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Vaccines without thiomersal: why so necessary, why so long coming?
Drugs 2001; 61(5):565-72D

Abstract

The inorganic mercurial thiomersal (merthiolate) has been used as an effective preservative in numerous medical and non-medical products since the early 1930s. Both the potential toxicity of thiomersal and sensitisation to thiomersal in relation to the application of thiomersal-containing vaccines and immunoglobulins, especially in children, have been debated in the literature. The very low thiomersal concentrations in pharmacological and biological products are relatively non-toxic, but probably not in utero and during the first 6 months of life. The developing brain of the fetus is most susceptible to thiomersal and, therefore, women of childbearing age, in particular, should not receive thiomersal-containing products. Definitive data of doses at which developmental effects occur are not available. Moreover, revelation of subtle effects of toxicity needs long term observation of children. The ethylmercury radical of the thiomersal molecule appears to be the prominent sensitiser. The prevalence of thiomersal hypersensitivity in mostly selected populations varies up to 18%, but higher figures have been reported. The overall exposure to thiomersal differs considerably between countries. In many cases a positive routine patch test to thiomersal should be considered an accidental finding without or, probably more accurately, with low clinical relevance. In practice, some preventive measures can be taken with respect to thiomersal hypersensitivity. However, with regard to the debate on primary sensitisation during childhood and renewed attention for a reduction of children's exposure to mercury from all sources, the use of thiomersal should preferably be eliminated or at least be reduced. In 1999 the manufacturers of vaccines and immunoglobulins in the US and Europe were approached with this in mind. The potential toxicity in children seems to be of much more concern to them than the hidden sensitising properties of thiomersal. In The Netherlands, unlike many other countries, the exposure to thiomersal from pharmaceutical sources has already been reduced. Replacement of thiomersal in all products should have a high priority in all countries.

Authors+Show Affiliations

Department of Dermatology and Venereology, Erasmus University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11368282

Citation

van't Veen, A J.. "Vaccines Without Thiomersal: Why so Necessary, Why so Long Coming?" Drugs, vol. 61, no. 5, 2001, pp. 565-72.
van't Veen AJ. Vaccines without thiomersal: why so necessary, why so long coming? Drugs. 2001;61(5):565-72.
van't Veen, A. J. (2001). Vaccines without thiomersal: why so necessary, why so long coming? Drugs, 61(5), pp. 565-72.
van't Veen AJ. Vaccines Without Thiomersal: Why so Necessary, Why so Long Coming. Drugs. 2001;61(5):565-72. PubMed PMID: 11368282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaccines without thiomersal: why so necessary, why so long coming? A1 - van't Veen,A J, PY - 2001/5/23/pubmed PY - 2001/9/28/medline PY - 2001/5/23/entrez SP - 565 EP - 72 JF - Drugs JO - Drugs VL - 61 IS - 5 N2 - The inorganic mercurial thiomersal (merthiolate) has been used as an effective preservative in numerous medical and non-medical products since the early 1930s. Both the potential toxicity of thiomersal and sensitisation to thiomersal in relation to the application of thiomersal-containing vaccines and immunoglobulins, especially in children, have been debated in the literature. The very low thiomersal concentrations in pharmacological and biological products are relatively non-toxic, but probably not in utero and during the first 6 months of life. The developing brain of the fetus is most susceptible to thiomersal and, therefore, women of childbearing age, in particular, should not receive thiomersal-containing products. Definitive data of doses at which developmental effects occur are not available. Moreover, revelation of subtle effects of toxicity needs long term observation of children. The ethylmercury radical of the thiomersal molecule appears to be the prominent sensitiser. The prevalence of thiomersal hypersensitivity in mostly selected populations varies up to 18%, but higher figures have been reported. The overall exposure to thiomersal differs considerably between countries. In many cases a positive routine patch test to thiomersal should be considered an accidental finding without or, probably more accurately, with low clinical relevance. In practice, some preventive measures can be taken with respect to thiomersal hypersensitivity. However, with regard to the debate on primary sensitisation during childhood and renewed attention for a reduction of children's exposure to mercury from all sources, the use of thiomersal should preferably be eliminated or at least be reduced. In 1999 the manufacturers of vaccines and immunoglobulins in the US and Europe were approached with this in mind. The potential toxicity in children seems to be of much more concern to them than the hidden sensitising properties of thiomersal. In The Netherlands, unlike many other countries, the exposure to thiomersal from pharmaceutical sources has already been reduced. Replacement of thiomersal in all products should have a high priority in all countries. SN - 0012-6667 UR - https://www.unboundmedicine.com/medline/citation/11368282/Vaccines_without_thiomersal:_why_so_necessary_why_so_long_coming L2 - https://dx.doi.org/10.2165/00003495-200161050-00002 DB - PRIME DP - Unbound Medicine ER -