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PEDIATRICS Vol. 104 No. 3 September 1999, pp. 570-574

AMERICAN ACADEMY OF PEDIATRICS:
Thimerosal in VaccinesAn Interim Report to Clinicians

Committee on Infectious Diseases and Committee on Environmental Health

The first 300 words of the full text of this article appear below.

On July 7, 1999, the American Academy of Pediatrics (AAP) issued with the US Public Health Service (USPHS) a joint statement alerting clinicians and the public of concern about thimerosal, a mercury-containing preservative used in some vaccines. That statement was disseminated widely, including on the AAP members e-mail list, and was posted on the AAP web site since July 7, 1999. The AAP Board of Directors recognizes that in the light of these concerns, clinicians need guidelines today on their infant immunization practices.

What follows is information prepared by our technical committees as sections introduced by the following headings: Thimerosal, Mercury Exposure and Toxicity, Federal Guidelines, and Risk of Withholding Vaccines. The AAP Board of Directors then offers specific interim guidelines based on its understanding of the information that is currently available. This material should allow clinicians to inform parents about thimerosal. It takes advantage of the flexibility of the 1999 Recommended Childhood Immunization Schedule of the American Academy of Pediatrics, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC), and the American Academy of Family Physicians (AAFP) with modest modifications, which provide an expansion of the margin of safety for small infants. It is important not to compromise the remarkable protection immunization now offers during that particularly vulnerable time of life.

	THIMEROSAL

Thimerosal has been used as an additive to biologics and vaccines since the 1930s because it is very effective for killing bacteria used in several vaccines and for preventing bacterial contamination, particularly in opened multidose containers. Some but not all of the vaccines recommended routinely for children in the United States contain thimerosal.¹ Thimerosal contains 49.6% mercury by weight and is metabolized to ethyl mercury and thiosalicylate. Data are limited regarding potential differences in toxicity between ethyl mercury and methyl mercury. Both forms of organic . . . [Full Text of this Article]

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