Browse history interactively

Page 1

Page 1Revision 1

Page 2

Page 2Revision 2

← Previous editContent deleted Content addedVisualWikitext

Revision as of 18:26, 19 September 2013 editIntoThinAir (talk | contribs)Extended confirmed users, New page reviewers, Pending changes reviewers, Rollbackers114,577 edits adding a reference← Previous edit		Latest revision as of 09:14, 25 December 2024 edit undoSalineBrain (talk | contribs)Extended confirmed users874 edits →Antiseptic/antifungal: Not a sentence changed to a sentence by removing the word "that".Tags: Mobile edit Mobile web edit Advanced mobile edit
(345 intermediate revisions by more than 100 users not shown)
Line 1:		Line 1:
			{{Short description|Organomercury antiseptic and antifungal agent}}
			{{use dmy dates |date=August 2021}}
			{{cs1 config|name-list-style=vanc|display-authors=6}}
	{{chembox		{{chembox
	| Verifiedfields = changed
	| Watchedfields = changed		| Watchedfields = changed
	| verifiedrevid = 440820672		| verifiedrevid = 573678824
	| Name = Thiomersal		| Name = Thiomersal
	| ImageFile = Thiomersal-Skeletal-Structure-SVG.svg		| ImageFile = Thiomersal.svg
	| ImageSize = 200px		| ImageSize =
	| ImageName = Thiomersal		| ImageName = Thiomersal
	| ImageFile2 = Thiomersal-from-xtal-3D-vdW.png		| ImageFile2 = Thiomersal-from-xtal-3D-balls.png
	| ImageSize2 = 200px		| ImageSize2 =
	| IUPACName = Ethyl(2-mercaptobenzoato-(2-)-O,S)<br />mercurate(1-) sodium		| IUPACName = Ethyl(2-mercaptobenzoato-(2-)-''O'',''S'') mercurate(1-) sodium
	| OtherNames = Mercury((o-carboxyphenyl)thio)ethyl sodium salt		| OtherNames = Mercury((''o''-carboxyphenyl)thio)ethyl sodium salt, sodium ethylmercurithiosalicylate
	| Name = Thiomersal
	| Section1 = {{Chembox Identifiers		| Section1 = {{Chembox Identifiers
	| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}		| CASNo_Ref = {{cascite|correct|CAS}}
			| CASNo = 54-64-8
			| Beilstein = 8169555
			| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
	| ChemSpiderID = 10772045		| ChemSpiderID = 10772045
			| ChEBI_Ref = {{ebicite|correct|EBI}}
			| ChEBI = 9546
	| ChEMBL_Ref = {{ebicite|correct|EBI}}		| ChEMBL_Ref = {{ebicite|correct|EBI}}
	| ChEMBL = 508338		| ChEMBL = 508338
			| DrugBank = DB11590
			| Gmelin = 1677155
			| KEGG = D00864
			| PubChem = 16684434
			| RTECS = OV8400000
			| EINECS = 200-210-4
	| UNII_Ref = {{fdacite|correct|FDA}}		| UNII_Ref = {{fdacite|correct|FDA}}
	| UNII = 2225PI3MOV		| UNII = 2225PI3MOV
	| InChI = 1/C7H6O2S.C2H5.Hg.Na/c8-7(9)5-3-1-2-4-6(5)10;1-2;;/h1-4,10H,(H,8,9);1H2,2H3;;/q;;2*+1/p-2/rC9H10HgO2S.Na/c1-2-10-13-8-6-4-3-5-7(8)9(11)12;/h3-6H,2H2,1H3,(H,11,12);/q;+1/p-1		| InChI = 1/C7H6O2S.C2H5.Hg.Na/c8-7(9)5-3-1-2-4-6(5)10;1-2;;/h1-4,10H,(H,8,9);1H2,2H3;;/q;;2*+1/p-2/rC9H10HgO2S.Na/c1-2-10-13-8-6-4-3-5-7(8)9(11)12;/h3-6H,2H2,1H3,(H,11,12);/q;+1/p-1
	| InChIKey = RTKIYNMVFMVABJ-TYXNQWANAP		| InChIKey = RTKIYNMVFMVABJ-TYXNQWANAP
	| ChEBI_Ref = {{ebicite|changed|EBI}}
	| ChEBI = 9546
	| SMILES = .C(=O)c1ccccc1SCC		| SMILES = .C(=O)c1ccccc1SCC
	| StdInChI_Ref = {{stdinchicite|correct|chemspider}}		| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
Line 28:		Line 38:
	| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}		| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
	| StdInChIKey = RTKIYNMVFMVABJ-UHFFFAOYSA-L		| StdInChIKey = RTKIYNMVFMVABJ-UHFFFAOYSA-L
			}}
	| CASNo_Ref = {{cascite|correct|CAS}}
			| Section2 = {{Chembox Properties
	| CASNo = 54-64-8
			| Formula = ]<sub>9</sub>]<sub>9</sub>]]]<sub>2</sub>]
	| PubChem = 16684434
			| MolarMass = 404.81 g/mol
	| RTECS = OV8400000
			| Appearance = White or slightly yellow powder
	| EINECS = 200-210-4
			| Density = 2.508 g/cm<sup>3</sup><ref name=molstruct/>
			| Solubility = 1000 g/L (20&nbsp;°C)
			| MeltingPtC = 232 to 233
			| MeltingPt_notes = (decomposition)
			}}
			| Section3 = {{Chembox Pharmacology
	| ATCCode_prefix = D08		| ATCCode_prefix = D08
	| ATCCode_suffix = AK06		| ATCCode_suffix = AK06
	}}
	| Section2 = {{Chembox Properties
	| Formula = ]<sub>9</sub>]<sub>9</sub>]]]<sub>2</sub>]
	| MolarMass = 404.81 g/mol
	| Appearance = White or slightly yellow powder
	| Density = 2.508 g/cm³<ref name=molstruct/>
	| Solubility = 1000 g/l (20&nbsp;°C)
	| MeltingPt = 232&ndash;233&nbsp;°C (decomposition)
	| BoilingPt =
	| pKa =
	}}
	| Section4 = {{Chembox Thermochemistry
	| DeltaHf =
	}}
	| Section7 = {{Chembox Hazards
	| EUClass = Very toxic ('''T+''')<br/>Dangerous for the environment ('''N''')<br/> Repr. Cat. 1
	| NFPA-H = 3
	| NFPA-F = 1
	| NFPA-R = 1
	| RPhrases = {{R26/27/28}} {{R33}} {{R40}} {{R50/53}} {{R60}} {{R61}}
	| SPhrases = {{S13}} {{S28}} {{S36}} {{S45}} {{S53}} {{S60}} {{S61}}
	| FlashPt = 250&nbsp;°C
	| ExternalMSDS =
	}}
	}}		}}
			|Section4 = {{Chembox Hazards
			|GHSPictograms = {{GHS06}}{{GHS08}}{{GHS09}}
			| GHSSignalWord = Danger
			| HPhrases = {{H-phrases|300|310|330|373|410}}
			| PPhrases = {{P-phrases|260|273|280|301|310|330|302|352|304|340}}<ref>{{Cite web |title=Thimerosal T5125 |url=https://www.sigmaaldrich.com/catalog/product/sigma/t5125?lang=en&region=US }}</ref>
			| NFPA-H = 3
			| NFPA-F = 1
			| NFPA-R = 1
			| FlashPtC = 250
			| LD50 = 75 mg/kg (oral, rat)<ref>{{cite web|url=https://chem.nlm.nih.gov/chemidplus/rn/54-64-8|title=ChemIDplus – 54-64-8 – RTKIYNMVFMVABJ-UHFFFAOYSA-L – Thimerosal – Similar structures search, synonyms, formulas, resource links, and other chemical information.| vauthors = Chambers M |website=chem.sis.nlm.nih.gov|access-date=3 April 2018}}</ref>
			| ExternalSDS =
			}}
			}}
			'''Thiomersal''' (]), or '''thimerosal''' (], ]), also sold under the name '''merthiolate'''<ref>{{Cite web |title=Merthiolate poisoning: MedlinePlus Medical Encyclopedia |url=https://medlineplus.gov/ency/article/002678.htm |access-date=2023-12-08 |website=medlineplus.gov |language=en}}</ref> is an ] compound. It is a well-established ] and ].<ref>{{Cite web |date=2020-08-25 |title=Thimerosal and Vaccines {{!}} Vaccine Safety {{!}} CDC |url=https://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html |access-date=2023-05-04 |website=Centers for Disease Control and Prevention |language=en-us}}</ref>
			The pharmaceutical corporation ] named it Merthiolate. It has been used as a ] in ]s, ] preparations, ], ]s, ] and nasal products, and ] inks.<ref>{{cite journal | vauthors = Sharpe MA, Livingston AD, Baskin DS | title = Thimerosal-Derived Ethylmercury Is a Mitochondrial Toxin in Human Astrocytes: Possible Role of Fenton Chemistry in the Oxidation and Breakage of mtDNA | journal = Journal of Toxicology | volume = 2012 | pages = 373678 | year = 2012 | pmid = 22811707 | pmc = 3395253 | doi = 10.1155/2012/373678 | quote = "...widely used in medical products, including as a preservative in vaccines, immunoglobulin preparations, skin test antigens, antivenins, ophthalmic and nasal products, and tattoo inks..." | doi-access = free }}</ref> In spite of the ] that fears about its safety are unsubstantiated,<ref name = "IOM2004" /><ref>{{cite journal | vauthors = Doja A, Roberts W | title = Immunizations and autism: a review of the literature | journal = The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques | volume = 33 | issue = 4 | pages = 341–346 | date = November 2006 | pmid = 17168158 | doi = 10.1017/s031716710000528x | doi-access = free }}</ref><ref name="CDC concerns">{{Cite web |title=Vaccines Do Not Cause Autism |url=https://www.cdc.gov/vaccinesafety/concerns/autism.html |website=cdc.gov |access-date=29 November 2015 }}</ref><ref>{{cite journal | vauthors = Gołoś A, Lutyńska A | title = Thiomersal-containing vaccines - a review of the current state of knowledge | journal = Przeglad Epidemiologiczny | volume = 69 | issue = 1 | pages = 59–64, 157–61 | date = 2015 | pmid = 25862449 }}</ref> its use as a vaccine preservative has been ] by ] groups.
	'''Thiomersal''' (]), commonly known in the US as '''thimerosal''', is an ] compound. This compound is a well established ] and ].
			A 1999 statement issued in ]'s ] announced that "the Public Health Service (]), the American Academy of Pediatrics (]), and vaccine manufacturers agree that thimerosal-containing vaccines should be removed as soon as possible" and that these groups would collaborate to replace them while manufacturers committed "to eliminate or reduce as expeditiously as possible the ] content of their vaccines."<ref>{{cite news |title=Thimerosal in Vaccines: A Joint Statement of the American Academy of Pediatrics and the Public Health Service |url=https://www.cdc.gov/mmwr/PDF/wk/mm4826.pdf |access-date=May 8, 2024 |work=Morbidity and Mortality Weekly Report Vol. 48 No. 26 |agency=Centers for Disease Control and Prevention |date=July 9, 1999 |pages=563–65}}</ref><ref>{{cite journal | vauthors = Hurley AM, Tadrous M, Miller ES | title = Thimerosal-containing vaccines and autism: a review of recent epidemiologic studies | journal = The Journal of Pediatric Pharmacology and Therapeutics | volume = 15 | issue = 3 | pages = 173–181 | date = July 2010 | doi = 10.5863/1551-6776-15.3.173 | pmid = 22477809 | pmc = 3018252 }}</ref><ref name=drugsaf/>
	The pharmaceutical corporation ] gave thiomersal the trade name '''Merthiolate'''. It has been used as a ] in ]s, ] preparations, ], ]s, ] and nasal products, and ] inks.<ref>{{cite doi|10.1155/2012/373678}}</ref> Its use as a vaccine preservative is ], and it is being phased out from routine childhood vaccines in the United States, the ], and a few other countries.<ref name=drugsaf/>
			It remains in use as a preservative for certain annual ], mostly those stored in multi-dose vials.<ref>{{Cite magazine |date=2015-02-08 |title=Not Immune |url=https://www.newyorker.com/magazine/2015/02/16/immune-3 |access-date=2022-10-02 |magazine=The New Yorker |language=en-US}}</ref><ref>{{cite web | url=https://www.cdc.gov/flu/prevent/thimerosal.htm | title=Thimerosal in Flu Vaccine &#124; CDC | date=22 August 2023 }}</ref> Single-dose vial flu shots are an option for those who prefer vaccines with no thiomersal, although no scientific data supports claims that there is any link between thiomersal and autism.
	==Structure==
	Thiomersal features mercury(II) with a coordination number 2, ''i.e.'' two ligands are attached to Hg, the ] and the ethyl group. The ] group is not coordinated, but confers solubility in water. Like other two-coordinate Hg(II) compounds, the coordination geometry of Hg is linear, with a 180° S-Hg-C angle. Typically, organomercury thiolate compounds are prepared from organomercury chlorides.<ref name="molstruct">{{ cite journal | first1 = J. G. | last1 = Melnick | first2 = K. | last2 = Yurkerwich | first3 = D. | last3 = Buccella | first4 = W. | last4 = Sattler | first5 = G. | last5 = Parkin | title = Molecular Structures of Thimerosal (Merthiolate) and Other Arylthiolate Mercury Alkyl Compounds | journal = ] | year = 2008 | volume = 47 | issue = 14 | pmid = 18533648 | pages = 6421–6426 | doi = 10.1021/ic8005426 }}</ref>
			__TOC__
	==Use==
	Thiomersal's main use is as an antiseptic and antifungal agent. In multidose injectable drug delivery systems, it prevents serious adverse effects such as the '']'' infection that, in one 1928 incident, killed 12 of 21 children ]d with a ] vaccine that lacked a preservative.<ref name=T-in-vaccines/> Unlike other vaccine preservatives used at the time, thiomersal does not reduce the potency of the vaccines that it protects.<ref name=Baker>{{cite journal |journal= Am J Public Health |year=2008 |title= Mercury, Vaccines, and Autism: One Controversy, Three Histories |author= Baker JP |doi=10.2105/AJPH.2007.113159 |pmid=18172138 |volume=98 |issue=2 |pages=244–53 |pmc= 2376879}}</ref> ]s like thiomersal are not needed in more-expensive single-dose injectables.<ref>{{cite web | url = http://www.fda.gov/cber/vaccine/thimfaq.htm | title = Thimerosal in Vaccines: Frequently Asked Questions | publisher = ] | accessdate = 2008-03-09 }}</ref>
			==History==
	In the United States, countries in the European Union and a few other affluent countries, thiomersal is no longer used as a preservative in routine childhood ]s.<ref name="drugsaf">{{cite journal |journal= Drug Saf |year=2005 |volume=28 |issue=2 |pages=89–101 |title= Thiomersal in vaccines: balancing the risk of adverse effects with the risk of vaccine-preventable disease |author= Bigham M, Copes R |pmid=15691220 |doi= 10.2165/00002018-200528020-00001}}</ref> In the U.S., the only exceptions among vaccines routinely recommended for children are some formulations of the inactivated influenza vaccine for children older than two years.<ref>{{cite web |title= Thimerosal in seasonal influenza vaccine |url=http://cdc.gov/FLU/ABOUT/QA/thimerosal.htm |date=2007-10-26 |accessdate=2008-04-02 |author= Coordinating Center for Infectious Diseases |publisher= Centers for Disease Control and Prevention |archiveurl = http://web.archive.org/web/20080411133237/http://www.cdc.gov/FLU/ABOUT/QA/thimerosal.htm |archivedate = 2008-04-11}}</ref> Several vaccines that are not routinely recommended for young children do contain thiomersal, including DT (] and ]), Td (tetanus and diphtheria), and TT (tetanus toxoid); other vaccines may contain a trace of thiomersal from steps in manufacture.<ref name=T-in-vaccines>{{cite web |date=2008-06-03 |url=http://www.fda.gov/cber/vaccine/thimerosal.htm |accessdate=2008-07-25 |title= Thimerosal in vaccines |publisher= Center for Biologics Evaluation and Research, U.S. Food and Drug Administration}}</ref> Also, four rarely used treatments for pit viper, coral snake, and black widow venom still contain thiomersal.<ref>{{cite web |date=2004-09-09 |url=http://www.fda.gov/cber/blood/mercplasma.htm |accessdate=2007-10-01 |title= Mercury in plasma-derived products |publisher= U.S. Food and Drug Administration |archiveurl = http://web.archive.org/web/20070929122259/http://www.fda.gov/cber/blood/mercplasma.htm <!-- Bot retrieved archive --> |archivedate = 2007-09-29}}</ref> Outside North America and Europe, many vaccines contain thiomersal; the ] has concluded that there is no evidence of toxicity from thiomersal in vaccines and no reason on safety grounds to change to more expensive single-dose administration.<ref>{{cite web |title= Thiomersal and vaccines |author= Global Advisory Committee on Vaccine Safety |publisher= World Health Organization |url=http://www.who.int/vaccine_safety/topics/thiomersal/en/index.html |date=2006-07-14 |accessdate=2007-11-20}}</ref> The ] backed away from an earlier proposal of adding thimerosal in vaccines to the list of banned compound in a treaty aimed at reducing exposure to mercury worldwide.<ref>{{cite web|url= http://www.npr.org/blogs/health/2012/12/17/167280941/experts-argue-against-proposed-ban-on-vaccine-preservative|title=Doctors Argue Against Proposed Ban on Vaccine Preservative|author=Hamilton, Jon|publisher=]|date=17 December 2012|accessdate=25 February 2013}}</ref> Citing medical and scientific consensus that thimerosal in vaccines posed no safety issues, but eliminating the preservative in multi-dose vaccines, primarily used in developing countries, will lead to high cost and requirement of refrigeration which the developing countries can ill afford, the UN’s final decision is to exclude thimerosal from the treaty.<ref>{{cite web|url=http://www.fiercevaccines.com/story/un-excludes-vaccine-preservative-mercury-treaty/2013-01-24|title=U.N. excludes vaccine preservative from mercury treaty|author=Bryant, Alison|publisher=fiercevaccine.com|date=24 January 2013|accessdate=25 February 2013}}</ref>
			], a ] then at the ] filed a patent application for thiomersal in 1927;<ref>{{US patent|1672615}} "Alkyl mercuric sulphur compound and process of producing it".</ref> Eli Lilly later marketed the compound under the trade name Merthiolate.<ref name="Baker"/> ] tests conducted by Lilly investigators H. M. Powell and W. A. Jamieson found that it was forty to fifty times as effective as ] against '']''.<ref name="Baker"/> It was used to kill bacteria and prevent contamination in antiseptic ointments, creams, jellies, and sprays used by consumers and in hospitals, including nasal sprays, eye drops, contact lens solutions, ]s, and vaccines. Thiomersal was used as a preservative (]) so that multidose vials of vaccines could be used instead of single-dose vials, which are more expensive. By 1938, Lilly's assistant director of research listed thiomersal as one of the five most important drugs ever developed by the company.<ref name="Baker"/>
			== Structure ==
			Thiomersal features ](II) with a coordination number 2, i.e. two ] are attached to Hg, the ] and the ]. The ] group confers ] in ]. Like other two-coordinate Hg(II) compounds, the coordination geometry of Hg is linear, with a 180° S-Hg-C angle. Typically, organomercury thiolate compounds are prepared from organomercury chlorides.<ref name="molstruct">{{cite journal | vauthors = Melnick JG, Yurkerwich K, Buccella D, Sattler W, Parkin G | title = Molecular structures of thimerosal (Merthiolate) and other arylthiolate mercury alkyl compounds | journal = Inorganic Chemistry | volume = 47 | issue = 14 | pages = 6421–6426 | date = July 2008 | pmid = 18533648 | doi = 10.1021/ic8005426 }}</ref>
			==Uses==
			=== Antiseptic/antifungal ===
			Thiomersal's main use is as an ] and ] agent, due to its ]. In multidose injectable drug delivery systems, it prevents serious adverse effects such as the '']'' infection that, in one 1928 incident, killed 12 of 21 children ]d with a ] vaccine that lacked a preservative.<ref name="T-in-vaccines" /> Unlike other preservatives at the time, such as ] and ], thiomersal does not reduce the potency of the vaccines that it protects.<ref name="Baker">{{cite journal | vauthors = Baker JP | title = Mercury, vaccines, and autism: one controversy, three histories | journal = American Journal of Public Health | volume = 98 | issue = 2 | pages = 244–253 | date = February 2008 | pmid = 18172138 | pmc = 2376879 | doi = 10.2105/AJPH.2007.113159 }}</ref> ]s such as thiomersal are not needed in single-dose injectables.<ref>{{cite web |url=https://www.fda.gov/cber/vaccine/thimfaq.htm |archive-url=https://web.archive.org/web/20081231152114/http://www.fda.gov/CbER/vaccine/thimfaq.htm | archive-date=31 December 2008 |title=Thimerosal in Vaccines: Frequently Asked Questions |publisher=] |access-date=9 March 2008 }}</ref>
			In the United States, the European Union, and a few other affluent countries, thiomersal is no longer used as a preservative in routine childhood ]s.<ref name="drugsaf">{{cite journal | vauthors = Bigham M, Copes R | title = Thiomersal in vaccines: balancing the risk of adverse effects with the risk of vaccine-preventable disease | journal = Drug Safety | volume = 28 | issue = 2 | pages = 89–101 | year = 2005 | pmid = 15691220 | doi = 10.2165/00002018-200528020-00001 | s2cid = 11570020 }}</ref> In the U.S., all vaccines routinely recommended for children 6 years of age and younger are available in ] that do not contain thimerosal. Two vaccines (a ] and the single-dose version of the trivalent ] Fluvirin) may contain a trace of thiomersal from steps in manufacture, but less than 1 microgram of mercury per dose.<ref name="T-in-vaccines">{{cite web |date=2018-01-02 |title=Thimerosal and vaccines |url=https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/thimerosal-and-vaccines |access-date=2023-04-09 |publisher=Center for Biologics Evaluation and Research, U.S. Food and Drug Administration |language=en}}</ref> The ''multi-dose'' versions of some trivalent and quadrivalent influenza vaccines can contain up to 25 micrograms of mercury per dose from thiomersal. Also, four rarely used treatments for pit viper, coral snake, and black widow venom contain thiomersal.<ref>{{cite web |date=September 9, 2004 |url=https://www.fda.gov/cber/blood/mercplasma.htm |access-date=October 1, 2007 |title=Mercury in plasma-derived products |publisher=U.S. Food and Drug Administration |archive-url=https://web.archive.org/web/20070929122259/https://www.fda.gov/cber/blood/mercplasma.htm <!-- Bot retrieved archive --> |archive-date=September 29, 2007 }}</ref>
			Outside North America and Europe, many vaccines contain thiomersal; the ] reported no evidence of toxicity from thiomersal in vaccines and no reason on safety grounds to change to more expensive single-dose administration.<ref>{{cite web |title=Thiomersal and vaccines |author=Global Advisory Committee on Vaccine Safety |publisher=World Health Organization |url=https://www.who.int/vaccine_safety/topics/thiomersal/en/index.html |archive-url=https://web.archive.org/web/20030820170557/http://www.who.int/vaccine_safety/topics/thiomersal/en/index.html |url-status=dead |archive-date=20 August 2003 |date=July 14, 2006 |access-date=November 20, 2007 }}</ref> The ] backed away from an earlier proposal of putting thiomersal on the list of banned vaccine compounds as part of its campaign to reduce mercury exposure.<ref>{{cite web|url=https://www.npr.org/blogs/health/2012/12/17/167280941/experts-argue-against-proposed-ban-on-vaccine-preservative|title=Doctors Argue Against Proposed Ban on Vaccine Preservative | vauthors = Hamilton J |publisher=] |date=17 December 2012|access-date=25 February 2013}}</ref> It stated that eliminating it in multi-dose vaccines, primarily used in developing countries, would lead to high cost and a refrigeration requirement that developing countries could ill afford. At the ] in 2013 thiomersal was excluded from the treaty.<ref>{{cite journal |url=https://www.aappublications.org/content/early/2013/01/22/aapnews.20130122-1 | archive-url = https://web.archive.org/web/20160113080618/https://www.aappublications.org/content/early/2013/01/22/aapnews.20130122-1 | archive-date = 13 January 2016 |date=January 22, 2013 |title=Global ban on mercury grants exception to thimerosal-containing vaccines | vauthors = Wyckoff AS |journal=AAP News |publisher=] |access-date=August 24, 2019 }}</ref>
	==Toxicology==		==Toxicology==
			===General toxicity===
	Thiomersal is very toxic by inhalation, ingestion, and in contact with skin (EC ] T+), with a danger of cumulative effects. It is also very toxic to aquatic organisms and may cause long-term adverse effects in aquatic environments (EC hazard symbol N).<ref>{{cite web |url=http://www.merck-chemicals.com/documents/sds/emd/int/en/8170/817043.pdf |format=PDF |date=2005-06-12 |accessdate=2010-01-01 |publisher=Merck |title=Safety data sheet, Thiomersal Ph Eur, BP, USP }}</ref> In the body, it is metabolized or degraded to ] (C<sub>2</sub>H<sub>5</sub>Hg<sup>+</sup>) and ].<ref name=T-in-vaccines/>
			Thiomersal is very toxic by inhalation, ingestion, and in contact with skin (EC ] T+), with a danger of cumulative effects. It is also very toxic to aquatic organisms and may cause long-term adverse effects in aquatic environments (EC hazard symbol N).<ref>{{cite web |url=http://www.merck-chemicals.com/documents/sds/emd/int/en/8170/817043.pdf |date=June 12, 2005 |access-date=January 1, 2010 |publisher=Merck |title=Safety data sheet, Thiomersal Ph Eur, BP, USP |archive-date=15 September 2009 |archive-url=https://web.archive.org/web/20090915050341/http://www.merck-chemicals.com/documents/sds/emd/int/en/8170/817043.pdf |url-status=dead }}</ref>
			In the body, it is metabolized or degraded to ] (C<sub>2</sub>H<sub>5</sub>Hg<sup>+</sup>) and ].<ref name=T-in-vaccines/>
	Few studies of the toxicity of thiomersal in humans have been performed. Cases have been reported of severe ] by accidental exposure or attempted suicide, with some fatalities.<ref>{{cite journal |journal=Environ Health Perspect |year=2002 |volume=110 |issue=S1 |pages=11–23 |title=The three modern faces of mercury |author=Clarkson TW |pmid=11834460 |pmc=1241144 |url=http://www.ehponline.org/members/2002/suppl-1/11-23clarkson/clarkson-full.html |doi=10.1289/ehp.02110s111 }}</ref> Animal experiments suggest that thiomersal rapidly dissociates to release ethylmercury after injection; that the disposition patterns of mercury are similar to those after exposure to equivalent doses of ethylmercury chloride; and that the central nervous system and the kidneys are targets, with lack of motor coordination being a common sign. Similar signs and symptoms have been observed in accidental human poisonings. The mechanisms of toxic action are unknown. Fecal excretion accounts for most of the elimination from the body. Ethylmercury clears from blood with a ] of about 18 days in adults. Ethylmercury is eliminated from the brain in about 14 days in infant monkeys.
	Risk assessment for effects on the nervous system have been made by extrapolating from dose-response relationships for ].<ref name=Clarkson/> Methylmercury and ethylmercury distributes to all body tissues, crossing the ] and the ], and ethylmercury also moves freely throughout the body.<ref>{{cite journal |author=Clarkson TW, Vyas JB, Ballatori N |title=Mechanisms of mercury disposition in the body |journal= Am J Ind Med |volume=50 |issue=10 |pages=757–64 |year=2007 |pmid=17477364 |doi=10.1002/ajim.20476 }}</ref> Concerns based on extrapolations from methylmercury caused thiomersal to be removed from U.S. childhood vaccines, starting in 1999. Since then, it has been found that ethylmercury is eliminated from the body and the brain significantly faster than methylmercury, so the late-1990s risk assessments turned out to be overly conservative.<ref name=Clarkson/> Though inorganic mercury metabolized from ethylmercury has a much longer half-life in the brain, at least 120 days, it appears to be much less toxic than the inorganic mercury produced from mercury vapor, for reasons not yet understood.<ref name=Clarkson>{{cite journal |journal=Crit Rev Toxicol |year=2006 |volume=36 |issue=8 |pages=609–62 |title=The toxicology of mercury and its chemical compounds |author=Clarkson TW, Magos L |doi=10.1080/10408440600845619 |pmid=16973445 }}</ref>
			Cases have been reported of severe ] by accidental exposure or attempted suicide, with some fatalities.<ref name = "Clarkson2">{{cite journal | vauthors = Clarkson TW | title = The three modern faces of mercury | journal = Environmental Health Perspectives | volume = 110 | issue = Suppl 1 | pages = 11–23 | date = February 2002 | pmid = 11834460 | pmc = 1241144 | doi = 10.1289/ehp.02110s111 | url = http://www.ehponline.org/members/2002/suppl-1/11-23clarkson/clarkson-full.html | url-status = dead | archive-url = https://web.archive.org/web/20080906092329/http://www.ehponline.org/members/2002/suppl-1/11-23clarkson/clarkson-full.html | archive-date = September 6, 2008 }}</ref> Animal experiments suggest that thiomersal rapidly dissociates to release ethylmercury after injection; that mercury's disposition patterns are similar to those after exposure to equivalent doses of ethylmercury chloride; and that the ] and the ] are targets. ] is a common sign. Similar signs and symptoms have been observed in accidental human poisonings. The mechanisms of toxic action are unknown.<ref name = "Clarkson2"/>
	===Allergies===
	Thiomersal is used in ] for people who have dermatitis, conjunctivitis, and other potentially allergic reactions. A 2007 study in Norway found that 1.9% of adults had a positive patch test reaction to thiomersal;<ref>{{cite journal |journal= Contact Dermatitis |year=2007 |volume=56 |issue=1 |pages=10–5 |title= Allergic contact sensitization in the general adult population: a population-based study from Northern Norway |author= Dotterud LK, Smith-Sivertsen T |doi=10.1111/j.1600-0536.2007.00980.x |pmid=17177703}}</ref> a higher prevalence of contact allergy (up to 6.6%) was observed in German populations.<ref name=Uter>{{cite journal |journal= J Clin Epidemiol |year=2004 |volume=57 |issue=6 |pages=627–32 |title= The prevalence of contact allergy differed between population-based and clinic-based data |author= Uter W, Ludwig A, Balda BR |doi=10.1016/j.jclinepi.2003.04.002 |pmid=15246132}}</ref> Thiomersal-sensitive individuals can receive ] rather than ] immunization,<ref>{{cite journal |journal= Contact Dermatitis |year=1991 |volume=24 |issue=1 |pages=6–10 |title= Vaccination despite thimerosal sensitivity |author= Aberer W |doi=10.1111/j.1600-0536.1991.tb01621.x |pmid=2044374}}</ref> though there have been no large sample sized studies regarding this matter to date. In real-world practice on vaccination of adult populations, contact allergy does not seem to elicit clinical reaction.<ref name=Uter/> Thiomersal allergy has decreased in Denmark, probably because of its exclusion from vaccines there.<ref>{{cite journal |journal= Contact Dermatitis |year=2007 |volume=57 |issue=5 |pages=287–99 |title= The epidemiology of contact allergy in the general population—prevalence and main findings |author= Thyssen JP, Linneberg A, Menné T, Johansen JD |doi=10.1111/j.1600-0536.2007.01220.x |pmid=17937743 |url=http://www.blackwell-synergy.com/doi/full/10.1111/j.1600-0536.2007.01220.x}}</ref> In a recent study of Polish children and adolescents with chronic/recurrent eczema, positive reactions to thiomersal were found in 11.7% of children (7-8 y.o.) and 37.6% of adolescents (16–17 y.o.). This difference in the sensitization rates can be explained by changing exposure patterns: The adolescents have received six thiomersal-preserved vaccines during their life course, with the last immunization taking place 2–3 years before the mentioned study, younger children received only four thiomersal-preserved vaccines, with the last one applied 5 years before the study, while further immunizations were performed with new thiomersal-free vaccines.<ref>{{cite journal |journal= Pediatr Allergy Immunol |year=2011 |volume=22 |issue=2 |pages=252–6 |title= The most important contact sensitizers in Polish children and adolescents with atopy and chronic recurrent eczema as detected with the extended European Baseline Series |author= Czarnobilska E, Obtulowicz K, Dyga W, Spiewak R |pmid=20969635 |doi=10.1111/j.1399-3038.2010.01075.x}}</ref>
			Fecal excretion accounts for most of the elimination from the body. Ethylmercury clears from blood with a ] of about 18 days in adults by breakdown into other chemicals, including ] mercury.<ref>{{cite journal | vauthors = Magos L | title = Neurotoxic character of thimerosal and the allometric extrapolation of adult clearance half-time to infants | journal = Journal of Applied Toxicology | volume = 23 | issue = 4 | pages = 263–269 | year = 2003 | pmid = 12884410 | doi = 10.1002/jat.918 | s2cid = 20703489 }}</ref> The ] of ethylmercury in the brains of infant monkeys is 14 days.<ref name=Clarkson/> Risk assessment for effects on the ] have been made by extrapolating from dose-response relationships for ].<ref name=Clarkson/> Methylmercury and ethylmercury distribute to all body tissues, crossing the ] and the ], and ethylmercury also moves freely throughout the body.<ref>{{cite journal | vauthors = Clarkson TW, Vyas JB, Ballatori N | title = Mechanisms of mercury disposition in the body | journal = American Journal of Industrial Medicine | volume = 50 | issue = 10 | pages = 757–764 | date = October 2007 | pmid = 17477364 | doi = 10.1002/ajim.20476 }}</ref>
	===Autism===
	{{main|Thiomersal controversy}}
			Concerns based on extrapolations from methylmercury caused thiomersal to be removed from U.S. childhood vaccines, starting in 1999. Later it was reported that ethylmercury is eliminated from the body and the brain significantly faster than methylmercury, so the late-1990s risk assessments turned out to be overly conservative.<ref name=Clarkson/> Though inorganic mercury metabolized from ethylmercury has a much longer half-life in the brain, at least 120 days, it appears to be much less toxic than the inorganic mercury produced from mercury ], for reasons not yet understood.<ref name="Clarkson">{{cite journal |vauthors=Clarkson TW, Magos L |date=September 2006 |title=The toxicology of mercury and its chemical compounds |url=https://www.tandfonline.com/doi/full/10.1080/10408440600845619 |journal=Critical Reviews in Toxicology |volume=36 |issue=8 |pages=609–662 |doi=10.1080/10408440600845619 |pmid=16973445 |s2cid=37652857}}</ref>
	Following a review of mercury-containing food and drugs mandated in 1999, the ] (CDC) and the ] asked vaccine manufacturers to remove thiomersal from vaccines as a purely precautionary measure, and it was rapidly phased out of most U.S. and European vaccines.<ref name="Baker"/><ref>{{cite web |url=http://www.fda.gov/cber/vaccine/thimfaq.htm |date=2007-06-07 |accessdate=2008-07-22 |title= Thimerosal in vaccines: frequently asked questions (FAQs) |publisher= Center for Biologics Evaluation and Research, U.S. Food and Drug Administration}}</ref> Many parents saw the action to remove thiomersal—in the setting of a perceived increasing rate of autism as well as increasing number of vaccines in the childhood vaccination schedule—as indicating that the preservative was the cause of autism.<ref name="Baker" /> The ] is that there is no scientific evidence supporting these claims, including the observation that the rate of autism continues to climb despite elimination of thiomersal from routine childhood vaccines.<ref name=DeStefano>{{cite journal |journal= Clin Pharmacol Ther |year=2007 |volume=82 |issue=6 |pages=756–9 |title= Vaccines and autism: evidence does not support a causal association |author= DeStefano F |doi=10.1038/sj.clpt.6100407 |pmid=17928818}}</ref><ref name=Doja>{{cite journal |journal= Can J Neurol Sci |year=2006 |volume=33 |issue=4 |pages=341–6 |title= Immunizations and autism: a review of the literature |author= Doja A, Roberts W |pmid=17168158}}</ref><ref name=IOM2004/> Major scientific and medical bodies such as the ]<ref name=IOM2004>{{cite book |author= Immunization Safety Review Committee, Board on Health Promotion and Disease Prevention, ] |title= Immunization Safety Review: Vaccines and Autism |publisher= The National Academies Press |location= Washington, DC |year=2004 |isbn=0-309-09237-X |url=http://www.nap.edu/catalog/10997.html}}</ref> and ]<ref name=WHO>{{cite web |author= World Health Organization |year=2006 |url=http://who.int/vaccine_safety/topics/thiomersal/questions/en/ |title= Thiomersal and vaccines: questions and answers |accessdate=2009-05-19}}</ref> as well as governmental agencies such as the ]<ref name=T-in-vaccines/> and the CDC<ref name=CDC>{{cite web |author= Centers for Disease Control |date=2008-02-08 |url=http://www.cdc.gov/vaccinesafety/updates/thimerosal.htm |title= Mercury and vaccines (thimerosal) |accessdate=2009-05-19}}</ref> reject any role for thiomersal in autism or other neurodevelopmental disorders.<ref name=Sugarman>{{cite journal |journal=N Engl J Med |year=2007 |volume=357 |issue=13 |pages=1275–7 |title=Cases in vaccine court—legal battles over vaccines and autism |author=Sugarman SD |pmid=17898095 |url=http://content.nejm.org/cgi/content/full/357/13/1275 |doi= 10.1056/NEJMp078168 }}</ref> This controversy has caused harm due to parents attempting to treat their autistic children with unproven and possibly dangerous treatments, discouraging parents from vaccinating their children due to fears about thiomersal toxicity<ref name=Harris>{{cite news |work= New York Times |url=http://nytimes.com/2005/06/25/science/25autism.htm |date=2005-06-25 |title= On autism's cause, it's parents vs. research |author= Harris G, O'Connor A |accessdate=2010-07-02}}</ref> and diverting resources away from research into more promising areas for the ].<ref name=Offit>{{cite journal |journal= N Engl J Med |year=2007 |volume=357 |issue=13 |pages=1278–9 |title= Thimerosal and vaccines—a cautionary tale |author= Offit PA |doi=10.1056/NEJMp078187 |pmid=17898096 |url=http://content.nejm.org/cgi/content/full/357/13/1278 |authorlink= Paul Offit}}</ref> Thousands of lawsuits have been filed in a ] to seek damages from alleged toxicity from vaccines, including those purportedly caused by thiomersal.<ref>Autism cases in vaccine court:
	*{{cite journal |journal= N Engl J Med |year=2007 |volume=357 |issue=13 |pages=1275–7 |title= Cases in vaccine court—legal battles over vaccines and autism |author= Sugarman SD |pmid=17898095 |url=http://content.nejm.org/cgi/content/full/357/13/1275 |doi= 10.1056/NEJMp078168}}
	*{{cite web |author= ] |date=2007-09-28 |url=http://www.uscfc.uscourts.gov/OSM/OSMAutism.htm |title= Vaccine Program/Office of Special Masters Omnibus Autism Proceeding |accessdate=2007-11-24 |archiveurl = http://web.archive.org/web/20071023235955/http://www.uscfc.uscourts.gov/OSM/OSMAutism.htm <!-- Bot retrieved archive --> |archivedate = 2007-10-23}}</ref>
			===As an allergen===
	==History==
			]]]
	], a ] at the ], filed a patent application for thiomersal in 1927;<ref>{{US patent|1672615}} "Alkyl mercuric sulphur compound and process of producing it".</ref> Eli Lilly later marketed the compound under the trade name Merthiolate.<ref name="Baker"/> ] tests conducted by Lilly investigators H. M. Powell and W. A. Jamieson found that it was forty to fifty times as effective as ] against '']''.<ref name="Baker"/> It was used to kill bacteria and prevent contamination in antiseptic ointments, creams, jellies, and sprays used by consumers and in hospitals, including nasal sprays, eye drops, contact lens solutions, ]s, and vaccines. Thiomersal was used as a preservative (]) so that multidose vials of vaccines could be used instead of single-dose vials, which are more expensive. By 1938, Lilly's assistant director of research listed thiomersal as one of the five most important drugs ever developed by the company.<ref name="Baker"/>
			Thiomersal is used in ]ing for people who have ], ], and other potentially allergic reactions. A 2007 study in Norway found that 1.9% of adults had a positive patch test reaction to thiomersal;<ref>{{cite journal | vauthors = Dotterud LK, Smith-Sivertsen T | title = Allergic contact sensitization in the general adult population: a population-based study from Northern Norway | journal = Contact Dermatitis | volume = 56 | issue = 1 | pages = 10–15 | date = January 2007 | pmid = 17177703 | doi = 10.1111/j.1600-0536.2007.00980.x | s2cid = 25765635 }}</ref> a higher prevalence of contact allergy (up to 6.6%) was observed in German populations.<ref name=Uter>{{cite journal | vauthors = Uter W, Ludwig A, Balda BR, Schnuch A, Pfahlberg A, Schäfer T, Wichmann HE, Ring J | title = The prevalence of contact allergy differed between population-based and clinic-based data | journal = Journal of Clinical Epidemiology | volume = 57 | issue = 6 | pages = 627–632 | date = June 2004 | pmid = 15246132 | doi = 10.1016/j.jclinepi.2003.04.002 }}</ref> Thiomersal-sensitive individuals can receive ] rather than ] immunization,<ref>{{cite journal | vauthors = Aberer W | title = Vaccination despite thimerosal sensitivity | journal = Contact Dermatitis | volume = 24 | issue = 1 | pages = 6–10 | date = January 1991 | pmid = 2044374 | doi = 10.1111/j.1600-0536.1991.tb01621.x | s2cid = 43264826 }}</ref> though there have been no large sample sized studies regarding this matter to date. In real-world practice on vaccination of adult populations, contact allergy does not seem to elicit clinical reaction.<ref name=Uter/>
			Thiomersal allergy has decreased in Denmark, probably because of its exclusion from vaccines there.<ref>{{cite journal | vauthors = Thyssen JP, Linneberg A, Menné T, Johansen JD | title = The epidemiology of contact allergy in the general population--prevalence and main findings | journal = Contact Dermatitis | volume = 57 | issue = 5 | pages = 287–299 | date = November 2007 | pmid = 17937743 | doi = 10.1111/j.1600-0536.2007.01220.x | s2cid = 44890665 | doi-access = free }}</ref> In a recent study of Polish children and adolescents with chronic/recurrent eczema, positive reactions to thiomersal were found in 11.7% of children (7–8 y.o.) and 37.6% of adolescents (16–17 y.o.). This difference in the sensitization rates can be explained by changing exposure patterns: The adolescents received six thiomersal-preserved vaccines during their life course, with the last immunization taking place 2–3 years before the study. Younger children received only four thiomersal-preserved vaccines, with the last one applied five years before the study, while further immunizations were performed with thiomersal-free vaccines.<ref>{{cite journal | vauthors = Czarnobilska E, Obtulowicz K, Dyga W, Spiewak R | title = The most important contact sensitizers in Polish children and adolescents with atopy and chronic recurrent eczema as detected with the extended European Baseline Series | journal = Pediatric Allergy and Immunology | volume = 22 | issue = 2 | pages = 252–256 | date = March 2011 | pmid = 20969635 | doi = 10.1111/j.1399-3038.2010.01075.x | s2cid = 22195669 }}</ref>
			===Removal from vaccines===
			The Center for Biologics Evaluation and Research (]) at the FDA initiated a formal risk assessment of thiomersal in vaccines beginning in 1998.<ref name = "Stratton_2001">{{cite book | vauthors = ((Institute of Medicine (US) Immunization Safety Review Committee)) | veditors = Stratton K, Gable A, McCormick MC | title = Immunization Safety Review: Thimerosal-Containing Vaccines and Neurodevelopmental Disorders. | chapter = Thimerosal-Containing Vaccines and Neurodevelopmental Disorders | location = Washington (DC) | publisher = National Academies Press (US) | date = 2001 | url = https://www.ncbi.nlm.nih.gov/books/NBK223724/ }}</ref> After determining the levels of ethylmercury exposure from the currently recommended vaccine schedule, the CBER found these amounts exceeded new standards for methylmercury exposure recently established by the Environmental Protection Agency.<ref name="Baker" /> On July 7, 1999, both the American Academy of Pediatrics and the US Public Health Service issued a statement calling for the removal of thiomersal-containing vaccines “as expeditiously as possible.”<ref>{{cite journal | pmc=1308509 | date=1999 | title=AAP and PHS Urge Reduction of Mercury in Vaccines | journal=Public Health Reports | volume=114 | issue=5 | pages=394–395 | doi=10.1093/phr/114.5.394 | doi-broken-date=1 November 2024 }}</ref><ref name="pmid10418806">{{cite journal | title = Thimerosal in vaccines: a joint statement of the American Academy of Pediatrics and the Public Health Service | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 48 | issue = 26 | pages = 563–565 | date = July 1999 | pmid = 10418806 | doi = | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4826a3.htm | author1 = Centers for Disease Control and Prevention (CDC) }}</ref> By March 2001, thiomersal-free versions of all the recommended childhood vaccines for children up to age 6 were available in the United States following the introduction of the new DtAP vaccine.<ref name = "Stratton_2001" />
			===Disproven autism hypothesis===
			{{main|Thiomersal and vaccines}}
			Following the phasing out of thiomersal from most U.S. and European vaccines,<ref name="Baker"/><ref>{{cite web |url=https://www.fda.gov/cber/vaccine/thimfaq.htm |date=June 7, 2007 |access-date=July 22, 2008 |title=Thimerosal in vaccines: frequently asked questions (FAQs) |publisher=Center for Biologics Evaluation and Research, U.S. Food and Drug Administration}}</ref> some parents saw the action to remove thiomersal—in the setting of a perceived increasing rate of ] as well as increasing number of vaccines in the childhood vaccination schedule—as indicating that the preservative was the cause of autism.<ref name="Baker" /> The ] is that no evidence supports these claims, while the rate of autism continued to climb in children who did not take the thiomersal-preserved childhood vaccines.<ref name="CDC concerns" /><ref name=DeStefano>{{cite journal | vauthors = DeStefano F | title = Vaccines and autism: evidence does not support a causal association | journal = Clinical Pharmacology and Therapeutics | volume = 82 | issue = 6 | pages = 756–759 | date = December 2007 | pmid = 17928818 | doi = 10.1038/sj.clpt.6100407 | s2cid = 12872702 }}</ref><ref name=Doja>{{cite journal | vauthors = Doja A, Roberts W | title = Immunizations and autism: a review of the literature | journal = The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques | volume = 33 | issue = 4 | pages = 341–346 | date = November 2006 | pmid = 17168158 | doi = 10.1017/s031716710000528x | doi-access = free }}</ref><ref name=IOM2004/>
			Scientific and medical bodies such as the ]<ref name="IOM2004">{{cite book | vauthors = ((Immunization Safety Review Committee)), ((Board on Health Promotion and Disease Prevention)), ((])) |title=Immunization Safety Review: Vaccines and Autism |publisher=The National Academies Press |location=Washington, DC |year=2004 |doi=10.17226/10997 |pmid=20669467 |isbn=978-0-309-09237-1 |url=http://www.nap.edu/catalog/10997.html}}</ref> and ],<ref name="WHO">{{cite web |author=World Health Organization |year=2006 |url=http://who.int/vaccine_safety/topics/thiomersal/questions/en/ |archive-url=https://web.archive.org/web/20031012231839/http://www.who.int/vaccine_safety/topics/thiomersal/questions/en/ |url-status=dead |archive-date=12 October 2003 |title=Thiomersal and vaccines: questions and answers |access-date=May 19, 2009 }}</ref><ref>{{cite web|url=https://www.who.int/vaccine_safety/committee/topics/thiomersal/statement_jul2006/en|archive-url=https://web.archive.org/web/20121029124603/http://www.who.int/vaccine_safety/committee/topics/thiomersal/statement_jul2006/en/|url-status=dead|archive-date=29 October 2012|title=Statement on thiomersal|author=WHO|website=www.who.int|access-date=3 April 2018}}</ref> as well as governmental agencies such as the ]<ref name="T-in-vaccines" /> and the CDC<ref name="CDC">{{cite web |author=Centers for Disease Control |date=February 8, 2008 |url=https://www.cdc.gov/vaccinesafety/updates/thimerosal.htm |title=Mercury and vaccines (thimerosal) |access-date=May 19, 2009 |archive-url=https://web.archive.org/web/20180418041930/https://www.cdc.gov/vaccinesafety/updates/thimerosal.htm |archive-date=April 18, 2018 |url-status=dead }}</ref> reject any role for thiomersal in autism or other neurodevelopmental disorders.<ref name="Sugarman">{{cite journal | vauthors = Sugarman SD | title = Cases in vaccine court--legal battles over vaccines and autism | journal = The New England Journal of Medicine | volume = 357 | issue = 13 | pages = 1275–1277 | date = September 2007 | pmid = 17898095 | doi = 10.1056/NEJMp078168 | doi-access = free }}</ref> Unconvinced parents attempted to treat their autistic children with unproven and possibly dangerous treatments, and refused to vaccinate them due to fears about thiomersal toxicity.<ref name="Harris">{{cite news|url=https://www.nytimes.com/2005/06/25/science/on-autisms-cause-its-parents-vs-research.html|title=On autism's cause, it's parents vs. research|date=June 25, 2005 |work=New York Times| vauthors = Harris G, O'Connor A |access-date=March 11, 2016 }}</ref> Studying thiomersal potentially diverts resources away from research into more promising areas for ].<ref name="Offit">{{cite journal | vauthors = Offit PA | title = Thimerosal and vaccines--a cautionary tale | journal = The New England Journal of Medicine | volume = 357 | issue = 13 | pages = 1278–1279 | date = September 2007 | pmid = 17898096 | doi = 10.1056/NEJMp078187 | author-link = Paul Offit | doi-access = free }}</ref> Thousands of lawsuits have been filed in ] to seek damages from allegedly toxic vaccines, including those purportedly caused by thiomersal.<ref>Autism cases in vaccine court:
			* {{cite journal | vauthors = Sugarman SD | title = Cases in vaccine court--legal battles over vaccines and autism | journal = The New England Journal of Medicine | volume = 357 | issue = 13 | pages = 1275–1277 | date = September 2007 | pmid = 17898095 | doi = 10.1056/NEJMp078168 | doi-access = free }}
			* {{cite web |author=U.S. Court of Federal Claims |author-link=U.S. Court of Federal Claims |date=September 28, 2007 |url=http://www.uscfc.uscourts.gov/OSM/OSMAutism.htm |title=Vaccine Program/Office of Special Masters Omnibus Autism Proceeding |access-date=November 24, 2007 |archive-url=https://web.archive.org/web/20071023235955/http://www.uscfc.uscourts.gov/OSM/OSMAutism.htm |archive-date=October 23, 2007 }}</ref>
	== See also ==		== See also ==
			* {{Annotated link|Nitromersol}}, a related antimicrobial
	* ]
			* ] – Organomercury compound with powerful antiseptic and antifungal effects
	* ], a related antimicrobial
	==References==		== References ==
			{{Reflist}}
	{{reflist|colwidth=30em}}
	{{Mercury compounds}}		{{Mercury compounds}}
	{{vaccines}}		{{Vaccines}}
	{{Antiseptics and disinfectants}}		{{Antiseptics and disinfectants}}
			{{Sodium compounds}}
	]
	]
	]
	]
	]
	]		]
			]
			]
			]
			]
			]