Vaccine Information Statements (VISs) are produced by the CDC and help vaccine providers inform patients about the benefits and risks of the vaccines they are getting.
In fact, under the National Vaccine Childhood Injury Act, vaccine providers are required to give out a VIS before giving a vaccine, including those for:
Diphtheria, tetanus and pertussis containing vaccines (DTaP, DT, Td, and Tdap)
Haemophilus influenzae type b (Hib)
Hepatitis A
Hepatitis B
Human Papillomavirus (HPV)
Influenza (both Inactivated and Live, Intranasal vaccines)
MMR
MMRV
Meningococcal
Pneumococcal Conjugate (PCV13)
Polio
Rotavirus
Varicella
Unlike the package insert for a vaccine, “VISs are based on the ACIP’s recommendations, which occasionally differ from those made by the manufacturer. These differences may involve adverse events. Package inserts generally tend to include all adverse events that were temporally associated with a vaccine during clinical trials, whereas ACIP tends to recognize only those believed to be causally linked to the vaccine.” That makes the VIS a better tool to use when doing your research on a vaccine.
Although it was never actually linked to any real side effects, thimerosal (mercury) was removed from almost all childhood vaccines in 1999.
Thimerosal, a preservative, only remained in flu vaccines for a few years, but thimerosal free flu vaccines have been available since 2003.
That’s also the year that the remaining non-flu vaccines with thimerosal expired – January 2003.
And this year, at least “120 million doses of thimerosal-free or preservative-free influenza vaccine will be produced.” That means that over 75% of flu shots are thimerosal free, leaving only some multi-dose vials of flu shots to still have thimerosal, but making it easy to avoid if you want to.
Myth of Continued Exposure to Mercury in Vaccines
Although thimerosal was removed from vaccines in 1999, some anti-vax folks still claim that many vaccines contain mercury. Photo courtesy of Refutations to Anti-Vaccine Memes
Although most anti-vaccine groups have moved on to other conspiracy theories to scare parents, some still falsely claim that vaccines continue to be made with thimerosal and that thimerosal is dangerous.
Robert F. Kennedy Jr., for example, continues to claim that even though thimerosal has been removed from pediatric vaccines, “thimerosal levels remain virtually unchanged.” This is mostly, he claims, because of flu shots with thimerosal. Also, when a pregnant woman gets a flu shot, Kennedy claims that the fetus gets a bolus of thimerosal “that’s about 800 times the amount of mercury the CDC recommends.”
First, it is important to remember that the original concerns about thimerosal were because children who received a complete set of thimerosal containing vaccines (only hepatitis B, DTaP, and Hib ever had thimerosal) could get up to 187.5 micrograms of ethyl mercury by the time they were six months old, which exceeded the EPA limits for methyl mercury ingestion (but was less than the FDA limits). They aren’t the same type of mercury though, and thimerosal free versions of DTaP and Hib were already available in the late 1990s, so many kids likely got less than 187.5 micrograms of ethyl mercury.
Since thimerosal was removed from almost all vaccines beginning in 1999, that left flu vaccines as the main pediatric vaccine that still used thimerosal as a preservative. So did expanded flu shot recommendations for kids mean that they still got a lot of thimerosal over the years?
It is extremely unlikely that many kids have gotten each and every one of their yearly flu vaccines with thimerosal. It is more likely that they got just a few with thimerosal and the rest without, as thimerosal free flu vaccines became more widely available. After all, a flu vaccine with reduced thimerosal was available as early as 2002.
In 2003, thimerosal free flu shots became available and Flumist, a thimerosal free flu nasal spray vaccine was also approved. The supply of thimerosal free flu vaccines increased each and every year. For the 2014-15 flu season, over 100 million doses of flu vaccine are available that are thimerosal free or preservative free (with only trace amounts of thimerosal).
Even if kids did get flu vaccines with thimerosal each year though, would it matter? A 2008 study in Pediatrics, “Mercury Levels in Newborns and Infants After Receipt of Thimerosal-Containing Vaccines,” found that the half-life of ethyl mercury was about two days, “suggesting that exposure to thimerosal-containing vaccines does not result in an accumulation of mercury in blood.” And the highest blood level they found was less than 5-8 nanograms/ml, which is far less than the 187.5 micrograms that anti-vax groups continue to talk about, even in infants who had already received a cumulative dose of 162.5 micrograms of thimerosal.
A 2010 study in Pediatrics, “Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism,” found that “prenatal and early-life exposure to ethylmercury from thimerosal-containing vaccines and immunoglobulin preparations was not related to increased risk of” autism spectrum disorders. Two other studies have also found that prenatal exposure to thimerosal from immunoglobulin preparations, like Rho(D) immune globulin, during pregnancy were not associated with an increased risk for autism.
And also consider that fewer than 15 to 30% of pregnant women got flu shots before 2009. After 2009 and the H1N1 pandemic, rates did increase, but only to about 38 to 52%.
Although current recommendations don’t state a preference for the type of flu shot for pregnant women, it is likely that at least some of them got thimerosal free flu shots. In California, for example, since the passage of their Mercury Free Act in 2006, pregnant women and children younger than age 3 years have to get vaccines that are ‘mercury free.’
What To Know About Thimerosal in Vaccines
Thimerosal is a preservative that was removed from vaccines beginning in 1999, which means that most teens today got little or no exposure to thimerosal from vaccines.
