In this report, the Immunization Safety Review committee examines the hypothesis of whether or not the use of vaccines containing the preservative thimerosal can cause neurodevelopmental disorders (NDDs), specifically autism, attention deficit/hyperactivity disorder (ADHD), and speech or language delay. Autism is a complex, severe developmental disorder characterized by impairments of social interaction, communication, and behavior. ADHD is a behavioral disorder characterized by persistent patterns of inattention and/or hyperactivity. Speech or language delay refers to several disorders characterized by significant impairments in vocabulary and difficulty in forming sentences, comprehending words or sentences, or forming age-appropriate speech sounds.

Contents

• THE NATIONAL ACADEMIES
• IMMUNIZATION SAFETY REVIEW COMMITTEE
• REVIEWERS
• Foreword
• Acknowledgments
• Executive Summary
  • PLAUSIBILITY ASSESSMENT
  • SIGNIFICANCE ASSESSMENT
  • PUBLIC HEALTH RESPONSE
  • SUMMARY
  • REFERENCES
• Immunization Safety Review. Thimerosal-Containing Vaccines and Neurodevelopmental Disorders
  • ORIGINS OF THE IMMUNIZATION SAFETY REVIEW PROJECT
  • THE CHARGE TO THE COMMITTEE
  • THE STUDY PROCESS
  • THE FRAMEWORK FOR ASSESSING CAUSALITY
  • UNDER REVIEW: THIMEROSAL-CONTAINING VACCINES AND NEURODEVELOPMENTAL DISORDERS
  • PLAUSIBILITY ASSESSMENT
  • CAUSALITY ARGUMENT
  • SIGNIFICANCE ASSESSMENT
  • RECOMMENDATIONS REGARDING THE PUBLIC HEALTH RESPONSE
  • SUMMARY
  • REFERENCES
• Appendix A Immunization Safety Review: Measles-Mumps-Rubella Vaccine and Autism Executive Summary
• Appendix B Monday, July 16, 2001 Meeting Agenda
• Appendix C Thimerosal Content in Licensed Vaccines
• APPENDIX D Immunization Safety Review Committee Biosketches

Support for this project was provided by the Centers for Disease Control and Prevention and the National Institute of Allergy and Infectious Diseases of the National Institutes of Health as part of a National Institutes of Health Task Order No. 74. The views presented in this report are those of the Institute of Medicine Immunization Safety Review Committee and are not necessarily those of the funding agencies.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.