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Wednesday, February 1, 2006

Doctors Mixed on Flu Shots

By Jackie Jadrnak
Journal Staff Writer
    Dr. Gary Overturf can't understand people who worry about mercury-containing preservatives in vaccine and then send their kids to school with tuna for lunch.
    "I'm sorry. It makes no sense at all," he said. "There's likely to be more actual methylmercury in a tuna fish sandwich." Industrial wastes taken up in fish and the environment are where people get most of their harmful mercury exposure, he said.
    Dr. Kenneth Stoller, medical director of the Santa Fe-based Hyperbaric Medical Center of New Mexico, understands the worry. He calls the use of thimerosal in vaccines "probably the largest iatrogenic (medically-caused harm) medical mistake in the world."
    "It's not easy to face up to," he said of his fellow pediatricians. "The whole thing is very sad."
    There, in an anecdotal nutshell, is the essence of an emotional debate that is spilling over to the Legislature. House Bill 271, sponsored by Rep. Rhonda King, D-Stanley, says children younger than 8 and pregnant women shall not receive influenza vaccine with more than trace amounts of mercury.
    It goes on to allow exemptions if the Department of Health says there isn't enough flu vaccine available without thimerosal.
    While the bill opens such loopholes, the state's medical community is bristling at what the majority of them see as untrue: the contention that thimerosal in vaccines is harmful.
    "I think this bill has taken time and energy away from other ways we can improve the health of our children," said Dr. Laurence Shandler, a Santa Fe pediatrician and immediate past president of the New Mexico Pediatric Society.
    Back in 1999, the American Academy of Pediatrics began considering concerns about mercury exposures and recommended that thimerosal be removed from early-childhood vaccines.
    Overturf, professor of pediatrics at the University of New Mexico, served on that committee. "It was a theoretical concern," he said. "We knew with methylmercury exposure, fetuses received severe neurological injury. There was no evidence of any problem with thimerosal in children."
    Thimerosal contains ethylmercury, which later research has shown is more easily metabolized and quickly excreted from the body, Overturf said. "Serum concentrations don't get as high, and (people) develop no central nervous system concentrations," he said.
    Stoller contends that while ethylmercury is removed more quickly from the blood, it then is deposited within the nervous system and brain. "We know this through animal studies," he said. "It gets converted more efficiently to inorganic mercury and has a half-life of decades."
    Stoller sees a link between thimerosal in vaccines and the rise of autism in this country. Since manufacturers began removing thimerosal two or three years ago, the rise in autism rates in California has begun to slow, he said.
    The New Mexico Immunizations Coalition notes that a 2004 Institute of Medicine report concluded that there is no evidence linking vaccines with autism.
    Currently, influenza vaccines for adults and children older than 3 are the ones kids still get that contain thimerosal. To keep costs down, the vaccines are sold in multi-dose vials instead of individual dosages. The preservative is used to prevent bacterial contamination.
    "The real risk of getting influenza is substantial. The very theoretical risk of harm from thimerosal has not been shown to be true," said Anna Pentler, the coalition's executive director. "We believe we best protect our children by immunizing them."
    But Stoller said he isn't convinced that influenza vaccinations are very effective in preventing the disease, nor does he believe that as many people die of the flu as health officials say. "New Mexico has been one of the hardest-hit by flu this year ... and not one child has died of flu this year in New Mexico," he said.
    And he dismisses the Institute of Medicine report. "They are quite compromised. It is not a sacrosanct, clean organization," Stoller said. "They got orders on what was said."
    Overturf said he has spent much of the last 12 years on vaccine safety and efficacy reviews. Stoller, he said, is voicing "a very, very minority opinion."
    "He expresses it like the other 99.9 percent of pediatricians are nuts," Overturf said. "That's a little unfortunate."