THE TINEA NIGRA / LA TIÑA NEGRA.

The Tinea Nigra.

La Tiña Negra. 

 

EDITORIAL ENGLISH

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Hello DERMAGICS friends, today's topic the Tinea Nigra, interesting fungus pathology described in tropical and subtropical zones, with environmental conditions that allow the development of this affection. There is a predisposing factor in those affected, which is palmoplantar hyperhidrosis.

Clinically manifested as circumscribed hyperpigmented black spots of different colors ranging from brown to black and the main sites of location are the palms and plants, rarely in other areas of the body which creates confusion to make the correct diagnosis.

It can be confused with a hyperpigmented nevus, solar lentigo including malignant melanoma ..

Lesions usually do not hurt and are not pruritic. Occasionally there is slight flaking and pruritus .

CAUSAL AGENT, TINEA NIGRA:

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The tinea nigra causal agent is the fungus classified as Exophiala werneckii, but more recently classified as Hortaea werneckii.

                                                                               

SYNONYMS:
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Phaeoannellomyces werneckii
Cladosporium werneckii (Horta)
Dematium werneckii (Dodge)
Pullularia werneckii (de Vries)
Aureobasidium mansonii (Cooke)
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LABORATORY DIAGNOSIS.

DIRECT EXAMINATION in fresh. It can be done by rinsing the skin flakes with 15% KOH for 10 min. Short filaments and sometimes isolated, elongated and bi-cellular spores are observed under the microscope. Brown.

CULTURE and lately DERMATOSCOPY has been very useful to make the correct diagnosis of this superficial skin disease

I hope these interesting references illustrate us well this curious and benign illness.

in the attach Tinea Nigra palmar and culture of the causal agent, yeast phase.

Greetings to all

Dr. José Lapenta R.



                                                                              

EDITORIAL ESPAÑOL
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Hola amigos DERMAGICOS, el tema de hoy la TIÑA NEGRA, interesante patología micótica, La Tiña Negra (T.N.) es una dermatomicosis superficial, descrita en zonas tropicales y subtropicales, con condiciones ambientales que permiten el desarrollo de esta afección. Existe un factor predisponente en los afectados que es la hiperhidrosis palmo-plantar. 

Clínicamente se manifiesta como máculas negruzcas hipopigmentadas circunscritas de diferentes colores que van del marrón al negro y los principales sitios de localización son las palmas y plantas, rara vez en otras aéreas del cuerpo lo cual crea confusión para hacer el diagnostico correcto.

Puede confundirse con un nevus hiperpigmentado, lentigo solar incluso melanoma maligno.. 

Las lesiones por lo general no duelen y no son pruriginosas. Ocasionalmente hay leve descamación y prurito..

AGENTE CAUSAL DE TINEA NIGRA:
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El agente causal de la tiña negra es el hongo Exophiala werneckii recientemente clasificado como Hortaea Werneckii

SINONIMOS:
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Phaeoannellomyces werneckii
Cladosporium werneckii (Horta)
Dematium werneckii (Dodge)
Pullularia werneckii (de Vries)
Aureobasidium mansonii (Cooke)

DIAGNOSTICO:

Diagnóstico de laboratorio. 

 EXAMEN DIRECTO en fresco. Puede efectuarse aclarando las escamas de piel con KOH al 15% durante 10 min, Se observa al microscopio filamentos cortos y en ocasiones esporas aisladas, alargadas y bi-celulares. de color marrón. 

CULTIVO y últimamente la DERMATOSCOPIA- ha sido de gran utilidad para hacer el diagnostico  correcto de esta enfermedad superficial de la piel

Espero que estas referencias sean útiles para ilustrar esta benigna y curiosa enfermedad de la piel

Hasta una nueva oportunidad !!! 

En el adjunto: Tiña Negra en region  palmar y cultivo del agente causal, fase de levadura

Dr. José Lapenta R.,,,




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REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES
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1.) Tinea nigra

2.) [Tinea nigra plantaris]

3.) Tinea nigra palmaris. Treatment with thiabendazole topically.

4.) [Tropic-subtropic fungus infections in Germany]

5.) The fine structure of Hortaea werneckii.

6.) Further studies on the phylogenesis of the genus Exophiala and Hortaea.

7.) Tinea nigra: report of four cases observed in Rio Grande do Sul

(Brazil) and a review of Brazilian literature.

8.) Tinea nigra masquerading as acral lentiginous melanoma.

9.) Association of anurans with pathogenic fungi.

10.) [Tinea nigra. 1st clinical case in Uruguay]

11.) Treatment of tinea nigra palmaris with miconazole.

12.) Polymerase chain reaction-mediated genotyping of Hortaea werneckii,

causative agent of tinea nigra.

13.) Tinea nigra: treatment with topical ketoconazole.

14.) Tinea nigra palmaris.

15.) Therapy of tinea nigra plantaris.

16.) [Tinea nigra. Apropos of a case diagnosed as melanoma of superficial

dissemination]

17.) Tinea nigra palmaris: differentiation from malignant melanoma or junctional nevi.

18.) Tinea nigra palmaris from South India.

19.) Cell-surface hydrophobicity and lipolysis as essential factors in human tinea nigra.

20.) Tinea nigra infection in Canada.

21.) Nature and identification of Exophiala werneckii.

22.) Fruiting organs of Cladosporium werneckii.

23.) Exophiala werneckii v. Arx

24.) Exophiala, species.

25.) Bilateral Tinea Nigra Plantaris with Good Response to Isoconazole Cream: A Case Report.

26.) Dermatoscopy in inflammatory and infectious skin disorders.

27.) Tinea nigra showing a parallel ridge pattern on dermoscopy.

28.) Dermoscopy revealing a case of Tinea Nigra.

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1.) Tinea nigra

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The University of Texas Medical Branch at Galveston, Texas, USA

Synonyms

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Pityriasis nigra, tinea nigra palmaris Definition

Tinea nigra is a superficial, asymptomatic fungal infection of the stratum

corneum characterized by brown to black nonscaly macules. The palmar

surfaces are most often affected, but lesions may occur on the plantar and

other surfaces of the skin.

Mycology

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Phaeoannellomyces werneckii

Natural habitat

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Plants, soil and Foods with a high salt content

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2.) [Tinea nigra plantaris]

TT [Tinea nigra plantaris.]

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SO - Hautarzt 1977 Aug;28(8):412-5

AU - Dorn M; Krempl-Lamprecht L

PT - JOURNAL ARTICLE

AB - A second case of tinea nigra occuring in Germany is recorded. The

patient was a 33 year old women, who supposedly acquired the infection in

Israel, which was not diagnosed until two years after the onset. Scrapings

from a dark macule on her sole yielded Cladosporium werneckii. The lesion

cleared with topical treatment of a keratinolytic ointment and a

haloprogin-cream.

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3.) Tinea nigra palmaris. Treatment with thiabendazole topically.

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SO - Arch Dermatol 1975 Jul;111(7):904-5

AU - Carr JF; Lewis CW

PT - JOURNAL ARTICLE

AB - A patient had tinea nigra palmaris that had not responed to

toinaftate or salicylic acid ointment during a period of seven years.

Thiabendazole suspension, 10 percent applied twice daily, cleared the

lesion in two weeks.

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4.) [Tropic-subtropic fungus infections in Germany]

TT - [Tropisch-subtropische Pilzinfektionen in Deutschland.]

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SO - Hautarzt 1978 Jan;29(1):17-21

AU - Krempl-Lamprecht L

PT - JOURNAL ARTICLE

AB - Observations by the author and other workers on exotic mycoses in

Germany are used in order to establish several groups of patients. The

following mycoses from tropical and subtropical areas and their causative

agents are mentioned: Tinea nigra (Cladosporium werneckii), south American

blastomycosis (Paracoccidioides brasiliensis), coccidioidomycosis

(Coccidioides immitis), histoplasmosis (Histoplasma capsulatum), mycetoma

(Madurella mycetomi), dermatophytosis/tinea capitis (Trichophyton

soudanense, Trichophyton violaceum, Microsporum ferrugineum),

sporotrichosis (Sporothrix schenckii), chromomycosis (Fonsecaea pedrosoi).

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5.) The fine structure of Hortaea werneckii.

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SO - Mycoses 1993 Nov-Dec;36(11-12):343-50

AU - Mittag H

AD - Abteilung fur Dermatologie mit Schwerpunkt Histopathologie und

Elektronenmikroskopie der Haut, Philipps-Universitat Marburg, Germany.

PT - JOURNAL ARTICLE

AB - Hortaea werneckii (strain CBS 107.67) was examined by light and

transmission electron microscopy (TEM). Special attention was paid to the

wall architecture, the septum with a simple pore apparatus, the annellidic

type of collar and the nuclei. Two-celled organisms showed signs of

distoseptation; nuclear events appeared to be rather synchronous in both

cells. The fine structural results provided evidence of endogenous conidia

development.

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6.) Further studies on the phylogenesis of the genus Exophiala and Hortaea.

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SO - Mycopathologia 1985 Nov;92(2):101-9

AU - Nishimura K; Miyaji M

PT - JOURNAL ARTICLE

AB - The conidial ontogenesis of the pathogenic black yeasts is studied at

an ultrastructural level and their phylogenesis is discussed. Five cultures

of Exophiala dermatitidis, four of E. jeanselmei, one of E. moniliae, one

of E. spinifera and six of H. werneckii were observed using a scanning

electron microscope. The conidial ontogenesis of the Exophiala species is

not pleomorphic but only annellidic. There are definite differences in

morphology of annellated tips among the Exophiala species. The ontogenesis

of Hortaea werneckii consists of a combination of sympodial and annellidic

conidiogenesis. Its sympodial anamorph is unique and the annellidic

anamorph is considered to be a homology of the sympodial one.

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7.) Tinea nigra: report of four cases observed in Rio Grande do Sul

(Brazil) and a review of Brazilian literature.

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SO - Mycopathologia 1994 Jun;126(3):157-62

AU - Severo LC; Bassanesi MC; Londero AT

AD - Instituto Especiolizodo em Pesquisa e Diagnostico, Santa Casa, Porto

Alegre, RS, Brazil.

PT - JOURNAL ARTICLE; REVIEW (44 references); REVIEW OF REPORTED CASES

AB - Four cases of Tinea Nigra by Exophiala werneckii, observed in Porto

Alegre, RS, during the period 1981-1992 were related. A boy presented

bilateral palmar lesions, one girl had plantar lesions and the remaining

two girls had lesions on the palms. Three cases were autochthonous and the

remaining patient was infected during a trip to Chile. A review of

Brazilian literature and comments on the epidemiology and clinical aspects

of the mycosis is presented.

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8.) Tinea nigra masquerading as acral lentiginous melanoma.

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SO - J Dermatol Surg Oncol 1986 May;12(5):502-4

AU - Babel DE; Pelachyk JM; Hurley JP

PT - JOURNAL ARTICLE

AB - Tinea nigra is a superficial mycosis that may mimic serious

pigmentary lesions. A lesion recently encountered on the foot was suspected

of being a malignant melanoma. Histologic and mycologic studies, done after

a biopsy was obtained, demonstrated Exophilia werneckii in the stratum

corneum. Tinea nigra should be considered in the diagnosis of pigmented

lesions of the hands and feet. A KOH examination is a simple and rapid

means of demonstrating this entity.

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9.) Association of anurans with pathogenic fungi.

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SO - Mycopathologia 1985 Oct;92(1):37-43

AU - Mok WY; Morato de Carvalho C

PT - JOURNAL ARTICLE

AB - In a study of 450 Amazonian anurans, we isolated yeasts and

yeast-like fungi from 54 animals (Bufo granulosus, B. marinus,

Dendrophrynyscus sp., Hyla geographica, H. lanciformes, Ololygon rubra,

Adenomera hylaedactyla, Eleutherodactylus fenestratus, Leptodactylus

fuscus, L. ocellatus, L. pentadactylus). The internal organs of these

animals did not show any macroscopic anomaly nor histopathology. We

recovered 105 fungal isolates from the anuran liver, lung, kidney, spleen,

heart and gonad. The isolates were made up of 30 fungal species, 9 of which

(48 isolates, 46%) were fungi with known pathogenic potentials, namely:

Candida guilliermondii, C. parapsilosis, C. tropicalis, C. glabrata,

Geotrichum candidum, Aureobasidium pullulans, Wangiella dermatitidis,

Trichosporon cutaneum and Exophiala werneckii. Eleven animals harbored

identical fungi in more than one of their internal organs; seven animals

had more than one fungal species colonizing a single organ. Our findings

indicated probable natural subclinical infections of candidiasis,

geotrichosis or phaeohyphomycosis, and also symbiotic presence of

non-pathogenic fungi among neotropical anurans.

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10.) [Tinea nigra. 1st clinical case in Uruguay]

TT - [Tina negra. Primera observacion en el Uruguay.]

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SO - Mycopathologia 1984 Aug 30;87(1-2):81-3

AU - Conti-Diaz IA; Burgoa F; Civila E; Bonasse J; Miller A

PT - JOURNAL ARTICLE

AB - The first case in Uruguay of 'tinea nigra' is described in a

44-year-old male patient with a maculous pigmented lesion on the right

foot. It represents the most meridional case of the disease yet recorded in

South America. Exophiala werneckii was isolated in cultures (strain 1905 IHM).

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11.) Treatment of tinea nigra palmaris with miconazole.

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SO - Arch Dermatol 1980 Mar;116(3):321-2

AU - Marks JG Jr; King RD; Davis BM

PT - JOURNAL ARTICLE

AB - A patient with tinea nigra palmaris was successfully treated with 2%

miconazole nitrate cream. In vitro studies demonstrated sensitivity of the

causative agent, Exophiala werneckii, to this antifungal agent.

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12.) Polymerase chain reaction-mediated genotyping of Hortaea werneckii,

causative agent of tinea nigra.

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SO - Mycoses 1994 Sep-Oct;37(9-10):307-12

AU - Uijthof JM; de Cock AW; de Hoog GS; Quint WG; van Belkum A

AD - Centraalbureau voor Schimmelcultures (CBS) Baarn, The Netherlands.

PT - JOURNAL ARTICLE

AB - The black yeast Hortaea werneckii is known to be a causative agent of

human tinea nigra but is also found in the environment. Strains from

dissimilar sources were studied by polymerase chain reaction fingerprinting

of nuclear DNA, using primers annealing to repetitive and random sequences.

The seven groups found correspond to those known from restriction fragment

length polymorphism (RFLP) studies of the mitochondrial DNA of the same

strains. Two main groups contained strains from human as well as from

non-human sources. The human strains did not cluster, but were randomly

distributed over several populations. It was concluded that these strains

are not pathogenic. The factor common to both niches is a relatively high

salt concentration.

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13.) Tinea nigra: treatment with topical ketoconazole.

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SO - Cutis 1993 Oct;52(4):209-11

AU - Burke WA

AD - Department of Internal Medicine, East Carolina University, School of

Medicine, Greenville, North Carolina 27858-4354.

PT - JOURNAL ARTICLE

AB - Tinea nigra is a relatively uncommon fungal infection presenting as a

pigmented macule of the palms or soles. Since the lesion can easily mimic a

melanocytic process, it is important to recognize the infection before

recommending unnecessary surgical procedures. A case of tinea nigra that

responded to treatment with topical ketoconazole is presented.

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14.) Tinea nigra palmaris.

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SO - Clin Exp Dermatol 1993 Sep;18(5):481-2

AU - Hughes JR; Moore MK; Pembroke AC

AD - Department of Dermatology, King's College Hospital, London, UK.

PT - JOURNAL ARTICLE

AB - Tinea nigra is a clinically distinctive superficial mycosis of the

palms, and occasionally the soles, caused by Phaeoannellomyces werneckii. A

patient, resident in the United Kingdom, is described who acquired the

infection in Thailand. The condition cleared after treatment with topical

miconazole cream 2%.

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15.) Therapy of tinea nigra plantaris.

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SO - Int J Dermatol 1989 Jan-Feb;28(1):46-8

AU - Sayegh-Carreno R; Abramovits-Ackerman W; Giron GP

AD - Department of Dermatology, Central University of Venezuela, Caracas.

PT - JOURNAL ARTICLE

AB - Four cases of tinea nigra plantaris are presented. The therapeutic

approaches used by different dermatologists who treated these patients are

analyzed in order to obtain a meaningful conclusion on how to best manage

this infrequent entity. We conclude that the visible affected skin should

be scraped off before using either ciclopiroxolamine or an imidazole

topically; systemic therapy is not recommended.

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16.) [Tinea nigra. Apropos of a case diagnosed as melanoma of superficial

dissemination]

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Author

Macotela-Ru´iz E; L´opez Mart´inez R; Gonz´alez Mendoza A; Soberanes

Valenzuela G; Su´arez de la Torre R

Source

Prensa Med Mex, 43(3-4):110-2 1978 Mar-Apr

Abstract

The authors report a case of tinea nigra of left sole, diagnosticate at the

beginning as melanoma of superficial dissemination. The mycological studies

confirmed the dermatological diagnostic of tinea nigra by Cladosporium

werneckii.

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17.) Tinea nigra palmaris: differentiation from malignant melanoma or junctional nevi.

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Author

Hall J; Perry VE

Address

Baylor College of Medicine, Houston, Texas, USA.

Source

Cutis, 62(1):45-6 1998 Jul

Abstract

Tinea nigra usually presents as a brown to black macule on the palmar or

plantar skin and is sometimes misdiagnosed as a malignant melanoma or as a

junctional nevus, prompting unnecessary surgical procedures and anguish for

the patient. Superficial scraping of the skin for microscopic inspection

with potassium hydroxide reveals pigmented hyphae, easily confirming the

diagnosis of tinea nigra.

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18.) Tinea nigra palmaris from South India.

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Author

Dasgupta LR; Agarwal SC; Bedi BM

Source

Sabouraudia, 13 Pt 1():41-3 1975 Mar

Abstract

A middle aged woman was diagnosed as a case of tinea nigra palmaris in a

Pondicherry hospital. Ascraping from a dark patch on her palm yielded

Cladosporium werneckii. This is the first report of mycologically confirmed

tinea nigra palmaris from India.

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19.) Cell-surface hydrophobicity and lipolysis as essential factors in human tinea nigra.

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Author

G¨ottlich E; de Hoog GS; Yoshida S; Takeo K; Nishimura K; Miyaji M

Address

Research Center for Pathogenic Fungi and Microbial Toxicoses, Chiba

University, Japan.

Source

Mycoses, 38(11-12):489-94 1995 Nov-Dec

Abstract

Hydrophobic adhesion of cells of the black yeast Hortaea werneckii (Horta)

Nishimura & Miyaji, causative agent of human tinea nigra, was established

by microbial adhesion to hexadecane (MATH) and adhesion to polystyrene, and

compared with adhesion of other species of black yeasts. Additional

ecophysiological tests were performed. Hortaea werneckii cells proved to

have a high degree of hydrophobicity (98.5% MATH). The species is unable to

degrade keratin, but shows significant lipolytic activity. It is concluded

that H. werneckii is a commensal, that shows lipophilic adhesion to human

skin and survives by the assimilation of excretion products.

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20.) Tinea nigra infection in Canada.

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Author

Kane J; Birkett B; Fischer JB

Source

Sabouraudia, 14(3):327-30 1976 Nov

Abstract

The first infection of tinea nigra known to occur in Canada is reported.

The infection occurred on the palm of a Canadian boy, 6 years of age, while

he was visiting in the Bahamas. Cultural studies identified the causative

fungus to be Cladosporium werneckii.

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21.) Nature and identification of Exophiala werneckii.

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Author

Mok WY

Source

J Clin Microbiol, 16(5):976-8 1982 Nov

Abstract

The morphological and physiological characteristics of 44 isolates of

Exophiala werneckii recovered from human and environmental sources were

indistinguishable from 2 isolates that caused tinea nigra. Casein

hydrolysis and inability to decompose tyrosine differentiate E. werneckii

from Exophiala jeanselmei, Exophiala spinifera, and Wangiella dermatitidis.

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22.) Fruiting organs of Cladosporium werneckii.

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Author

Volc´an G; Godoy GA; Battistini F; Alvarez A

Source

Sabouraudia, 14(2):115-22 1976 Jul

Abstract

Submerged mycelia of a strain of Cladosporium werneckii isolated from tinea

nigra palmaris, when cultured on enriched corn-meal agar media, developed

fruiting bodies resembling perithecia.

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23.) Exophiala werneckii v. Arx

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(syns Cladosporium werneckii Horta, Dematium werneckii Dodge, Pullularia werneckii de Vries, Aureobasidium mansonii Cooke)

This organism is the causative agent of tinea nigra, a superficial phaeohyphomycosis characterised by dark macular patches on the palms or palmar aspects of the wrists and fingers (Ajello & Padhye 1980, McGinnis 1980). The use of the term tinea to describe the disease is misleading since it is not a form of ringworm (Roberts et al. 1984, McGinnis et al. 1985).

There is a great deal of confusion in the literature concerning the taxonomy of Exophiala werneckii and its relationship with Microsporum mansonii Castellani. McGinnis (1979) attempted to clarify the situation and concluded that the confusion arose when a case of pityriasis versicolor was misdiagnosed as tinea nigra. The organism responsible was named Microsporum mansonii by Castellani and later renamed Aureobasidium mansonii by Cooke. However, Cooke was actually naming the causative organism of tinea nigra, so his name is now considered to be a synonym of Exophiala werneckii. Since Castellani's name actually referred to the causative organism of pityriasis versicolor, it is now considered to be a synonym of Malassezia furfur Baillon.

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24.) Exophiala species

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Exophiala species are usually included among the fungi called "black yeasts". Conidia are typically borne at the tips of short annellides produced along the vegetative hyphae. The annellides are often difficult to see and to determine that they actually are annellides. Species of Phialophora are similar but produce their conidia on phialides rather than annellides. Species of Aureobasidium, another genus of black yeasts, produce conidia holoblastically on minute peg-like extensions of short hyphal branches or directly along the hyphae themselves.

Some species of Exophiala are known to cause a subcuaneous disease in humans and other vertebrates. Although not normally life-threatening, these infections must be removed surgically or they may continue to grow for years. In handling these fungi, care must be taken not to accidentally inoculate oneself with contaminated instruments.

The natural habitats of Exophiala species are hard to pin down. They can be isolated from decaying plant material, wood, sewage sludge, soil, tree exudates and many other sources. They sometimes appear in unlikely places, such as in syrup-like solutions of polyvinyl alcohol. They are often most easily found by locating the small perithecia of the Exophiala holomorphs.

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25.) Bilateral Tinea Nigra Plantaris with Good Response to Isoconazole Cream: A Case Report.

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Case Rep Dermatol. 2015 Oct 28;7(3):306-10. doi: 10.1159/000441602.

Falcão EM1, Trope BM1, Martins NR1, Barreiros Mda G2, Ramos-E-Silva M1.

Author information

1Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

2Mycology Laboratory, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Abstract

Tinea nigra is a superficial fungal infection caused by Hortaea werneckii. It typically affects young individuals as an asymptomatic unilateral macule, from light brown to black on the palms and soles, mainly in tropical and subtropical regions. In 1997, Gupta et al. [Br J Dermatol 1997;137:483-484] described the dermoscopic characteristics of tinea nigra. Topical antifungals with or without keratolytic agents can be used for the treatment. The authors report a case of a 47-year-old man with asymptomatic light brown macules bilaterally on the plantar regions. Dermoscopic examination revealed brownish spicules consistent with the pattern described in the literature. Treatment with isoconazole cream was effective with complete resolution.

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26.) Dermatoscopy in inflammatory and infectious skin disorders.

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G Ital Dermatol Venereol. 2015 Oct;150(5):521-31.

Lacarrubba F1, Verzì AE, Dinotta F, Scavo S, Micali G.

Author information

1Dermatology Clinic, University of Catania, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy - cldermct@gmail.com.

Abstract

Dermatoscopy is a non-invasive technique that allows a rapid and magnified in vivo observation of the skin surface. By definition, it is performed with handheld devices (dermatoscopes) allowing X10 magnification. More expensive, computer-assisted digital systems (videodermatoscopes) may be equipped with lenses that ensure magnifications up to X1000; in this case the term videodermatoscopy is generally used. Dermatoscopy is mainly utilized for the evaluation of pigmented skin lesions, and has increasing applications in dermatology. In this paper the use of dermatoscopy in a variety of inflammatory (psoriasis, lichen planus, pityriasis lichenoides, rosacea, lichen sclerosus, Darier's disease, pigmented purpuric dermatoses) and infectious (human papillomaviruses infections, molluscum contagiosum, tinea capitis, tinea nigra, scabies, head and pubic lice, tungiasis, cutaneous leishmaniasis and cutaneous larva migrans) cutaneous disorders will be analyzed. In these conditions, dermatoscopy may assist the clinical diagnosis, reducing the need of semi-invasive or invasive procedures such as skin scrapings and/or biopsy. Depending on the disease, the choice to use low or high magnifications may be crucial. Dermatoscopy may also be useful for prognostic evaluation and monitoring of response to treatment, representing an important and relatively simple aid in daily clinical practice.

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27.) Tinea nigra showing a parallel ridge pattern on dermoscopy.

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Noguchi H1, Hiruma M, Inoue Y, Miyata K, Tanaka M, Ihn H.

Author information

1Noguchi Dermatology Clinic, Kumamoto, Japan; Department of Immunology, Allergy & Vascular Biology, Kumamoto University, Kumamoto, Japan.

Abstract

An 18-year-old healthy female student noticed a brown macule measuring 21 mm in diameter on the left palm and visited our clinic concerned about a cancerous mole. Dermoscopic examination revealed a brown, fine-dotted and granule-like structure overlapping an amorphous light brown macule. However, unlike previous cases, analysis of the high dynamic range-converted image revealed the parallel ridge pattern frequently observed in malignant melanomas. Brown mycelia were detected on direct microscopic examination; black colonies were isolated on fungal culture and the fungus was identified as Hortaea werneckii. The lesion was treated with topical ketoconazole cream, and it diminished 1 month later.

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28.) Dermoscopy revealing a case of Tinea Nigra.

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An Bras Dermatol. 2013 Jan-Feb;88(1):128-9.

Criado PR1, Delgado L, Pereira GA.

Author information

1State of São Paulo Cancer Institute, Faculty of Medicine, University of São Paulo (ICESP - FMUSP), São Paulo, SP, Brazil.

Abstract

Dermoscopy has being used over the past twenty years as a noninvasive aid in the diagnosis of innumerable skin conditions, including infectious diseases and infestations (Entodermoscopy).Tinea nigra is a superficial phaeohyfomycosis that affects mainly the glabrous skin of palms and soles. We describe a 14 year-old girl with a three-month history of an enlarging brown patch of her hand diagnosed as Tinea Nigra following clinical and dermoscopy examination.These images emphasize the importance of dermoscopy as a diagnostic tool in the daily routine of dermatologists.

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  Produced by Dr. Jose Lapenta R. Dermatologist

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EDITORIAL ENGLISH 
===================

Hello friends of the net, DERMAGIC again with you with this NON DERMATOLOGIC
EXPRESS Titled: AUTISM, THIMEROSAL AND VACCINES, topic very hot today in day, for
the fact that recently VERY PROBABLY THE INCIDENCE OF AUTISM IN THE PLANET, is
increasing because of the SAME VACCINES that PREVENT US OF OTHER ILLNESSES.

The AUTISM is a neurological disorder that is characterized by impairments in language, cognitive
and social development. Symptoms usually manifest in the first two years of life.

Initially the AUTISM was attributed to the mother's behavior toward the boy: "COLD" mothers and
of "little" love to their children, later studies evidence that also is associated to dysfunctions of the
immune, gastrointestinal and neurological system. And lately THE TOXICITY WITH MERCURY
had taken a lot of popularity, mainly the THIMEROSAL content in THE VACCINES.


MERCURY is the SECOND most toxic element on earth to plutonium. Toxicity of mercury has
been linked to many different diseases, including autism,learning disabilities, Alzheimer’s, multiple
sclerosis, fibromyalgia, lupus, chronic fatigue syndrome, arthritis, depression, and bipolar disorder.
The amount of mercury found in one mercury thermometer is ENOUGH TO POLLUTE A SMALL
LAKE.

In the year of 1946 three nurses died from SYSTEMIC LUPUS ERYTHEMATOSUS as a
manifestation of MULTIPLE vaccines to that were subjected, during an investigation work, fact that
I mark a clear evidences that A VACCINE to part of preventing a ILLNESS, it can UNCHAIN
OR CAUSE ANOTHER.

Recently IN 1.995 the APPEARANCE OF LICHEN PLANUS (dermatologic disorder) has been
described after vaccination AGAINST THE HEPATITIS B. and many other secondary effects have
been described after the placement of vaccines, among them demyelination (in experimentation
animals.)

In the year of 1.943 the Dr Leo Kanner, psychiatrist of the Hospital Jhon Hopkins diagnoses the
AUTISM for the first time, and later on the Austrian pediatrics Hans Asperger. Both Doctors
suggested that the illness could be related with the genes, because it had met members of oneself
family with AUTISM and parents'direct transmission to Children.

Previously FREUD had said that the PSYCHOLOGICAL PROBLEMS of the children NOT
They were GENETIC, inculpating to the family environment, mainly the lack of maternal love the one
origin of the illnesses of the human behavior.

In 1.981 the Dra Lorna Wing, a British psychiatrist publishes a very interesting study where she
revives the interest for the theories of Kanner and Asperger, on the GENETIC ORIGIN OF the
illness.

These eminent investigators NEVER suspected was that THE SIMPLE THIMEROSAL,
compound that it contains MERCURY and that it is used in the VACCINES that we use in our
children, it could BE the CAUSE of AUTISM.

THE FACTS:
----------------

1.) The thimerosal was introduced for the first time in the vaccines like preservative in l.930. The
statistical studies before 1.970 reveal a prevalence of autism of 1 in 2000 In studies from 1.970 at
1990 the average was of 1 in 1.000. This was the period in that increment the vaccination with the
TRIPLE VACCINE (DPT) that THIMEROSAL contained.


2.) For beginnings of the years 1.990 the prevalence of Autism was 1 in 500, and in the 2.000, 1 in
150. In the years 80 and 90 2 new vaccines were added with content from THIMEROSAL to the
traditional outlines, the HIB (multidosis) and the vaccine against the hepatitis B.

3.) The TRIPLE vaccine MMR (measles, mumps and rubella) it has been one of those but
questioned in the inducion of the AUTISM.

4.) For the beginnings of the year 1982 the FDA issued to proposed regulation calling for the
removal of thimerosal from over the counter products, but these regulations were not finalized until
1998, 16 sixteen years after the FDA expert panel concluded thimerosal was unsafe, ineffective like
to bacteriostatic agent, and caused cell damage. For the 16 years, and even today, thimerosal was
continued in it uses regardless of the known fact that it is to NEUROTOXIN. Mercury exposures
may causes neurological problems in 60,000 children every year.

5.) In July 1.999 the FDA urges to the makers of vaccines to remove the thimerosal of its products
because the immunization outlines were in some children in a HIGH EXHIBITION of quantity of
mercury, but that the established one as sure.

6.) In July 11, 2000 it is reported that Methyl-mercury exposure is to “widespread and persistent
problem in the environment” and may causes neurological problems in 60,000 children born in the
U.S. each year.

7.) In July 4 - 26, 2.001 it is revealed that the effects of the exposure to the Ethylmercury in
children WERE NEVER STUDIED. !!

8.) THE FDA in the year of 1.999 recognized that the quantities of ETHYL-MERCURY
(THIMEROSAL) contained in the pediatric vaccines they were INVOLVED IN THE
ALARMING increase of the INCIDENCE OF THE AUTISM in the whole nation, mainly New
Jersey and California, and it recommended to the MANUFACTURING LABORATORIES OF
VACCINES to diminish to the maximum the content of Thimerosal.

9.) FOR March of the 2.000 THE FDA informs that most of the VACCINES THAT AT THE
MOMENT are using, they have single TRACES of mercury and in some of them the MERCURY
was ELIMINATED TOTALLY, achieving to diminish in 98% the quantity of THIMEROSAL OF
THE SAME ones.

10.) In January 3 of the 2.002 a secret report of the CDC of ATLANTA found an increase of the
risk in 2.48 times but so that a boy acquires autism exposed MORE THAN 62.5 micrograms of
MERCURY BEFORE OF THE FIRST 3 MONTHS OF LIFE, through pediatric vaccines, that
which confirms THE THEORY THAT the VACCINATION TRULY causes an increase of the
cases of AUTISM.
 

..."in a vaccine case, a relative risk greater than 2.0 establishes that there is a greater than 50%
chance that the injury was caused by the vaccine." 

CONCLUSIONS:
---------------------
 
1.) The first case of Autism induced by THIMEROSAL was reported in TEXAS, Austin, a children
under the name of Joseph Counter. To this, they continued him many other but.
All they were able to UNCOVER THE "POT" that really THE contained THIMEROSAL in the
vaccines had been the causing one.
 
2.) It should BE ELIMINATED THE THIMEROSAL of the vaccines TOTALLY. If THE FDA
had concluded that it is INEFFECTIVE LIKE BACTERIOSTATIC and preservative, WHY there
are TRACES of mercury at the moment in SOME VACCINES. ??? 
 
3.) THE ADJUVANTS that are placed in ALMOST ALL THE VACCINES they cause
immunologic events in the children, it could be that these TRACES of mercury, be EVEN LOW,
and some other components cause in genetically susceptible children THE AUTISM. 
 

4.) 16 years passed since in 1.982 the FDA recognized the problem of the THIMEROSAL IN THE

vaccines UNTIL nowadays, A GENERATION of AUTISTIC children THAT MAKES ME

REMEMBER that SAD generation caused by THE THALIDOMIDE. Where the ERROR was???

It was SIMPLY HUMAN, it was never thought neither study THE harmful EFFECTS OF THE

THIMEROSAL in our children. 

 

5.) Genetically an association of the major histocompatibility complex (MHC) HLA DbR1 has been
linked with AUTISM. This ratifies that Asperger and Kanner had reason as for the genetic
predisposisicion. In this particular case THE MERCURY or OTHER ADJUVANTS OF THE
VACCINES were very probably THE TRIGGER so that the children genetically predisposed they
DEVELOPED AUTISM. 
 
6.) FREUD ALSO partly HAD THE REASON, many children are not born AUTISTIC, but they
were not THE "COLD" MOTHERS, the cause was THE Thimerosal that converted them in
AUTISTIC and I ISOLATE these children OF our WORLD putting them in a DIMENSION that
we are beginning to know. 
 
7.) In all family where Autistic children exist or with learning problems, if he will be born new
children it is necessary to WATCH OVER the outlines of VACCINATION very closely, and to try
to determine IF the VACCINES were the causing of these conditions. 
 
8.) This revision is a TRIBUTE TO Joseph Counter AND ALL those HEALTHY CHILDREN that
BECAME IN AUTISTIC by reason of a SIMPLE VACCINATION, and a REFLECTION to our
BIG EXPERTS in the medic science so that this doesn't happen again. 
 
9.) Today's year 2,017 scientists discuss whether mercury or thimerosal in vaccines causes AUTISM or other neurological disorders, if you look in most databases the reports deny such an association, but the FDA ordered most The laboratories ELIMINATE where possible the thimerosal or mercury of the vaccines, which has been fulfilled in many of them, however there are still vaccines with TRACE OF mercury that suppose the absence of risk for AUTISM or other neurological disorders in vaccinated children. Read references (8 and 27) where the FDA speaks extensively about THIMEROSAL IN VACCINES.

10.) I leave this paragraph extracted from the COMMITTEE that studied the possible effects of thimerosal in the VACCINES year 2001:

... "The Committee concluded that the hypothesis that exposure to vaccines containing thimerosal could be associated with neurodevelopmental disorders was biologically plausible ...."
 
11.) Today most vaccines do not contain THIMEROSAL as a preservative, but some contain traces. In reference 21 you can see the number of vaccines containing thimerosa years ago, and in the 28 pediatric vaccines today for children 6 years and younger and their mercury content.

 
If you has some friend or family with AUTISTIC children sends them this LINK , be maybe he
USEFUL!!

In the references the facts

Greetings to all

Dr José Lapenta R. 

EDITORIAL ESPAÑOL
===================
Hola amigos de la red, DERMAGIC de nuevo con ustedes con este EXPRESS NO
DERMATOLOGICO titulado: AUTISMO, THIMEROSAL Y VACUNAS, tema bien caliente
hoy en dia, por el hecho de que recientemente MUY PROBABLEMENTE LA INCIDENCIA DE
AUTISMO EN EL PLANETA, este aumentando a causa de las MISMAS VACUNAS que NOS
PREVIENEN DE OTRAS ENFERMEDADES.  
 
EL AUTISMO es un desorden neurologico caracterizado por el deterioro del lenguaje y
comportamiento social y cognositivo. Los sintomas usualmente aparecen en los dos primeros años
de edad.  Inicalmente el AUTISMO fue atribuido al trato de la madre hacia el niño: madres "FRIAS" y de poco amor a sus hijos, posteriores estudios evidencian que tambien esta asociado a trastornos del
sistema inmune, gastrointestinal y neurologico. Y ultimamente LA TOXICIDAD CON MERCURIO
a tomado mucho auge, sobre todo el contenido en LAS VACUNAS.  
 
EL MERCURIO es el segundo elemento SOBRE EL PLANTETA MAS TOXICO, despues del
PLUTONIO. La toxicidad por mercurio a sido asociada a numerosas enfermedades incluyendo el
AUTISMO, dificultad del aprendizaje, enfermedad de alzheimer, esclerosis multiple, fibromialgia,
sindrome de la fatiga cronica, artritis, depresion, y desordenes bipolares. La cantidad de mercurio
contenida en un termometro ES SUFICIENTE PARA CONTAMINAR UN PEQUEÑO LAGO. 
 
En el año de 1946 tres enfermeras murieron de LUPUS ERITEMATOSO SISTEMICO como una
manifestacion de MULTIPLES vacunas a que fueron sometidas, durante un trabajo de investigacion,
hecho que marco una clara evidencia que UNA VACUNA a parte de prevenir una
ENFERMEDAD, PUEDE DESENCADENAR OTRA.  
 
Recientemente EN 1.995 se ha descrito la APARICION DE LIQUEN PLANO (desorden
dermatologico) despues de vacunacion CONTRA LA HEPATITIS B. y muchos otros efectos
secundarios han sido descritos despues de la colocacion de vacunas, entre ellos desmielinizacion (en
animales de experimentacion.)   
 
En el año de 1.943 el Dr Leo Kanner, psiquiatra del Hospital Jhon Hopkins diagnostico por
primera vez el AUTISMO, y posteriormente el pediatria Austriaco Hans Asperger. Ambos
Doctores sugirieron que la enfermedad podia estar relacionada con los genes, pues se habia
encontrado miembros de una misma familia con AUTISMO y transmision directa de padres a 
Hijos.  
 
Previamente FREUD habia dicho que los PROBLEMAS PSICOLOGICOS de los niños NO
ERAN GENETICOS, inculpando al entorno familiar, sobre todo la falta de amor materno el
origen de las enfermedades del comportamiento humano. 
 
En 1.981 la Dra Lorna Wing, una psiquiatra britanica publico un estudio muy interesante donde se
reavivo el interes por las teorias de Kanner y Asperger, sobre el ORIGEN GENETICO DE la
enfermedad. 
 
Lo que NUNCA sospecharon estos eminentes investigadores era que EL SIMPLE
THIMEROSAL, compuesto que contiene MERCURIO y que es utilizado en las VACUNAS que
utilizamos en nuestros hijos, podia SER el desencadenante de AUTISMO.  

LOS HECHOS:
-------------------
 
1.) El thimerosal fue introducido por primera vez en las vacunas como preservativo en l.930. Los
estudios estadisticos antes de 1.970 revelan una prevalencia de autismo de 1 en 2000. En estudios
desde 1.970 a 1990 el promedio fue de 1 en 1.000. Este fue el periodo en que se incremento la
vacunacion con la VACUNA TRIPLE (DPT) que contenia THIMEROSAL. 
 
2.) Para comienzos de los años 1.990 se encontro una prevalencia de Autismo de 1 en 500, y en el
2.000 de 1 en 150. En los años 80 y 90 se agregaron 2 nuevas vacunas con contenido de
THIMEROSAL a los esquemas tradicionales, la HIB (multidosis) y la vacuna contra la hepatitis B.  
 
3.) La vacuna TRIPLE MMR (sarampion, paperas y rubeola) ha sido una de las mas cuestionadas 
en la inducion del AUTISMO. 
 
4.) Para los comienzos de el año 1.982 la FDA propuso la remocion del thimerosal de los 
PRODUCTOS OTC (Venta libre), pero dicha regulacion no finalizaria hasta 1.998. 16 años
despues expertos de la FDA concluyeron que el THIMEROSAL es inseguro, inefectivo como
bacteriostattico y causa daño celular. Durante estos 16 años y aun hoy dia el thimerosal a
continuado usandose aun sabiendose que es una NEUROTOXINA. La exposicion al MERCURIO
puede causar desordenes neurologicos en 60.000 niños cada año. 
 
5.) En Julio de 1.999 la FDA pidio a los fabricantes de vacunas remover el thimerosal de sus
productos porque los esquemas de inmunizacion resultaron en algunos niños en una ALTA
EXPOSICION de cantidad de mercurio, mas que la establecida como segura.  
 
6.) En Julio 11 del 2000 se reporta la alta toxicidad del mercurio y su posible relacion con la
afectacion de 60.000 niños al año. 
 
7.) En Julio 4 -26 del 2.001 se revela que los efectos de la exposicion al Ethilmercurio en niños
NUNCA FUE ESTUDIADA. 
 
8.) LA FDA en el año de 1.999 reconocio que las cantidades de ETHYL MERCURIO
(THIMEROSAL) contenidas en las vacunas pediatricas ESTABAN INVOLUCRADAS EN EL
ALARMANTE aumento de la INCIDENCIA DEL AUTISMO en toda la nacion, sobre todo New
Jersey y California, y recomendo a los LABORATORIOS FABRICANTES DE VACUNAS
disminuir al maximo el contenido de Thimerosal. 
 
9.) PARA Marzo del 2.000 LA FDA informa que la mayoria de las VACUNAS QUE
ACTUALMENTE se estan utilizando tienen solo TRAZAS de mercurio y en algunas de ellas el
MERCURIO FUE ELIMINADO TOTALMENTE, lograndose disminuir en un 98 % la cantidad
de THIMEROSAL DE LAS MISMAS. 
 
10.) En Enero 3 del 2.002 un reporte secreto del CDC de ATLANTA encontro un aumento del
riesgo en 2.48 veces mas para que un niño adquiera autismo expuestos a MAS DE 62.5
microgramos de MERCURIO ANTES DE LOS 3 PRIMEROS MESES DE VIDA, a traves de
vacunas pediatricas, lo cual confirma LA TEORIA DE QUE VERDADERAMENTE la
VACUNACION provoco un aumento de los casos de AUTISMO.  
 
..." En el caso de las vacunas un riesgo relativo mayor de 2.0 establece que hay una probabilidad de
mas del 50% que los daños sean causados por la vacuna" 
 
CONCLUSIONES:
-----------------------  
 
1.) El primer caso de Autismo inducido por THIMEROSAL fue roportado en TEXAS, Austin,,
conocido bajo el nombre de Joseph Counter. A este le siguieron muchos otros mas.
Todos ellos lograron DESTAPAR LA OLLA de que realmente EL THIMEROSAL contenido en
las vacunas habia sido el causante. 
 
2.) DEBE ELIMINARSE TOTALMENTE EL THIMEROSAL de las vacunas. Si LA FDA ha
concluido que es INEFECTIVO COMO BACTERIOSTATICO y preservativo, PORQUE hay
actualmente TRAZAS de mercurio en ALGUNAS VACUNAS. ??? 

3.) LOS ADJUVANTES que son colocados en CASI TODAS LAS VACUNAS desencadenan
respuestas inmunologicas en los niños, podria ser que estas TRAZAS de mercurio, AUN SIENDO
BAJAS, y algunos otros componentes provoquen en niños geneticamente susceptibles EL
AUTISMO. 
 
4.) Pasaron 16 años desde que en 1.982 la FDA reconocio el problema del THIMEROSAL EN
LAS vacunas HASTA hoy dia, UNA GENERACION de niños AUTISTAS QUE ME HACE
RECORDAR a aquella TRISTE generacion provocada por LA THALIDOMIDA. Donde estuvo el
ERROR ??? SIMPLEMENTE FUE HUMANO, nunca se penso ni se estudio LOS EFECTOS
dañinos DEL THIMEROSAL en nuestros niños. 
 
5.) Geneticamente se ha demostrado una asociacion de LOS ANTIGENOS DE
HISTOCOMPATIBILIDAD HLA DbR1 con AUTISMO. Esto ratifica que Asperger y Kanner
tenian razon en cuanto a la predisposisicion genetica. En este caso particular muy probablemente EL
CONTENIDO DE MERCURIO u OTROS ADJUVANTES DE LAS VACUNAS FUERON EL
DETONANTE para que los niños geneticamente predispuestos DESARROLLARAN AUTISMO. 
 
6.) FREUD TAMBIEN en parte TENIA LA RAZON, muchos niños no nacen AUTISTAS, pero
no eran LAS MADRES FRIAS las desencadenantes, EL Thimerosal los convirtio en AUTISTAS y
AISLO a estos niños DE nuestro MUNDO metiendolos en una DIMENSION que apenas estamos
comenzando a conocer. 
 
7.) En toda familia donde existan niños Autistas o con problemas de aprendizaje, si va a nacer
nuevos niños hay QUE VIGILAR muy de cerca los esquemas de VACUNACION, y tratar de
determinar SI las VACUNAS fueron las causantes de estas condiciones. 
 
8.) Esta revision es un TRIBUTO A Joseph Counter Y TODOS aquellos NIÑOS SANOS que por
causa de una SIMPLE VACUNACION se CONVIRTIERON EN AUTISTAS, y una
REFLEXION a nuestros GRANDES EXPERTOS en la ciencia medica para que cosas como esta
no vuelvan a ocurrir. 

9.) Hoy dia año 2.017 los cientificos discuten si el mercurio o timerosal en las vacunas ocasiona AUTISMO u otros desordenes neurologicos, si usted  busca en la mayoria de las bases de datos los reportes NIEGAN tal asociacion, pero la FDA ordeno a la mayoria de los laboratorios ELIMINAR EN LO POSIBLE EL timerosal o mercurio de las vacunas, lo cual ha sido cumplido en muchas de ellas, sin embargo todavia existen vacunas con TRAZAS DE mercurio que suponen la usencia de riesgo para AUTISMO u otros desordenes neurologicos en niños vacunados. lea la referencias (8 y 27) donde la FDA habla extensamente sobre el TIMEROSAL EN LAS VACUNAS.

10.) Les dejo este parrafo extraido deL COMITE que estudio los posibles efectos del timerosal en las VACUNAS año 2.001:

..."El Comité llegó a la conclusión de que la hipótesis de que la exposición a las vacunas que contenían timerosal podía estar asociada con trastornos del desarrollo neurológico era biológicamente plausible...."

11.) Hoy dia la mayoria de las vacunas no contienen TIMEROSAL como preservativo, pero algunas de ellas contienen trazas. En la referencia 21 puede ver el numero de vacunas que contenian timerosal hace años, y en la 28 las vacunas pediatricas hoy dia para niños de 6 años y menores y su contenido de mercurio.

Si tiene algun amigo o familiar con niños AUTISTAS envieles este link, quiza le sea UTIL !!

En las referencias los hechos

Saludos a todos

Dr Jose Lapenta R. 

==================================================================  REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES 
==================================================================
1.) Autism and Mercury, Coincidence or Cause and Effect?
2.) AUTISM CAUSED BY CHILDHOOD VACCINATIONS CONTAINING THIMEROSAL
OR MERCURY
3.) Link Between Neurodevelopmental Disorders and Thimerosal Remains Unclear
4.) Have be you been injured by a thimerosal vaccine ?
5.) Unraveling autism
6.) Dangers Of Mercury
7.) Secret CDC vaccine study Thimerosal an autism risk
8.) The FDA REPORT ABOUT VACCINES AND AUTISM
9.) Vaccines, Mercury Toxicity and Skyrocketing Autism: 2002 Update Report
10.) Vaccine Induced Autism
11.) Major CDC Study on Thimerosal Flawed
12.) Effects of Ethylmercury Exposure in Infants Never Studied
13.) ER Exploits MMR Vaccine Myth
14.) Autism: a Novel Form of Mercury Poisoning
15.) Adverse Effects Of Adjuvants In Vaccines
16.) Thimerosal info
17.) Thimerosal litigation
19.) Vaccine Information
18.) Lawyers Claim CDC Cooked Books on Mercury: Secret Report Reveals
20.) The facts about vaccine and autism by date
21.) vaccines that contain thimerosal
22.) The national, Newspaper of Venezuela from 4/05/02
23.) [Lichen planus and vaccination against hepatitis B]
24.) ALERTAS SOBRE LA SEGURIDAD DE MEDICAMENTOS
NOTA INFORMATIVA DEL COMITÉ DE SEGURIDAD DE MEDICAMENTOS SOBRE
TIOMERSAL
25.) Strong Association of the Third Hypervariable Region of HLA-DRb1 with Autism
26.) Vaccine Induced Demyelination.
27.)THIMEROSAL IN VACCINES / FDA nowdays 2.017 28.) Thimerosal Content of Vaccines Routinely Recommended for Children 6 Years of Age and Younger
==============================================================
==============================================================
1.) Autism and Mercury, Coincidence or Cause and Effect?
==============================================================
Source: autism-mercury.com 
Autism is a neurological disorder that is characterized by impairments in language, cognitive and
social development. Symptoms usually manifest in the first two years of life. Once considered a rare
disorder with an incidence of only 1-3 per 10,000 births, autism is now reaching epidemic
proportions with an incidence of 20-40 per 10,000 births and “clusters” of 1 per 150 have been
reported in New Jersey and California. Autism now ranks third among childhood developmental
disorders, making it more common than Down’s syndrome, Multiple Sclerosis and Cystic Fibrosis. 
Initially thought to be psychiatric in nature, autism was attributed to a child’s exposure to an uncaring
or “refrigerator” mother. Currently, autism is undergoing more scientific scrutiny and as a result,
abnormalities in the immune, gastrointestinal and neurological systems have been documented.
Another abnormal finding is the presence of heavy metal toxicity, notably mercury, in autistic
children. When considering a source for exposure to mercury in the first two years of life, one
possible source is immunizations. 
In June 1999, the Food and Drug Administration discovered that “Infants who receive thimerosal
containing vaccine at several visits may be exposed to more mercury than recommended by Federal
guidelines for total mercury exposure.” Thimerosal, a preservative used in some vaccines to prevent
contamination, is 49.6% mercury by weight. Infants who are being vaccinated using multi-dose vials
with thimerosal can receive 62.5 micrograms of mercury per visit. For an average sized child this
represents an exposure approximately 100 times the 0.1 micrograms per kilogram of daily exposure
considered safe by the Environmental Protection Agency. The manufactures safety data sheet for
thimerosal states, “Highly toxic…Danger of cumulative effects…Avoid prolonged or repeated
exposure… and the Chemical, physical, and toxicological properties have not been thoroughly
investigated.” 
Next is the question of cause and effect, in other words, is a high dose bolus exposure to mercury a
possible explanation for the myriad of abnormalities found in the child suffering from autism? I believe
the answer to this question is yes. Mercury is known to cause neurotoxicity, especially in small
infants whose brains are still developing. Mercury also disrupts cell physiology through its covalent
binding to sulfur which results in widespread dysfunction of enzymes, membranes, and structural
proteins. Symptoms of mercury toxicity in young children mirror those of autism. The recent
increase in the numbers of children diagnosed with autism directly correlates with the addition of
hepatitis B and HIB vaccine to infants in the early 1990s. 
News Flash!! 
The first known civil suit alleging that thimerosal causes mercury poisoning and symptoms similar to
autism has been filed in Austin, Texas. The case is called Joseph Counter, et al v. Abbott
Laboratories, Inc., et al (Cause No. GN100866 ) and is pending in the 200th District Court for
Travis County, Texas. The suit alleges that cumulative exposures to the mercury-based thimerosal
preservative found in many pediatric vaccines contributed to cause a body burden of mercury that,
in certain susceptible individuals, causes significant neurological disabilities, developmental problems
and other symptoms. The case has been filed by Waters & Kraus, a national law firm with its
headquarters in Dallas, Texas. The firm anticipates filing additional cases. If you are interested in
having your potential case considered by a firm that specializes in these types of cases, please click
here. If you prefer to speak to Waters & Kraus, the toll free phone number is 1-866-NOHGVAX. 
The issue of mercury in vaccines is the subject of further investigations at this time. Please return to
this website for current updates as they become available. 
To go to the website http://www.safeminds.org/, click here. 
This site is being developed by a mother, Lyn Redwood, whose son, Will, was exposed to mercury
in excess of federal guidelines via thimerosal in vaccines. After developing normally, in his second
year of life he began to slip away...losing speech, eye contact and becoming withdrawn and
despondent. Ultimately, he was diagnosed autistic. When the announcement by the FDA that some
infants had been exposed to mercury in excess of federal guidelines, Lyn began further investigations
into her son's level of exposure and indeed, he was one of those infants. Analysis of his baby hair (at
the age of 20 months) revealed toxic levels of mercury. It is her hypothesis that this may be the cause
of his autism. Her goal is to conduct and support efforts toward research and treatment of Autism
spectrum disorders and to educate parents into this area. If you have any questions or would like to
contact her, e-mail her at autism-mercury@mindspring.com. 
==============================================================
2.) AUTISM CAUSED BY CHILDHOOD VACCINATIONS CONTAINING THIMEROSAL
OR MERCURY
==============================================================
Source: Ashcraftandgerel.com 
A full generation of children in America was exposed to dangerous doses of highly toxic ethyl
mercury from 1990 through 2000. Children were injected with the toxic mercury that was a major
ingredient in a chemical product called thimerosal, an additive and biological preservative packaged
into multi-dose vials of many childhood vaccines. With each dose of vaccine that contained
thimerosal, a child would also get an injection of toxic mercury. Each one of those mercury injections
exposed the child to levels of toxic mercury in excess of the federal government's own safety
guidelines.
Mercury is widely known to cause neurological damage, often permanent. Current clinical and
epidemiological research suggests that the mercury-laden thimerosal so widely given to children by
the drug companies in the 1990's might cause a range of neurological and neurodevelopmental
injuries, including autism. Compounding this public health disaster is that the toxic exposure was
entirely avoidable. The thimerosal was added merely as product packaging for the multi-dose vials,
and is not needed as a preservative when the vaccines are packaged in single-dose vials or
single-use syringes. Thimerosal had nothing to do with vaccine safety, and everything to do with the
profits and convenience of packaging for the pharmaceutical companies. 
Ashcraft & Gerel has participated in the early stages of legal activities seeking to have Thimerosal
removed from childhood vaccinations but has not yet committed to representing individual claimants
for injuries alleged to have been caused by by Thimerosal. This web page will be updated at such
time as we decide to become involved in litigating individual claims 
==============================================================
3.) Link Between Neurodevelopmental Disorders and Thimerosal Remains Unclear
==============================================================
For Immediate Release
Source: nationalacademies.org 
Date: Oct. 1, 2001
Contacts: Saira Moini, Media Relations Officer
Cory Arberg, Media Relations Assistant
(202) 334-2138; e-mail <news@nas.edu> 

WASHINGTON -- Current scientific evidence neither proves nor disproves a link between the
mercury-containing preservative thimerosal and neurodevelopmental disorders in children, says a
new report from the Institute of Medicine of the National Academies. While very few vaccines given
to children in the United States today still contain thimerosal, prudence dictates that precautionary
measures be taken to decrease thimerosal exposure even further. 
Thimerosal is used in some vaccines and other pharmaceutical products to prevent bacterial
contamination. Vaccines against measles, mumps, and rubella; varicella; and polio have never
contained the preservative. However, until recently, several other vaccines on the recommended
childhood immunization schedule in the United States did. They are now manufactured without
thimerosal, but an unknown, probably small number of vaccine doses for hepatitis B; diphtheria,
tetanus, and pertussis; and haemophilus influenzae type B, a form of bacterial meningitis, are still on
clinic shelves. These supplies should not be used when alternatives are available, said the committee
that wrote the report. 
"Most children in the United States being immunized today and in the future are unlikely to receive a
vaccine that contains thimerosal," said committee chair Marie McCormick, professor of maternal
and child health at Harvard School of Public Health, Boston. "In those few cases where only
supplies containing the preservative are available, the vaccines should be administered rather than
foregoing immunization. While the health effects of thimerosal are uncertain, we know for sure that
these vaccines protect against real, proven threats to unvaccinated infants, children, and pregnant
women." 
A connection between exposure to certain forms of mercury and nervous system abnormalities has
long been recognized. People exposed to high mercury levels can experience difficulties with
coordination, vision, and learning. Most studies of the effects of low-level exposure have focused on
methylmercury from fish and seafood products. Thimerosal contains a different chemical form called
ethylmercury. 
The committee's comprehensive assessment of the scientific literature on thimerosal included analyses
of published and unpublished studies proposing an association with disorders such as autism, and it
found them to be inconclusive. No evidence currently exists that proves a link between
thimerosal-containing vaccines and autism, attention deficit-hyperactivity disorder, speech or
language delays, or other neurodevelopmental disorders. 
Mercury can build up in the body with each additional exposure, whether from vaccinations or other
sources, such as fish consumption. It is medically plausible that some children's risk of a
neurodevelopmental disorder could rise in part through increased mercury exposure from
thimerosal-containing vaccines. Because safety guidelines were established specifically for
methylmercury, however, it is not clear whether additional exposure from ethylmercury could result
in an unsafe cumulative level. 
However, as another precaution, policy-makers in the United States should consider changing
existing policies to reduce exposure to thimerosal as much as possible. For example, professional
societies and government agencies should review their policies about nasal sprays, eye drops, and
other products that contain thimerosal and are used for infants, children, and pregnant women, the
report says. 
For more than half a century, thimerosal was added to some vaccines that protected children against
serious diseases. In 1999 the U.S. Public Health Service, the American Academy of Pediatrics, and
the American Academy of Family Physicians issued precautionary recommendations limiting mercury
exposure of infants and young children, a measure that prompted development of thimerosal-free
versions of routine childhood vaccines. By mid-2000, thimerosal-free vaccines against hepatitis B
and bacterial meningitis were widely available. A combination vaccine for diphtheria, pertussis, and
tetanus also is available today without thimerosal. 
The preservative is still used in a few vaccines, including influenza vaccine, which is given annually
during the viral flu season to adults and some children. The Centers for Disease Control and
Prevention recommend that protecting pregnant women and high-risk children during flu season take
precedence over any possible risk from thimerosal exposure. 
Public trust in vaccine safety must be maintained, the committee said. To this end, it is important to
understand more fully the possible effects of thimerosal. Future research should include population
studies of the occurrence of neurodevelopmental disorders before and after thimerosal was removed
from most vaccines. Levels of women's prenatal and postnatal mercury exposure from medicinal
products and sources such as fish consumption should be examined as well. Clinical research also
should examine how the bodies of children, including those diagnosed with neurodevelopmental
disorders, absorb and process heavy metals like mercury and which medical therapies are effective
in ridding the body of them. This second study in a series on vaccine safety was sponsored by the
Centers for Disease Control and Prevention and the National Institute of Allergy and Infectious
Diseases. The Institute of Medicine is a private, nonprofit institution that provides health policy
advice under a congressional charter granted to the National Academy of Sciences. A committee
roster follows.
Copies of Thimerosal-Containing Vaccines and Neurodevelopmental Disorders are available from
the National Academy Press; tel. (202) 334-3313 or 1-800-624-6242 or on the Internet at
http://www.nap.edu/. The cost of the report is $25.00 (prepaid) plus shipping charges of $4.50 for
the first copy and $.95 for each additional copy. Reporters may obtain a copy from the Office of
News and Public Information (contacts listed above). 
==============================================================
4.) Have be you been injured by a thimerosal vaccine ?
==============================================================
Source: thimerosalautism.com
yourlawyer.com 
Thimerosal is the most common preservative that is used in vaccines and biologics that are marketed
in the United States. Thimerosal is used to help prevent a vaccine from spoiling, for inactivating
bacteria used to formulate several vaccines, and in preventing bacterial contamination of the final
product. Several of the vaccines recommended routinely for children in the United States contain
thimerosal. However, reports have surfaced linking thimerosal to mercury poisoning in infants often
causing autism. 
On July 7, 1999, the American Academy of Pediatrics (AAP) issued with the US Public Health
Service (USPHS) a joint statement alerting clinicians and the public of concern about thimerosal, a
mercury-containing preservative used in some vaccines.The reason for the warning is that himerosal
contains a related mercury compound called ethyl mercury. Mercury is a toxic metal that can cause
immune, sensory, neurological, motor, and behavioral dysfunctions. 
The Food and Drug Administration suggested that some infants, depending on which vaccines they
receive and the timing of those vaccines, may be exposed to levels of ethyl mercury that could build
up to exceed one of the federal guidelines established for the intake of methyl mercury. Symptoms of
mercury toxicity in young children are extremely similar to those of autism. 
This can explain the recent increase in the numbers of children diagnosed with autism since the early
1990's. The numerous amount of children diagnosed with autism seems to directly correlate with the
recommendation of both the hepatitis B and HIB vaccine to infants in the early 1990s. Autism is a
neurological disorder that is characterized by impairments in language, cognitive and social
development. 
Autism symptoms are usually encountered iin the first two years of life. In the past autism was
considered a rare disorder with an incidence of occurance of aprroximately 1-3 per 10,000 births.
More recently however, Autism is being diagnosed much more frequently with an incidence of
occurance of 20-40 per 10,000 births and reports of of 1 per 150 births have been reported in
several states including New Jersey and California. 

==============================================================
5.) Unraveling autism
==============================================================
Source: nurseweek.com 


Health experts tackle escalating incidents of developmental disorders 
By Nancy Devine
November 20, 2000
Photo: M.I.N.D. Institute, UC Davis 

Developmental pediatrician Robin Hansen, MD, works with a young patient at the M.I.N.D.
Institute at UC Davis. Scientists are trying to pinpoint a cause and relieve symptoms for autistic
children who have become isolated and unable to respond to others. 
After giving birth to her son, Lyn Redwood, MSN,FNP, of Tyrone, Ga., and her physician-husband
tracked his development up to 15 months. After a series of vaccines, the boy started to regress, so
Redwood had him tested. The diagnosis: severe developmental delay. 
Redwood began to investigate the vaccines that preceded the diagnosis and found that all contained
thimerosal, a preservative containing 49.6 percent ethylmercury by weight. By examining her son’s
records, she found that he had received 237.5 micrograms of ethylmercury in the first 18 months of
life. 
"I sent a piece of my son’s baby hair for mercury testing and it came back with a report stating it
contained 4.8 parts of mercury per million," Redwood said. "That’s five times the allowable level for
mercury. Research studies of children in the Faroe Islands whose mothers were eating
mercury-contaminated seafood during pregnancy reported blood levels of 15 to 30 micrograms at
birth, resulting in developmental delay. So I started looking at all the diagnostic markers for autism
and found all those diagnostic markers to mercury. Looking back at it now, my son’s symptoms for
mercury poisoning were classic. My husband’s a physician and he didn’t see it, and I’m a nurse
practitioner, but I had never seen a child with mercury poisoning." 
Thimerosal – scientifically associated with a number of neurological disorders including autism,
attention deficit disorder, speech delays and tics – was originally determined to be dangerous and
was recommended to be withdrawn from nonprescription products by FDA experts in 1982,
Redwood said. Some manufacturers dropped it; others didn’t. In 1998, thimerosal was banned for
use in over-the-counter products by the FDA, yet it continues to be used in some pediatric
vaccines. 
Redwood and the Coalition for Safe Minds filed a petition Oct. 24 in Washington’s federal district
court to obtain an immediate recall of all pediatric vaccines containing thimerosal or other toxic
mercury compounds. She has written several research papers on mercury toxicity, and the
Washington Post published a column by Marguerite Kelly on Nov. 1 that discussed the need for
mercury-free vaccines. 

~ Nancy Devine 

Imagine living in a world where fluorescent lights scream like chainsaws, sunlight pierces like a laser
and visual images shatter into fragments. More than half a million Americans live in some variation of
that red-alert, anxiety-filled world – those individuals diagnosed with autism or some form of
pervasive developmental disorder (PDD) that usually appears during the first three years of life. 
Autism is a complex developmental disability that affects normal brain development, according to the
Autism Society of America. Several related disorders are grouped together under PDD, all
characterized by severe and pervasive impairment in social interaction and communication skills. 
The disability, which may be mild or severe, is four times more prevalent in boys, and about 75
percent of affected individuals test in the range of mental retardation. Those who test above normal
I.Q. are called "high functioning" and may hold jobs. 
No cause, no cure
The prevalence rate for autism, estimated by the CDC to affect one in 500 individuals, has escalated
at an alarming rate in certain regions, where increases of up to one in 150 individuals have been
reported. 
Health experts have responded with more studies and treatments for a disorder with no proven
cause or cure, even as existing services for developmentally disabled patients are overwhelmed.
Scientists and parents are pursuing every possible connection or treatment that could pinpoint a
cause or relieve painful symptoms for children who have become profoundly isolated and unable to
respond to others. 
"We have several medical intervention studies, one of which is a double-blind placebo control study
of children within the PDD spectrum taking risperidone, which is approved for adults for problems
such as inattention, anxiety, obsessive-compulsive behavior or aggressive and self-injurious
behavior," said Kathy Koenig, MSN, an associate research scientist at Yale Child Study Center in
New Haven, Conn. 
"We also have social skills intervention studies because early training can help these children, and
one new study is on explicit explanations of eye contact skills, turn-taking in conversation and others.
Any improvement is progress." 
Autism is treated with speech/language therapy, physical therapy, sensory integration, occupational
therapy, applied behavior analysis, medications and dietary interventions, but more research is
needed to determine the most effective treatments for each disability. Early diagnosis and intervention
are crucial. 
Researching a reason
Many experts are looking for possible biomarkers in blood or genes that could indicate a child’s
predisposition to autism, while others are examining levels of medications or chemicals that may be
involved in triggering the disability to cause the increase in prevalence. 
"Very often, autism develops after a series of vaccines, or maternal measles, or a series of antibiotics
for infections – these things tend to precede the diagnosis," said Sharla Perel, MS, OT, who has
worked with autistic children at P.S. 77 in Borough Park, N.Y., for 10 years. "There’s enough
evidence for correlation that one has to look at these things." 
One team developed the Defeat Autism Now protocol, a guide for parents and practitioners to
reduce food allergies, mineral deficiencies, yeast overgrowth and medication toxicities that, when
eliminated, have helped autistic individuals progress, according to Maureen McDonnell, RN, owner
and director of Health Education Services in Pennington, N.J. 
Another group has identified a preservative in some pediatric vaccines, thimerosal, as a trigger for
autism. Thimerosal contains 49.6 percent mercury by weight and has been scientifically associated
with a number of neurological disorders including autism, attention deficit disorder, speech delays
and tics, said Lyn Redwood, MSN, FNP, president of the Coalition for Safe Minds in Tyrone, Ga. 
"We feel strongly this epidemic has been the result of mercury exposure," Redwood said. 
In 1998, parents and physicians launched the Medical Investigation of Neurodevelopmental
Disorders Institute in Davis because they believed a possible link existed between environmental
contributions and neurodevelopmental disorders. The institute received $34 million from the state of
California in June to pursue 19 studies, which now are under way. 
"Estimates from the NIH show that 17 percent to 29 percent of all American children have
neurodevelopmental disorders," said David Amaral, Ph.D., professor at the UC Davis department of
psychiatry. 
"I’m a neuroscientist, not an immunologist, and it might be environmental exposure or some change in
pediatric care policy, but we’re facing an incredible lack of knowledge. 
"It’s a win-win to conduct the vaccine study in a neutral way. If investigations show a clear link
between vaccines and autism, then we could prevent future cases," said Amaral, who is also the
institute’s research director. "If, conversely, we can’t demonstrate a link, that would be reassuring to
parents." 
Meanwhile, autistic children can greatly benefit from applied behavior analysis at schools like the
ABC School in Sacramento. 
"We use a set of principles to reinforce specific behaviors," said Michelle Williams-Wenell, ABC
school public relations and development specialist. "Our data shows that 40 percent of the kids who
come here before the age of 4 years and 1 month have gone on to full-inclusion settings." 
==============================================================
6.) Dangers Of Mercury
==============================================================
Source: Thimerosal-autism-Symptoms.com 
Mercury is the second most toxic element on earth to plutonium. Toxicity of mercury has been linked
to many different diseases, including autism, learning disabilities, Alzheimer’s, multiple sclerosis,
fibromyalgia, lupus, chronic fatigue syndrome, arthritis, depression, and bipolar disorder. The amount
of mercury found in one mercury thermometer is enough to pollute a small lake. 
Health effects of mercury toxicity have been a concern because of the potential for it to act as a
poison. Toxic doses of mercury can cause developmental effects in the fetus, as well as affecting the
kidney and the nervous system in children and adults. Mercury exists in a number of different
chemical forms, each one consisting of different levels of toxicity. The forms of mercury can also be
converted from one to another in the environment and in the body, so symptoms caused by mercury
poisoning depends on the precise chemical forms involved. 
Mercury can be toxic when inhaled, eaten, or when placed on the skin. Low concentrations of
mercury may appear to have no effect but signs of toxicity can develop later or become more
noticeable with continued exposure. When toxicity in humans takes place loss of feeling or a burning
sensation in arms and legs, psychological effects, loss of memory, loss of vision, loss of hearing,
paralysis, congenital malformations, kidney toxicity, and death may occur. Prenatal toxicity can result
in a child with normal appearance at birth but who later exhibits a developmental delay in the ability
to walk and/or talk. Because of the long latent period for observable effects, the need for treatment
may be recognized too late. 
Health effects vary according to the amount of mercury exposure is taken into the body. The health
risks of mercury at low levels of exposure remain uncertain, but this continues to be a highly
debatable topic with ongoing scientific investigation. Fetuses, infants and small children appear to be
particularly sensitive to mercury because their brains are still developing. Vaccines with mercury have
been considered to contribute to autism, learning disabilities, Alzheimer’s Disease, and other
neurological conditions, and an FDA review conducted in 1998 determined that, at the time, children
who received the full complement of childhood vaccines were potentially exposed to levels of
mercury that were sometimes 30 to 50 times the acceptable levels established by the EPA. 
High-level exposures to mercury can cause serious effects or even be lethal. Several historical
examples of epidemic mercury poisonings in other parts of the world provide classic examples of
investigative epidemiology and toxicology and serve to highlight the reasons why regulators are
concerned about mercury. Effects on the brain and nervous system are frequently seen with
high-level exposures to mercury and can be quite severe. 

==============================================================
7.) Secret CDC vaccine study Thimerosal an autism risk
==============================================================
Source: whale.to 
AUTISM FIRST STEPS
AUTISM DAILY NEWSLETTER
Thursday January 3, 2002
SPECIAL EDITION 

An unreleased confidential report by Center's for Disease Control (CDC) scientists reveals that
exposure to significant amounts of mercury during the first months of life significantly increases a
child's risk of developing autism, according to an attorney with the law firm of Walters & Kraus. The
firm is a part of a coalition of law firms, representing families in at least 25 states, that has filed
lawsuits in an attempt to force drug companies to investigate the possible link between mercury and
developmental disorders. 
Attorney Andy Walters says that the unreleased CDC report, obtained by the SAFEMINDS
advocacy group, found a 2.48 times increased risk of autism in children exposed to more then 62.5
micrograms of mercury before they were 3 months of age. In a press release, Walters and Kraus
notes that "in the United States, courts of law have generally held that a relative increased risk of 2.0
or higher is sufficient to substantiate that a given exposure causes disease." Walters says that in many
of the cases that his firm has evaluated, autistic children have received more than 62.5 micrograms of
mercury through pediatric vaccines. 
A report made public by the CDC in the fall claimed that the thimerosal, the mercury containing
preservative used in many vaccines, could not be linked to autism, while calling on Physicians to
avoid thimerosal containing vaccines when possible. However, according to Walters & Kraus, the
confidential CDC report states: "As for the exposure evaluated at 3 months of age, we found
increasing risks of "neurological developmental disorders" with increasing cumulative exposure to
thimerosal... within the group of "developmental disorders"... for the subgroup called "specific
delays," and within the this subgroup for the specific disorder "developmental speech disorder," and
for "autism" "stuttering" and "attention deficit disorder". 
Walters says the report's contents, and the fact that it was kept secret, are "shocking, but
unfortunately not surprising, given the political influence of pharmaceutical companies and the
tremendous liability they face if they are forced to compensate thousands of families for the costs of
care that these children require". 
Press Release, Walters & Kraus, 2001 
******************************
PRESS RELEASE 
An announcement was made today by the law firm of Waters & Kraus, the firm that filed the first
known lawsuit alleging that a mercury preservative in children's vaccines caused neurological damage
to an infant ultimately diagnosed with autism. Waters & Kraus is leading a consortium of ten firms in
as many states that are actively prosecuting cases of this nature (firms listed below). Andy Waters,
the lead attorney in the cases, announced that his firm is now in possession of a previously
unreleased confidential report authored by Centers for Disease Control scientists which studied
autism as a potential neurological injury caused by mercury in children's vaccines. A different version
of the report was made public and has been cited by the recent Institute of Medicine study as
inconclusive on the issue of whether the mercury-based vaccine preservative known as Thimerosal
has contributed to cause a nationwide epidemic of regressive autism and other neurological disorders
in small children. The confidential version of the study, however, clearly demonstrated that an
exposure to more than 62.5 micrograms of mercury within the first three months of life significantly
increased a child's risk of developing autism. Specifically, the study found a 2.48 times increased
risk of autism _ that is to say, children with the exposure were more than twice as likely to develop
autism as children not exposed. Click here to view the full report. (27 pages formatted in TIFF) In
the United States, courts of law have generally held that a relative increased risk of 2.0 or higher is
sufficient to substantiate that a given exposure causes disease. As but one example, in the case of
Cook v. United States, 545 F.Supp. 306, at 308 (Northern District _ California 1982) the Court
stated that, "in a vaccine case, a relative risk greater than 2.0 establishes that there is a greater than
50% chance that the injury was caused by the vaccine." Waters indicated that, in many of the cases
his firm has evaluated, including the case filed in a Texas state court on behalf of the Counter family,
the affected child received more than 62.5 micrograms of mercury through pediatric vaccines in the
first three months of life. The confidential report, which was obtained by the SAFEMINDS support
and advocacy group, states: "As for the exposure evaluated at 3 months of age, we found increasing
risks of 'neurological developmental disorders' with increasing cumulative exposure to thimerosal ...
within the group of 'developmental disorders'... for the sub_group called 'specific delays,' and within
this sub_group for the specific disorder 'developmental speech disorder,' and for 'autism,' 'stuttering'
and 'attention deficit disorder.'" The report also contained the graph depicted below which illustrated
the report's findings of a child's increasing risk of developing the neurological symptoms of autism
after receiving increasing amounts of thimerosal.Graph 3: Relative risk 95 % CI of Autism after
different exposure levels of thimerosal at 3 months of age, NCK & GHCWaters pointed out that the
confidential study's lead author, Thomas Verstraeten, has since left the Centers for Disease Control
and is now employed by GlaxoSmithKline, a manufacturer of thimerosal_containing vaccines for
many years that is a defendant in numerous suits pending nationwide. "We have asked
GlaxoSmithKline to provide Mr. Verstraeten's deposition in order to understand if conflict of interest
issues may have played a role in the CDC's decision to keep this report confidential, and specifically,
their failure to reveal it to the Institute of Medicine."Waters called the report's contents and the fact
that it was kept from the public as "shocking, but unfortunately not surprising, given the political
influence of pharmaceutical companies and the tremendous liability they face if they are forced to
compensate thousands of families for the costs of care that these children require." Waters added
that "no amount of money can give these children back the potential that they were born with, and no
amount of money will comfort the parents that watched helplessly as their children literally just
slipped away." The purpose of the lawsuits his firm is currently prosecuting, said Waters, is "to bring
to the surface the truth on this issue, a truth that government agencies seem unwilling to admit,
perhaps for fear that parents will stop vaccinating their children, and to force the companies that
profited from this disastrous mistake to shoulder the responsibility that so many families now bear on
their own, often without even the aid of health insurance benefits." Media inquiries should be
directed to Melissa Miles at 214-357-6244.Client inquiries should be directed to Victoria Gibson,
toll-free at 1-866-829-7529, or to the firms listed below.Other firms working with Waters & Kraus
to prosecute individual cases involving thimerosal exposure are:ANDERSON & KRIGER,
APLC40925 County Center Drive, Suite 210Temecula, California 92591Telephone:
909.296.5090DOGAN & WILKINSON726 Delmas AvenuePascagoula, Mississippi
39567Telephone: 228.762.2272 DORAN & MURPHY, LLP1234 Delaware AvenueBuffalo, New
York 14209Telephone: 716.884.2000EVERT & WEATHERSBY, L.L.C.3405 Piedmont Road,
Suite 225Atlanta, Georgia 30305-1764Telephone : 404.233.8718HENDRICKSON & LONG214
Capital StreetP.O. Box 11070Charleston, W. VA 25339Telephone: 304.346.5500JONES,
MARTIN, PARRIS, &TESSENER LAW OFFICES, PLLC410 Glenwood Ave., Suite
200Raleigh, North Carolina 27603Telephone: 919.821.0005LEACH, SCHWARZ
&STRASSBERG11 Bala Ave.Bala Cynwyd, Pennsylvania 19004Telephone:
610.668.7964MARTZELL & BICKFORD338 Lafayette StreetNew Orleans, Louisianna
70130Telephone: 504.581.90653555 College AvenueWISE & JULIAN, PC3555 College
AvenueAlton, Illinois 62002Telephone: 618.462.2600 
To View this CDC Unreleased reportit will be found in the 2nd paragraph: click on the link that
states: Click here to view the full report (27 pages formatted in TIFF) or click below
Mercury - Autism Links 
This story and the link listed above is found here at:
http://www.autismfraud.com/00000121.tiff 

Link to the Never Released CDC Report: 
http://www.autismfraud.com/00000121.tiff 
==============================================================
8.) The FDA REPORT ABOUT VACCINES AND AUTISM
============================================================== 
STATEMENT BY
KAREN MIDTHUN, M.D., DIRECTOR
OFFICE OF VACCINES RESEARCH AND REVIEW
CENTER FOR BIOLOGICS EVALUATION AND RESEARCH
FOOD AND DRUG ADMINISTRATION
DEPARTMENT OF HEALTH AND HUMAN SERVICES
BEFORE THE
COMMITTEE ON GOVERNMENT REFORM
UNITED STATES HOUSE OF REPRESENTATIVES
APRIL 26, 2001
INTRODUCTION 

Mr. Chairman and Members of the Committee, I am Karen Midthun, M.D., Director, Office of
Vaccines Research and Review (OVRR), Center for Biologics Evaluation and Research (CBER) at
the Food and Drug Administration (FDA or the Agency). OVRR regulates the development and
licensure of vaccines. We appreciate the opportunity to participate in this hearing on autism and to
respond to the Committee's concerns regarding a potential link between vaccines and autism. It is
important to note that to date, the existing data do not demonstrate a causal relationship between
vaccines and autism. Nevertheless, we want to assure this Committee, the public, and, especially the
parents that are here today, that FDA takes these concerns very seriously and we want to explain
FDA's ongoing efforts in response to the issue of vaccines and autism. 
Childhood vaccines have contributed to a significant reduction of vaccine-preventable diseases,
(e.g., polio, measles, and whooping cough). In fact, vaccine preventable infectious diseases are at an
all-time low and now it is rare for American children to experience the devastating effects of these
illnesses. Before vaccines were routinely administered, there were over 175,000 cases of diphtheria
annually (1920-22), over 147,000 cases of pertussis (1922-25), and over 503,000 cases of
measles (1951-54) reported in the United States (U.S.). These diseases have essentially
disappeared in countries with high vaccination coverage, such as the U.S. Up until 1985 and the
introduction of an infant vaccine, an estimated 20,000 cases of invasive Haemophilus type b disease,
primarily meningitis, occurred annually in the U.S. Now, because of vaccination, the number of cases
of invasive Haemophilus b disease has been decreased by more than 98 percent. All of the diseases
mentioned above were associated with significant mortality and morbidity. 
BACKGROUND 
Like all products regulated by FDA, vaccines undergo a rigorous review of laboratory and clinical
data by highly trained scientists and clinicians to help ensure the safety, purity, and potency of these
products. From an FDA regulatory perspective, there are four stages in vaccine development: the
pre-investigational new drug (IND) stage (before the product is used in people), the IND stage
(where human use occurs under limited study conditions), the license application stage for vaccines
(where FDA reviews the results of the clinical studies and the manufacturing process), and the
post-licensure stage (following approval of the product for marketing). 
A sponsor seeks licensure of a complete product as it is formulated for use, not of individual
components. Evidence of any acute toxicity from the use of an investigational drug, including
vaccines, is included in safety data from human clinical studies, as required under Title 21, Code of
Federal Regulations (CFR) Part 312. If any ingredient or ingredients causes acute toxicity, the
pre-market safety data would most likely indicate acute toxicity from use of the vaccine product.
Such data, however, generally would not show whether any particular ingredient or combination of
ingredients is the source of toxicity. 
Like other approved drug and licensed biological products, vaccines licensed for marketing may also
be required to undergo additional, Phase IV, studies to further evaluate the vaccine or to address
specific questions about the vaccine. For example, the manufacturer of Varicella Virus Vaccine
committed to perform a post-licensure study with fifteen years of safety follow-up. These studies will
provide information about the effects of the vaccine in a population larger than that exposed during
clinical trials. If additional side effects are identified during the post-marketing phase, either pursuant
to adverse event reports filed by health care providers or consumers, or pursuant to Phase IV
studies, FDA would take appropriate regulatory action to protect the public health such as, among
other options, changing the product's labeling information to reflect the possible side effects, or, in
cases of imminent or substantial hazard to the public health, ordering a recall of the product. 
Because of the complex manufacturing processes for most biological products, each product
undergoes thorough laboratory testing for purity, potency, identity, and sterility. Manufacturers may
release lots only after this testing is documented. FDA may require lot samples and protocols
showing results of applicable tests to be submitted for review, and where appropriate, further testing
by FDA. The lot release program is part of our multi-part strategy that helps ensure product safety
by providing a quality control check on product specifications. 
Vaccine Adverse Event Reporting System 
Licensure of all vaccines marketed in the U.S. is based on a benefit-to-risk analysis of the safety and
efficacy data submitted by sponsors to FDA. During the pre-market review process, manufacturers
and FDA focus on identifying and understanding risks before an overall risk-benefit decision can be
made on the product's licensure. When using any drug or medical product, a patient runs the risk of
experiencing reactions. For pharmaceuticals, including vaccines, these reactions are commonly
termed "side effects." They usually are identified in clinical trials conducted before licensure and are
described in a product's labeling. Known side effects, discovered in the course of clinical trials, upon
which a product's licensure or approval is based, comprise the majority of reported adverse events
after licensure. 
Like all other medical products, vaccines are not entirely risk-free. While serious complications are
rare, they can occur. Vaccines are unique medical products in that they are generally administered to
a large number of healthy individuals, primarily children. Therefore, it is very important to identify
even rare adverse reactions. CBER and the Centers for Disease Control and Prevention (CDC)
jointly manage the Vaccine Adverse Event Reporting System (VAERS), a cooperative program for
vaccine safety. VAERS is a post-marketing safety surveillance program that collects information
about adverse events that occur after the administration of U.S. licensed vaccines. An "event" is
simply an outcome. However, any outcome that an individual, whether a health care provider or a
consumer, believes may have resulted from the administration of a vaccine may be reported to
VAERS. Such report will be included in the system, regardless of whether there appears to be a
causal relation to the vaccine. Under FDA regulations, 21 CFR, Subpart D - Reporting Adverse
Experiences, section 600.80, licensed vaccine manufacturers must report to FDA adverse
experience information, and establish and maintain records. 
It should be emphasized that adverse event reports can be made by anyone, including health care
professionals, patients, and parents. If a patient's physician does not file a VAERS report, the patient
can do so. FDA protects the confidentiality of patients for whom an adverse event has been
reported. FDA encourages individuals to report to VAERS any clinically significant adverse event
occurring after the administration of any vaccine licensed in the U.S. Individuals who want to make a
report to VAERS can call VAERS at a toll-free number, 1-800-822-7967, to obtain a reporting
form. Forms and reporting instructions also are available on the Internet at
www.fda.gov/cber/vaers.html and at www.vaers.org. 
Follow-up Study of VAERS Autism Reports 
FDA has taken seriously VAERS reports of developmental delay following vaccination and wants to
assure the public that the Agency is researching any possible relationship between vaccines and
autism. CBER proposes to conduct a follow-up study of VAERS reports of autism. As part of the
study, CBER, in conjunction with outside autism experts, will review available medical records and
develop an interview questionnaire for parents and others who have reported autism after
vaccinations. The goal of the interviews is to gather information about demographics, clinical
features, potential risk factors, family history, vaccines administered, time interval from vaccination to
autism onset, rapidity of symptom onset, and interval from diagnosis to submission of reports.
Though this study cannot determine whether vaccines cause autism, it might suggest hypotheses that
could be further evaluated in subsequent controlled, epidemiologic studies. 
Autism-related Laboratory Activities 
FDA is actively pursuing research involving the characterization and development of the first
virus-induced animal model for autism - Borna disease virus (BDV) infection of the neonatal rat.
There is no direct evidence for any relationship between BDV infection and human autism. However,
BDV is used as the environmental damaging agent because it infects the brain of newborn rats. It is
important to note that BDV is not a cause of autism. The damage it does and the disease syndrome it
produces in rats are used only as a "model" to study general biological principles of autism. The
features of this model, which FDA scientists have developed over the past ten years, have excellent
correlation with what is known about human autism including neuroanatomical, behavioral, and
neurochemical correlations. This model is being used in laboratories throughout the U.S. and
internationally. 
Thimerosal 
FDA, together with other U.S. public health agencies, recognizes and supports the goal of reducing
exposure to mercury from all sources. Consistent with this goal, FDA has encouraged manufacturers
for several years to develop new vaccines without thimerosal as a preservative and to remove or
reduce the thimerosal content of existing, licensed vaccines. This joint effort by manufacturers and
FDA is reflected by the licensure of thimerosal-free products such as Comvax [Haemophilus b
Conjugate Vaccine and Hepatitis B Vaccine (Recombinant) manufactured by Merck & Company,
Inc.], licensed October 2, 1996, Infanrix [Diphtheria and Tetanus Toxoids and Acellular Pertussis
(DTaP) manufactured by GlaxoSmithKline], licensed January 29, 1997, and Prevnar
(Pneumococcal 7-valent Conjugate Vaccine manufactured by Wyeth-Lederle Vaccines and
Pediatrics), licensed on February 17, 2000, and the removal or reduction of thimerosal from
previously licensed products. 
In response to section 413 of the Food and Drug Administration Modernization Act (FDAMA) of
1997, FDA conducted a review of the use of thimerosal in childhood vaccines. Our review revealed
no evidence of harm caused by thimerosal used as a preservative in vaccines, except for local
hypersensitivity reactions. Under the U.S. recommended childhood immunization schedule, the
maximum cumulative exposure to mercury from thimerosal, at the time of this review in 1999, was
within acceptable limits for the methyl mercury exposure set by FDA, the Agency for Toxic
Substances and Disease Registry, and the World Health Organization. Of note, such guidelines
contain safety margins and are meant as starting points for evaluation of mercury exposure, not
absolute levels above which toxicity can be expected to occur. However, the maximum cumulative
exposure level exceeded the more conservative limits of the Environmental Protection Agency
(EPA). The clinical significance of exceeding EPA's limits is not currently known. 
Nevertheless, reducing exposure to mercury from vaccines is warranted. This is achievable, in part,
because it is possible in the U.S. to replace multi-dose vials with single dose vials, which do not
require a preservative. 
We are pleased to be able to report substantial progress in the effort to reduce thimerosal exposure
from vaccines. At this time, all routinely recommended licensed pediatric vaccines that are currently
being manufactured for the U.S. market, contain no thimerosal or contain only trace amounts of
thimerosal. The vaccines with trace amount of thimerosal licensed to date contain less than 0.5
micrograms of mercury per dose, that is, a given dose of vaccine contains less than 1 part per
million. 
Our efforts over approximately the past year and a half to accomplish this goal include the licensure
of a thimerosal free Hepatitis B Vaccine (Recombinant) manufactured by Merck and Company in
August 1999. FDA licensed another hepatitis B vaccine with trace amounts of thimerosal,
manufactured by GlaxoSmithKline in March 2000. A supplement for a new formulation of Aventis
Pasteur's DTaP Vaccine with only a trace amount of thimerosal was approved in March 2001.
Additionally, Wyeth-Lederle Vaccines and Pediatrics now only markets a single-dose,
thimerosal-free formulation of its Haemophilus b Conjugate Vaccine in the U.S. 
Therefore, all routinely recommended U.S. licensed pediatric vaccines are now available in either
thimerosal-free formulations or in formulations that contain only trace amounts of thimerosal. The
routinely recommended vaccines include hepatitis B Vaccine, Haemophilus b Conjugate Vaccine,
Measles Mumps and Rubella Vaccine, Pneumococcal Conjugate Vaccine, DTaP Vaccine,
Inactivated Polio Vaccine, and Varicella Vaccine. Prior to the recent initiative to reduce or eliminate
thimerosal from childhood vaccines, the maximum cumulative exposure to mercury via routine
childhood vaccinations during the first six months of life was 187.5 micrograms. With the newly
formulated vaccines, the maximum cumulative exposure during the first six months of life will now be
less than three micrograms of mercury; this represents a greater than 98 percent reduction in the
amount of mercury a child would receive from vaccines in the first six months of life. 
Thimerosal and the National Toxicology Program 
The National Toxicology Program (NTP) was established in 1978 by the Secretary of the
Department of Health and Human Services (DHHS or the Department) to coordinate toxicology
research and testing activities within the Department, to provide information about potentially toxic
chemicals to regulatory and research agencies and the public, and to strengthen the science base in
toxicology. The NTP has become a world leader in designing, conducting, and interpreting animal
assays for toxicity and/or carcinogenicity. 
NTP uses a chemical nomination and selection process as a means to best use its resources with
respect to the testing of chemicals of greatest health concern. Member agencies of the NTP,
including FDA, are the primary sources of nominations to the NTP. Because of the continued
interest on the part of the public, as well as public health agencies, to better characterize the potential
toxicity that could have accompanied an exposure to thimerosal from vaccines, FDA is in the
process of nominating thimerosal to the NTP for further study to adequately assess gaps in
knowledge regarding, among other things, neurodevelopmental toxicity. 
CONCLUSION 
Vaccines provide a great public health benefit in reducing or eliminating vaccine preventable
diseases. Like all medical products, there are risks with vaccines and FDA is committed to
continuing its efforts to ensure the safety of vaccines. We have worked diligently with manufacturers
to eliminate or reduce exposure to mercury from thimerosal in vaccines. As stated previously, all
licensed vaccines currently being manufactured for the U.S. market that are on the routine childhood
immunization schedule have formulations that are thimerosal-free or contain only trace amounts of
thimerosal. Although no causal relationship between vaccines and autism has been established, FDA,
along with other DHHS agencies, continues to pursue research activities to increase our
understanding of any relationship between vaccines and neurodevelopmental disorders. 
We thank you for your leadership in this area. I would be happy to answer any questions you might
have. 
==============================================================
9.) Vaccines, Mercury Toxicity and Skyrocketing Autism: 2002 Update Report
==============================================================
Source: tetrahedron.org 
by Ingri Cassel-Harkins 
Dear Friends: 
Please read the following three articles that should make it very clear why the concept of "safer"
vaccines is an oxymoron (i.e., the 2 words that basically are recited together are oppositional and
"make no sense.") We need to be clear when we communicate to others that: 
1. all "vaccine preventable" diseases are not scary; most well fed and cared-for children and adults
recover from them with natural immunity (immunity that lasts a lifetime) provided they are not already
"immune compromised" by nutritional and hygienic neglect and abuse. 
2. Most vaccines use thimerosal in the manufacturing process and this is not always mentioned in the
package insert of ingredients. In fact, if the vaccine is thimerosal-free, they often double the amount
of other adjuvants such as aluminum phosphate (or other "activating" ingredients which are often
heavy metals.) 
3. Vaccines are toxic and we are experiencing skyrocketing epidemics of disabled and neurologically
impaired children because of them. Now more than ever before. ~The damage to the entire human
genome of this grand and coerced medical experimentation is unparalleled in history and catastrophic
to our survival as a species. 
Source: http://www.autismsocietyofberks.org/pages/news.html California has just experienced the
largest quarterly increase in the number of new cases of level one autism in it's history. According to
DDS, between July 6, 2001, and October 4, 2001, a record number 705 new cases of DSM IV
autism entered California's developmental services system. As with all of DDS's autism case growth
reporting, the 705 new cases do NOT include other autism spectrum disorders such as PDD, NOS,
Asperger's, etc. The 2001 Third Quarter report represents a 54% increase over year prior, and
shows that autism accounts for 8 new children entering the system PER DAY. In October 2000
level one autism accounted for 28% of the total number of all new intakes (autism, cerebral palsy,
mental retardation, epilepsy, and conditions similar to mental retardation). Now in October 2001
level one autism accounted for 36% of all new intakes. California's numbers are significant because
they are one of the few states to actually track, record and report. Source: California Department of
Developmental Services (DDS). read the full text at http://www.feat.org 
-------------------------------------------------------------- 
LAWYERS CLAIM CDC COOKED BOOKS ON MERCURY; SECRET REPORT
REVEALED A leading vaccine injury law group announced today that their firm is now in
possession of an unreleased confidential report authored by Centers for Disease Control scientists
which studied autism as a potential neurological injury caused by mercury in children's vaccines. An
announcement was made by the law firm of Waters & Kraus, the firm that filed the first known
lawsuit alleging that a mercury preservative in children's vaccines caused neurological damage to an
infant ultimately diagnosed with autism. Andy Waters, the lead attorney in the firm, warned that a
different version of the report was eventually made public and has been cited by the recent Institute
of Medicine study as inconclusive on the issue of whether the mercury-based vaccine preservative
known as thimerosal has contributed to cause a nationwide epidemic of regressive autism and other
neurological disorders in small children. The confidential version of the study, however, clearly
demonstrated that an exposure to more than 62.5 micrograms of mercury within the first three
months of life significantly increased a child's risk of developing autism. Specifically, the study found
a 2.48 times increased risk of autism - that is to say, children with the exposure were more than
twice as likely to develop autism as children not exposed. For your own copy of the new report,
please email Claire@ASBESTOS-LAWYER.COM. (at Waters & Kraus.) 
--------------------------------------------------------------------------------------------------
another site----- source: http://forums.parenthood.com/viewmessages.cfm?Forum=55&Topic=617
(Email forum) 
We should be past the point of wasting time with claims that the amount of mercury in shots is
"miniscule." 
Study Finds Excessive Mercury in Hair of Infants: 'Cause for Concern' 1: Neurotoxicology 2001
Oct;22(5):691-7 
Mercury (Hg) is considered one of the world's most toxic metals. Current thinking suggests that
exposure to mercury occurs primarily from seafood contamination and rare catastrophic events.
Recently, another common source of exposure has been identified. Thimerosal (TMS), a
preservative found in many infant vaccines, contains 49.6% ethyl mercury (EtHg) by weight and
typically contributes 25 microg of EtHg per dose of infant vaccine. As part of an ongoing review, the
Food and Drug Administration (FDA) announced in 1999 that infants who received multiple
TMS-preserved vaccines may have been exposed to cumulative Hg in excess of Federal safety
guidelines. According to the centers for disease control (CDC) recommended immunization
schedule, infants may have been exposed to 12.5 microg Hg at birth, 62.5 microg EtHg at 2 months,
50 microg EtHg at 4 months, 62.5 microg EtHg at 6 months, and 50 microg EtHg at approximately
18 months, for a total of 237.5 microg EtHg during the first 18 months of life, if all TMS-containing
vaccines were administered. 
Neurobehavioral alterations, especially to the more susceptible fetus and infant, are known to occur
after relatively low dose exposures to organic mercury compounds. In effort, to further elucidate the
levels of ethyl mercury resulting from exposure to vaccinal TMS, we estimated hair Hg
concentrations expected to result from the recommended CDC schedule utilizing a one compartment
pharmacokinetic model. This model was developed to predict hair concentrations from acute
exposure to methymercury (MeHg) in fish. Modeled hair Hg concentrations in infants exposed to
vaccinal TMS are in excess of the Environmental Protection Agency (EPA) safety guidelines of 1
ppm for up to 365 days, with several peak concentrations within this period. More sensitive
individuals and those with additional sources of exposure would have higher Hg concentrations.
Given that exposure to low levels of mercury during critical stages of development has been
associated with neurological disorders in children, including ADD, learning difficulties, and speech
delays, the predicted hair Hg concentration resulting from childhood immunizations is cause for
concern. Based on these findings, the impact which vaccinal mercury has had on the health of
American children warrants further investigation. PMID: 11770890 [PubMed - in process] 
========
Ingri Cassel,
President Vaccination Liberation - Idaho Chapter
P.O. Box 1444 Coeur d'Alene, ID 83816
(208)255-2307/ 765-8421
vaclib@coldreams.com
www.vaclib.org
"The Right to Know, The Freedom to Abstain" 
Courtesy of Dr. Leonard G. Horowitz and Tetrahedron Publishing Group
206 North 4th Avenue, Suite 147 Sandpoint, Idaho 83864
http://www.tetrahedron.org
Toll free order line: 888-508-4787;
Office telephone: 208-265-2575;
FAX: 208-265-2775 E-mail: tetra@tetrahedron.org
See also: http://www.healingcelebrations.com for vaccine injury treatment recommendations. 
==============================================================
10.) Vaccine Induced Autism
==============================================================
Source: mercola.com 
Rick Rollens is a parent advocate who presented this testimony last week in Washington D.C. to a
packed hearing room. The immediate reaction in the room at the end of his speech was stunned
silence, reports Rick. 
Mr. Chairman and Members: 
My name is Rick Rollens. I currently reside in Granite Bay, California which is located 30 miles east
of Sacramento with my wife of 23 years, Janna, and my two sons, Matthew, 13 and Russell, 8.
Thank you for inviting me to testify today. For me, this is somewhat of a homecoming. In 1973, I
had the privilege of serving on the Washington staff of former Representative Jerome Waldie of
California. Following my service in the House, I embarked upon a 23-year career of public service
with the California State Senate. Working through the ranks, I was elected by the Members of the
Senate to serve as the Secretary of the Senate until I chose to resign my position in 1996, in order to
dedicate myself to the pursuit of effective treatments and a cure for my son, Russell. 
I am here today to share with you the story of my son's case of vaccine induced autism, and to
report on the growing autism epidemic in California, and the pandemic of autism sweeping across
this country. Russell began his life as a normal, healthy, and robust child, meeting all his age
appropriate milestones. At seven months old, within 72 hours after receiving his third DPT and his
first HIB vaccinations, Russell developed a high fever and shrieked with a high wailing scream for
days. After these vaccinations, he started losing eye contact, smiling less, losing interest in people,
developed constant croup and was chronically sick. At seven months old, Russell's life had begun to
change along with the lives of all who know and love him. Within days after his first MMR
vaccination at 18 months old, Russell began his final journey into the abyss of what my wife and I
now know as autism -- losing most of his remaining skills, developing severe sleep irregularities,
chronic gastrointestinal problems, and expressing constant pain exhibited by harrowing days of
endless crying. 
Russell was officially diagnosed at two and a half years old with autism. After many months of
medical investigation of Russell's condition, including state-of-the-art brain scans, immunological,
neurological and genetic work-ups, we consulted a noted pediatric neurologist who thoroughly
examined Russell and reviewed all of Russell's medical history. He advised us that, in part, Russell's
brain dysfunction had very likely occurred as a result of some form of encephalitis, resulting in
bilateral damage to the temporal lobes of his brain. Based on the facts that we have absolutely no
family history of autism or any other type of brain disorders in our family, that he was born a normal,
healthy child. That there exists the strong temporal relationship between the timing of the DPT
vaccination he received at seven months and the onset of his autistic condition, his classic DPT
vaccine reactions, coupled with the 18 month old hit from the MMR and the subsequent
deterioration of his condition, as well as the scientific evidence that one of the many serious adverse
effects of DPT vaccine is encephalitis and brain damage, I believe that Russell is a victim of
vaccine-induced autism. 
My story is far from unique. Mr. Chairman and members, next week when you return home to your
districts, talk to your constituents, many of whom are among the growing number of parents who
have children with autism. I can assure you that you will hear first-hand accounts from those parents
about their normally developing children, about the introduction and reaction to a vaccine or multiple
complications that accompany the acquired autistic condition. The first rule of medicine is to listen to
the patient. A child born today in California will have received his first vaccination between six to
eight hours old. By the time that child is 6 months old he will have received 15 doses of vaccines
and by the age of five years old, 33 doses of vaccines. 
Vaccine contains numerous active agents such as live viruses, killed bacteria and toxic chemicals
including aluminum, mercury and formaldehyde. Where are the safety studies on the short or long
term effects of the interaction of these numerous multiple vaccines and their agents on the developing
brain and immune systems of our children? Where is the science? Many safety studies of individual
vaccines only include a few days follow-up period for reactions, but the CDC tells parents and the
news media that the onset of autism after vaccination could only be an "unrelated chance
occurrence." Show me - CDC - the science. Show me the studies Dr. Satchir. 
Is it appropriate to continue to entrust the CDC and the indemnified vaccine manufacturers with the
responsibility of guaranteeing parents of this country that these vaccines do not cause autism or other
brain disorders when these same groups are the most aggressive promoters of vaccine use? The
situation can easily be likened to charging the tobacco industry to undertake independent scientific
studies to find out if there is any relationship between lung cancer and smoking. This science on the
safety of vaccines and their relationship to the development of autism is not there. Not there
because the pleas of parents have been ignored. I suffered the ultimate betrayal of trust by blindly
allowing my child to be injected with a multitude of vaccines . . .trusting my government had made
sure that my child would not become autistic after his vaccinations. 
Responding to the outcry of parents, professionals, and educators over the concern of the rapidly
increasing number of children with autism and autism spectrum disorders, the California Legislature
and two Governors of different political parties responded within the past 12 months by requiring a
study on whether autism was increasing in the State and, after finding that there was a huge,
unexpected increase, appropriated several million dollars for independent research as well as an
independent follow-up study into the real factors causing the increase. Under the leadership of
former State Senator, now U.S. Representative Mike Thompson, last year the Legislature required
the Department of Development Services to report on the increase of autism in California from
1987-1998. The report was released earlier this year and documents a very conservative 237%
increase in the number of new children with autism entering the developmental services system; 1685
new children last year alone when incidence projection would have predicted 105 - 263 new
children. 
The report led the Los Angeles Times to declare that the state has an epidemic of autistic children.
We all know there is no such thing as a genetic disease epidemic, so clearly other factors are
involved. According to the Department, from January 6 to July 7 of this year, 1,027 new children
were added to the system; which means that California alone added on average six new autistic
children a day, seven days a week . . .or one new child every four hours! Besides the immeasurable
human cost on child and family, the thousands of autistic children already in our system along with
these 1,027 new children are, according to the Department, going to cost the taxpayers of California
and the country a minimum of $2 million each for their lifetime of care. Surely any intelligent,
thoughtful person cannot with a straight face suggest that the huge increase in one of the most easily
recognizable of all childhood disorders is all due to genetics, better recognition, or to minor changes
in the diagnostic criteria that occurred 10 years after the massive increase in autism had already
begun over two decades ago. 
Earlier this year, the national and local news media extensively covered the story of the observations
by parents in Brick Township, New Jersey that there were a lot of kids with autism in their
community. In fact, the CDC publicly announced that they had discovered a cluster of autism in
Brick was 1 in 150 children. 1 in 150 children with autism represents a prevalence rate 12 times
higher than the published prevalence rate. My family and I reside in a community approximately
three thousand miles from Brick Township, a community that is almost in every way as different from
Brick as two communities in America can be. Where we live, our children are served by a single
public elementary school district. The prevalence of autism in our elementary school district is 1 in
132 children. Mr. Chairman and Members, Brick Township, New Jersey and Granite Bay
California are not "clusters" of autism, but snapshots of what is occurring everywhere. 
Numerous parent organizations around the world, including the Autism Research Institute, the
National Vaccine Information Center, Families for Early Autism Treatment (FEAT), Autoimmunity
Research Project, Cure Autism Now, and Allergy Induced Autism are all constantly hearing from
scores of parents reporting vaccine-related autism. You will find these children throughout the
neighborhoods of your own districts. Vaccine policy has always been a cost-benefit proposition. I
am here to tell you today that the once numerically rare sacrificial lambs that society has been willing
to tolerate for the good of the whole could now, very likely before our eyes, be turning into herds of
casualties of the most precious resource we have - our children and grandchildren. We must act
quickly, by investing in good, independent research and science to pursue the truth about the link
between vaccines and autism. If we don't discover all the causes, we will never find a cure. Thank
you. 
==============================================================
11.) Major CDC Study on Thimerosal Flawed
==============================================================
Author Admits Findings Incorrect 
Source: autism.about.com 
Dateline: 07/25/01 
The author of a major study of the link between Vaccinations and Developmental Disorders which is
widely quoted by the Centers for Disease Control and Prevention (CDC) has admitted that the study
is inaccurate in its findings. Dr. Thomas Verstraeten, of the CDC's National Immunization Program,
is quoted as saying, "One thing is for sure, there is certainly under-ascertainment of all these
[conditions] because some of the children are just not old enough to be diagnosed." This was
confirmed by a professor who has reviewed the research. He stated that there were too few children
in the study to pick up all cases of autism. 
The study in question has been widely quoted as evidence that Autism and other Pervasive
Developmental Disorders are in no way linked to the vaccines which are routinely given to children
around the world. Now it seems this conclusion is invalid and the true relationship has yet to be
discovered. 
Additionally, it appears that the CDC is now reversing its stand. According to the Sunday Times, the
Centers for Disease Control and Prevention has found a "statistically significant" link between
mercury in vaccines and developmental disorders, including Attention Deficit Disorder and speech
and language delays. The CDC, however, still recommends vaccinations with thimerosal containing
vaccines, saying there are safety measures in place to prevent overdoses of mercury. 
Autism rates around the world are rising and the rise coincides with the availability of more vaccines
containing mercury, a lowering of the age at which vaccines are given to babies and the introduction
of the combined MMR vaccine, which does not contain mercury, but which has been linked to
Autism by some researchers. 
Now that the research quoted by the CDC and other governmental agencies has been found
inadequate, and since there are research findings which suggest a link between mercury and
developmental disorders, it is time to begin serious research into these issues. In addition, the link
between the MMR vaccine and Autism should be explored further, since it appears to be associated
in some way with the increased rates. 
In spite of the dangers of mercury exposure in infants, the CDC continues to recommend that, "State
and local immunization programs or private health care providers should use the vaccines available in
their stock. All vaccines are safe and effective as stated by FDA." Yet the American Academy of
Pediatrics and other medical groups has called for the removal of mercury from all vaccines. Why
then does the CDC continue to state that they should be used? While they say they are working
cooperatively with vaccine manufacturers to implement a plan to reduce and eventually eliminate
future purchases of thimerosal containing vaccines for federal programs, it appears that these moves
may be too little, too late. While the government is, "working cooperatively," with the manufacturers,
more and more children are being exposed to potentially toxic levels of mercury and more and more
families are having their lives destroyed by its effects. The time to act is now. 
Congressman Dan Burton (R-Indiana) and others have called for the removal of all vaccines
containing thimerosal. So far their words have fallen on deaf ears. Vaccines with excessive levels of
mercury are still being routinely used and there is no clear end in sight. Until adequate research is
done either proving or disproving the relationship between these vaccines and neurological damage,
their use should be discontinued. Vaccines which do not contain thimerosal are available and their
use should be mandated by the federal government 
==============================================================
12.) Effects of Ethylmercury Exposure in Infants Never Studied
==============================================================
Expert Tells IOM No Studies Done 
Source:autism.about.com 
On July 26, 2001, the Institute of Medicine will conduct hearings into thimerosal-containing vaccines
and the neurodevelopmental outcomes of exposure to them. As a part of their preliminary research,
the Immunization Safety Review Committee questioned Dr. László Magos, author of "Physiology
and Toxicology of Mercury" and an internationally known expert in field. 
While many of the answers that Dr. Magos gave were so scientifically complex that the lay person
could never hope to comprehend them, I found it interesting that two of these answers, perhaps the
most important two, were perfectly plain, clear and understandable to anyone reading his statement. 

Have there been any studies, including animal studies, which have looked specifically at infant
ethylmercury exposure and the effect on neurological development? "No, it has not been studied."
What is thought to be currently the best hypothesis (if any) regarding the mechanism of neurotoxic
mechanism of neurotoxicity of organic Hg (mercury)? "Unfortunately, there is no answer. Chang
(1996) suggested four "major thoughts" on the mechanism of actions. These "thoughts" have not
reached the level of a hypotheses, and even less the level of 'the best hypothesis'." 
Why are these questions so important? The answer is simple. They provide a clue into the direction
that researchers and government agencies need to go, if we are to ever learn the true relationship
between mercury based substances such as thimerosal and their effects on the lives of our children
when they are ingredients in the vaccines we are routinely administering. 
How can we ever believe the reports that attempt to validate the use of vaccines which contain
thimerosal, when there have been NO STUDIES done on this important question, according to Dr.
Magos? And how can we believe the theories that have been proposed on how mercury works to
damage the neurological system of the body, when there hasn't even been a hypothesis made on this
question. As I remember my studies of the "scientific method," a hypothesis must be made and tested
and the tests replicated, before a theory can be advanced. We are not at the point of having a
hypothesis, let alone enough material to propose a theory. 
As parents, we know what happened to our children. We know when their development began to
regress, but our knowledge is not enough to base policy on, according to the experts. They say we
must have hard facts and research studies before our "anecdotal evidence" can be believed. Yet the
scientific community has failed to provide the same standard of evidence in support of their opinions.
Hearings and inquiries are not enough. Neither are statements that defend the status quo and tout the
safety of vaccines. Until that research is done, the public will have every right to be skeptical about
the statements that come out of the medical community regarding the safety of these vaccines 
==============================================================
13.) ER Exploits MMR Vaccine Myth
==============================================================
Alternatives to the MMR Vaccine
Source|: autism.about.com 
A recent episode of the NBC Television program, ER, featured a story about a child who died of
measles after his parents refused to have him vaccinated. This storyline exploited the myth that the
Measles, Mumps and Reubella (MMR) vaccine is perfectly safe and that those who choose to not
use this combination vaccine are risking the lives of their children. The program has caused people
across the country to think carefully about the benefits and risks of mandatory childhood
vaccinations and wondering about their decisions to immunize or not. If you've been keeping up with
the controversy about the effects of the Measles, Mumps and Reubella (MMR) vaccine and its
potential for being a cause or trigger for Autism, pay close attention to this article. While it is not
intended as medical advice, it does provide valuable information which you and your physician need
to make an informed decision regarding this vaccine. Always consult with your physician regarding
any medication or vaccination questions you might have. 
For years a controversy has raged in the medical community about the effects of the MMR vaccine.
Researchers, such as Dr. Andrew Wakefield, have found that the MMR potentially is a trigger or
even the cause of Autism and other Pervasive Developmental Disorders. Further research has found
that it may be the combination of ingredients in the MMR that is the culprit, not the individual
vaccines themselves. Because of this, it has been recommended that these multiple vaccines be
avoided and instead single dose vaccines be substituted. 
I have heard from countless parents who have said they requested the single measles, mumps or
reubella vaccine and been told, it isn't available. If you are one of those parents, you were either lied
to or your medical provider is uninformed. The single dose vaccine is available, from the same
manufacturer who makes the multi-dose version, however many physicians and clinics hesitate to
purchase it because of the way the vaccine is marketed. It seems that Merck Pharmaceuticals
requires that it be purchased in minimum lots of 10, which means that to cover your child, the health
care provider must purchase 30 doses, instead of the 10 required for the multi-dose vaccine. 
It's a matter of basic economics. It costs less to get 10 doses than it does 30, so why spend the
extra money. Their cost cutting measures could be the reason your child can't get the single dose
vaccine, and could possibly, if the researchers are correct, be the reason that Autism/PDD has
increased so dramatically in the past 20 years. Additionally, managed health care plans have put in
place a system that only allows for a certain number of well-child visits, falsely leading the parents to
believe they cannot make additional appointments for separated vaccinations. A vaccination
appointment in nearly every medical office, is not an appointment with the physician and should not
be billed as such. It is an appointment with the nurse and therefore is not constricted by a managed
health care's well-child health care schedule. 
What can you do about this? The answer is simple. When you go to your doctor or clinic, arrive
armed with the correct information which will allow you to counteract their claim that the vaccine is
not manufactured and can't be purchased. According to information from the FEAT newsletter and
Elizabeth Bowers of ARMED (Autism Recovery through Medicine, Education & Diet), the item
numbers below are from the current Physician's Desk Reference (PDN) for the individual dosages of
the vaccines, manufactured by Merck. Demand that these be purchased for use with your child, and
put it in writing. If the health care provider refuses, get it in writing that you provided them with the
information and made a formal written request which was refused. In this way, you have the
evidence that might help in a potential legal action, should the vaccine injury compensation laws ever
be changed to cover this type of situation. Without it, it's your word against theirs. 

Measles: # NDC00064709-00, single dose
Mumps: #NDC00064753-00, single dose
Rubella (called Meruvac II): #NDC00064747-00, single dose 
==============================================================14.)
Autism: a Novel Form of Mercury Poisoning
==============================================================
S. Bernard, B.A., A. Enayati, M.S.M.E., L. Redwood, M.S.N., H. Roger, B.A., T. Binstock
Sallie Bernard, ARC Research, 14 Commerce Drive, Cranford, NJ 07901 USA, 908.276.6300,
fax 908.276.1301 
Source: mercola.com 
Summary 
Autism is a syndrome characterized by impairments in social relatedness and communication,
repetitive behaviors, abnormal movements, and sensory dysfunction. Recent epidemiological studies
suggest that autism may affect 1 in 150 U. S. children. 
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. 
Thimerosal, a preservative added to many vaccines, has become a major source of mercury in
children who, within their first two years, may have received a quantity of mercury that exceeds
safety guidelines. 
A review of medical literature and U.S. government data suggests that 

i) many cases of idiopathic autism are induced by early mercury exposure from thimerosal; 
(ii) this type of autism represents an unrecognized mercurial syndrome; and 
(iii) genetic and non-genetic factors establish a predisposition whereby thimerosal's adverse effects
occur only in some children. 
Introduction 
Autistic Spectrum Disorder (ASD) is a neurodevelopmental syndrome with onset prior to age 36
months. Diagnostic criteria consist of impairments in sociality and communication plus repetitive and
stereotypic behaviors (1). Traits strongly associated with autism include movement disorders and
sensory dysfunctions (2). Although autism may be apparent soon after birth, most autistic children
experience at least several months, even a year or more of normal development -- followed by
regression, defined as loss of function or failure to progress (2,3,4). 
The neurotoxicity of mercury (Hg) has long been recognized (5). 
Primary data derive from victims of contaminated fish (Japan - Minamata Disease) or grain (Iraq,
Guatemala, Russia); from acrodynia (Pink Disease) induced by Hg in teething powders; and from
individual instances of mercury poisoning (HgP), many occurring in occupational settings (e.g., Mad
Hatter's Disease). 
Animal and in vitro studies also provide insights into the mechanisms of Hg toxicity. More recently,
the Food and Drug Administration (FDA) and the American Academy of Pediatrics (AAP) have
determined that the typical amount of Hg injected into infants and toddlers via childhood
immunizations has exceeded government safety guidelines on an individual (6) and cumulative
vaccine basis (7). 
The mercury in vaccines derives from thimerosal (TMS), a preservative which is 49.6%
ethylmercury (eHg) (7). 
Past cases of HgP have presented with much inter-individual variation, depending on the dose, type
of mercury, method of administration, duration of exposure, and individual sensitivity. Thus, while
commonalities exist across the various instances of HgP, each set of variables has given rise to a
different disease manifestation (8,9,10,11). 
It is hypothesized that the regressive form of autism represents another form of mercury poisoning,
based on a thorough correspondence between autistic and HgP traits and physiological
abnormalities, as well as on the known exposure to mercury through vaccines. 
Furthermore, other phenomena are consistent with a causal Hg-ASD relationship. These include: 

a) symptom onset shortly after immunization; 
(b) ASD prevalence increases corresponding to vaccination increases; (c) similar sex ratios of
affected individuals; 
(d) a high heritability rate for autism paralleling a genetic predisposition to Hg sensitivity at low doses;
and 
(e) parental reports of autistic children with elevated Hg. 
Trait Comparison 
ASD manifests a constellation of symptoms with much inter-individual variation (3,4). A comparison
of traits defining, nearly universal to, or commonly found in autism with those known to arise from
mercury poisoning is given in Table I. The characteristics defining or strongly associated with autism
are also more fully described. 
Autism has been conceived primarily as a psychiatric condition; and two of its three diagnostic
criteria are based upon the observable traits of 

a) impairments in sociality, most commonly social withdrawal or aloofness, and 
b) a variety of perseverative or stereotypic behaviors and the need for sameness, which strongly
resemble obsessive-compulsive tendencies. 

Differential diagnosis may include childhood schizophrenia, depression, obsessive-compulsive
disorder (OCD), anxiety disorder, and other neuroses. 
Related behaviors commonly found in ASD individuals are irrational fears, poor eye contact,
aggressive behaviors, temper tantrums, irritability, and inexplicable changes in mood (1,2,12-17).
Mercury poisoning, when undetected, is often initially diagnosed as a psychiatric disorder (18). 
Commonly occurring symptoms include: 

a) "extreme shyness," indifference to others, active avoidance of others, or “a desire to be alone”;(b)
depression, “lack of interest” and “mental confusion;” 
(c) irritability, aggression, and tantrums in children and adults; 
(d) anxiety and fearfulness; and 
(e) emotional lability. 

Neuroses, including schizoid and obsessive-compulsive traits, problems in inhibition of perseveration,
and stereotyped behaviors, have been reported in a number of cases; and lack of eye contact was
observed in one 12 year old girl with mercury vapor poisoning (18-35). 
The third diagnostic criterion for ASD is impairment in communication (1). Historically, about half of
those with classic autism failed to develop meaningful speech (2), and articulation difficulties are
common (3). Higher functioning individuals may have language fluency but still show semantic and
pragmatic errors (3,36). In many cases of ASD, verbal IQ is lower than performance IQ (3).
Similarly, mercury-exposed children and adults show a marked difficulty with speech (9,19,37). 
In milder cases scores on language tests may be lower than those of unexposed controls (31,38).
Iraqi children who were postnatally poisoned developed articulation problems, from slow, slurred
word production to an inability to generate meaningful speech; while Iraqi babies exposed prenatally
either failed to develop language or presented with severe language deficits in childhood (23,24,39).
Workers with Mad Hatter's disease had word retrieval and articulation difficulties (21). 
Nearly all cases of ASD and HgP involve disorders of physical movement (2,30,40). 
Clumsiness or lack of coordination has been described in many higher functioning ASD individuals
(41). Infants and toddlers later diagnosed with autism may fail to crawl properly or may fall over
while sitting or standing; and the movement disturbances typically occur on the right side of the body
(42). Problems with intentional movement and imitation are common in ASD, as are a variety of
unusual stereotypic behaviors such as toe walking, rocking, abnormal postures, choreiform
movements, spinning; and hand flapping (2,3,43,44). 
Noteworthy because of similarities to autism are reports in Hg literature of: 

a) children in Iraq and Japan who were unable to stand, sit, or crawl (34,39); 
(b) Minamata disease patients whose movement disturbances were localized to one side of the
body, and a girl exposed to Hg vapor who tended to fall to the right (18,34); 
(c) flapping motions in an infant poisoned from contaminated pork (37) and in a man injected with
thimerosal (27); 
(d) choreiform movements in mercury vapor intoxication (19); 
(e) toe walking in a moderately poisoned Minamata child (34); 
(f) poor coordination and clumsiness among victims of acrodynia (45); 
(g) rocking among infants with acrodynia (11); and 
(h) unusual postures observed in both acrodynia and mercury vapor poisoning (11,31). The
presence of flapping motions in both diseases is of interest because it is such an unusual behavior that
it has been recommended as a diagnostic marker for autism (46). 

Virtually all ASD subjects show a variety of sensory abnormalities (2). Auditory deficits are present
in a minority of individuals and can range from mild to profound hearing loss (2,47). Over- or
under-reaction to sound is nearly universal (2,48), and deficits in language comprehension are often
present (3). Pain sensitivity or insensitivity is common, as is a general aversion to touch; abnormal
sensation in the extremities and mouth may also be present and has been detected even in toddlers
under 12 months old (2,49). 
There may be a variety of visual disturbances, including sensitivity to light (2,50,51,52). As in autism,
sensory issues are reported in virtually all instances of Hg toxicity (40). HgP can lead to mild to
profound hearing loss (40); speech discrimination is especially impaired (9,34,). Iraqi babies
exposed prenatally showed exaggerated reaction to noise (23), while in acrodynia, patients reported
noise sensitivity (45). Abnormal sensation in the extremities and mouth is the most common sensory
disturbance (25,28). Acrodynia sufferers and prenatally exposed Iraqi babies exhibited excessive
pain when bumping limbs and an aversion to touch (23,24,45,53). A range of visual problems has
been reported, including photophobia (18,23,34). 

Comparison Of Biological Abnormalities 
The biological abnormalities commonly found in autism are listed in Table II, along with the
corresponding pathologies arising from mercury exposure. Especially noteworthy similarities are
described. 
Autism is a neurodevelopmental disorder which has been characterized as "a disorder of neuronal
organization, that is, the development of the dentritic tree, synaptogenesis, and the development of
the complex connectivity within and between brain regions" (54). Depressed expression of neural
cell adhesion molecules (NCAMs), which are critical during brain development for proper synaptic
structuring, has been found in one study of autism (55). Organic mercury, which readily crosses the
blood-brain barrier, preferentially targets nerve cells and nerve fibers (56); primates accumulate the
highest Hg-levels in the brain relative to other organs (40). 
Furthermore, although most cells respond to mercurial injury by modulating levels of glutathione
(GSH), metallothionein, hemoxygenase, and other stress proteins, neurons tend to be “markedly
deficient in these responses” and thus are less able to remove Hg and more prone to Hg-induced
injury (56). In the developing brain, mercury interferes with neuronal migration, depresses cell
division, disrupts microtubule function, and reduces NCAMs (28, 57-59). 
While damage has been observed in a number of brain areas in autism, many nuclei and functions are
spared (36). HgP’s damage is similarly selective (40). Numerous studies link autism with neuronal
atypicalities within the amygdala, hippocampi, basal ganglia, the Purkinje and granule cells of the
cerebellum, brainstem, basal ganglia, and cerebral cortex (36,60-69). Each of these areas can be
affected by HgP (10,34,40,70-73). Migration of Hg, including eHg, into the amygdala is particularly
noteworthy, because in primates this brain region has neurons specific for eye contact (74) and it is
implicated in autism and in social behaviors (65,66,75). 
Autistic brains show neurotransmitter irregularities which are virtually identical to those arising from
Hg exposure: 

both high or low serotonin and dopamine, depending on the subjects studied;
elevated epinephrine and norepinephrine in plasma and brain; elevated glutamate; and
acetylcholine deficiency in hippocampus (2,21,76-83). 
Gillberg and Coleman (2) estimate that 35-45% of autistics eventually develop epilepsy. A recent
MEG study reported epileptiform activity in 82% of 50 regressive autistic children; in another study,
half the autistic children expressed abnormal EEG activity during sleep (84). Autistic EEG
abnormalities tend to be non-specific and have a variety of patterns (85). Unusual epileptiform
activity has been found in a number of mercury poisoning cases (18,27,34,86-88). 
Early Hg exposure enhances tendencies toward epileptiform activity with a reduced level of
seizure-discharge amplitude (89), a finding consistent with the subtlety of seizures in many autism
spectrum children (84,85). The fact that Hg increases extracellular glutamate would also contribute
to epileptiform activity (90). 
Some autistic children show a low capacity to oxidize sulfur compounds and low levels of sulfate
(91,92). These findings may be linked with HgP because (a) Hg preferentially binds to sulfhydryl
molecules (-SH) such as cysteine and GSH, thereby impairing various cellular functions (40), and (b)
mercury can irreversibly block the sulfate transporter NaSi cotransporter NaSi-1, present in kidneys
and intestines, thus reducing sulfate absorption (93). 
Besides low sulfate, many autistics have low GSH levels, abnormal GSH-peroxidase activity within
erythrocytes, and decreased hepatic ability to detoxify xenobiotics (91,94,95). GSH participates in
cellular detoxification of heavy metals (96); hepatic GSH is a primary substrate for organic-Hg
clearance from the human (40); and intraneuronal GSH participates in various protective responses
against Hg in the CNS (56). 
By preferentially binding with GSH, preventing absorption of sulfate, or inhibiting the enzymes of
glutathione metabolism (97), Hg might diminish GSH bioavailability. Low GSH can also derive from
chronic infection (98,99), which would be more likely in the presence of immune impairments arising
from mercury (100). 
Furthermore, mercury disrupts purine and pyrimidine metabolism (97,10). Altered purine or
pyrimidine metabolism can induce autistic features and classical autism (2,101,102), suggesting
another mechanism by which Hg can contribute to autistic traits. 
Autistics are more likely to have: 
allergies
asthma
selective IgA deficiency (sIgAd)
enhanced expression of HLA-DR antigen
and an absence of interleukin-2 receptors
as well as familial autoimmunity
and a variety of autoimmune phenomena
These include elevated serum IgG
and ANA titers,
IgM and
IgG brain antibodies,
and myelin basic protein (MBP) antibodies (103-110). 
Similarly, atypical responses to Hg have been ascribed to allergic or autoimmune reactions (8), and
genetic predisposition to such reactions may explain why Hg sensitivity varies so widely by individual
(88,111). 
Children who developed acrodynia were more likely to have asthma and other allergies (11); IgG
brain autoantibodies, MBP, and ANA have been found in HgP subjects (18,111,112); and mice
genetically prone to develop autoimmune diseases "are highly susceptible to mercury-induced
immunopathological alterations" even at the lowest doses (113). 
Additionally, many autistics have reduced natural killer cell (NK) function, as well as immune-cell
subsets shifted in a Th2 direction and increased urine neopterin levels, indicating immune system
activiation (103,114-116). Depending upon genetic predisposition, Hg can induce immune
activation, an expansion of Th2 subsets, and decreased NK activity (117-120). 

Population Characteristics 
In most affected children, autistic symptoms emerge gradually, although there are cases of sudden
onset (3). 
The earliest abnormalities have been detected in 4 month olds and consist of subtle movement
disturbances; subtle motor-sensory disturbances have been observed in 9 month olds (49). More
overt speech and hearing difficulties become noticeable to parents and pediatricians between 12 and
18 months (2). TMS vaccines have been given in repeated intervals starting from infancy and
continuing until 12 to 18 months. 
While HgP symptoms, may arise suddenly in especially sensitive individuals (11), usually there is a
preclinical "silent stage" in which subtle neurological changes are occuring (121) and then a gradual
emergence of symptoms. 
The first symptoms are typically sensory- and motor-related, which are followed by speech and
hearing deficits, and finally the full array of HgP characteristics (40). 
Thus, both the timing and nature of symptom emergence in ASD are fully consistent with a vaccinal
Hg etiology. 
This parallel is reinforced by parental reports of excessive amounts of mercury in urine or hair from
younger autistic children, as well as some improvement in symptoms with standard chelation therapy
(122). 
The discovery and rise in prevalence of ASD mirrors the introduction and spread of thimerosol in
vaccines. 
Autism was first described in 1943 among children born in the 1930s (123). Thimerosal was first
introduced into vaccines in the 1930s (7). In studies conducted prior to 1970, autism prevalence
was estimated, at 1 in 2000; in studies from 1970 to 1990 it averaged 1 in 1000 (124). This was a
period of increased vaccination rates of the TMS-containing DPT vaccines among children in the
developed world. 
In the early 1990s, the prevalence of autism was found to be 1 in 500 (125), and in 2000 the CDC
found 1 in 150 children affected in one community, which was consistent with reports from other
areas in the country (126). In the late 1980s and early 1990s, two new TMS vaccines, the HIB and
Hepatitis B, were added to the recommended schedule (7). 
Nearly all US children are immunized, yet only a small proportion develop autism. 
A pertinent characteristic of mercury is the great variability in its effects by individual, so that at the
same exposure level, some will be affected severely while others will be asymptomatic (9,11,28). An
example is acrodynia, which arose in the early 20th Century from mercury in teething powders and
afflicted only 1 in 500-1000 children given the same low dose (28). 
Studies in mice as well as humans indicate that susceptibility to Hg effects arises from genetic status,
in some cases including a propensity to autoimmune disorders (113,34,40). ASD exhibits a strong
genetic component, with high concordance in monozygotic twins and a higher than expected
incidence among siblings (4); autism is also more prevalent in families with autoimmune disorders
(106). 
Additionally, autism is more prevalent among boys than girls, with the ratio estimated at 4:1 (2).
Mercury studies in mice and humans consistently report greater effects on males than females, except
for kidney damage (57). At high doses, both sexes are affected equally; at low doses only males are
affected (38,40,127). 

Discussion 
We have shown that every major characteristic of autism has been exhibited in at least several cases
of documented mercury poisoning. 
Recently, the FDA and AAP have revealed that the amount of mercury given to infants from
vaccinations has exceeded safety levels. The timing of mercury administration via vaccines coincides
with the onset of autistic symptoms. Parental reports of autistic children with measurable mercury
levels in hair and urine indicate a history of mercury exposure. Thus the standard primary criteria for
a diagnosis of mercury poisoning - observable symptoms, known exposure at the time of symptom
onset, and detectable levels in biologic samples (11,31) - have been met in autism. 
As such, mercury toxicity may be a significant etiological factor in at least some cases of regressive
autism. Further, each known form of HgP in the past has resulted in a unique variation of
mercurialism - e.g., Minamata disease, acrodynia, Mad Hatter’s disease - none of which has been
autism, suggesting that the Hg source which may be involved in ASD has not yet been characterized;
given that most infants receive eHg via vaccines, and given that the effect on infants of eHg in
vaccines has never been studied (129), vaccinal thimerosal should be considered a probable source.
It is also possible that vaccinal eHg may be additive to a prenatal mercury load derived from
maternal amalgams, immune globulin injections, or fish consumption, and environmental sources. 
Conclusion 
The history of acrodynia illustrates that a severe disorder, afflicting a small but significant percentage
of children, can arise from a seemingly benign application of low doses of mercury. This review
establishes the likelihood that Hg may likewise be etiologically significant in ASD, with the Hg
derived from thimerosal in vaccines rather than teething powders. Due to the extensive parallels
between autism and HgP, the likelihood of a causal relationship is great. Given this possibility, TMS
should be removed from all childhood vaccines, and the mechanisms of Hg toxicity in autism should
be thoroughly investigated. 
With perhaps 1 in 150 children now diagnosed with ASD, development of HgP-related treatments,
such as chelation, would prove beneficial for this large and seemingly growing population. 

For References Click Here 
Originally published in the FEAT (http://www.feat.org) online newsletter. 

-------------------------------------------------------------- 
DR. MERCOLA'S COMMENT: 
This is an excellent review of the mercury-autism link and is well referenced. It has been increasingly
obvious that mercury should be screened for in autism which is why I have started to aggressively
screen and treat this problem in the autistic children that I care for. 
This week I post my pediatric mercury detoxification program which is a modification of the program
that I have used for adults for many years. I will start chelating my first patients in about one month
as many are in the process of preparing for the chelation process with some homeopathic
preparations. 
==============================================================
15.) Adverse Effects Of Adjuvants In Vaccines
==============================================================
by Viera Scheibner 
Source: mercola.com 
Systemic lupus erythematosus is one of the innumerable recognized side effects of a number of
vaccinations. One of the best papers (if not the best on this) is by Ayvazian and Badger (1948), and
it has not lost any of its punch and relevance since it was published. 
They describe three cases of nurses who were literally vaccinated to death. The authors surveyed a
group of 750 nurses who trained at a large municipal hospital between 1932 and 1946, and detailed
the cases of three nurses who were vaccinated with a multitude of vaccines over a period of time and
developed and succumbed to disseminated lupus erythematosus. 
Typically, these nurses were given the following tests and vaccines in short succession: 
the Schick test; 
three days later, the Dick test; 
seven days later, typhoid-paratyphoid vaccine; 
seven days later, another typhoid-paratyphoid vaccine (a double dose); 
seven days later, the third typhoid-paratyphoid vaccine; 
and seven days later, the fourth typhoid-paratyphoid vaccine.
Every time, the recipient developed local erythema and/or fever and malaise, but it did not deter the
doctor from administering yet another series of vaccines, starting only 14 days after the first lot of
tests and typhoid-paratyphoid vaccines. 
This time, after all these injections, one of the trainee nurses was given her first injection of scarlet
fever streptococcus toxin with "no ill results". 
One week later, she was given the second injection of streptococcus toxin, after which she
developed joint pains and fever. She did not report these reactions to the health office. 
Nine days later, she returned and received the third injection of a fourfold dose of streptococcus,
after which she developed severe joint pain in the fingers and knees and a sore throat. 
She was hospitalized for five days and discharged with the diagnosis "Dick-toxin reaction". Only five
days later her inoculations were continued, first in lower and then in gradually increasing doses so
that the series included a total of 10 instead of the usual seven injections. Epinephrine was
administered with each of these injections of streptococcus toxin and toxin-antitoxin. 
Two months after the last lot, the trainee nurse was re-admitted to the hospital with swelling and pain
of the ankles and toes and tenderness of the joints of both hands, which had been constant since the
first Dick test five months earlier. The diagnosis was "rheumatic arthritis". 
She was given aspirin, but two weeks later the pain came back and she developed chills and fever,
sore throat and cough. One month later, the trainee nurse was readmitted to hospital for two weeks,
and during this admission a streptococcus vaccine was started in small doses, but because of her
severe reaction "further vaccines were refused". The diagnosis after this admission was "rheumatoid
arthritis and infectious mononucleosis". 
Four months later, the trainee nurse noticed skin eruptions over her nose and both cheeks, and her
saliva became foul. The skin and cheeks, upper lips and the bridge of the nose were covered with
purplish red, mottled and indurated rash eruptions. Two months later, the eruptions spread over
much of the body. A year later, the trainee nurse died, but not before developing severe symptoms
of high fever, tachycardia, diarrhea and showing abnormal blood tests. 
It was not enough that this unfortunate trainee nurse died; there were another two cases reported,
almost identical to the first case. We shall never know how many of the remaining 747 trainee nurses
developed less lethal, but still health-incapacitating. reactions. 
If someone said that this type of "medical treatment' had been given to the inmates of the Nazi
concentration camps, I would not be surprised. However, this type of "medical treatment" was and is
being given with impunity to millions of babies, children, teenagers and adults in so-called free and
democratic countries as well as in the Third World. Meanwhile, the health authorities refuse to
accept that vaccines cause such reactions and even deaths. 
Vaccination: A Safety Warning 
The conclusions which follow the study of relevant medical and immunological literature dealing with
vaccines and the adjuvants used in vaccines is that the absolute safety of these substances can never
be guaranteed. 
According to Gupta et al. (1993), the toxicity of adjuvants can be ascribed in part to the unintended
stimulation of various mechanisms of the immune response. That's why the safety and adjuvancy
must be balanced to get the maximum immune stimulation with minimum side effects. 
My conclusion is that such balance is impossible to achieve, even if we fully understood the immune
system and the full spectrum of deleterious effects of foreign antigens and other toxic substances such
as vaccine and drug adjuvants and medications on the immune system of humans, and particularly on
the immature immune system of babies and small children. 
Injecting any foreign substance straight into the bloodstream will only cause anaphylactic
(sensitization) reactions. Nature, over thousands and thousands of years, has developed effective
immune responses; yet man, without respect for nature, demonstrably causes more harm than good. 
Vaccination procedures are a highly politically motivated non-science, whose practitioners are only
interested in injecting multitudes of vaccines without much interest or care as to their effects. Data
collection on reactions to vaccines is only paid lip service, and the obvious ineffectiveness of
vaccines to prevent diseases is glossed over. 
The fact that natural infectious diseases have beneficial effect on the maturation and development of
the immune system is ignored or deliberately suppressed. 
Consequently, parents of small children and any potential recipients of vaccines and any orthodox
medications should be wary of any member of the medical establishment (which is little more than a
highly politicized business system) extolling the nonexistent virtues of vaccination. 
http://www.whale.to/vaccine/adjuvants1.html 
You can go on to the more technically oriented manuscript which details many of the specifics of
vaccine adjuvants. 
-------------------------------------------------------------- 
DR. MERCOLA'S COMMENT: 
This is an excellent resource that clearly documents all the OTHER material that are in the vaccines.
One of the worst is thimerosol, a mercury derivative, which US health authorities finally recognized a
few years may be causing problems. 
Problems with mercury? Yes, indeed. Many experts believe the mercury in the hepatitis B vaccine,
which was often given to children the DAY OF BIRTH, may be largely responsible for the huge
increase in autism that we have experienced in the US. 

Adjuvants, Preservatives And Tissue Fixatives In Vaccines 
Vaccines contain a number of substances which can be divided into the following groups: 
Micro-organisms, either bacteria or viruses, thought to be causing certain infectious diseases and
which the vaccine is supposed to prevent. These are whole-cell proteins or just the broken-cell
protein envelopes, and are called antigens.
Chemical substances which are supposed to enhance the immune response to the vaccine, called
adjuvants.
Chemical substances which act as preservatives and tissue fixatives, which are supposed to halt any
further chemical reactions and putrefaction (decomposition or multiplication) of the live or attenuated
(or killed) biological constituents of the vaccine.
All these constituents of vaccines are toxic, and their toxicity may vary, as a rule, from one batch of
vaccine to another. 
In this article, the first of a two-part series, we shall deal with adjuvants, their expects role and the
reactions (side effects). 
Adjuvants 
The desired immune response to vaccines is the production of antibodies, and this is enhanced by
adding certain substances to the vaccines. These are called adjuvants (from the Latin adjuvare,
meaning "to help"). 
The chemical nature of adjuvants, their mode of action and their reactions (side effect) are highly
variable. According to Gupta et al. (1993), some of the side effects can be ascribed to an
unintentional stimulation of different mechanisms of the immune system whereas others may reflect
general adverse pharmacological reactions which are more less expected. 
There are several types of adjuvants. 
Today the most common adjuvants for human use are 
aluminum hydroxide,
aluminum phosphate
and calcium phosphate.
However, there are a number of other adjuvants based on oil emulsions, products from bacteria
(their synthetic derivatives as well as liposomes) or gram-negative bacteria, endotoxins, cholesterol,
fatty acids, aliphatic amines, paraffinic and vegetable oils. 
Recently, monophosphoryl lipid A, ISCOMs with Quil-A, and Syntex adjuvant formulations (SAFs)
containing the threonyl derivative or muramyl dipeptide have been under consideration for use in
human vaccines. 
Chemically, the adjuvants are a highly heterogenous group of compounds with only one thing in
common: their ability to enhance the immune response-their adjuvanticity. 
They are highly variable in terms of how they affect the immune system and how serious their
adverse effects are due to the resultant hyperactivation of the immune system. 
The mode of action of adjuvants was described by Chedid (1985) as: the formation of a depot of
antigen at the site of inoculation, with slow release; the presentation of antigen immunocompetent
cells; and the production of various and different lymphokines (interleukins and tumour necrosis
factor). 
The choice of any of these adjuvants reflects a compromise between a requirement for adjuvanticity
and an acceptable low level of adverse reactions. 
The discovery of adjuvants dates back to 1925 and 1926, when Ramon (quoted by Gupta et al.,
1993) showed that the antitoxin response to tetanus and diphtheria was increased by injection of
these vaccines, together with other compounds such as agar, tapioca, lecithin, starch oil, saponin or
even breadcrumbs. 
The term adjuvant has been used for any material that can increase the humoral or cellular immune
response to an antigen. In the conventional vaccines, adjuvants are used to elicit an early, high and
long-lasting immune response. The newly developed purified subunit or synthetic vaccines using
biosynthetic, recombinant and other modern technology are poor immunogens and require adjuvants
to evoke the immune response. 
The use of adjuvants enables the use of less antigen to achieve the desired immune response, and this
reduces vaccine production costs. 
With a few exceptions, adjuvants are foreign to the body and cause adverse reactions. 
Oil Emulsions 
In the 1960s, emulsified water-in-oil and water-in-vegetable-oil adjuvant preparations used
experimentally showed special promise in providing exalted "immunity" of long duration (Hilleman,
1966). The development of Freund's adjuvants emerged from studies of tuberculosis. 
Several researchers noticed that immunological responses in animals to various antigens were
enhanced by introduction into the animal of living Mycobacterium tuberculosis. In the presence of
Mycobacterium, the reaction obtained was of the delayed type, transferable with leukocytes. 
Freund measured the effect of mineral oil in causing delayed-type hypersensitivity to killed
mycobacteria. There was a remarkable increase in complement-fixing antibody response as well as
in delayed hypersensitivity reaction. 
Freund's adjuvant consists of a water-in-oil emulsion of aqueous antigen in paraffin (mineral) oil of
low specific gravity and low viscosity. Drakeol 6VR and Arlacel A (mannide monooleate) are
commonly used as emulsifiers. 
There are two Freund's adjuvants: incomplete and complete. 
The incomplete Freund's adjuvant consists of water-in-oil emulsion without added mycobacteria; the
complete Freund's adjuvant consists of the same components but with 5 mg of dried, heat-killed
Mycobacterium tuberculosis or butyricum added. 
The mechanism of action of Freund's adjuvants is associated with the following three phenomena: 
1. The establishment of a portion of the antigen in a persistent form at the injection site, enabling a
gradual and continuous release of antigen for stimulating the antibody;
2. The provision of a vehicle for transport of emulsified antigen throughout the lymphatic system to
distant places, such as lymph nodes and spleen, where new foci of antibody formation can be
established; and,
3. Formation and accumulation of cells of the mononuclear series which are appropriate to the
production of antibody at the local and distal sites.
The pathologic reaction to the Freund's adjuvants starts at the injection site with mild erythema and
swelling followed by tissue necrosis, intense inflammation and the usual progression to the formation
of a granulomatous lesion. Scar and abscess formation may occur. The reactions observed following
the administration of the complete adjuvant are generally far more extensive than with the incomplete
adjuvant. 
The earliest cellular response is polymorphonuclear, then it changes into mononuclear and later
includes plasmocytes. The adjuvant emulsion may be widely disseminated in varrious organs,
depending on the route of inoculation, with the development of focal granulomatous lesions at distal
places. Various gram-negative organisms may show a potentiating effect of the adjuvant, similar to
that displayed by mycobacteria. 
The earliest use of oil emulsion adjuvants was made with the influenza, vaccine by Friedwald (1944)
and by Henle and Henle (1945). Following their promising results on animals, Salk (1951)
experimented with such adjuvants on soldiers under the auspices of the US Armed Forces
Epidemiological Board. 
He used a highly refined mineral oil, and developed a purified Arlacel A emulsifier which was free of
toxic substances, such as oleic acid which had caused sterile abscesses at the injection site, and he
administered the vaccine by intramuscular route. 
Subsequently, Miller et al. (1965) reported their, failure to enhance the antibody and protective
response to types 3, 4 and 7 adenovirus vaccines in mineral oil adjuvant compared with aqueous
vaccine. Unpublished studies have revealed the need for an adequate minimal amount of antigen to
trigger an antibody response to the emulsified preparations. 
Salk et al. (1953) applied Freund's adjuvant to poliomyelitis vaccine, and later followed with
extensive testing of killed crude as well as purified polio virus vaccine in animals and humans, where
the reactions in humans were considered inconsequential. 
Grayston et al. (1964) reported highly promising results with the trachoma vaccine using an oil
adjuvant. 
However, the trachoma vaccine lost its relevance because, as demonstrated by Dolin et al. (1997) in
their 37 years of research in a sub-Saharan village, the dramatic fall in the disease occurrence was
closely connected with improvements in 
sanitation,
water supply,
education
and access to health care.
According to Dolin et al. (1997), the decline in trachoma occurred without any trachoma-specific
intervention. 
Allergens in Freund's adjuvant deserve special attention because they can be dangerous. These
dangers include an overdose, i.e., the immediate release of more than the tolerated amount of
properly emulsified vaccine in sensitive persons, or the breaking of the emulsion with the release of
all or part of the full content of the allergen within a brief period of time. 
Long-term delayed reactions include the development of nodules, cysts or sterile abscesses requiring
surgical incision. It is also likely that some allergens used, such as house dust or mould, might have
acted like mycobacteria to potentiate the inflammatory response. Such reactions have been reduced
with the use of properly tested and standardized reagins. 
One must also consider that the first application of Freund's adjuvants was made at a time when
modern concepts of safety were nonexistent Indeed, mineral oil adjuvants have not been approved
for human use in some countries, including the USA. 
Mineral Compounds 
Aluminum phosphate or aluminum hydroxide (alum) are the mineral compounds most commonly
used as adjuvants in human vaccines. Calcium phosphate is another adjuvant that is used in many
vaccines. Mineral salts of metals such as cerium nitrate, zinc sulfate, colloidal iron hydroxide and
calcium chloride were observed to increase the antigenicity of' the toxoids, but alum gave the best
results. 
The use of alum was applied more than 70 years ago by Glenny et al. (1926), who discovered that a
suspension of alum-precipitated diphtheria toxoid had a much higher immunogenicity than the fluid
toxoid. Even though a number of reports stated that alum-adjuvanted vaccines were no better than
plain vaccines (Aprile and Wardlaw, 1966), the use of alum as an adjuvant is now well established. 
The most widely used is the antigen solution mixed with pre-formed aluminum hydroxide or
aluminum phosohate under controlled conditions. Such vaccines are now called aluminium-adsorbed
or aluminium-adjuvanted. However, they are difficult to manufacture in a physico-chemically
reproducible way, which results in a batch-to-batch variation of the same vaccine. 
Also, the degree of antigen absorption to the gels of aluminum phosphate and aluminum hydroxide
varies. To minimize the variation and avoid the non-reproducibility, a specific preparation of
aluminum hydroxide (Alhydrogel) was chosen as the standard in 1988 (Gupta et al., 1993). 
The aluminum adjuvants allow the slow release of antigen, prolonging the time for interaction
between antigen and antigen-presenting cells and lymphocytes. However, in some studies, the
potency of adjuvanted pertussis vaccines was more than that of the plain pertussis vaccines, while in
others no effect was noted. 
The serum agglutinin titres, after vaccination with adjuvanted pertussis vaccines, were higher than
those of the plain vaccines, with no difference in regard to protection against the disease (Butler et
al., 1962). 
Despite these conflicting results, aluminum compounds are universally used as adjuvants for the DPT
(diphtheriapertussis-tetanus) vaccine. Hypersensitivity reactions following their administration have
been reported which could be attributed to a number of factors, one of which is the production of
IgE along with IgG antibodies. 
It was suggested that polymerased toxoids, such as the so-called glutaraldehyde-detoxifled purified
tetanus and diphtheria toxins, should be used instead of aluminum compounds. They are usually
combined with glutaraldehyde-inactivated pertussis vaccine. 
Calcium phosphate adjuvant has been used for simultaneous vaccination with diphtheria, pertussis,
tetanus, polio, BCG, yellow fever, measles and hepatitis B vaccines and with allergen (Coursaget et
al., 1986). 
The advantage of this adjuvant has been seen to be that it is a normal constituent of the body and is
better tolerated and absorbed than other adjuvants. It entraps antigens very efficiently and allows
slow release of the antigen. Additionally, it elicits high amounts of IgG-type antibodies an much less
of IgE-type (reaginic) antibodies. 
Bacterial Products 
Microorganisms in bacterial infections and the administration of vaccines containing whole killed
bacteria and some metabolic products and components of various microorganisms have been known
to elicit antibody response and act as immunostimulants. The addition of such microorganisms and
substances into vaccines augments the immune response to other antigens in such vaccines. 
The most commonly used microorganisms, whole or their parts, are 
Bordetella pertussis components,
Corenybacterium derived P40 component,
cholera toxin
and mycobacteria.
B. Pertussis Components 
The killed Bordetella pertussis has a strong adjuvant effect on the diptheria and tetanus toxoids in the
DPT vaccines. However, there are a number of admitted and well-describe reactions to it, such as 
convulsion Reye syndrome
infantile spasms Guilain-Barre syndrome
epilepsy sudden infant death syndrome (SIDS)
transverse myelitis 
Immunology Principles: Antibody Response 
To explain the action of adjuvants, we should look into immunology. 
The theory of vaccine efficacy is based on the ability of vaccines to evoke the formation of
antibodies. 
This is of varying efficacy, depending on the nature of the antigen(s) and the amount of antigenic
substance administered. 
However, the mechanisms for the diversity of immune reactions are complex, and to this day are not
quite known and understood. There are numerous theories, the favoured one being antibody
response as the sign of immunization (acquiring immunity). 
Specific immunity to a particular disease is generally considered to be the result of two kinds of
activity: 
the humoral antibody
and the cellular sensitivity.
The ability to form antibodies develops partly in utero and partly after birth in the neonatal period. In
either case, immunological competence-the ability to respond immunologically to an antigenic
stimulus-appears to originate with the thymic activity. 
The thymus initially consists largely of primitive cellular elements which become peripheralised to the
lymph nodes and spleen. These cells give rise to lymphoid cells, resulting in the development of
immunological competence. 
The thymus may also exert a second activity in producing a hormone-like substance, which is
essential for the maturation of immunological competence in lymphoid cells. Such maturation also
takes place by contact with thymus cells in the thymus. 
Stimulation of the organism by antigen results in proliferation of cells of the lymphoid series
accompanied by the formation of immunocytes, and this leads to the antibody production. 
Certain lymphocytes and possibly reticulum cells may be transformed into immunoblasts, which
develop into immunologically active ("sensitized") lymphocytes and plasmocytes (plasma cells).
Antibody formation is connected with plasma cells, while cellular immunity reactions are mainly
lymphocytic. 
None of the theories for antibody formation comprehends all the biological and chemical data now
available. However, several principal theories have been considered at length. 
The so-called instructive theory holds that the antigen is brought to the locus of antibody synthesis
and there imposes in some way the synthesis of the specific antibody with reactive sites that are
complementary to the antigen. 
The clonal selection theory, evolved by Burnett (1960), presupposes that the information requisite to
the synthesis of the antibody is part of the genetics. While the body develops a wide range of clones
of cells necessary to cover all antigenic determinants by random mutation during early embryonic life,
those clones which are capable of reacting with antigens of the body ("self') are destroyed, leaving
only those cells which are not oriented to self ("non-self'). 
Upon stimulation by a foreign antigen, the clones of the cells corresponding to the particular foreign
antigen are stimulated to proliferate and to produce the antibody. 
Other researchers demonstrated that there are at least four different antigens formed by descendants
of a single cloned cell. By this mechanism, the information for antibody synthesis is contained in the
genetic material of each cell (DNA) but is normally repressed. 
The antigen then assumes the role of a de-repressor and initiates (provokes) the RNA synthesis for a
particular messenger, resulting in the corresponding antibody production. 
The antigen would instruct the genetically predisposed capability of multipotential cells as to which
antibody to produce and might also command the cells to proliferate, resulting in clones of properly
instructed cells. 
There are two possible mechanisms for the elimination of antibodies against self: 
immunological nonresponsiveness
and immunological paralysis.
There are several states of immunological nonresponsiveness; one is illustrated by the exposure of a
fetus or newborn to an antigen prior to the development of its ability to recognize the antigen as
non-self (immunological incompetence). Immunological paralysis results from the injection of a very
large amount of antigen into immunologically competent individuals. Nonspecific immunological
suppression by cortisone, ACTH, nitrogen mustards and irradiation is also well known. 
Cellular sensitivity, also known as delayed or cellular hypersensitivity, depends on the development
of immunologically reactive or "sensitive" lymphocytes and possibly other cells which react with the
corresponding antigen to give a typical delayed-type reaction after a period of several hours, days or
even weeks. 
Cellular hypersensitivity depends on the original antigenic stimulation and a latent period, and is
specific in its response. Delayed-type hypersensitivity is characteristic of the body's response to
various infectious agents such as viruses, bacteria, fungi, spirochetes and parasites. It is also
characteristic of the body's response to various chemicals, such as mercury, endotoxins, antibiotics,
various drugs and many other substances foreign to the body. 
The induction of a hypersensitivity reaction requires the presence in the tissues of the whole organism
or certain derivatives of it, in addition to the specific antigen such as a lipid in addition to tubercle
bacillus protein. 
Sensitization to a noninfectious substance must be mediated through the skin or mucous membranes
which probably provide further necessary cofactors. 
A delayed hypersensitivity reaction may be enhanced experimentally by the employment of the
antigen in a mineral oil adjuvant with added Mycobacterium tuberculosis or by injection of the
antigen directly into the lymphatics. 
The delayed hypersensitivity response is accompanied by mild to severe inflammation that may cause
cell injury and necrosis. The inflammatory response which occurs in delayed-type hypersensitivity
may not be protective, and in many instances may even be harmful (e.g., rejection of grafts is directly
linked to delayed hypersensitivity). 
Immunopathology Of Hypersensitivity Reactions: 
Immediate Hypersensitivity
This is the antibody-type reaction that is a secondary consequence to the beneficial effect of the
combination of an antibody with its antigen. 
Arthus-type Reaction
This reaction results from the precipitative union of a large amount of antigen with a highly reactive
antibody in the blood vessels, and leads to vascular damage. The cascade of events includes spastic
contraction of the arterioles, endothelial damage, formation of leukocyte thrombi, exudation of fluid
and blood cells into the tissues, and sometimes ischemic necrosis. 
Periarteritis nodosa results from a similar antigen-antibody reaction and is characterized by
inflammation of the smaller arteries and periarterial structures. It is accompanied by proliferation of
the intima and two types of occlusion: 
(a) by proliferation or thrombosis;
or (b) by the formation of nodules containing neutrophils and eosinophils.
Anaphylaxis Injection of antigen and its combination with antibody may cause release from the cells
(especially mast-cell fixed basophils) of physiologically active substances such as histamine,
serotonin, acetyicholine, slow-reacting substances (SRS) and heparin. 
They act on smooth muscle and blood vessels and cause 
• rhinitis or hay fever • anaphylactic (hypersensitivity) shock
• asthma attack • accumulation of fluid in the joints
• allergic oedema 
Atopy is caused by the union of antigen-usually pollens, dust, milk, wheat and animal danders-with a
peculiar type of antibody (reagin). This reaction is relatively heat-labile and cannot be demonstrated
by in vitro procedure. It has a special affinity for the skin and for familial predisposition to the
disease. 
The reaction is nevertheless similar to other immediate-type sensitivities, with the release of histamine
and its manifestation principally as 
asthma (breathing paralysis),
hay fever,
urticaria,
angioedema
and infantile eczema.
Delayed Hypersensitivity The typical pathology of delayed hypersensitivity due to infectious agents
involves perivascular infiltration of lymphocytes and histiocytes with the destruction of the
antigen-containing parenchyma in the infiltrated area. The visual manifestations may vary from slight
erythema and oedema to a violent reaction with progressive tissue destruction and necrosis. 
Local reactions include papular rose spots of typhoid fever, meningitis and a variety of infectious
diseases, and contact sensitivities to plant and chemical substances manifesting as erythema, followed
by papule and vesicle formation with resultant tissue damage and desquamation. 
Systemic reactions may accompany severe local reactions or may result from inhalation of the
allergenic substances. 
Humoral antibodies do not seem to play a role in delayed hypersensitivity reaction. The reactivity is
transferred only by cells, presumably sensitized lymphocytes, and it is unlikely that histamine or other
physiologically active substances play a role in the reaction. The reaction extends to any or all tissues
where the offending antigen may occur. 
Isoimmunological Disease This is the result of an immunological reaction of a member of the same
species to the tissue of another member of the same species. A blood transfusion reaction in a
person given an incompatible blood type is a typical example. 
Another example is erythroblastosis fetalis, which results from the transfer of antibodies against the
red blood cells of the foetus to the foetal circulation. Homograft rejection of tissues or organs
between nonisologous members of a species is also immunologically based. 
Immunological Disease Resulting from Adsorption of Foreign Substances Under certain
circumstances, foreign substances such as medications may combine with cells to render them
antigenic. Subsequent exposure to such a foreign substance results in lytic, agglutinative or other
types of cell-destructive activity. Such a reaction may involve red blood cells (drug-induced
anaemias), platelets (drug-induced thrombocytopemc purpura), and leukocytosis (drug-induced
agranulocytosis). 
Bacteria or viruses may also alter cell surfaces by coating or by unmasking antigens through
enzymatic activity which may render them vulnerable to immunological destruction. 
Autoimmune Disease Under certain circumstances, the body may respond immunologically to its
own components or to intrinsic substances which are related antigenically to the host's own tissues.
The circulating antibody or sensitized cells which are produced are then active in causing cellular
injury to the tissues or organs of the body which bear the corresponding antigen. 
Waksman (1962) proposed several mecnamsms of autoimmunisation, such as: 
1. Vaccination with organ-specific antigens which are isolated from the lymphatic channels and
bloodstream and are not recognized as self when brought into contact with the immunologic process.
They are represented in the central and peripheral nervous systems, lens, uvea, testes, thyroid
(thyroglobulin), kidneys and other organs. 
2. Vaccination against constituents of tissues which have been altered antigenetically by various
factors. These include 
myocardial infarction,
X-irradiation,
enzymatic or other chemical alteration,
and changes induced by infectious disease agents or by drugs.
Erythrocytes, platelets and leucocytes are the most affected cells. Various organs may also be
affected. 
3. Vaccination with heterologous antigens which are sufficiently different to permit an immunological
response but sufficiently alike to react with autologous antigens. 
4. Alteration of the immunological apparatus so as to result in the failure of recognition of self. This
occurs in neoplasia of the lymphatic system and in experimental grafting of immunologically
competent heterologous lymphatic tissues under conditions which suppress the host's response to the
graft and give rise to the wasting "runt disease" or "homologous disease". 
5. Possible hereditary or other immunological abnormality. This is represented by a hyper-reactivity
to antigens or other aberrations without apparent antigenic stimulation. Such mechanisms might be
related to certain forms of the "collagen diseases", such as systemic lupus erythematosus in which
there is an antibody against a diversity of antigens. 
6. Experimentally, Freund's mineral oil adjuvant (usually with added mycobacteria) and certain
bacteria or bacterial toxins may so alter the host as to bring about a ready response to unaltered
normal homologous tissue. These "experimental autoallergies" include a wide variety of organs and
tissues, and are now being employed as model systems for investigation of autoimmune phenomena. 
Both humoral antibody and sensitized cells may function in autoimmune disease. Auto-antibodies
seem to be involved in reactions with cells which are easily accessible, such as the formed elements
of the blood (in haemolytic anaemia, leucopeni thrombocytopenia), vascular endothelium, vascular
basement membrane including the glomerulus (in acute glomerulonephritis and ascites cells
(neoplastic immunity). 
Production of lesions in the solid vascularised tissues appears to depend on delayed hypersensitivity
reactions with sensitized lymphoid cells (such as in allergic encephalomyeitis, thyroiditis, subacute
and chronic glomerulonephritis, orchitis, adrenalitis and many other diseases). 
It is quite obvious now that the same autoimmune mechanisms are responsible for the same diseases
in human beings and that the extent of such damage is enormous and keeps increasing with more and
more vaccines added to to "recommended" schedule. 
Indeed, vaccines such as the pertussis vaccine are actually used to induce autoimmune diseases in
laboratory animals, the best and most publicized example being the so-called experimental allergic
encephalomyelitis (EAE). 
When, as expected, these unfortunate animals develop EAE from the pertussis vaccine, the causal
link is never disputed; yet when babies after vaccination with the same vaccines develop the same
symptoms of EAE as the laboratory animals, the causal link to the administered vaccine is always
disputed and usually considered "coincidental". 
Lately, innocent parents and other carers have been accused of causing the symptoms of vaccine
darn age by allegedly shaking their babies. 
==============================================================
16.) Thimerosal info
==============================================================
Source:thimerosal-info.com 
Inquiry into vaccine safety is exploding like never before, even in the popular press. Research
coming from dozens of mainstream medical studies can no longer be easily suppressed, as it has
been in the past, especially with the prevalence of online information exchange. 
By age two, American children have already received 237 micrograms of mercury through vaccines
alone, which far exceeds current EPA "safe" levels of .1 mcg/kg. per day. That's one-tenth of a
microgram, not one microgram. 
In the U.S., EPA mercury toxicity studies have involved contamination from fish, air, and other
environmental sources. This is inorganic mercury (methylmercury). 
Methylmercury has long been associated with serious neurological disorders, demyelinating diseases,
gut disease, and visual damage. 
The mercury in vaccines, however, is in the form of Thimerosal, which is 50 times more toxic than
plain mercury (methylmercury). 
Reasons for this include: 

Injected mercury is far more toxic than ingested mercury.
There's no blood-brain barrier in infants.
Mercury accumulates in brain cells and nerves.
Infants don't produce bile, which is necessary to excrete mercury.
If you need information about the safety of various children's vaccines information is available from
the Center For Disease Control & Prevention. The link below will take you to the center's website 
==============================================================
17.) Thimerosal litigation
==============================================================
Source:thimerosal-litigation.com 
A drastic jump has been made in the number of children that have been affected by autism. In 1970
there was 1 in 2,000 children with autism compared to 1 in 250 in 2000, and the number of children
diagnosed with learning disabilities is now 1 in 5. Thimerosal vaccines contain mercury, which is
considered to contribute to autism and learning disabilities, as well as Alzheimer’s disease and other
neurological conditions. 
Find out some of the US licensed vaccines that still contain thimerosal from the Vaccine Safety
Institute. Click here. 
As early as 1982 the FDA issued a proposed regulation calling for the removal of thimerosal from
over the counter products, but these regulations were not finalized until 1998, 16 sixteen years after
the FDA expert panel concluded thimerosal was unsafe, ineffective as a bacteriostatic agent, and
caused cell damage. For the 16 years, and even today, thimerosal was continued in use regardless of
the known fact that it is a neurotoxin. Mercury exposures may cause neurological problems in
60,000 children every year. 
In July of 1999 the FDA requested that manufacturers remove thimerosal from pediatric vaccines
because the immunization schedule had resulted in some children receiving a higher amount of
mercury than the established amount deemed safe. Researchers found that by following the vaccine
schedule that American children are given would result in exposure of 30 times the minimum
acceptable level of mercury from vaccines. Yet, thimerosal continues to be stocked on shelves while
clinics and other healthcare centers use up the stocks of mercury containing vaccines. 
Thimerosal can cause life-altering effects on a child’s life, exposing them to chemicals that may lead
to neuro-developmental disorders. Drug companies withheld information to doctors regarding how
much mercury was contained in the vaccines until the FDA ordered them in 1997. We have
provided contact information for those of you with questions regarding possible suffering that
thimerosal has caused a loved one. Learn about your legal rights and help get thimerosal off the
shelves. 
The Dangers of Thimerosal and Mercury
------------------------------------- 
In June of 1999, the Agency for the Evaluation of Medicinal Products in Europe, the equivalent of
the U.S.’s FDA, completed an 18-month inquiry into the risks and benefits of using thimerosal in
vaccines. They concluded that, “although there is not evidence of harm caused by the level of
exposure from vaccines, it would be prudent to promote the general use of vaccines without
thimerosal.” It was then that the FDA’s Center for Biologics Evaluation and Research (CBER)
confirmed that thimerosal was present in over 30 licenses vaccines in the U.S. in concentrations of
0.003% to 0.01%. CBER than make the remarkable discovery than the mercury intake through
vaccination in the first six months of life exceeded the limit set by the EPA. 
Mercury is the second most toxic element on earth to plutonium. Toxicity of mercury has been linked
to many different diseases, including autism, learning disabilities, Alzheimer’s, multiple sclerosis,
fibromyalgia, lupus, chronic fatigue syndrome, arthritis, depression, and bipolar disorder. The amount
of mercury found in one mercury thermometer is enough to pollute a small lake. 
Health effects of mercury toxicity have been a concern because of the potential for it to act as a
poison. Toxic doses of mercury can cause developmental effects in the fetus, as well as affecting the
kidney and the nervous system in children and adults. Mercury exists in a number of different
chemical forms, each one consisting of different levels of toxicity. The forms of mercury can also be
converted from one to another in the environment and in the body, so symptoms caused by mercury
poisoning depends on the precise chemical forms involved. 
Find out some of the US licensed vaccines that still contain thimerosal from the Vaccine Safety
Institute. Click here.
Mercury can be toxic when inhaled, eaten, or when placed on the skin. Low concentrations of
mercury may appear to have no effect but signs of toxicity can develop later or become more
noticeable with continued exposure. When toxicity in humans takes place loss of feeling or a burning
sensation in arms and legs, psychological effects, loss of memory, loss of vision, loss of hearing,
paralysis, congenital malformations, kidney toxicity, and death may occur. Prenatal toxicity can result
in a child with normal appearance at birth but who later exhibits a developmental delay in the ability
to walk and/or talk. Because of the long latent period for observable effects, the need for treatment
may be recognized too late. 
Health effects vary according to the amount of mercury exposure is taken into the body. The health
risks of mercury at low levels of exposure remain uncertain, but this continues to be a highly
debatable topic with ongoing scientific investigation. Fetuses, infants and small children appear to be
particularly sensitive to mercury because their brains are still developing. Vaccines with mercury have
been considered to contribute to autism, learning disabilities, Alzheimer’s Disease, and other
neurological conditions, and an FDA review conducted in 1998 determined that, at the time, children
who received the full complement of childhood vaccines were potentially exposed to levels of
mercury that were sometimes 30 to 50 times the acceptable levels established by the EPA. 
High-level exposures to mercury can cause serious effects or even be lethal. Several historical
examples of epidemic mercury poisonings in other parts of the world provide classic examples of
investigative epidemiology and toxicology and serve to highlight the reasons why regulators are
concerned about mercury. Effects on the brain and nervous system are frequently seen with
high-level exposures to mercury and can be quite severe. 
==============================================================
18.) Lawyers Claim CDC Cooked Books on Mercury: Secret Report Reveals
==============================================================
Source: goodlight.net 
October 17, 2001
Press release re internal CDC report on thimerosal and autism 
An announcement was made today by the law firm of Waters & Kraus, the firm that filed the first
known lawsuit alleging that a mercury preservative in children's vaccines caused neurological damage
to an infant ultimately diagnosed with autism. Waters & Kraus is leading a consortium of ten firms in
as many states that are actively prosecuting cases of this nature (firms listed below). Andy Waters,
the lead attorney in the cases, announced that his firm is now in possession of a previously
unreleased confidential report authored by Centers for Disease Control scientists which studied
autism as a potential neurological injury caused by mercury in children's vaccines. 
A different version of the report was made public and has been cited by the recent Institute of
Medicine study as inconclusive on the issue of whether the mercury-based vaccine preservative
known as thimerosal has contributed to cause a nationwide epidemic of regressive autism and other
neurological disorders in small children. The confidential version of the study, however, clearly
demonstrated that an exposure to more than 62.5 micrograms of mercury within the first three
months of life significantly increased a child's risk of developing autism. Specifically, the study found
a 2.48 times increased risk of autism - that is to say, children with the exposure were more than
twice as likely to develop autism as children not exposed. 
In the United States, courts of law have generally held that a relative increased risk of 2.0 or higher is
sufficient to substantiate that a given exposure causes disease. As but one example, in the case of
Cook v. United States, 545 F.Supp. 306, at 308 (Northern District - California 1982) the Court
stated that, "in a vaccine case, a relative risk greater than 2.0 establishes that there is a greater than
50% chance that the injury was caused by the vaccine." 
Waters indicated that, in many of the cases his firm has evaluated, including the case filed in a Texas
state court on behalf of the Counter family, the affected child received more than 62.5 micrograms of
mercury through pediatric vaccines in the first three months of life. 
The confidential report, which was obtained by the SAFEMINDS support and advocacy group,
states: "As for the exposure evaluated at 3 months of age, we found increasing risks of 'neurological
developmental disorders' with increasing cumulative exposure to thimerosal ... within the group of
'developmental disorders'... for the sub-group called 'specific delays,' and within this sub-group for
the specific disorder 'developmental speech disorder,' and for 'autism,' 'stuttering' and 'attention
deficit disorder.'" 
The report also contained the graph depicted below which illustrated the report's findings of a child's
increasing risk of developing the neurological symptoms of autism after receiving increasing amounts
of thimerosal. 
Graph 3: Relative risk - 95 % CI of Autism after different exposure levels of thimerosal at 3 months
of age, NCK & GHC (see www.vaccineinfo.net/autismHg.htm to view graph) 
Waters pointed out that the confidential study's lead author, Thomas Verstraeten, has since left the
Centers for Disease Control and is now employed by GlaxoSmithKline, a manufacturer of
thimerosal-containing vaccines for many years that is a defendant in numerous suits pending
nationwide. "We have asked GlaxoSmithKline to provide Mr. Verstraeten's deposition in order to
understand if conflict of interest issues may have played a role in the CDC's decision to keep this
report confidential, and specifically, their failure to reveal it to the Institute of Medicine." 
Waters called the report's contents and the fact that it was kept from the public as "shocking, but
unfortunately not surprising, given the political influence of pharmaceutical companies and the
tremendous liability they face if they are forced to compensate thousands of families for the costs of
care that these children require." Waters added that "no amount of money can give these children
back the potential that they were born with, and no amount of money will comfort the parents that
watched helplessly as their children literally just slipped away." The purpose of the lawsuits his firm is
currently prosecuting, said Waters, is "to bring to the surface the truth on this issue, a truth that
government agencies seem unwilling to admit, perhaps for fear that parents will stop vaccinating their
children, and to force the companies that profited from this disastrous mistake to shoulder the
responsibility that so many families now bear on their own, often without even the aid of health
insurance benefits." 
==============================================================
19.) Vaccine Information
==============================================================
Source:thimerosal-litigation.com 
A vaccine is a preparation containing the weakened or killed microorganisms that cause a particular
disease. When these substances are injected or taken orally, the body stimulates the immune system
to produce the necessary defenses against that disease. Adverse reactions to vaccines can occur
because of the organisms introduced into the body. 
Vaccine related damage provokes controversy of whether vaccines are good or bad. Vaccines and
diseases both pose risk so it is hard to decide which side to take. Unfortunately, few studies of the
long-term risks of vaccines exist. In July, as a pre-cursor to hearings into thimerosal-containing
vaccines and the neurodevelopmental outcomes of exposure to them, Immunization Safety Review
Committee questioned Dr. Laszlo Magos, author of Physiology and Toxicology of Mercury and an
internationally known expert in field. Two questions he was asked with his answers are as included: 
Have there been any studies, including animal studies, which have looked specifically at infant
ethylmercury exposure and the effect on neurological development?
"No, it has not been studied." 
What is thought to be currently the best hypothesis (if any) regarding the mechanism of neurotoxic
mechanism of neurotoxicity of organic Hg (mercury)?
"Unfortunately, there is no answer. Chang (1996) suggested four "major thoughts" on the mechanism
of actions. These "thoughts" have not reached the level of a hypotheses, and even less the level of
'the best hypothesis'." 

While parents struggle to make hard decisions involving the safety of their children with vaccination,
they receive mixed messages from the experts. Though no vaccines are perfectly safe the FDA has
gone from deeming thimerosal unsafe to asking vaccine manufacturers to voluntarily phase-out
thimerosal from their products. People are now wondering if the vaccines containing thimerosal are in
fact safe to use while clinics are using up the extra supplies they have kept stock of since the 1998
FDA request. 
Vaccination may damage children in several ways. Live or attenuated virus vaccination can actually
produce the infection that the vaccine is supposed to prevent. For example, live polio should never
be administered to a child who comes in contact with an HIV patient, for the attenuated virus can
"leap" to the HIV patient and produce polio. Reports exist of normal parents who have developed
polio from the viral vaccine given to their children. 
A second mechanism of damage comes from neurotoxic materials found sometimes in vaccines.
Thimerosal is the most widely discussed, since it contains mercury. The amount is small. Each
vaccine is equivalent to the amount of mercury found in a 6 oz. can of tuna fish. Nevertheless, some
argue that even these levels may be important in a vulnerable child. 
The third, and probably the most important theory of vaccine damage, relates to allergic reactions
and the development of an autoimmune response, stimulated by the vaccine and its adjuvant.
Vaccines always contain adjuvants, which are substances known to amplify the body's response to
the vaccine. These adjuvants are known to sometimes cause allergic and auto-immune responses on
their own. 
==============================================================
20.) The facts about vaccine and autism by date
==============================================================
Source: Thimerosal-litigation.com 
October 3, 2001, “Chairman Burton Requests Recall Of 
Childhood Vaccines with Thimerosal,”
Chairman Burton stated, “We cannot in good conscience leave Thimerosal-containing vaccines on
the shelf until used up, potentially exposing children to chemicals that may lead to
neuro-developmental disorders. Mercury is toxic to the human body. I will be sending a letter this
week to Secretary Thompson asking that these products be recalled. In the meantime, I am asking
every doctor, every health clinic, and every facility that provides childhood immunizations to check
your vaccine supplies and return all Thimerosal-containing vaccines and request Thimerosal-free
vaccines.” Read More… 

July 25, 2001, “Major CDC Study on Thimerosal Flawed,”
The author of a major study of the link between Vaccinations and Developmental Disorders, which
is widely quoted by the Centers for Disease Control and Prevention (CDC), has admitted that the
study is inaccurate in its findings. Dr. Thomas Verstraeten, of the CDC's National Immunization
Program, is quoted as saying, "One thing is for sure, there is certainly under-ascertainment of all
these [conditions] because some of the children are just not old enough to be diagnosed." A
professor who has reviewed the research confirmed this. He stated that there were too few children
in the study to pick up all cases of autism. Additionally, it appears that the CDC is now reversing its
stand. According to the Sunday Times, the Centers for Disease Control and Prevention has found a
"statistically significant" link between mercury in vaccines and developmental disorders, including
Attention Deficit Disorder and speech and language delays. The CDC, however, still recommends
vaccinations with thimerosal containing vaccines, saying there are safety measures in place to prevent
overdoses of mercury. Read More… 
July 4, 2001, “Effects of Ethylmercury Exposure in Infants Never Studied”
On July 26, 2001, the Institute of Medicine will conduct hearings into thimerosal-containing vaccines
and the neurodevelopmental outcomes of exposure to them. As a part of their preliminary research,
the Immunization Safety Review Committee questioned Dr. László Magos, author of Physiology and
Toxicology of Mercury and an internationally known expert in field. How can we ever believe the
reports that attempt to validate the use of vaccines which contain thimerosal, when there have been
NO STUDIES done on this important question, according to Dr. Magos? And how can we believe
the theories that have been proposed on how mercury works to damage the neurological system of
the body, when there hasn't even been a hypothesis made on this question. Read More… 
April 26, 2001, Statement By Karen Midthun, M.D., Director Office of Vaccines Research and
Review Center For Biologics Evaluation and Research Food and Drug Administration Department
of Health and Human Services, Before the Committee on Government Reform United States
Representatives. Read More… 

January 15, 2001, “Healthcast: Vaccines With Mercury Cause Controversy Medical Community
Debates Safety of Thimerosal”
While childhood immunizations are important for maintaining good health, WTAE-TV medical editor
Marilyn Brooks reports that there may be something dangerous in those shots. A mercury-based
preservative called thimerosal is commonly used in several vaccines, Brooks reports. 
Doctors are debating whether the preservative gives parents cause for concern, but Brooks says that
mercury-free vaccinations for children are available upon request. 
Congressman Dan Burton recently asked the Food and Drug Administration to recall all vaccines
containing mercury, but Health and Human Services Secretary Donna Shalala, citing extensive safety
testing, refused the request. 
Brooks reports that no case has been documented which proves that vaccines with thimerosal cause
mercury poisoning. Read More... 

“Uproar over a little-known preservative, thimerosal, jostles U.S. hepatitis B vaccination policy”
Read the entire report… 
October 26, 2000, “Chairman Burton Requests Vaccine Recall”
In an October 25, 2000 letter to HHS Secretary Donna Shalala, Congressman Dan Burton (R-IN),
Chairman of the House Committee on Government Reform, requested a recall of all vaccines
containing Thimerosal. The mercury-based product Thimerosal is added to vaccines as a
preservative. On July 18, 2000 the Committee conducted a hearing entitled, “Mercury in Medicine:
Are We Taking Unnecessary Risks?” During the hearing, the FDA admitted that children are being
exposed to unsafe levels of mercury through vaccines containing Thimerosal. It was also determined
that symptoms of mercury poisoning mimic symptoms of autism -- a disease that has reached
epidemic levels in the United States. However, the FDA has chosen to allow pharmaceutical
companies to merely phase out their use of Thimerosal, leaving mercury-containing vaccines at public
and private health facilities. Read More… 

June 18, 2000, The committee conducted a hearing entitled, “Mercury in Medicine: Are We Taking
Unnecessary Risks?”
During the hearing, the FDA admitted that children are being exposed to unsafe levels of mercury
through vaccines containing Thimerosal. It was also determined that symptoms of mercury poisoning
mimic symptoms of autism -- a disease that has reached epidemic levels in the United States.
However, the FDA has chosen to allow pharmaceutical companies to merely phase out their use of
Thimerosal, leaving mercury-containing vaccines at public and private health facilities. Read More… 

July 11, 2000, “Mercury Toxicity”
Methyl-mercury exposure is a “widespread and persistent problem in the environment” and may
cause neurological problems in 60,000 children born in the U.S. each year, according to a report
released today by a panel of National Academy of Sciences experts. Read More… 

July 10, 1999, “Mercury Alert: US Urges For Delay For Hepatitis B Vaccine”
The American Academy of Pediatrics (AAP), U.S. Public Health Service (PHS) and vaccine
manufacturers have announced, that because of potential health risks, thimerosal-containing vaccines
should be removed from circulation as soon as possible. Thimerosal contains mercury and is made
from a combination of ethyl mercuric chloride, thiosalicylic acid, sodium hydroxide and ethanol. It is
used as a preservative in many recombinant vaccines, such as the Hepatitis B, diptheria, pertussis,
acellular pertussis, tetanus, and Hib vaccines. Read More… 
==============================================================
21.) vaccines that contain thimerosal
==============================================================
DTaP Acel-Imune
Lederle Laboratories
Tripedia Pasteur Merieux Connaught
Certiva North American Vaccine
DTwP All products
DT All products
Td All products
TT All products
DtwP-Hib Tetramune
Lederle Laboratories
TriHIBit Pasteur Merieux Connaught
HibTITER (multidose) Lederle Laboratories
ProHIBit4 Pasteur Merieux Connaught
Hepatitis B virus Engerix-B
SmithKline Beecham
Recombivax HB Merck
Influenza All
Meningococcal Menomune A, C, AC and A/C/Y/W-135
CLI
Pneumococcal Pnu-Imune 23
Lederle Laboratories
Rabies Rabies Vaccine Adsorbed
BioPort Corporation
==============================================================
22.) The secret world of the autism.
==============================================================
Source: The national, Newspaper of Venezuela from 4/05/02, t 
Taken of the magazine TIME, by Amy Bonestel/Atlanta
==============================================================
23.) [Lichen planus and vaccination against hepatitis B]
tO: Lichen plan et vaccination anti-hepatite B.
============================================================
AU: Lefort-A; Dachary-D; Vergier-B; Boiron-G
AD: Service d'Anatomopathologie, Hopital du Haut Leveque, Pessac.
SO: Ann-Dermatol-Venereol. 1995; 122(10): 701-3
ISSN: 0151-9638
PY: 1995
LA: FRENCH; NON-ENGLISH
CP: FRANCE
AB: INTRODUCTION: The association of lichen planus with liver diseases is
now well established. Lichen planus following hepatitis B vaccination are
much more unusual. We report here the fifth case of this kind. CASE REPORT:
A 16 years old girl developed a purely cutaneous lichen planus one week
after the first injection of hepatitis B vaccine Gen Hevac B (Institut
Pasteur), which appeared again 3 days after the second injection. The
histologic features shown lichenoid pattern with intense keratinocytes
necrosis more in favor of lichenoid drug eruption than lichen planus.
DISCUSSION: According to our knowledge, only four similar cases have been
previously reported. Comparison between the different vaccines used shows
that only the HBs antigen and its epitope S could be involved in the lichen
planus eruption. Our case is specific due to the early appearance of the
eruption after the first injection and by its histologic features.
CONCLUSION: New cases of lichen planus following hepatitis B vaccination
should help to explain the causal relationship between lichen planus
eruption and hepatitis B vaccination.
==============================================================
24.) ALERTAS SOBRE LA SEGURIDAD DE MEDICAMENTOS
NOTA INFORMATIVA DEL COMITÉ DE SEGURIDAD DE MEDICAMENTOS SOBRE
TIOMERSAL
==============================================================
Source: www.sefh.es / Sociedad Española de Farmacia Hospitalaria. 
El Tiomersal es un conservante de tipo organomercurial cuya acción antimicrobiana se basa en la
liberación de etilmercurio. El tiomersal se ha venido empleando durante muchos años en la
fabricación de medicamentos; en el caso concreto de las vacunas, se utiliza como conservante en el
producto terminado. Sin embargo, la exposición acumulada a etilmercurio procedente de distintas
fuentes (alimentos, medicamentos) puede constituir un motivo de preocupación. 
Recientemente el Centro para el Control y Prevención de las Enfermedades (CDC) de Estados
Unidos ha evaluado los resultados de varios estudios epidemiológicos que fueron diseñados para
establecer si existe algún riesgo de desarrollar alteraciones neurológicas asociadas a la utilización de
vacunas formuladas con tiomersal. Los hallazgos derivados de estos estudios no permiten alcanzar
conclusiones científicamente validas por lo que se hace necesaria la necesaria de más estudios. 
El Comité de Especialidades Farmacéuticas (CPMP) de la Agencia Europea de Evaluación de
Medicamentos (EMEA), que cuenta con representación española, ha venido promoviendo la
utilización de vacunas exentas de mercurio en su composición y, en esa línea, ha solicitado a los
Laboratorios farmacéuticos fabricantes de vacunas que propongan planes de fabricación en los que
se excluya la utilización de organomercuriales como conservantes en el producto final. 
En concordancia con este objetivo, la Agencia Española del Medicamento hizo pública el pasado
día 13 de marzo de 2000 la Circular 1/2000 en la que, además de requerir la inclusión en fichas
técnicas y prospectos de las pertinentes advertencias sobre el riesgo de aparición de reacciones
alérgicas descritas con los conservantes de tipo organomercurial, insta a los Laboratorios
productores de vacunas a intensificar sus esfuerzos al efecto de eliminar de forma definitiva la
presencia de los mencionados conservantes. 
En el momento actual, ninguna de las nuevas solicitudes de autorizaciones de vacunas pendientes de
aprobación en la Unión Europea incluyen al tiomersal como conservante. Las nuevas vacunas para
inmunización infantil exentas de tiomersal como conservante están pendientes de aprobación por
procedimiento centralizado y se prevé que estarán disponibles en Europa a finales de este año. Las
vacunas de Hepatitis B libres de tiomersal estarán disponibles en Europa en agosto de 2000. Para el
resto de vacunas se está trabajando actualmente en la eliminación del tiomersal como conservante;
este proceso va a requerir introducir modificaciones en algunas fases del proceso de fabricación por
lo que resulta imposible prever el plazo para su conclusión. 
Teniendo en cuenta todo lo anterior, la Agencia Española del Medicamento considera que los
beneficios de la vacunación en la población general e infantil son muy superiores a los riesgos
potenciales, si es que existen, derivados de la exposición a vacunas que contienen tiomersal 
EL SUBDIRECTOR GENERAL
DE SEGURIDAD DE MEDICAMENTOS
==============================================================
25.) Strong Association of the Third
Hypervariable Region of HLA-DRb1 with Autism
==============================================================
Source: www.enabling.org 
Copyright by Michael Jones, Bill Elkus, Jim Lyles, and Lisa Lewis 1995, 1996, 1997 - All rights
reserved worldwide. 
Disclaimer
Feedback to the Listowners. 

By Reed P. Warren, J. Dennis Odell, W. Louise Warren, Roger A. Burger,
Alma Maciulis, Wayne W. Daniels and Anthony R. Torres 
The Center for Persons with Disabilities and the Department of Biology,
Utah State University, Logan, Utah 84322. 
Address all correspondence to Reed P. Warren, Ph.D., UMC 6895, Utah
State University, Logan, Utah, 84322, USA, Telephone: (801) 797-1924,
FAX: (801) 797-2044, E-mail: Medlab@cc.usu.edu 

=======
Summary
======= 
We reported that the major histocompatibility complex (MHC) including
the null allele of the C4B gene and the extended haplotype B44-C30-DR4
is associated with autism. We report now that the third hypervariable
region (HVR-3) of certain DRb1 alleles have very strong association with
autism. The HVR-3 of DRb1*0401 or the shared HVR-3 alleles DRb1*0404
and DRb1*0101, was expressed on extended haplotypes in 23 of 50 (46%)
autistic subjects as compared to only 6 of 79 (7.5%) normal subjects.
Another HVR-3 sequence, the DRb1*0701 allele, was carried on extended
haplotypes in 16 (32.0%) of the autistic subjects as compared to 8
(10.1%) of the normal subject
==============================================================
26.) Vaccine Induced Demyelination
==============================================================
Source:healing-arts.org 
Myelination is an essential part of human brain development. Nerves can only conduct pulses of
energy efficiently if covered by myelin. Like insulation on an electric wire, the fatty coating of myelin
keeps the pulses confined and maintains the integrity of the electrical signal so that it has a high
signal-to-noise ratio. When the insulation on a wire is damaged or destroyed, the flow of electrical
current may be interrupted and a short-circuit occurs.
Oligodendrocyte cells give white matter its color by manufacturing myelin. If myelin falls into
disrepair, nerve axons cease to function, even though they themselves aren't damaged. Protecting
oligodendrocytes after brain or spinal cord injury might keep nerve cells intact. 
At birth, relatively few pathways have myelin insulation. Myelination in the human brain continues
from before birth until at least 20 years of age. Up until the age of 10 or so, vast areas of the cortex
are not yet myelinated. Up to the age of 20, large areas of the frontal lobes are not yet myelinated.1 
Myelination begins in the developmentally oldest parts of the brain, like the brain stem, moving to the
areas of the nervous system that have developed more recently, like the prefrontal lobe and cortex.
Myelin spreads throughout the nervous system in stages, which vary slightly in each individual.
Impairment of myelination can alter neural communication without necessarily causing severe CNS
(central nervous system) damage. 
The prefrontal portions of the cerebrum have a profound influence on human behavior.2 If an
individual is injected with vaccines,most of which have adjuvants like mercury and aluminum
compounds, as well as foreign proteins (some from other species in which the vaccines were grown)
and biological organisms, unprotected nerves may be impacted. The argument for a role of vaccines
in the development of autistic disorders hinges on these biological effects upon nerves, damaging
them in a way that influences behavior and learning patterns. 
The argument for adjuvants evoking an auto-immune response does not hinge on any inherent
neuro-toxicity of these compounds, but on the initiation of an allergic response. 
The model by which adjuvants initiate an immune response is that of Experimental Allergic
Encephalomyelitis (EAE). To date, EAE is recognized as the best available animal model of several
degenerative human diseases, like multiple sclerosis and post-vaccinal encephalopathies. EAE3 is
generally thought to be an autoimmune response to myelin basic protein (MBP). Oddly, MBP can
also suppress EAE, and many observations suggest that an independent immune response to
so-called "adjuvant" material is also necessary to EAE induction. Of course, this is why adjuvants are
used in vaccines, to dramatically increase the likelihood of an immune response to the administered
biological material. 
Thus, EAE may be a result of a pair of interactive immune responses, one against MBP, and one
against the adjuvant. If so, the adjuvant should, like MBP, suppress EAE. Root-Bernstein, et al.
(1986) presented data from experiments on strain 13 guinea pigs demonstrating EAE suppression by
muramyl dipeptide, an active component of complete Freund's adjuvant. In the past, adjuvants have
only been classified as immunopotentiators, not immunosuppressants. Apparently, adjuvants are
both. This study strengthens the argument that adjuvants may be crucial to initiating an auto-immune
response leading to post-vaccine neurological symptoms. 
========================================================================
27.) THIMEROSAL IN VACCINES / FDA nowdays 2.017
========================================================================
SOURCE: FDA


Introduction
Thimerosal is a mercury-containing organic compound (an organomercurial). Since the 1930s, it has been widely used as a preservative in a number of biological and drug products, including many vaccines, to help prevent potentially life threatening contamination with harmful microbes. Over the past several years, because of an increasing awareness of the theoretical potential for neurotoxicity of even low levels of organomercurials and because of the increased number of thimerosal containing vaccines that had been added to the infant immunization schedule, concerns about the use of thimerosal in vaccines and other products have been raised. Indeed, because of these concerns, the Food and Drug Administration has worked with, and continues to work with, vaccine manufacturers to reduce or eliminate thimerosal from vaccines.
Thimerosal has been removed from or reduced to trace amounts in all vaccines routinely recommended for children 6 years of age and younger, with the exception of inactivated influenza vaccine (see Table 1). A preservative-free version of the inactivated influenza vaccine (contains trace amounts of thimerosal) is available in limited supply at this time for use in infants, children and pregnant women. Some vaccines such as Td, which is indicated for older children (≥ 7 years of age) and adults, are also now available in formulations that are free of thimerosal or contain only trace amounts. Vaccines with trace amounts of thimerosal contain 1 microgram or less of mercury per dose.
In the following pages, a discussion of preservatives, the use of thimerosal as a preservative, guidelines on exposure to organomercurials (primarily methylmercury), thimerosal toxicity, recent and future FDA actions, and the conclusions of the Institute of Medicine's most recent review of thimerosal in vaccines are presented. This narrative on thimerosal contains references to the literature and links to other sites for readers who wish additional information; for quick reference, a number of frequently asked questions (FAQs) and answers are provided.
Preservatives in Vaccines
To begin, we need to answer two questions-what are preservatives and why are they used in vaccines. For our purposes, preservatives may be defined as compounds that kill or prevent the growth of microorganisms, particularly bacteria and fungi. They are used in vaccines to prevent microbial growth in the event that the vaccine is accidentally contaminated, as might occur with repeated puncture of multi-dose vials. In some cases, preservatives are added during manufacture to prevent microbial growth; with changes in manufacturing technology, however, the need to add preservatives during the manufacturing process has decreased markedly.
The United States Code of Federal Regulations (the CFR) requires, in general, the addition of a preservative to multi-dose vials of vaccines; indeed, worldwide, preservatives are routinely added to multi-dose vials of vaccine. Tragic consequences have followed the use of multi-dose vials that did not contain a preservative and have served as the impetus for this requirement. One particularly telling incident from Australia is described by Sir Graham S. Wilson in his classic book, The Hazards of Immunization
In January 1928, in the early stages of an immunization campaign against diphtheria, Dr. Ewing George Thomson, Medical Officer of Health of Bundaberg, began the injection of children with toxin-antitoxin mixture. The material was taken from an India-rubber-capped bottle containing 10 mL of TAM. On the 17th, 20th, 21, and 24th January, Dr. Thomson injected subcutaneously a total of 21 children without ill effect. On the 27th a further 21 children were injected.Of these children .eleven died on the 28th and one on the 29th. (Wilson 1967)
This disaster was investigated by a Royal Commission and the final sentence in the summary of their findings reads as follows:
The consideration of all possible evidence concerning the deaths at Bundeberg points to the injection of living staphylococci as the cause of the fatalities.
From this experience, the Royal Commission recommended that biological products in which the growth of a pathogenic organism is possible should not be issued in containers for repeated use unless there is a sufficient concentration of antiseptic (preservative) to inhibit bacterial growth.
The U.S. requirement for preservatives in multi-dose vaccines was incorporated into the CFR in January 1968, although many biological products had contained preservatives, including thimerosal, prior to this date. Specifically, the CFR states:
Products in multi-dose containers shall contain a preservative, except that a preservative need not be added to Yellow Fever Vaccine; Polio-virus Vaccine, Live Oral; viral vaccine labeled for use with the jet injector; dried vaccines when the accompanying diluent contains a preservative; or to an Allergenic Product in 50 percent or more volume (v/v) glycerin. [21 CFR 610.15(a)]
The CFR also requires that the preservative used
...[s]hall be sufficiently non-toxic so that the amount present in the recommended dose of the product will not be toxic to the recipient, and in combination used it shall not denature the specific substance in the product to result in a decrease below the minimal acceptable potency within the dating period when stored at the recommended temperature. [21 CFR 610.15(a)]
Preservatives cannot completely eliminate the risk of contamination of vaccines. The literature contains several reports of bacterial contamination of vaccines despite the presence of a preservative, emphasizing the need for meticulous attention to technique in withdrawing vaccines from multi-dose vials. (Bernier et al 1981; Simon et al. 1993). The need for preservatives in multi-dose vials of vaccines is nonetheless clear. Several preservatives are used in U.S. licensed vaccines, and these are listed in Table 2. It is important to note that the FDA does not license a particular preservative; rather, the product containing that preservative is licensed, with safety and efficacy data generally collected in the context of a license application for a particular product.
Thimerosal as a Preservative
Thimerosal, which is approximately 50% mercury by weight, has been one of the most widely used preservatives in vaccines. It is metabolized or degraded to ethylmercury and thiosalicylate. Ethylmercury is an organomercurial that should be distinguished from methylmercury, a related substance that has been the focus of considerable study (see "Guidelines on Exposure to Organomercurials" and "Thimerosal Toxicity", below).
At concentrations found in vaccines, thimerosal meets the requirements for a preservative as set forth by the United States Pharmacopeia; that is, it kills the specified challenge organisms and is able to prevent the growth of the challenge fungi (U.S. Pharmacopeia 2004). Thimerosal in concentrations of 0.001% (1 part in 100,000) to 0.01% (1 part in 10,000) has been shown to be effective in clearing a broad spectrum of pathogens. A vaccine containing 0.01% thimerosal as a preservative contains 50 micrograms of thimerosal per 0.5 mL dose or approximately 25 micrograms of mercury per 0.5 mL dose.
Prior to its introduction in the 1930's, data were available in several animal species and humans providing evidence for its safety and effectiveness as a preservative (Powell and Jamieson 1931). Since then, thimerosal has been the subject of several studies (see Bibliography) and has a long record of safe and effective use preventing bacterial and fungal contamination of vaccines, with no ill effects established other than minor local reactions at the site of injection.
While the use of mercury-containing preservatives has declined in recent years with the development of new products formulated with alternative or no preservatives, thimerosal has been used in some immune globulin preparations, anti-venins, skin test antigens, and ophthalmic and nasal products, in addition to certain vaccines. Under the FDA Modernization Act of 1997, the FDA compiled a list of regulated products containing mercury, including those with thimerosal (Federal Register 1999). It is important to note that this list was compiled in 1999; some products listed are no longer manufactured and many products have been reformulated without thimerosal. Updated lists of vaccines and their thimerosal content can be found in Table 1 (routinely recommended pediatric vaccines) and Table 3 (expanded list of vaccines).
Guidelines on Exposure to Organomercurials
Mercury is an element that is dispersed widely around the earth. Most of the mercury in the water, soil, plants and animals is found as inorganic mercury salts. Mercury accumulates in the aquatic food chain, primarily in the form of the methylmercury, an organomercurial. Organic forms of mercury are more easily absorbed when ingested and are less readily eliminated from the body than are inorganic forms of mercury. Humans are exposed to methylmercury primarily from the consumption of seafood (Mahaffey et al. 1997).
Methylmercury is a neurotoxin. The toxicity of methylmercury was first recognized during the late 1950s and early 1960s when industrial discharge of mercury into Minimata Bay, Japan led to the widespread consumption of mercury-contaminated fish (Harada 1995). Epidemics of methylmercury poisoning also occurred in Iraq during the 1970s when seed grain treated with a methylmercury fungicide was accidentally used to make bread (Bakir et al. 1973). During these epidemics, fetuses were found to be more sensitive to the effects of methylmercury than adults. Maternal exposure to high levels of methylmercury resulted in infants exhibiting severe neurologic injury including a condition resembling cerebral palsy, while their mothers showed little or no symptoms. Sensory and motor neurologic dysfunction and developmental delays were observed among some children who were exposed in utero to lower levels of methylmercury.
More recently, several epidemiological studies have examined the effect of low dose dietary exposure to methylmercury, with inconsistent results. Studies from the Faroe Islands reported that subtle cognitive deficits (e.g., performance on attention, language, and memory tests), detectable by sophisticated neuropsychometric testing, were associated with methylmercury levels previously thought to be safe (Grandjean et al 1997). Studies in the Seychelles, evaluating more global developmental outcomes, did not reveal any correlation between abnormalities and methylmercury levels (Davidson et al. 1998).
Various agencies have developed guidelines for safe exposure to methylmercury, including the U.S. Environmental Protection Agency (Mahaffey et al. 1997), U.S. Agency for Toxic Substances and Disease Registry (ATSDR 1999), the FDA (Federal Register 1979)1, and the World Health Organization (WHO 1996). These exposure levels range from 0.1 µg/kg body weight/day (EPA) to 0.47 µg/kg body weight/day (WHO)2. The range of recommendations is due to varying safety margins, differing emphasis placed on various sources of data, the different missions of the agencies and the population that the guideline is intended to protect. All guidelines, however, fall within the same order of magnitude. While these guidelines may be used as screening tools in risk assessment to evaluate the "safety" of mercury exposures, they are not meant to be bright lines above which toxicity will occur. However, as exposure levels increase in multiples of these guidelines, there is increasing concern on the part of the public health community that adverse health consequences may occur (Mahaffey 1999).
To address the issue of conflicting methylmercury exposure guidelines, Congress asked the National Academy of Sciences to study the toxicological effects of methylmercury and provide recommendations on the establishment of a scientifically appropriate methylmercury reference dose. Their report concluded that the EPA's current reference dose, the RfD, for methylmercury, 0.1 µg/kg/day is a scientifically justifiable level for the protection of human health. (See "Related Links" below for link to the report: "The National Academies Press: Toxicological Effects of Methylmercury.") The FDA is considering this and other data relevant to its exposure guideline for methylmercury.
Thimerosal Toxicity
The various mercury guidelines are based on epidemiological and laboratory studies of methyl mercury, whereas thimerosal is a derivative of ethyl mercury. Because they are different chemical entities - ethyl- versus methylmercury - different toxicological profiles are expected. There is, therefore, an uncertainty that arises in applying the methylmercury-based guidelines to thimerosal. Lacking definitive data on the comparative toxicities of ethyl- versus methylmercury, FDA considered ethyl- and methyl-mercury as equivalent in its risk evaluation. There are some data and studies bearing directly on thimerosal toxicity and these are summarized in this Section.
Allergic responses to thimerosal are described in the clinical literature, with these responses manifesting themselves primarily in the form of delayed-type local hypersensitivity reactions, including redness and swelling at the injection site (Cox and Forsyth 1988; Grabenstein 1996). Such reactions are usually mild and last only a few days. Some authors postulate that the thiosalicylate component is the major determinant of allergic reactions (Goncalo et al. 1996). In a clinical setting, however, it is usually not possible to determine whether local reactions are caused by thimerosal or other vaccine components.
The earliest published report of thimerosal use in humans was published in 1931 (Powell and Jamieson 1931). In this report, 22 individuals received 1% solution of thimerosal intravenously for unspecified therapeutic reasons. Subjects received up to 26 milligrams thimerosal/kg (1 milligrams equals 1,000 micrograms) with no reported toxic effects, although 2 subjects demonstrated phlebitis or sloughing of skin after local infiltration. Of note, this study was not specifically designed to examine toxicity; 7 of 22 subjects were observed for only one day, the specific clinical assessments were not described, and no laboratory studies were reported.
Several cases of acute mercury poisoning from thimerosal-containing products were found in the medical literature with total doses of thimerosal ranging from approximately 3 mg/kg to several hundred mg/kg. These reports included the administration of immune globulin (gamma globulin) (Matheson et al. 1980) and hepatitis B immune globulin (Lowell et al. 1996), choramphenicol formulated with 1000 times the proper dose of thimerosal as a preservative (Axton 1972), thimerosal ear irrigation in a child with tympanostomy tubes (Rohyans et al. 1994), thimerosal treatment of omphaloceles in infants (Fagan et al. 1977), and a suicide attempt with thimerosal (Pfab et al. 1996). These studies reported local necrosis, acute hemolysis, disseminated intravascular coagulation, acute renal tubular necrosis, and central nervous system injury including obtundation, coma, and death. (IOM)
Several animal studies have evaluated the toxicity of thimerosal. In 1931 Powell and Jamieson reported acute toxicity studies in several animal species. Maximum tolerated doses not associated with death of the animals were 20 mg thimerosal/kg (rabbits) and 45 mg/kg (rats). Blair evaluated the administration of thimerosal intranasally for 190 days and observed no histopathological changes in the brain or kidney (Blair et al. 1975). Magos et al. directly compared the toxicity of ethyl- versus methylmercury in adult male and female rats administered 5 daily doses of equimolar concentrations of ethyl- or methylmercury by gavage (Magos et al 1985). Magos concluded that ethylmercury, the mercury derivative found in thimerosal, is less neurotoxic than methylmercury, the mercury derivative for which the various guidelines are based.
One final piece of data regarding thimerosal is worth noting. At the initial National Vaccine Advisory Committee-sponsored meeting on thimerosal in 1999, concerns were expressed that infants may lack the ability to eliminate mercury. More recent NIAID-supported studies at the University of Rochester and National Naval Medical Center in Bethesda, MD examined levels of mercury in blood and other samples from infants who had received routine immunizations with thimerosal-containing vaccines. [Pichichero ME, et al. Lancet 360:1737-1741 (2002)] Blood levels of mercury did not exceed safety guidelines for methyl mercury for all infants in these studies. Further, mercury was cleared from the blood in infants exposed to thimerosal faster than would be predicted for methyl mercury; infants excreted significant amounts of mercury in stool after thimerosal exposure, thus removing mercury from their bodies. These results suggest that there are differences in the way that thimerosal and methyl mercury are distributed, metabolized, and excreted. Thimerosal appears to be removed from the blood and body more rapidly than methyl mercury. NIAID is sponsoring a follow-up study with larger numbers of infants in Buenos Aires where thimerosal-containing vaccines are still administered to children. See "Related Links" below to find a link to the NIH/NIAID vaccines/thimerosal web site.
Recent and Future FDA Action
FDA has been actively addressing the issue of thimerosal as a preservative in vaccines. Under the FDA Modernization Act (FDAMA) of 1997, the FDA conducted a comprehensive review of the use of thimerosal in childhood vaccines. Conducted in 1999, this review found no evidence of harm from the use of thimerosal as a vaccine preservative, other than local hypersensitivity reactions (Ball et al. 2001).
As part of the FDAMA review, the FDA evaluated the amount of mercury an infant might receive in the form of ethylmercury from vaccines under the U.S. recommended childhood immunization schedule and compared these levels with existing guidelines for exposure to methylmercury, as there are no existing guidelines for ethylmercury, the metabolite of thimerosal. At the time of this review in 1999, the maximum cumulative exposure to mercury from vaccines in the recommended childhood immunization schedule was within acceptable limits for the methylmercury exposure guidelines set by FDA, ATSDR, and WHO. However, depending on the vaccine formulations used and the weight of the infant, some infants could have been exposed to cumulative levels of mercury during the first six months of life that exceeded EPA recommended guidelines for safe intake of methylmercury.
As a precautionary measure, the Public Health Service (including the FDA, National Institutes of Health (NIH), Center for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) and the American Academy of Pediatrics issued two Joint Statements, urging vaccine manufacturers to reduce or eliminate thimerosal in vaccines as soon as possible (CDC 1999) and (CDC 2000). The U.S. Public Health Service agencies have collaborated with various investigators to initiate further studies to better understand any possible health effects from exposure to thimerosal in vaccines.
Available data has been reviewed in several public forums including the Workshop on Thimerosal held in Bethesda in August 1999 and sponsored by the National Vaccine Advisory Committee, two meetings of the Advisory Committee on Immunization Practices of the CDC, held in October 1999 and June 2000, and the Institute of Medicine's Immunization Safety Review Committee in July 2001 and May 2004. Through its Vaccine Safety Datalink, the CDC has examined the incidence of autism as a function of the amount of thimerosal a child received from vaccines. Preliminary results indicated no change in autism rates relative to the amount of thimerosal a child received during the first six months of life (from 0 micrograms to greater than 160 micrograms). A weak association was found with thimerosal intake and certain neurodevelopmental disorders (such as attention deficit hyperactivity disorder) in one study, but was not found in a subsequent study. Additional studies are planned in these areas.
Much progress has been made to date in removing or reducing thimerosal in vaccines. New pediatric formulations of hepatitis B vaccines have been licensed by the FDA, Recombivax-HB (Merck, thimerosal free) in August 1999 and Engerix-B (Glaxo SmithKline, thimerosal free) in January 2007. In March 2001 the FDA approved a second DTaP vaccine formulated without thimerosal as a preservative (Aventis Pasteur's Tripedia, trace thimerosal). Aventis Pasteur, Ltd was also approved to manufacture a thimerosal-free DTaP vaccine, Daptacel, in 2002. In September 2001 Chiron/Evans was approved for manufacturing a preservative-free formulation of their influenza vaccine, Fluvirin, that contained trace thimerosal. In September of 2002, Aventis Pasteur, Inc was approved to manufacture a preservative-free formulation of their influenza vaccine, Fluzone that contained trace thimerosal, and in December 2004, a thimerosal-free formulation of Fluzone was approved. Two Td vaccines are also available in preservative-free formulations, Aventis Pasteur Inc's Decavac, and Aventis Pasteur, Ltd's Td vaccine. Also, Aventis Pasteur Inc's DT vaccine is now available only in a preservative-free formulation. These changes have been accomplished by reformulating products in single dose vials that do not contain a preservative. At present, all routinely recommended vaccines for U.S. infants are available only as thimerosal-free formulations or contain only trace amounts of thimerosal (≤1 than micrograms mercury per dose), with the exception of inactivated influenza vaccine. Inactivated influenza vaccine for pediatric use is available in a thimerosal-preservative containing formulation and in formulations that contain either no thimerosal or only a trace of thimerosal, but the latter is in more limited supply; see Table 1. A more extensive tabulation of vaccines and thimerosal content may be found in Table 3.
The Safety Review of Thimerosal-containing Vaccines and Neurodevelopmental Disorders Conducted by the Institute of Medicine
In 2001, the Institute of Medicine convened a committee (the Immunization Safety Review Committee) to review selected issues related to immunization safety. [For more information regarding this committee, their charge, and their reports, find the link to IOM's Web site in "Related Links" below.] The IOM has, to date, completed reviews in two areas. The first review by this committee focused on a potential link between autism and the combined mumps, measles, and rubella vaccine. The second review focused on a potential relationship between thimerosal use in vaccines and neurodevelopmental disorders (IOM 2001). This latter issue was brought to the fore primarily as the result of the hypothesis, formulated by S. Bernard and others from Cure Autism Now, that autism is a novel form of mercury poisoning (Bernard et al. 2001); this hypothesis, linking autism to mercury, was based on a comprehensive review of the scientific literature on mercury toxicity.
In its report of October 1, 2001, the IOM's Immunization Safety Review Committee concluded that the evidence was inadequate to either accept or reject a causal relationship between thimerosal exposure from childhood vaccines and the neurodevelopmental disorders of autism, attention deficit hyperactivity disorder (ADHD), and speech or language delay. Additional studies were needed to establish or reject a causal relationship. The Committee did conclude that the hypothesis that exposure to thimerosal-containing vaccines could be associated with neurodevelopmental disorders was biologically plausible.
The Committee believed that the effort to remove thimerosal from vaccines was "a prudent measure in support of the public health goal to reduce mercury exposure of infants and children as much as possible." Furthermore, in this regard, the Committee urged that "full consideration be given to removing thimerosal from any biological product to which infants, children, and pregnant women are exposed."
In 2004, the IOM's Immunization Safety Review Committee issued its final report, examining the hypothesis that vaccines, specifically the MMR vaccines and thimerosal containing vaccines, are causally associated with autism. In this report, the committee incorporated new epidemiological evidence from the U.S., Denmark, Sweden, and the United Kingdom, and studies of biologic mechanisms related to vaccines and autism since its report in 2001. The committee concluded that this body of evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism, and that hypotheses generated to date concerning a biological mechanism for such causality are theoretical only. Further, the committee stated that the benefits of vaccination are proven and the hypothesis of susceptible populations is presently speculative, and that widespread rejection of vaccines would lead to increases in incidences of serious infectious diseases like measles, whooping cough and Hib bacterial meningitis.
The FDA is continuing its efforts to reduce the exposure of infants, children, and pregnant women to mercury from various sources. Discussions with the manufacturers of influenza virus vaccines (which are now routinely recommended for pregnant women and children 6-23 months of age) regarding their capacity to potentially increase the supply of thimerosal-reduced and thimerosal-free presentations are ongoing. Discussions are also underway with regard to other vaccines. Of note, all hepatitis B vaccines for the U.S., including for adults, are now available only as thimerosal-free or trace-thimerosal-containing formulations. In addition, all immune globulin preparations including hepatitis B immune globulin, and Rho(D) immune globulin preparations are manufactured without thimerosal. For additional information on the issue of thimerosal in vaccines, see Frequently Asked Questions (FAQs).
References
Agency for Toxic Substances and Disease Registry. Toxicological profile for mercury. Atlanta, GA: Agency for Toxic Substances and Disease Registry;1999.
Axton JMH. Six cases of poisoning after a parenteral organic mercurial compound (merthiolate). Postgrad Med J 1972;48:417-421.
Bakir F, Damlugi SF, Amin-Zaki L, Murtadha M, Khalidi A, Al-Rawi NY, Tikriti S, Dhahir HI, Clarkson TW, Smith JC, Doherty RA. Methylmercury poisoning in Iraq. Science 1973;181:230-241.
Ball LK, Ball R, Pratt RD. An assessment of thimerosal use in childhood vaccines. Pediatrics 2001;1147-1154.
Bernard S, Enayati A, Redwood L, Roger H, and Binstock T. Med. Hypotheses 2001, 56: 462-471.
Bernier RH, Frank JA, Nolan TF. Abscesses complicating DTP vaccination. Am J Dis Child 1981;135:826-828.
Blair AMJN, Clark B, Clarke, AJ, Wood, P. Tissue Concentrations of Mercury after Chronic Dosing of Squirrel Monkeys with Thimerosal. Toxicology 1975;3:171-1766.
Centers for Disease Control and Prevention. Notice to Readers: Thimerosal in Vaccines: A Joint Statement of the American Academy of Pediatrics and the Public Health Service. Morb Mort Wkly Rep 1999;48:563-565.
Cox NH, Forsyth A. Thimerosal allergy and vaccination reactions. Contact Dermatitis 1988;18:229-233.
Davidson PW, Myers GJ, Cox C, Axtell C, Shamlaye C, Sloan-Reeves J, Cernichiari E, Needham L, Choi A, Wang Y, Berlin M, Clarkson TW. Effects of prenatal and postnatal methylmercury exposure from fish consumption on neurodevelopment: Outcomes at 66 months of age in the Seychelles child development study. JAMA 1998;280:701-707.
Fagan DG, Pritchard JS, Clarkson TW, Greenwood MR. Organ mercury levels in infants with omphaloceles treated with organic mercurial antiseptic. Arch Dis Child 1977;52:962-964.
Federal Register, January 19, 1979;44;3990.
Federal Register. November 19, 1999;64:63323-63324.
Goncalo M, Figueiredo A, Goncalo S. Hypersensitivity to thimerosal: the sensitivity moiety. Contact Dermatitis 1996;34:201-203.
Grabenstein JD. Immunologic necessities: diluents, adjuvants, and excipients. Hosp Pharm 1996; 31:1387-1401.
Grandjean P, Weihe P, White RF et al. Cognitive deficit in 7 year old children with prenatal exposure to methylmercury. Neurotoxicol Teratol 1997;6:417-428.
Harada M. Minamata disease: Methylmercury poisoning in Japan caused by environmental pollution. Crit Rev Toxicol 1995;25:1-24.
IOM (Institute of Medicine). Thimerosal-containing vaccines and neurodevelopmental disorders. Washington DC: National Academy Press; 2001.
Lowell HJ, Burgess S, Shenoy S, Peters M, Howard TK. Mercury poisoning associated with hepatitis B immunoglobulin. Lancet 1996:347:480.
Magos L, Brown AW, Sparrow S, Bailey E, Snowden RT, Skipp WR. The comparative toxicology of ethyl- and methylmercury. Arch Toxicol 1985,57:260-267.
Mahaffey KR, Rice G, et al. An Assessment of Exposure to Mercury in the United States: Mercury Study Report to Congress. Washington, DC: U.S. Environmental Protections Agency; 1997. Document EPA-452/R097-006.
Mahaffey KR. Methylmercury: A new look at the risks. Public Health Rep 1999;114:397-413
Matheson DS, Clarkson TW, Gelfand EW. Mercury toxicity (acrodynia) induced by long-term injection of gammaglobulin. J Pediatr 1980: 97:153-155Moller H. All these positive tests to thimerosal. Contact Dermatitis 1994; 31:209-213.
Pfab R, Muckter H, Roider G, Zilker T. Clinical Course of Severe Poisoning with Thiomersal. Clin Toxicol 1996;34:453-460.
Powell HM, Jamieson WA. Merthiolate as a Germicide. Am J Hyg 1931;13:296-310.
Rohyans J, Walson PD, Wood GA, MacDonald WA. Mercury toxicity following merthiolate ear irrigations. J Pediatr 1994;104:311-313.
Simon PA, Chen RT, Elliot JA, Schwartz B. Outbreak of pyogenic abscesses after diphtheria and tetanus toxoids and pertussis vaccine. Pediatr Infect Dis J 1993;12:368-371.
U.S. Pharmacopeia 24, Rockville, MD: U.S. Pharmacopeial Convention; 2001.
Wilson GS. The Hazards of Immunization. New York, NY: The Athlone Press; 1967:75-84.
World Health Organization. Trace elements and human nutrition and health. Geneva: World Health Organization;1996:209.
Bibliography
Studies on Safety and Effectiveness of Thimerosal:
Batts AH, Narriott C, Martin GP, et al. The effect of some preservatives used in nasal preparations on mucociliary clearance. Journal of Pharmacy and Pharmacology 1989; 41:156-159.
Batty I, Harris E, Gasson A. Preservatives and biological reagents. Developments in Biological Standardization 1974;24:131-142.
Beyer-Boon ME, Arntz PW, Kirk RS. A comparison of thimerosal and 50% alcohol as preservatives in urinary cytology. Journal of Clinical Pathology 1979;32:168-170.
Gasset AR, Itoi M, Ishii Y, Ramer RM. Teratogenicities of ophthalmic drugs. II. Teratogenicites and tissue accumulation of thimerosal. Archives of Ophthalmology 1975;93:52-55.
Goldman KN, Centifanta Y, Kaufman HF, et al. Prevention of surface bacterial contamination of donor corneas. Archives of Ophthalmology 1978;96:2277-2280.
Keeven J, Wrobel S, Portoles M, et al. Evaluating the preservative effectiveness of RGP lens care solutions. Contact Lens Association of Ophthalmologists Journal 1995;21:238-241.
Naito R, Itoh T, Hasegawa E, et al. Bronopol as a substitute for thimerosal. Developments in Biological Standardization 1974;24:39-48.
Wozniak-Parnowska W, Krowczynski L. New approach to preserving eye drops. Pharmacy International 1981;2(4):91-94.

1 FDA's guideline is based in part on a maximum tolerable daily intake of 30 µg/day of methylmercury from the diet; for purposes of comparison this would translate to approximately 0.43 micrograms/kg/day for a 70 kg adult. The FDA recommends that pregnant women, women of childbearing age who may become pregnant, nursing mothers and young children do not consume certain kinds of fish that may contain high levels of methylmercury (i.e., shark, swordfish, king mackerel, and tilefish); see http://www.cfsan.fda.gov/~lrd/tphgfish.html
2 The WHO guideline is expressed as 3.3 µg/kg/week and has been converted to a daily dose for purposes of comparison.

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28.) Thimerosal Content of Vaccines Routinely Recommended for Children 6 Years of Age and Younger
===============================================================================
source: FDA
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Thimerosal Content of Vaccines Routinely Recommended for Children 6 Years of Age and Younger Vaccine Tradename
(Manufacturer) Thimerosal Status Concentration**(Mercury) Approval Date for Thimerosal Free or Thimerosal / Preservative Free (Trace Thimerosal)*** Formulation ===============================================================================
DTaP Infanrix
(GlaxoSmithKline Biologicals) Free Never contained more than a trace of thimerosal, approval date for thimerosal-free formulation 9/29/2000
Daptacel
(Sanofi Pasteur, Ltd.) Free Never contained Thimerosal
Tripedia
(Sanofi Pasteur, Inc.) Trace(≤0.3 µg Hg/0.5mL dose) 03/07/01
DTaP-HepB-IPV Pediarix
(GlaxoSmithKline Biologicals) Free Never contained more than a Trace of Thimerosal, approval date for thimerosal-free formulation 1/29/2007
DTaP-IPV/Hib Pentacel (sanofi pasteur Ltd.) Free Approved June 20, 2008, never contained thimerosal
DTaP-IPV KINRIX (Glaxo SmithKline Biologicals) Free Approved October 8, 2009, never contained thimerosal
Pneumococcal conjugate Prevnar
(Wyeth Pharmaceuticals Inc.) Free Never contained Thimerosal
Prevnar 13 (Wyeth Pharmaceuticals Inc.) Free Approved February 24, 2010, never contained thimerosal
Inactivated Poliovirus IPOL
(Sanofi Pasteur, SA) Free Never contained Thimerosal
Varicella (chicken pox) Varivax
(Merck & Co, Inc.) Free Never contained Thimerosal
Mumps, measles, and rubella M-M-R-II
(Merck & Co, Inc.) Free Never contained Thimerosal
Mumps, measles, rubella and varicella ProQuad (Merck & Co., Inc.) Free Approved September 6, 2005, never contained thimerosal.
Heptatitis A Havrix (GlaxoSmithKline Biologicals) Free Never contained thimerosal
Vaqta (Merck & Co., Inc.) Free Never contained thimerosal
Hepatitis B Recombivax HB
(Merck & Co, Inc.) Free 08/27/99
Engerix B
(GlaxoSmithKline Biologicals) Free 03/28/00, approval date for thimerosal-free formulation 1/30/2007
Haemophilus influenzae type b conjugate (Hib) ActHIB
(Sanofi Pasteur, SA)
OmniHIB
(GlaxoSmithKline) Free Never contained Thimerosal
PedvaxHIB
(Merck & Co, Inc.) Free Approval date for thimerosal free formulation 08/99
HIBERIX (GlaxoSmithKline Biologicals) Free Approved August 19, 2009, never contained thimerosal
Hib/Hepatitis B combination Comvax (Discontinued)
(Merck & Co, Inc.) Free Never contained Thimerosal
Seasonal Trivalent
Influenza
Fluzone (multi-dose presentation)
(Sanofi Pasteur, Inc.) 0.01% (12.5 µg/0.25 mL dose, 25 µg/0.5 mL dose)2
Fluzone (single-dose presentation)
(Sanofi Pasteur, Inc.)3 Free 12/23/2004
Fluvirin (multi-dose presentation)
(Novartis Vaccines and Diagnostics Ltd.) 0.01% (25 µg/0.5 mL dose)
Fluvirin (single dose presentation)
(Novartis Vaccines and Diagnostics Ltd.)
(Preservative Free) Trace (<1ug Hg/0.5mL dose) 09/28/01
Fluarix (single-dose presentation) (GlaxoSmithKline Biologicals) Free Approved 10/19/09, never contained thimerosal
Afluria (multi-dose presentation)
(CSL Limited)
0.01% (24.5 µg/0.5 mL dose)
Afluria (single-dose presentation) (CSL Limited) Free Approved 11/10/09, never contained thimerosal
Seasonal Influenza, live FluMist
(MedImmune Vaccines, Inc.) Free Never contained Thimerosal
Rotavirus RotaTeq (Merck and Co., Inc.) Free Approved February 3, 2006, never contained thimerosal
Rotarix (GlaxoSmithKline Biologicals) Free Approved April 3, 2008, never contained thimerosal
** Thimerosal is approximately 50% mercury (Hg) by weight. A 0.01% solution (1 part per 10,000) of thimerosal contains 50 µg of Hg per 1 mL dose or 25 µg of Hg per 0.5 mL dose.
*** The term "trace" has been taken in this context to mean 1 microgram of mercury per dose or less.
1 HibTiITER was also manufactured in thimerosal-preservative containing multidose vials but these were no longer available after 2002.
2 Children 6 months old to less than 3 years of age receive a half-dose of vaccine, i.e., 0.25 mL; children 3 years of age and older receive 0.5 mL.
3 A trace thimerosal containing formulation of Fluzone was approved on 9/14/02 and has been replaced with the formulation without thimerosal.
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