RFK Jr. vaccine advisory panel votes against thimerosal in flu vaccines

An influential vaccine advisory panel made up of allies of RFK Jr. has voted to recommend against the use of certain flu vaccines.

An influential vaccine advisory panel made up of allies of Robert F. Kennedy Jr. has voted to recommend against the use of flu vaccines containing thimerosal, a commonly used, mercury-based preservative that has long been a target of anti-vaccination groups.

Health experts, including one voting member on the committee, have warned that the move could restrict access to multi-dose flu shots, exposing people to deadly influenza to mitigate the “non-existent” health risks of thimerosal.

The Advisory Committee on Immunization Practices (ACIP), a panel of outside experts that makes recommendations on vaccinations to the US Centers for Disease Control and Prevention (CDC) and plays a key role in determining immunisation schedules, voted in favour of the motion.

It recommended that “all adults receive seasonal influenza vaccines only in single-dose formulations that are free of thimerosal as a preservative” at its meeting in Atlanta, Georgia on Thursday.

The vote passed with five yes votes, one no vote and one abstention.

“My concern is that by insisting the multi-dose vials [do not] contain thimerosal, that might limit the availability of the influenza vaccine for some people,” said Dr Cody Meissner, professor of pediatrics at Dartmouth’s Geisel School of Medicine and the lone no vote.

“I would like to have that question answered but it’s probably a difficult one to answer. My point is the risk from influenza is so much greater than the non-existent, as far as we know, risk from thimerosal. So I would hate for a person not to receive the influenza vaccine because the only available preparation contains thimerosal. I find that very hard to justify.”

US Health and Human Services Secretary Robert F. Kennedy Jr. Picture: Tasos Katopodis/Getty Images/AFP

RFK Jr., Donald Trump’s Health and Human Services (HHS) Secretary and a long-time vaccine sceptic, earlier this month fired the entire 17-member ACIP panel, all of whom were appointed under former President Joe Biden.

Mr Kennedy claimed in a Wall Street Journal op-ed that the ousted panel was “plagued with persistent conflicts of interest” and had become “little more than a rubber stamp for any vaccine”.

“Today we are prioritising the restoration of public trust above any specific pro- or anti-vaccine agenda,” he said in a HHS press release announcing the decision.

“The public must know that unbiased science — evaluated through a transparent process and insulated from conflicts of interest — guides the recommendations of our health agencies.”

Mr Kennedy subsequently appointed eight new members to the panel, all of whom were ideological allies and prominent vaccine critics.

They include Dr Robert Malone, an early researcher of mRNA technology who vocally opposed the Covid vaccines, and Dr Martin Kulldorff, a Swedish epidemiologist and biostatistician who criticised lockdown and social distancing policies, co-authoring the October 2020 “Great Barrington Declaration” with Oxford professor Dr Sunetra Gupta and Stanford professor Dr Jay Bhattacharya, who is now the director of the National Institutes of Health (NIH).

This week’s regular two-day ACIP meeting, which had been set to vote on the safety of flu vaccines and discuss proposed recommendations for the use of the combined MMRV vaccine for children under five, was updated to include a presentation on thimerosal by Lyn Redwood, a nurse practitioner and former president of Children’s Health Defense, the anti-vaccination group founded by Mr Kennedy.

ACIP members Dr Cody Meissner, left, and Vicky Pebsworth speak on screen. Picture: Mike Stewart/AP

Prior to the meeting, a slide contained in the presentation purporting to show thimerosal can have “long-term consequences in the brain” was discovered to reference a non-existent study.

Thimerosal, which is used in about 5 per cent of multi-dose flu vaccines, is a mercury-based preservative that has been in use for decades.

It contains ethylmercury, which is cleared from the human body more quickly than methylmercury — the type of mercury found in certain kinds of fish that can be toxic to people at high exposure levels — and is therefore less likely to cause any harm.

“There is no evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site,” a fact sheet on the CDC website states. “In July 1999, the Public Health Service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure.”

Dr Kulldorf, the new ACIP chair, said after Ms Redwood’s presentation that mercury toxicity was a “cumulative issue” and “we should try to minimise exposure”.

“Let’s say a child is exposed to mercury from 10 different sources,” he said. “Each of those 10 sources might be small enough, that source in itself is not dangerous, but if you then put all 10 together then it might be dangerous.”

Secondly, he noted “there are alternatives, and in fact most of the influenza vaccines given today do not contain thimerosal, so it’s very feasible to not use thimerosal-containing vaccines … we don’t really need it”.

Thimerosal is a mercury-based preservative used in some multi-dose flu vials. Picture: David Goldman/AP

Dr Kulldorf added that “if we put mercury in a product people are not going to want to buy” it.

“So if we want to promote people taking vaccines we should remove these mercury-containing preservatives,” he said.

Dr Meissner said he was “not quite sure how to respond to this presentation”.

“This is an old issue that has been addressed in the past,” he said.

“Of all the issues I think ACIP needs to focus on, this is not a big issue. I will also hasten to add that thimerosal is included in most vaccines that are administered around the globe.

“That is because single-dose vials are more expensive and many countries cannot afford a single-dose vial. I realise ACIP is focused on the United States, but the recommendations that the ACIP makes are followed among many countries around the world, and removing thimerosal from all vaccines that are used in other countries, for example, is going to reduce access to these vaccines, it will increase cost.”

Dr Meissner stressed “it’s important to note that no study has ever indicated any harm from thimerosal”.

“It’s been used in vaccines since before World War II,” he said.

“The decision by the FDA to remove thimerosal as much as possible is a very reasonable recommendation, but this recommendation was made not because there was any evidence of harm from thimerosal. It was made in an effort to reduce the total exposure to mercury in our environment. That’s a reasonable objective. But you also have to consider what are the consequences of these sorts of recommendations.”

Demonstrators rally outside the ACIP meeting in Atlanta, Georgia. Picture: Mike Stewart/AP

Dr Joseph Hibbeln, a psychiatrist and neuroscientist with the National Institutes of Health (NIH), noted there was “a significant benefit to the use of multi-dose vaccines instead of single-dose vaccines”.

“And apparently there is good data that other preservatives can be used, so I hope that the committee will put on the agenda the consideration of multi-use vials … that have other, better preservatives,” he said.

Dr Jason Goldman, president of the American College of Physicians (ACP), asked during the public comment section “if we will have an actual scientific presentation with peer-reviewed literature, strong evidence to actually discuss this issue”.

“Many statements have been made here today without support of science or evidence but merely opinion,” he said. “Will there be an actual CDC presentation done by staff, scientists, physicians and those who are subject matter experts with accurate, peer-reviewed scientific data or will we have layperson presentations only?”

Responding to the criticisms, Dr Kulldorf said “I think it’s inappropriate to dismiss a presentation just because the person does not have a PhD or an MD”.

“There are a lot of knowledgeable people who we would like to hear from,” he said.

Prior to the meeting, the panel was reduced to seven members with the withdrawal of Dr Michael Ross.

HHS said in a statement Dr Ross withdrew “during the financial holdings review required of members before they can start work on the committee”, without providing further details.

Dr Ross was described as a clinical professor of obstetrics and gynaecology at George Washington University and Virginia Commonwealth University, but US media reports suggested he had not worked at either school in years. More recently he was linked to private biotech and healthcare ventures.