Robert F. Kennedy, Jr, Vaccines, and Mercury

Hospital Corpsman 2nd Class Eric M. Garneau prepares to administer an H1N1 flu vaccine aboard the amphibious assault ship USS Bataan 2009. Via Wikimedia

I recently received a copy of Robert Fitzgerald Kennedy, Junior’s new book, titled Thimerosal: Let the Science Speak (Skyhorse Publishing, 2015), which is dramatically subtitled The evidence supporting the immediate removal of mercury—a known neurotoxin—from vaccines. My first impression was one of confusion over the title, since the book is written in English and almost no English-speaking countries use thimerosal in any vaccines. The only exception is a limited number of flu vaccines, which are not generally used on children. RFK Jr has a long history of environmental activism, including fighting against industrial mercury pollution. He has a more recent track record of objecting to the vaccine preservative thimerosal—almost an obsession with the topic. He has been very vocal on talk shows and on Capitol Hill of late. Given the author, who is credited as “editor,” I was not surprised by the subject matter. What caught my eye was the subtitle “let the science speak,” an ironic statement to say the least. The book is a short, well-written redress of a completely inaccurate meme: namely, that vaccines cause autism or autism spectrum disorder (ASD). It is a unique tract on the subject. Another whole book could be written on the inaccuracies in this book, I will try to limit the issues to the overriding theme. Let’s take a look at the book, its themes, and its implied (yet denied) purpose.

The most interesting thing about this book is the regular insistence that it is not about vaccines. The forward by Dr. Mark Hyman MD is a five-page statement of how this book is pro-vaccine and the only issue is the pharmaceutical industry and the additive thimerosal. It’s a good way to present a scientifically unsupported idea to the lay public. By proposing that you really support the treatment and are just trying to fix this one small problem it is very disarming and effective to the casual reader. A reader may just be curious. Set a reasonable tone and make your progression to the unreasonable more compelling. It’s very slick and very effective but openly deceptive. If you’re pro-vaccine, you don’t systematically give the impression that thimerosal is in wide use, that thimerosal is threatening, and that vaccine producers conspire with government to poison children—all without evidence.

If you’re pro-vaccine, you don’t include a preface written by a well-know medical fringe doctor, given the veneer of authority by the MD appended to his name. Dr. Hyman is physician who has many unsupported thoughts about autism, and a cottage industry called “Functional Medicine.” I highly recommend David Gorski’s Orac blogpost/treatise on Dr. Hyman.

Additionally, if you’re pro-vaccine you don’t have an introduction by Dr. Martha R. Herbert MD, a regular keynote speaker at most anti-vaccine conferences. Dr. Herbert had proposed a multitude unsupported and fringe mechanisms for autism. She has testified in court that “potential environmental triggers under active debate and research” for autism included “mercury, intrauterine viral infections, season of birth, global positioning, and water pollution,” none of which are supported. GPS is giving your child autism. Maintaining an unscientific fringe opposition does not constitute “active debate and research.” She is a supporter of the dangerous and useless practice of chelation therapy for autism.

The bottom line is that these are not the people you would ask to do your introductions if you were writing a pro-vaccine book. The opening lets your know exactly where this is going and what the real point is.

Kennedy proposes a common and tired anti-vaccine theme in his book: mercury is a neurotoxin, thimerosal contains mercury, and therefore vaccines that contain thimerosal are neurologically damaging children.

The book does scientific backflips to make this point, trying to fit a square peg in a round hole. Theres tons of listed research showing how mercury is dangerous. Other research attempting to show reasonable yet unproven theories why thimerosal’s ethylmercury is the same as methymercury exposure. Yet it isn’t.

From The CDC (one of Kennedy’s bogeymen):

  • When learning about thimerosal and mercury it is important to understand the difference between two different compounds that contain mercury: ethylmercury and methylmercury. They are totally different materials.
  • Methylmercury is formed in the environment when mercury metal is present. If this material is found in the body, it is usually the result of eating some types of fish or other food. High amounts of methylmercury can harm the nervous system. This has been found in studies of some populations that have long-term exposure to methylmercury in foods at levels that are far higher than the U.S. population. In the United States, federal guidelines keep as much methylmercury as possible out of the environment and food, but over a lifetime, everyone is exposed to some methylmercury.
  • Ethylmercury is formed when the body breaks down thimerosal. The body uses ethylmercury differently than methylmercury; ethylmercury is broken down and clears out of the blood more quickly. Low-level ethylmercury exposures from vaccines are very different from long-term methylmercury exposures, since the ethylmercury does not stay in the body.

Even if you deny what the CDC is saying, as the authors do, and try to say that ethylmercury could be retained as methyl, it still just doesn’t have the autism effect the authors imply. This has been unequivocally proven by thimerosal’s complete removal from the vaccine schedule in 2002. As previously noted, it now remains only in some flu vaccines not given to children. The total dose of thimerosal exposure is far below 1990 levels. Children at that time were receiving vaccines with thimerosal well before before ASD diagnoses began to rise. Despite predictions by anti-vaccination proponents that ASD rates would fall dramatically in the years following the removal of thimerosal, the rate at which the disorder is diagnosed continues to rise, without even the slightest change in the rate of increase. This effect has been replicated in other countries. If you read data as sloppily as the anti-vaccine advocates do, you could argue that reducing thimerosal exposure actually caused the incidence of autism to go up. That correlation (not causation) is more strongly supported by evidence than the one suggesting the opposite effect. But it’s just as specious.

Children just aren’t given thimerosal in the vaccines they receive. The only US vaccine left with thimerosal is Fluvirin from Noventis (<1ug Hg/0.5mL dose). It is only given to adults. You inhale more mercury from air pollution than you get from that dose. Children don’t get injectable flu vaccine for the most part. Nasal administration of attenuated flu vaccine is the common practice for children, not injectable, it has no thimerosal. If a child has to have the injectable form for some medical reason, there are versions with no thimerosal. This is fear mongering built on myth.

This image depicts a qualified nurse in a clinical setting, who was in the process of administering a dosage of FluMist® live attenuated intranasal vaccine LAIV) into the left nostril, and into this patient’s nasal cavity. Via Wikimedia

Thimerosal wasn’t removed because of a proven problem. The evidence is that thimerosal was, and probably is, completely safe in vaccines. It was removed on the precautionary principle. Time and data supports the idea that its removal was unnecessary from a risk standpoint. It was that abundance of caution which caused removal. The removal is the foundation to the continuing ideology that thimerosal, and therefore vaccination, is somehow very dangerous.

The real answer to thimerosal is that there is no correlation between autism and vaccines, but the data does expose the authors’ bias, especially since they work hard to dismiss obvious flaws in their arguments. With an unfounded yet plausible-sounding, medically inaccurate hypothesis, they try to lead readers to draw the conclusion that thimerosal is a threat. Kennedy impressively adds reams of footnoted research, trying to support the idea that there is a ton of evidence for this idea. He is missing the point.

This book is focusing on a non-issue that just doesn’t exist in most English-speaking countries. Early in the book he talks about the 2002 removal of thimerosal in order to support the idea that it is a problem. He then proceeds to insist it is still a problem, which exposes clearly his lack of congruent thinking about this issue. The truth is that in poor countries without good medical infrastructure, thimerosal is still used because single-use, short-shelf-life doses of vaccine  are not practical and damage the usefulness of the treatment. Thimerosal is an excellent and safe preservative, and is really effective, giving more people a chance to be spared debilitating or life-threatening diseases. Interestingly, those countries that still use thimerosal have the lowest rates of ASD over the last 10 years.

Kennedy counters this by saying that those environments lack the medical infrastructure to diagnose the condition. True, but mounting evidence shows that the increase in autism in the west is because of medical pursuit of the diagnosis.

There have been persistent concerns during the so-called “autism epidemic” that the increasing ASD rates are more a function of looking for it, rather than it truly being a increase. New research strongly supports this hypothesis. Kennedy couldn’t have possibly known this when he wrote the book, since the research was only recently published, but it clearly shows that increasing surveillance and diagnostic criteria as the cause for the increase in autism spectrum disorder. I am fairly certain that this bit of evidence will not be the tipping point for Kennedy’s opinion. 13 years after thimerosal was removed from US vacccines, the quixotic anti-vaccine crusade hasn’t been derailed at all.

It is not science that guides the misinformation in this book. It is ideology: the unwavering misinformation that vaccines somehow directly link with a multitude pediatric neurological disorders. The author and other anti-vaccine proponents try to retain this argument by claiming that environmental exposure or some other outside mechanism is the reason why ASD is still going up. Kennedy offers an avalanche of data showing increasing neurological disorders, and research supporting mercury toxicity. But, despite his efforts to hold these two facts side-by-side, he is unable to show any link between the two problems. He and his coauthors are just plain wrong; science does not work that way. Scientific evaluation is the best way to evaluate medical risk and effectiveness. If your data shows no correlation then there is no correlation. If your hypothesis is that thimerosal causes autism, and after removing thimerosal from vaccines autism continues to increase, you have eliminated that as a possibility. You don’t try to make excuses, or come up with other more elaborate and implausible reasons why it still must be true. That is not “letting the science speak.” That is silencing science with ideology. It’s shameful.

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About Stephen Propatier

Stephen Propatier is a board certified acute care nurse practitioner specializing in spine and sports medicine. He is a member of the Society for Science Based Medicine and is adjunct faculty for both Brown University Warren Alpert Medical School and Rhode Island College Graduate School of Nursing.
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14 Responses to Robert F. Kennedy, Jr, Vaccines, and Mercury

  1. Nelson says:

    As usual Stephen, you focus on one thing and completely ignore or keep quite on a even more important issue. They may have removed thimersal from vaccines but other more dangerous adjuvants have been substituted. Namely chemicals and toxins like aluminum hydroxide, Formaldehyde, Polysorbate 80, Phenol, Triton X100 Resin and gelatin. Sounds like the ingredient list for twinkies. I’m sure they are all completely harmless, right Mr. Propatier?

    • Ray says:

      I’m sure there must be a name for the fallacy of associating unrelated fears with the issue at hand and thereby effectively changing the subject but I can’t think of it right now. Perhaps false equivalence? Either way that’s what you’re doing. The subject here is the alleged relationship between mercury and autism, not the chemicals you’ve cited and autism. Be kind and honest enough to stick to the subject and not pollute the discussion with something that has nothing to do with it.

      • Nelson says:

        So, because the discussion falsely imply s that because one adjuvant has not been used in vaccines for a number of years, that vaccines are therefore safe? Ridiculous. I am sticking to the topic and I won’t let you get away with your pushing off my comment just to be microscopic in scope to prove your (Mr. Propatiers) ridiculous false premise or attack on the point made in the book he is criticizing . The point, Ray, is that autism has only increased since the removal of one toxin but has been replaced with numerous other toxins that most likely may be responsible for causing it and to ignore that fact and to only focus on the one toxin that has been removed is just plain stupid. I don’t know which catch phrase accurately categorizes that kind of wrong headed thinking but if I made an equivalent statement I’m sure you pull one out of your bag of skeptical verbiage. You, Ray, like most other so called skeptics fall prey to the naming fallacy (see I also have some catch phrases), whereby when you can fit some comment into one of you stock catch phrases, you act as though you have demolished your opponents point, like citing a statement a straw man fallacy or when you can’t think of one that fits just make one up: Perhaps “false equivalence” might do the trick….. .No, it didn’t.

        • John Symon says:

          The article refutes a specific book, Nelson. You’re claiming that it doesn’t show vaccines are safe is a strawman. The article doesn’t address that issue.
          On the more general issue of chemical phobias you should read the lead article in this edition where you will find it about formaldehyde and, more generally, about toxicity.
          Vaccines, when used and prepared properly are safe for the overwhelming majority of people. When the MMR scare reduced uptake of that vaccine we didn’t see a drop in the numbers of, well, anything but we did see an increase in the numbers dying from measles.
          Can I turn your question on its head, Nelson? How about showing that vaccinations are dangerous?

    • To answer your unrelated question, yes i have evaluated the concerns related to adjutants, and the concerns that other “toxins” no matter how small the dose are behind autism spectrum disorder and a host of other diseases. My answer is simple. My children are vaccinated on schedule and I sleep like a baby. Your concerns are unfounded scare mongering brought by a cottage industry of people who make a very nice living by scaring the heck out of parents. Fostered by a few ideologues that always change the story as each piece of their unsubstantiated concerns are disproven. They expand endlessly to keep their fear based convictions, monetarily motivated reasoning, or to keep their unreasonable positions sounding plausible. I am assuming that you don’t know that an organic apple has over 50mg of formaldehyde in it and no one is blaming apples for autism. Just one example of how people are loosing tract of the facts with the mis-information out there. So I suggest that the best information about these falsehoods and half truths can be found on Science Based Medicine website.

  2. Walter Clark says:

    Great article Stephen.
    As I was reading it, I was thinking, how could Kennedy be so stupid. Ooops then I realized stupid is the wrong word. It takes intelligence and drive to do what he’s doing. I then thought how can he make such a huge mistake. But that isn’t right either. It is actually a small mistake; one that could easily be fixed. (Methyl versus ethyl) It is the consequence of his effort on such a small error that’s the problem. OK, now I’m worried. I could easily be like Kennedy. In my case it is my very minority view on the economy (I’m voluntarist, anarcho-capitalist, an Austrian economist. Virtually no economist outside of a few private colleges are employed with this unpopular view.) So the subject that is far more important to me, than what this well written article is about, is how do we know we aren’t like Kennedy, where the feeling of truth is substantiated by our own enthusiasm? How can we tell the difference between the familiar and the truth; what feels right and what is right?

    • MBDK says:

      Mr. Clark, I noticed you never got a reply to your comment. I would like to say that there really is no absolute right in anything. The very nature of reality is our interpretation of what we perceive with our senses, which we know to be imperfect. However, what the scientific method does, is to study a subject and attempt to make logical conclusions based on repeatable observations performed under specific conditions. Still, said conclusions are subject to change/amendment/discarding as further evidence comes to light. That is why science never stops. Peer review is a fairly effective tool to recognize when feelings and other biases encroach into such findings. To me, this can only truly work when each and every individual involved accepts the idea that they cannot be afraid to be wrong. If someone advocates a position from an standpoint of unwavering fervor, that is a telling sign that he/she may be too invested in that position to accept a disagreeable truth. Again, do not be afraid to be wrong. This is not an easy thing to do or recognize, but I believe that it is the mindset necessary to sift through any and all evidence in order to reach a fair and logical interpretation.

  3. Calling ethyl mercury “mercury” is like calling sodium chloride “sodium”. Or calling dihydrogen monoxide “hydrogen”.Anybody not know what dihydrogen monoxide is?

    • Petit Prince IV says:

      unicorndaniel: Will you try to hide from the keen readers of this blog that dihydrogen monoxide caused 368 thousand deaths just in 2013?

      In the US it gets one in fifty thousand persons per annum!

    • Noah Dillon says:

      That’s what I keep thinking. Every time I read that thimerosal is “mercury-based,” I think, well, you could just as easily call it carbon-based, hydrogen-based, sodium-based, oxygen-based, or sulfur-based. You could also point out that sodium chloride contains two dangerous elements. One is a heavy metal that can spontaneously explode or catch on fire in the presence of regular old water. It produces a base compound that can cause severe caustic burns to the skin. The other is itself a caustic material used in bleach, and its vapor can kill a person. Put them together and the resulting compound makes food taste great and is found everywhere and is given to kids and is basically safe in levels lower than what most people eat. The fixation on one atom, completely decontextualized from the rest of the molecule, is completely absurd.

  4. wordwizardw says:

    I just found this posted to my Facebook page by a friend.
    It sounds plausible, until it starts mentioning the effect of mercury in the flu vaccine. WHAT mercury in the flu vaccine? Even if there is any, aren’t there also other versions of the vaccine w/o it? What say you?

  5. wordwizardw says:

    I forgot to check “Notify me of follow-up comments by email.”

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