesn’t really affect the scientist’s reputation. Maybe the original scientist discovered that they did something wrong or had a lab accident or contamination and requests to retract their own paper.
Sometimes, there are more significant problems. Maybe other labs fail to confirm the results when they repeat the study. Maybe…. wait for it….. someone discovers that there is FRAUD in the paper.
Dun dun dun…..
Fraud, you say?
Oh yes. And a lot of it.
Claiming that a vaccine may be associated with autism (even though the paper didn’t actually claim that…. people took it that way and Wakefield indicated it that way in later interviews) is a extraordinary claim that many other scientists immediately jumped on. A wave of other studies were performed showing that there was NO association between MMR and autism. More than a dozen, and some of those studies were extensive, like a Danish study of over 657,000 children.
A investigative journalist named Brian Deer with some impressive chops in medical reporting (he identified a cover up of serious side effects and it led to the withdrawl of the drug Vioxx) spent 6 years looking into the Wakefield study. His findings then led to the UK’s General Medical Council to do their own investigation….together, this is what they found:
Wakefield received $55,000 in funds from legal aid to study a MMR/autism connection but failed to report this in his paper as a financial conflict of interest
The medical records of EACH of the 12 children was manipulated in some way (ex: two children had onset of autism BEFORE receiving MMR but it was reported in the paper that autism onset was AFTER MMR. One child’s neuropsychology report was doctored to indicate autistic behaviors when there were actually none)
Images of the childrens’ intestines were photoshopped to show abnormalities
A former lab worker said Wakefield threw out data that did not support an association
Wakefield had been hired by an attorney to “find an association” between MMR and autism for a future class-action lawsuit and was paid over $600,000.
The paper said children were referred to the study by their physicians, when actually they were recruited by the above lawyer who found them by email blast looking for parents who wanted to sue a vaccine manufacturer.
Invasive and painful tests were performed on children without approval by the ethics board (this includes Wakefield taking blood samples from children at a child’s birthday party, and performing spinal taps, barium enemas and colonoscopies on children when it was not indicated.) This is medical child abuse.
Wakefield was in the process of developing a SINGLE measles vaccine (remember the bolded part way above? Yeah, he was trying to create a single measles vaccine and used this study to discredit the combo MMR vaccine to remove his competition in the market)
He gave children unapproved and experimental “autism drugs” under the guise of his new business “Carmel Healthcare” in which he planned to create “autism testing kits” and “autism cures” for an expected profit of 43 million per year.
The GMC came to the conclusion that Wakefield had been dishonest in his research, acted against his patient’s best interests, mistreated developmentally delayed children, and failed in his duties as a responsible consultant. They revoked his license to practice medicine in the UK permanently.
This. Stupid. Paper.
What did Wakefield do after this???
He moved to America, and hopped on the autism train. He wrote books, movies, associated with anti-vax celebrities like Jenny McCarthy.
He dated supermodel Elle McPherson. He was invited to Donald Trump’s inaugural ball in 2016 and was asked to be the leader of a possible vaccine safety commission (luckily that never panned out).
And in a media interview, Wakefield said about DJT: “For the first time in a long time, I feel very positive about this, because Donald Trump is not beholden to the pharmaceutical industry. He didn’t rely upon [drug makers] to get him elected. And he’s a man who seems to speak his mind and act accordingly. So we shall see.”
While a lot of this is political posturing that never amounted to anything, Wakefield also did some really harmful things.
In Minnesota, autism rates are unusually high in a Somali immigrant community, for reasons doctors can’t explain (although there is some discussion about vitamin D levels and the amount of sunlight difference between Somalia and Minnesota and also autism is not diagnosed in Somalia, so there really is no basis for comparison). Wakefield has given several talks to Somali families in Minnesota and urged them not to take the MMR vaccine. By 2017, the MMR vaccination rate in that community plummeted from 92% to 42%. What happened is tragic and predictable. Two large Measles outbreaks ravaged that community, the largest outbreaks in Minnesota in decades.
Sidebar: Measles is a nasty disease that not only can lead to death and permanent physical damage but can also wipe out your immune system. Read more about measles here and here.
Why are we still dealing with this?
I like to believe that people do their best with the information that they have. When Wakefield published a paper that implied (but did not state) that MMR was associated with autism, parents acted in their children’s best interest. MMR vaccinations plummeted in England from 92% to 73%, and as low as 50% in some parts of London. They didn’t yet know about the fraud and so they believed this doctor was being honest and ringing the alarm bell. Wouldn’t you have done the same?
But now that we know about all the fraud, why are people still believing this? Maybe because Wakefield himself has continued to spew these lies in the guise of “there’s a big conspiracy to silence me and THEY don’t want you to know” type of stuff. And there are a LOT of people out there that are vulnerable to conspiracy theories, especially after the erosion of trust in the medical establishment post-COVID.
Maybe people don’t know about the fraud and all they know is what their facebook algorithms show them. Maybe once you plant an idea in someone’s head, its impossible to dig it back out. Maybe people are so worried about autism that they will “err on the side of caution” just in case there is a kernel of truth to this conspiracy.
But the truth is this: Wakefield made most of this up. We have the receipts. Why is he doing this, I’ll never know. Maybe he really believes it. Maybe he is so deep in his lies he thinks there is no way out of it. Maybe after he was stripped of his ability to practice medicine and was shunned from the scientific community, the only way for him to support himself is through the conspiratorial money-making machine. Maybe he’s just a giant turd.
Stay happy, healthy and informed.
Jessica at TCA
Deer, B. How the case against the MMR vaccine was fixed. BMJ. 2011.
Andrew Wakefield’s Fitness to Practice Panel Hearing. General Medical Council. 2010.
DeStefano and Shimabukuro. The MMR Vaccine and Autism. Annu. Rev. Virol. 2019.
Tanne, J. MMR vaccine is not linked with autism, says Danish study. BMJ. 2002.
Johnson, Pat. Vaccine Challenges in a New Administration. American Academy of Pediatrics. 2017.
Branswell, H. Measles sweeps an immigrant community targeted by anti-vaccine activists. STAT. 2017.