Debbie Nicholson

AAP supports the World Health Organization stand on mercury-based preservative

It appears the controversy on thimerosal will once again be heating up as news breaks the American Academy of Pediatrics (AAP) stands behind the World Health Organization (WHO) that the mercury –based compound thimerosal should remain in vaccines and should not be banned in order to avoid devastations in developing countries.

In 1999, questions regarding exposure to mercury following immunization with thimerosal containing vaccines were being raise in the United States. The Global Advisory Committee on Vaccine Safety had concluded there was no evidence of mercury toxicity in infants, children or adults exposed to vaccines containing thimerosal.

By 2001, the United States, countries in the European Union and other prosperous countries no longer used thimerosal as a preservative in vaccines however; it still remains in some seasonal influenza vaccines such as the three in one shot in 2010.

In recent decades concerns have been raised over the thimerosal and autism connection. These concerned were raised over the issue was that about half the mercury contained ethyl mercury, resulting in scientists using methyl mercury.

The Centers for Disease Control and Prevention in a 2010 study demonstrated that prenatal and infant exposure to vaccines containing thimerosal do not increase the risk for autism.

Thimerosal faces a possible ban by the United Nations. Next month in Geneva representatives world-wide will be in session assembled by the United Nations Environmental Program for the preparation of a global treaty to reduce health hazards by placing a ban certain products and processes in which release mercury into the environment. The proposal to ban thimerosal is meeting with great opposition from pediatricians.

Dr. Louis Cooper is Professor Emeritus of Pediatrics at the College of Physicians and Surgeons of Columbia University and a past (2001-2002) President of the American Academy of Pediatrics, related to Reuters Health "Subsequently an awful lot of effort has been put into trying to sort out whether thimerosal causes any harm to kids, and the bottom line is basically, it doesn't look as if it does.”

The American Academy of Pediatricians is calling to reverse the 1999 decision on the removal of thimerosal from the U.S. pediatric vaccine schedule.

Dr. Cooper and Dr. Samuel L. Katz co –authors of the article which will appear today in Pediatrics had written the following:

Had the AAP (and, we suspect, the USPHS) known what research has revealed in the intervening 14 years, it is inconceivable to us that these organizations would have made the joint statement of July 7, 1999. The World Health Organization 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.

Once again thimerosal is not used in any vaccines with the exception of some influenza shots.

Dr. Walter A. Orenstein, MD, FIDSA, professor of medicine, global health, and pediatrics at Emory University and member of AAP Committee on Infectious Diseases, said that nobody is arguing that it should change, according to Reuters Health report.

The AAP is arguing that in countries with fewer resources where many children die from vaccine preventable diseases, thimerosal should be used because it is less costly and easier to multi-dose vials of vaccines against diseases such as diphtheria.

The AAP writes "Thimerosal allows the use of multiuse vials, which reduce vaccine cost and the demand on already constrained cold-chain systems.” They add that the benefits of thimerosal outweigh the risks.

WHO's Strategic Advisory Group of Experts (SAGE) in their recommendations note that there are no viable alternatives.

Basically the recommendations state that banning thimerosal may threaten access to certain vaccines such as diphtheria and hepatitis B around the world and especially in developing countries.

The statement reads "There would be a high risk of serious disruption to routine immunization programs and mass immunization campaigns if thimerosal-preserved multi=dose vials were not available for inactivated vaccines, with a predictable and sizable increase in mortality, for exceedingly limited environmental benefits.”

Once again fuel is being added to the fire in the war over thimerosal. The California based group SafeMinds which has had an important part in the push for the international ban.

Eric Uram, Executive Director at SafeMinds commented the practice is "egregious, offensive and unacceptable," as noted by NPR News.

According to Uram the group had contacted officials from countries that included Nigeria and Uganda and found they are concerned. He says the countries are afraid to speak up because WHO has declared them safe. Uram believes the ban would be phased in and allow countries to have time to find an alternative.

Dr. Heidi Larson, MA, PhD, anthropologist, says there is no good alternative right now for thimerosal and no scientific reasons to ban it. "It would be bowing to public pressure, “says Dr. Larson.

Do you believe there should be a world-wide ban on thimerosal? Feel free to weigh in on the debate.