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Cited by 242Vaccine Coverage and HesitancyAutism Spectrum Disorder ResearchHeavy Metal Exposure and Toxicity

Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A Critical Review of Published Original Data

Parker, Sarah K., Schwartz, Benjamin, Todd, James, Pickering, Larry K.·2004·Pediatrics
DOI 10.1542/peds.2004-0434
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Abstract

Objective. The issue of thimerosal-containing vaccines as a possible cause of autistic spectrum disorders (ASD) and neurodevelopmental disorders (NDDs) has been a controversial topic since 1999. Although most practitioners are familiar with the controversy, many are not familiar with the type or quality of evidence in published articles that have addressed this issue. To assess the quality of evidence assessing a potential association between thimerosal-containing vaccines and autism and evaluate whether that evidence suggests accepting or rejecting the hypothesis, we systematically reviewed published articles that report original data pertinent to the potential association between thimerosal-containing vaccines and ASD/NDDs. Methods. Articles for analysis were identified in the National Library of Medicine's Medline database using a PubMed search of the English-language literature for articles published between 1966 and 2004, using keywords thimerosal, thiomersal, mercury, methylmercury, or ethylmercury alone and combined with keywords autistic disorder, autistic spectrum disorder, and neurodevelopment. In addition, we used the “related links” option in PubMed and reviewed the reference sections in the identified articles. All original articles that evaluated an association between thimerosal-containing vaccines and ASD/NDDs or pharmacokinetics of ethylmercury in vaccines were included. Results. Twelve publications that met the selection criteria were identified by the literature search: 10 epidemiologic studies and 2 pharmacokinetic studies of ethylmercury. The design and quality of the studies showed significant variation. The preponderance of epidemiologic evidence does not support an association between thimerosal-containing vaccines and ASD. Epidemiologic studies that support an association are of poor quality and cannot be interpreted. Pharmacokinetic studies suggest that the half-life of ethylmercury is significantly shorter when compared with methylmercury. Conclusions. Studies do not demonstrate a link between thimerosal-containing vaccines and ASD, and the pharmacokinetics of ethylmercury make such an association less likely. Epidemiologic studies that support a link demonstrated significant design flaws that invalidate their conclusions. Evidence does not support a change in the standard of practice with regard to administration of thimerosal-containing vaccines in areas of the world where they are used.

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  • There is now a scientific consensus that the evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism.

    “there is now a scientific consensus that the evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism”

    From Autism risk factors: genes, environment, and gene-environment interactions (2012) · cites this paper as [80]

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Related

Authors
Parker, S. K., Schwartz, B., Todd, J., & Pickering, L. K.
Affiliations
  • University of Colorado Denver (US)
  • Centers for Disease Control and Prevention (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2004-09-01
Volume
114
Issue
3
Pages
793-804
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2004-0434
OpenAlex
W2169021074
Cited by
242
References
50
Citations by year
2026: 2 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 5 · 2019: 10 · 2018: 11 · 2017: 6 · 2016: 10 · 2015: 8 · 2014: 17 · 2013: 9 · 2012: 13
FWCI
3.82
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Institute of Allergy and Infectious Diseases (K08AI050646)
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Heavy Metal Exposure and Toxicity
Keywords
thimerosal, autism spectrum disorder, neurodevelopmental disorders, ethylmercury, methylmercury, mercury, vaccine safety, vaccine adverse events
MeSH terms
Autistic Disorder, Child, Developmental Disabilities, Child Development Disorders, Pervasive, Ethylmercury Compounds, Half-Life, Humans, Methylmercury Compounds, Preservatives, Pharmaceutical, Research Design, Thimerosal, Diphtheria-Tetanus-Pertussis Vaccine, Diphtheria-Tetanus Vaccine

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