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Infant: H1N1 flu vaccine now or wait for preservative-free version
October 23, 2009 1:15 PM   Subscribe

Is it worth delaying H1N1 swine flu vaccination for an 8-month-old infant to get the preservative-free version?

As for me, shoot me up, whatever, go nuts. But I wonder about the wee one and the higher concentration of thimerosal she would get due to her tiny mass and two shots to my one. Is it worth delaying until we can be sure we're getting the preservative free version? What are the facts and numbers driving the answer?

I understand there's no established link for autism. I get that. But mercury is still best avoided when feasible, so does the current pandemic change the definition of "feasible"?

NaturalNews-type scaremongering will be disregarded, so don't bother with that. Thanks.
posted by NortonDC to Health & Fitness (52 answers total) 3 users marked this as a favorite
 
How long would you be delaying? What are disease rates in your area and among her peers? What are the outcomes for infants who get the CURRENT vaccine vs. those who don't?
posted by chesty_a_arthur at 1:24 PM on October 23, 2009


Since few of us are physicians, let alone pediatricians or medical epidemiologists, I can only tell you what I would tell my daughters re: my grandchildren. Get the vaccinations. Since there is no evidence of any adverse effects from the preservatives ( 100's if not 1,000's of studies all over the world) but clear and compelling evidence of severe illness and death from H1N1 (rare but statistically predictable) get the shot. Are "wee ones" eligible for the preservative free? Isn't that the nasal vaccinations by partially live viruses. BTW, I have nothing agains partially luve viruses.
posted by rmhsinc at 1:27 PM on October 23, 2009


In addition to chesty_a_arthur's questions, I'd consider if my 8-month-old was in daycare or another group situation and whether his/her caregivers (including parents) were being immunized.

What does the pediatrician say about preservatives vs. preservative-free?

My 17-month-old got the first of her preservative-free swine flu shots this past week. It is out there, but our doctor only had 100 doses and was rationing them for those under 2 plus the parents of children six months and younger. If this really bothers you, can you get into another doctor's office?
posted by FergieBelle at 1:32 PM on October 23, 2009


I am 100% sympathetic with your concerns. Unfortunately, the themerisol free version is the nasal spray version, which is made from live virus and is therefore not recommended for children under 2 (who have less developed immune systems). See CDC guidelines.
posted by serazin at 1:34 PM on October 23, 2009


There is absolutely no evidence of any sort of damage from thiomersal. There is simply no reason to avoid it. Simply saying "mercury is to be avoided" implies that you should never use fluorescent lights, batteries, or some light switches.

The answer is absolutely, unequivocally, and undeniably, "vaccinate your child immediately unless you have a pediatrician-sourced reason not to."
posted by saeculorum at 1:37 PM on October 23, 2009 [3 favorites]


chesty_a_arthur:
1. The delay is unknown. Supplies are tight. Our county currently doesn't even have any vaccine appropriate for kids under 24 months.

2. What does the current disease rate matter when it takes 38 days to reach full protection for infants on a two-shot treatment course?

3. I don't know. Do you have an answer?

rmhsinc: Yes, single-shot preservative free doses appropriate for children from 6 to 24 months have been manufactured, but delivery and availability aren't clear yet.

serazin, the H1N1 vaccine is being manufactured in single-dose preservative free injection form.
posted by NortonDC at 1:39 PM on October 23, 2009


You should consideration the scarcity of vaccines. Massachusetts, for example, has received less than 10% of the number of 2009 H1N1 vaccines that we are supposed to get. (That rate is for infant + adult, I think, not sure of the breakdown.) These are going to be in short supply. I imagine it is possible that you might miss out on any chance to vaccinate your daughter if you wait.
posted by teragram at 1:40 PM on October 23, 2009


You should really read this. Don't listen to crazy logic from non-scientists. It's easy to fall into it, but you have to resist and use facts as your guide.
Twelve epidemiological studies have found no data that links the MMR (measles/mumps/rubella) vaccine to autism; six studies have found no trace of an association between thimerosal (a preservative containing ethylmercury that has largely been removed from vaccines since 20011) and autism, and three other studies have found no indication that thimerosal causes even subtle neurological problems. The so-called epidemic, researchers assert, is the result of improved diagnosis, which has identified as autistic many kids who once might have been labeled mentally retarded or just plain slow. In fact, the growing body of science indicates that the autistic spectrum — which may well turn out to encompass several discrete conditions — may largely be genetic in origin. In April, the journal Nature published two studies that analyzed the genes of almost 10,000 people and identified a common genetic variant present in approximately 65 percent of autistic children.
posted by Mach5 at 1:46 PM on October 23, 2009 [3 favorites]


I would vaccinate sooner than later. I just had to call 4 places this Monday in order to find a drugstore that still had the seasonal flu vaccine in stock, and it's only October. (I did finally find it, and I got all shot up on Tuesday.) If you can snag the H1N1 vaccine now for your child, I'd jump at it.
posted by spinifex23 at 1:47 PM on October 23, 2009 [1 favorite]


As others have said, just because crazy-ass-crazy people tell you something is dangerous doesn't make it so. There have been ass-loads of studies that says these things are safe, and shit loads of people have been vaccinated and not developed crazy-ass diseases, including a bunch of babies.

I like this infographic about the HPV vaccine.

NYT article about the Flu Vaccine. They mention that a tuna fish sandwich will have more mercury in it than the vaccine. Not that you're feeding your baby tuna, but i'm guessing the dosage isn't harmful. It's not like doctors want to hurt your baby.
posted by chunking express at 1:53 PM on October 23, 2009 [2 favorites]


Thanks for the concern in your autism answers, but that's really not what's driving my question. I'm not worried about autism. I get that it's doesn't come from vaccinations. Plus, she's a girl and therefore has a fraction of the already tiny risk that boys have anyway.

I get it.

It's about balancing the value of minimizing her exposure to mercury in general versus the timeliness of vaccination, and looking for ways to weigh those competing concerns.

Thanks.
posted by NortonDC at 1:53 PM on October 23, 2009


Say it with me: ethylmercury is NOT methylmercury.
posted by squorch at 1:57 PM on October 23, 2009 [2 favorites]


Repeated studies have shown thimerosal to be safe.
posted by chunking express at 1:59 PM on October 23, 2009 [3 favorites]


From what I have heard, and I am not an epidemiologist, there is little to no evidence that thiomersal causes harm. Eliminating it from most childhood vaccines was precautionary but probably unnecessary.

However, 2009 H1N1 flu will kill some infants this year. You may have a shot at a vaccine later, but you really may not. I'm a healthcare worker and I haven't gotten mine yet. I'd go with vaccinate.
posted by teragram at 1:59 PM on October 23, 2009 [2 favorites]


It really comes down to a question of relative risk. The preservatives appear to be largely safe, but you're right to think that avoidance of mercury-based compounds, when possible, is prudent. That's why most children's vaccines are now made without thiomersal.

But these are not ordinary circumstances. Infants are among those at highest risk for hospitalization, complications, and death stemming from H1N1 infection, and the preliminary numbers are quite sobering. Currently, the CDC is reporting infant hospitalization rates typically only seen during the peak of an ordinary flu season. Nothing certain, but things will probably get a lot worse.

You also should consider the fact that vaccination doesn't just benefit your child: it benefits you, the rest of your family, your child's peers, and others in your community. Vaccination doesn't guarantee anything, but it will lessen your child's risk, and lessen the risks of others coming into contact with your child.

Every medical procedure -- even super safe ones like vaccination -- carry some risks, and I won't fault any parent for being concerned. But the evidence is overwhelmingly on the side of taking the vaccination you can get as soon as you can get it.

Best of luck.
posted by j-dawg at 2:00 PM on October 23, 2009 [3 favorites]


Oh yeah, and you're helping to protect <6 month old infants who are too young to be vaccinated.
posted by teragram at 2:01 PM on October 23, 2009 [1 favorite]


There has never been a proven risk of anything from thermisol exposure. Please don't assume we're only talking about autism. Again, I have to point out that if you're so concerned about mercury, get rid of all your fluorescent lights and the thermostat for your air conditioning system. Of course, don't even think about feeding tuna or high fructose corn syrup to your child. All of these expose your child to much more mercury than in a vaccine, which is on the order of tens of micrograms.
posted by saeculorum at 2:02 PM on October 23, 2009 [1 favorite]


Disease rates could matter, because the sooner she is immunized, the safer she will be in highly infectious areas, I'd imagine (And so would immunocompromised folks, like kids on chemo, who depend on herd immunity) - if she's in a large daycare for example, it might be worth getting the shot now - and as to, what's the big deal on timing, a few days can make a big difference, if one day she's exposed and the other she is not. Unfortunately, I know you don't know that in advance - but if she's exposed to a lot of the public, maybe it's better to go now.

The CDC agreed that thimerosal should be removed from vaccines because mercury can pose a neurotoxicity risk - but not in the doses you find in the vaccines, and prior to that call, there was no evidence found that the thimerosal caused mercury poisoning in recipients. Here is the link to the CDC study on mercury related issues. It's not a perfect study - but it is reassuring nonetheless. To me, that reads that there's no harm in getting the shot now, and the good that could come from it is earlier immunity for your daughter and those she's around who might depend on her (not that the latter is likely a big factor, but it is one I personally think about).
posted by mccn at 2:02 PM on October 23, 2009


NortonDC, I feel pretty much the same way as you about vaccines. I don't think they cause Autism, but I do think it is preferable and smart to get the preservative-free versions for little ones. I have a 5 month old and a 2 year old, who are both in daycare. I am high-risk (asthma), so I really want those swine flu vaccines asap. Unfortunately I am in a position where my doctor and the pediatrician are not getting the vaccines for another 3 weeks.

So my personal opinion is that if I were in your shoes, I would take the vaccines now, since they are available. The gamble is - risk exposure while waiting for preservative free or risk unknown side effects (possibly long term?) by taking the currently available shot. I think the chances of you and your family being exposed are much greater than the chances of something adverse happening. Add to that, the risk that you won't be able to get the preservative-free ones later due to shortages, I think its better to take what's available now.
posted by Joh at 2:02 PM on October 23, 2009


or risk unknown side effects (possibly long term?) by taking the currently available shot

Except, as others have said, this really isn't a risk in the same way getting the flu is. It's certainly possible that all sorts of doctors and scientists are wrong about thimerosal in vaccines and the harm it may cause, but it's probably very unlikely. On the other hand, there are people catching swine flu and getting very sick or dying right now. Real people. It's disingenuous to conflate the two. They aren't in the same league of risk at all.
posted by chunking express at 2:09 PM on October 23, 2009


This article from Factcheck.org, seems to think it's safe. There's a whole discussion of thimerisol in the article.
posted by otherwordlyglow at 2:52 PM on October 23, 2009


saeculorum, we don't feed our infant daughter tuna, we don't feed her HFCS, we did switch out the CFLs with conventional lamps in the rooms she frequents, and I did replace the mercury switch thermostat with a solid state model before she was on the scene. Really. And yes, thimerosal absolutely has been shown to be toxic at high enough exposure levels.

And if someone has misgivings about me swapping out the CFLs, well that's just too bad for now, but the real solution will have to wait until consumer LEDs quit sucking.

Thanks for the thoughtful answers, folks. I appreciate hearing the analysis of others considering this tradeoff. Thanks for sharing your attention and time with me.
posted by NortonDC at 2:58 PM on October 23, 2009 [1 favorite]


The answer is absolutely, unequivocally, and undeniably, "vaccinate your child immediately unless you have a pediatrician-sourced reason not to."

I was talking about H1N1 with my boss, who told me surprisingly that his family's pediatrician is refusing to give the H1N1 vaccine to any of their patients, citing safety concerns. I was completely thrown for a loop. Is this even legal?

Nothing I could say dissuaded him. Not that I blame him, I mean I'm not a doctor, but come on.
posted by odinsdream at 3:22 PM on October 23, 2009


chunking express - you'll notice I used the word "unknown" and a question mark after the phrase "long-term effects". These linguistic devices are used to express the concept of uncertainty. In my opinion, we don't truly know if there are any problems, or what they might be, if they even exist. You yourself even said "it's probably very unlikely". So you aren't 100% certain then? No, neither am I, which is why I consider it when I have the option of thimerosol free shots. I am pro-vaccine, but cautious, not the anti-vaccine person you seem to be trying to make me out to be.

Also, it is not at all disingenuous to conflate the two risks, since that was essentially the question the OP asked.
posted by Joh at 4:24 PM on October 23, 2009


3. I don't know. Do you have an answer?

Not a study -- I poked around a little bit but I didn't see anything in non-doctor language describing a comparison of outcomes; I don't know how the trials were/are structured.

Here's how I'm thinking about it: I do know that H1N1 can and does kill little kids, and thimerosal has not been proven (despite many efforts) to do them any harm in the doses present in vaccines; the vaccine, even if only somewhat effective, therefore seems like a must-have for my 2-year-old, and a thimerosal-free one a nice-to-have. Since waiting for the nice-to-have might cost the must-have, I am not going to wait.
posted by chesty_a_arthur at 5:45 PM on October 23, 2009


I would absolutely advise getting the vaccine that is available to you. Exposure to mercury in various forms is unavoidable for people living on planet Earth. Ethylmercury is a form of mercury that is eliminated from the body quickly and there has never been the slightest hint that it causes harm even in newborns. H1N1, on the other hand, is a known killer.
posted by lakeroon at 6:46 PM on October 23, 2009 [2 favorites]


And yes, thimerosal absolutely has been shown to be toxic at high enough exposure levels.

One vaccine does not contain toxic concentrations of thimerosal. Thirty or forty within a couple of days might, maybe, but definitely not one. And unless you break lightbulbs and thermostats all the time I'm really not seeing any compelling safety reasons for you to have switched out for mercury-free alternatives there either.

Your infant getting that vaccine has a chance of not only saving that child's life, but raising herd immunity and saving other children's lives as well. There is absolutely no evidence for any vaccine ever causing harm from thimerosal, ever. If that's your only concern, then you have no reason to put it off.
posted by sandswipe at 8:58 PM on October 23, 2009 [2 favorites]


I think all you are going to get here are links to sites that support what that user believes. Everyone will give you links to prove their own point, thus biasing all the links. I think I understand where you are coming from on this, and I don't really have an answer. I don't believe that thimerosol/vaccines cause autism, but I still don't want unnecessary crap and preservatives in my child.

I think the best you can do is consult with a couple of pediatricians to determine your best course of action. Obviously supplies are probably going to be limited and that will have to play into your decision.

Good luck, I have also been dealing with this question for my own child. His vaccines thus far have been delayed and well-planned and this is something that will take some good research of your own.
posted by Lullen at 9:30 PM on October 23, 2009


I think all you are going to get here are links to sites that support what that user believes. Everyone will give you links to prove their own point, thus biasing all the links.

That's not a fair way to phrase it, since links that disprove any link to therimisol and illness are backed by real science, and links that say it might be a problem are backed by zero science whatsoever. Science is not a matter of opinion. Statistics aren't a matter of opinion: Statistically, without the vaccine, your child runs and actual risk of getting H1N1, and that carries with it an actual, demonstrable risk of death. No similar risk exists for the vaccine.
posted by Astro Zombie at 11:24 PM on October 23, 2009 [2 favorites]


I was talking about H1N1 with my boss, who told me surprisingly that his family's pediatrician is refusing to give the H1N1 vaccine to any of their patients, citing safety concerns. I was completely thrown for a loop. Is this even legal?

Wow, a friend of a friend just got the same response from her pediatrician here in L.A. -- he's refusing to give the H1N1 vaccine to anyone (adults or children, in high-risk categories or not), and is strongly advising his entire staff not to get vaccinated either. We were wondering the same thing re: the legality of this. And then I put my head down on my desk and despaired.

posted by scody at 2:28 AM on October 24, 2009


That's not a fair way to phrase it, since links that disprove any link to therimisol and illness are backed by real science, and links that say it might be a problem are backed by zero science whatsoever. Science is not a matter of opinion. Statistics aren't a matter of opinion: Statistically, without the vaccine, your child runs and actual risk of getting H1N1, and that carries with it an actual, demonstrable risk of death. No similar risk exists for the vaccine.

Some of us have a lot of issues with preservatives in vaccines and we don't want our kids pumped with unnecessary chemicals. Some people don't mind it and find that the vaccine is worth it. People on both sides can easily come up with evidence to back up why they are right. The point is that everyone has to do what they feel comfortable with, and we can't answer that for the OP.
posted by Lullen at 6:26 AM on October 24, 2009


we can't answer that for the OP

True, but the OP was asking for guidance in making this decision. My guidance is, I'd rather have my kid "pumped with" unnecessary chemicals, to the tune of a less mercury than you find in a tuna sandwich and has been repeatedly demonstrated to be about as safe as anything that's going to go into my child's body, than have my child pumped with H1N1, which is statistically far, far more dangerous.
posted by Astro Zombie at 7:36 AM on October 24, 2009 [1 favorite]


Also, it is not at all disingenuous to conflate the two risks, since that was essentially the question the OP asked.

Except one is an actual risk, and one is 'risk' not backed by any science whatsoever. And this has been pointed out several times. I get the sense the OP already knows what she wants to do.
posted by chunking express at 8:19 AM on October 24, 2009 [1 favorite]


There is no well-documented risk from thimerosal. There is well-documented risk of illness and even death from H1N1. H1N1 is quite widespread. For every unprotected person who is at high risk of catching H1N1, there's also the risk that that person will spread H1N1

Balance the risk. Very small risk of harm from thimerosal vs. medium risk of your child getting H1N1 vs. very small risk of serious harm to your child from H1N1. I honestly don't believe thimerosal is harmful.

In the case of H1N1, unlike, say, measles, I'm not sure there's any social burden. I don't think an un-H1N1-vaccinated child poses the same risk an un-measles-vaccinated child does, and H1N1 vaccine is in very short supply. If you decline it, someone else will want it. You aren't declining other vaccines, are you? Please don't.
posted by theora55 at 9:27 AM on October 24, 2009 [1 favorite]


theora55, I asked about the flu shots because they are unique among the shots broadly recommended for children in that they do contain significant amounts of thimerosal.

Three rapid-succession shots with significant amounts of thimerosal (seasonal and the 2-shot H1N1 course) did make me concerned enough enough to ask this question regarding the value of waiting for the preservative-free variety of shot.
posted by NortonDC at 4:54 PM on October 24, 2009


Some of us have a lot of issues with preservatives in vaccines and we don't want our kids pumped with unnecessary chemicals. Some people don't mind it and find that the vaccine is worth it. People on both sides can easily come up with evidence to back up why they are right. The point is that everyone has to do what they feel comfortable with, and we can't answer that for the OP.

This is not an "agree to disagree" issue. On the "get vaccinated" side of the issue we have evidence-based science, which works because it proves or disproves hypotheses without relying on opinion or feelings. On the "preservative scare-mongering" side of the issue there is hand-waving, but no facts, and no evidence.

While it might appear at first logical and reasonable to say "Well, you never can be too safe with kids!" that's not actually the case here. Evidence is not "this website agrees with me." Evidence is a specific, scientific term.
posted by odinsdream at 6:01 PM on October 24, 2009 [3 favorites]


Thank you for your answer, odinsdream, but please remember that my question is not whether or not to vaccinate, but whether or not to aim for the mercury-free variety of vaccine at the possible cost of a delay in vaccination. Both answers are "get vaccinated."

My intense desire is to vaccinate my daughter to protect her. My concern arises from the fact that protecting her from the swine and seasonal flus seems to mean giving her three of the only shots still containing real amounts of mercury, within a month. The articles I read (linked in here, thank you all) indicate that thimerosal is safe at the level found in one shot. Those articles lack quatitative measures, making it hard to tell how close the exposure level of multiple shots is to the exposure level of the one shot they endorse.
posted by NortonDC at 8:44 AM on October 25, 2009


Norton, I didn't intend it as snark. I believe the risk from thimerosal is small, and the risk from H1N1 is hard to gauge. There's risk on both sides, so it's about balancing the risk. If I were making the decision for my young child, I'd make sure he got the vaccine, as soon as possible. My son's in his early 20s and did get it.
posted by theora55 at 6:54 PM on October 25, 2009


My intense desire is to vaccinate my daughter to protect her. My concern arises from the fact that protecting her from the swine and seasonal flus seems to mean giving her three of the only shots still containing real amounts of mercury, within a month.

I went ahead and had all 3 of mine(ages 9, 5, and 4)done yesterday. They got the nasal mist, but had it come right down to it, if only the injection had been available, I'd have had that done....for the same reasons listed by other posters above.

From what I learned last night, the H1N1 should be followed up with a booster in 30 days. So it would be 3 shots in a month, which shouldn't be a problem, although obviously IANAD and you should of course check with yours.

But I do know that if I was in a similar situation, I'd go with the H1N1 vaccine over the seasonal vaccine this year. Again, for the reasons listed by other posters. 1,000 deaths so far, 100 of them have been kids, and it's only October. It's not even *really* flu season yet. Not a pair of dice I care to roll if I don't have to.
posted by spirit72 at 12:04 PM on October 27, 2009


The New Plague:
What has led to this new epidemic of fear? The answer is complex, involving a convergence of multiple factors: a lack of understanding of how science works, mistrust in medicine in general and in expert advice even more generally, mistrust in government oversight and the pharmaceutical industry, and a growing counter-culture trend, particularly in more highly educated socio-economic populations. The most common vaccine concerns can be summarized as follows:

1. Vaccines have been linked to autism – While this is true, vaccines have been linked to autism, they don’t actually have anything to do with autism. I will not tackle this myth here, but suffice it to say, not a single shred of valid scientific evidence has ever been put forth to support a causal link between vaccines and autism. However, volume upon volume of excellent, peer-reviewed data has unequivocally shown no such a linkage [for a complete set of references, see the references section of this post from the Science-Based Medicine blog].

2. Vaccine ingredients, like thimerosal, aluminum, squalene, and others can lead to immunological and neurological consequences in infants – Again, no valid data exists to support such a belief, and the existing science points us in the opposite direction.

3. Too many vaccines can overwhelm an infant’s immune system, leading to a host of disease conditions – This is absurd on its face to anyone familiar with basic immunological principles. All of the childhood vaccines combined, are but a mere drop in the bucket compared to the immunological challenges an infant faces every day. Not only can an infant’s immune system easily handle the combinations recommended in the routine schedule, but the number of immunologic stressors, if you will, contained in the current schedule (that enormous, and growing list the anti-vaccine community complains so much about) has actually been decreasing due to improved vaccine technologies [2].
posted by chunking express at 1:24 PM on October 27, 2009 [2 favorites]


Thank you for taking the time to respond again, chunking express. As this askme has progressed it has helped me to refine and narrow my question, to this: what are the health effects of injecting three flu-shot doses of thimerosal into an 18-pound infant in side of 30 days?

I don't see you answering that question. I am trying to answer that question, but I'm having trouble finding quantitative information on the exposure levels (blood concentrations?) shown to be safe with thimerosal and how the blood level of three shots in 28 days into an 18 pound infant compares to what is known to be safe.

Can you answer my question, chunking express? That would be very helpful.

Once that's established, then if the blood levels are outside what's been established as safe, then how do the risks compare to the reduction in flu risk they would be granting?
posted by NortonDC at 10:24 AM on October 28, 2009


Can you answer my question, chunking express? That would be very helpful.

No. I'm not a doctor. Sorry. What was your doctors take on things? I don't think you've mentioned that here. I emailed my cousin who is a doctor about this. My guess is you won't listen to her opinion on this either.

If you don't want to give you baby a shot, just don't. Asking people for their opinion and then continuing to ignore it seems like a waste of everyones time.
posted by chunking express at 11:44 AM on October 28, 2009 [1 favorite]


Twelve epidemiological studies have found no data that links the MMR (measles/mumps/rubella) vaccine to autism; six studies have found no trace of an association between thimerosal (a preservative containing ethylmercury that has largely been removed from vaccines since 2001) and autism, and three other studies have found no indication that thimerosal causes even subtle neurological problems. – An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All
posted by chunking express at 11:47 AM on October 28, 2009 [1 favorite]


“Chemically, the way the mercury (in the flu shot) is bound, it just can’t be utilized by the body like other forms of mercury,” says Roberts. “That’s why the flu shot is perfectly safe.” – Are flu shots safe for young children?
posted by chunking express at 11:50 AM on October 28, 2009 [1 favorite]


Also from Wired: Answering Your Questions About Thimerosal
posted by chunking express at 11:59 AM on October 28, 2009 [1 favorite]


A restated opinion is still your opinion, but I've been asking for quantitative information from the beginning. This may be a start:
Early effects of mercury toxicity have been found when the blood concentration exceeds 3 ug/100 mL. Levels above 2.8 ug/DL are required to be reported to the Health Department. Any worker exceeding this level should be placed in a non-exposed job until dietary and workplace exposures have been evaluated and blood levels have returned to baseline.
That's a bit thin (no mention of age differences, for example), but it's the best quantitative information I've gotten so far.

Can anyone work the math on blood concentration of mercury for an 18-pound infant getting three of the thimerosal-containing flu shots (from multidose-vials) in 28 days?

As for our doctor's take on things, he offered and perhaps suggested waiting for the thimerosal-free version of the seasonal shot, before it was established that the H1N1 vaccination would be a two-shot course. He's given no guidance on the H1N1; he doesn't have any variety of it.
posted by NortonDC at 1:05 PM on October 28, 2009


As I understand things, a baby's dose of the vaccine is two 0.25mL doses. So you'd have 12.5 micrograms of mercury each dose, since thimerosal is 50% mercury. A baby has 90mL of blood per kilogram they weigh, so for your baby that would be 734 ml. If more then 3 micrograms per 100 ml is dangerous, than you want to stay under 22 micrograms per 734 ml. One shot you'd be quite under the limit, two shots you'd be over just over, 3 shots you'd be even more over. Of course, your baby is going to get rid of that mercury over the course of a month. And the limit in that study is pretty arbitrary, since we don't really know anything at all about it.

Anyway, as I said up thread, there is no scientific evidence that the does of thimerosal in these shots is dangerous to people. And babies are people too. I think you should make up your own mind. We aren't your doctors. At the end of the day, no one here can make a decision about your baby for you. No one wants that on their hands. I certainly don't.

Hope that helps.
posted by chunking express at 2:09 PM on October 28, 2009 [1 favorite]


I hope I'm not prolonging a contentious topic, but per Pichichero ME et al. in the Feb 08 issue of Pediatrics, the half-life of blood mercury in infants is 3.7 days. So, as chunking express suggested, the amounts aren't really additive over a 30-day period. It appears to be mainly excreted via the GI tract.

The study emphasizes that guidelines for safe oral methylmercury exposure in adults are not applicable to thimerosal-derived ethylmercury exposure in infants. (The methylmercury guidelines are more stringent than would be appropriate for ethylmercury, given its short half-life.)
posted by lakeroon at 3:42 PM on October 29, 2009


Thanks, lakeroon. You mention what the ethylmercury guidelines are not. Can you share what they are?

As for our kiddo, it turns out that for her seasonal shot she'll be getting the single-dose-vial without significant mercury, so any H1N1 vaccine we can get her will be spaced out by 4 weeks, so no worries on addititve exposure before she rids herself of the mercury.
posted by NortonDC at 7:31 PM on October 29, 2009


There aren't any specific guidelines for ethylmercury; that's why the methylmercury standard got dragged into this - it seemed like the closest thing, I suppose - but despite the similar names, actually the molecules have important differences.

Good to hear she'll be able to get all three shots and it's not stressing you out too much.
posted by lakeroon at 10:15 PM on October 29, 2009


Note that Sanofi's dosage also contains traces of formeldehyde. So we have that going for us. Good luck in obtaining it. As for today, I can't find it anywhere. I made an appointment at the Chicago Dept. of Public Health and they said the earliest they can get my son is Dec 7.

So mad at the way this is being handled. It's either a 3 hour minimum line in the cold, freezing rain or you have to run around finding it, being on hold, and waiting a month out.

I have my standstill vaccine appt. but will continue to search for somewhere sooner.
posted by stormpooper at 10:46 AM on November 5, 2009


Your body also produces formaldehyde, so just the fact of it being present doesn't trouble me. If it crossed some threshold exposure level, only then would I be the least bit concerned about that.
posted by NortonDC at 11:03 AM on November 5, 2009


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