Intended for healthcare professionals

Rapid response to:

Analysis And Comment Public health

Influenza vaccination: policy versus evidence

BMJ 2006; 333 doi: (Published 26 October 2006) Cite this as: BMJ 2006;333:912

Rapid Response:

Re: Side effects of mercury containing vaccines like influenza

Joachim Mutter raises two important issues.

i) In the US, where the mercury content of infant vaccine has been
progressively removed over a number of years, most infants will now be re-
exposed to it through flu-vaccine. In the UK some flu vaccine still
evidently contains mercury, though I have no uptodate information. This
constitutes an unnecessary risk, particularly to infants.

ii) Mercury to exposure to infants through vaccine goes on unabated
in the developing world. Andrews et al [1], which recommended the
continued use of thimerosal in the developing world stated that the then
UK exposure through DPT vaccine (75 µg between 2 and 4 months) was the
same as the WHO exposure:

"This level of Hg exposure, although lower than the maximum of 187.5
µg received in the United States by 6 months of age, is similar to the
level received by 3 to 4 months of age in the United States. It is also
the same as the amount of thimerosal used by developing countries that
follow the expanded immunization schedule [1].

However, a contemporaneous Committee for Safety of Medicines document
obtained under a Freedom of Information Request gave the WHO exposure as
187.5 µg by 14 weeks [2]. No satisfactory explalnation of this discrepancy
has ever been offered. The indifference of the WHO to this concern must
call the whole present motivation behind the programme into question.

A study in north east London (Lingam et al) focussing on MMR showed
diagnosed autism incidence double synchronous with the accelerated DPT
schedule in 1990, although this important confounder was not noted [3].
Four of the authors were identical with the Thimerosal study [1].

[CSM document submitted]

[1] Andrews N, Miller E, Grant A, Stowe J, Osborne V, and Taylor B,
'Thimerosal Exposure in Infants and Developmental Disorders: A
Retrospective Cohort Study in the United Kingdom Does Not Support a Causal
Association', PEDIATRICS Vol. 114 No. 3 September 2004, pp. 584-591

[2] Stone J, 'Mercury and Autism in the United Kingdom', Red Flags
February 2006,

[3] Lingam R, Simmons A, Andrews N, Miller E, Stowe J and Taylor B,
'Prevalence of autism and parentally reported triggers in a north east
London population', Archives of Disease in Childhood 2003;88:666-670,

Competing interests:
Autistic son

Competing interests: No competing interests

23 November 2006
John Stone
London N22