What's safe?

Posted: Jun 18, 2005 12:00 AM

Small actions sometimes have long-term consequences.

In 1981 a fire broke out in the state office building in Binghamton, N.Y. It spread smoke containing polychlorinated biphenyls (PCBs) throughout the 18-story building, which was closed as the state attempted to clean it. A month after the blaze, a frustrated Gov. Hugh Carey wanted his people to get back to work. He claimed PCBs weren?t dangerous, and even offered ?to walk into Binghamton or any part of that building and swallow an entire glass of PCBs.?

 On second thought, the governor decided to skip the PCB cocktail. The cleanup ended up costing $47 million and the building remained closed until 1994.

 Childhood vaccinations are another seemingly small action that may -- may -- have long-term consequences.

 The federal government recommends that, during their first two years of life, all children be vaccinated against 11 diseases. This involves as many as 20 shots. The government insists this is safe and necessary to protect children. Many parents disagree.

 They point to the alarming rise in autism. Today one child in 166 is autistic, up from one in 10,000 in 1989. This rise seems to track with the introduction of a series of new vaccines around 1990. Many of those vaccines contained thimerosal -- a preservative that?s half mercury.

 In 2004 the government?s Institute of Medicine wrote a report that supposedly proved there wasn?t any connection between thimerosal and autism. According to the Food and Drug Administration?s Web site, ?The committee concluded that this body of evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism, and that hypotheses generated to date concerning a biological mechanism for such causality are theoretical only.? In other words, there?s no proof that thimerosal leads to autism -- it?s only a theory.

 But if the government wants to insist that thimerosal is safe, it apparently doesn?t have the courage of its convictions. ?The FDA is encouraging the reduction or removal of thimerosal from all existing vaccines,? its Web site says. ?Much progress has been made to date. The FDA has been actively working with manufacturers, particularly those that manufacture childhood vaccines, to reach the goal of eliminating thimerosal from vaccines.?

If thimerosal were safe, though, there would be no reason to take it out of vaccines. That?s a point not lost on Dr. Paul Offit, chief of infectious diseases at the Children?s Hospital of Philadelphia. ?We gave thimerosal a scarlet letter,? he told author David Kirby in the book Evidence of Harm. ?We precipitously pulled it out of vaccines and the consequence was immunization programs were disrupted.?

Offit goes so far as to claim that thimerosal is actually safe. ?If I sat here and drank 10 gallons of water quickly I would feel sick,? he told Kirby. ?But that doesn?t make water unsafe. It just means I shouldn?t take 10 gallons at once. I feel the same way about these substances, which are in the environment already. I think the way they?re presented in vaccines, they are at levels which are helpful, not harmful.?

Parents are really to blame here, Offit says. ?You did more harm than good in sort of quote/unquote allowing the parent to be fully informed. There?s no politically correct way to say this, but being fully informed is not always the best thing,? he told Kirby. ?You can take that out of context and make me look like a jerk, but you know what I?m saying.? Indeed we do.

In the same vein, the federal government knows mercury is dangerous, and has long warned pregnant women to avoid eating fish that contain too much. Yet for years it encouraged parents to inject their children with vaccines that contained mercury. That?s because, ?the risks of not vaccinating children on time are significant, whereas the risks of thimerosal-containing vaccines have not been proven scientifically,? as the CDC puts it.

Of course, the risk of deadly outbreaks is also theoretical. Last July the CDC reported, ?the nation?s childhood immunization rates are at record high levels,? with 79 percent of children getting their shots on time. That leaves 21 percent unprotected, though -- a rather large population. That would seem to be enough children to trigger outbreaks, and we haven?t seen one.

Still, it does make sense to vaccinate. But we should slow down and give children one shot at a time instead of three or four in one day. We also should allow parents to opt out of vaccinations such as Hepatitis B if they?re confident their child won?t be exposed to the disease. And parents deserve to know all the ingredients in the vaccines they?re using.

One wonders if Dr. Offit would be willing to take the Gov. Carey test. Would he, an adult with a fully developed brain, be willing to inject 50 micrograms of mercury into his body? That?s still less mercury than some children got in the late 1990s when they were just a few months old. That?s why the debate over thimerosal is far from settled.

What?s certain is that, whatever caused the spike in autism, solving the problem is going to cost more and take longer than we can even imagine.