July 9, 1999
Here’s guidance on questions about mercury in vaccines
News reports this week on removal of mercury from vaccines
may cause your patients to avoid immunizing their babies—putting children at
high risk for diseases.
The Food and Drug Administration is asking the
pharmaceutical industry to remove mercury from vaccines or reduce the amount of
it in vaccines because of a minimal, if any, risk to babies’ health.
Some parents may draw wrong conclusions about the FDA
action.
“The risk of devastating childhood diseases from failure
to vaccinate far outweighs the minimal, if any, risk of exposure to cumulative
levels of mercury in vaccines,” says U.S. Surgeon General David Satcher, M.D.,
Ph.D., a family physician.
The Public Health Service is asking family physicians for help in setting parents straight. Some tips:
First, thimerosal, containing mercury, is the most widely used
preservative in vaccines. It helps prevent bacterial contamination when vaccine
vials are
opened.
Second, thimerosal leaves the body over time.
Third, no known harm has occurred from vaccines used in
the United States, but due to theoretical concerns, vaccines in the future will
be made according to a broader measure of safety.
Fourth, the current immunization schedule should be
followed, with exceptions for the first dose of Hepatitis B vaccine. Namely:
For infants born to Hepatitis B surface antigen-negative
women, the first dose of Hepatitis B vaccine should be given at two to six
months of age (the current schedule calls for the vaccine between birth and two
months of age).
This shift in schedule may be temporary, lasting until
Hepatitis B vaccines without thimerosal are available.
Preterm infants born to HBsAg-negative mothers should receive
hepatitis B vaccine when they reach term gestational age and a weight of at
least 2.5
kilograms.
Current recommendations should be followed regarding the
immunization of infants of HBsAg-positive mothers or of mothers whose status is
not known.
In populations in which HBsAg screening of pregnant woment
is not routinely performed, vaccination of all infants at birth should be
maintained, as currently recommended.
The above guidance, developed by the Public Health Service and
the American Academy of Pediatrics, was approved by the AAFP in early July.
The Recommended Childhood Immunization Schedule for the
year 2000 likely will include a new recommendation for vaccinating children
against polio.
The schedule is expected to encourage physicians to offer
the injected polio vaccine for all immunizations, instead of the previously
recommended series of two injected and two oral doses of the vaccine.
The change is in line with recent recommendations of the
Centers for Disease Control and Prevention’s Advisory Committee on Immunization
Practices, which develops the annual immunization schedule with the AAFP and
American Academy of Pediatrics.
The ACIP recently announced its recommendation for an
all-injected vaccine, generating extensive news coverage. As the ACIP debated
the issue over the last couple of years, the AAFP was skeptical, concerned that
parents would object to having their children receive as many as four shots in
one visit.
However, studies now show that parents are comfortable
with the injected series, so the AAFP Board authorized support for the new
recommendation in June.
ALL
INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.