REVISTA DERMATOLÓGICA FEBRERO 2004



MMR vaccine against measles, mumps and rubella.






ACTUALIZADO 2024



ESPAÑOL


En este "Bloque" de noticias me refiero al tema de la vacuna MMR (Rubeola, sarampión y Parotiditis), la cual ha sido asociada a la aparición de autismo en niños, hecho no comprobado HOY dia 2024.

De hecho en algunas poblaciones ha aumentado el Sarampión por la negación de los padres ha colocar la vacuna a sus hijos.

Se han hecho estudios en más de 95.000 mil niños y 537.000 mil niños en Dinamarca y hoy dia, aun siendo un debate, LA MAYORÍA DE LOS CIENTÍFICOS NO relacionan directamente esta vacuna con Autismo. Hay otro grupo que si apoya esta teoría.

Pero recordemos que las VACUNAS de antaño casi TODAS CONTENÍAN TIMEROSAL, el cual si se ha asociado a autismo. Pero el mismo fue eliminado de casi todas estas en el año 2001.

El tema seguirá siendo un debate, sobre todo por los grandes problemas ocasionados con la vacuna contra el COVID 19, contra el virus Sars-Cov 2.

Siempre he mantenido y dicho que las VACUNAS se hicieron para PREVENIR enfermedades, el problema se presenta cuando hay efectos secundarios.

Saludos,,, 

Dr. José Lapenta.


ENGLISH


In this "News Block" I refer to the topic of the MMR vaccine (Measles, Mumps and Rubella), which has been associated with the appearance of autism in children, a fact not proven TODAY 2024.

In fact, in some populations, Measles has increased due to the refusal of parents to vaccinate their children.

Studies have been done on more than 95,000 children and 537,000 children in Denmark and today, even though it is a debate, MOST SCIENTISTS DO NOT directly relate this vaccine to Autism. There is another group that does support this theory.

But let us remember that the VACCINES of yesteryear almost ALL CONTAINED THIMEROSAL, which has been associated with autism. But it was eliminated from almost all of these in 2001.

The issue will continue to be a debate, especially due to the major problems caused by the COVID 19 vaccine, against the Sars-Cov 2 virus.

I have always maintained and said that VACCINES were made to PREVENT diseases, the problem arises when there are side effects.

Greetings...

Dr. José Lapenta R. 






 

 1.) Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism.

2.)Unintended events following immunization with MMR: a systematic review.

3.) Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism.

4.) Elevated levels of measles antibodies in children with autism.

5.) Media misled the public over the MMR vaccine, study says. 

6.) Prevalence of autism and parentally reported triggers in a north east London population.

7.) Does the MMR vaccine and secretin or its receptor share an antigenic epitope?.

8.) A population-based study of measles, mumps, and rubella vaccination and autism.

9.) Vaccines, viruses, and voodoo.

10.) The Not-So-Crackpot Autism Theory / looking for a links between autism and thimerosal.



 

1.)  Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism.
 

Source:J Biomed Sci. 2002 Jul-Aug;9(4):359-64.

Singh VK, Lin SX, Newell E, Nelson C.

Department of Biology and Biotechnology Center, Utah State University, Logan, Utah 84322, USA. singhvk@cc.usu.edu

Autoimmunity to the central nervous system (CNS), especially to myelin basic protein (MBP), may play a causal role in autism, a neurodevelopmental disorder. Because many autistic children harbor elevated levels of measles antibodies, we conducted a serological study of measles-mumps-rubella (MMR) and MBP autoantibodies. Using serum samples of 125 autistic children and 92 control children, antibodies were assayed by ELISA or immunoblotting methods. ELISA analysis showed a significant increase in the level of MMR antibodies in autistic children. Immunoblotting analysis revealed the presence of an unusual MMR antibody in 75 of 125 (60%) autistic sera but not in control sera. This antibody specifically detected a protein of 73-75 kD of MMR. This protein band, as analyzed with monoclonal antibodies, was immunopositive for measles hemagglutinin (HA) protein but not for measles nucleoprotein and rubella or mumps viral proteins. Thus the MMR antibody in autistic sera detected measles HA protein, which is unique to the measles subunit of the vaccine. Furthermore, over 90% of MMR antibody-positive autistic sera were also positive for MBP autoantibodies, suggesting a strong association between MMR and CNS autoimmunity in autism. Stemming from this evidence, we suggest that an inappropriate antibody response to MMR, specifically the measles component thereof, might be related to pathogenesis of autism. Copyright 2002 National Science Council, ROC and S. Karger AG, Basel


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2.) Unintended events following immunization with MMR: a systematic review.


Vaccine. 2003 Sep 8;21(25-26):3954-60.

Jefferson T, Price D, Demicheli V, Bianco E; European Research Program for Improved Vaccine Safety Surveillance (EUSAFEVAC) Project.

Reparto Epidemiologia Clinica, Istituto Superiore di Sanita, Viale Regina Elena, 299-00161 Rome, Italy. toj1@aol.com

Public debate over the safety of the trivalent measles, mumps and rubella (MMR) vaccine and the drop in vaccination rates in several countries persists despite its almost universal use and accepted effectiveness. We carried out a systematic review to assess the evidence of unintended effects (beneficial or harmful) associated with MMR and the applicability of systematic reviewing methods to the field of safety evaluation. Eligible studies were comparative prospective or retrospective on healthy individuals up to 15 years of age, carried out or published by 2003. We identified 120 articles satisfying our inclusion criteria and included 22. MMR is associated with a lower incidence of upper respiratory tract infections, a higher incidence of irritability, similar incidence of other adverse effects compared to placebo and is likely to be associated with benign thrombocytopenic purpura (TP), parotitis, joint and limb complaints and aseptic meningitis (mumps Urabe strain-containing MMR). Exposure to MMR is unlikely to be associated with Crohn's disease, ulcerative colitis, autism or aseptic meningitis (mumps Jeryl-Lynn strain-containing MMR). The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. The evidence of adverse events following immunization with MMR cannot be separated from its role in preventing the target diseases




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3.) Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism.


Clin Immunol Immunopathol. 1998 Oct;89(1):105-8.

Singh VK, Lin SX, Yang VC.

College of Pharmacy, University of Michigan, Ann Arbor, Michigan, 48109-1065, USA.

Considering an autoimmunity and autism connection, brain autoantibodies to myelin basic protein (anti-MBP) and neuron-axon filament protein (anti-NAFP) have been found in autistic children. In this current study, we examined associations between virus serology and autoantibody by simultaneous analysis of measles virus antibody (measles-IgG), human herpesvirus-6 antibody (HHV-6-IgG), anti-MBP, and anti-NAFP. We found that measles-IgG and HHV-6-IgG titers were moderately higher in autistic children but they did not significantly differ from normal controls. Moreover, we found that a vast majority of virus serology-positive autistic sera was also positive for brain autoantibody: (i) 90% of measles-IgG-positive autistic sera was also positive for anti-MBP; (ii) 73% of measles-IgG-positive autistic sera was also positive for anti-NAFP; (iii) 84% of HHV-6-IgG-positive autistic sera was also positive for anti-MBP; and (iv) 72% of HHV-6-IgG-positive autistic sera was also positive for anti-NAFP. This study is the first to report an association between virus serology and brain autoantibody in autism; it supports the hypothesis that a virus-induced autoimmune response may play a causal role in autism. Copyright 1998 Academic Press.




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4.)  Elevated levels of measles antibodies in children with autism.


Pediatr Neurol. 2003 Apr;28(4):292-4.

Singh VK, Jensen RL.

Department of Biology and Biotechnology Center, Utah State University, Logan, Utah, USA.

Virus-induced autoimmunity may play a causal role in autism. To examine the etiologic link of viruses in this brain disorder, we conducted a serologic study of measles virus, mumps virus, and rubella virus. Viral antibodies were measured by enzyme-linked immunosorbent assay in the serum of autistic children, normal children, and siblings of autistic children. The level of measles antibody, but not mumps or rubella antibodies, was significantly higher in autistic children as compared with normal children (P = 0.003) or siblings of autistic children (P <or= 0.0001). Furthermore, immunoblotting of measles vaccine virus revealed that the antibody was directed against a protein of approximately 74 kd molecular weight. The antibody to this antigen was found in 83% of autistic children but not in normal children or siblings of autistic children. Thus autistic children have a hyperimmune response to measles virus, which in the absence of a wild type of measles infection might be a sign of an abnormal immune reaction to the vaccine strain or virus reactivation.



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5.) Media misled the public over the MMR vaccine, study says.

News roundup

BMJ 2003;326:1107 (24 May), doi:10.1136/bmj.326.7399.1107-a

Abergavenny Roger Dobson



Most people wrongly believed that doctors and scientists are equally divided over the safety of the measles, mumps, and rubella (MMR) vaccine, according to new research carried out during the high profile public debate over the vaccine last year.

At the height of the media coverage the impression was created that medical scientists were split down the middle over the vaccine’s safety, including reports of links with autism, say the study’s authors, from Cardiff University.

Less than one in four people were aware that the bulk of the evidence favoured the vaccine, say the authors of the study. "Although almost all scientific experts rejected the claim of a link between MMR and autism, 53% of those [the people] surveyed at the height of the media coverage of the issues assumed that because both sides of the debate received equal media coverage, there must be equal evidence for each. Only 23% of the population were aware that the bulk of evidence favoured supporters of the vaccine," says the study.

The researchers looked at how three subjects—the MMR vaccine, genetics, and climate change—were reported by the media and at the public’s knowledge of the issues.

The research was carried out between January and September 2002 and involved two national surveys of more than 1000 people and an analysis of 2214 newspaper, radio, and television stories. The study included 561 media reports on MMR over a seven month period. More than half these stories were concentrated in one month between 28 January and 28 February 2002.

The focus of the media reporting was the possible link between the MMR vaccine and autism, a link mentioned in more than two thirds of the articles, say the authors, Professor Ian Hargreaves, Professor Justin Lewis, and Ms Tammy Spears, who carried out the study with funding from the Economic and Social Research Council.

Almost half (48%) of the people surveyed believed that on public health issues the media should wait for confirmatory studies before reporting "alarming research," say the authors. But 34% believed that concerns about the MMR vaccine such as those of Dr Andrew Wakefield vaccine should be reported.

"The survey confirms that the news media play a key role in informing the way people understand issues such as the controversy around MMR. While [Dr] Wakefield’s claims are of legitimate public interest, our report shows that research questioning the safety of something that is widely used should be approached with caution, both by scientists and journalists," said Professor Lewis.

"This is especially the case where any decline in confidence can have serious consequences for public health. The research also has implications for the debate about fairness in journalism, suggesting that legal definitions of impartiality in broadcast journalism should not be interpreted in a simplistic fashion."




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6.) Prevalence of autism and parentally reported triggers in a north east London population.
 

Arch Dis Child. 2003 Aug;88(8):666-70.

Lingam R, Simmons A, Andrews N, Miller E, Stowe J, Taylor B.

Centre for Community Child Health, Royal Free and University College Medical School, Royal Free Campus, University College London, London NW3 2PF.

BACKGROUND: The recorded prevalence of autistic spectrum disorders has risen over recent decades. Measles, mumps and rubella (MMR) vaccine has been blamed, by causing a "new variant" form of "regressive autism" associated with "autistic enterocolitis". AIMS: To estimate the prevalence of autism and to assess any changes in parental perception regarding the onset or causes of autism. METHODS AND RESULTS: A total of 567 children with autistic spectrum disorder in five districts in north east London were identified, born 1979-98. Reported autism, excluding the 94 cases of Asperger's syndrome, increased by year of birth until 1992, since when prevalence has plateaued. This flattening off persisted after allowing for expected delay in diagnosis in more recent birth cohorts. The age at diagnosis of autistic spectrum disorder was estimated to have decreased per five year period since 1983, by 8.7% for childhood autism and by 11.0% for atypical autism. There was some evidence that MMR was more likely to be mentioned as a trigger after August 1997 than before. CONCLUSIONS: The prevalence of autism, which was apparently rising from 1979 to 1992, reached a plateau from 1992 to 1996 at a rate of some 2.6 per 1000 live births. This levelling off, together with the reducing age at diagnosis, suggests that the earlier recorded rise in prevalence was not a real increase but was likely due to factors such as increased recognition, a greater willingness on the part of educationalists and families to accept the diagnostic label, and better recording systems. The proportion of parents attributing their child's autism to MMR appears to have increased since August 1997.


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 7.) Does the MMR vaccine and secretin or its receptor share an antigenic epitope?
 

Med Hypotheses. 2003 May;60(5):650-3.

Mehta BK, Munir KM.

Memorial University of Newfoundland, Newfoundland, Canada.

In a subgroup of children with autism-spectrum like conditions symptoms seem to appear as a 'regression' (in normal development). It has been postulated that the onset of such autistic symptoms may involve an autoimmune response against the central nervous system and that the antigenic determinant could possibly be gastrointestinal in origin. It has been suggested that the presence of the measles virus and 'autistic enterocolitis' demonstrates the possibility that the MMR triple vaccine may be mediating the inflammation with possible production of antibodies against the virus containing vaccine. Such an antibody may share antigenic determinant to molecules found in the gut. We propose that this may be secretin or its receptor, found in the gut as well as in the central nervous system. The antibody response to the gut may also conceivably occur in the brain at a critical time in development. The modulation of development by secretin may be a static event possibly occurring at a specific time in early childhood development and if it involves an autoimmune response then a disruption in development may result. These hypothesized events can only occur if the MMR vaccine shares antigenic determinants that resemble secretin or any of its receptor types and remains to be studied.




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8.) A population-based study of measles, mumps, and rubella vaccination and autism.


N Engl J Med. 2002 Nov 7;347(19):1477-82.

Comment in:
Evid Based Ment Health. 2003 May;6(2):62.
Evid Based Nurs. 2003 Jul;6(3):89.
N Engl J Med. 2002 Nov 7;347(19):1474-5.
N Engl J Med. 2003 Mar 6;348(10):951-4; author reply 951-4.
N Engl J Med. 2003 Mar 6;348(10):951-4; author reply 951-4.
N Engl J Med. 2003 Mar 6;348(10):951-4; author reply 951-4.

Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, Olsen J, Melbye M.

Danish Epidemiology Science Center, Department of Epidemiology and Social Medicine, Arhus, Denmark. kmm@dadlnet.dk

BACKGROUND: It has been suggested that vaccination against measles, mumps, and rubella (MMR) is a cause of autism. METHODS: We conducted a retrospective cohort study of all children born in Denmark from January 1991 through December 1998. The cohort was selected on the basis of data from the Danish Civil Registration System, which assigns a unique identification number to every live-born infant and new resident in Denmark. MMR-vaccination status was obtained from the Danish National Board of Health. Information on the children's autism status was obtained from the Danish Psychiatric Central Register, which contains information on all diagnoses received by patients in psychiatric hospitals and outpatient clinics in Denmark. We obtained information on potential confounders from the Danish Medical Birth Registry, the National Hospital Registry, and Statistics Denmark. RESULTS: Of the 537,303 children in the cohort (representing 2,129,864 person-years), 440,655 (82.0 percent) had received the MMR vaccine. We identified 316 children with a diagnosis of autistic disorder and 422 with a diagnosis of other autistic-spectrum disorders. After adjustment for potential confounders, the relative risk of autistic disorder in the group of vaccinated children, as compared with the unvaccinated group, was 0.92 (95 percent confidence interval, 0.68 to 1.24), and the relative risk of another autistic-spectrum disorder was 0.83 (95 percent confidence interval, 0.65 to 1.07). There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder. CONCLUSIONS: This study provides strong evidence against the hypothesis that MMR vaccination causes autism. Copyright 2002 Massachusetts Medical Society



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9.) Vaccines, viruses, and voodoo.



J Investig Allergol Clin Immunol. 2002;12(3):155-68.

Borchers AT, Keen CL, Shoenfeld Y, Silva J Jr, Gershwin ME.

Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA, USA.

Vaccinations are invaluable in protection from a wide variety of diseases that can cause substantial morbidity and mortality. Although a rare complication of vaccination, autoimmune disorders represent one of these morbidities. Recently, widespread public concern has arisen from case reports suggesting that--similar to what has been observed after natural viral infections--there might be an association between specific immunizations and autoimmune diseases. Herein we address the biological plausibility of such a connection, focusing particularly on the examples of hepatitis B, rubella, and measles-mumps-rubella (MMR) vaccinations, and the autoimmune diseases they are potentially associated with. Our review of the available data suggests that, for the general population, the risk: benefit ratio is overwhelmingly in favor of vaccinations. However, the possibility cannot be ruled out that, in genetically susceptible individuals, vaccination can result in the unmasking of an autoimmune disease triggered by the immunization. We also critically examine the existing data suggesting a link between immunization against MMR and autism, and briefly discuss the controversial evidence pointing to a possible relationship between mercury exposure from vaccines and autistic disorders. There is a continued urgent need for rigorously designed and executed studies addressing these potential associations, although the use of vaccinations remains a critical public health tool for protection against infectious disease.



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10.) The Not-So-Crackpot Autism Theory / looking for a links between autism and thimerosal.

.

source: Http://www.ourstolenfuture.org/

New York Times Magazine
10 November 2002

By ARTHUR ALLEN

Danish study on MMR published during same week
Comments by Neal Halsey about this story

Neal Halsey's life was dedicated to promoting vaccination. In June 1999, the Johns Hopkins pediatrician and scholar had completed a decade of service on the influential committees that decide which inoculations will be jabbed into the arms and thighs and buttocks of eight million American children each year. At the urging of Halsey and others, the number of vaccines mandated for children under 2 in the 90's soared to 20, from 8. Kids were healthier for it, according to him. These simple, safe injections against hepatitis B and germs like haemophilus bacteria would help thousands grow up free of diseases like meningitis and liver cancer.

Halsey's view, however, was not shared by a small but vocal faction of parents who questioned whether all these shots did more harm than good. While many of the childhood infections that vaccines were designed to prevent -- among them diphtheria, mumps, chickenpox and polio -- seemed to be either antique or innocuous, serious chronic diseases like asthma, juvenile diabetes and autism were on the rise. And on the Internet, especially, a growing number of self-styled health activists blamed vaccines for these increases.

Like all medical interventions, vaccines sometimes cause adverse reactions. But unlike pills, vaccines come packaged with high expectations, which make them particularly vulnerable to public criticism. Vaccines don't cure people, and they are administered to healthy children, which gives them few opportunities for good press. When they work, nothing happens. When vaccinated children become ill, their parents are grief-stricken and often enraged, even if vaccines aren't proved to be at fault. All of this puts public-health advocates like Halsey on the defensive. Most attacks on vaccines, they say, are based on hysteria, bad science and dubious politics.

Halsey, 57, has green eyes, a white beard that makes him look like a ship's captain and an air of careful authority. As chairman of the American Academy of Pediatrics committee on infectious diseases from 1995 through June 1999, he often appeared in the media administering calm reassurance. ''Many of the allegations against vaccines,'' Halsey said in one interview, ''are based on unproven hypotheses and causal associations with little evidence.''

And then suddenly in June 1999, during a visit to the Food and Drug Administration, a squall appeared on the horizon of Halsey's confidence. Halsey attended a meeting to discuss thimerosal, a mercury-containing preservative that at the time was being used in several vaccines -- including the hepatitis B shot that Halsey had fought so hard to have administered to American babies. By the time the dust kicked up in that meeting had settled, Halsey would be forced to reckon with the hypothesis that thimerosal had damaged the brains of immunized infants and may have contributed to the unexplained explosion in the number of cases of autism being diagnosed in children.

That Halsey was willing even to entertain this possibility enraged some of his fellow vaccinologists, who couldn't fathom how a doctor who had spent so much energy dismantling the arguments of people who attacked vaccines could now be changing sides. But to Halsey's mind, his actions were perfectly consistent: he was simply working from the data. And the numbers deeply troubled him. ''From the beginning, I saw thimerosal as something different,'' he says. ''It was the first strong evidence of a causal association with neurological impairment. I was very concerned.''

The investigation into mercury vaccines was instigated in 1997 by Representative Frank Pallone Jr., a New Jersey Democrat whose district includes a string of shore towns where mercury in fish is one of many environmental concerns. Pallone, who had been pressing the government to re-evaluate its overall guidelines on mercury toxicity, attached an amendment to an F.D.A. bill requiring the agency to inventory all mercury contained in licensed drugs and vaccines.
The job of adding up the amount of mercury in vaccines and assessing its risk fell to Robert Ball, an F.D.A. scientist, and two F.D.A. pediatricians, Leslie Ball, Robert's wife, and R. Douglas Pratt. Thimerosal, which is 50 percent ethyl mercury by weight, had been used as a vaccine preservative since the 1930's in the diphtheria-tetanus-pertussis shot, known as D.T.P., and it was later added to some vaccines for hepatitis B and haemophilus bacteria, which by the early 1990's had become routine immunizations for infants.

The F.D.A. team's conclusions were frightening. Vaccines added under Halsey's watch had tripled the dose of mercury that infants got in their first few months of life. As many as 30 million American children may have been exposed to mercury in excess of Environmental Protection Agency guidelines -- levels of mercury that, in theory, could have killed enough brain cells to scramble thinking or hex behavior.

''My first reaction was simply disbelief, which was the reaction of almost everybody involved in vaccines,'' Halsey says. ''In most vaccine containers, thimerosal is listed as a mercury derivative, a hundredth of a percent. And what I believed, and what everybody else believed, was that it was truly a trace, a biologically insignificant amount. My honest belief is that if the labels had had the mercury content in micrograms, this would have been uncovered years ago. But the fact is, no one did the calculation.''

Making matters worse, the latest science on mercury damage suggested that even small amounts of organic mercury could do harm to the fetal brain. Some of the federal safety guidelines on mercury were relaxed in the 90's, even as the amount of mercury that children received in vaccines increased. The more Halsey learned about these mercury studies, the more he worried.

''My first concern was that it would harm the credibility of the immunization program,'' he says. ''But gradually it came home to me that maybe there was some real risk to the children.'' Mercury was turning out to be like lead, which had been studied extensively in the homes of the Baltimore poor during Halsey's tenure at Hopkins. ''As they got more sophisticated at testing for lead, the safe level marched down and down, and they continued to find subtle neurological impairment,'' Halsey says. ''And that's almost exactly what happened with mercury.''

Halsey was beginning to think that it would be prudent to limit thimerosal-containing vaccines and urge pediatricians to use thimerosal-free shots when possible. But his decision inflamed some of his peers. After all, although the thimerosal data was worrisome to Halsey, the available science offered no clear proof that the preservative posed a genuine danger to children when given in parts per million. Moreover, it wasn't clear that there were enough thimerosal-free vaccines available for diseases like pertussis and hepatitis B. Should an unproven fear justify the cessation of a procedure that protected children from proven dangers?

Halsey looked into the matter further and found only complexity. In the medical literature, most cases of acute mercury poisoning result from doses hundreds or thousands of times higher than what infants received with thimerosal-laden vaccines. And although the thimerosal levels in vaccines exceeded the E.P.A.'s guidelines for methyl mercury, thimerosal contained ethyl mercury, a compound that behaves somewhat differently in the body. The E.P.A. based its guidelines on a series of studies of 917 children born in 1987 in the Faeroe Islands, a windswept North Atlantic archipelago, to women who ate methyl-mercury-tainted whale meat. The Faeroes children, whose umbilical cord blood averaged four times the E.P.A.'s daily ''safe'' dose -- which was 0.1 micrograms per kilo -- exhibited small but measurable neurological deficits seven years later. They had slower reaction times and diminished attention spans and their word choice and memorization were less keen than those of their classmates who had been exposed to less mercury, according to Philippe Grandjean, a Danish researcher who leads the continuing Faeroes study and teaches at Boston University.

During most of the 90's, many American 6-month-olds received a total of 187.5 micrograms of ethyl mercury through vaccination. While the Faeroes children were exposed to mercury as developing fetuses, and therefore were more vulnerable than the vaccinated American infants, the American babies included about 60,000 each year who had already been exposed to high mercury levels because their mothers had eaten a lot of contaminated fish. What's more, hundreds of thousands of Rh-negative pregnant women and their unborn Rh-positive babies received additional thimerosal each year through injections designed to keep the mothers' immune systems from attacking the fetuses.

The Faeroes studies, though they dealt with methyl mercury, unnerved Halsey. Other researchers were troubled, too. George Lucier, a toxicologist who led a 1998 White House review of mercury's dangers, went so far as to say it was ''very likely'' that thimerosal had damaged some children. There was precious little data to back up that precise suspicion -- and little to dismiss it -- because of the lack of toxicology research on ethyl mercury.

On July 7, 1999, at Halsey's urging, the American Academy of Pediatrics and the Public Health Service released a statement urging vaccine manufacturers to remove thimerosal as quickly as possible and advising pediatricians to postpone giving most newborns the birth dose of the hepatitis B vaccine. The decision, which helped to create vaccine shortages and led some babies to become infected with hepatitis B, outraged some senior vaccine experts. Walter Orenstein, director of the National Immunization Program at the Centers for Disease Control and Prevention, would charge that the rush to remove thimerosal-containing vaccines was ''precipitous.'' Stanley Plotkin, a renowned vaccine developer, said that it was fruitless to try to soothe vaccination critics. ''If antivaccinationists did not have mercury, they would have another issue,'' he said at one meeting. ''One cannot prevent them from making hay regardless of whether the sun is shining or not.''

In Halsey's view, however, thimerosal wasn't simply a bone for rabid vaccine opponents to gnaw on. In the middle of that hectic summer he took a vacation in Maine. Canoeing on a lake, he came across posters that advised fishermen to ''protect your children -- release your catch.'' Halsey took that message to heart. If the government was warning people against eating fish with mercury, he asked his colleagues, ''does it make sense to allow it to be injected into infants?''

Although other vaccinologists criticized Halsey, many of his colleagues rallied around him. ''Neal put kids ahead of the vaccination program, which was gutsy,'' says Lynn Goldman, a former E.P.A. official who has been on the Hopkins faculty since 1999 and worked with Halsey on thimerosal. ''It would have been easier for him to line up on the other side.''
Few scientists believe that the spike in autism could have been caused solely by the thimerosal in vaccines, but in October 2001, a vaccine-safety committee at the starchy Institute of Medicine confirmed that it was ''biologically plausible'' -- though by no means proved -- that thimerosal could be related to neurodevelopmental delays in some children. The committee recommended that thimerosal be removed from vaccines and called for extensive research to determine any damage it had caused.

Halsey's fellow researchers were right about one thing. Antivaccine advocates immediately seized upon the thimerosal theory, and Halsey became something of an unwilling hero to the vaccine-safety advocates with whom he had so often sparred. In fact, thousands of parents with autistic children have responded to the Institute of Medicine report by filing lawsuits. Michael Williams, who has won millions in toxic tort settlements from pharmaceutical companies, was among the first lawyers to sue vaccine manufacturers, on behalf of William Mead, a 4-year-old Portland, Ore., boy with autism. Williams also filed a separate class-action lawsuit with William's healthy older sister, Eleanor, as lead plaintiff, demanding that vaccine makers also pay for studies to determine thimerosal's effects on millions of children who might have lower I.Q.'s or other less obvious signs of mercury poisoning. Past studies have shown that mercury's effects vary tremendously from person to person, presumably because of genetic differences in the body's capacity to protect delicate organs from it.

''In order to win the Eleanor lawsuit you need to establish liability, but I don't think that is going to be that hard,'' Williams said in a recent chat in his Portland office. ''Organic mercury is a very serious neurotoxin.''

Williams embodies the vaccine establishment's worst fear about Halsey's course of action -- which is that taking the precautionary step of eliminating thimerosal would be read as an admission of fault. ''The agenda was set by the lawyers and the antivaccine activists,'' a source close to a number of manufacturers complained to me. ''The scientists responded to it scientifically, and that put them behind the eight ball right away. You had Neal Halsey running around saying: 'We've got to do something! We've got to show we're concerned!'''

Paul Offit, a vaccinologist at the Children's Hospital of Philadelphia, takes it a step further. ''In some instances I think full disclosure can be harmful,'' he says. ''Is it safe to say there is zero risk with thimerosal, when it is remotely possible that one child would get sick? Well, since we say that mercury is a neurotoxin, we have to do everything we can to get rid of it. But I would argue that removing thimerosal didn't make vaccines safer -- it only made them perceptibly safer.''

For Halsey, thimerosal injury is a possibility that must be addressed -- but by science, not by the courts. The scientific agenda, however, is already deeply politicized. From the start, the C.D.C.'s efforts to examine the possibility of thimerosal damage became snarled in acrimony. Critics of the vaccination system don't trust the C.D.C., which monitors evidence of adverse reactions to vaccines through the Vaccine Safety Datalink, a computerized set of 7.5 million medical records. Safe Minds, an advocacy group of parents who believe that their autistic children were damaged by thimerosal, has used the Freedom of Information Act to obtain documents showing that as early as December 1999 the C.D.C. had reason to believe that thimerosal caused developmental delays in some children. It was far from conclusive evidence, but vaccine critics charged that the C.D.C. tried to play it down. One of those critics was Dan Burton, a Republican congressman from Indiana, who says he firmly believes that his grandson's autism is a result of vaccines. ''I'm so ticked off about my grandson, and to think that the public-health people have been circling the wagons to cover up the facts!'' Burton fumed at a June hearing. ''Why, it just makes me want to vomit!''

What comes through in an examination of the documents uncovered by Safe Minds is less a coverup than an impression of scientists anxiously watching over their shoulders as they work. One document, for example, records comments made by Robert Brent, a Philadelphia pediatrician who served as a consultant for the thimerosal study. ''The medical-legal findings in this study, causal or not, are horrendous,'' Brent said. ''If an allegation was made that a child's neurobehavioral findings were caused by thimerosal-containing vaccines, you could readily find a junk scientist who would support the claim with a reasonable degree of certainty. But you will not find a scientist with any integrity who would say the reverse with the data that is available. . . . So we are in a bad position from the standpoint of defending any lawsuits if they were initiated.''

More research is in the works. The C.D.C. is setting up a study of neurodevelopmental effects based in part on the Faeroe Islands model. The N.I.H. is financing studies of thimerosal metabolism in animals and children. (An early University of Rochester study was reassuring: it indicated that children eliminate thimerosal much more quickly than expected.)
Clearly, a lot is riding on this research, and pressure is being brought to bear on both sides. Can the vaccine authorities accept a positive answer? Can the vaccine opponents accept a negative one? ''No one wants to think that harm might have been done,'' Halsey says. ''I don't want to think harm might have been done.''

American children still receive up to 20 vaccines in the first two years of life. The first symptoms of autism often appear between the ages of 12 and 24 months. Most autism experts say that the two facts are coincidental, but as a major California study recently confirmed, autism is being diagnosed in numbers far higher than ever before, suggesting that a nongenetic cause may be partly to blame. In some children, the behavioral traits of autism present themselves along with physical problems like sensory dysfunction and motor disorders that have rough correlates in the mercury-poisoning literature. For some parents, thimerosal provides a grand unifying theory that squarely points the finger at the government and vaccine makers.

During much of the 20th-century, children suffered from an ailment called pink disease, which caused peeling skin on the extremities as well as regressive behavior. In 1948, a keen-eyed Cincinnati pediatrician named Josef Warkany noticed a common risk factor in these children: they had all been given teething powders containing calomel, a mercury derivative. Only about 1 in 500 children whose parents gave them calomel got pink disease -- suggesting that a constitutional vulnerability to mercury was part of the clinical picture. Soon after the powders were taken off the market, pink disease disappeared.

Autism is a global phenomenon that was first reported in America in 1943, long before the potential dangers of thimerosal vaccines were raised. Removing the preservative won't -- even in the best case -- eliminate the illness. But scientists estimate that the current rate of autism in its various forms might be as high as 1 in 500. If the autism trend begins to recede now that thimerosal has been removed, it could certainly suggest a cause. If it does decline, we might have Neal Halsey to thank. If it doesn't, his colleagues in the vaccine establishment may blame him for stoking an irrational protest from the public.

Halsey, who still heads the Hopkins Institute for Vaccine Safety, which he was a founder of in 1997, is on the fence. ''I don't believe the evidence is convincing now that there has definitely been harm done by thimerosal,'' he says, absently stroking his balding head. But to keep the vaccine program on a steady keel, Halsey says, the public-health authorities simply must follow through with the studies and face the consequences without flinching. If there is damage, he says, ''there should be some kind of compensation, though I don't know how.'' He pauses, and sighs. ''I empathize with families of children with these disorders. How are you going to put dollar values on that?''
 



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DATA-MEDICOS /DERMAGIC-EXPRESS /JANUARY JOURNAL 2..003/ DR. JOSE LAPENTA R.  DERMATOLOGIST

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