For more than a year, Springfield radiologist David
Ayoub has immersed himself in the noisy politics of a silent disease.
He’s familiar with the characteristic blank stares of autistic
toddlers and the quiet panic of parents wandering uncharted medical,
financial, and emotional territory.
He’s equally familiar with the quiet panic of
pharmaceutical giants who can read the writing on the wall.
The big drug companies, according to recent reports,
may have known for years of the potential risks of thimerosal, a
mercury-based preservative used in many common vaccines. Mercury exposure
has been linked in several studies to neurodevelopmental disorders that
afflict children, including autism and attention-deficit/hyperactivity
disorder.
Ayoub has plunged into the scientific literature
— and emerged fully convinced that the case against the preservative
is “unequivocal.” He’s helping lead the push in Illinois
to ban mercury from vaccines, an effort that’s gaining momentum even
though it has yet to be embraced by much of the medical and public-health
community.
Not the sort to put much faith in the establishment,
Ayoub says that trust in government and mainstream medicine can be badly
misplaced.
“The debacle with Vioxx and other drugs should
be a warning,” he says. “The system can fail. Sometimes it can
fail spectacularly.”
Ayoub, 45, isn’t one to seek the limelight,
but it often finds him. At Peoria High School, he set a state track record
that still stands. At the University of Illinois, the two-time All-American
in track and field earned a Big Ten title. In the honors program there, he
was thinking fast, too. He critiqued scientific studies weekly for two
years and says it helped him hone his ability to spot flawed research.
As an undergrad, in 1983, he broke another record
when his work was published in the elite journal Science. The coup led to a flurry of
national media coverage, and Ayoub recalls being teased for being
“sex-obsessed” by a Peoria newspaper reporter because the study
he co-authored was focused on differences between neurons in the brains of
male and female juvenile macaque monkeys. “Sex differences in the
brain was a hot topic at the time,” Ayoub says.
Since then, Ayoub’s been teaching and
practicing radiology. He’s lived in Springfield 14 years and works
part-time at Memorial Medical Center in addition to carrying out the duties
of his post as director of the Prairie Collaborative for Immunization
Safety.
In 2003, while reading medical journals, Ayoub
decided to investigate breakthrough biomedical treatments at a Defeat
Autism Now! conference in Washington, D.C. “Once you attend a DAN
conference, you don’t come back the same,” he says.
Now he’s begging physicians to take a closer
look at new treatments and old problems. He’s summarized his
exhaustive research on an extensively documented CD, which he’s
titled The Science and Politics of
Vaccine-Induced Autism. He says that
physicians can no longer afford to blindly trust the literature.
Ayoub has joined forces with others, such as
Springfield lobbyist Laura Cellini, whose son Jonathan is autistic.
They’re pushing the Illinois General Assembly to pass legislation
banning the use of vaccines containing thimerosal. The effort is similar to
last year’s unsuccessful push in neighboring Missouri, where a
filibuster in the state Senate killed the bill.
Illinois’ version, the Mercury-Free Vaccine
Act, is sponsored by Rep. Kurt Granberg, D-Carlyle. The bill specifies that no one in
Illinois under the age of 3 years or who is pregnant may be given a vaccine
containing more than 0.5 micrograms of mercury per 0.5-milliliter dose, or
an influenza vaccine containing more than 1.0 microgram of mercury per 0.5
milliliter dose. The bill was approved in the House Feb. 16 by a vote of
115-0, and moved on to the Senate, where it was set for first reading on
Wednesday, Feb. 23. The Senate bill is sponsored by Senator Mattie Hunter,
D-Chicago.
Even if the bill becomes state law, Illinois could be
trumped by Congress, which is considering Senate Bill 3, the Protecting
America in the War on Terror Act of 2005. The proposed federal legislation,
which increases benefits for the families of U.S. soldiers who die in Iraq,
also includes language protecting vaccine makers from product liability
under the guise of bioterrorism protection.
According to the Coalition for SafeMinds (Sensible
Action for Ending Mercury-Induced Neurological Disorders), a nonprofit
advocacy group based in Cranford, N.J., the federal legislation would block
civil claims for injuries caused by mercury in vaccines. Lujene Clark of St. Louis, president
of nomercury.org, which serves as an information clearinghouse for
advocates of a thimerosal ban, says the legislation would also prevent
states from banning mercury, regulating drugs, or warning citizens that
mercury-containing vaccines or other drugs may be dangerous. Clark says it
includes sweeping changes in pharmaceutical-product liability, research,
and the Vaccine Injury Compensation Act, which already gives drug companies
unprecedented protection.
With federal bills pending, states are moving fast to
pass mercury bans. Last year, Iowa and California passed laws restricting
the use of mercury in vaccines. Nine states — including Illinois
— are considering similar legislation. The anti-mercury effort also
extends to the dental profession.
In Arizona, a bill to warn parents and pregnant women
that mercury fillings can harm the developing brain of a child or a fetus
has garnered bipartisan support. Another bipartisan effort in New Mexico
resolves to study the health and environmental impact of mercury amalgam
fillings.
This flurry of legislative action provokes
reactions ranging from skepticism to fear among many health professionals.
They contend that thimerosal’s critics are alarmists, that an
outright ban risks the return of dreaded diseases.
Dr. Lawrence Frenkel, professor of pediatrics and
microbiology at the University of Illinois College of Medicine at Rockford,
says people are being needlessly frightened.
“It’s the bogeyman,” says Frenkel.
“The level of thimerosal, or the ethylmercury
[in pediatric vaccines], is very, very low,” he says. “Yes, it
reaches the safety margin for methylmercury, but that’s not been
proven to be an issue or a problem.”
Frenkel says the risk doesn’t outweigh the
consequences of not getting children immunized.
“I’m old enough to have seen children
suffer and die with many vaccine-preventable diseases,” says Frenkel.
“The vaccines are better than the disease.”
Mercury occurs naturally in the environment, in
either inorganic or organic forms. According to the federal
government’s Agency for Toxic Substances and Disease Registry,
organic forms of mercury, such as ethylmercury and methylmercury, have
“a significantly greater toxic effect than other mercury
compounds.” Federal regulatory agencies have set limits to the
exposure from ingestion of methylmercury — found in fish — but
not ethylmercury, found in vaccines.
That doesn’t mean, however, that state and
federal agencies have failed to limit exposure to thimerosal. In 1982, FDA
officials said that thimerosal was “not safe for over-the-counter
topical use.” Thimerosal has also been on California’s
Proposition 65 list of known reproductive and developmental toxins for more
than a decade. It was removed from animal vaccines in the ’90s.
U.S. Rep. Dan Burton, R-Ind., chaired the oversight
committee that in 2003 produced a report on the use of mercury-based
vaccines titled Mercury in Medicine. The committee heard expert testimony and examined
research from leading universities. Burton concluded: “It should be
crystal-clear by now that mercury is a toxic substance that does not belong
in pediatric vaccines.”
Drugmaker Merck & Co. Inc., still contending with
the Vioxx controversy, is one of the companies embroiled in the thimerosal
dispute. According to an internal memo obtained by the Los Angeles Times, thimerosal was on
Merck’s radar as early as 1991. Merck executives expressed concern
that babies could be exposed to dangerously high thimerosal levels. The
memo noted that some 6-month-old children would get a mercury dose
“up to 87 times higher than guidelines for the maximum daily
consumption of mercury from fish.”
Eli Lilly and Co. introduced thimerosal around 1930
with minimal safety testing. According to the Burton committee report, a
1935 internal document noted that Merthiolate, the brand name for
thimerosal, was unsatisfactory as a serum for use on dogs.
Mercury foes don’t like GlaxoSmithKline,
either. The pharmaceutical giant hired Dr. Thomas Verstraeten, a Centers
for Disease Control and Prevention scientist and lead author of a
controversial study published in Pediatrics in 2003. Activists criticized the journal for failing to
disclose that Verstraeten was now employed by GSK, a vaccine-maker named in
thimerosal litigation.
In June of 2000, Verstraeten had presented the
results of his review of vaccination data, which suggested a link between
thimerosal and neurological disorders. However, after several drafts, the
version published in Pediatrics indicated that a link could not be confirmed.
National media headlines trumpeted that thimerosal
had been cleared, fueling the anger of parents who had seen the original
data showing a link. After much public outcry, Verstaeten wrote to Pediatrics to say that the
results were inconclusive and more research was needed.
The controversy heightened when activists obtained
transcripts from an off-site meeting convened by the CDC in 2000. Vaccine
experts — including pharmaceutical company representatives —
gathered to discuss Verstraeten’s findings. According to the
transcripts, Verstraeten said that when he saw the literature, he was
stunned because he thought a link was plausible.
Advisory-committee member Dr. David Johnson said that
he was concerned enough that he did not want his grandson to get a
thimerosal-containing vaccine.
After analyzing the Verstaeten data, researchers at
SafeMinds found strong evidence of a link. A SafeMinds release reports that
Verstaeten’s initial analysis indicates that CDC officials were aware
in 1999 of an 11-fold increase in autism risk among children who received
thimerosal-containing vaccines. Noted impairments included “an
unspecified developmental delay,” ADHD, tics, language and speech
delays, and “the entire category of neurodevelopmental delays.”
In 2001, the CDC commissioned the Institute of
Medicine to examine the thimerosal-autism evidence. The IOM’s first
analysis found the hypothesis “biologically plausible” and
called for further research. A 2004 reanalysis rejected any link.
According to nomercury.org’s Lujene Clark, IOM
committee-meeting transcripts were leaked and turned over to authorities.
The transcripts suggest that CDC officials pressured committee members.
“The CDC contracted and paid for this series of
reports from the IOM,” says Clark. “They made it very clear
that they wanted the IOM to give the nod, to say that ‘We see no
problems.’ That’s very, very frightening.”
Emerging evidence suggests that mercury was the last
biochemical straw for some kids — especially those who got 187
micrograms of mercury during the first six months of life. Autism may be
caused by a genetic predisposition triggered by heavy metal or pesticide
insults that damage metabolic pathways.
Dr. Jill James, a University of Arkansas biochemist,
recently published a study showing that kids with autism have a highly
abnormal metabolic profile. “They have very low levels of …
glutathione,” says James. “Glutathione is well established to
be the major mechanism of mercury detoxification and excretion.
“Given an equal exposure to heavy metals
— and we’d want to focus on any of them; mercury could be one,
arsenic, lead — if you’ve got less glutathione around,
it’s going to be more toxic.”
Scientists have found heavier body burdens of mercury
in autistic kids, implying an impaired ability to get rid of the heavy
metal. Additional research has found that thimerosal induces DNA breakage,
membrane damage, and cell death in human neurons. Inherited DNA breakage
could leave each subsequent generation more vulnerable to heavy-metal
damage.
Replicated studies of baby hair and teeth have shown
that autistic kids have lower mercury levels, again implying that these
children’s bodies retain mercury.
“These kids with autism have three times as
much mercury in them,” says Dr. James Adams, chemical-engineering
professor at Arizona State University. “You know there’s
something very wrong with their mercury metabolism.”
Other findings include evidence of brain
inflammation, gastrointestinal inflammation, and autoimmune activation in
autistic kids. The authors of a breakthrough Columbia University study
reported that they induced autism in mice with the suspected genetic
predisposition by giving them vaccine-comparable doses of thimerosal.
With all of the mounting evidence, David Ayoub
wonders why vaccine makers are still putting 25 micrograms of thimerosal in
flu vaccines given to babies, pregnant women, and senior citizens.
For the first time, the CDC recommended this year
that babies get flu shots earlier, at 6 months of age. Pregnant women were
also encouraged to get flu shots.
The package insert for Fluzone — an influenza
vaccine distributed by Aventis Pasteur — states, “It is not
known whether Influenza Virus Vaccine can cause fetal harm when
administered to a pregnant woman or can affect reproduction
capacity.”
“The EPA’s allowable daily exposure limit
is 0.1 micrograms per kilogram of body weight,” Ayoub says. “To
meet this guideline, those who receive a flu vaccine must weigh at least
550 pounds. The fetus would receive a dose exceeding federal limits by
several hundredfold.”
In 2000, an FDA neurotoxicology study found that
thimerosal crosses the placental and blood-brain barriers. According the
CDC, one in 12 women of childbearing age has an unsafe level of mercury in
her body, putting newborns at risk.
“There is as far as I know no definitive plan . . . to remove mercury from flu shots,” Ayoub says.
According to an Aventis Pasteur spokesman, the
world’s largest flu-vaccine producer, supply is not an issue.
“This is the third year that we’ve
produced the preservative-free formulation,” says spokesperson Len
Lavenda. “We have never sold out — even this year, or last
year, when we had a shortage.
“They [healthcare providers] have a choice.
Both formulations are approved by the FDA for people aged 6 months and
older . . . I think the preservative-free is a little more, but we’re
not talking dollars more — it’s cents more.”
Ayoub says that shows why voluntary removal
doesn’t work.
“A law banning thimerosal is necessary,”
Ayoub says. “Voluntary removal or reduction doesn’t assure
safety.”
Parents say the best way to restore public confidence
is to “come clean” and fix a broken system.
“Get the mercury out,” says Lujene Clark,
“and reassure parents that you are finally starting to make decisions
in the best interests of the citizens.”
Ayoub agrees: “The autism epidemic is largely
the result of heavy pharmaceutical industry influence. To prevent future
tragedies, we need major reform.
“Exposure of the truth is the first
step.”
This article appears in Feb 24 – Mar 2, 2005.
