Holy Mercury Batman! Re-examining the vaccine-autism controversy

BEFORE YOU BEGIN: This is a very rich subject area and your Intrepid Pharmacist only has so much space and time per column. There are numerous links that provide additional or supporting information and details for those wishing to explore this subject further. These range from the US Forestry Services statistics on mercury sources to disease study listings.

As flu vaccinations get underway, one last point on vaccines needs to be examined: the issue surrounding the compound thimerosal. The mainstream press has noted thimerosal is a preservative added to some vaccines and it breaks down in the body to a salicylate (aspirin is in this family) and ethyl-mercury. And the comment is usually left at that since such “reporting” really is focused on trying to stoke the autism-mercury-vaccine controversy, rather than provide intelligent dialogue or information for the reader.

As a result, people leave comments on blogs to they would rather their child risk getting disease “X” than risk getting autism from a vaccine against the disease (these logic flaws discussed below). This kind of hysteria in the face of numerous contrary facts is cause for concern. When a mother posts that she would rather her daughter risk having rubella, a mild, non-threatening illness, anyway, as she points out, one can only wonder if she read the entire disease information page or even a history of it. If she had she would note that should her daughter contract rubella while pregnant, there are after effects in the form of birth defects. This is called congenital rubella syndrome and includes for the newborn such exciting features as deafness, retardation and cataracts. On the upside for her, though, people can literally mean it when they look at the newborn and say “Aww! He has his grandmother’s eyes.” The easy solution of vaccinating is to prevent this scenario from being a risk in the first place.
 

These misconceptions about vaccines arise largely from a lack of scientific teaching in schools (the state tests are all about English and mathematics, after all) and to fill this void (and for general convenience) the general public (with a little help from the mass media) divides all chemical compounds as good or bad, lauded or vilified.
 

Such a black-white categorization is highly inaccurate. Richard DeGrandpre makes this point in his book The Cult of Pharmacology. Chemical compounds are far more pervasive and diverse than people seem willing to allow. Consider amphetamines. Speed. Uppers. As meth-amphetamine it is an addictive drug (T. Tina. Ice. Meth.) made from Sudafed via home chemistry and sold on the street and in the dance clubs of your better mega-cities. As dextro-amphetamine (Adderall,Vyvanse, Dexedrine), however, it is a good drug that helps the ever increasing number of children (and now adults) who cannot focus due to ADD pharmacologically possess the ability to do so. Does that make amphetamine a good drug or a bad drug? An angel or a demon? Perhaps this is a lingering effect of Christianity’s need for things to be hot or cold, but not warm. In religious terms, though, the Buddhists would be correct: it is both an angel and demon.

What goes unmentioned by the mainstream press is that all mercuries are not created equal. Ethyl-mercury is not the same as methyl-mercury in the same way ethyl-alcohol is not the same as methyl-alcohol. The former alcohol is found in many pleasurable adult beverages, while drinking the latter earns one a trip to the hospital and possibly the morgue: but they are both alcohol. Likewise, ethylene glycol (anti-freeze) will sicken or kill you, while polyethylene glycol is the stuff found in the laxative Miralax, which will resolve your constipation. Mercury works the same way.
 

Methyl-mercury is the substance found in nature, including most fish these days. A large by-product of forest fires and coal burning, it was used until the 1940’s in hat making at which time it was banned; the constant exposure causing neural damage often driving the hatters “mad.” Methyl-mercury, unlike ethyl-mercury, has a very long half-life.

A half-life is the amount of time it takes any compound (including drugs) to be half of what it was. For instance, if a 100 milligram drug has a half life of 12 hours then at the 12 hour mark it will be 50 milligrams, at the 24 hour mark it will be 25 milligrams, at the 36 hour mark it will be 12.5 milligrams, and so on. This simple process is complicated when we are not dealing with a single dose but consistent re-exposure, which is what happened to the hatters. This is also why you take an antibiotic multiple times: to keep up the level of the drug even as each dose is going through its half life process. The half life of methyl-mercury is some 72 days. If it were 100 milligrams it would take a year just to get to the 12.5 milligram mark, and that’s assuming no subsequent re-exposure. Ethyl mercury, on the other hand, has a half-life of about 18 days, so it takes only a few months to reach the same point.
 

Mercury is a curious substance. It has become the whipping boy for autism and anti-immunization groups in spite of the fact that the facts don’t fit. The claim by such groups asserts there has been a rising tide of autism in America and this is directly related to the mercury in vaccines. The flaws in this thinking are many. Your Intrepid Pharmacist will touch on a few of the most important of these logic lapses.
 

Logic Lapses:
In the logic lapse department, stop number one is Scientific Studies. The data supporting autism simply isn’t there in study after study. In fact, the British study that garnered rabid media attention was later retracted by its lead author and, as the mass media omitted, the study only used twelve children. The Immunization Action Coalition has a complete list of studies for and against (23 to 2 if you’re keeping score). And if you take the time to check this list out, take a moment, too, to notice the numbers of children involved in each of the studies. Thousands more children are examined in the “no connection” studies. For a correlation to exist, the occurrence of event “X” (in this case, autism) most happen more often in the group receiving the treatment (in this case a vaccine) compared to the same rate of occurrence of event “X” among those not receiving it. The number of study participants also must be sufficiently large enough to be representative of the entire population and decrease the possibility that the results are due to chance.

Not everyone is convinced by studies when their minds have already been made up (ironically by other studies (see below)), but other logic lapse issues do not require studies. Two such lapses concern how autism is diagnosed and the removal of thimerosal from most vaccines. To address these in order…

Autism diagnosis guidelines (DSMV-IV) changed significantly in 1992, affecting how it is diagnosed and the number of kids diagnosed with it. (Brief history of diagnostic evolution here). In short, it was expanded and the criteria are more inclusive than the European counterparts; we add a number of autism-like diseases in with the autism, which falsely inflates the numbers. For a comparator here, consider attention deficit disorder or ADD. It didn’t used to be all that either, but thanks to another section of the DSMV-IV criteria, more and more children each year are diagnosed with it and placed on ADD drugs. So, changing the guidelines by which something is diagnosed, can increase (or decrease) the numbers of diagnosed patients.
 

Next, amid outcry, thimerosal was removed by the turn-of-the-century from all but a few vaccines (complete list here), and nearly all having a non-thimerosal alternative. With that change, one would expect the autism rate to decline significantly. Never mind that if you accept the premise thimerosal/mercury = autism, the autism rate should have been sky high to start with, not increasing during the 1990’s, since all of us born in the 1960’s, 1970’s and 1980’s all received thimerosal containing vaccines. This chart lists autism prevalence studies conducted around the world starting as early as 1966. Notice the “Criteria used” column and how the “Prevalence” column’s numbers jump from less than one percent to four, five and six percent as everything moves into the DSMV-IV diagnosis criteria.

Our exposure to mercury in medicine has, in fact, decreased over the last 20 years, not increased. Mercury thermometers, (which are long since off the market though people continue to ask your Intrepid Pharmacist for one) and play toys like the Quicksilver games of the 1970’s and 80’s all increased the possibility of mercury exposure. With mercury having been in so many vaccines before, plus removal of other mercury products, we should see a decrease rather than an increase in autism rates. The reality is that in spite of thimerosal removal from most vaccines, the autism rate has not wavered significantly since the DSMV-IV criteria was put into place nearly 20 years ago (refer to the above paragraph’s chart). Thus, vaccines as the source must be ruled out no matter how desperately people wish to cling to this notion.

And then, of course, is the aforementioned half-life between ethyl and methyl mercuries and the required constant exposure for neural damage to occur. Taken in total, there is no way any rational person can buy the thimerosal in vaccines leads to autism argument. The bigger problem perhaps is the fact that, apart from HIV, there has been no communicable disease health crisis in this country in more than half a century and we are now dealing with several generations of people who do not remember the real threats and consequences of these diseases…and they probably won’t until something hits and people are dropping like flies (as we saw with HIV before the cocktail drug treatments). Which is sad for the children, who ultimately will be the ones to suffer for their parent’s decisions.