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A Comparative Pharmacokinetic Estimate of Mercury in U.S. Infants Following Yearly Exposures to Inactivated Influenza Vaccines Containing Thimerosal

Authors

  • Robert J. Mitkus,

    Corresponding author
    1. Office of Biostatistics and Epidemiology, USFDA Center for Biologics Evaluation and Research, Rockville, MD, USA
    • Address correspondence to Robert J. Mitkus, Office of Biostatistics and Epidemiology, USFDA Center for Biologics Evaluation and Research, 1401 Rockville Pike, HFM-210, Rockville, MD 20852, USA; tel: 301-827-6083; robert.mitkus@fda.hhs.gov.

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  • David B. King,

    1. Office of Biostatistics and Epidemiology, USFDA Center for Biologics Evaluation and Research, Rockville, MD, USA
    2. Co-first author; current address: Office of New Animal Drug Evaluation, Center for Veterinary Medicine, Rockville, MD, USA
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  • Mark O. Walderhaug,

    1. Office of Biostatistics and Epidemiology, USFDA Center for Biologics Evaluation and Research, Rockville, MD, USA
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  • Richard A. Forshee

    1. Office of Biostatistics and Epidemiology, USFDA Center for Biologics Evaluation and Research, Rockville, MD, USA
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Abstract

The use of thimerosal preservative in childhood vaccines has been largely eliminated over the past decade in the United States because vaccines have been reformulated in single-dose vials that do not require preservative. An exception is the inactivated influenza vaccines, which are formulated in both multidose vials requiring preservative and preservative-free single-dose vials. As part of an ongoing evaluation by USFDA of the safety of biologics throughout their lifecycle, the infant body burden of mercury following scheduled exposures to thimerosal preservative in inactivated influenza vaccines in the United States was estimated and compared to the infant body burden of mercury following daily exposures to dietary methylmercury at the reference dose established by the USEPA. Body burdens were estimated using kinetic parameters derived from experiments conducted in infant monkeys that were exposed episodically to thimerosal or MeHg at identical doses. We found that the body burden of mercury (AUC) in infants (including low birth weight) over the first 4.5 years of life following yearly exposures to thimerosal was two orders of magnitude lower than that estimated for exposures to the lowest regulatory threshold for MeHg over the same time period. In addition, peak body burdens of mercury following episodic exposures to thimerosal in this worst-case analysis did not exceed the corresponding safe body burden of mercury from methylmercury at any time, even for low-birth-weight infants. Our pharmacokinetic analysis supports the acknowledged safety of thimerosal when used as a preservative at current levels in certain multidose infant vaccines in the United States.

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