Original Article
Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years
N Engl J Med 2007; 357:1281-1292September 27, 2007DOI: 10.1056/NEJMoa071434
- Abstract
Background
It has been hypothesized that early exposure to thimerosal, a mercury-containing preservative used in vaccines and immune globulin preparations, is associated with neuropsychological deficits in children.
Methods
We enrolled 1047 children between the ages of 7 and 10 years and administered standardized tests assessing 42 neuropsychological outcomes. (We did not assess autism-spectrum disorders.) Exposure to mercury from thimerosal was determined from computerized immunization records, medical records, personal immunization records, and parent interviews. Information on potential confounding factors was obtained from the interviews and medical charts. We assessed the association between current neuropsychological performance and exposure to mercury during the prenatal period, the neonatal period (birth to 28 days), and the first 7 months of life.
Results
Among the 42 neuropsychological outcomes, we detected only a few significant associations with exposure to mercury from thimerosal. The detected associations were small and almost equally divided between positive and negative effects. Higher prenatal mercury exposure was associated with better performance on one measure of language and poorer performance on one measure of attention and executive functioning. Increasing levels of mercury exposure from birth to 7 months were associated with better performance on one measure of fine motor coordination and on one measure of attention and executive functioning. Increasing mercury exposure from birth to 28 days was associated with poorer performance on one measure of speech articulation and better performance on one measure of fine motor coordination.
Conclusions
Our study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins and deficits in neuropsychological functioning at the age of 7 to 10 years.
Media in This Article
Table 1
Cumulative Exposure to Ethyl Mercury, According to Age Range.Table 2
Association between Prenatal Thimerosal Exposure and Neuropsychological Outcomes.Article Activity
- Article
Thimerosal has been used as a preservative in vaccines since the 1930s. It is 49.6% mercury by weight and is metabolized into ethyl mercury and thiosalicylate.1 In 1999, the Food and Drug Administration (FDA) estimated that infants who were immunized according to the recommended schedule could receive amounts of mercury exceeding the limits set by the Environmental Protection Agency for exposure to methyl mercury.2 As a precautionary measure, the Public Health Service and the American Academy of Pediatrics urged vaccine manufacturers to remove thimerosal from all infant vaccines as soon as was practical and recommended that studies be carried out to understand better the risks associated with mercury exposure from thimerosal-containing vaccines.3 In response, the Centers for Disease Control and Prevention (CDC) performed an analysis using computerized databases from three large health maintenance organizations (HMOs).4 Increasing exposure to mercury was associated with a greater likelihood of tics in one HMO population and language delay in another; in the third HMO, no significant associations were found.
Our study was designed to assess more rigorously the relationship between mercury exposure from thimerosal and neuropsychological functioning in a manner similar to that of previous studies of prenatal exposure to methyl mercury.5,6 Our study improved on previous thimerosal studies by enrolling children on the basis of thimerosal exposure, independent of health status; prospectively assessing neuropsychological functioning independently of exposure and health care–seeking behavior; and collecting extensive information on potential confounders, including medical history and socioeconomic and educational factors that could influence a child's health and development.
Methods
Study Design
We performed a cohort study with extensive assessments of relevant exposures and neuropsychological functioning. The institutional review boards of all participating organizations approved the study. A panel of independent external consultants in the fields of toxicology, epidemiology, biostatistics, and vaccine safety approved the study protocol and planned analyses. Further details regarding the study design, analyses, and results can be found in two technical reports.7,8
Study Population
We enrolled children from four HMOs that participate in the CDC's Vaccine Safety Datalink.9,10 Children from each HMO were eligible to participate if they were 7 to 10 years of age and had been enrolled in the HMO from birth through their first birthday. Birth dates ranged from January 1, 1993, to March 30, 1997; testing was conducted between June 1, 2003, and April 27, 2004. All parents provided written informed consent for their children to participate in the study. Children were excluded if they had certain conditions recorded in their medical records that could bias neuropsychological testing (e.g., encephalitis, meningitis, or hydrocephalus) or if their birth weight was less than 2500 g (Table A of the Supplementary Appendix, available with the full text of this article at www.nejm.org).
Thimerosal exposure in the first 7 months of life was estimated for the entire eligible population from HMO computerized records, and a sample was selected with the use of these data to include adequate numbers of children across a range of ages and estimated exposures.
Exposure to Mercury
We determined the mercury content of vaccines and immune globulins that the study children received when they were infants (1993–1998) from published data11-13 and the FDA (Table B of the Supplementary Appendix). We identified vaccines and immune globulins that children had received from HMO computerized immunization records, paper medical records, personal immunization records, and maternal interviews. Prenatal exposure to mercury included all known exposures of the mother to thimerosal-containing vaccines and immune globulins during pregnancy. We defined postnatal exposure as micrograms of mercury divided by the weight of the child in kilograms at the time of administration of each vaccine or immune globulin. Individual exposures were summed during the period of interest: birth to 1 month and birth to 7 months (1 to 214 days). We did not assess periods of thimerosal exposure after 214 days of age because we hypothesized that the potential effect of such exposure would be small. (Since most vaccines that are administered after 214 days would typically be given at 12 to 18 months of age, the dose per kilogram would be substantially lower.)
Neuropsychological Assessment
Each child was assessed on 42 neuropsychological outcomes selected on the basis of findings from the CDC's screening study,4 previous studies of methyl mercury,5 and the recommendations of an external panel of independent consultants. Most of the measures were collected during a 3-hour neuropsychological assessment performed by trained evaluators. The outcome measures included speech and language indexes, verbal memory, achievement, fine motor coordination, visuospatial ability, attention and executive-functioning tasks, behavior regulation, tics, and general intellectual functioning (Table C of the Supplementary Appendix). Measures of attention, hyperactivity, and executive functioning were based on reports from parents and teachers. We evaluated motor tics, phonic tics, and stuttering on the basis of a combination of ratings by evaluators and reports by parents and teachers (Table D of the Supplementary Appendix). Personnel who were administering the neuropsychological battery were not aware of the children's exposure to mercury or medical history. Mothers were asked to refrain from giving children selected prescription medicines for attention deficit–hyperactivity disorder (ADHD) the day before testing. Since the CDC is conducting a separate case–control study of autism in relation to mercury exposure, a measure of autism was not included in the test battery.
Maternal Interview and Maternal IQ Test
Mothers of all children were biologic mothers. During the maternal interview, a standardized questionnaire was administered, covering receipt of immune globulins (e.g., Rh immune globulin), influenza vaccine, and other vaccines during pregnancy; prenatal and postnatal exposures to potential environmental toxins, including mercury in the diet or from dental fillings; the Home Observation for Measurement of the Environment (HOME) inventory14,15; socioeconomic indicators; pregnancy and birth history; children's experience in infancy and early childhood; and children's experience with computers. The Kaufman Brief Intelligence Test was also administered to the mothers.
Medical-Record Abstraction
Trained abstractors reviewed the medical records of mothers and children for maternal receipt of immune globulins and vaccines during pregnancy and children's prenatal and birth histories, including the receipt of immune globulins, the vaccination history until the age of 5 years, antibiotic use during the first 7 months, anemia or pica, and neurodevelopmental disabilities. Computerized pharmacy records were reviewed for the history of dispensing of ADHD medications (Table E of the Supplementary Appendix) and antibiotics.
Statistical Analysis
We examined two primary exposure periods: the prenatal period and the period from birth to 7 months (1 to 214 days). We also evaluated exposures to mercury from hepatitis B vaccines and immune globulins in the first 28 days of life. Separate effects for boys and girls were estimated from models that included sex-by-exposure interaction terms. Furthermore, we tested two a priori interactions between prenatal and postnatal mercury exposures and between postnatal mercury exposure and antibiotic use.
We used ordinary least-squares regression and logistic regression to estimate measures of association. The effect size for least-squares regression used standardized regression coefficients,16-18 which represents the change in the outcome, expressed in standard-deviation units (SD), given a change of 1 SD in the exposure variable. We measured tics and stuttering dichotomously, and we estimated odds ratios for a 2-SD increase in mercury exposure. All tests were two-tailed; statistical significance was set at P<0.05 without correction for the number of statistical tests performed. The study was designed to have a power of 90% to detect a standardized regression coefficient of 0.10.
We analyzed raw test scores adjusted for a priori confounders, including linear terms for age, family income, and score on the HOME scale14,15 and dummy-coded variables for sex, HMO, maternal IQ, maternal education, single-parent status, and birth weight. Other covariates were included in the full model if the P value was less than 0.20 or if their inclusion resulted in a change of 10% or more in the estimate of the main effect of mercury exposure19,20 (Table F of the Supplementary Appendix).
Results
Characteristics of the Children
Of 3648 children selected for recruitment, 1107 (30.3%) were tested. Among children who were not tested, 512 did not meet one or more of the eligibility criteria, 1026 could not be located, and 44 had scheduling difficulties; in addition, the mothers of 959 children declined to participate. Most of the mothers (68%) who declined to participate in the study and provided reasons for nonparticipation cited a lack of time; 13% reported distrust of or ambivalence toward research. Of the 1107 children who were tested, 60 were excluded from the final analysis for the following reasons: missing vaccination records, 1 child; missing prenatal records, 5; missing data regarding weight, 7; and discovery of an exclusionary medical condition during record abstraction, 47. Thus, 1047 children were included in the final analyses. The exposure distribution of the final sample was similar to the exposure distribution of the initial 3648 children selected for recruitment in the study.
The median cumulative exposure to mercury from thimerosal from birth to 7 months was 112.5 μg (range, 0 to 187.5); 8.9% of the children had cumulative exposures of 62.5 μg or less of mercury, and 25.1% had cumulative exposures of 150 μg or more (Table 1Table 1
Cumulative Exposure to Ethyl Mercury, According to Age Range.). Sixteen children (1.5%) had no documented exposure to any thimerosal-containing vaccine or immune globulin during their first 7 months of life. In the first 28 days of life, 30% of children had no thimerosal exposure, and 1.6% received more than 12.5 μg of mercury from hepatitis B vaccine and immune globulins.Less than 11% of children were exposed to thimerosal prenatally through maternal vaccination or receipt of immune globulins. The sources of exposure included the following: influenza vaccine, 9 children; tetanus toxoid, 3; diphtheria and tetanus toxoid, 8; hepatitis B vaccine, 1; and thimerosal-containing Rh immune globulins, 103.
Children who had been exposed to higher levels of thimerosal were more likely to have mothers with higher IQ scores and levels of education and to be from two-parent households where English was the primary language spoken.
Neuropsychological Performance
Among the 42 neuropsychological outcomes that we assessed, we found few significant associations between performance on a neuropsychological test and exposure to mercury from vaccines and immune globulins administered prenatally or during the first 7 months of life. Significant findings are discussed below.
Prenatal Exposure
Increasing prenatal exposure to mercury was associated with significantly better performance on the Developmental Neuropsychological Assessment (NEPSY) speeded naming test and poorer performance on the digit-span test of backward recall on the Wechsler Intelligence Scale for Children, third edition (WISC-III) (Table 2Table 2
Association between Prenatal Thimerosal Exposure and Neuropsychological Outcomes.). Among boys, higher prenatal exposure to mercury was associated with significantly better performance on the Stanford–Binet copying test and poorer performance on the WISC-III digit-span test of backward recall. Among girls, there were no significant associations.Exposure from Birth to 7 Months
Increasing mercury exposure from birth to 7 months was associated with significantly better performance on the Grooved Pegboard Test of the nondominant hand and the WISC-III digit-span test (Table 3Table 3
Association between Thimerosal Exposure and Neuropsychological Outcome, According to Age Range.). Among boys, higher exposure to mercury from birth to 7 months was associated with significantly better performance on letter and word identification on the Woodcock–Johnson test, third edition (WJ-III), poorer performance on the parental rating of behavioral regulation on the Behavior Rating Inventory of Executive Function, and a higher likelihood of motor and phonic tics, as reported by the children's evaluators. Among girls, higher exposure to mercury from birth to 7 months was associated with significantly better performance on the Grooved Pegboard Test of the nondominant hand and the WISC-III digit-span test of backward recall.Exposure from Birth to 28 Days
Higher mercury exposure during the first 28 days of life was associated with significantly poorer performance on the Goldman–Fristoe Test of Articulation, second edition (GFTA-2), and better performance on the Finger Tapping Dominant Hand test (Table 3). Among boys, higher neonatal mercury exposure was associated with significantly better performance on the Finger Tapping Dominant Hand test, the Finger Tapping Non-dominant Hand test, and performance IQ on the Wechsler Abbreviated Scale of Intelligence (WASI). Among girls, increased neonatal mercury exposure was associated with significantly lower scores in verbal IQ on the WASI and a lower likelihood of motor tics on the basis of ratings by parents.
Tests of the interactions of mercury exposure with antibiotic use in the first 7 months of life did not show any consistent pattern of results. The tests of an interaction between prenatal and postnatal mercury exposure revealed no important differences from the above-mentioned main results.
Discussion
We assessed children on 42 neuropsychological outcomes and found few significant associations with exposure to mercury from vaccines and immune globulins administered prenatally or during the first 7 months of life. The associations that we detected were small, almost equally divided between positive and negative effects, and mostly sex-specific.
We found no consistent pattern between increasing mercury exposure from birth to 7 months and performance on neuropsychological tests. Among girls, the only significant findings were two associations with better test performance. Among boys, there was a beneficial association between mercury exposure and identification of letters and words on the WJ-III and a detrimental association with behavioral regulation and motor and phonic tics according to the ratings of evaluators. An association with tics was also found in one HMO in the screening analysis of the CDC's Vaccine Safety Datalink4 and an analysis of the General Practice Research Database.21 The replication of the findings regarding tics suggests the potential need for further studies.
Increasing exposure to mercury during the neonatal period (birth to 28 days) was related to significantly poorer performance on the GFTA-2 measure of speech articulation, one of nine tests that measured speech and language performance. An increase of 2 SD in mercury exposure resulted in an average increase of 0.29 articulation error. Among children overall, we found no association between neonatal exposure to mercury from thimerosal and total IQ. Among boys, there was a significant positive association with performance IQ, and among girls there was a significant negative association with verbal IQ. An increase of 2 SD in mercury exposure was associated with an average of a 3-point increase in performance IQ among boys and a 3-point decrease in verbal IQ among girls.
Although the effect sizes were very small, the speech-articulation findings among all children and the lower verbal IQ findings among girls suggest a possible adverse association between neonatal exposure to mercury and language development. In the previous Vaccine Safety Datalink analysis, an increased risk of language delays at one HMO was associated with postneonatal exposure to thimerosal-containing vaccines.4 Conversely, the finding of higher scores on the performance IQ tests in boys makes it difficult to draw general conclusions about possible effects of neonatal mercury exposure from vaccines and immune globulins on intellectual abilities.
Previous studies have reported negative effects of thimerosal exposure on neuronal cells, biochemical pathways, and animal behavior.22-31 One study showed persistently low levels of inorganic mercury in the brains of monkeys exposed to ethyl mercury, but the implication of these findings for humans is not known.24 In contrast to some laboratory studies and studies in animals, epidemiologic studies have shown few associations between exposure to thimerosal-containing vaccines in infancy and subsequent neurodevelopmental disorders, and these findings include similar frequencies of better and poorer performance. Andrews and colleagues21 studied 103,043 British children and found more protective associations than harmful associations with mercury exposure from vaccines administered in the first year of life. The one deleterious association involved an increased risk of tics, a finding similar to that in our study. Heron and Golding32 studied 12,956 British children who typically had been exposed to mercury from vaccination at 3, 4, and 6 months of age. Among 69 outcomes, the only adverse association was poorer prosocial behavior, and there were several beneficial associations.
Several studies of the effects of prenatal exposure to methyl mercury from fish consumption on neuropsychological performance have shown negative associations with speech and verbal abilities, dexterity, attention, and visuospatial abilities,5,33 whereas other studies have shown no effects.34 Summaries of these studies by the National Research Council and other groups have concluded that there were significant negative effects.17,35 However, the appropriateness of methyl mercury as a referent for assessment of exposure to ethyl mercury from thimerosal is questionable, since the half-life of ethyl mercury in blood (<10 days) is much shorter than the half-life of methyl mercury (>20 days).24,36
Our study had several limitations. A majority of the selected families declined to participate or could not be located, and we were able to enroll only 30% of the subjects included for recruitment. Therefore, our findings may have been influenced by selection bias. In addition, we were not able to control for interventions, such as speech therapy, that may have ameliorated the potential negative effects of thimerosal exposure and could have biased the results toward the null hypothesis. Given that parents were not trained to assess tics, the parental ratings of tics may have been less reliable than the ratings by trained evaluators. We did not assess exposure to thimerosal beyond 214 days. Finally, the information available for some potential confounding factors, such as family income, which may have resulted in unmeasured residual confounding, was imprecise. Our study did not examine the possible association between autism and exposure to mercury from vaccines and immune globulins.
Our study had several strengths. We performed a comprehensive neuropsychological assessment that was similar to the assessment used in the landmark studies of prenatal exposure to methyl mercury.5,6 Potential biases were reduced by enrolling children on the basis of receipt of vaccination, without regard to the seeking of health care or documented neurodevelopmental diagnoses. We collected exposure information from many different sources and controlled for confounding by adjusting our analyses for a wide range of characteristics and exposures for both mothers and children.
The weight of the evidence in this study does not support a causal association between early exposure to mercury from thimerosal-containing vaccines and immune globulins administered prenatally or during infancy and neuropsychological functioning at the age of 7 to 10 years. The overall pattern of results suggests that the significant associations may have been chance findings stemming from the large number of statistical tests that we performed.
Supported by the CDC.
The findings and conclusions in this study are those of the authors and do not necessarily represent the views of the CDC.
Dr. Thompson reports being a former employee of Merck; Dr. Marcy, receiving consulting fees from Merck, Sanofi Pasteur, GlaxoSmithKline, and MedImmune; Dr. Jackson, receiving grant support from Wyeth, Sanofi Pasteur, GlaxoSmithKline, and Novartis, lecture fees from Sanofi Pasteur, and consulting fees from Wyeth and Abbott and serving as a consultant to the FDA Vaccines and Related Biological Products Advisory Committee; Dr. Lieu, serving as a consultant to the CDC Advisory Committee on Immunization Practices; Dr. Black, receiving consulting fees from MedImmune, GlaxoSmithKline, Novartis, and Merck and grant support from MedImmune, GlaxoSmithKline, Aventis, Merck, and Novartis; and Dr. Davis receiving consulting fees from Merck and grant support from Merck and GlaxoSmithKline. No other potential conflict of interest relevant to this article was reported.
We thank Xian-Jie Yu of Harvard Medical School, Anita Feins and James Cooley of Harvard Vanguard Medical Associates; Zendi Solano, Jeff-Oliver DelaCruz, and Jerri McIlhagga of the UCLA Center for Vaccine Research; Patricia Ross and Patti Hallam of Northern California Kaiser; clinic managers Jean Caiani, Ramon Campana, Katherine Eng, Elle Garcia, Julie Gronouski, Joanne Melton, Victoria Mendez, Judith Meyer, Valerie S. Miran, Elizabeth Munoz, Diane G. Preciado, and P. Ana Silfer; child evaluators Aimee L. Adray, Kathy Angell, Candace Wollard Bivona, Karrie Campbell, Maureen O'Kane Grissom, Debbie Groff, Anne E. Hay, Kerri Johnson, Darcey A. Reeves, Angela J. Stewart, Mery Macaluso, Tracie Takeshita, Jolie C. von Suhr, Jennifer A. Wittert, Kevin Wittenberg, and Christine Zalecki; consulting psychologists Christine H. Duong-Perez, Maury Eldridge, Susan Yuh Harrison, Kelly A. Johnson, Robert Kretz, Stephanie Marcy, Denise Noonan, Mina D. Nguyen, Susan Toth Patiejunas, David Scott, T. Kristian von Almen, and Michael White; Jane Bernstein, Michael Shannon, Michael Kirkwood, Robin Rumsey, Steven Kennedy, W. Carter Smith, Patty Connor, Amanda Parsad, and Laura Simpson of Abt Associates; Robert Chen of the CDC; Douglas Frazier of the FDA; and external consultants Anne Abramowitz, Thomas Campbell, Lorne Garretteson, Roberta White, Robert Wright, and Sallie Bernard (dissenting member).
Source Information
From the Influenza Division (W.W.T., D.K.S.) and Immunization Safety Office (E.S.W., R.L.D.), Centers for Disease Control and Prevention, Atlanta; Abt Associates, Cambridge, MA (C.P., B.G., G.S.); Group Health Center for Health Studies, Seattle (P.B., J.D., L.A.J.); the Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston (V.L.H., T.A.L.); Kaiser Permanente Division of Research and Vaccine Study Center, Oakland, CA (E.L., P.R.); UCLA Center for Vaccine Research, Torrance, CA (E.E., S.M.M.); Southern California Kaiser Permanente, Los Angeles (S.M.M.); RTI International, Atlanta (F.D.); and Stanford University, Palo Alto, CA (S.B.).
Address reprint requests to Dr. Thompson at the National Center for Immunizations and Respiratory Diseases, Influenza Division, Centers for Disease Control and Prevention, MS A32, 1600 Clifton Rd. NE, Atlanta, GA 30333, or at wct2@cdc.gov.
- References
References
1
Goldfrank LR, Flonenbaum NE, Lewin NA, Howland MA, Hoffman RS, Nelson LS. Goldfrank's toxicologic emergencies. 7th ed. New York: McGraw-Hill, 2002.
2
Ball LK Ball R Pratt RD
CrossRef | Web of Science | Medline3
Joint statement of the American Academy of Pediatrics (AAP) and the United States Public Health Service (USPHS). Pediatrics 1999;104:568-569
CrossRef | Web of Science | Medline4
Verstraeten T Davis RL DeStefano F
CrossRef | Web of Science | Medline5
Grandjean P Budtz-Jorgensen E White RF
Web of Science | Medline6
Davidson PW Myers GJ Cox C
CrossRef | Web of Science | Medline7
Price C, Goodson B, Stewart G. Infant environmental exposure to thimerosal and neuropsychological outcomes at ages 7 to 10 years. Technical report. Vol. I. Bethesda, MD: Abt, 2007.
8
Idem. Infant environmental exposure to thimerosal and neuropsychological outcomes at ages 7 to 10 years. Technical report. Vol. II. Bethesda, MD: Abt, 2007.
9
Chen RT Glasser JW Rhodes PH
CrossRef | Web of Science | Medline10
Chen RT DeStefano F Davis RL
Web of Science | Medline11
Physicians' desk reference. 49th ed. Montvale, NJ: Medical Economics, 1995.
12
Physicians' desk reference. 53rd ed. Montvale, NJ: Medical Economics, 1999.
13
Committee on Infectious Diseases, Committee on Environmental Health
CrossRef | Web of Science | Medline14
Bradley BJ Caldwell BM
CrossRef | Web of Science15
Totsika V Sylva K
CrossRef16
Hunter JE Hamilton MA
CrossRef | Web of Science17
Jacobson JL
CrossRef | Web of Science | Medline18
Kim J Feree G
Web of Science19
Maldonado G Greenland S
Web of Science | Medline20
Budtz-Jorgensen E Keiding N Grandjean P Weihe P
CrossRef | Web of Science | Medline21
Andrews N Miller E Grant A Stowe J Osborne V Taylor B
CrossRef | Web of Science | Medline22
Hornig M Chian D Lipkin WI
CrossRef | Web of Science | Medline23
Mutkus L Aschner JL Syversen T Shanker G Sonnewald U Aschner M
CrossRef | Web of Science | Medline24
Burbacher TM Shen DD Liberato N Grant KS Cernichiari E Clarkson T
CrossRef | Web of Science | Medline25
Goth SR Chu RA Gregg JP Cherednichenko G Pessah IN
CrossRef | Web of Science | Medline26
Havarinasab S Hultman P
CrossRef | Web of Science | Medline27
Havarinasab S Haggqvist B Bjorn E Pollard KM Hultman P
CrossRef | Web of Science | Medline28
Parran DK Barker A Ehrich M
CrossRef | Web of Science | Medline29
Baskin DS Ngo H Didenko VV
CrossRef | Web of Science | Medline30
Waly M Olteanu H Banerjee R
CrossRef | Web of Science | Medline31
James SJ Slikker W III Melnyk S New E Pogribna M Jernigan S
CrossRef | Web of Science | Medline32
Heron J Golding J
CrossRef | Web of Science | Medline33
Crump KS Kjellstrom T Shipp AM Silvers A Stewart A
CrossRef | Web of Science | Medline34
Davidson PW Kost J Myers GJ Cox C Clarkson TW Shamlaye CF
CrossRef | Web of Science | Medline35
Stern AH Jacobson JL Ryan L Burke TA
CrossRef | Medline36
Pichichero ME Cernichiari E Lopreiato J Treanor J
CrossRef | Web of Science | Medline
- Citing Articles (131)
Citing Articles
1
Mary Woolley. . 2017. Clinical Research in the Public Eye. Clinical and Translational Science, 457-477.
CrossRef2
Marilena Colaianna, Sten Ilmjärv, Hedi Peterson, Ilse Kern, Stephanie Julien, Mathurin Baquié, Giorgia Pallocca, Sieto Bosgra, Agapios Sachinidis, Jan G. Hengstler, Marcel Leist, Karl-Heinz Krause. . (2017) Fingerprinting of neurotoxic compounds using a mouse embryonic stem cell dual luminescence reporter assay. Archives of Toxicology 91:1, 365-391.
CrossRef3
José G. Dórea. . (2017) Low-dose Thimerosal in pediatric vaccines: Adverse effects in perspective. Environmental Research 152, 280-293.
CrossRef4
Lisa A. Grohskopf, Leslie Z. Sokolow, Karen R. Broder, Sonja J. Olsen, Ruth A. Karron, Daniel B. Jernigan, Joseph S. Bresee. . (2016) Prevention and Control of Seasonal Influenza with Vaccines. MMWR. Recommendations and Reports 65:5, 1-54.
CrossRef5
Nicola Principi, Susanna Esposito. . (2016) Adverse events following immunization: real causality and myths. Expert Opinion on Drug Safety 15:6, 825-835.
CrossRef6
L.A. Sealey, B.W. Hughes, A.N. Sriskanda, J.R. Guest, A.D. Gibson, L. Johnson-Williams, D.G. Pace, O. Bagasra. . (2016) Environmental factors in the development of autism spectrum disorders. Environment International 88, 288-298.
CrossRef7
Jazmin Del Carmen Ruiz, James J. Quackenboss, Nicolle S. Tulve, David O. Carpenter. . (2016) Contributions of a Child’s Built, Natural, and Social Environments to Their General Cognitive Ability: A Systematic Scoping Review. PLOS ONE 11:2, e0147741.
CrossRef8
Lulzim Zeneli, Ankica Sekovanić, Majlinda Ajvazi, Leonard Kurti, Nexhat Daci. . (2016) Alterations in antioxidant defense system of workers chronically exposed to arsenic, cadmium and mercury from coal flying ash. Environmental Geochemistry and Health 38, 65-72.
CrossRef9
Jason M. Glanz, Sophia R. Newcomer, Michael L. Jackson, Saad B. Omer, Robert A. Bednarczyk, Jo Ann Shoup, Frank DeStefano, Matthew F. Daley. . (2016) White Paper on studying the safety of the childhood immunization schedule in the Vaccine Safety Datalink. Vaccine 34, A1-A29.
CrossRef10
Harvey S. Singer, Jonathan W. Mink, Donald L. Gilbert, Joseph Jankovic. . 2016. Tics and Tourette Syndrome. Movement Disorders in Childhood, 81-109.
CrossRef11
Myron M. Levine, Wilbur H. Chen. . 2016. How are Vaccines Assessed in Clinical Trials?. The Vaccine Book, 97-119.
CrossRef12
Jason M. Glanz, Sophia R. Newcomer, Matthew F. Daley, David L. McClure, Roger P. Baxter, Michael L. Jackson, Allison L. Naleway, Marlene M. Lugg, Frank DeStefano. . (2015) Cumulative and episodic vaccine aluminum exposure in a population-based cohort of young children. Vaccine 33, 6736-6744.
CrossRef13
Bharathi S. Gadad, Wenhao Li, Umar Yazdani, Stephen Grady, Trevor Johnson, Jacob Hammond, Howard Gunn, Britni Curtis, Chris English, Vernon Yutuc, Clayton Ferrier, Gene P. Sackett, C. Nathan Marti, Keith Young, Laura Hewitson, Dwight C. German. . (2015) Administration of thimerosal-containing vaccines to infant rhesus macaques does not result in autism-like behavior or neuropathology. Proceedings of the National Academy of Sciences 112, 12498-12503.
CrossRef14
Luzhao Feng, Peng Yang, Tao Zhang, Juan Yang, Chuanxi Fu, Ying Qin, Yi Zhang, Chunna Ma, Zhaoqiu Liu, Quanyi Wang, Genming Zhao, Hongjie Yu. . (2015) Technical guidelines for the application of seasonal influenza vaccine in China (2014–2015). Human Vaccines & Immunotherapeutics 11:8, 2077-2101.
CrossRef15
Lakshmi Sukumaran, Natalie L. McCarthy, Rongxia Li, Eric S. Weintraub, Steven J. Jacobsen, Simon J. Hambidge, Lisa A. Jackson, Allison L. Naleway, Berwick Chan, Biwen Tao, Julianne Gee. . (2015) Demographic characteristics of members of the Vaccine Safety Datalink (VSD): A comparison with the United States population. Vaccine 33, 4446-4450.
CrossRef16
Alejandro E. Macias, Alexander R. Precioso, Ann R. Falsey, . . (2015) The Global Influenza Initiative recommendations for the vaccination of pregnant women against seasonal influenza. Influenza and Other Respiratory Viruses 9, 31-37.
CrossRef17
David A. Geier, Paul G. King, Brian S. Hooker, José G. Dórea, Janet K. Kern, Lisa K. Sykes, Mark R. Geier. . (2015) Thimerosal: Clinical, epidemiologic and biochemical studies. Clinica Chimica Acta 444, 212-220.
CrossRef18
Dorota Mrozek-Budzyn, Renata Majewska, Agnieszka Kiełtyka. . (2015) Early exposure to thimerosal-containing vaccines and children’s cognitive development. A 9-year prospective birth cohort study in Poland. European Journal of Pediatrics 174, 383-391.
CrossRef19
Maths Berlin, Rudolfs K. Zalups, Bruce A. Fowler. . 2015. Mercury. Handbook on the Toxicology of Metals, 1013-1075.
CrossRef20
Susan M. Barlow, Frank M. Sullivan, Richard K. Miller. . 2015. Occupational, industrial and environmental agents. Drugs During Pregnancy and Lactation, 599-638.
CrossRef21
Jean Golding, Pauline Emmett, Yasmin Iles-Caven, Colin Steer, Raghu Lingam. . (2014) A Review of Environmental Contributions to Childhood Motor Skills. Journal of Child Neurology 29:11, 1531-1547.
CrossRef22
Susan E. Levy, Susan L. Hyman. . (2014) Complementary and Alternative Medicine Treatments for Children with Autism Spectrum Disorders. Child and Adolescent Psychiatric Clinics of North America.
CrossRef23
S. I. Shah. . (2014) Immunization Issues in Preterm Infants: Pertussis, Influenza, and Rotavirus. NeoReviews 15, e439-e448.
CrossRef24
Ruth Lynfield, Robert S. Daum. . (2014) The Complexity of the Resurgence of Childhood Vaccine-Preventable Diseases in the United States. Current Pediatrics Reports 2, 195-203.
CrossRef25
Michael M. McNeil, Julianne Gee, Eric S. Weintraub, Edward A. Belongia, Grace M. Lee, Jason M. Glanz, James D. Nordin, Nicola P. Klein, Roger Baxter, Allison L. Naleway, Lisa A. Jackson, Saad B. Omer, Steven J. Jacobsen, Frank DeStefano. . (2014) The Vaccine Safety Datalink: successes and challenges monitoring vaccine safety. Vaccine 32, 5390-5398.
CrossRef26
Erina White. . (2014) Science, Pseudoscience, and the Frontline Practitioner: The Vaccination/Autism Debate. Journal of Evidence-Based Social Work 11, 269-274.
CrossRef27
Robert J. Mitkus, David B. King, Mark O. Walderhaug, Richard A. Forshee. . (2014) A Comparative Pharmacokinetic Estimate of Mercury in U.S. Infants Following Yearly Exposures to Inactivated Influenza Vaccines Containing Thimerosal. Risk Analysis 34:10.1111/risa.2014.34.issue-4, 735-750.
CrossRef28
X. Li, F. Qu, W. Xie, F. Wang, H. Liu, S. Song, T. Chen, Y. Zhang, S. Zhu, Y. Wang, C. Guo, T.-S. Tang. . (2014) Transcriptomic Analyses of Neurotoxic Effects in Mouse Brain After Intermittent Neonatal Administration of Thimerosal. Toxicological Sciences.
CrossRef29
Charlotte I S Barker, Matthew D Snape. . (2014) Pandemic influenza A H1N1 vaccines and narcolepsy: vaccine safety surveillance in action. The Lancet Infectious Diseases 14, 227-238.
CrossRef30
Brian Hooker, Janet Kern, David Geier, Boyd Haley, Lisa Sykes, Paul King, Mark Geier. . (2014) Methodological Issues and Evidence of Malfeasance in Research Purporting to Show Thimerosal in Vaccines Is Safe. BioMed Research International 2014, 1-8.
CrossRef31
Shahed Iqbal, John P. Barile, William W. Thompson, Frank DeStefano. . (2013) Number of antigens in early childhood vaccines and neuropsychological outcomes at age 7-10 years. Pharmacoepidemiology and Drug Safety 22:10.1002/pds.v22.12, 1263-1270.
CrossRef32
Kristen A. Feemster. . (2013) Can building evidence move a persistent vaccine safety concern?. Pharmacoepidemiology and Drug Safety 22:10.1002/pds.v22.12, 1271-1273.
CrossRef33
(2013) Committee Opinion No. 566. Obstetrics & Gynecology 121, 1411-1414.
CrossRef34
Robert Davis. . (2013) Vaccine Safety Surveillance Systems: Critical Elements and Lessons Learned in the Development of the US Vaccine Safety Datalink’s Rapid Cycle Analysis Capabilities. Pharmaceutics 5, 168-178.
CrossRef35
Michiru Ida-Eto, Akiko Oyabu, Takeshi Ohkawara, Yasura Tashiro, Naoko Narita, Masaaki Narita. . (2013) Prenatal exposure to organomercury, thimerosal, persistently impairs the serotonergic and dopaminergic systems in the rat brain: Implications for association with developmental disorders. Brain and Development 35, 261-264.
CrossRef36
Yahya M. Al-Farsi, Mostafa I. Waly, Marwan M. Al-Sharbati, Mohammed A. Al-Shafaee, Omar A. Al-Farsi, Maha M. Al-Khaduri, Ishita Gupta, Allal Ouhtit, Samir Al-Adawi, Mona F. Al-Said, Richard C. Deth. . (2013) Levels of Heavy Metals and Essential Minerals in Hair Samples of Children with Autism in Oman: a Case–Control Study. Biological Trace Element Research 151, 181-186.
CrossRef37
Beatrice “Bean” E. Robinson, Jennifer S. Galbraith, Rebecca E. Swinburne Romine, Qing Zhang, Jeffrey H. Herbst. . (2013) Differences Between HIV-Positive and HIV-Negative African American Men Who Have Sex with Men in Two Major U.S. Metropolitan Areas. Archives of Sexual Behavior 42, 267-278.
CrossRef38
Paul A. Offit, Frank DeStefano. . 2013. Vaccine safety. Vaccines, 1464-1480.
CrossRef39
Sean T. O'Leary, Mandy A. Allison, Shannon Stokley, Lori A. Crane, Laura P. Hurley, Brenda Beaty, Allison Kempe. . (2013) Physicians' confidence in vaccine safety studies. Preventive Medicine.
CrossRef40
Tais F. Galvao, Marcus T. Silva, Ivan R. Zimmermann, Luiz Antonio B. Lopes, Eneida F. Bernardo, Mauricio G. Pereira. . (2013) Influenza Vaccination in Pregnant Women: A Systematic Review. ISRN Preventive Medicine 2013, 1-8.
CrossRef41
Bharathi S. Gadad, Laura Hewitson, Keith A. Young, Dwight C. German. . (2013) Neuropathology and Animal Models of Autism: Genetic and Environmental Factors. Autism Research and Treatment 2013, 1-12.
CrossRef42
Carl R. Baum. . (2012) Mercury: What's In It For Kids?. Clinical Pediatric Emergency Medicine 13, 324-330.
CrossRef43
F. Chast. . (2012) Vaccines, public health and social care. Annales Pharmaceutiques Françaises 70, 307-308.
CrossRef44
John M. Kelso, Matthew J. Greenhawt, James T. Li, Richard A. Nicklas, David I. Bernstein, Joann Blessing-Moore, Linda Cox, David Khan, David M. Lang, John Oppenheimer, Jay M. Portnoy, Christopher R. Randolph, Diane E. Schuller, Sheldon L. Spector, Stephen A. Tilles, Dana Wallace. . (2012) Adverse reactions to vaccines practice parameter 2012 update. Journal of Allergy and Clinical Immunology 130, 25-43.
CrossRef45
Andreu Segura Benedicto. . (2012) La supuesta asociación entre la vacuna triple vírica y el autismo y el rechazo a la vacunación. Gaceta Sanitaria 26, 366-371.
CrossRef46
John Iskander, Claudia Vellozzi, Jane Gidudu, Robert T. Chen. . 2012. Vaccine Safety. Vaccinology, 509-524.
CrossRef47
Yota Uno, Tokio Uchiyama, Michiko Kurosawa, Branko Aleksic, Norio Ozaki. . (2012) The combined measles, mumps, and rubella vaccines and the total number of vaccines are not associated with development of autism spectrum disorder: The first case–control study in Asia. Vaccine 30, 4292-4298.
CrossRef48
A. Chauvat, N. Benhamouda, E. Loison, M.L. Gougeon, A. Gey, E. Levionnois, P. Ravel, V. Abitbol, S. Roncelin, E. Marcheteau, F. Quintin-Colonna, W.H. Fridman, O. Launay, E. Tartour. . (2012) Pitfalls in anti-influenza T cell detection by Elispot using thimerosal containing pandemic H1N1 vaccine as antigen. Journal of Immunological Methods 378, 81-87.
CrossRef49
Beth Colaluca, Jonelle Ensign. . 2012. Assessing and Intervening with Chronically Ill Children. Best Practices in School Neuropsychology, 693-736.
CrossRef50
Robert T. Chen, Jason M. Glanz, Claudia Vellozzi. . 2012. Pharmacoepidemiologic Studies of Vaccine Safety. Pharmacoepidemiology, 423-468.
CrossRef51
Claudia A. Chiriboga. . 2012. Neurologic Complications of Immunization. Swaiman's Pediatric Neurology, 1867-1875.
CrossRef52
Marinos C. Makris, Konstantinos A. Polyzos, Michael N. Mavros, Stavros Athanasiou, Petros I. Rafailidis, Matthew E. Falagas. . (2012) Safety of Hepatitis B, Pneumococcal Polysaccharide and Meningococcal Polysaccharide Vaccines in Pregnancy. Drug Safety 35, 1-14.
CrossRef53
Harvey S. Singer. . 2012. Tics and Tourette's Syndrome. Swaiman's Pediatric Neurology, 1009-1019.
CrossRef54
Robin L. Blendell, Jessica L. Fehr. . (2012) Discussing Vaccination With Concerned Patients. The Journal of Perinatal & Neonatal Nursing 26:3, 230-241.
CrossRef55
Anna Kata. . (2011) Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement. Vaccine.
CrossRef56
Juan M. Pascual. . (2011) Animal models of the human mind: Is there anything like being autistic?. Neuroscience Letters 505, 59-60.
CrossRef57
David Fortin, Michael S.W. Lee, Mike Male. . (2011) Against medical advice: the anti‐consumption of vaccines. Journal of Consumer Marketing 28:7, 484-490.
CrossRef58
R. Rappuoli. . (2011) Twenty-first century vaccines. Philosophical Transactions of the Royal Society B: Biological Sciences 366, 2756-2758.
CrossRef59
Jeffrey S. Kennedy, David A. Lawrence. . (2011) Coincidental associations do not provide proof for the etiology of autism. Journal of Immunotoxicology 8, 198-203.
CrossRef60
J. P. Barile, G. P. Kuperminc, E. S. Weintraub, J. W. Mink, W. W. Thompson. . (2011) Thimerosal Exposure in Early Life and Neuropsychological Outcomes 7-10 Years Later. Journal of Pediatric Psychology.
CrossRef61
L. Bensefa-Colas, P. Andujar, A. Descatha. . (2011) Intoxication par le mercure. La Revue de Médecine Interne 32, 416-424.
CrossRef62
L. Barregard, D. Rekic, M. Horvat, L. Elmberg, T. Lundh, O. Zachrisson. . (2011) Toxicokinetics of Mercury after Long-Term Repeated Exposure to Thimerosal-Containing Vaccine. Toxicological Sciences 120, 499-506.
CrossRef63
Harvey S. Singer. . 2011. Tourette syndrome and other tic disorders. Hyperkinetic Movement Disorders, 641-657.
CrossRef64
Zain A Al-Safi, Valerie I Shavell, Bernard Gonik. . (2011) Vaccination in pregnancy. Women's Health 7, 109-119.
CrossRef65
Woolf T Walker, Saul N Faust. . (2010) Monovalent inactivated split-virion AS03-adjuvanted pandemic influenza A (H1N1) vaccine. Expert Review of Vaccines 9, 1385-1398.
CrossRef66
Cindy P. Lawler, Alycia Halladay. . 2010. Developmental Trajectories of Autism and Environmental Exposures-What We Know and Where We Need to Go. Developmental Neurotoxicology Research, 163-193.
CrossRef67
José G. Dórea. . (2010) Making sense of epidemiological studies of young children exposed to thimerosal in vaccines. Clinica Chimica Acta 411, 1580-1586.
CrossRef68
Marc Montana, Pierre Verhaeghe, Caroline Ducros, Thierry Terme, Patrice Vanelle, Pascal Rathelot. . (2010) Safety Review: Squalene and Thimerosal in Vaccines. Thérapie 65:6, 533-541.
CrossRef69
Stephan Bose-O'Reilly, Kathleen M. McCarty, Nadine Steckling, Beate Lettmeier. . (2010) Mercury Exposure and Children's Health. Current Problems in Pediatric and Adolescent Health Care 40, 186-215.
CrossRef70
Michael Aschner, Sandra Ceccatelli. . (2010) Are Neuropathological Conditions Relevant to Ethylmercury Exposure?. Neurotoxicity Research 18, 59-68.
CrossRef71
R. Scott Akins, Kathy Angkustsiri, Robin L. Hansen. . (2010) Complementary and alternative medicine in autism: An evidence-based approach to negotiating safe and efficacious interventions with families. Neurotherapeutics 7, 307-319.
CrossRef72
Pranita D Tamma, Marc C Steinhoff, Saad B Omer. . (2010) Influenza infection and vaccination in pregnant women. Expert Review of Respiratory Medicine 4, 321-328.
CrossRef73
Philip J Landrigan. . (2010) What causes autism? Exploring the environmental contribution. Current Opinion in Pediatrics 22, 219-225.
CrossRef74
Pritish K. Tosh, Robert M. Jacobson, Gregory A. Poland. . (2010) Influenza Vaccines: From Surveillance Through Production to Protection. Mayo Clinic Proceedings 85, 257-273.
CrossRef75
José G. Dórea. . (2010) More on low-level non-occupational mercury exposure and health concerns. Science of The Total Environment 408, 2008-2009.
CrossRef76
John B. Whitfield, Veronica Dy, Robert McQuilty, Gu Zhu, Andrew C. Heath, Grant W. Montgomery, Nicholas G. Martin. . (2010) Genetic Effects on Toxic and Essential Elements in Humans: Arsenic, Cadmium, Copper, Lead, Mercury, Selenium, and Zinc in Erythrocytes. Environmental Health Perspectives 118, 776-782.
CrossRef77
Harvey S. Singer, Jonathan W. Mink, Donald L. Gilbert, Joseph Jankovic. . 2010. Tics and Tourette Syndrome. Movement Disorders in Childhood, 40-55.
CrossRef78
Harvey S. Singer. . 2010. Tics and Gilles de la Tourette Syndrome. MOVEMENT DISORDERS 4, 651-663.
CrossRef79
2010. Environmental and Nutritional Diseases. Robbins and Cotran Pathologic Basis of Disease, 399-445.
CrossRef80
Charlotte Schubert. . (2010) Pandemic blows lid off laws limiting mercury in vaccines. Nature Medicine 16, 9-9.
CrossRef81
José M. Bayas Rodríguez, Alberto L. García-Basteiro, Guillermo Mena Pinilla. . (2010) Problemática de la vacunación contra la gripe A en España. Archivos de Bronconeumología 46, 32-38.
CrossRef82
Lin H. Chen, Caroline Zeind, Sheila Mackell, Trisha LaPointe, Margot Mutsch, Mary E. Wilson. . (2010) Breastfeeding Travelers: Precautions and Recommendations. Journal of Travel Medicine 17, 32-47.
CrossRef83
Yongqun He, Rino Rappuoli, Anne S. De Groot, Robert T. Chen. . (2010) Emerging Vaccine Informatics. Journal of Biomedicine and Biotechnology 2010, 1-26.
CrossRef84
Pranita D. Tamma, Kevin A. Ault, Carlos del Rio, Mark C. Steinhoff, Neal A. Halsey, Saad B. Omer. . (2009) Safety of influenza vaccination during pregnancy. American Journal of Obstetrics and Gynecology 201, 547-552.
CrossRef85
T. A. Lewandowski, S. M. Bartell, J. W. Yager, L. Levin. . (2009) An Evaluation of Surrogate Chemical Exposure Measures and Autism Prevalence in Texas. Journal of Toxicology and Environmental Health, Part A 72, 1592-1603.
CrossRef86
Harumi Jyonouchi. . 2009. Possible Impact of Innate Immunity on Autism. Autism, 245-275.
CrossRef87
Kirsten J. Helmcke, Tore Syversen, David M. Miller, Michael Aschner. . (2009) Characterization of the effects of methylmercury on Caenorhabditis elegans. Toxicology and Applied Pharmacology 240, 265-272.
CrossRef88
Erika Hashimoto, Toshihisa B. Oyama, Keisuke Oyama, Yumiko Nishimura, Tomohiro M. Oyama, Toshiko Ueha-Ishibashi, Yoshiro Okano, Yasuo Oyama. . (2009) Increase in intracellular Zn2+ concentration by thimerosal in rat thymocytes: Intracellular Zn2+ release induced by oxidative stress. Toxicology in Vitro 23, 1092-1099.
CrossRef89
Martha Kay Libbus, Lynelle M. Phillips. . (2009) Public Health Management of Perinatal Hepatitis B Virus. Public Health Nursing 26:10.1111/phn.2009.26.issue-4, 353-361.
CrossRef90
Lisa Miller, Joni Reynolds. . (2009) Autism and Vaccination-The Current Evidence. Journal for Specialists in Pediatric Nursing 14:10.1111/jspn.2009.14.issue-3, 166-172.
CrossRef91
Ann M. Rhodes. . (2009) Autism and the Courts. Journal for Specialists in Pediatric Nursing 14:10.1111/jspn.2009.14.issue-3, 215-216.
CrossRef92
Danuta M. Skowronski, Gaston De Serres. . (2009) Is routine influenza immunization warranted in early pregnancy?. Vaccine 27, 4754-4770.
CrossRef93
Jagannath M. Muzumdar, Richard R. Cline. . (2009) Vaccine supply, demand, and policy: A primer. Journal of the American Pharmacists Association 49:4, e87-e99.
CrossRef94
Rejane C. Marques, José G. Dórea, José V.E. Bernardi, Wanderley R. Bastos, Olaf Malm. . (2009) Prenatal and Postnatal Mercury Exposure, Breastfeeding and Neurodevelopment During the First 5 Years. Cognitive and Behavioral Neurology 22, 134-141.
CrossRef95
Omer , Saad B. , Salmon , Daniel A. , Orenstein , Walter A. , deHart , M. Patricia , Halsey , Neal , . . (2009) Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases. New England Journal of Medicine 360:19, 1981-1988.
Free Full Text96
Harumi Jyonouchi. . (2009) Food allergy and autism spectrum disorders: Is there a link?. Current Allergy and Asthma Reports 9, 194-201.
CrossRef97
Barbara J. Martin. . (2009) Re: Biomarkers of Environmental Toxicity and Susceptibility in Autism. Journal of the Neurological Sciences 280, 127-128.
CrossRef98
Jeffrey S. Gerber, Paul A. Offit. . (2009) Vaccines and Autism: A Tale of Shifting Hypotheses. Clinical Infectious Diseases 48:10.1086/597429, 456-461.
CrossRef99
Matti Sällberg. . (2009) Oral viral infections of children. Periodontology 2000 49:10.1111/prd.2008.49.issue-1, 87-95.
CrossRef100
Mary Woolley. . 2009. Clinical Research in the Public Eye. Clinical and Translational Science, 429-439.
CrossRef101
Wesley Sattler, Kevin Yurkerwich, Gerard Parkin. . (2009) Molecular structures of protonated and mercurated derivatives of thimerosal. Dalton Transactions, 4327.
CrossRef102
Georgina Peacock, Marshalyn Yeargin-Allsopp. . (2009) Autism Spectrum Disorders: Prevalence and Vaccines. Pediatric Annals 38, 22-25.
CrossRef103
Alicia Demirjian, Ofer Levy. . (2009) Safety and efficacy of neonatal vaccination. European Journal of Immunology 39, 36-46.
CrossRef104
Leon Eisenberg, Myron Belfer. . (2009) Prerequisites for global child and adolescent mental health. Journal of Child Psychology and Psychiatry 50:10.1111/jcpp.2009.50.issue-1-2, 26-35.
CrossRef105
José G. Dórea. . (2009) Cord Blood Mercury and Early Child Development: Effects of the World Trade Center. Environmental Health Perspectives.
CrossRef106
Frank DeStefano. . (2009) Thimerosal-containing vaccines: evidence versus public apprehension. Expert Opinion on Drug Safety 8, 1-4.
CrossRef107
(2009) Influenza Vaccine 2008–2009. Obstetrics & Gynecology 113:1, 221-223.
CrossRef108
Rodney R. Dietert, Janice M. Dietert. . (2008) Potential for Early-Life Immune Insult Including Developmental Immunotoxicity in Autism and Autism Spectrum Disorders: Focus on Critical Windows of Immune Vulnerability. Journal of Toxicology and Environmental Health, Part B 11, 660-680.
CrossRef109
John R. Hughes. . (2008) A review of recent reports on autism: 1000 studies published in 2007. Epilepsy & Behavior 13, 425-437.
CrossRef110
José G. Dórea. . (2008) Effects of Prenatal Exposure to Pollutants on Children’s Development: Additional Issues. Environmental Health Perspectives 116, A418-A418.
CrossRef111
Susan E. Levy, Susan L. Hyman. . (2008) Complementary and Alternative Medicine Treatments for Children with Autism Spectrum Disorders. Child and Adolescent Psychiatric Clinics of North America 17, 803-820.
CrossRef112
A. G. Habib, S. B. Abubakar, I. S. Abubakar, S. Larnyang, N. Durfa, A. Nasidi, P. O. Yusuf, J. Garnvwa, R. D. G. Theakston, L. Salako, D. A. Warrell, . . (2008) Envenoming after carpet viper ( Echis ocellatus ) bite during pregnancy: timely use of effective antivenom improves maternal and foetal outcomes. Tropical Medicine & International Health 13:10.1111/tmi.2008.13.issue-9, 1172-1175.
CrossRef113
Lisa A. Croen, Marilyn Matevia, Cathleen K. Yoshida, Judith K. Grether. . (2008) Maternal Rh D status, anti-D immune globulin exposure during pregnancy, and risk of autism spectrum disorders. American Journal of Obstetrics and Gynecology 199, 234.e1-234.e6.
CrossRef114
Maria E Johnson, Cary Sanders, Jeffrey L Rausch. . 2008. The Gene-Environment Interaction in Asperger's Disorder. Asperger's Disorder, 205-232.
CrossRef115
Jeffrey P. Baker. . (2008) BAKER RESPONDS. American Journal of Public Health 98:8, 1350-1351.
CrossRef116
Genevive Bjorn. . (2008) Fearful of vaccines, some parents find cause for celebration. Nature Medicine 14, 699-699.
CrossRef117
Isaac N. Pessah, Richard F. Seegal, Pamela J. Lein, Janine LaSalle, Benjamin K. Yee, Judy Van De Water, Robert F. Berman. . (2008) Immunologic and neurodevelopmental susceptibilities of autism. NeuroToxicology 29, 532-545.
CrossRef118
Emily Oken, David C Bellinger. . (2008) Fish consumption, methylmercury and child neurodevelopment. Current Opinion in Pediatrics 20, 178-183.
CrossRef119
(2008) Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiology and Drug Safety 17:10.1002/pds.v17:4, i-xvi.
CrossRef120
Archana Chatterjee. . (2008) Vaccine safety: genuine concern or a legacy of unfounded skepticism?. Expert Review of Vaccines 7, 275-277.
CrossRef121
Yu Gao, Chong-Huai Yan, Xiao-Ming Shen. . (2008) Response to “Early mercury exposure (with ethylmercury) could include 3-day olds: Is that the case in China?”. Environmental Research 106, 421-422.
CrossRef122
R. F. Berman, I. N. Pessah, P. R. Mouton, D. Mav, J. Harry. . (2008) Low-Level Neonatal Thimerosal Exposure: Further Evaluation of Altered Neurotoxic Potential in SJL Mice. Toxicological Sciences 101, 294-309.
CrossRef123
(2008) Early Thimerosal Exposure and Neuropsychological Outcomes. New England Journal of Medicine 358:1, 93-94.
Free Full Text124
B.H. Thiers. . (2008) Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years. Yearbook of Dermatology and Dermatologic Surgery 2008, 75-76.
CrossRef125
Luke T. Curtis, Kalpana Patel. . (2008) Nutritional and Environmental Approaches to Preventing and Treating Autism and Attention Deficit Hyperactivity Disorder (ADHD): A Review. The Journal of Alternative and Complementary Medicine 14, 79-85.
CrossRef126
(2008) Early exposure to mercury-containing vaccines has no consistent effect on neuropsychology. Nature Clinical Practice Neurology 4, 7-8.
CrossRef127
(2008) Influenza Vaccine 2007–2008. Obstetrics & Gynecology 111:1, 206-207.
CrossRef128
D. C. Bellinger. . (2007) Author's response. Journal of the American Dental Association 138, 1537-1537.
CrossRef129
Kurt Samson. . (2007) CDC Finds No Link Between Thimerosal and Neuropsychological Problems in Children. Neurology Today 7, 33-35.
CrossRef130
Sugarman , Stephen D. , . . (2007) Cases in Vaccine Court — Legal Battles over Vaccines and Autism. New England Journal of Medicine 357:13, 1275-1277.
Free Full Text131
Offit , Paul A. , . . (2007) Thimerosal and Vaccines — A Cautionary Tale. New England Journal of Medicine 357:13, 1278-1279.
Free Full Text
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