Barbara Pfeffer Billauer
integrating law, policy, religion and science

More on Measles: De -Mystifying the Myths: #1 Autism, Thimerosal and the Vaccine

The Mad Hatter alludes to the hatters' syndrome which is caused by INORGANIC mercury poisoning  - NOT thimerosol
illustrated John Tenniel
The Mad Hatters syndrom is caused by INORGANIC mercury poisoning - not by thimerosal.

While the measles epidemic rages on in Israel, now at over 4500 cases since October of 2018, with five related deaths and one case in ten requiring hospitalization, you might wonder what our government is doing about it. In the U.S., not only have Health Departments crushed the epidemic, but legislatures are rushing to curtail excuses to avoid vaccinating. In New Jersey, the legislature just enacted legislation abolishing religious exemptions, joining New York and California. By comparison, the Israeli Ministry of Health has been rather sluggish in its response.

This should not be interpreted to suggest the danger is over. As of this week, in Samoa, 76 people have died from measles – mostly children – in the past two and a half months, alone. Also this week, the Israeli Health Ministry promulgated a warning that passengers traveling to or from Georgia (Dec. 12- Dec. 16) may have been exposed to the diseases.

Now, you would think this would warrant a call for travelers to epidemic-prone countries to get vaccinated. Alas, not. You see, with only 115,000 vaccines available in Israel, there isn’t enough vaccine in Israel to vaccinate the two million unvaccinated citizens. Israeli adults are simply advised to tell their doctors if they notice signs of the disease. Worse, for adults, the vaccine isn’t part of the health basket, and scheduling a vaccine, even if you wanted to shell out from your own pocket, is tough and the wait is long. Perhaps you think a strong travel ban is in effect for epidemic-prone countries? Alas, diplomatic concerns apparently trump public health. So, no. Travel is still unrestricted. We are even sending an Israeli team to help the Samoans counter the dangers of their anti-vax movement, all the while the anti-vaxxers in Israel are in full force.

These facts might explain why the epidemic was stopped in the US at 1276 cases, and still rages on here, as the anti-vaxxers have caught the public ear and there is no organized movement to stop them.

So, given the void in governmental action, the impetus falls on us foot-soldiers to get the word out:

Measles is dangerous. Measles is costly. Vaccination is crucial. The only way to protect everyone – is if everyone who can – gets vaccinated. (Share this post!)

As I mentioned in my last post, messages from the anti-vax community are sophisticated, targeted and ubiquitous. In the US, for example, there still is reliance on the old – and now thoroughly debunked –trope that the vaccine causes autism. After all, the anti-vaxxers claim it contains a form of mercury that could ass the blood-brain barrier. Perhaps. Except there is no credible evidence that it does. But myths don’t spring up from thin air, so perhaps we should revisit Olympus and see just how this myth got born. By the way, there are tons of websites discounting the claim. What isn’t too easy to access is how this anti-vax measles-trope got birthed – so here it is:

Concurrent with governmental pressure for increased vaccination, some people noticed an increase in autism. And in fact, the incidence of autism did appear to be increasing. At least according to reported statistics – so, it’s tempting to correlate the two. Well, perhaps, the statistics are lying, as they are wont to do? Alas, not. But contrary to anti-vaxxers, the autism increase has nothing to do with vaccines,

This may be hard to accept for a parent who sees a bright and rambunctious toddler suddenly turn taciturn, troublesome, withdrawn and unsociable – especially if coincidentally that happens shortly after vaccination. After all, humans are programmed to seek and see causes for effects we observe. If there is an effect, there must be a cause we can apprehend, especially if the effect is unpleasant and unexpected (or so we think). Normally, we tend to grab at the handiest explanation to blame. Whether it is a witch in Salem, or a Jew in the Pale baking a matzo, the scapegoat is usually the most obvious stereotypical culprit we can lay our hands-on. Enter the measles vaccine. One danger with this tendency, aside from scientific invalidity, is that if we blame the measles vaccine for the autism increase, the real culprit gets away.

Now, we can intellectualize that correlation is not causation. But that’s hard to do when watching a formerly healthy child now with developmental problems. But it isn’t the vaccine’s fault. Here’s why:

The measles vaccine no longer contains thimerosal. It was removed almost twenty years ago- in 2001. But even when it did contain the substance, it’s highly unlikely the chemical was the culprit.

The natural increase in autism rates:

In 1987 the diagnostic criteria for autism were broadened, and so by dint of a simple definitional change – there were more cases. The definition was broadened yet again in 1994 and 2000, and so we saw even more cases.


Autism cases per 1,000 children in the U.S. from 1996 to 2007.
Thimerosal was removed from the measles vaccine in 2001. Chart courtesy wikipedia.

But in 2013 the diagnostic criteria were tightened. And we still saw more cases. After that, the levels tapered to a plateau. So, we really don’t know what’s responsible for all the increase. It could be the broader definition; it could be genetic relationships we are now finding; it certainly reflects the greater benefits parents get for developmentally disabled children and thus a parental lobby for the diagnosis. There may also be an environmental component, as yet undiscovered.

Trend in the number of U.S. children per 1,000 receiving special education services for autism, ages 6 to 17 years, 2001–2012
Source: U.S. Census Bureau, 2011, 2015a; U.S. Department of Education, 2013, 2014.
https://www.ncbi.nlm.nih.gov/books/NBK332896/figure/fig_14-4/?report=objectonly

But one thing we know. It isn’t thimerosal. (THIGH-MER-OH-SOL) – the stuff the anti-vaxxers claim is in measles vaccines. And we know that for several reasons. As I said, measles vaccines don’t have thimerosal anymore.

So, if it’s not used — why do we find it in anti-vax literature? Why do speakers raise it at those “informed consent” rallies or “science-symposia”? Not a clue. It is totally irrelevant to any informed consent issue – But it sounds really bad. And that’s really good for producing hysteria or confusion.

Here’s the low-down: thimerosal has Mercury, right? And mercury is really bad, right?

Bionerd – Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=4972709\

Thimerosal is a mercury-containing compound once used to preserve the measles vaccine from bacterial and fungal contamination. It degrades into something called ethylmercury. But it’s not used in measles vaccines and it’s not used in most other vaccines either. (And where it still is you can request preservative-free vaccine).

I know. I know. But thimerosal has MERCURY – and that’s bad. And it was once used in measles vaccines. So it’s fair to target it, right? And Andrew Wakefield is talking at all these conferences. And he was the one who determined there is a relationship between the vaccine and the condition. And from there, it was just a short leap to fingering the thimerosal. Right? Well, not so right.

First the chemical: A bit about mercury 

Mercury, the chemical, not the planet, is a metallic element, the only one which is liquid at room temperature. It’s sometimes called “quicksilver.” It’s been associated both with health hazards and healthful uses. You probably used mercurochrome as a kid. That’s a topical antiseptic made with mercury. Mercury was also used in dental amalgams – our cavities were filled with them. In fact, most of us are sitting with mouths full of mercury-containing fillings right now. The trend is to phase out mercury-containing products – but, it’s not the chemical that’s the key determinant of toxicity – it’s the dose that counts. (“Dose makes the poison”).

Mercurochrome: An Anti-Infective

KevinVreeland courtesy wikipedia

Mercury poisoning has been a concern for a long time – since the 1800s, at least. It was one of the earliest occupational diseases known. Milliners and hatters using inorganic mercury in felt production for hats became ill from breathing the vapors and suffered mental and neurological defects. That’s where the phrase “Mad as a Hatter” comes from.

Lewis Carroll’s Mad Hatter may allude to the hatters’ syndrome which is caused by mercury poisoning, but the character itself appears to have been based on an eccentric furniture dealer.
illustration Tenniel – – Wikipedia Public Domain,

In the mid-later1900s, mercury pollution ravaged Japan and Iraq in the form of pesticides and insecticides. In Japan, a form of mercury, methylmercury, was released in industrial wastewater, eaten and biomagnified by fish and shellfish in Minamata Bay. The fish were eaten by the local population and their pets. And the chemical bio-accumulated in their bodies – meaning the doses remained in the body without being excreted or eliminated, accumulating over time – causing mercury poisoning. In cats, they called the disease “dancing cat fever.” Hair samples from Minamata patients recorded 705 parts per million (ppm). In people outside the area, the level was 4 ppm. In 1971 grain treated with a methylmercury fungicide was imported into Iraq as seed grain – and erroneously fed to the local population, who became ill.

Interestingly, those who were exposed at high enough levels did become ill – but there was no increase in autism.

METHYLMERCURY COURTESY WIKIPEDIA

Chemical Formula: [CH3Hg]

Most compounds with METHYL mercury are poisonous. But it is still used in flourescent lights, batteries, and in polyvinyl chloride.

By contrast, thimerosal breaks down into a different chemical called ETHYLmercury — which is NOT related to methylmercury. And vaccines that do have thimersol (flu vaccines, for example) have a trace amount (0.01%) – roughly the same amount of mercury as a 3 ounce can of tuna fish.

ETHYLMERCURY

The formula for ethylmercury is  C2H5Hg+.,

Desi: I said ETHEL, Fred. Not Methyl. Not Meryl, Not Mindl, and not Moti.
Ethel: It’s me, Ethyl, Lucy! Not Methyl. Oh, and by the way, thimerosal is still used in mascara.

Thimerosal doesn’t cause autism

So, how do we know?

For one thing, multiple attempts to prove causation in a legal setting have uniformly failed (except for one case with a pre-existing related disorder). Six test cases (dispositive of 5000 claims) were brought in special proceedings heard by three special masters which provided a forum for a retinue of experts and testimony on both sides. In all the cases, the special master denied compensation and rejected any causal link between thimerosal and autism. In one of the test cases, Michelle Cedillo v. Secretary of Health and Human Services, Special Master George Hastings stated that that “the Cedillos have been misled by [six] physicians [brought as expert witnesses and] who are guilty, in my view, of gross medical misjudgment.”

For another thing, numerous epidemiological studies have evaluated the claim. In total, these studies have examined something like a million children and didn’t find a link. One study examined 467,450 Danish children and found no relationship between thimerosal in vaccines and autism; another study of 109,863 British children also found no association; a third study of 78,829 American children taken from the Vaccine Safety Datalink (VSD) confirmed these findings. And the list of studies showing no causal association goes on and on. Extensive data reviews confirm the lack of causal connection.

So, how do the anti-vaxxers gain adherents to this message?

There seem to be two ways they use to convince the untutored. One is to repeat over and over and over again false “facts” – even if there is no basis. Loudly. Refusing to read or hear any other view. Sadly, that method seems to be gaining momentum. Hopefully, continued counter anti-vax messages might gain some traction. (Please share this post and let’s get the word out!)

Another is to take advantage of a scapegoat. And thimerosal, tainted by its relationship with mercury, was the perfect candidate – quicksilver for the anti-vaxxers – waiting to be spread before the unsuspecting anti-vax consumer, now to be used in the form of fraudulent or “junk science.” Thus, there came into the literature not too long ago a few odd epidemiological reports. One related to a claimed increase in autism in African-American boys – supposedly due to the measles vaccine. That study, by a Brian Hooker, whose degrees are in chemical engineering, and who is involved in the vaccine litigation, was retracted.

A second “study” suggesting that an association between thimerosal and measles vaccine was authored by the same Brian Hooker, this one along with David A Geier, whose terminal degree is a bachelor’s degree in biology, along with his father Mark, an obstetrician, and three others. Notably, this “study” was funded by Dwoskin Family Foundation, a proponent and funder of anti-vax groups, along with the Selz Foundation, a major (three million dollar) anti-vax funder who financed the anti-vax activities in Rockland County and was involved with the Tel Aviv Informed Consent (Anti-vax) conference. Mark Geier has been involved in scores of anti-vax litigation cases as a paid expert witness. His testimony has been seriously criticized by judges and his license to practice medicine suspended. In one 2010 decision, the presiding jurist stated: “In summary, I conclude that all of the Geier epidemiologic studies are not reliable, and cannot be accorded any weight.”

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In the great story Dune by Frank Herbert, “The Bene Gesserit practice “religious engineering” through a faction called the Missionaria Protectiva, which spreads “infectious superstitions on primitive worlds.” Maybe this is what is infecting the great measles controversy?

It’s up to us – to protect the health of all our children, including immunocompromised children who can’t be vaccinated – to get the word out: If your children can be vaccinated – vaccinate them. Not just for their sake, but for the sake of all of us. We are our sibling’s keepers.

 

About the Author
Grew up on Long Island, attended Cornell University (BS Hons.)and Hofstra ULaw School, MA in Occupational Health from NYU, Ph.D,. in Law and Science from Uof Haifa. Practiced trial law in New York City, Taught at NYU, University of Md Law School, Stony Brook School of Medicine. Currently Research Professor of Scientific Statecraft, Institute of World Politics, Washington, DC, Professor, International Program in Bioethics, University of Porto, Portugal. Editor Prof. Amnon Carmi's Casebook on Bioethics for Judges, Member of Advisory Board, UNESCO Committee on Bioethics. Currently residing in Netanya, Israel.
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