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对美国接种百白破疫苗(DTP)和b型流感嗜血杆菌疫苗(Hib)后报告的硫柳汞对神经发育障碍的影响与接种百白破-嗜血杆菌结合疫苗(DTPH)后的影响进行评估。

An evaluation of the effects of thimerosal on neurodevelopmental disorders reported following DTP and Hib vaccines in comparison to DTPH vaccine in the United States.

作者信息

Geier David A, Geier Mark R

机构信息

The Genetic Centers of America, Silver Spring, Maryland 20905, USA.

出版信息

J Toxicol Environ Health A. 2006 Aug;69(15):1481-95. doi: 10.1080/15287390500364556.

DOI:10.1080/15287390500364556
PMID:16766480
Abstract

Thimerosal is an ethylmercury (49.55% mercury by weight) preservative historically added to some vaccines. Toxicokinetic studies showed children in the United States received doses of mercury from Thimerosal-containing vaccines (TCVs) in excess of safety guidelines. In the United States during the 1990s, diphtheria-tetanus-pertussis (DTP) and Haemophilus influenzae type b (Hib) vaccines (maximally, 50 mug mercury per joint administration) and diphtheria-tetanus-pertussis-Haemophilus influenzae type b (DTPH) vaccines (25 mug mercury per administration) were given to children in the same childhood vaccination schedule at 2, 4, 6, and 15-18 mo, so that children receiving DTP and Hib vaccines may have maximally received an additional 100 mug more mercury exposure from TCVs than children administered DTPH vaccines. A case-control epidemiological study of neurodevelopmental disorders (NDs) reported to the Vaccine Adverse Event Reporting System (VAERS) (online public access version; updated 31 August 2004) following administration of DTP vaccines in comparison DTPH vaccines manufactured by Lederle Laboratories (Pearl River, NY) from 1994 through 1998 was undertaken. Significantly increased odds ratios for autism, speech disorders, mental retardation, infantile spasms, and thinking abnormalities reported to VAERS were found following DTP vaccines in comparison to DTPH vaccines with minimal bias or systematic error. Additional ND research should be undertaken in the context of evaluating mercury-associated exposures, especially since in 2005 the Institute of Medicine issued a report calling into question handling of vaccine safety data by the National Immunization Program of the Centers for Disease Control and Prevention.

摘要

硫柳汞是一种乙基汞(按重量计含汞49.55%)防腐剂,历史上曾被添加到某些疫苗中。毒代动力学研究表明,美国儿童从含硫柳汞疫苗(TCV)中摄入的汞剂量超过了安全指南。在20世纪90年代的美国,白喉-破伤风-百日咳(DTP)疫苗和b型流感嗜血杆菌(Hib)疫苗(每次联合接种最多含50微克汞)以及白喉-破伤风-百日咳-b型流感嗜血杆菌(DTPH)疫苗(每次接种含25微克汞)在2、4、6和15 - 18个月时按照相同的儿童疫苗接种程序给儿童接种,因此接种DTP和Hib疫苗的儿童从TCV中摄入的汞可能比接种DTPH疫苗的儿童最多多100微克。对1994年至1998年期间由莱德勒实验室(纽约州珍珠河)生产的DTP疫苗与DTPH疫苗接种后向疫苗不良事件报告系统(VAERS)(在线公共访问版本;2004年8月31日更新)报告的神经发育障碍(ND)进行了病例对照流行病学研究。与DTPH疫苗相比,向VAERS报告的DTP疫苗接种后自闭症、言语障碍、智力迟钝、婴儿痉挛和思维异常的优势比显著增加,偏差或系统误差最小。应在评估与汞相关的暴露背景下进行更多的ND研究,特别是因为2005年医学研究所发布了一份报告,对疾病控制和预防中心国家免疫规划处理疫苗安全数据的方式提出了质疑。

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