Respectful Insolence

One of the oldest topics I’ve dealt with on this blog, a topic that I’ve been writing about on and off (unfortunately, mostly on) about the antivaccine movement. Ever since I first discovered about a decade ago that, yes, there are people ignorant enough about science and medicine that they actually think that vaccines are harmful and cause autism, as well as actually believing that it is a good idea not to vaccinate their children against even deadly diseases like the measles, polio, Haemophilus influenzae type B (HiB), and more. As a group, hiding behind the risible claim that they are “not antivaccine” but rather “pro-vaccine safety,” whether they admit it or not, they seem bound and determined to allow the return of diseases that had been brought under control or even, like polio, on the brink of being eliminated.

While overseas, particularly in the U.K., the vaccine bogeyman is the MMR vaccine, thanks to a campaign of fear stoked by a British gastroenterologist and incompetent scientist named Andrew Wakefield who was also in the pay of trial lawyers looking to sue vaccine manufacturers. In the U.S, the vaccine bogeyman is a preservative used to prevent bacterial contamination of multi-dose vials known as thimerosal. What makes thimerosal so easy to demonize is that it just so happens to contain mercury, and back in the 1990s the myth that mercury in thimerosal-containing vaccines (TCVs) causes autism spread throughout the U.S., even though there was no compelling evidence that TCVs were in any way correlated with the risk of autism or autism spectrum disorders. It is a hypothesis that had a tiny modicum of plausibility 15 years ago but whose plausibility has long been crushed. It is a failed hypothesis. Even though it was pretty well established that this was the case back in 1999, the FDA and CDC still moved to remove thimerosal from vaccines in 1999, a process that was complete by the end of 2001. Since then, it’s gone way beyond “pretty well established” and into the realm of a falsified hypothesis. The idea that mercury in vaccines is in any way related to autism is about as falsified as a hypothesis can be, particularly in light of multiple studies that have failed to find a decrease in the prevalence of autism in the years since 2001, something that should have happened by now if TCVs contributed to autism.

Even though the evidence shows that TCVs do not cause autism, thimerosal is not used in vaccines in the U.S. and developed countries. However, in the U.S. and developed countries, we can afford single-dose vials of vaccine that do not require a preservative, either thimerosal or another preservative to take its place. We also have ready access to refrigeration for these vaccines. Such is not necessarily the case in much of the world, particularly in impoverished Third World countries, where cost and access to adequate refrigeration are major considerations. Reflecting this reality, public health experts and doctors have warned about one perils of banning mercury in certain processes and products:

A group of prominent doctors and public health experts warns in articles to be published Monday in the journal Pediatrics that banning thimerosal, a mercury compound used as a preservative in vaccines, would devastate public health efforts in developing countries.

Representatives from governments around the world will meet in Geneva next month in a session convened by the United Nations Environmental Program to prepare a global treaty to reduce health hazards by banning certain products and processes that release mercury into the environment.

But a proposal that the ban include thimerosal, which has been used since the 1930s to prevent bacterial and fungal contamination in multidose vials of vaccines, has drawn strong criticism from pediatricians.

They say that the ethyl-mercury compound is critical for vaccine use in the developing world, where multidose vials are a mainstay.

Banning it would require switching to single-dose vials for vaccines, which would cost far more and require new networks of cold storage facilities and additional capacity for waste disposal, the authors of the articles said.

Perhaps the key article published online in Pediatrics is entitled Global Justice and the Proposed Ban on Thimerosal-Containing Vaccines by Katherine King, Megan Paterson and Shane K. Green. King et al begin the article by pointing out that thimerosal-free single dose vials of vaccines were introduced into high income countries as a “precautionary move, now known to be unfounded. However, for low- and middle income countries, where, the authors note, the burden of vaccine-preventable diseases are most severe, multi-dose vials of TCVs are a critical part of immunization programs. Indeed, the authors point out that switching away from TCVs in such countries would have a high price:

Extensive additional resources associated with increased manufacturing, shipping, cold-chain storage, administration, and waste-handling infrastructure would be required by a move away from multidose vaccines; for example, a shift to single-dose vials would increase the annual cost of Pan American Health Organization– or UNICEF–supplied vaccines by .$300 million.

In early 2013 governments will be set to finalize the products and processes that will be prohibited in a multilateral environmental treaty whose purpose is to limit human exposure to mercury. While I agree that this is a laudable goal, as do the authors of this commentary, such a move could have severe unintended consequences for global vaccination programs, which is why the World Health Organization and “much of the broader scientific and public health community” have recommended that thimerosal-containing vaccines be exempt from any ban on mercury-containing products, in order to avoid compromising global vaccination efforts in the very countries where strong vaccination programs are most needed.

One of the interesting aspects of those arguing against such an exemption is that they think it’s a matter of justice. In other words, they argue that it’s unjust to subject children in impoverished nations to a compound whose exposure is being limited in everyone else. I’ve heard this argument before. Basically, it involves the implication that we are somehow willing to “poison” poor people, that it’s somehow hypocritical to be willing to allow the use of a substance in poor countries that we do not use in our own. Superficially, it sounds like a compelling argument, but it rests on a false premise. That’s why to this the authors respond that difference does not necessarily signal injustice. I think I’ll let King et al explain, because the they do it well:

Although vaccines containing thimerosal are more widely used in LMICs than in HICs, a difference in immunization practice that would persist if thimerosal use were to continue in LMICs, the charge of injustice is misguided. Different practices, in and of themselves, do not make for injustice; they are morally problematic only if they are unjustified and compromise the interests of the affected parties. The moral intuition at work here is one of equality, that each life must be treated with equal respect and regard. Treating individuals with equal regard, however, does not mean that all people are treated the same in all respects. Indeed, promoting equality in 1 sphere, such as health, often requires that people be treated differently in response to their unique needs and circumstances. It is only when differences in practice are not justified by differences in the needs and circumstances of the target individual or group, leading to avoidable harms, that concerns of injustice and inequality arise. Thus, the use of thimerosal-containing vaccines in some jurisdictions but not others would only be unjust if this practice were harmful and unjustified. Neither is true.

King et al then go on to point out that there is “no credible scientific evidence” that TCVs represent any threat to human health, which is true. Like the parrot in the famous Monty Python sketch, the hypothesis that TCVs cause autism is, deader than dead can be. Antivaccinationists will tell you that it’s “pining for the fjords,” but in reality It’s not pinin,’ it’s passed on! This hypothesis is no more! It has ceased to be! It’s expired and gone to meet its maker! This is a late hypothesis! It’s a stiff! Bereft of life, it rests in peace! If antivaccinationists hadn’t nailed it to its perch it would be pushing up the daisies! Its metabolical processes are of interest only to historians! It’s hopped the twig! It’s shuffled off this mortal coil! It’s run down the curtain and joined the choir invisible! This…. is an EX-HYPOTHESIS!

Sorry, I couldn’t resist. Besides, it’s been a long time since I’ve done that; so I was due.

Because there is no credible evidence to support the hypothesis that TCVs do any of the harms attributed to them by antivaccinationists (or any harm at all other than occasional local reactions), King et al conclude:

In the absence of risk to human health, the use of thimerosal in vaccination programs in LMICs presents no threat of injustice. Rather, it is banning thimerosal that would cause an injustice to those living in LMICs and relying on these vaccines for effective protection against many harmful infectious diseases. Currently, multidose vaccines containing thimerosal are used in .120 countries to immunize ∼84 million children every year,19 saving the lives of ∼1.4 million people annually. 20 They are also used throughout the world, including the United States and other HICs, for pandemic influenza vaccines, because it allows for more rapid production and easier dissemination of the vaccines.20 And yet, banning thimerosal would amount to banning such multidose vaccines, including tetanus toxoid, diphtheriatetanus- whole cell pertussis, and hepatitis B vaccines.

The results would be potentially catastrophic. Leaving cost aside, while the infrastructure and manufacturing capabilities to replace multi-dose TCVs with single-dose preservative-free vials, there would be an enormous strain on the resources and public health infrastructure of low income countries. Even if the challenges could be met, disruption to vaccine supplies would be inevitable, and such supply disruptions would be likely to last for several years, which is why King et al pose a question:

Not surprisingly, during the course of negotiations, LMIC governments have questioned whether thimerosal should be exempted from the treaty.25 The resistance to its continued use comes entirely from nongovernmental organizations in HICs, the populations of which would not suffer the consequences of the potential ban. Where’s the justice in that?

Where indeed?

That is why the American Academy of Pediatrics has endorsed the recommendation of the WHO’s Strategic Advisory Group of Experts regarding TCVs, particularly given that there is no viable alternative to thimerosal that can be used as a preservative in multi-dose vaccine vials.

Predictably, the antivaccine loons have come out of the woodwork over this. For example, over at the MedPageToday report on the AAP’s recommendation, the commenters are overwhelmingly antivaccine loons ranting at big pharma, throwing down fallacies about thimerosal, and in general spewing the usual long-debunked and scientifically unsupported canards, along with a heapin’ helpin’ of pure paranoid conspiracy mongering. It’s truly depressing to behold; the reason-based community there could really use some tactical air support. And, of course, the merry band of antivaccine propagandists over at the antivaccine crank blog, Age of Autism, are enraged—enraged, I tell you!—at the AAP. (When are they ever not enraged at the AAP and CDC?)

Personally, I’d actually go further than the AAP and WHO here. I’d argue that the claimed link between TCVs and autism has been so thoroughly falsified that it would not be unreasonable to lift the ban on TCVs in all countries, not just impoverished countries. After all, even here in the U.S., we have areas with poor children who could benefit from less expensive, more available vaccines. It won’t happen, of course, but it’s not as crazy as antivaccinationists would make you think it sounds.

Comments

  1. #1 Darwy
    Røde grøde med fløde
    December 19, 2012

    Unless there’s a cost-effective replacement for thimerosal which has undergone rigorous testing, thimerosal isn’t going to go anywhere.

    I figure one of those nutjobs will suggest putting nanosilver in the multi-dose vials.

  2. #2 elburto
    December 19, 2012

    Darwy – either that, or MMS. I shudder to think.

    There was a BBC documentary that aired this year, about the cold chain, Cold Chain Mission.

    In it, Ewan McGregor followed the chain through India and Nepal, then the Congo. To say it was an eye-opener would be an understatement. Banning TCVs would blow the chain wide open. Privilege and stupidity are a deadly mix.

    Also, I still cannot believe that US citizens have to pay for immunisation.

    Given that there are isolated and impoverished places that might as well be classed as “developing” rather than “developed” (Appalachia springs to mind, along with FLDS enclaves like Yearning For Zion), it’s a public health disaster in the making as it is, never mind the additional burden of making vaccines a luxury item. That’s not the way to get coverage to a protective level.

    Info about CCM –

    http://www.unicef.org.uk/asp/cold-chain-ewan-mcgregor/

  3. #3 Tony Mach
    December 19, 2012

    What both the anti-vaxxers and the medical community fail to mention in this discussion: How much Thimerosal is there in a dose of a vaccine? And how much mercury is that? And how much is that compared to the average content of mercury in, say, a can of tuna-fish?

    (And by the way, that Thimerosal was pulled from vaccines, and that there seemed to – according to the anti-vaxxers – be little data about the safety of Thimerosal, was something that made me slightly anti-vax at the time.

    I’m over my anti-vax phase now, so, just saying.)

  4. #4 Grant
    December 19, 2012

    Tony,

    While not quite answering your question, there have been studies trying to establish where what mercury people have in their bodies comes from. I covered one of these papers a few years ago: http://sciblogs.co.nz/code-for-life/2009/10/27/autistic-children-and-blood-mercury-levels/

  5. #5 Todd W.
    harpocratesspeaks.com
    December 19, 2012

    @Tony

    I also have some info on thimerosal a antiantivax.flurf.net, including how much mercury is in a can of tuna (~69.19mcg in an average can of white albacore tuna).

  6. #6 LW
    December 19, 2012

    @elburto: “Also, I still cannot believe that US citizens have to pay for immunisation.”

    Where I live, Oklahoma, the County Health Department gives all the childhood vaccines, and flu vaccines for adults (and maybe other vaccines but I haven’t checked), free. You can go to a pharmacy instead (and I have) because pharmacies have better hours, are more convenient when you’re working, and have shorter lines. Also many companies provide free flu shots for adults, as does mine.

  7. #7 Todd W.
    harpocratesspeaks.com
    December 19, 2012

    If I’m not mistaken, the newly enacted Federal Affordable Care Act (aka “Obamacare”) requires insurance companies to fully cover the ACIP recommended vaccines for children and adults, at no cost to the patient, as long as they use a provider that is within their insurer’s network.

    As LW says, you can still go outside your insurance network and go to, say, a pharmacy, but you’ll have to pay out of pocket for the vaccine then.

  8. #8 Dangerous Bacon
    December 19, 2012

    Off-topic, but there’s a great rant on NaturalNews against Dr. Oz, who already was in trouble for seemingly having recanted earlier statements questioning vaccines. Now that he’s publicly doubted the benefits of organic food, the gloves are really off.

    “Dr. Oz’s purported audience is a sham, by the way. Natural News has a far larger audience than Dr. Oz, especially when you count the cumulative IQ points of our respective followers.”

    h_tp://www.naturalnews.com/038157_Dr_Oz_organic_food_sellout.html#ixzz2FVGWcb00

  9. #9 Lawrence
    December 19, 2012

    @Dangerous Bacon – I love it when the alt-med crowd eats one of their own…..

  10. #10 dandover
    42.45989,-71.268009
    December 19, 2012

    Speaking of immunization in third-world countries, the present thimerosal controversy may be the least of our problems. There have been *more* killings of immunization program workers in Pakistan:

    http://www.nytimes.com/2012/12/20/world/asia/un-suspends-immunization-work-in-pakistan.html?_r=0

    Let’s hope that the kooks behind such monstrosities as “The Thinking Moms’ Revolution” or AoA will not get ideas from this. Past acts of violence in western countries perpetrated by members of animal rights groups and anti-abortion groups makes me think it might not be so far fetched that something like this could happen here.

  11. #11 Denice Walter
    December 19, 2012

    OT: BUT is criticism of experts fuelled by overly enthusiastic self-regard that is obviously un-encumbered by higher cortical processses EVER truly OT @ RI?

    Today @ TMR, guest diarist Katie Wright describes the recent congressional meeting: thinking moms resplendent in their co-dependent t-shirts and governmental in-experts, Guttmacher and Boyle, confessing their lack of knowldge.
    Wright opines “the simple act of thinking, and thinking carefully, seems a lost art at the CDC”.
    ” My nine year old knows more about autism than these two.”

    She wouldn’t recognise serious thought if it hit her in the head with a brick.

  12. #12 Lawrence
    December 19, 2012

    @dandover – it was incredibly stupid and misguided for the CIA to use the Vaccine Program as a cover for their activities in Pakistan……it is already difficult enough to get into the tribal areas, now it is next to impossible…..

  13. #13 Calli Arcale
    December 19, 2012

    dandover — hopefully, the dread of being associated with the Taliban and Al Quaeda will stop them from such things. That said, it isn’t just anti-vax nonsense behind those killings. There are several elements. There is a conspiracy theory that the CIA has snuck secret sterilizing ingredients into the vaccines. I’m not sure the Taliban actually believe that, BTW, or whether they’re just exploiting the theory — one aspect of the vaccination program is to try to reach people in these hostile areas in a friendly way and try to reduce some of the hostility against the government that way. And any smart Taliban will realize that’s a threat to their goals. There’s also the worry of espionage, fed heavily when it was revealed that the CIA found Osama Bin Laden through a vaccination program — in other words, there was, at least once, a doctor involved who really was feeding information to the Americans. And then there’s the fact that the murdered vaccine workers were nearly all women, which for some, is motive enough all by itself. I would hope the Thinking Mom’s Revolution would be smart enough to realize that these people are no sort of ally. Certainly the Taliban would not see them as an ally, but as just one more agent of the enemy.

    As to the title of this article, the answer is obviously “no”. It saddens me that so many wealthy people, who would suffer nothing from a ban against thimerosal and are too blinkered to see thimerosal never was a threat in this context, would happily ban it from people who cannot afford to lose it.

  14. #14 Science Mom
    http://justthevax.blogspot.com/
    December 19, 2012

    I truly hope that the United Nations Environmental Program will consider King et al.’s pragmatic statements. If the UN wants to reduce mercury exposure then there are far more environmentally-relevant sources that should be considered, namely in the form of methyl mercury. While removing TCVs may seem like a feel-good, doing-something approach, the consequences would be devastating and do nothing to reduce mercury exposure.

    Elburto highlighted one of the other important factors for maintaining vaccine viability and that is maintaining the cold chain. This is difficult even now and countless batches of vaccines that have been administered have been found to be rendered ineffective due to improper handling. I shudder to think what will happen if TCVs are removed.

    The anti-vaxx loons are crowing about this from the lens of their first-world privilege and simply want to be validated by having TCVs removed completely. They don’t give a rat’s posterior about children in third world countries, only about their own massive egos and vindication for their erroneous beliefs.

  15. #15 Eric Lund
    December 19, 2012

    hopefully, the dread of being associated with the Taliban and Al Quaeda will stop them from such things

    Unfortunately, it hasn’t stopped a different group which partially overlaps the anti-vaxers and which also takes a highly selective approach to dealing with facts. (I’m looking at you, Rep. Bachman.) I fear that such people are likely to make the bad assumption that “the enemy of my enemy is my friend”.

  16. #16 Rebecca Fisher
    December 19, 2012

    They don’t give a rat’s posterior about children in third world countries, only about their own massive egos and vindication for their erroneous beliefs.

    100% Hence JB Handley’s rant the other week;

    “None of us give a flying F%$# about the prevalence of autism in South Korea”

  17. #17 Sullivanthepoop
    December 19, 2012

    I cannot believe the comments on that story. None of them have any idea what they are talking about yet they are willing to risk the lives of children for some false pet ideology from the comfort of their first world homes where they have never had to worry about 4 out of their five children dying before they make it to middle school. What does that say about us?

  18. #18 WoefullyUnderEducated
    December 19, 2012

    If Dr Oz really iswilling to change his advice based on good data then I say good on him! The biggest boost for critical thinking would be someone like him embracing it after being on the woo side for so long!
    The issue with Oz is that I believe he studied medecine and business simultaneously (impressive)and that suggests a certain priority to me,. I dont believe that his advice always coincides with his view medically where a vague mid ground can earn him a buck.

  19. #19 Vincent
    December 19, 2012
  20. #20 lilady
    December 19, 2012

    I already posted on Medpage yesterday as soon as their article came through on my email…but it has not appeared yet.

    I posted again this morning and I’m still stuck in moderation

    What gives? They have posted 11 comments that primarily are anti-vaccine and off-topic.

    AoA has a link up to sign a SafeMind’s petition about the AAP’s Statement about Thimerasol in multi-dose vials. How “convenient” that it is demanding a Congressional investigation and addressed to Rep. Darrell Issa…their new point man in Congress.

  21. #21 Narad
    December 19, 2012

    They have posted 11 comments that primarily are anti-vaccine and off-topic.

    This one was pretty good: “Even the Egyptians knew in 400 BC that asbestos caused death in workers, but $$$$ buys its way to greedy profits.” This is actually a further mangling of a contention that doesn’t hold up in the first place.

  22. #22 Krebiozen
    December 19, 2012

    Science Mom,

    If the UN wants to reduce mercury exposure then there are far more environmentally-relevant sources that should be considered, namely in the form of methyl mercury.

    Coal burning power stations are probably the worst culprits. They were certainly still a major source of environmental mercury in the US just a few years ago:

    The top 50 most-polluting coal-burning power plants in the United States emitted 20 tons of toxic mercury into the air in 2007

    That’s just the top 50, and I can’t find anything to suggest this figure has fallen significantly since then. In 1997 the EPA estimated that about 52 tons of mercury were deposited on the 48 lower US states every year (along with all manner of other nasty cr@p). When you consider that 52 tons of mercury is 47 trillion micrograms, it makes concerns about 50 micrograms of mercury in a vaccine shot look more than a little silly. It’s also, of course, a good argument for more wind, wave, solar and nuclear power (thorium plants are my favorite).

  23. #23 lilady
    December 19, 2012

    Autism News Beat has an excellent article up about the AAP Statement…and my comment was published:

    http://autism-news-beat.com/archives/1949

  24. #24 DavidCT
    Texas
    December 19, 2012

    When drug companies eliminated Thimerasol, from childhood vaccines they did so initially not by taking it out of multidose containers but by making the vaccines available as single dose containers only. They simply eliminated the lower cost option. Not so much a problem in the US but critically important in the third world. The preservative is still used in multidose containers of Flu vaccine so its safety is continually being confirmed. A general ban would likely have an immediate cost effect if all flu shots were to become single dose. There may be a substitute but anything effective enough to control microorganisms would likely be a dreaded “toxin” at a higher dose.

  25. #25 lilady
    December 19, 2012

    How about this comment from AoA’s blog about the AAP Statement?:

    http://www.ageofautism.com/2012/12/american-academy-of-pediatricians-wants-to-keep-mercury-in-global-vaccines.html

    “Thank God for Brian Hooker, CoMed, the Geiers and Lisa Sykes and sites like AofA, who are all actively working on making sure the facts remain part of the public’s knowledge .

    Posted by: Jenny | December 18, 2012 at 11:05 AM”

    The Geiers? The Geiers who used their false hypothesis about “mercury toxicity” to chelate autistic kids, before they castrated them with Lupron? The Geiers? Senior Geier has had his medical license revoked in most of the States where he *practiced* and Junior Geier was found guilty of practicing medicine without a license, for their *chelation/castrating treatment/cures of autism”.

  26. #26 Denice Walter
    December 19, 2012

    @ lilady:

    I think that Hooker is the more recent public face of CoMed- chiefly because his name isn’t “Geier”- he’s appeared on PRN about Hg in the past year or so.

  27. #27 lilady
    December 19, 2012

    @ Denice Walter: Brian Hooker’s testimony at the recent sham Congressional Hearings on autism is discussed here:

    http://www.ageofautism.com/2012/12/brian-hookers-testimony-autism.html

    “Brian Hooker is the father of a son with autism and he holds a PhD in Biochemical Engineering, in addition to being a dedicated member of the autism community. He also played a role in how the House autism hearing came to be.”

    Scroll on down to see how he and AoA’ operative Andrew Wakefield wined and dined Congressmen and their wives repeatedly to set up the sham hearing and to set its “agenda”.

  28. #28 Lauren @ the VEC
    December 19, 2012

    To learn more about thimerosal, The Vaccine Education Center has a Question and Answer sheet titled “Thimerosal: What you should know”: http://www.chop.edu/export/download/pdfs/articles/vaccine-education-center/thimerosal.pdf.

    You can also visit our thimerosal hot topics page on our website: http://www.chop.edu/service/vaccine-education-center/hot-topics/thimerosal.html

  29. #29 Chris
    Neither here nor there...
    December 19, 2012

    Ms. Walter, I am going to modify you sentence just slightly to give it a more accurate reading: “I think that Hooker is the more recent public face of CoMedy- chiefly because his name isn’t “Geier”- he’s appeared on PRN about Hg in the past year or so.”

    ;-)

  30. #30 lilady
    December 19, 2012

    My comment on MedPage Today, is out of moderation:

    http://www.medpagetoday.com/comments.cfm?tbid=36480

    Anyone else want to join me there?

  31. #31 Beamup
    December 19, 2012

    They simply eliminated the lower cost option. Not so much a problem in the US but critically important in the third world.

    Given how ludicrously out of control our health care costs are, I don’t think we can label any simple, easy, downside-free ways to lower costs (even a little bit) which isn’t happening because some people are morons “not so much a problem.”

  32. #32 herr doktor bimler
    December 19, 2012

    In other words, they argue that it’s unjust to subject children in impoverished nations to a compound whose exposure is being limited in everyone else.

    Wait what. People in first-world countries allow themselves to be railroaded into buying the luxury version of a product., so for the sake of fairness we should force impoverished nations to buy only the more expensive version too?

    Clearly the people peddling this argument are the dupes of Big Pharma.

  33. #33 Denice Walter
    December 19, 2012

    @ Chris:

    I know. They mix caps and lower case in *CoMeD* in order for it to NOT resemble ‘comedy’ when the overall effect of that organisation’s activities is exactly that! I don’t know why they just didn’t choose another name and acronym.
    Perseveration?

    @ lilady:

    I’ve been following his antics for a while. He had some sort of PR statement last year IIRC ( archives PRN).

    I wonder how many die-hard ‘vaccines-cause-autism’ faithful are NOT either disgruntled parents and/ or providers** of alt med services, including legal?

    ** or Jake,

  34. #34 herr doktor bimler
    December 19, 2012

    They mix caps and lower case in *CoMeD* in order for it to NOT resemble ‘comedy’

    Perhaps they mean ‘comedo’.

  35. #35 Darwy
    Røde grøde med fløde
    December 19, 2012

    They still stamp their little feet with the ‘ingestion is not the same as injection’ mantra.

    As usual, they ignore the fact that our GI tract is very, VERY good at absorbing MeHg – close to 100% of the ingested makes it into the bloodstream.

  36. #36 lilady
    December 19, 2012

    I just “scored” another comment on the MedPage Today blog, while *managing* to take a swipe at the poster who slimed and libeled Dr. Offit and Bill Gates:

    http://www.medpagetoday.com/comments.cfm?tbid=36480

  37. #37 Dangerous Bacon
    December 19, 2012

    I just scored a dose of thimerosal (in my yearly flu vaccine).

    No problwims to repioaert yeett..,

  38. #38 MI Dawn
    December 19, 2012

    @Dangerous Bacon…Sciblogs needs a “I LOVE YOUR COMMENT” button…

    I regret to report that my annual flu shot had no effects on me, even with the thimerosal. Of course, given my age and the fact we used to use Merthiolate to paint ourselves red to play “cowboys and indians”, I’ve probably got so much thimerosal in my system the injection can’t add to it measurably…(and yes, painting yourself with that damn little glass thing was tedious…)

  39. #39 Matt Carey
    December 19, 2012

    Krebiozen,

    to add to your comment–

    a back of the envelope calculation of total mercury released to the environment from TCV’s gave about 2kg. (84 million and 25micrograms per vaccine).

    That would be about 387 cubic centimeters. About the volume of a coke can. Sure, it would be good to not put that into the environment. Give a good alternative and take it out of vaccines. I have no great desire to have thimerosal in vaccines.

    But, compare this the total worldwide emissions for mercury:

    “Estimated proportion of global anthropogenic mercury emissions in 2005 from different sources.
    Total = 1930 metric tons”

    http://www.epa.gov/international/toxics/mercury/mercury_context.html

    From an environmental issue, TCV’s are extremly small fraction of mercury release. Tagging thimerosal use onto a ban on mercury emissions is an odd move.

    I have never seen anything from the self-proclamed “vaccine safety groups” in terms of improving cold-chain or research on alternate vaccine preservatives. They have, instead, funded work to claim that vaccines cause harm. Some of that work is of extremely low quality.

  40. #40 elburto
    December 19, 2012

    Todd, WRT:

    “Obamacare”) requires insurance companies to fully cover the ACIP recommended vaccines
    for children and adults, at no cost to the patient, as long as they use a provider that is within their insurer’s network.

    I’d heard that, but my worry is the families in the ‘can’t afford insurance/don’t qualify for Medicaid’ gap. The biggest cause for concern, IMO, is parents. who literally cannot take time off work to care for an unwell child, and have no option but to send her to school, carrying [virus] with her.

    I know one state has mandatory insurance. (Mass.?) but not the rest,and ACA will obviously take time to implement fully.

    Over here in the UK, vaccine uptake (particularly pertussis and MMR) is finally creeping back up, but only because of the heartbreaking and unnecessary deaths of several babies.

    In some areas with low uptake, nurses are making home visits to at-risk families who, for whatever reason, are behind schedule. They talk about the vax programme/schedule and give info and advice. The parents can then get the child[ren] brought up to date on the spot, as the nurses carry the necessary equipment.

    As most cases were either “Didn’t realise [VPD] was harmful/currently active” , “Run off my feet with new baby+other kids/work+kids” or “lost track of time, is it booster time already?”, the nurses and health visitors are making inroads. It’s about time, Mr W*nkfield and his flying monkeys have caused enough suffering and death.

  41. #41 Mu
    December 19, 2012

    It’s the same kind of thinking that included medical applications in the freon ban, giving pharma companies the ability to repatent hundreds of inhaled medications with the new inhalant. Allowed them to raise the price of a generic $4 Albuterol inhaler to $44 for the new “brand”. Ditto on Flonase. I’m sure that a mercury free thimerosal replacement is ready to go, as soon as the new premium pricing justifies its release.

  42. #42 Krebiozen
    December 19, 2012

    Matt Carey,

    Give a good alternative and take it out of vaccines. I have no great desire to have thimerosal in vaccines.

    I agree, as long as we can find an alternative that is just as cheap and effective, or almost so. The dangers of contaminated vaccines in multi-use vials in a tropical climate vastly outweigh even the worst fears of the “safer vaccine” brigade.

    I don’t know how common it is for pharmaceutical products intended for injection to be preservative free, but it may be significant that the recent tragic fungal contamination of steroid injections was in a preservative-free product. Was this to avoid sensitivity reactions to preservatives, or was this a manifestation of the irrational fear of preservatives we often see? The fact this was a compounding pharmacy makes me suspect the latter.

    There have been a number of other instances where public fear of a product’s safety has led to a more dangerous product. BHT, a fat soluble antioxidant that prevents lipid peroxide formation in foods, springs to my mind. Health scares have led to the use of BHA and vitamin E instead of BHT. BHA is less well-tested than BHT and is classed as a carcinogen in California, vitamin E (though natural and organic) is a feeble antioxidant compared to BHT, and lipid peroxides are very nasty indeed. It seems likely that the removal of BHT from food has actually made it more dangerous.

    I also suspect that European reluctance to use GMOs has led to environmental damage (bee problems for example), due to the increased use of toxic pesticides (particularly neonicotinoids) and herbicides that non-GMO crops require. Again, the opposite of the desired effect has been achieved. Again, fear of technology is at its root.

    Is there a name for the unexpected consequences of the actions of Luddites? If there isn’t there should be.

  43. #43 Sullivanthepoop
    December 19, 2012

    Not to mention unfounded fear over the whole cell pertussis vaccine led to a much less effective pertussis vaccine.

  44. #44 Denice Walter
    December 19, 2012

    Today Gary Null and Richard Gale responded with ” American Academy of Pediatrics: Pimping for BIg Pharma”.
    ( @ Progressiveradionetwork.com)

  45. #45 Narad
    December 19, 2012

    Is there a name for the unexpected consequences of the actions of Luddites?

    “Cruise to Australia in steerage”?

  46. #46 lilady
    December 19, 2012

    @ Sullivanthepoop:

    “Not to mention unfounded fear over the whole cell pertussis vaccine led to a much less effective pertussis vaccine.”

    But Barbara Loe Fisher managed to turn that unfounded fear of the whole cell pertussis vaccine into a career:

    http://blogs.plos.org/thepanicvirus/2012/09/13/the-whole-cell-pertussis-vaccine-media-malpractice-and-the-long-term-effects-of-avoiding-difficult-conversations/

  47. #47 Sullivanthepoop
    December 20, 2012

    Lilady: True enough, and also proved beyond a doubt that antivax people are not pro safer vaccine. If she really cared about vaccine safety there are many many things she could have done to really improve things.

  48. #48 lilady
    December 20, 2012

    Anne Dachel must be “slipping”. She didn’t notify her groupies who follow her daily “Media Update” and link to this article on the Ho-Po http://www.huffingtonpost.com/2012/12/17/thimerosal-vaccines-aap-mercury_n_2316473

    I’ve posted several times, with some of my comments still in moderation, but the spamming bot and her pals haven’t showed up yet.

  49. #49 Kelly M Bray
    December 20, 2012

    Lilady, I just posted on the HuffPo articles. the morons are out in force. There is a total idiot named Sabelmouse who posts alot. She just said…”childhood diseases are rarely dangerous, the complications are what dangerous. ”

    Dumbass. If you don’t get the disease you don’t get the complications.

  50. #50 lilady
    December 20, 2012

    @ Kelly M. Bray:

    I’ve just posted at the dumbasses on the Ho-Po. I’ll be waiting for Sabelmouse’s comment about the head of the “heath” department who *agrees* with her.

    I haven’t seen J.R. Smith, a.k.a. (Not An) ASD Researcher, a.k.a. Blackheart posting his spam lately. Could it be that the Ho-Po moderators are finally putting him into a spam filter?

  51. #51 Narad
    December 20, 2012

    Anne Dachel must be “slipping”. She didn’t notify her groupies who follow her daily “Media Update” and link to this article on the Ho-Po

    I strongly suspect that these delays, which aren’t new, are deliberate. I haven’t looked at the HuffPo item in question, but if Meleck popped up in short order, it’s a very good sign that the Dachelbot is P2P.

  52. #52 Heliantus
    December 21, 2012

    @ Matt Carey, Krebiozen

    Give a good alternative and take it out of vaccines. I have no great desire to have thimerosal in vaccines.

    I understand and agree to the ecological point of view (to reduce the release of mercury-containing substances in the environment), but I wonder about the toxicity angle.
    It’s wild speculation, but wouldn’t a product strong enough to simultaneously kill bacteria and fungi be very likely to also show some level of toxicity in mammals? We are talking very wide spectrum biocides, here.
    (OK, if the dose is high enough, everything will show toxicity)

    That I actually mean is, is it likely to find a product which will be simultaneously effective, cheap, and exempt enough of scary substances to be accepted by the “chemical is poison’ crowd?
    There may be nothing good enough to replace thimerosal.

  53. #53 dingo199
    December 21, 2012

    Off topic, I know, but I couldn’t help noticing earlier on a link from the NaturalNews superstore that Moringa Oleifera “A True Superfood!” has the highest ORAC value ever measured in a superfood.
    Way to go, ORAC! Recognition at last from the woomeisters.
    http://www.sozonutritionals.com/Moringa_Oleifera_Products_s/75.htm

  54. #54 herr doktor bimler
    December 21, 2012

    wouldn’t a product strong enough to simultaneously kill bacteria and fungi be very likely to also show some level of toxicity in mammals?

    Even if it didn’t it would still be an EVIL TOXIN, as shown by its ability to kill bacteria and fungi, so the outcry about its presence in vaccines would be no more subdued. But you knew that.

  55. #55 Krebiozen
    December 21, 2012

    Heliantus,

    It’s wild speculation, but wouldn’t a product strong enough to simultaneously kill bacteria and fungi be very likely to also show some level of toxicity in mammals?

    There are probably common metabolic pathways in bacteria and fungi that are not present in mammals, and you could probably find some substance that would disrupt these without affecting mammals at all. There may be other ways of making a selective toxin, for example Bt toxin that is present in some pest-resistant GM crops only affects insects as it binds to specific receptors in insect guts that mammals don’t have. However, this theoretical toxin would undoubtedly be more expensive than thimerosal, due to development costs. Also, as HDB pointed out, this would still be considered an evil toxin that hadn’t been tested for several decades in combination with every other substance that children are exposed to.

  56. #56 lilady
    December 21, 2012

    The comments are still open at MedPage Today. I’ve just posted several comments at one of the trolls. Does anyone want to add their comment?

    http://www.medpagetoday.com/comments.cfm?tbid=36480

  57. #57 JGC
    vaccines versus sandwiches for lunch
    December 21, 2012

    Following injection thimerosal rapidly dissociates to form ethyl (not methyl) mercury and is rapidly eliminated from the body, primarily by fecal excretion. Ethyl mercury has a half-life of less than 4 days and a vaccinated infant’s blood mercury level returns to pre-vaccination levels by 30 days after immunization. (see Mercury Levels in Newborns and Infants After Receipt of Thimerosal-Containing Vaccines, Pichichero et al, Pediatrics Vol. 121 No. 2 February 1, 2008 pp. e208 -e214)

    If someone’s really concerned about children being needlessly exposed to mercury, they should be concenred about tuna fish sandwiches rather than vaccines. There can legally be twice as much mercury in a can of tuna fish than in any vaccine shot (up to to 0.1 milligrams of methylmercury in a 100 gram can of tuna)–and with tuna fish you’re talking about methyl ( not ethyl) mercury.

  58. #58 Krebiozen
    December 21, 2012

    lilady,

    Does anyone want to add their comment?

    I’ve added a comment about a study I came across that I hadn’t seen before in which 26 patients were given intravenous injections of between 4 and 734 milligrams (mean 157 milligrams) of thimerosal over periods ranging from six months to 17 years. Note that there is at most 0.05 milligrams of thimerosal in a vaccine shot. These patients were given between 4,000 and 734,000 micrograms of thimerosal directly into their bloodstreams (unlike vaccines which are mostly given subcutaneously or intramuscularly), that is between 80 and 14,680 times the dose of thimerosal given in a vaccine.

    Were these patients hoplessly brain-damaged by these enormous doses of thimerosal? Not at all.
    “None of our 26 patients had overt clinical evidence of mercury toxicity. Neurological or intestinal symptoms that were present in our patients usually predated treatment and were attributed to the well-recognised complications of antibody deficiency. Three other patients (not included here) had uneventful pregnancies and gave birth to healthy children while receiving regular replacement therapy.”

  59. #59 lilady
    December 21, 2012

    I just read your comment Krebiozen and JGC’s comment as well.

    They are both excellent and your links are superb. We just *might have* shut down the comments from the quacks and trolls on that blog. Here’s double smileys for both of you. :-) :-)

  60. #60 Alain
    December 21, 2012

    @ lilady, I second that but wished I knew earlier because I’d have a point to debate stone at AoA the last time I posted there.

    Alain

  61. #61 lilady
    December 21, 2012

    @ Alain: Our very own “Autismum” has posted on the Skeptoid blog about the unfair misrepresentation of Adam Lanza’s supposed “ASD diagnosis” and the bullsh!t pseudoscience posts and comments you’ve read at AoA:

    http://skeptoid.com/blog/2012/12/17/sinister-speculation-part-1-autism/

    Again Alain, I am cautioning you about taking on John Stone or any of the groupies on the AoA blog. They have a history of going after people at their blogs and at their places of employment. (Feel free to attack them on other sites where they post their bullsh!t, that I and other posters here link to, where your anonymity is assured).

  62. #62 Alain
    December 21, 2012

    They have a history of going after people at their blogs and at their places of employment.

    Fine, I’m just looking after that. They can email my prof of chemistry, my dean and a number of other prof close to me and they will get to see how I can handle their asses on a platter for everyone to see. They are invited to bring it on….

    To be realistic, I am more concerned about the animal right movement because of an anatomy lab I did many years ago.

    Alain

  63. #63 Notsosure
    December 27, 2012

    Polio hasn’t gone from India Orac they just renamed it NPFP

  64. #64 Antaeus Feldspar
    December 28, 2012

    Polio hasn’t gone from India Orac they just renamed it NPFP

    By NPFP I assume you’re referring to “non-polio acute flaccid paralysis.” We’ve heard this claim before, but it never makes sense; it confuses a description of symptoms (i.e. acute flaccid paralysis) with a diagnosis of the cause (i.e. poliovirus.)

    I’m struggling to find an analogy that will express it so that you can understand how absurd it is. Here, try this: Everyone knows that car accidents can easily cause whiplash injuries, right? So let’s assume that some technological innovation is devised, like automated braking, that radically reduces the number of car accidents. Now how much sense would it make to look at all whiplash injuries which occurred by means other than car accidents and declare “oh, car accidents haven’t decreased; they’ve simply been renamed ‘whiplash injuries that didn’t come from car accidents’?”

  65. #65 Lawrence
    December 28, 2012

    @Antaeus – because when you are talking about complete eradication, you want to make sure that actual polio cases are diagnosed, as opposed to being confused with other “non-polio” cases….since acute flaccid paralysis can be caused by other factors, it is important to be able to rule out polio as the causative factor….

  66. #66 lilady
    December 28, 2012

    @ Notsosure: I am *sure* that the many cases of acute flaccid paralysis that you believe to be a “renaming of polio” are caused by other infections, diseases and disorders, as confirmed by laboratory tests and by acute flaccid paralysis differential diagnoses:

    http://www.uom.ac.mu/medicalupdate/files/2010/dec/AFP_Differential_Diagnosis.pdf

    The exceedingly small number of acute flaccid paralysis caused by the polio virus are reported each week, along with the “typing” of polio virus:

    http://www.polioeradication.org/Dataandmonitoring/Poliothisweek.aspx

  67. #67 lilady
    December 29, 2012

    Omsted at AoA, in his “Weekly Wrap-Up has this to say about the AAP Statement in support of the WHO to continue using Thimerosal in multi-dose vials of vaccine:

    http://www.ageofautism.com/

    “I hate to beat a dead horse, but when the supposedly dead horse is the fact that – contrary to the American Academy of Pediatricians– mercury in vaccines causes autism, I’m afraid I’m going to have to go on beating it…..”

    No Dan, you enjoy beating dead horses. Thanks for the laughs.

  68. #68 Healthy
    December 29, 2012

    I gotta say it. I routinely use thimerosal as a preservative in the lab and I have progressively started to guess if I am feeling symptoms of lab autism. hehe ;)

    For funding, research and peer finding please refer to the non-profit Aging Portfolio.

  69. #69 Jen
    December 30, 2012

    lilady, you must be projecting when you say, ‘I’d be cautious about taking anyone on at AoA’, to Alain (and perhaps even worse, playing on his fears). You know you people have gone on just as rabidly, and I’d say worse, digging up stuff on people who disagree with your views and your obsession with Jake and dissing his education, commenting on his dating life etc. are all very nasty. Some on your side have even gone as far as to ban him from events that are open to the public on false grounds. Nice try, though.

  70. #70 Narad
    December 30, 2012

    Some on your side have even gone as far as to ban him from events that are open to the public on false grounds.

    “False grounds”? Being a one-trick pony who only shows up at public lectures to derail Q&A sessions isn’t a “false ground.” If you’re asked to leave, you leave. I don’t see you being up in arms about the truly creepy ejections from Autism One, where people have paid to attend and aren’t making asses of themselves.

  71. #71 Agashem
    December 30, 2012

    Oh don’t bother with Jen, she’s a Canadian hater of all things medical. She is really equating Google searching names and coming up with websites to what has happened to bloggers, including lawsuits and pleas to employers to fire said bloggers. Not that this won’t change Jen’s mind. She firmly believes that due to one unfortunate and no doubt scary incident in her family, all pharma and especially vaccines are bad.

  72. #72 Lawrence
    December 30, 2012

    @Jen – yes, given that people were escorted out of Autism One just because of who they were, not because of anything they were doing (as opposed to Jake, who routinely makes an ass of himself at Q&As), I don’t think you are one to talk…..

  73. #73 lilady
    December 30, 2012

    Back again Jen?

    Yes I did caution Alain about posting on AoA…based on their history of mounting campaigns to have science bloggers lose their jobs.

    Crosby and other *journalists* at AoA libel respected science bloggers, respected physicians, respected scientists and respected researchers. Their enemies lists libels real journalists such as Brian Deer, Anderson Cooper and others who have interviewed Andy Wakefield and called him out on his bullsh!t.

    Jake’s one trick pony act…”Six, Sixty, Six Hundred degrees of Separation” is pathetic…yet you and your pals think of him as a hero. No I am not “playing into Alain’s fears”, but you and your groupies are encouraging Jake’s bad behavior.

  74. #74 Chemmomo
    wow auto correct is bizarre
    January 20, 2013

    ten minutes of messing with the touchpad just to get a cookie

  75. #75 Kelly Clover
    February 11, 2013

    A petition has been created to get President Obama to
    permanently ban the use of thimerosal in all vaccines. To view this petition and get your signature added go to this web
    address: http://wh.gov/dc7U
    We need as amny signatures as possible as quickly as
    possible. The stakes are sky-high. For many years the CDC
    and FDA have covered up the truth about thimerosal at the behest of powerful special interests. This must stop now. Take a clear uncompromising stand now.

  76. #76 AdamG
    February 11, 2013

    Kelly, did you even read this article?

  77. #77 Todd W.
    http://www.harpocratesspeaks.com
    February 11, 2013

    @Kelly Clover

    One would think that there are more important things for the president to do than ban the use of a preservative that causes no harm in the amounts found in vaccines.

  78. #78 Lawrence
    February 11, 2013

    @Todd – or consider taking a step that could potentially put hundreds of thousands or perhaps millions of children at risk, world-wide, from vaccine preventable diseases…..

  79. #79 Mephistopheles O'Brien
    February 11, 2013

    Kelly Clover – it’s also important to realize that while the petitions on wh.gov serve a useful purpose for the administration, they have no legal force whatever. I don’t want to dissuade you from your political activism, but consider that there are really only three possible outcomes:
    1. Your petition is brushed off.
    2. The FDA reports that, no, they haven’t been covering up the truth all these years and people who say otherwise are either misinformed or a bunch of cranks.
    3. The President, who is in charge of the people who run the FDA, tells the FDA that they might want to improve the cover-up a little better (assuming such exists).

    The thought that the FDA has been conducting a cover-up behind the back of the President and his cabinet strikes me as highly improbably.

  80. #80 Chris
    February 11, 2013

    Kelly Clover, President Obama is only president of the United States of America. That is just one country, not the whole planet. He has no power over the World Health Organizations and other international health organizations.

    What kind of grade did you get in high school American Government?

  81. #81 Shay
    February 11, 2013

    @Chris

    Probably the same grade he/she got in chemistry.

  82. #82 lilady
    February 11, 2013

    The *petition* was started by “k.c.”…would that be you, Kelly Clover?

    Did you even read this blog or look at the links that other posters have provided?

  83. [...] containing vaccines, but the world public health community strongly objected because doing so would devastate efforts to bring vaccine-preventable diseases under control in Third World [...]

  84. #84 Phillip
    Dallas, Texas
    March 11, 2013

    If, as you say, vaccines are totally safe for all children, why is it that there has been $2,448,256,199.98 dispersed by a special US vaccine injury court? It is extremely difficult to win a case against the US government as you can imagine. These ‘winning’ cases are those in which the children have literally convulsed in the doctors office or on the way home from getting their jab.

    I think the point of the so called ‘anti-vaxers’ is that there are too many vaccines too soon in a child’s life. There has never been any long-term study on the COMBINED effects of 25+ jabs by the age of 3.

    Do you homework and you’ll find the reality of how the immune system is affected by so many agents that are introduced to a baby’s immune system in so short of a time.

    1 in 4 children now are diagnosed with an neurological disorder.

    Reference the governments own data:
    http://www.hrsa.gov/vaccinecompensation/data.html

  85. #85 Beamup
    March 11, 2013

    If, as you say, vaccines are totally safe for all children, why is it that there has been $2,448,256,199.98 dispersed by a special US vaccine injury court?

    Nobody says vaccines are “totally safe for all children.” Everyone here acknowledges that there are rare serious side effects. But here’s the thing – they’re WAY safer than the diseases they prevent.

    It is extremely difficult to win a case against the US government as you can imagine.

    Actually it’s extremely easy… for injuries actually established to be a risk of vaccination. Ever hear of a “table injury?”

    These ‘winning’ cases are those in which the children have literally convulsed in the doctors office or on the way home from getting their jab.

    A flat-out lie. The standards are quite lenient and don’t call for anything like that.

    I think the point of the so called ‘anti-vaxers’ is that there are too many vaccines too soon in a child’s life.

    [citation needed]

    There has never been any long-term study on the COMBINED effects of 25+ jabs by the age of 3.

    Another flat-out lie – each new vaccine is extensively studied for safety in the context of the then-existing vaccine schedule.

    Do you homework and you’ll find the reality of how the immune system is affected by so many agents that are introduced to a baby’s immune system in so short of a time.

    Yes, it responds by protecting the child against those diseases. If you want to claim harm, [citation needed].

    1 in 4 children now are diagnosed with an neurological disorder.

    An utter irrelevance, unless you have evidence of some kind of link… which you don’t.

  86. #86 herr doktor bimler
    March 11, 2013

    1 in 4 children now are diagnosed with an neurological disorder.
    Which four children?

  87. #87 Chris
    Neither here nor there...
    March 11, 2013

    Phillip, what is your verifiable and affordable plan to protect children in developing countries from diphtheria, tetanus and pertussis. Worldwide there are almost 200000 deaths from tetanus, so how would you prevent those?

    When you have a viable plan to safely deliver those thimerosal-free vaccines by maintaining the cold chain to kids in Ghana, Nigeria, Afghanistan, etc, be sure to take it to the World Health Organization.

  88. #88 Narad
    March 11, 2013

    There has never been any long-term study on the COMBINED effects of 25+ jabs by the age of 3.

    Oh, look, someone asserting a location in Texas using UK lingo.

  89. #89 Edith Prickly
    March 11, 2013

    @Narad – yes, I noticed that too.

  90. #90 Lawrence
    March 11, 2013

    You know who else hates the Vaccine Compensation Program? Trial Lawyers – because they are precluded from making obscene amounts of money filing frivolous lawsuits…….and their fees have to be approved by the Vaccine Court.

  91. #91 herr doktor bimler
    March 11, 2013

    25+ jabs by the age of 3.

    That is TOO EARLY for tattooing.

  92. #92 Julian Frost
    NOYDB
    March 12, 2013

    @hdb: LOLOLOL!

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