Letter to the Editor:
The recent article by Offit and Jew [1] is misleading and contains
many inaccurate statements. The authors obviously did not take the proper
time to search and review the literature that is a requisite for writing a
review article. The following comments will be directed to their specific
section on thimerosal.
First, the authors stated, “Although no published studies to date
have compared the incidence of neurodevelopmental delay in children who
received thimerosal-free or thimerosal-containing vaccines, several
factors are reassuring that the level of mercury contained in the vaccines
was not likely to be harmful.” In fact, there are three studies [2-4] in
the peer-reviewed literature that have examined children receiving
thimerosal-containing childhood vaccines in comparison to thimerosal-free
(i.e. contained 2-phenoxyethanol as a preservative since their
introduction) childhood vaccines administered to children as part of the
routine childhood immunization schedule. These studies have shown 2- to 6-
fold statistically significant increased risks for neurodevelopmental
disorders and increasing dose-response effects for additional doses of
mercury from thimerosal-containing childhood vaccines in comparison to
thimerosal-free childhood vaccines.
Second, the authors stated, “However, no data exist on the capacity
of low-dose, chronic exposure to ethylmercury to harm the developing
nervous system.” In addition to the three previously referenced articles
showing a direct relationship between increasing mercury from thimerosal
and neurodevelopmental disorders from two different databases [2-4],
Blaxill [5] has in an ecological analysis shown that the prevalence of
autism in the state of California was directly correlated with the doses
of mercury children received from thimerosal-containing childhood
vaccines. Hornig [6] has found that early postnatal administration of
thimerosal to mice using doses and timing that mimic the childhood
immunization schedule induced mouse strain-specific effects mirroring
those of human neurodevelopmental disorders. It has also been shown by
other authors evaluating the effects of ethylmercury in animal systems
that ethylmercury causes distinct-specific damage to the nervous system
[7,8]. Bernard et al. [9,10] have evaluated mercury and autism, and
determined that exposure to mercury can cause immune, sensory,
neurological, motor, and behavioral dysfunctions similar to traits
defining or associated with autism, and the similarities extend to
neuroanatomy, neurotransmitters, and biochemistry. Authors from the
Centers for Disease Control and Prevention (CDC) [11] concluded that they
had serious reservations about administering higher doses of mercury from
thimerosal-containing childhood vaccines than the 25 micrograms of mercury
from a single DTP vaccine at one time because of, “the need to assure
safety of the preservative.” Evaluation of children with autistic spectrum
disorders in comparison to normal-matched control children has shown that
autistic children retain abnormally high concentrations (thimerosal has
been shown [12] and conceded by authors from the Food and Drug
Administration (FDA) [13] to cross the blood-brain barrier and placental
barrier resulting in considerable concentrations of mercury in the brain)
of mercury from such sources as thimerosal-containing childhood vaccines,
whereas normal vaccinated children retain similar concentrations of
mercury as normal unvaccinated children [14,15]. It has been reported that
children who go onto to develop autism have a genetic polymorphism (i.e.
lower numbers of sulfhydryl groups) that causes them to have a decreased
ability to excrete mercury, and as a result they buildup concentrations of
mercury in their brains resulting in neurotoxicity [14]. Furthermore,
evaluation of micromolar concentrations of thimerosal on neurons in tissue
culture has shown that thimerosal can interfere with the conduction of
neurons [16], cause neurodegeneration [17], and induce DNA breaks, caspase
-3 activation, membrane damage, and cell death [18]. Most recently, Waly
et al. [19], from the Johns Hopkins University, Northeastern University,
Tufts University, and the University of Nebraska have published, “A recent
analysis of data from the Vaccine Adverse Event Reporting System,
maintained by the Centers for Disease Control, found a significant
correlation between the use of the thimerosal-containing formulation (vs
the thimerosal-free formulation) of the Diphtheria, Tetanus, acellular
Pertussis (DTaP) vaccine and autism. The discovery of the PI3-kinase/MAP-
kinase/MS pathway, and its potent inhibition by developmental neurotoxins,
including vaccine components thimerosal and aluminum, provides a potential
molecular explanation for how increased use of vaccines could promote and
increase in the incidence of autism.”
Third, the authors stated, “However, the pharmacokinetics of
ethylmercury and methylmercury are not the same. Methylmercury has a
biological half-life in blood of approximately 50 days compared with that
of approximately 7 days for ethylmercury.” We have found numerous articles
that have reported that ethylmercury and methylmercury are similar. Tan
and Parkin [20] have reported that ethylmercury ions and methylmercury
ions should display similar complexion and chemical characteristics. Fagan
et al. [21] have published that although thimerosal is an ethylmercury
compound, it has similar toxicological properties to methylmercury, and
the long-term neurological sequelae produced by the ingestion of either
methyl- or ethylmercury based fungicides are indistinguishable. Zhang [22]
has reported that ethylmercury compounds have toxicological properties
similar to those of methylmercury compounds, and there is evidence that
both methyl- and ethylmercury can persist in the body for a long time.
Yonaha et al. [8] have reported that the clinical signs and pathological
findings caused by methlmercury compounds in animal experiments are known
to be similar to Minamata disease manifested in humans. At the same time,
the symptoms in cats, calves, and mice poisoned by ethylmercury compounds
are similar to those in methylmercury compounds. Further, alkylmercury
compounds having short carbon chains (C1-C3) bring about specific
neurotoxicity and signs of poisoning in rats including weight loss,
ataxia, and closing of the hind legs. Ueha-Ishibashi et al. [23] have
conducted studies with thimerosal and methylmercury demonstrating that
both had similar in vitro toxic effects on cerebellar granule neurons
dissociated from 2-week-old rats. An international committee [24] has
previously evaluated the maximum allowable concentrations of mercury
compounds. The authors reported that the elimination of methyl- and
ethylmercury is very slow, especially in man and primates, and
consequently there is a considerable risk of mercury accumulation. It was
determined that women of childbearing age should not be exposed to an
occupational risk from methyl- and ethlmercury compounds. The authors
concluded that for methyl- and ethylmercury salts, the ceiling value for
mercury in whole blood was the same. Even authors from the FDA [25] have
published, “Because higher-dose exposure to ethylmercury from thimerosal
results in toxicity comparable to that observed after high-dose exposure
to methylmercury, and because of the chemical similarity of the 2
compounds, it appears reasonable to consider toxicity of low doses of
methylmercury and ethylmercury to be similar.”
Miller et al. [26] have investigated the distribution and excretion
of methyl- and ethylmercury in animal systems. The authors intramuscularly
injected chicks with 3.0 mg of methyl- and ethylmercury per kilogram of
body weight. It was determined that higher concentrations of mercury were
observed in the liver, blood, and kidney of chicks following ethylmercury
injection than methylmercury injection. Similarly, decreasing blood
mercury concentrations were observed following injection of chicks with
methyl- or ethylmerucry, and significantly higher concentrations of
mercury were present in the kidney and liver of ethylmercury injected
chicks in comparison to methylmercury injected chicks 1-10 days following
injection. Brooks et al. [27] developed a precise and accurate method for
the determination of either methyl- or ethylmercury in the blood and
tissue of rats using capillary gas chromatography with electron-capture
detection. The authors applied their method to evaluate a pharmacokinetic
study in rats dosed orally with 8 mg mercury/kg as methylmercury chloride
and ethylmercury chloride. The authors found higher concentrations of
mercury present in the blood of ethylmercury (~100% of the dose entered
the blood) treated rats than methylmercury (~80% of the dose entered the
blood) treated rats. The authors also determined that the peak mercury
blood concentration occurred sooner in methylmercury treated rats (12
hours) in comparison to ethylmercury (24 hours), and that greater amounts
of mercury were present in the blood for longer times in ethylmercury (at
5 days: ~75% of maximum value) treated rats in comparison to methylmercury
(at 5 days: ~60% of maximum value) treated rats.
Fourth, the authors stated that thimerosal was removed from most
childhood vaccines by 2001 as a precautionary measure. In reality, as the
CDC has recently conceded in a recent communication with Dr. Weldon, a
Florida Congressman, some of the routinely recommended childhood vaccines
contained the full amounts of thimerosal even as late as 2003, and many
vaccines given to children even today contain 25 micrograms of thimerosal
including: pediatric Diphtheria-Tetanus (DT) vaccine, Tetanus-diphtheria
(Td) vaccine, tetanus toxoid vaccine, meningitis vaccine, and influenza
vaccine. Many of these vaccines have expiration dates towards the end of
2005, and there is no reason to think that the manufacturers are planning
to completely remove thimerasol anytime soon. In fact several documents
recently obtained from WHO state that is their policy to lobby strongly
for maintaining thimerasol in childhood vaccines for the foreseeable
future because they say it is necessary for use in third world counties
and if it is removed from US vaccines these countries may refuse to use
thimerasol containing vaccines.
Fifth, the authors stated that the developing CNS of the fetus is
more susceptible to environmental and toxic insults than that of the
newborn. This fact further accentuates the dangers from the high levels of
thimerosal, which is capable of crossing the placental and blood brain
barriers, [12,13] that were contained until recently in Rho-
immunoglobulin. Rho-immunoglobulin in some formulations contained more
than 100 micrograms per dose and pregnant women often got more than one
dose during their pregnancy. A recent paper by Holmes et al. [15] showed
that autism occurred far more in children born to women receiving Rho-
immunoglobulin than in comparison to matched-controls. The fact that
fetuses are highly susceptible to mercury toxicity is a reason to question
the current recommendation to give thimerosal-containing (i.e. 25
micrograms of mercury per dose) influenza vaccines to pregnant women while
at the same time recommending that they not eat any fish.
Sixth, with regard to the authors comments on the birth doses of
hepatitis B vaccine, since the hepatitis B status of most pregnant women
who deliver babies in the US is known, and is negative in the vast
majority of cases, it would seem that a more prudent recommendation would
be to administer thimerosal-free hepatitis B vaccine to infants at birth
only when their mothers are known to be carriers of the disease, or
perhaps, if the hepatitis status is unknown.
Seventh, the authors imply that there is little or no peer-reviewed
literature on the dangers of thimerosal. Nothing could be further from the
truth. By simply doing a literature search anyone can confirm that there
are literally many hundreds of articles in the peer-reviewed literature on
the dangers of thimerasol (merthiolate) including case-reports, animal
studies, tissues culture studies, genetic studies, toxicology studies, and
biochemical studies. These papers were published over many decades by
authors from a wide variety of fields in science and medicine.
Finally, the only way to restore confidence in our much needed
vaccine program is to admit our past mistakes, correct them as soon as is
possible and to conduct accurate, honest and open discussion of the
problems associated with vaccines. In light of the recent “Autism Alarm”
from the CDC, HHS and AAP which warns that now 1/166 children have
autistic spectrum disorders, and even far worse 1/6 children have
developmental and/or behavioral disorders, we must demand the immediate
removal of thimerasol from all vaccines and other medical products.
Dr. Mark R. Geier has been a consultant and expert witness in cases
involving vaccine adverse reactions before the National Vaccine Injury
Compensation Program and in civil litigation.
David A. Geier has been a consultant in cases involving vaccine
adverse reactions before the National Vaccine Injury Compensation Program
and in civil litigation.
References
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contain harmful preservatives, adjuvant, additives, or residuals?
Pediatrics. 2003;112:1394-1401.
2. Geier MR, Geier DA. Neurodevelopmental disorders following
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Phys Surg. 2003;8(1):6-11.
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