January 4, 2013

Thimerosal for Vaccines - AAP Endorses WHO Statement

Some people seem to like controversies. This is one controversy that I wish our medical researchers could eliminate. For the present, many people will need to continue to be exposed to (admittedly extremely low) low levels of mercury poisoning, especially the children of the world. At the center of this controversy is thimerosal, a preservative used to prevent contamination in multidose vaccine vials. Why science or our researchers refuse to find an alternative preservative that is mercury free is indeed a puzzle.

The World Health Organization's (WHO's) Strategic Advisory Committee (SAGE) wants thimerosal exempted from a pending international treaty aimed at reducing global health hazards by limiting exposure to mercury. The American Academy of Pediatrics and many other medical professional organizations have now supported the position of SAGE. Why, you may ask? Because banning thimerosal would make our flu vaccines, cost nearly triple what they do presently by using thimerosal. The cost of manufacturing vials for single-use shots of vaccines (including the flu) would make the cost go up.

Thimerosal contains ethyl mercury, which supposedly has not been linked with any of the toxic effects associated with its relative compound, methyl mercury. Methyl mercury is a known neurotoxin. Since the late 1990s, studies have found no evidence of harm by using thimerosal in vaccines, and the WHO endorsed the use of thimerosal in vaccines in 2008.

The American Academy of Pediatrics in 1999, issued a joint statement with the US Public Health Service, advocating for the elimination of mercury in vaccines. Then in 2002, they pulled the statement.

Currently the United Nations Environmental Program is developing an international treaty that would call for the elimination of any controllable mercury pollution and exposure around the world. The treaty under consideration would remove mercury from thermometers and other medical devices and would remove thimerosal from vaccines.

The principal reason for resistance to removal of thimerosal is cost, cost, and cost. The cost of manufacturing in switching from multidose to single dose will vary greatly from country to country. This cost increase will range from 200% to greater than 500%. Then add the costs of adding additional manufacturing space since current manufacturing space would be limited. The costs of transportation and storage space would also increase for single dose vials by three times. Last, consider the policy and vaccine program changes necessary to accommodate the single dose use.

Now consider this, thimerosal is not generally used in the United States, where vaccines are now single-dose. However, and this is a biggie, our seasonal influenza vaccines still use thimerosal. Yes, our flu shots are available without thimerosal, but the cost is almost triple. Most doctors will not keep a supply of the thimerosal free flu vaccine on hand because of this cost and most insurance will not cover this.

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