State governments join debate over mercury in vaccines

While the Centers for Disease Control and Prevention and a large section of the nation's medical field denies that mercury-containing vaccines have contributed to the national autism explosion, politicians are beginning to show an interest in enacting new restrictions.

The U.S. Congress and legislatures in Missouri, Kentucky, Iowa, Nebraska and Minnesota are hashing out bills that would eliminate or restrict thimerosal or at least require physicians to notify their patients if the shots they are receiving contain mercury.

Prior to this year, no government had addressed thimerosal specifically, although some states have ruled on mercury in tooth fillings, trash dumps and the disposal of mercury-vapor lighting.

In Missouri, many medical professionals say the bill is unnecessary because thimerosal already has been removed from required childhood vaccines. Skeptics also say the bill would profoundly affect how many flu shots could be given to children, considering most flu vaccines contain more than a trace amount of thimerosal.

Proponents of the legislation say there is no harm in banning a toxic element from inoculations.

A Food and Drug Administration list of vaccines that contain thimerosal shows that more than "trace" amounts (defined by the FDA as one-millionth of a gram of thimerosal or 0.5 millionths of a gram of mercury per dose) of the preservative is found in some tetanus/diphtheria, tetanus toxoid, adult hepatitis B, hepatitis A/B, influenza and meningococcal vaccines.

Missouri's bill, introduced by state Rep. Dr. Roy Holand, R-Springfield, already passed by a 152-4 vote in the House. The Senate Committee on Aging, Families, Mental and Public Health unanimously passed the bill on to the Senate. The bill has not yet made the calendar.

The legislation would prohibit giving vaccines with more than trace amounts of mercury to children 8 years or younger.

"Much of the research that has been shown to me by doctors and pediatricians, and Doc Holand is chief among them, shows we can provide immunization shots without mercury being a preservative," said Jason Crowell, the House majority leader from Cape Girardeau. "There seems to be a polar connection, meaning the more mercury you get, the better chance you have of getting autism, so I think we're moving in the right direction."

'I'm highly uncertain'

Republican state Sen. Peter Kinder of Cape Girardeau doesn't agree with Crowell.

"My understanding is that it is totally unproven that there is any connection between vaccines and autism," Kinder said. "I'm highly uncertain and highly unconvinced of the need of HB852 at this time. Pediatricians and other medical officials have told me that this bill would be placing thousands and thousands of children at risk. Any proposal such as this needs a burden of proof. At this point, the burden has not been met."

Kinder referred to the risk that parents might avoid getting immunizations or flu shots for their children out of ungrounded fears about thimerosal.

The Missouri bill also says that any person receiving an immunization containing more than a trace amount would have to be informed that the shot contains mercury.

The bill also would allow public health clinics to issue thimerosal-containing vaccines in the event of a disease outbreak -- but only if the supply of mercury-free vaccines ran out. The law would also require insurance providers to cover mercury-free vaccinations if they also cover the thimerosal-containing vaccines.

Holand's original bill also prohibited mercury-containing dental amalgams and was to go into effect on Jan. 1, 2005. However, in order to get the bill out of committee, Holand removed the amalgam language and pushed the effective date back to Jan. 1, 2006, to allow additional time for drug companies to remove thimerosal.

'Homemade' disaster

Dr. Robert Harris, a Columbia pediatrician, testified against the bill at the Senate hearing. He said mercury should be removed from vaccines but questioned whether the proposed bill would do more harm than good.

"Any time you raise an issue like this in a generation of people who have not seen the death from these diseases, they begin to question whether they should get vaccines," Harris said. "You can have a homemade medical disaster."

Jeff Harris, Dr. Harris' son, is the minority whip in the Missouri House. He was one of the four who voted against the bill. While sympathetic to the parents of autistic children, he couldn't bring himself to vote for the bill, citing a lack of evidence linking thimerosal and autism and a motive to protect the vaccine program.

"I recognize that the individuals who support this measure may not individually be anti-vaccine, but from where I sit, I see a larger anti-vaccine movement, and it concerns me," he said.

At the national level, thimerosal and politics have been bedfellows for a while.

In 2002, U.S. House Majority Leader Dick Armey added into the Homeland Security Act a provision that protected pharmaceutical companies from lawsuits connected to mercury poisoning. Armey told CBS News at the time that the country would need the companies' vaccines if ever there were a biological attack on the nation. The lawsuits, he said, had the potential to put the vaccine manufacturers out of business.

Earlier this month, Dr. Dave Weldon, a physician and congressman from Florida, introduced a mercury-vaccine bill.

Weldon is on the front lines of the thimerosal battle. At an Institute of Medicine vaccine committee meeting in February, he criticized the CDC for its conflict of interest and for not being more proactive in finding neutral sources to study the issue.

The CDC says the organization is appointing an "objective, expert, external blue ribbon" panel to review its vaccine safety monitoring policies. The CDC hopes to have the panel in place within the next two months.

Regardless of the new steps, Weldon thinks legislation banning mercury in shots makes sense and believes it will pass.

"One thing we can be certain of is that injecting mercury into an eight-, 12- or 16-pound infant cannot have a positive effect on that child, particularly when one in six infants is born with a mercury level that the EPA considers harmful," Weldon said. "Mercury finally has been eliminated from most childhood vaccines, and there is no reason we cannot eliminate it from the pediatric flu vaccine as well."

bmiller@semissourian.com

243-6635

Federal and state legislation limiting the use of thimerosal:

H.R. 4169, Mercury-free

Vaccines Act of 2004

Sponsors: Dr. Dave Weldon (R-Fla.), Carolyn Maloney (D-NY)

Status: Weldon, Maloney seeking co-sponsors

What it says:

Requires that by Jan. 1, 2005, no childhood vaccine have more than one microgram of mercury.

Requires that the flu vaccine administered to children, beginning later this year with the 2004-2005 flu season, have no more than 1 mcg of mercury.

Requires that by Jan. 1, 2006, mercury be removed completely from all childhood and adolescent vaccines.

Requires that for all adult vaccines, no vaccine may contain more than 1 mcg of mercury after Jan. 1, 2007.

Directs the CDC to include information in the vaccine datasheets provided to parents and those being vaccinated, making them aware of the mercury in vaccines and how they may obtain mercury-free vaccines.

Expresses the sense of Congress that the CDC should incorporate into its vaccine promotion messages a recommendation against administering a mercury-containing vaccine to pregnant women.

Missouri HB852

Sponsor: Dr. Roy Holand (R-Springfield, Mo.)

Status: In Senate; passed 152-4 in House.

What it says:

Effective Jan. 1, 2006.

Prohibits immunizations administered to children less than 8 years old from containing mercury preservatives, including thimerosal. The bill allows for trace amounts of thimerosal.

All other persons receiving vaccines containing thimerosal must be informed.

Requires Missouri insurers to cover thimerosal-free inoculations at the same percentage rate as the usual charges of inoculations that contain mercury.

The director of the Department of Health and Senior Services will be exempt from this law by providing documentation of an outbreak requiring a public vaccination program when a sufficient supply of mercury-free vaccines is not available.

Iowa SB 2208

Sponsor: Ken Veenstra

Status: Passed 91-8 in House

What it says:

Effective Jan. 1, 2005.

Prohibits more than trace amounts of mercury or perservatives containing heavy metals in early childhood (less than 8 years old) vaccines.

Bill shall not apply for influenza immunization or in times of emergency or epidemic as determined by the director of public health.

Insurance providers must provide reimbursement at same rate for thimerosal-free immunizations.

Kentucky SB 141

Sponsor: T. Buford

Status: Referred to Committee on Health and Welfare.

What it says:

Prohibits the use of mercury dental restorations. The provisions shall not apply to existing dental restorations unless replacement of the restorations is necessitated based on accepted dental practices or the patient's request for replacement.

Prohibits the use of mercury-containing preservatives, including thimerosal, in vaccinations

Requires that insurance plans cover nonmercury alternatives the same as mercury-containing vaccines.

Minnesota HB887

Sponsor: Nienow, Foley, Fischbach

Status: At Health and Family Security Committee

What it says:

The commissioner of health shall continue the educational campaign to providers and hospitals on vaccine safety, including the information on vaccine adverse events reporting system, the federal vaccine information statements and medical precautions and contraindications to immunization.

The commissioner shall encourage providers to provide the vaccine information statements at multiple visits and in anticipation of subsequent immunizations.

The commissioner shall encourage providers to use existing screening for immunization precautions and contraindication materials and make proper use of VAERS.

Shall develop and make available patient education materials on immunizations including contraindications and precautions regarding vaccines and materials that educate providers about vaccine content.

The commissioner shall encourage health-care providers to use thimerosal-free vaccines when available.

Nebraska LB1158

Sponsor: Landis

Status: Approved by Health and Human Services Committee; placed on general file

What it says:

Effective Jan. 1, 2006.

Medical professionals must notify patient, or guardians of patient, before administering any shot that contains mercury.

Prohibits the use of mercury-containing preservatives, including thimerosal, in vaccinations.

Requires that insurance plans cover nonmercury alternatives the same as mercury-containing vaccines.