Baker 2008 Mercury, vaccines and autism

Baker 2008 Mercury, vaccines and autism - PUBLIC HEALTH...

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PUBLIC HEALTH THEN AND NOW Mercury, Vaccines, and Autism One Controversy, Three Histories The controversy regarding the once widely used mercury-containing preservative thimerosal in childhood vaccines has raised many historical questions that have not been adequately explored. Why was this preservative incorporated in the first place? Was there any real evidence that it caused harm? And how did thimerosal become linked in the public mind to the "autism epidemic"? I examine the origins of the thimerosal controversy and their legacy for the debate that has followed. More specifically, I explore the parallel histories of three factors that convei^ed to create the crisis: vaccine preservatives, mercury poisoning, and autism. An understanding of this history provides important lessons for physicians and policymakers seeking to preserve the puhlic's trust in the nation's vaccine system. (Om J Public Health. 2008;9S:244-253. doi:10.2105/AJPH.2007J13159) Jeffrey P Baker, MD, PhD DESPITE THE REASSURANCE of no less than eight safety review panels conducted by the Institute of Medicine (IOM) since 2001, tnany parents continue to fecir that childhood vaccines can cause a host of adverse effects ranging from immune dysfunction to at- tention deficit disorder and autism.' Several trends no doubt contribute to this anxiety: fading memory of vaccine-preventable diseases, adverse media coverage, misinformation on the Internet, and litigation.^ Yet global explana- tions of this sort fail to do justice to the fact that controversies over vaccines have often followed quite disparate trajectories in dif- ferent settings. For example, al- though the alleged relationship between childhood vaccines and autism has been the dominant controversy over child immuniza- tion of recent years, British anxi- ety has centered on the measles- mumps-rubella vaccine, whereas Americans have focused much more on the role of mercury in vaccine preservatives.' I examine the origins of the American debate surrounding vaccines, mercury, and autism to illuminate how historical analysis can contribute to understanding public attitudes toward vaccine Scifety. It is not my intent to an- swer whether mercury in vaccines explains the increasing prevalence of autism; the IOM has already determined over the course of two reviews that available evi- dence fails to support such a con- clusion.'' Instead, I examine the historical questions that have been raised in the debate but only superficially addressed by the IOM. Why was the mercury- containing preservative thimerosal introduced in infant vaccines in the first place? Why was its tise not questioned until the late 1990s, long after the toxic effects of mercury had been recognized? Why was autism perceived to be "epidemic" in the 1990s, and how did it become linked to vaccines in the public's mind?
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Baker 2008 Mercury, vaccines and autism - PUBLIC HEALTH...

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