Sample from the Book

Introductory Chapters


Vaccinations are among the most important advances in medicine in the last century. We have eradicated smallpox from the planet and dramatically reduced death and suffering from infectious disease around the globe.

I am aggressively pro-vaccine, as are the editor and introduction contributor of this book. I am a father and family physician. I have vaccinated my children. I have been vaccinated and recommend vaccination to my patients.

Critics of this book will quickly polarize the debate. It is easy to oversimplify the issue of Thimerosal into pro-vaccine or anti-vaccine, or to confuse this issue by debating whether Thimerosal causes autism, which has not been definitively proven. This is unfortunate, and detracts from a much simpler set of questions that are ultimately the subject of this scientifically dense book.

There is no debate that mercury in any form is toxic. Scientists may debate the differences in toxicity between different forms of mercury, such as ethylmercury (which is an ingredient in Thimerosal) or methylmercury (from fish). But all would agree that mercury is a potent neurotoxin.

There is also no debate about the dramatic increase in prevalence of neurodevelopmental disorders, over the last few decades, including learning disabilities, attention deficit disorders, and autism.

There may, however, be debate on the strength of the data and science implicating mercury in this increased prevalence of brain injury in children. These questions can never be adequately answered given the challenges of doing experimental studies on human subjects over long periods of time. Obviously, no ethical review board would ever approve a study in which children were purposefully exposed to mercury in order to test its toxicity. Population studies show correlations, but never prove causation, making it impossible to draw firm conclusions.

That leaves us with a very simple, moral question, and ultimately a very personal one. Because at some point in our lives, nearly all of us will have a child or grandchild who requires vaccinations. Or we will know a pregnant woman who will have to decide whether or not to get a flu shot that might contain mercury. All of us are people and parents first, and scientists and policy makers second.

So there is only one question that really matters:

Would you expose the unborn child or infant of a loved one to a vaccine containing mercury, a known neurotoxin, if there were other safer alternatives?

The answer to this question is simply common sense and requires no further scientific inquiry, but as Voltaire said, “common sense is not so common.”

If there were no other options, if it were a question of whether to vaccinate or not to vaccinate, then of course we would choose vaccination. But that is a false choice. There are 137 million children born each year in the world. Is our only option to subject them to a potent neurotoxin in their most delicate neurodevelopmental period? How can we best protect that future generation from preventable harm?

The arguments put forth that we cannot remove Thimerosal from vaccines are invalid. Thimerosal has already been removed from nearly all vaccines except the multidose flu vaccine in the United States. This was based on government recommendations and a call to action from many agencies and health organizations, as is well documented in this book.

However, Thimerosal still remains in nearly all the pediatric vaccines used in the developing world. There are effective alternative preservatives already in use (2-phenoxyethanol), and new ones can be developed. The Food and Drug Administration (FDA) banned mercury as a topical antiseptic (remember Mercurochrome?). And any medical products containing Thimerosal or mercury cannot be thrown in the garbage. The Environmental Protection Agency (EPA) considers them hazardous waste. Does it make any sense that even though Thimerosal is not safe to put on your skin, or to throw in the garbage, it is safe to inject into pregnant women and babies?

Cost considerations are also used as an argument to keep Thimerosal in vaccines. There is a small cost increase to use single-dose flu vaccines, but it is minor compared to the cost of neurodevelopmental disease in children. The global cost of taking Thimerosal out of all vaccines is $300 million a year, while the annual cost of autism in the United States alone is well over $100 billion. In the developing world, studies show that there is significant wastage of multidose vials, making single-dose vials comparable in cost.

There are other arguments. Some scientists we spoke to at the Department of Health and Human Services said that Thimerosal may contribute to the effectiveness of the vaccines. Any agent that increases vaccine effectiveness is referred to as an adjuvant. However, Thimerosal is approved for use only as a preservative, not as an active ingredient, and such use is illegal.

I have been involved in reviewing and contributing ideas and scientific references to this manuscript. I have also been involved in efforts to change regulatory and legislative policy to reduce potential harm from Thimerosal. I do not belong to any organization connected in any way with this issue. Nor do I have any personal or financial interest in this issue other than a scientific and moral one.

And, as a physician, my Hippocratic oath is to “first, do no harm.” We should practice the precautionary principle in medicine and avoid doing harm whenever possible. And given the simple fact that mercury is toxic, I can come to no other conclusion than this: we should immediately remove Thimerosal from vaccines and all other products used in medicine.

Mark Hyman, MD
West Stockbridge, Massachusetts
June 7, 2014

Introduction: Removal of Mercury from Vaccines in the Epoch of Error Correction

This book is aggressively pro-vaccine. Its focus is not on vaccines in any general way, but only on one particular ingredient, Thimerosal, which contains ethylmercury.

Although the conversation surrounding vaccines, as with any medical issue, has many facets (especially when you consider technical issues), many people are aware of only two black-and-white options: you are either pro-vaccine, or anti-vaccine. If you are a reader who wishes to absorb and evaluate the information in this book, I ask you to consider that, at minimum, there is a third alternative: you can be pro-vaccine and at the same time seek to improve the vaccine program.[i]

This book advocates one specific step to improve vaccines: removing a known neurotoxin (mercury, in the form of Thimerosal) from the list of ingredients. To make a strong case for taking this step, the book presents voluminous evidence of:

  • The toxicity of Thimerosal
  • Its ineffectiveness even in the bactericidal role it is supposed to play
  • Safer alternatives to Thimerosal that are already available
  • A history of the calls of scientists and high-level governmental and international agencies around the world to remove Thimerosal entirely from vaccines
  • Implementation of this course of action in some other countries

It argues that removing Thimerosal entirely will improve both vaccines themselves and people’s trust in them.

That mercury is toxic cannot be disputed. To say otherwise is to pick a fight with the periodic table and the fundamental principles of physical chemistry. Consider the organization of electrons in atoms. Mercury is a large, heavy atom with more orbitals than lighter metals, like copper or zinc, and has a greater capacity to pick up and exchange electrons. The specific ways it can do this are not as tightly determined as in lighter atoms, making it a biochemical “wild card.” Mercury is thus a metabolic poison because it can insinuate itself into situations where it doesn’t belong. In particular it can substitute itself for lighter metals like zinc and selenium around which critical ancient enzyme systems are designed. This grossly cripples the specificity of enzymes and rates of reaction, and can spread chaos in the networks of metabolic processes, which try to generate workarounds to this logjam—but at great cost to biological and energetic resources, and often without success. This chaos may disrupt development as well as ongoing function throughout life.

Moreover, while claims have been made that the ethylmercury in Thimerosal is safer than the much better-studied methylmercury, these claims are based on weak, questionable evidence and poorly chosen assumptions. As reviewed in Chapters 4–6 herein, available data suggests that the toxicity of these two forms of mercury is at least comparable, and that ethylmercury may leave the blood more quickly—only to persist more stubbornly in organs and tissues of the body, particularly the brain.

Furthermore, mercury’s toxicity can be even worse in the presence of aluminum, which is also an ingredient in many vaccines and has toxicity issues of its own (Chapter 11).

This all being the case, why are we still putting mercury in vaccines—or in any medical product (roughly 169 consumer products including eyedrops and nose drops still contain Thimerosal)—and how can we bring ourselves to stop doing this?

To generate the fortitude to do the right thing, it may help to put this problem in a broader context.

Although potentially hazardous substances have long been buried in the seams of the earth’s mantle, leaching slowly or on occasion volcanically exploding into the living environment, human activities have contributed greatly to bringing them to the surface and putting them into circulation. Our clever, problem-solving minds have created a flood of ingenious products that increase demand for—and exposures to—these sources of potential harm.

For many years our measurement instruments were blunt enough that we only detected problems when exposures were severe. Concerns about an underbelly to our inventions were buried under elation about remarkable innovation and progress. There was little motivation to look broadly for latent or downstream effects.

Today, however, our confidence in progress is no longer so dominant, and we have entered a period of pervasive fragility. Planetary biogeochemical cycles are becoming unstable; economic vulnerabilities are persisting rather than resolving; large numbers of people are chronically ill despite enormous health care expenditures; 100,000 people a year die from unintended effects of medications used according to label;[ii] and systems science is increasingly suggesting that we need fresh approaches to health care, product development, energy, and ecosystems management.

It appears that our world is finally grasping our pileup of a huge number of errors, and we are at last entering an epoch of error correction.

What is an error? Put simply, it is a mismatch between our predictions and the outcomes. Put in systems terms, an “error” is an action that looks like a success when viewed through a narrow lens, but whose disruptive additional effects become apparent when we zoom out.

Why do predictions fail to anticipate major complications? Ironically the exquisite precision of our science may itself promote error generation. This is because precision is usually achieved by ignoring context and all the variation outside of our narrow focus, even though biological systems in particular are intrinsically variable and complex rather than uniform and simple. In fact our brains utilize this subtlety and context to make important distinctions, but our scientific methods mostly do not. The problems that come back to bite us then come from details we didn’t consider.

Once an error is entrenched it can be hard to change course. The initial investment in the error, plus fear of the likely expense (both in terms of time and money) of correcting the error, as well as the threat of damage to the reputations of those involved—these all serve as deterrents to shifting course. Patterns of avoidance then emerge that interfere with free and unbiased conduct of scientific investigations and public discourse. But if the error is not corrected, its negative consequences will continue to accumulate. When change eventually becomes unavoidable, it will be a bigger, more complicated, and expensive problem to correct—with further delay making things still worse.

Some errors happen out of naïveté and then perpetuate themselves—the introduction of nonnative species, such as rabbits in Australia that lack local predators, need not be repeated for the problem to perpetuate itself. Some catastrophes, such as the British Petroleum oil spill in the Gulf of Mexico, are local but with widely dispersed consequences, and they dramatize the need for upgrading workflows and standards to prevent similar catastrophes in the future. Some disasters occur through a combination of errors—for example, in the case of Hurricane Katrina and the flooding of New Orleans, the combination of institutional failures and a global warming–driven increase in the power and frequency of storms. These catastrophes and disasters are often worsened by a series of unfortunate actions and/or inaction.

When it comes to mercury, not only is it clearly toxic, even at very low exposures,[iii iv v] but our bodies derive no physiological benefit from it whatsoever. Nevertheless, one out of six children in the United States is born with levels of mercury high enough to be put at risk for neurological complications like learning disabilities, motor skill impairments, and short-term memory loss.[vi]

We can be exposed to mercury by eating fish (particularly those predators high on the food chain), being downwind of coal-fired power plants and other coal-fired industrial processes such as cement kilns, being near mines, being downwind of trash incinerators that burn hazardous and medical waste, breaking mercury-containing devices such as older thermometers, and having dental amalgams. People, including infants and pregnant mothers, can also be exposed to mercury through vaccines. In the United States, this exposure comes mainly from influenza vaccines. Although Thimerosal was removed from mandatory childhood vaccines in the United States, cumulative exposure is still high due to regular Thimerosal-containing flu shot administration starting in pregnancy and infancy. In other countries, however, particularly in developing countries (Chapters 2 and 3), more types of vaccines may contain mercury, and at higher levels.

To reduce the population’s exposure to mercury from non-vaccine sources requires policy, educational, and technical changes targeting wide swaths of the population and many different industries and communities. It is a protracted process that will be slowed by significant industry pushback. In addition, the oceans, atmosphere, waterways, and areas of land that have been contaminated with mercury will be very difficult to clean up comprehensively.

To take mercury out of vaccines is a different matter. It is used as a preservative in multidose vials, even though it doesn’t actually do that job so well (Chapter 10), and we have safe and effective alternatives (Chapter 12). Companies making vaccines could either change the preservative or shift to single-dose vials, which actually will not increase societal costs as much as has been claimed, because of wastage associated with multidose vials (see Chapter 12 and the book’s recommendations). The big point here is that there are a finite and modest number of entities that need to make a discrete and specific change—and then the job of getting mercury out of vaccines will be done.

You may ask why we should take mercury out of vaccines if there’s no definitive proof that vaccines or the mercury in them causes autism. To this I will answer: that is not the right question. The right question is, why do we persist in putting a potent toxin into a vital medical product when we don’t really need to?

Complex chronic illnesses are generally multifactorial—genetic weak spots may create vulnerability—but a pileup of noxious exposures and stressors is what wears the system down. I include autism in the broad category of complex chronic disease because of the thousands of papers now in the scientific literature documenting pathophysiology such as oxidative stress, dysfunction of mitochondrial bioenergetics, and immune/inflammatory responses that greatly overlap with what we are finding in other chronic illnesses.[vii viii] For all of these conditions the tipping point is not just the environmental insult itself, but the way it overwhelms the system, which has been pushed close to the edge by a prior accumulation of environmental insults that have been progressively degrading the physiological systems in our bodies and brains. The shift into an illness state may be gradual, or it may occur at some particular point when the physiological systems cannot compensate anymore and shift their functioning to a less resource- and energy-demanding (and thereby less efficient) state. I predict that ultimately we will determine that it is not any one or a few environmental risk factors that uniquely tip people over into chronic illness, but rather the total, degradative load (or “allostatic load”) of exposures, stressors, and low-nutrient-density food that tips most people over the edge into illness from latent vulnerabilities.[ix x xi xii]

From the vantage point of a total (allostatic) load model of chronic disease, basic management and prevention principles include reducing noxious exposures and stressors as much as possible, and also increasing nutritional and lifestyle supports.[xiii] Every little bit counts—and in the case of mercury, it is so toxic that even a little bit can go a long way in dragging the system down. As a metabolic “wild card” mercury does not have a one-to-one relationship with specific illnesses; but rather, by disturbing fundamental developmental processes and acting as a metabolic poison, it degrades the integrity of the system and aggravates people’s vulnerabilities. In particular, it poisons critical core regulatory and protective pathways (including methylation, DNA repair, and thioredoxin)[xiv xv xvi xvii xviii xix xx]—and, when such systems are dysfunctional, many things suffer. Even at low doses it can interfere with chemical processes in brain and body, lead to gross and subtle neuromotor problems and subtle or dramatic cognitive impairment,[xxi] promote autoimmune conditions such as rheumatoid arthritis and multiple sclerosis,[xxii] and bias the system toward being more fragile and vulnerable to future challenges.

Even so, while our physiology has environmentally vulnerable spots where mercury can contribute to this process of system overload and degradation, those same physiological processes are also vulnerable to myriad other noxious influences.[xxiii] From both the total (allostatic) load and the precautionary points of view, mercury is among a broad range of noxious exposures that degrade body and brain health. Such exposures should therefore be totally avoided, if possible.[xxiv] Different people may have different weak points, making epidemiology of particular diseases an insensitive way to pick up the range of mercury’s impacts.

With all of this in mind, the bottom line is that by exposing the population to unnecessary mercury in vaccines, we are gambling with population health through the same intervention that we use to protect it.

The painful truth is that our country and planet face a rocky road in years to come—unstable weather patterns, fires, natural disasters, risks of novel infectious diseases, risks of food and water shortages, health problems exacerbated by these environmental challenges, and prospects of recurrent economic constriction. Under these circumstances, why would we want to expose our population to yet another noxious stressor that could further deplete our resilience and interfere with our ability to think straight—when it is totally unnecessary?

Based upon all of this, it is clear now that mercury is something to which no one should be deliberately exposed. As such, it is an error to include it in vaccines or indeed in any therapeutics—and in these domains it is an error within our grasp to correct, and prudent to do so. We tend to take a long time to correct errors[xxv]—it took seventy-five years to get the lead out of gasoline.[xxvi xxvii] Let’s do a better job this time. So many considerations and pieces of evidence are compiled in this one comprehensive volume. I hope and implore that it moves us all to do whatever it takes—make whatever adjustments necessary—to correct this error, because it CAN be corrected—indeed MUST be corrected—so let’s just DO IT. THEN we can focus more effectively on the harder problems lying ahead.

Martha R. Herbert, PhD, MD




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[v]Agency for Toxic Substances and Disease Registry CfDC. Toxic Substances Portal – Mercury. April, 1999:
[vi]US National Institute of Environmental Healthy Sciences. Child Development and Environmental Toxins.
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[x]Herbert MR, Weintraub K. The Autism Revolution: Whole Body Strategies for Making Life All It Can Be. New York, NY: Random House with Harvard Health Publications; 2012.
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Editor’s Introduction

People who advocate for safer vaccines should not be marginalized or denounced as anti-vaccine. I am pro-vaccine. I had all six of my children vaccinated. I believe that vaccines have saved the lives of hundreds of millions of humans over the past century and that broad vaccine coverage is critical to public health. But I want our vaccines to be as safe as possible.

Indeed, the greatest threats to the kind of widespread vaccine coverage needed to protect global health are public doubt about vaccine safety and mistrust of vaccine regulators. And we cannot heal that mistrust by simply dismissing legitimate questions about Thimerosal as the fruit of mindless paranoia. For example, solid peer-reviewed science supports the well-documented popular skepticism about the safety of the mercury-laden vaccine preservative Thimerosal.

As this book shows, there is a broad consensus among research scientists that Thimerosal is a dangerous neurotoxin that should be immediately removed from medicines. Several hundred peer-reviewed scientific publications by the world’s leading research scientists, public health agencies, universities, and teaching hospitals have confirmed that Thimerosal is a potent neurotoxin that has never been proven safe for medical use and for which cost-effective alternatives exist.

Indeed, the evidence of Thimerosal’s neurotoxicity is so overwhelming and the lack of any safety data so complete that anyone who is willing to read science and who believes in the capacity for scientific methods to determine empirical truths must conclude that Thimerosal causes serious brain damage.

I am rabidly pro-science. For thirty years as a litigator and environmental advocate, I have fought to make rigorous science the driver of public policy in the global warming arena, in the tobacco wars, and in my many battles with pesticide and chemical companies as well as in many dozens of legal skirmishes ranging from the Hudson River to Alaska’s Cook Inlet, from the West Virginia coal fields to the Louisiana oil patch, from the Caribbean island of Vieques to Puget Sound. I have fought these battles on issues including acid rain, ozone, coal ash, particulates, PCBs, lead, mercury, hydrocarbons, pesticides, and numerous other poisons that have been the subject of the hundreds of cases I’ve argued against polluters and their crooked scientists.

For many years, I’ve been puzzled by the bland and apparently baseless insistence by public health regulators and members of the press that it is safe to inject mercury—one of the world’s most neurotoxic elements—into young children and pregnant women. Over the past three years, I’ve engaged a crack team of respected scientific researchers to review the voluminous peer-reviewed literature related to Thimerosal and human health. Not surprisingly, that team was unable to find even a single publication that credibly demonstrates Thimerosal’s safety. Meanwhile, reams of toxicological, pharmacological, epidemiological, animal, and human studies have implicated Thimerosal in a range of neurological disorders. In fact, there is a virtually unanimous scientific consensus among the hundreds of research scientists who have published peer-reviewed articles in the field that Thimerosal is immensely toxic to brain tissue and should not be injected into children.

Nevertheless, today, we continue to expose millions of babies and pregnant women in this country and elsewhere to one of the world’s most potent neurotoxins, even though far safer and more economic alternatives exist. Most US vaccine makers, for example, have already switched to Thimerosal-free injections in pediatric vaccines administered to American children. And the vaccine industry had pleaded with the CDC to allow it to switch to nontoxic alternatives in the remaining Thimerosal-preserved vaccines. The CDC’s refusal to allow the transition is baffling. I assembled this book to make that task easier for the agency and to dissuade the press from accepting the tired claim that anyone who questions Thimerosal safety is “anti-science” and “anti-vaccine.”

Robert F. Kennedy, Jr.