Sykes Lisa K, Geier David A, King Paul G, Kern Janet K, Haley Boyd E, Chaigneau Carmen G, Megson Mary N, Love James M, Reeves Robert E, Geier Mark R
CoMeD, Inc, Silver Spring, MD United States.
CoMeD, Inc, Silver Spring, MD; Institute of Chronic Illnesses, Inc, Silver Spring, MD United States.
Indian J Med Ethics. 2014 Oct-Dec;11(4):206-18. doi: 10.20529/IJME.2014.054. Epub 2014 Apr 11.
When addressing toxins, one unmistakable parallel exists between biology and politics: developing children and developing nations are those most vulnerable to toxic exposures. This disturbing parallel is the subject of this critical review, which examines the use and distribution of the mercury (Hg)-based compound, thimerosal, in vaccines. Developed in 1927, thimerosal is 49.55% Hg by weight and breaks down in the body into ethyl-Hg chloride, ethyl-Hg hydroxide and sodium thiosalicylate. Since the early 1930s, there has been evidence indicating that thimerosal poses a hazard to the health of human beings and is ineffective as an antimicrobial agent. While children in the developed and predominantly western nations receive doses of mostly no-thimerosal and reduced-thimerosal vaccines, children in the developing nations receive many doses of several unreduced thimerosal-containing vaccines (TCVs). Thus, thimerosal has continued to be a part of the global vaccine supply and its acceptability as a component of vaccine formulations remained unchallenged until 2010, when the United Nations (UN), through the UN Environment Programme, began negotiations to write the global, legally binding Minamata Convention on Hg. During the negotiations, TCVs were dropped from the list of Hg-containing products to be regulated. Consequently, a double standard in vaccine safety, which previously existed due to ignorance and economic reasons, has now been institutionalised as global policy. Ultimately, the Minamata Convention on Hg has sanctioned the inequitable distribution of thimerosal by specifically exempting TCVs from regulation, condoning a two-tier standard of vaccine safety: a predominantly no-thimerosal and reduced-thimerosal standard for developed nations and a predominantly thimerosal-containing one for developing nations. This disparity must now be evaluated urgently as a potential form of institutionalised discrimination.
在应对毒素问题时，生物学与政治之间存在一个明显的相似之处：发育中的儿童和发展中国家是最易受到毒素暴露影响的群体。这种令人不安的相似性是本篇批判性综述的主题，该综述探讨了含汞化合物硫柳汞在疫苗中的使用和分布情况。硫柳汞于1927年研制而成，按重量计含汞量为49.55%，在体内会分解为氯化乙基汞、氢氧化乙基汞和硫代水杨酸钠。自20世纪30年代初以来，就有证据表明硫柳汞对人类健康构成危害，且作为抗菌剂并无效果。在发达国家以及主要是西方国家，儿童接种的大多是不含硫柳汞和含少量硫柳汞的疫苗，而发展中国家的儿童却要接种多剂含硫柳汞且未减量的多种疫苗。因此，硫柳汞一直是全球疫苗供应的一部分，并且直到2010年，其作为疫苗配方成分的可接受性都未受到质疑，当时联合国通过联合国环境规划署开始谈判起草具有法律约束力的全球性《汞的水俣公约》。在谈判过程中，含硫柳汞疫苗被从受管制的含汞产品清单中删除。结果，此前因无知和经济原因而存在的疫苗安全双重标准，如今已被制度化成为全球政策。最终，《汞的水俣公约》通过特别豁免含硫柳汞疫苗不受管制，认可了硫柳汞的不公平分配，容忍了疫苗安全的两级标准：发达国家主要采用不含硫柳汞和含少量硫柳汞的标准，而发展中国家主要采用含硫柳汞的标准。现在必须紧急评估这种差异，将其视为一种潜在的制度化歧视形式。
