Mercury falling

BY MICHLEEN COLLINS
Springfield radiologist David Ayoub is helping lead the push in
Illinois to rid vaccines of a mercury-based preservative
PHOTO BY NICK STEINKAMP

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."

-- Michleen Collins is a Springfield-based freelance writer. Her work
has appeared in Business Facilities magazine, Midwest Traveler, the
Kansas City Star, and other publications.