Merthiolate hypersensitivity and vaccination

Abstract

Epicutaneous tests with 0.1% merthiolate in petrolatum showed hypersensitivity in 96 of 4647 eczema patients (2.0%) and in seven of 105 healthy recruits (7%). There was a marked preponderance of young age classes in the eczema group. Twelve of 41 merthiolate-positive patients tested reacted to mercury alone, three to thiosalicylic acid alone and one to both. The remaining 25 patients reacted to neither of the individual components although the merthiolate complex as a whole gave a positive test result. Forty-five of the merthiolate-positive patients were tested subcutaneously with 0.5 ml of a 0.01% merthiolate solution, i.e. a dose equal to that contained in one shot of tetanus toxoid, for example. Nine patients developed a local reaction at the site of the injection, and the area became eczematous in four cases. In one of the patients the eczema spread over the body, causing fever. Since merthiolate-sensitive patients also react to merthiolate administered intracutaneously, the vaccinator should avoid the use of a needle whose outer surface has been contaminated when the vaccine was aspirated from the bottle. However, even when this precautionary measure is taken, local reactions can be expected in such a high percentage of merthiolate-sensitive persons that merthiolate in vaccines should be replaced by another antibacterial agent.

All these positive tests to thimerosal

“…When 0.5 ml T 0.01% was given as a subcutaneous provocation to 45 recruits with T allergy, skin reactions occurred in 9, with 8 local and 1 general reaction (5). With this I exception, it is noteworthy that in subjects with delayed hypersensitivity to T, no systemic reaction is observed after subcutaneous injections containing the preservative (15,34,35).…”

“…1 ), has attracted particular interest because of early reports of frequent cross-sensitivity between T and this compound (28,29). In later studies, only a few patients with T allergy have reacted to thiosalicylic acid (3,5,16,26,27), which seems to rule out this part of the T molecule as a major allergenic determinant. In animal experiments, however, there seems to be full cross-sensitivity between the 2 compounds (22).…”

Immunotherapy of Allergic Contact Dermatitis

“…Despite positive patch test, the patients tolerate well further thiomersal-preserved vaccines provided these are administered intramuscularly [65]. Among 45 patients with positive patch tests to thiomersal who were challenged with subcutaneous administration of this hapten, one patient developed generalized eczema and four reacted with local eczematous reaction; nevertheless, 40 patch test-positive patients remained tolerant to subcutaneous injection of the hapten [66]. On the other hand, there are data indicating a higher frequency of contact hypersensitivity to thiomersal among patients with chronic eczema: when comparing the aforementioned positivity rates among Polish children and adolescents with chronic eczema (11.7% in 7-8-year-olds and 37.6% in 16-17-year-olds in 2009 [64]) with samples from the general Polish population (8% among 13-15-year-olds in 1999 [67] and 18.5% among 18-19-yearolds in 2002 [68]), it becomes apparent that despite the partial withdrawal of thiomersalcontaining vaccines that took place between these studies, the sensitization rates among children with eczema are 1.5-2-times higher than in the general population, which would indicate that thiomersal hypersensitivity might be of some importance in ACD.…”

El timerosal y las enfermedades del neurodesarrollo infantil

“…Luego de dicha publicación, los países soviéticos retiraron el timerosal de sus vacunas infantiles, a principios de la dé-cada de los 80. Muchos otros estudios llegan a conclusiones similares, señalando la inconveniencia del timerosal en las vacunas, ya sea por su capacidad de inducir respuestas alérgicas ( 155,156 ), su pobre efectividad antiséptica ( 157 ) y/o su degradación en sustancias neurotóxicas ( 158 ). Un estudio descriptivo publicado el año 2002 mostraba, aparentemente, buenas noticias: el timerosal, después de inoculado a través de las vacunas sobre niños recién nacidos, determinaba niveles sanguíneos significativamente menores y más cortos que el metilmercurio, excretándose en cantidades apreciables en las heces ( 159 ).…”