
HHS recommends to remove thimerosal from all flu vaccines in the United States
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The US Department of Health and Human Services has adopted a recommendation to remove thimerosal from all influenza vaccines distributed in the United States, even though there is no clear evidence of harm from the mercury-based preservative.
On Wednesday, the department announced that HHS Secretary Robert F. Kennedy Jr. has formally signed the recommendation, which was made last month by the US Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP). Kennedy's signature means that the recommendation is now federal health policy.
'After more than two decades of delay, this action fulfills a long-overdue promise to protect our most vulnerable populations from unnecessary mercury exposure,' Kennedy said in the HHS announcement Wednesday. 'Injecting any amount of mercury into children when safe, mercury-free alternatives exist defies common sense and public health responsibility. Today, we put safety first.'
Other recommendations from ACIP's June meeting are currently under review, according to HHS.
Thimerosal was largely removed from most vaccines about 25 years ago. The US Food and Drug Administration asked manufacturers to remove it out of an abundance of caution, not because of evidence of harm, according to the CDC. All vaccines routinely recommended for young children are now available in doses that don't have the preservative, which contains a form of mercury.
Flu vaccines drawn from multidose vials still contain thimerosal in order to prevent bacterial contamination. Only about 4% of flu vaccines given in the United States last year contained thimerosal as a preservative.
When ACIP voted in June to endorse thimerosal-free flu vaccines, it was among the panel's first actions taken as a new committee that was appointed by Kennedy after he dismissed the previous panel, claiming that they had conflicts of interest.
In a series of three votes, the new ACIP panel voted 5-1, with one member abstaining, to recommend that only single-dose flu vaccines be given to children, adults and pregnant women in the United States. Single-dose shots are free of thimerosal.
Drs. Robert Malone, Joseph Hibbeln, Martin Kulldorff, Retsef Levi and Joseph Pagano voted yes on the thimerosal recommendations. Dr. Cody Meissner voted no.
Dr. Vicky Pebsworth, volunteer director of research and patient safety at the National Vaccine Information Center, a group that emphasizes risks around vaccines while downplaying their benefit, abstained from the vote because she objected to its wording.
Vaccines with thimerosal are still approved by the FDA, but ACIP recommendations are tremendously influential in how vaccines are used in the US, with implications for insurance coverage and state policies.
In justifying his vote, Meissner, a professor of pediatrics at the Dartmouth Geisel School of Medicine, said at the time that he was worried that expressing a preference for single-dose vials might keep people from getting doses from multidose formulations in situations in which those shots may be the only option.
'That might limit the availability of the influenza vaccine for some people,' he said.
'My point is, the risk from influenza is so much greater than the nonexistent — as far as we know — risk from thimerosal, so I would hate for a person not to receive the influenza vaccine,' Meissner said. 'I find that very hard to justify.'
Some public health experts said that they were puzzled to see thimerosal included in ACIP's meeting agenda for a vote.
'I actually don't know any pediatric practices that even use that multidose influenza vaccine,' Dr. Sean O'Leary, a pediatrician at Children's Hospital Colorado and former liaison to the CDC's Advisory Committee on Immunization Practices, or ACIP, for the American Academy of Pediatrics, said at the time.
In that same ACIP meeting, six committee members voted to continue to recommend that everyone 6 months and older receive an annual flu vaccine. Pebsworth abstained.
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