The Peer and the prick - vaccines and autism.
Lord Hodgson, who is sponsoring David Kirby’s speaking engagement at the Palace of Westminster, has made good use of his position in the House of Lords to question government ministers on vaccine safety. He is particularly interested in thiomersal/thimerosal and has even enquired after its use in cosmetics.
Lord Hodgson of Astley Abbotts asked Her Majesty’s Government:
- How many of the standard vaccinations that children receive in the United Kingdom contain thiomersal; for how many years these standard vaccinations have contained thiomersal; and what research has been carried out into the cumulative effects of the mercury content of thiomersal on infant children.[HL429]
Lord Hunt of Kings Heath replied:
Vaccines containing thiomersal (a mercury-containing compound known as thimerosal in the United States) have been in use for over 60 years. The only vaccines used in the routine United Kingdom childhood immunisation programme which contain thiomersal as an excipient in the final product are diphtheria, tetanus and whole cell pertussis (DTwP) and diphtheria and tetanus vaccines.
In 2001, the Committee on Safety of Medicines (CSM) reviewed the available data relating to possible neurotoxicity of thiomersal in vaccines and advised that there is no evidence of harm caused by doses of thiomersal in vaccines. The CSM concluded that the risk: benefit balance of thiomersal-containing vaccines remains overwhelmingly positive. The Institute of Medicine (IOM) in the United States also published a detailed review of the evidence relating to possible neurotoxicity of thiomersal in vaccines in October 2001. The IOM findings were consistent with the CSM conclusions.
We are aware of two new studies in the UK looking at the relationship between mercury in vaccines and neurodevelopmental disorders in children. One of these studies is funded by the Department of Health and uses the Avon Longitudinal Study of Pregnancy and Childhood. The other study is using the General Practice Research Database and is funded jointly by the World Health Organisation and the Public Health Laboratory Service (which receives its funding from the department). Neither of these studies supports an association between thiomersal exposure through the UK programme and neurodevelopmental disorders in children. The results of these studies have been made available to the department and a summary of the findings is available in a report to the US Congress which has been placed in the Library.
In addition to the above studies, evidence from a recent study by M Pichichero et al (published in the November 30 2002 Lancet) showed that giving vaccines containing thiomersal does not raise blood levels of mercury. The findings of this paper suggested that ethylmercury is rapidly eliminated from the blood after administration intra-muscularly. The levels of ethylmercury in the blood were no higher than in samples taken at birth—before any vaccines had been received.
Lord Hodgson of Astley Abbots asked Her Majesty’s Government:
- Whether each child will by its 16th week of life have received, as part of the standard diphtheria, tetanus and pertussis (DTwP) immunisation programme, 150 micrograms of thimerosal which, in turn, contain 75 micrograms of mercury; and, if not, how much each child will receive.[HL1023]
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath) replied:
The recommended vaccine for routine immunisation of children against diphtheria, tetanus and pertussis remains diphtheria, tetanus and wholecell pertussis (DTwP) vaccine. A course of primary immunisation with DTwP vaccine consists of three doses starting at two months, with an interval of one month between each dose. Each dose of the standard DTwP vaccine contains 50 micrograms of thimerosal (containing 25 micrograms of ethylmercury). Therefore, by 16 weeks the total thimerosal exposure would be no more than 150 micrograms (75 micrograms ethylmercury).
This is significant. In 2003 the exposure to thiomersal in the UK was the same as that in the USA in 1987. Then the USA added the thimerosal containing vaccines HIB and Hep-B to the infant vaccination schedule. These raised the exposure levels for ethyl mercury in 6 month old infants who were fully vaccinated from 75 micrograms to 187 micrograms. Throughout the 1990s recorded rates for autistic spectrum disorders rose both in the UK and in the USA. In fact the UK has consistently recorded higher rates compared to the USA. The headline figure in the US is currently 1 in 150. In the UK it is around 1 in 100.
Whatever the cause for the increase, one would expect it to be the same for two countries who share so many other features. Thiomersal is obviously not the reason for the increase in the UK. So why invoke it to explain the increase in the USA? And why is our noble lord so concerned to invoke thimerosal in the UK? This is even more pertinent when we consider Lord Hodgson’s next foray into the world of vaccines, which confirmed that the infant vaccine schedule in the UK is now thimerosal free.
Lord Hodgson of Astley Abbotts asked Her Majesty’s Government:
- What is the difference in cost between Pediacel and the vaccine currently in use.
The Parliamentary Under-Secretary of State, Department of Health (Lord Warner) replied:
Pediacel costs over £5 more per dose than the vaccines previously used.
Lord Hodgson of Astley Abbotts asked Her Majesty’s Government:
- Whether Pediacel will be the only form of vaccine available for the immunisation of children against diphtheria, tetanus, pertussis, HIB and polio, or will others be available on request.
Lord Warner replied:
For infants, Pediacel will be the only vaccine supplied by the National Health Service because it provides the best protection against these serious infections.
Lord Hodgson of Astley Abbotts asked Her Majesty’s Government:
- Whether the inactivated polio vaccine, part of the new five-in-one vaccine, is incompatible with the preservative Thiomersal.
Lord Warner replied:
Thiomersal is not a component of the new vaccines as it would render the inactivated polio vaccine component ineffective.
So there you have it. There was never very much thiomersal in the UK vaccine schedule and now there is none. Case closed. But two months later Lord Hodgson was back on the case.
Lord Hodgson of Astley Abbotts asked Her Majesty’s Government what they propose to do to increase the level of public trust in their vaccination and immunisation programme. The noble Lord said:
My Lords, the trigger for my decision to ask this Question was the Government’s sudden decision in August this year to introduce a new five-in-one child vaccine called Pediacel. Pediacel replaces the four-in-one vaccine previously used and adds polio to the diptheria, tetanus, pertussis and haemophilus influenzae type B—HIB—vaccine. The other critical by-product of the introduction of Pediacel has been the withdrawal of the preservative thimerosal which consists of 50 per cent ethyl mercury.
The withdrawal of a toxin as potentially harmful as that contained in thimerosal from infants’ vaccine, however small the amount contained therein, is a positive development on which the Government are to be warmly congratulated. However, I am not clear as to why this step was taken, if one is of a cynical turn of mind, in early August during the holiday season when minimum press comment could be expected.
He is still pursuing the argument that thiomersal was dangerous to health and had no place in childhood vaccines. He is implying that the government knew this all along and sneaked the thimerosal out of the vaccines in the same underhand way that they had originally sneaked it in. There follows a good bit of politicking on the same theme before he comes to the scientific evidence for thiomersal’s harmful nature
Most recently, a study by Doctors Hornig, Chian and Lipkin of Columbia University, published online on 8 June 2004 in the Nature publication, Molecular Psychiatry, indicated that postnatal exposure to thimerosal can lead to the development of autism-like damage in autoimmune disease susceptible mice. This reinforces previous studies, such as the works of Dr Mark and Dr David Geier, showing that a genetic predisposition in combination with certain environmental triggers can cause an increased risk of an adverse reaction.
I do not know who led Lord Hodgson to Mady Hornig’s infamous mouse study. It was probably the same person who introduced him to the Geiers’ less than monumental contribution to the literature of autism. I do not know if he actually read this tosh or was merely informed about it as part of a briefing. If he read it he was obviously not qualified to judge its merits. You might describe it as a failure of Peer review.
The noble lord then continues with his twin themes of government incompetence in undermining confidence in their own vaccine schedule and simultaneously implying that the schedule is not safe anyway. But this combination of politicking and scientificking is fundamentally dishonest. Lord Hodgson advocates for the sort of bad science that has had a demonstrable effect in undermining public confidence in vaccines on both sides of the Atlantic. He contributes to the scare stories and then admonishes the government for is ham-fisted response to those scare stories. He continues:
To a Written Question I put down on 22 January 2003, the noble Lord, Lord Hunt of Kings Heath, the Minister’s predecessor, answered that,
“there is no evidence of harm from thiomersal contained in vaccines. Therefore, the CSM advised that the benefits of immunisation with thiomersal-containing vaccines outweigh any potential risks of vaccination”.—[Official Report, 22/1/03; col. WA 101.]
Such responses exemplify the Government’s reaction to the thimerosal debate over the past two years. Until August this year the Government gave the impression that it was much ado about nothing and there was no reason for thimerosal to be withdrawn. In August, at the height of the holiday season, thimerosal was suddenly withdrawn.
Whether thimerosal does have an effect on certain autoimmune disease sensitive infants may be proved or disproved in times to come or there may never be a conclusive result. But what does matter is that the Government should maintain the highest degree of transparency and openness in their communications with the public in this important and sensitive area.
