The committee concludes that although the hypothesis that exposure to thimerosal-containing vaccines could be associated with neurodevelopmental disorders is not established and rests on indirect and incomplete information, primarily from analogies with methylmercury and levels of maximum mercury exposure from vaccines given in children, the hypothesis is biologically plausible.

The committee also concludes that the evidence is inadequate to accept or reject a causal relationship between thimerosal exposures from childhood vaccines and the neurodevelopmental disorders of autism, ADHD, and speech or language delay.

Public Health Response Recommendations

Policy Review and Analysis

The committee recommends the use of the thimerosal-free DTaP, Hib, and hepatitis B vaccines in the United States, despite the fact that there might be remaining supplies of thimerosal-containing vaccine available.

The committee recommends that full consideration be given by appropriate professional societies and government agencies to removing thimerosal from vaccines administered to infants, children, or pregnant women in the United States.

The committee recommends that appropriate professional societies and government agencies review their policies about the non-vaccine biological and pharmaceutical products that contain thimerosal and are used by infants, children, and pregnant women in the United States.

The committee recommends that policy analyses be conducted that will inform these discussions in the future.

The committee recommends a review and assessment of how public health policy decisions are made under uncertainty.

The committee recommends a review of the strategies used to communicate rapid changes in vaccine policy, and it recommends research on how to improve those strategies.

Public Health and Biomedical Research

The committee recommends a diverse public health and biomedical research portfolio.

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