Worldwide Ban on Thimerosal Would Cost Lives
Dec 17, 2012

Amy Pisani, Executive Director of Every Child By Two, offers insight on an important global decision regarding thimerosal in vaccines. 

Today, the American Academy of Pediatrics is supporting the World Health Organization’s position to continue to use the preservative thimerosal to vaccinate children in developing nations.

As our readers are most likely aware, thimerosal was removed from the majority of vaccines provided to infants and children in the U.S. due to concerns that this mercury-based preservative could cause detrimental effects.  So why would the World Health Organization (WHO) and the American Academy of Pediatrics (AAP) support the continued use of thimerosal in foreign countries?  The simple answer is that thimerosal is a safe and necessary component of vaccines and that millions of lives would be lost if efforts to ban it globally were to succeed.  But the story behind the decision is not as simple.

Thimerosal…what is it, and how did that one word spread havoc in the hearts of a nation at the outset of the new millennium?

Thimerosal is an ethyl mercury based preservative that prevents the growth of bacteria and fungi.  The preservative was included in all multi-dose vials of vaccines to eliminate the chances of contamination, which could occur as syringe needles are reinserted into multi-dose vials.  This contamination has the potential to cause severe reactions at the site of the injections, as well as serious illness and even death, hence the need for a stable preservative in the vials.
PD_0173Up until the late 1990s many of the vaccines used in the U.S were in multi-dose vials and therefore included thimerosal.  The Food and Drug Modernization Act of 1997 required that the Food and Drug Administration (FDA) review mercury content in all biological products.  The review noted that the cumulative amounts of ethyl mercury found in the vaccine series given to young infants could potentially exceed the US Environmental Protection Agency (EPA) guidelines.   It is important to note that the EPA’s standards were stricter than those of the FDA or the Agency for Toxic Substances Disease Registry (TSDR).  Vaccines did not surpass the levels set forth by either the FDA or TSDR.
In response to the EPA findings, the AAP and US Public Health Service (USPHS) called for the elimination of mercury in vaccines as a precautionary measure.  Manufacturers responded by altering production procedures to create single dose vials of those vaccines that were formerly stored in multi-dose vials.  The only vaccine for children that currently contains thimerosal are some doses of influenza vaccination – a necessary decision due to the need to rapidly disseminate vaccines, particularly in face of serious pandemics of influenza.  Most people are unaware that several vaccines, including MMR (measles, mumps, rubella) vaccine, never contained thimerosal in the first place.
As it turns out, the EPA standards were set for methyl mercury, commonly found in fish and wildlife, which are themselves contaminated through environmental mercury pollution.  Methyl mercury, which accumulates in the body at least seven times longer than ethyl mercury, has been proven to cause adverse neurodevelopmental effects.

What we have learned.

In the time since the decision was made to remove thimerosal from vaccines, numerous studies have been conducted worldwide to determine the effects of thimerosal on infants and children.  These studies have found no evidence that the preservative causes harm to infants or children.  Special attention has been focused on the question of whether the removal of thimerosal from vaccines would result in a rapid decline in autism cases.  This was not the case; even with the decline in use of thimerosal containing vaccines, autism rates continued to climb.
It was hoped that by clarifying the difference between methyl and ethyl-mercury, the lack of that one letter “m” in front of the word describing a dangerous compound, the fears of a nation would be alleviated…no such luck!
BurtonThimerosalOne man ensured that our fears were fed through a series of highly publicized hearings on Capitol Hill; Congressman Dan Burton, who was convinced that his grandson was rendered autistic due to his vaccines.  As an expectant mother at the time, I can attest to the fact that these hearings, and subsequent news stories, planted seeds of doubt regarding whether sufficient research was in hand to make a determination about the connection between vaccines and autism.  In all honesty, I sat through hearing after hearing trying to wrap my non-medically trained brain around the concept of the difference between types of mercury and studies already present that clarified there was no fear to be had from ethyl mercury.  To make matters worse, Burton was incredibly demeaning to and argumentative towards any scientist who testified regarding the safety of thimerosal, making it very difficult to focus on the content of their presentations.
As it turns out, the answer really was simple…. Unlike the methyl mercury found in the environment, ethyl mercury is quickly excreted from the body. Therefore, it is much less likely to accumulate in the body, causing the type of harm that methyl mercury is proven to cause, such as brain damage. It is truly as simple as that.  And, based on this fact and the dozens of studies conducted throughout the world since 1999, parents can unequivocally place their fears about thimerosal containing vaccines beyond the back burner.

Flash forward to 2012.

With the exception of some influenza doses, U.S. vaccines no longer contain thimerosal.  Families are increasingly gaining confidence in the research that exonerates vaccines as a cause of autism or other neurological disorders.  And yet, a draft treaty is currently under consideration by the United Nations Environmental Program (UNEP) to ban the use of mercury-based compounds, including thimerosal, worldwide.  While the UNEP’s proposal to eliminate exposure to dangerous forms of mercury is a noble goal, the inclusion of thimerosal in the treaty is misguided, since scientific consensus concludes that this form of mercury does not pose a threat to humans.
In fact, thimerosal-containing vaccines are critical in the efforts to distribute vaccines to developing countries for several reasons.  The use of multi-dose vials reduces the cost of vaccines and the demand on already constrained cold-chain systems (vaccines must be kept at stable temperatures to remain viable, a particular challenge in resource-poor countries).
WHOAccording to the WHO, if thimerosal is no longer in use, single dose vials will increase the amount of transportation and storage space required more than threefold with an estimated cost increase that exceeds 300 million annually.
This explains why the WHO, as well as U.S. and foreign governmental and non-governmental organizations, are taking steps to educate government agencies worldwide regarding the need to continue to allow thimerosal in vaccines and remove it from the list of banned mercury products.

Today’s announcements and commentaries.

Today, we commend the AAP, who has announced their endorsement of the recommendation of the WHO’s Strategic Advisory Group of Experts on Immunization pertaining to the use of thimerosal in vaccines.  Three captivating commentaries accompany their endorsement of the use of thimerosal in vaccines.  The first titled Ban on Thimerosal in Draft Treaty on Mercury: Why the AAP’s Position in 2012 Is So Important provides the rational for the call for the removal of thimerosal from vaccines in 1999.  The commentary concludes with this decisive statement;

“Had the AAP known what research has revealed in the intervening 14 years, it is inconceivable to us that these organizations (AAP and USPHS) would have made the joint statement of July 7, 1999. The WHO recommendation to delete the ban on thimerosal must be heeded or it will cause tremendous damage to current programs to protect all children from death and disability caused by vaccine-preventable diseases”

AfricanKidsThe second commentary Global Vaccination Recommendations and Thimerosal”, includes the specific findings of experts on the devastating effects that a global ban on thimerosal would have on efforts to vaccinate children globally.  Vaccines currently prevent more than 2.5 million deaths annually.  Millions more could be saved if global vaccine efforts received the proper support.  This ban would have the opposite effect, resulting in the deaths of untold numbers of children worldwide.
While some claim it unjust to allow thimerosal use in developing nations, since it has been phased out of the supply chain for wealthier nations, the final commentary, titled Global Justice and the Proposed Ban on Thimerosal-Containing Vaccines” counters that argument.  The writers provide the rational for opposing a ban on thimerosal in resource-poor countries based on the fact that current science does not support such a decision in 2012 and that there would be a certain loss of lives if such a decision were to be made.
Back in 2002, after evaluating the research that showed that thimerosal posed no risk of harm, the AAP retired their statement from 1999 that called for the removal of thimerosal from vaccines.  Today, they have taken a monumental step in supporting the rights of children worldwide to have access to life-saving vaccines by endorsing the WHO’s position and the publication of these three monumental essays.

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