October 5, 2001

Louis Z. Cooper, MD

President – Elect

The American Academy of Pediatrics

141 Northwest Point Boulevard

Elk Grove Village, IL 60007-1098

RE:  Safe Minds Response to AAP Press Release Concerning IOM Report on Thimerosal in Vaccines

Dear Dr. Cooper:

The American Academy of Pediatrics stance on the Institute of Medicine review of thimerosal containing vaccines and neurodevelopmental outcomes (AAP press release of October 1, 2001) left me wondering if we had read the same report.  Pediatricians pay sizeable dues to be members of the American Academy of Pediatrics and rely on your organization to keep them up to date on research and policy that impact their practice. In my opinion, the 55,000 members of AAP deserve a refund.

I find the views expressed in the AAP press release to be directly misleading to pediatricians, other physicians, and to the American public.  The highlights of the IOM report were (a) there is insufficient evidence to support or refute the safety of thimerosal in vaccines; (b) the association between thimerosal and neurodevelopmental disorders is biologically plausible; (c) thimerosal should be removed from medical products; and (d) further research is necessary. Instead of relaying these balanced set of facts, your press release focused on these misleading statements:

·         It quotes only one line from the IOM report: “No evidence currently exists that proves a link between thimerosal-containing vaccines and autism, attention deficit hyperactivity disorder and speech and language delay”; and then takes that quote out of the context in which it appeared by concluding that: “’Parents should be reassured about the safety of vaccines’, according to AAP President Elect Louis Z. Cooper, MD.  ‘Children should be immunized according to the recommended age-appropriate schedule.’”

·         In actuality, the IOM report states in the Executive Summary (page 3): “The committee concludes that although the hypothesis that exposure to thimerosl containing vaccines could be associated with neurodevelopmental disorders is not established, and rests on indirect or incomplete information, primarily from analogies with methyl mercury and levels of maximum mercury exposure from vaccines given in children, the hypothesis is biologically plausible.”  As you well know, acknowledging biological plausibility is the first step necessary in establishing a causal relationship.

·         The report goes on to state (page 4): “The evidence is inadequate to accept or reject a causal relationship between exposure to thimerosal from vaccines and the neurodevelopmental disorders of autism, ADHD, and speech and language delay.”  It is not surprising that the large case controlled studies that are necessary, according to IOM standards, to either prove or disprove causality have not yet been done.  This issue surfaced two years ago at FDA and none of the logical funding agencies have allocated the time or resources to complete the required investigations. The IOM strongly recommended that such studies be undertaken. Toxicokinetic and treatment studies were also recommended – details not touched on in your media release.

·         The comment made by AAP that “children should be immunized according to the age-appropriate schedule” was not even an issue addressed by the report. The question was if children should be receiving mercury in their vaccines and the answer was a resounding no.  “The committee recommends the use of thimerosal-free DTaP, Hib and Hepatitis B vaccines in the United States, despite the fact that there might be remaining supplies of thimerosal-containing vaccine available.” (page 7) 

The American public, partially due to advances on the Internet, is now able to access documents like the IOM report and read the findings themselves.  They will no longer tolerate “cherry picking” of reports to portray a false sense of security.  The AAP may fear that if parents are given the truth about the safety of thimerosal, some may opt to forgo vaccination.  What AAP does not seem to understand is that the real risk to long term immunization levels lies in misleading the public by not correctly portraying the facts – it is the systematic distortion of the truth by official, “prestigious” organizations which erodes the publics trust in our vaccine program and puts our children’s health in jeopardy. 

The AAP portrayal of the IOM findings is inconsistent with the widespread media coverage of the report.  Your statement may thus create an even greater rift between parents and their physicians, since parents are reading the news articles and pediatricians are relying on AAP to keep them informed.  Additionally, you risk undermining your credibility among many of your own members, since physicians also read the newspapers and they can read the IOM report themselves on the IOM website.  A study conducted over a year ago and mentioned in the IOM report (Freed, 2000) found that 24% of family physicians and 13% of pediatricians agreed that “I am more concerned about vaccine safety as a result of thimerosal issues.” You can now count on those numbers rising even higher as organizations such as yours conduct spin campaigns to hide the facts. 

Thimerosal in vaccines is a serious issue which must be addressed with good science and accurate reporting of the facts. With estimates that 17% of children today under the age of 18 suffer with one or more learning, developmental or behavioral disabilities, the last thing a parent should feel is reassured - especially those parents whose children received multiple thimerosal containing vaccines and now suffer with a broad range of learning disabilities.

Shame on you AAP!

Sincerely,

Lyn Redwood, RN, MSN, CRNP

President, SAFE MINDS