Published online February 1, 2008
PEDIATRICS Vol. 121 No. 2 February 2008, pp. e208-e214 (doi:10.1542/peds.2006-3363)
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ARTICLE

Mercury Levels in Newborns and Infants After Receipt of Thimerosal-Containing Vaccines

Michael E. Pichichero, MDa, Angela Gentile, MDb, Norberto Giglio, MDb, Veronica Umido, MDb, Thomas Clarkson, PhDc, Elsa Cernichiari, MSc, Grazyna Zareba, PhDc, Carlos Gotelli, PhDd, Mariano Gotelli, PhDd, Lihan Yan, MSe and John Treanor, MDa

a Department of Microbiology/Immunology, Pediatrics, and Medicine, University of Rochester, Rochester, New York
b Department of Epidemiology, R. Gutierrez Children's Hospital, Buenos Aires, Argentina
c Department of Environmental Medicine, University of Rochester, Rochester, New York
d Center of Toxicology Research, Buenos Aires, Argentina
e EMMES Corp, Rockville, Maryland

OBJECTIVES. Thimerosal is a mercurial preservative that was widely used in multidose vaccine vials in the United States and Europe until 2001 and continues to be used in many countries throughout the world. We conducted a pharmacokinetic study to assess blood levels and elimination of ethyl mercury after vaccination of infants with thimerosal-containing vaccines.

METHODS. Blood, stool, and urine samples were obtained before vaccination and 12 hours to 30 days after vaccination from 216 healthy children: 72 newborns (group 1), 72 infants aged 2 months (group 2), and 72 infants aged 6 months (group 3). Total mercury levels were measured by atomic absorption. Blood mercury pharmacokinetics were calculated by pooling the data on the group and were based on a 1-compartment first-order pharmacokinetics model.

RESULTS. For groups 1, 2, and 3, respectively, (1) mean ± SD weights were 3.4 ± 0.4, 5.1 ± 0.6, and 7.7 ± 1.1 kg; (2) maximal mean ± SD blood mercury levels were 5.0 ± 1.3, 3.6 ± 1.5, and 2.8 ± 0.9 ng/mL occurring at 0.5 to 1 day after vaccination; (3) maximal mean ± SD stool mercury levels were 19.1 ± 11.8, 37.0 ± 27.4, and 44.3 ± 23.9 ng/g occurring on day 5 after vaccination for all groups; and (4) urine mercury levels were mostly nondetectable. The blood mercury half-life was calculated to be 3.7 days and returned to prevaccination levels by day 30.

CONCLUSIONS. The blood half-life of intramuscular ethyl mercury from thimerosal in vaccines in infants is substantially shorter than that of oral methyl mercury in adults. Increased mercury levels were detected in stools after vaccination, suggesting that the gastrointestinal tract is involved in ethyl mercury elimination. Because of the differing pharmacokinetics of ethyl and methyl mercury, exposure guidelines based on oral methyl mercury in adults may not be accurate for risk assessments in children who receive thimerosal-containing vaccines.

Key Words: thimerosal • vaccine • neurotoxicity • ethyl mercury

Abbreviations: Hib—Haemophilus influenzae type b • HBV—hepatitis B virus • CI—confidence interval • DTwP—diphtheria–tetanus–whole-cell pertussis • CVAFS—cold-vapor atomic fluorescence spectrophotometry • GGT—{gamma}-glutamyl transpeptidase

Accepted Jul 16, 2007.




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