Thursday, December 22, 2011

[sehat] Digest Number 16752

Messages In This Digest (25 Messages)

1a.
Vaksin mengandung merkuri? From: zoe_getme@yahoo.com
1b.
Re: Vaksin mengandung merkuri? From: Siska
1c.
Re: Vaksin mengandung merkuri? From: tristanathan
1d.
Re: Vaksin mengandung merkuri? From: Pamelia Yulianto
1e.
Re: Vaksin mengandung merkuri? From: arianyhy@gmail.com
1f.
Re: Vaksin mengandung merkuri? From: Sativa Huang
1g.
Re: Vaksin mengandung merkuri? From: zoe_getme@yahoo.com
1h.
Re: Vaksin mengandung merkuri? From: Sativa Huang
1i.
Re: Vaksin mengandung merkuri?  Komposisi Vaksin Produk Lokal & Inte From: /ghz
2a.
Re: (Sharing) Cerita Pesat Aceh 2 From: sari_paprika@yahoo.com
2b.
Re: (Sharing) Cerita Pesat Aceh 2 From: Ida Rifai
2c.
Re: (Sharing) Cerita Pesat Aceh 2 From: Hoesana.Doee
2d.
Re: (Sharing) Cerita Pesat Aceh 2 From: niea_152@yahoo.com
2e.
Re: (Sharing) Cerita Pesat Aceh 2 From: VIE
3a.
OOT: diphtheria outbreak di Indonesia From: Ratna Sari
3b.
Re: OOT: diphtheria outbreak di Indonesia From: tristanathan
3c.
Re: OOT: diphtheria outbreak di Indonesia From: arianyhy@gmail.com
4a.
Re: Epilepsi From: Endah
5.
Re: OOT: Diphtheria outbreak di Indonesia From: F.B.Monika
6a.
Re: baca ttg konstipasi dan Hirschsprung's Disease jadi khawatir.. From: gita Nasution
7a.
Re: re : Ask-Urgent: IUFD di 28 minggu, what to do? From: nisriin usman
8a.
Re: (Oot) tas lapis aluminium. u/ bekal. From: pria ardhana
8b.
Re: (Oot) tas lapis aluminium. u/ bekal. From: VIE
9.1.
Daftar Sementara Pemesanan Buku_VERSI 5 From: /ghozansehat
10a.
Re: Met Ultah Sewindu Milis Sehat From: romzy@cbn.net.id

Messages

1a.

Vaksin mengandung merkuri?

Posted by: "zoe_getme@yahoo.com" zoe_getme@yahoo.com   zoe_getme

Wed Dec 21, 2011 10:35 pm (PST)



Dear sps and docs,
Sesuai dengan judul di atas benarkah vaksin mengandung merkuri? Mohon sharing informasinya.terimakasih

Best regards,

Bunda etzel
Powered by Telkomsel BlackBerry®
1b.

Re: Vaksin mengandung merkuri?

Posted by: "Siska" blue_for_sure@yahoo.com   blue_for_sure

Wed Dec 21, 2011 10:44 pm (PST)



Bunda etzel,

Maaf g bisa kasih link nya,tapi kurleb beberapa hari yg lalu kan heboh tuh msl vaksin, mgkn bisa bongkar arsip milis.

Ato ke blog nya pak e kayanya lengkap tuh :)
Siska ¤Mamae FayzaNamira¤
Powered by the Love of God®

-----Original Message-----
From: zoe_getme@yahoo.com
Sender: sehat@yahoogroups.com
Date: Thu, 22 Dec 2011 06:35:19
To: <sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: [sehat] Vaksin mengandung merkuri?

Dear sps and docs,
Sesuai dengan judul di atas benarkah vaksin mengandung merkuri? Mohon sharing informasinya.terimakasih

Best regards,

Bunda etzel
Powered by Telkomsel BlackBerry®

------------------------------------

Milis SEHAT mengucapkan terimakasih kepada:
- Asuransi AIA atas partisipasinya sebagai sponsor PESAT Bali 2011
- PT LG Electronics Indonesia atas partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.

Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland, dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."

"Milis SEHAT didukung oleh : CBN Net Internet Access &Website.
=================================================================
Milis Sehat thanks to:
- AIA Insurance as sponsor for PESAT Bali 2011
- PT LG Electronics Indonesia as exclusive partner of FAMILY FUN DAY MILIS SEHAT 2011.

Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk. who have consistently sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
"SEHAT mailing list is supported by CBN Net for Internet Access &Website.

Kunjungi kami di (Visit us at):
Official Web : http://milissehat.web.id/
FB : http://www.facebook.com/pages/Milissehat/131922690207238
Twitter : @milissehat <http://twitter.com/milissehat/>
==================================================================
Donasi (donation):
Rekening Yayasan Orang Tua Peduli
Bank Mandiri
Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
==================================================================Yahoo! Groups Links

1c.

Re: Vaksin mengandung merkuri?

Posted by: "tristanathan" tristanathan.amadeo@gmail.com   trinovi

Wed Dec 21, 2011 10:46 pm (PST)



sebenernya, di thread bbrp hari terakhir ini (yg bikin pak'e benjol dan
meja kantornya sampe rusak) ada disebut soal ini.

singkatnya aja ya mbak, ada yg ada ada yg gak ada.
kalaupun ada, jumlahnya gak ada apa2nya dibanding merkuri yg ada di dalam
tubuh ikan yg kita makan.

jadi, buat saya, gak ada concern dg masalah ini

-ria-

2011/12/22 <zoe_getme@yahoo.com>

[Non-text portions of this message have been removed]

1d.

Re: Vaksin mengandung merkuri?

Posted by: "Pamelia Yulianto" hidupsehat.pam@gmail.com   pamelia_yulianto

Wed Dec 21, 2011 10:49 pm (PST)



Kl mau bongkar file bs dgn keyword "thimerosal" - SOL

- p a m e l i a -
"No Labelling, Stop Judging, Start Supporting"

Powered by my children's existance

1e.

Re: Vaksin mengandung merkuri?

Posted by: "arianyhy@gmail.com" arianyhy@gmail.com   ariany_hy

Wed Dec 21, 2011 10:52 pm (PST)



Dear bunda Etzel..
Maaf ga potek

Vaksin yg mana ya? Dan dapat kabar HOAX dari mana? Kalo dapat dari bbgroup.. Yah biasanya dari para pendukung anti vaksin yg broadcast..

Banyak sekali pembahasan mengenai vaksin di group sehat... Coba di search ya mbak.. Maaf sy ga bs kasi link, handheld lowbatt, mgkn sps yg lebih berkompeten bisa menjawab..

*sedihnya masih adaaa aja yg mempermasalahkan vaksin dan ketakutan sendiri.. Padahal DEMI kesehatan dan daya tahan tubuh anak kedepannya.... Tsk.. *

Regards,
Ariany



Sent from my AXIS Worry Free BlackBerry® smartphone

-----Original Message-----
From: zoe_getme@yahoo.com
Sender: sehat@yahoogroups.com
Date: Thu, 22 Dec 2011 06:35:19
To: <sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: [sehat] Vaksin mengandung merkuri?

Dear sps and docs,
Sesuai dengan judul di atas benarkah vaksin mengandung merkuri? Mohon sharing informasinya.terimakasih

Best regards,

Bunda etzel
Powered by Telkomsel BlackBerry®

------------------------------------

Milis SEHAT mengucapkan terimakasih kepada:
- Asuransi AIA atas partisipasinya sebagai sponsor PESAT Bali 2011
- PT LG Electronics Indonesia atas partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.

Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland, dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."

"Milis SEHAT didukung oleh : CBN Net Internet Access &Website.
=================================================================
Milis Sehat thanks to:
- AIA Insurance as sponsor for PESAT Bali 2011
- PT LG Electronics Indonesia as exclusive partner of FAMILY FUN DAY MILIS SEHAT 2011.

Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk. who have consistently sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
"SEHAT mailing list is supported by CBN Net for Internet Access &Website.

Kunjungi kami di (Visit us at):
Official Web : http://milissehat.web.id/
FB : http://www.facebook.com/pages/Milissehat/131922690207238
Twitter : @milissehat <http://twitter.com/milissehat/>
==================================================================
Donasi (donation):
Rekening Yayasan Orang Tua Peduli
Bank Mandiri
Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
==================================================================Yahoo! Groups Links

1f.

Re: Vaksin mengandung merkuri?

Posted by: "Sativa Huang" sativahuang@gmail.com   sativahuang

Wed Dec 21, 2011 11:05 pm (PST)



Hi Mom Zoe,
Mom menggunakan vaksin apa?
Tergantung vaksinnya, sebagian besar tidak mengandung merkuri.

Coba dicek merek vaksinnya, terus Mom bisa lihat di tabel berikut:
Thimerosal in Vaccines
http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228

Kandungan dalam vaksin, misalnya DTaP merek Tripedia (nggak ada di
Indo kayaknya) mengandung 0,3 mikro gram etil merkuri bukan metil
merkuri, sehingga tidak berbahaya (bisa dibaca di link atas juga).

Sedangkan untuk ikan, kerang, kandungan metil merkurinya bisa mencapai
4.5 ppm (mg/kg). Jika saya ambil contoh 0.8 ppm dan kalau makan 200g
(0,2 kg) ikan, berarti akan mengkonsumsi 0.16 mg sama dengan 160 mikro
gram metil merkuri.

Mercury Levels in Commercial Fish and Shellfish
(1990-2010)
http://www.fda.gov/food/foodsafety/product-specificinformation/seafood/foodbornepathogenscontaminants/methylmercury/ucm115644.htm

Dari tabel tersebut bisa dihitung dan disimpulkan bahwa kandung 0,3
mkro gram ini masih lebih rendah daripada kandungan merkuri dalam ikan
yang memiliki kandungan merkuri rendah.

Jadi terlihat, konsumsi ikan (khususnya yang tercerma) adalah
berbahaya. Sedangkan isu merkuri tidak menjadi masalah, karena rendah
dan kandungannya bukan metil merkuri, melainkan etil merkuri.

Salam,

2011/12/22 <zoe_getme@yahoo.com>:
> Dear sps and docs,
> Sesuai dengan judul di atas benarkah vaksin mengandung merkuri? Mohon sharing informasinya.terimakasih
>
> Best regards,
>
> Bunda etzel
> Powered by Telkomsel BlackBerry®
>
> ------------------------------------
>
> Milis SEHAT mengucapkan terimakasih kepada:
> - Asuransi AIA atas partisipasinya sebagai sponsor PESAT Bali 2011
> - PT LG Electronics Indonesia atas partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.
>
> Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland, dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
>
> "Milis SEHAT didukung oleh : CBN Net Internet Access &Website.
> =================================================================
> Milis Sehat thanks to:
> - AIA Insurance as sponsor for PESAT Bali 2011
> - PT LG Electronics Indonesia as exclusive partner of FAMILY FUN DAY MILIS SEHAT 2011.
>
> Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk. who have consistently sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
> "SEHAT mailing list is supported by CBN Net for Internet Access &Website.
>
> Kunjungi kami di (Visit us at):
> Official Web : http://milissehat.web.id/
> FB           : http://www.facebook.com/pages/Milissehat/131922690207238
> Twitter      : @milissehat <http://twitter.com/milissehat/>
> ==================================================================
> Donasi (donation):
> Rekening Yayasan Orang Tua Peduli
> Bank Mandiri
> Cabang Kemang Raya Jakarta
> Account Number: 126.000.4634514
> ==================================================================Yahoo! Groups Links
>
>
>

1g.

Re: Vaksin mengandung merkuri?

Posted by: "zoe_getme@yahoo.com" zoe_getme@yahoo.com   zoe_getme

Thu Dec 22, 2011 12:01 am (PST)



Terimakasih banyak pak sativanya untuk penjelasannya.akan saya baca juga linknya :)
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1h.

Re: Vaksin mengandung merkuri?

Posted by: "Sativa Huang" sativahuang@gmail.com   sativahuang

Thu Dec 22, 2011 12:09 am (PST)



Sami-sami Bu Zoe.
Kalau ada keraguan mengenai vaksin dari segi medis, bisa ditanyakan
lagi di milis.
Namun kalau ada pertanyaan mengenai vaksin dalam hubungannya dengan
agama, japri Pak e aja hehehehehe. Just kidding.

Semoga sehat.

Salam,

2011/12/22 <zoe_getme@yahoo.com>:
> Terimakasih banyak pak sativanya untuk penjelasannya.akan saya baca juga linknya :)

1i.

Re: Vaksin mengandung merkuri?  Komposisi Vaksin Produk Lokal & Inte

Posted by: "/ghz" ghozan10032005@gmail.com

Thu Dec 22, 2011 12:24 am (PST)



On 12/22/2011 2:05 PM, Sativa Huang wrote:
> sedikit copas dari link yg dikasih pak sativa dan secuil tambahan
> informasi

Mercury in Vaccines

Updated: August 6, 2008

This article answers the most frequently asked questions about
thimerosal and its use as a preservative in vaccines.

Toxic mercury exposure has a wide range of adverse health effects.
Currently in the United States there is a public health effort to reduce
human exposure to mercury from all sources. 1
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote1_3ja8108>

What is thimerosal, and why is it in some vaccines?

Thimerosal is a compound that is 49.6% mercury by weight. Although it is
not used in all vaccines (for example, it is not used in
measles-mumps-rubella or chickenpox vaccines), it has been part of the
manufacture of many vaccines since the 1930s. Thimerosal has been used:

* to kill the bacteria that make the vaccine itself (e.g., whole
cell pertussis vaccine)
* to kill bacteria that might enter the vaccine during the
production process (e.g., influenza vaccine)
* as a preservative to prevent bacterial and fungal contamination of
vaccines during their clinical use. In this case, thimerosal is
added at the end of the production process either to the liquid
vaccine itself or â€" in the case of dry powder vaccines â€" to the
liquid used to dilute the vaccine

Unless used as a preservative, thimerosal contributes little to the
final concentration of thimerosal in vaccine (at most 2 to 3 micrograms
of thimerosal per milliliter of vaccine), so the chief concern has
centered on thimerosal as a preservative. 2
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote2_5jp0f8a>

Although preservatives are not required for single-dose vaccine vials,
preservatives are required to help prevent bacterial contamination of
vaccine vials that contain many doses 2
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote2_5jp0f8a>

Why is this? Most multi-dose vaccines come in vials that are topped with
a rubber-like stopper. With vials that contain many doses of vaccine,
health care workers repeatedly pass needles through the stopper when
drawing up later vaccine doses into the syringe and this can let
bacteria enter the vial and contaminate the vaccine.

Does thimerosal in vaccines pose a risk to infants?

When pregnant women eat foods or take medicines that contain mercury,
the mercury can be transferred to the developing fetus through the
placenta. Infants can be exposed to mercury through foods, including
breast milk, or medicines.

Developing fetuses and young children are believed to be more
susceptible to mercury exposure than adults because mercury can
interfere with the developing nervous system.1
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote1_3ja8108>

Guidelines for safe exposure to methylmercury
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#guideline>,
based on the analysis of cases where people were accidentally exposed to
toxic levels of mercury, have been developed by three federal agencies1
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote1_3ja8108>.
Although the three agencies’ guidelines are each slightly different,
each leaves a large margin for safety, and exposure to amounts that
exceed these guidelines does not mean that the individual has been
exposed to toxic levels of mercury.

Additionally, it should be noted that, some studies 3
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote3_m6nhe5h>
5
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote5_k2incny> show
that ethylmercury (the kind to which thimerosal is metabolized) may be
less toxic than methylmercury (the kind that was used in establishing
the safety guidelines). However, because little information about
ethylmercury has been available until recently, guidelines for
thimerosal safety have been based on methylmercury guidelines.

As part of the Food and Drug Administration (FDA) Modernization Act of
1997, the FDA began compiling a list of the amount and type of mercury
in drugs and foods.

Notably, since the last formal FDA review of thimerosal use in biologics
in 1976, two important things have changed regarding vaccines: there
have been advances in the understanding of the human health effects of
low-level exposure to mercury, and there has been an increase in the
number of vaccines recommended for routine use in children2
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote2_5jp0f8a>.

In their recent review, the FDA found that, depending on which
formulation an infant received for each of his or her recommended
vaccines, the infant could potentially be exposed on an immunization day
to total levels of mercury that would exceed the Environmental
Protection Agency (EPA) guideline of 0.1 micrograms of methylmercury per
kilogram of infant body weight per day. (See also FDA’s response
<http://www.immunizationinfo.org/assets/files/pdfs/FDA_letter.pdf> to a
petiton to suspend and revoke all vaccines containing thimerosal for
which there is a thimerosal-free replacement available).

This should have posed no risk to the child because the guidelines were
established based on exposure to this amount of mercury every day. (See
the National Academy of Science’s National Research Council July 2000
review of the EPA guideline
<http://www4.nationalacademies.org/news.nsf/isbn/0309071402?OpenDocument>.)
Nevertheless, this finding led to the request for removal of thimerosal
from vaccines and the temporary suspension of the birth dose of
hepatitis B vaccine until formulations of the vaccine became available
that did not contain thimerosal as a preservative.

Many questions are being asked about the potential effect of thimerosal
on the developing fetus and infant, in particular on the developing
nervous system 6
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote6_g3r8glp>.
To begin, how is thimerosal processed in the bodies of infants?

In one study
<http://www.immunizationinfo.org/issues/thimerosal-mercury/immunization_science_detail.cfv?id=5>,
scientists at the University of Rochester Medical Center tested the
blood levels of mercury in 16 full-term infants shortly after the
children had received recommended vaccines that contained thimerosal.
They found that “none of the blood mercury levels observed in the
studied infants exceeded the most recently revised lowest level of
maternal blood mercury considered to represent a potentially significant
exposure to the developing fetus.” 7
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote7_5h7hcjp>

More research is planned to evaluate if the thimerosal in vaccines poses
a risk to children. The study also suggested that unlike the toxin
methylmercury, thimerosal is eliminated through stools within two weeks.

Is thimerosal still in the vaccines that children receive?

Currently, all pediatric vaccines in the routine infant immunization
schedule are manufactured without thimerosal as a preservative. As of
January 14, 2003, the final lots of vaccines containing thimerosal as a
preservative expired.

Other vaccines (for example, influenza vaccine; tetanus and diphtheria
vaccine for older children and adults) continue to be manufactured with
thimerosal as a preservativeâ€"although influenza vaccine without
thimerosal preservative is also available.

Trivalent inactivated influenza vaccine (TIV)
<http://www.immunizationinfo.org/issues/thimerosal-mercury/vaccineInfo/vaccine_detail.cfv?id=6>
has recently been recommended for all children 6-23 months of age, in
addition to the long-standing recommendations to give TIV to children
and adults with certain medical conditions as well as older adults.

Thimerosal-free TIV is not available in the United States. However, TIV
is available both with trace amounts of thimerosal and with thimerosal
as a preservative.

The amount of thimerosal in current influenza vaccines is so low that it
should not raise concern. The concern in 1999 regarding thimerosal in
childhood vaccines was for their administration to infants in the first
6 months of life and reflected the possible cumulative total ethyl
mercury burden from all the thimerosal-containing products administered
at newborn, 2, 4 and 6 months of age.

For a current listing of the mercury concentration
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#concentration>
in most U.S. licensed vaccines, you can access the website of the FDA
<http://www.fda.gov/cber/vaccine/thimerosal.htm#t3> or the Johns Hopkins
University Institute for Vaccine Safety
<http://www.vaccinesafety.edu/thi-table.htm>.

The U.S. Institute of Medicine (IOM) of the National Academy of
Sciencesâ€"a private, independent organization created by the federal
government to be an adviser on scientific and technological mattersâ€"has
established an independent expert committee to review immunization
safety concerns, including thimerosal in vaccines.

On October 1, 2001, the IOM Immunization Safety Review Committee issued
its report “Thimerosal-Containing Vaccines and Neurodevelopmental
Disorders,” concluding, “The hypothesis that thimerosal exposure through
the recommended childhood immunization schedule has caused
neurodevelopmental disorders is not supported by clinical or
experimental evidence”.

Since that review, several new studies have looked for, but not foundâ€"an
association of thimerosal exposure with autism and other developmental
disorders (see References
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#ref>).

In 2004, the IOM Vaccine Safety Committee again began a review to
consider any possible associations between vaccines and the occurrence
of autism. The 2004 report, “Vaccines and Autism
<http://www.immunizationinfo.org/issues/thimerosal-mercury/iom_reports_detail.cfv?id=42>”
states that “the body of epidemiological evidence favors rejection of a
causal relationship between thimerosal-containing vaccines and autism.”

Notes

Guidelines for safe exposure to methylmercury are based on the analysis
of unintended environmental exposures resulting in overt toxicity. Such
guidelines have been developed by three federal agencies and the World
Health Organization (WHO <http://www.who.int>).

The World Health Organization recommends a limit of 3.3 micrograms of
methylmercury/ kilogram of body weight/ week (0.47 micrograms/ kg/ day).

Three U.S. federal agencies have set lower guidelines for
methylmercury exposure:

*
Environmental Protection Agency: 0.1 micrograms/ kg/ day
*
Agency for Toxic Substances Disease Registry: 0.3 micrograms/ kg/ day
*
Food and Drug Administration: 0.4 micrograms/ kg/ day 2
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote2_5jp0f8a>

Although these guidelines are each slightly different, but each leaves a
large margin for safety, and exposure to amounts that exceed these
guidelines does not mean that the developing infant is exposed to toxic
levels of mercury. 8
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnote8_9jtrnu1>

A concentration of 1:10,000

= 0.01% concentration
= 50 micrograms per 0.5 mL

1 microgram

= 1mcg
= one millionth of a gram

Most pediatric vaccines come in doses of 0.5 mL (one-half milliliters)
so most concentrations are reported “per 0.5 mL.”

Because thimerosal is half mercury, a vaccine with 0.01% concentration
of thimerosal

= 0.005% concentration of mercury
= 25 micrograms of mercury per 0.5 mL of vaccine.

(For comparison, most commercial fish contain an average of 23
micrograms of mercury per 8 ounces of fish (i.e., 0.1 micrograms of
mercury per gram of fish)).

Other websites of interest

* American Academy of Pediatrics
<http://www.aap.org/policy/t109907.html> statement on mercury in
the environment
* American Academy of Pediatrics
<http://www.aap.org/advocacy/releases/vaccinesafety.htm> statement
on the October 2001 IOM report
* American Medical Association
<http://jama.ama-assn.org/cgi/content/short/282/13/1219>
information on thimerosal-free hepatitis B vaccine
*
The CDC’s National Immunization Program
<http://www.cdc.gov/nip/vacsafe/concerns/thimerosal/default.htm>
information on thimerosal in vaccines
* Environmental Protection Agency
<http://www.epa.gov/opptintr/pbt/mercury.htm> general information
on mercury and its effects
* Food and Drug Administration
<http://www.fda.gov/bbs/topics/NEWS/2001/NEW00756.html>
information on trace amounts of thimerosal in new DTaP vaccine
* Food and Drug Administration
<http://www.fda.gov/cber/vaccine/thimerosal.htm> general
information on thimerosal
* Immunization Action Coalition
<http://www.immunize.org/safety/thimerosal.htm> general
information and resources on thimerosal
* Johns Hopkins University Institute for Vaccine Safety
<http://www.vaccinesafety.edu/cc-thim.htm> references and
useful links
* National Institue of Allergy and Infectious Diseases
<http://www.niaid.nih.gov/factsheets/thimerosal.htm> research
on thimerosal
* National Partnership for Immunization
<http://www.partnersforimmunization.org/guidebook.html>
thimerosal section
* World Health Organization
<http://www.who.int/vaccine_safety/topics/thiomersal/en/index.html> questions
and answers on thimerosal

Additional References

American Academy of Pediatrics, Committee on Infectious Diseases and
Committee on Environmental Health. (1999). Thimerosal in vaccines â€" An
interim report to clinicians. /Pediatrics/, 104(3), 570-574.

Brayden RM, Pearson KA, Jones JS, Renfrew BL, and Berman S. (2001).
Effect of thimerosal recommendations on hospitals’ neonatal hepatitis B
vaccination policies. /Journal of Pediatrics/, 138(5), 752-755.

Clark SJ, Cabana MD, Malik T, Yusuf H, and Freed GL. (2001). Hepatitis B
vaccination practices in hospital newborn nurseries before and after
changes in vaccination recommendations. /Archives of Pediatric and
Adolescent Medicine/, 155(8), 915-920.

Clements CJ, Ball LK, Ball R, and Pratt RD. (2001). Thimerosal in
vaccines: Is removal warranted? /Drug Safety/, 24(8), 567-574.

Hurie MB, Saari TN, and Davis JP. (2001). Impact of the joint statement
by the American Academy of Pediatrics/US Public Health Service on
thimerosal in vaccines on hospital infant hepatitis B vaccination
practices. /Pediatrics/, 107(4), 755-758.

Mahaffey KR. (1999). Methylmercury: A new look at the risks. /Public
Health Reports/, 114(5), 396-399, 402-413.

Oram RJ, Daum RS, Seal JB, and Lauderdale DS. (2001). Impact of
recommendations to suspend the birth dose of hepatitis B virus vaccine.
/Journal of the American Medical Association/, 285(14), 1874-1879.

Parker SK, Schwartz B, Todd J, and Pickering LK (2004).
Thimerosal-Containing Vaccines and Autistic Spectrum Disorder: A
Critical Review of Published Original Data
<http://pediatrics.aappublications.org/cgi/content/abstract/114/3/793>.
/Pediatrics/, 114:793-804.

References

* 1. a.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref1_3ja8108>
b.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref1_z2o3lmq>
c.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref1_1n5sx6p>
Goldman LR and Shannon MW. (2001). Technical report: Mercury in
the environment: Implications for pediatricians
<http://pediatrics.aappublications.org/cgi/content/abstract/108/1/197>.
/Pediatrics,108(1), 197-205/
* 2. a.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref2_5jp0f8a>
b.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref2_dkfjqzm>
c.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref2_tdai5oa>
d.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref2_hexr677>
Ball LK, Ball R, and Pratt RD. (2001). An assessment of thimerosal
use in childhood vaccines
<http://pediatrics.aappublications.org/cgi/content/abstract/107/5/1147>.
/Pediatrics, 107(5), 1147-1154/
* 3.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref3_m6nhe5h>
Magos L. (2001). Review on the toxicity of ethylmercury, including
its presence as a preservative in biological and pharmaceutical
products
<http://www3.interscience.wiley.com/cgi-bin/fulltext/76510597/PDFSTART>.
/Journal of Applied Toxicology, 21(1), 1-5/
* 5.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref5_k2incny>

* 6.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref6_g3r8glp>
Bernard S, Enayati A, Redwood L, Roger H, and Binstock T. (2001).
Autism: A novel form of mercury poisoning
<http://www.sciencedirect.com/science/article/B6WN2-456JRB7-5K/2/715dc6df0693d8354a72129ba129a90f>.
/Medical Hypotheses, 56(4), 462-471/
* 7.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref7_5h7hcjp>
Pichichero ME, Cernichiari E, Lopreiato J, Treanor J. (2002).
Mercury concentrations and metabolism in infants receiving
vaccines containing thiomersal: a descriptive study
<http://www.immunizationinfo.org/issues/thimerosal-mercury/immunization_science_detail.cfv?id=5>.
/The Lancet, 360(9347):1737-41/
* 8.
<http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines#footnoteref8_9jtrnu1>
Halsey, N. (1999). Limiting infant exposure to thimerosal in
vaccines and other sources of mercury
<http://jama.ama-assn.org/content/vol282/issue18/index.dtl>.
/JAMA. 282(18),1763-1766/

http://www.immunizationinfo.org/issues/thimerosal-mercury/mercury-vaccines

Thimerosal in Vaccines

See also "Mercury in Plasma-Derived Products"
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/BloodSafety/ucm095529.htm>^1

----------------------------------------------------------

*Table of Contents*

* Introduction
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#intro>
* Preservatives in Vaccines
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#pres>
* Thimerosal as a Preservative
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#thi>
* Guidelines on Exposure to Organomercurials
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#guid>
* Thimerosal Toxicity
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#tox>
* Recent and Future FDA Actions
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#act>
* The Safety Review of Thimerosal-containing Vaccines and
Neurodevelopmental Disorders Conducted by the Institute of
Medicine
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#saf>
* Tables
o Table 1. Thimerosal Content of the Routinely Recommended
Pediatric Vaccines
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t1>
o Table 2. Preservatives in U.S. Licensed Vaccines
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t2>
o Table 3. Thimerosal and Expanded List of vaccines
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t3>
* References
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#ref>
* Bibliography
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#bib>

----------------------------------------------------------

*Introduction*

Thimerosal is a mercury-containing organic compound (an
organomercurial). Since the 1930s, it has been widely used as a
preservative in a number of biological and drug products, including many
vaccines, to help prevent potentially life threatening contamination
with harmful microbes. Over the past several years, because of an
increasing awareness of the theoretical potential for neurotoxicity of
even low levels of organomercurials and because of the increased number
of thimerosal containing vaccines that had been added to the infant
immunization schedule, concerns about the use of thimerosal in vaccines
and other products have been raised. Indeed, because of these concerns,
the Food and Drug Administration has worked with, and continues to work
with, vaccine manufacturers to reduce or eliminate thimerosal from vaccines.

Thimerosal has been removed from or reduced to trace amounts in all
vaccines routinely recommended for children 6 years of age and younger,
with the exception of inactivated influenza vaccine (see Table 1
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t1>).
A preservative-free version of the inactivated influenza vaccine
(contains trace amounts of thimerosal) is available in limited supply at
this time for use in infants, children and pregnant women. Some vaccines
such as Td, which is indicated for older children (≥ 7 years of age) and
adults, are also now available in formulations that are free of
thimerosal or contain only trace amounts. Vaccines with trace amounts of
thimerosal contain 1 microgram or less of mercury per dose.

In the following pages, a discussion of preservatives, the use of
thimerosal as a preservative, guidelines on exposure to organomercurials
(primarily methylmercury), thimerosal toxicity, recent and future FDA
actions, and the conclusions of the Institute of Medicine's most recent
review of thimerosal in vaccines are presented. This narrative on
thimerosal contains references to the literature and links to other
sites for readers who wish additional information; for quick reference,
a number of frequently asked questions (FAQs) and answers are provided.

Table of Contents
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#toc>

----------------------------------------------------------

*Preservatives in Vaccines*

To begin, we need to answer two questions-what are preservatives and why
are they used in vaccines. For our purposes, preservatives may be
defined as compounds that kill or prevent the growth of microorganisms,
particularly bacteria and fungi. They are used in vaccines to prevent
microbial growth in the event that the vaccine is accidentally
contaminated, as might occur with repeated puncture of multi-dose vials.
In some cases, preservatives are added during manufacture to prevent
microbial growth; with changes in manufacturing technology, however, the
need to add preservatives during the manufacturing process has decreased
markedly.

The United States Code of Federal Regulations (the CFR) requires, in
general, the addition of a preservative to multi-dose vials of vaccines;
indeed, worldwide, preservatives are routinely added to multi-dose vials
of vaccine. Tragic consequences have followed the use of multi-dose
vials that did not contain a preservative and have served as the impetus
for this requirement. One particularly telling incident from Australia
is described by Sir Graham S. Wilson in his classic book, /The Hazards
of Immunization/

In January 1928, in the early stages of an immunization campaign
against diphtheria, Dr. Ewing George Thomson, Medical Officer of
Health of Bundaberg, began the injection of children with
toxin-antitoxin mixture. The material was taken from an
India-rubber-capped bottle containing 10 mL of TAM. On the 17th,
20th, 21, and 24th January, Dr. Thomson injected subcutaneously a
total of 21 children without ill effect. On the 27th a further 21
children were injected.Of these children .eleven died on the 28th
and one on the 29th. (Wilson 1967)

This disaster was investigated by a Royal Commission and the final
sentence in the summary of their findings reads as follows:

The consideration of all possible evidence concerning the deaths at
Bundeberg points to the injection of living staphylococci as the
cause of the fatalities.

From this experience, the Royal Commission recommended that biological
products in which the growth of a pathogenic organism is possible should
not be issued in containers for repeated use unless there is a
sufficient concentration of antiseptic (preservative) to inhibit
bacterial growth.

The U.S. requirement for preservatives in multi-dose vaccines was
incorporated into the CFR in January 1968, although many biological
products had contained preservatives, including thimerosal, prior to
this date. Specifically, the CFR states:

Products in multi-dose containers shall contain a preservative,
except that a preservative need not be added to Yellow Fever
Vaccine; Polio-virus Vaccine, Live Oral; viral vaccine labeled for
use with the jet injector; dried vaccines when the accompanying
diluent contains a preservative; or to an Allergenic Product in 50
percent or more volume (v/v) glycerin. [21 CFR 610.15(a)]

The CFR also requires that the preservative used

.[s]hall be sufficiently non-toxic so that the amount present in the
recommended dose of the product will not be toxic to the recipient,
and in combination used it shall not denature the specific substance
in the product to result in a decrease below the minimal acceptable
potency within the dating period when stored at the recommended
temperature. [21 CFR 610.15(a)]

Preservatives cannot completely eliminate the risk of contamination of
vaccines. The literature contains several reports of bacterial
contamination of vaccines despite the presence of a preservative,
emphasizing the need for meticulous attention to technique in
withdrawing vaccines from multi-dose vials. (Bernier et al 1981; Simon
et al. 1993). The need for preservatives in multi-dose vials of vaccines
is nonetheless clear. Several preservatives are used in U.S. licensed
vaccines, and these are listed in Table 2
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t2>.
It is important to note that the FDA does not license a particular
preservative; rather, the product containing that preservative is
licensed, with safety and efficacy data generally collected in the
context of a license application for a particular product.

Table of Contents
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#toc>

----------------------------------------------------------

*Thimerosal as a Preservative*

Thimerosal, which is approximately 50% mercury by weight, has been one
of the most widely used preservatives in vaccines. It is metabolized or
degraded to ethylmercury and thiosalicylate. Ethylmercury is an
organomercurial that should be distinguished from methylmercury, a
related substance that has been the focus of considerable study (see
"Guidelines on Exposure to Organomercurials
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#guid>"
and "Thimerosal Toxicity
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#tox>",
below).

At concentrations found in vaccines, thimerosal meets the requirements
for a preservative as set forth by the /United States Pharmacopeia/;
that is, it kills the specified challenge organisms and is able to
prevent the growth of the challenge fungi (U.S. Pharmacopeia 2004).
Thimerosal in concentrations of 0.001% (1 part in 100,000) to 0.01% (1
part in 10,000) has been shown to be effective in clearing a broad
spectrum of pathogens. A vaccine containing 0.01% thimerosal as a
preservative contains 50 micrograms of thimerosal per 0.5 mL dose or
approximately 25 micrograms of mercury per 0.5 mL dose.

Prior to its introduction in the 1930's, data were available in several
animal species and humans providing evidence for its safety and
effectiveness as a preservative (Powell and Jamieson 1931). Since then,
thimerosal has been the subject of several studies (see Bibliography
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#bib>)
and has a long record of safe and effective use preventing bacterial and
fungal contamination of vaccines, with no ill effects established other
than minor local reactions at the site of injection.

While the use of mercury-containing preservatives has declined in recent
years with the development of new products formulated with alternative
or no preservatives, thimerosal has been used in some immune globulin
preparations, anti-venins, skin test antigens, and ophthalmic and nasal
products, in addition to certain vaccines. Under the FDA Modernization
Act of 1997, the FDA compiled a list of regulated products containing
mercury, including those with thimerosal (Federal Register 1999). It is
important to note that this list was compiled in 1999; some products
listed are no longer manufactured and many products have been
reformulated without thimerosal. Updated lists of vaccines and their
thimerosal content can be found in Table 1
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t1>
(routinely recommended pediatric vaccines) and Table 3
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t3>
(expanded list of vaccines).

Table of Contents
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#toc>

----------------------------------------------------------

*Guidelines on Exposure to Organomercurials*

Mercury is an element that is dispersed widely around the earth. Most of
the mercury in the water, soil, plants and animals is found as inorganic
mercury salts. Mercury accumulates in the aquatic food chain, primarily
in the form of the methylmercury, an organomercurial. Organic forms of
mercury are more easily absorbed when ingested and are less readily
eliminated from the body than are inorganic forms of mercury. Humans are
exposed to methylmercury primarily from the consumption of seafood
(Mahaffey et al. 1997).

Methylmercury is a neurotoxin. The toxicity of methylmercury was first
recognized during the late 1950s and early 1960s when industrial
discharge of mercury into Minimata Bay, Japan led to the widespread
consumption of mercury-contaminated fish (Harada 1995). Epidemics of
methylmercury poisoning also occurred in Iraq during the 1970s when seed
grain treated with a methylmercury fungicide was accidentally used to
make bread (Bakir et al. 1973). During these epidemics, fetuses were
found to be more sensitive to the effects of methylmercury than adults.
Maternal exposure to high levels of methylmercury resulted in infants
exhibiting severe neurologic injury including a condition resembling
cerebral palsy, while their mothers showed little or no symptoms.
Sensory and motor neurologic dysfunction and developmental delays were
observed among some children who were exposed /in utero/ to lower levels
of methylmercury.

More recently, several epidemiological studies have examined the effect
of low dose dietary exposure to methylmercury, with inconsistent
results. Studies from the Faroe Islands reported that subtle cognitive
deficits (e.g., performance on attention, language, and memory tests),
detectable by sophisticated neuropsychometric testing, were associated
with methylmercury levels previously thought to be safe (Grandjean et al
1997). Studies in the Seychelles, evaluating more global developmental
outcomes, did not reveal any correlation between abnormalities and
methylmercury levels (Davidson et al. 1998).

Various agencies have developed guidelines for _safe_ exposure to
methylmercury, including the U.S. Environmental Protection Agency
(Mahaffey et al. 1997), U.S. Agency for Toxic Substances and Disease
Registry (ATSDR 1999), the FDA (Federal Register 1979)^1
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#f1>,
and the World Health Organization (WHO 1996). These exposure levels
range from 0.1 µg/kg body weight/day (EPA) to 0.47 µg/kg body weight/day
(WHO)^2
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#f2>.
The range of recommendations is due to varying safety margins, differing
emphasis placed on various sources of data, the different missions of
the agencies and the population that the guideline is intended to
protect. All guidelines, however, fall within the same order of
magnitude. While these guidelines may be used as screening tools in risk
assessment to evaluate the "safety" of mercury exposures, they are not
meant to be bright lines above which toxicity will occur. However, as
exposure levels increase in multiples of these guidelines, there is
increasing concern on the part of the public health community that
adverse health consequences may occur (Mahaffey 1999).

To address the issue of conflicting methylmercury exposure guidelines,
Congress asked the National Academy of Sciences to study the
toxicological effects of methylmercury and provide recommendations on
the establishment of a scientifically appropriate methylmercury
reference dose. Their report concluded that the EPA's current reference
dose, the RfD, for methylmercury, 0.1 µg/kg/day is a scientifically
justifiable level for the protection of human health. (See "Related
Links" below for link to the report: "The National Academies
Press: Toxicological Effects of Methylmercury.") The FDA is considering
this and other data relevant to its exposure guideline for methylmercury.

Table of Contents
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#toc>

----------------------------------------------------------

*Thimerosal Toxicity*

The various mercury guidelines are based on epidemiological and
laboratory studies of methyl mercury, whereas thimerosal is a derivative
of ethyl mercury. Because they are different chemical entities - ethyl-
versus methylmercury - different toxicological profiles are expected.
There is, therefore, an uncertainty that arises in applying the
methylmercury-based guidelines to thimerosal. Lacking definitive data on
the comparative toxicities of ethyl- versus methylmercury, FDA
considered ethyl- and methyl-mercury as equivalent in its risk
evaluation. There are some data and studies bearing directly on
thimerosal toxicity and these are summarized in this Section.

Allergic responses to thimerosal are described in the clinical
literature, with these responses manifesting themselves primarily in the
form of delayed-type local hypersensitivity reactions, including redness
and swelling at the injection site (Cox and Forsyth 1988; Grabenstein
1996). Such reactions are usually mild and last only a few days. Some
authors postulate that the thiosalicylate component is the major
determinant of allergic reactions (Goncalo et al. 1996). In a clinical
setting, however, it is usually not possible to determine whether local
reactions are caused by thimerosal or other vaccine components.

The earliest published report of thimerosal use in humans was published
in 1931 (Powell and Jamieson 1931). In this report, 22 individuals
received 1% solution of thimerosal intravenously for unspecified
therapeutic reasons. Subjects received up to 26 milligrams thimerosal/kg
(1 milligrams equals 1,000 micrograms) with no reported toxic effects,
although 2 subjects demonstrated phlebitis or sloughing of skin after
local infiltration. Of note, this study was not specifically designed to
examine toxicity; 7 of 22 subjects were observed for only one day, the
specific clinical assessments were not described, and no laboratory
studies were reported.

Several cases of acute mercury poisoning from thimerosal-containing
products were found in the medical literature with total doses of
thimerosal ranging from approximately 3 mg/kg to several hundred mg/kg.
These reports included the administration of immune globulin (gamma
globulin) (Matheson et al. 1980) and hepatitis B immune globulin (Lowell
et al. 1996), choramphenicol formulated with 1000 times the proper dose
of thimerosal as a preservative (Axton 1972), thimerosal ear irrigation
in a child with tympanostomy tubes (Rohyans et al. 1994), thimerosal
treatment of omphaloceles in infants (Fagan et al. 1977), and a suicide
attempt with thimerosal (Pfab et al. 1996). These studies reported local
necrosis, acute hemolysis, disseminated intravascular coagulation, acute
renal tubular necrosis, and central nervous system injury including
obtundation, coma, and death. (IOM)

Several animal studies have evaluated the toxicity of thimerosal. In
1931 Powell and Jamieson reported acute toxicity studies in several
animal species. Maximum tolerated doses not associated with death of the
animals were 20 mg thimerosal/kg (rabbits) and 45 mg/kg (rats). Blair
evaluated the administration of thimerosal intranasally for 190 days and
observed no histopathological changes in the brain or kidney (Blair et
al. 1975). Magos et al. directly compared the toxicity of ethyl- versus
methylmercury in adult male and female rats administered 5 daily doses
of equimolar concentrations of ethyl- or methylmercury by gavage (Magos
et al 1985). Magos concluded that ethylmercury, the mercury derivative
found in thimerosal, is less neurotoxic than methylmercury, the mercury
derivative for which the various guidelines are based.

One final piece of data regarding thimerosal is worth noting. At the
initial National Vaccine Advisory Committee-sponsored meeting on
thimerosal in 1999, concerns were expressed that infants may lack the
ability to eliminate mercury. More recent NIAID-supported studies at the
University of Rochester and National Naval Medical Center in Bethesda,
MD examined levels of mercury in blood and other samples from infants
who had received routine immunizations with thimerosal-containing
vaccines. [Pichichero ME, et al. Lancet 360:1737-1741 (2002)] Blood
levels of mercury did not exceed safety guidelines for methyl mercury
for all infants in these studies. Further, mercury was cleared from the
blood in infants exposed to thimerosal faster than would be predicted
for methyl mercury; infants excreted significant amounts of mercury in
stool after thimerosal exposure, thus removing mercury from their
bodies. These results suggest that there are differences in the way that
thimerosal and methyl mercury are distributed, metabolized, and
excreted. Thimerosal appears to be removed from the blood and body more
rapidly than methyl mercury. NIAID is sponsoring a follow-up study with
larger numbers of infants in Buenos Aires where thimerosal-containing
vaccines are still administered to children. See "Related Links" below
to find a link to the NIH/NIAID vaccines/thimerosal web site.

Table of Contents
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#toc>

----------------------------------------------------------

*Recent and Future FDA Action*

FDA has been actively addressing the issue of thimerosal as a
preservative in vaccines. Under the FDA Modernization Act (FDAMA) of
1997, the FDA conducted a comprehensive review of the use of thimerosal
in childhood vaccines. Conducted in 1999, this review found no evidence
of harm from the use of thimerosal as a vaccine preservative, other than
local hypersensitivity reactions (Ball et al. 2001).

As part of the FDAMA review, the FDA evaluated the amount of mercury an
infant might receive in the form of /*ethyl*/mercury from vaccines under
the U.S. recommended childhood immunization schedule and compared these
levels with existing guidelines for exposure to /*methy*/lmercury, as
there are no existing guidelines for ethylmercury, the metabolite of
thimerosal. At the time of this review in 1999, the maximum cumulative
exposure to mercury from vaccines in the recommended childhood
immunization schedule was within acceptable limits for the methylmercury
exposure guidelines set by FDA, ATSDR, and WHO. However, depending on
the vaccine formulations used and the weight of the infant, some infants
could have been exposed to cumulative levels of mercury during the first
six months of life that exceeded EPA recommended guidelines for safe
intake of methylmercury.

As a precautionary measure, the Public Health Service (including the
FDA, National Institutes of Health (NIH), Center for Disease Control and
Prevention (CDC) and Health Resources and Services Administration (HRSA)
and the American Academy of Pediatrics issued two Joint Statements,
urging vaccine manufacturers to reduce or eliminate thimerosal in
vaccines as soon as possible (CDC 1999) and (CDC 2000). The U.S. Public
Health Service agencies have collaborated with various investigators to
initiate further studies to better understand any possible health
effects from exposure to thimerosal in vaccines.

Available data has been reviewed in several public forums including the
Workshop on Thimerosal held in Bethesda in August 1999 and sponsored by
the National Vaccine Advisory Committee, two meetings of the Advisory
Committee on Immunization Practices of the CDC, held in October 1999 and
June 2000, and the Institute of Medicine's Immunization Safety Review
Committee in July 2001 and May 2004. Through its Vaccine Safety
Datalink, the CDC has examined the incidence of autism as a function of
the amount of thimerosal a child received from vaccines. Preliminary
results indicated no change in autism rates relative to the amount of
thimerosal a child received during the first six months of life (from 0
micrograms to greater than 160 micrograms). A weak association was found
with thimerosal intake and certain neurodevelopmental disorders (such as
attention deficit hyperactivity disorder) in one study, but was not
found in a subsequent study. Additional studies are planned in these areas.

Much progress has been made to date in removing or reducing thimerosal
in vaccines. New pediatric formulations of hepatitis B vaccines have
been licensed by the FDA, Recombivax-HB (Merck, thimerosal free) in
August 1999 and Engerix-B (Glaxo SmithKline, thimerosal free) in January
2007. In March 2001 the FDA approved a second DTaP vaccine formulated
without thimerosal as a preservative (Aventis Pasteur's Tripedia, trace
thimerosal). Aventis Pasteur, Ltd was also approved to manufacture a
thimerosal-free DTaP vaccine, Daptacel, in 2002. In September 2001
Chiron/Evans was approved for manufacturing a preservative-free
formulation of their influenza vaccine, Fluvirin, that contained trace
thimerosal. In September of 2002, Aventis Pasteur, Inc was approved to
manufacture a preservative-free formulation of their influenza vaccine,
Fluzone that contained trace thimerosal, and in December 2004, a
thimerosal-free formulation of Fluzone was approved. Two Td vaccines are
also available in preservative-free formulations, Aventis Pasteur Inc's
Decavac, and Aventis Pasteur, Ltd's Td vaccine. Also, Aventis Pasteur
Inc's DT vaccine is now available only in a preservative-free
formulation. These changes have been accomplished by reformulating
products in single dose vials that do not contain a preservative. At
present, all routinely recommended vaccines for U.S. infants are
available only as thimerosal-free formulations or contain only trace
amounts of thimerosal (≤1 than micrograms mercury per dose), with the
exception of inactivated influenza vaccine. Inactivated influenza
vaccine for pediatric use is available in a thimerosal-preservative
containing formulation and in formulations that contain either no
thimerosal or only a trace of thimerosal, but the latter is in more
limited supply; see Table 1
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t1>.
A more extensive tabulation of vaccines and thimerosal content may be
found in Table 3
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t3>.

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*The Safety Review of Thimerosal-containing Vaccines and
Neurodevelopmental Disorders Conducted by the Institute of Medicine*

In 2001, the Institute of Medicine convened a committee (the
Immunization Safety Review Committee) to review selected issues related
to immunization safety. [For more information regarding this committee,
their charge, and their reports, find the link to IOM's Web site in
"Related Links" below.] The IOM has, to date, completed reviews in two
areas. The first review by this committee focused on a potential link
between autism and the combined mumps, measles, and rubella vaccine. The
second review focused on a potential relationship between thimerosal use
in vaccines and neurodevelopmental disorders (IOM 2001). This latter
issue was brought to the fore primarily as the result of the hypothesis,
formulated by S. Bernard and others from Cure Autism Now, that autism is
a novel form of mercury poisoning (Bernard et al. 2001); this
hypothesis, linking autism to mercury, was based on a comprehensive
review of the scientific literature on mercury toxicity.

In its report of October 1, 2001, the IOM's Immunization Safety Review
Committee concluded that the evidence was inadequate to either accept or
reject a causal relationship between thimerosal exposure from childhood
vaccines and the neurodevelopmental disorders of autism, attention
deficit hyperactivity disorder (ADHD), and speech or language delay.
Additional studies were needed to establish or reject a causal
relationship. The Committee did conclude that the hypothesis that
exposure to thimerosal-containing vaccines could be associated with
neurodevelopmental disorders was biologically plausible.

The Committee believed that the effort to remove thimerosal from
vaccines was "a prudent measure in support of the public health goal to
reduce mercury exposure of infants and children as much as possible."
Furthermore, in this regard, the Committee urged that "full
consideration be given to removing thimerosal from any biological
product to which infants, children, and pregnant women are exposed."

In 2004, the IOM's Immunization Safety Review Committee issued its final
report, examining the hypothesis that vaccines, specifically the MMR
vaccines and thimerosal containing vaccines, are causally associated
with autism. In this report, the committee incorporated new
epidemiological evidence from the U.S., Denmark, Sweden, and the United
Kingdom, and studies of biologic mechanisms related to vaccines and
autism since its report in 2001. The committee concluded that this body
of evidence favors rejection of a causal relationship between
thimerosal-containing vaccines and autism, and that hypotheses generated
to date concerning a biological mechanism for such causality are
theoretical only. Further, the committee stated that the benefits of
vaccination are proven and the hypothesis of susceptible populations is
presently speculative, and that widespread rejection of vaccines would
lead to increases in incidences of serious infectious diseases like
measles, whooping cough and Hib bacterial meningitis.

The FDA is continuing its efforts to reduce the exposure of infants,
children, and pregnant women to mercury from various sources.
Discussions with the manufacturers of influenza virus vaccines (which
are now routinely recommended for pregnant women and children 6-23
months of age) regarding their capacity to potentially increase the
supply of thimerosal-reduced and thimerosal-free presentations are
ongoing. Discussions are also underway with regard to other vaccines. Of
note, all hepatitis B vaccines for the U.S., including for adults, are
now available only as thimerosal-free or trace-thimerosal-containing
formulations. In addition, all immune globulin preparations including
hepatitis B immune globulin, and Rho(D) immune globulin preparations are
manufactured without thimerosal. For additional information on the issue
of thimerosal in vaccines, see Frequently Asked Questions (FAQs).

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*Tables*

Table 1. Thimerosal Content of Vaccines Routinely Recommended for
Children 6 Years of Age and Younger

Vaccine Tradename
(Manufacturer) Thimerosal Status Concentration**(Mercury) Approval
Date for Thimerosal Free or Thimerosal / Preservative Free (Trace
Thimerosal)*** Formulation
DTaP Infanrix
(GlaxoSmithKline Biologicals) Free Never contained more than a trace
of thimerosal, approval date for thimerosal-free formulation 9/29/2000
Daptacel
(Sanofi Pasteur, Ltd) Free Never contained Thimerosal
Tripedia
(Sanofi Pasteur, Inc) Trace(≤0.3 µg Hg/0.5mL dose) 03/07/01
DTaP-HepB-IPV Pediarix
(GlaxoSmithKline Biologicals) Free Never contained more than a Trace
of Thimerosal, approval date for thimerosal-free formulation 1/29/2007
DTaP-IPV/Hib Pentacel (sanofi pasteur Ltd.) Free Approved June 20,
2008, never contained thimerosal
DTaP-IPV KINRIX (Glaxo SmithKline Biologicals) Free Approved October
8, 2009, never contained thimerosal
Pneumococcal conjugate Prevnar
(Wyeth Pharmaceuticals Inc) Free Never contained Thimerosal
Prevnar 13 (Wyeth Pharmaceuticals Inc.) Free Approved February 24,
2010, never contained thimerosal
Inactivated Poliovirus IPOL
(Sanofi Pasteur, SA) Free Never contained Thimerosal
Varicella (chicken pox) Varivax
(Merck & Co, Inc) Free Never contained Thimerosal
Mumps, measles, and rubella M-M-R-II
(Merck & Co, Inc) Free Never contained Thimerosal
Mumps, measles, rubella and varicella ProQuad (Merck & Co., Inc.)
Free Approved September 6, 2005, never contained thimerosal.
Heptatitis A Havrix (GlaxoSmithKline Biologicals) Free Never
contained thimerosal
Vaqta (Merck & Co., Inc.) Free Never contained thimerosal
Hepatitis B Recombivax HB
(Merck & Co, Inc) Free 08/27/99
Engerix B
(GlaxoSmithKline Biologicals) Free 03/28/00, approval date for
thimerosal-free formulation 1/30/2007
Haemophilus influenzae type b conjugate (Hib) ActHIB
(Sanofi Pasteur, SA)
OmniHIB
(GlaxoSmithKline) Free Never contained Thimerosal
PedvaxHIB
(Merck & Co, Inc) Free Approval date for thimerosal free formulation
08/99
HIBERIX (GlaxoSmithKline Biologicals) Free Approved August 19, 2009,
never contained thimerosal
Hib/Hepatitis B combination Comvax
(Merck & Co, Inc) Free Never contained Thimerosal

Seasonal Trivalent

Influenza

Fluzone (multi-dose presentation)
(Sanofi Pasteur, Inc) 0.01% (12.5 µg/0.25 mL dose, 25 µg/0.5 mL dose)2
Fluzone (single-dose presentation)
(Sanofi Pasteur, Inc)3 Free 12/23/2004
Fluvirin (multi-dose presentation)
(Novartis Vaccines and Diagnostics Ltd) 0.01% (25 µg/0.5 mL dose)
Fluvirin (single dose presentation)
(Novartis Vaccines and Diagnostics Ltd)
(Preservative Free) Trace (<1ug Hg/0.5mL dose) 09/28/01
Fluarix (single-dose presentation) (GlaxoSmithKline Biologicals) Free
Approved 10/19/09, never contained thimerosal

Afluria (multi-dose presentation)

(CSL Limited)

0.01% (24.5 µg/0.5 mL dose)
Afluria (single-dose presentation) (CSL Limited) Free Approved
11/10/09, never contained thimerosal
Seasonal Influenza, live FluMist^
(MedImmune Vaccines, Inc) Free Never contained Thimerosal
Rotavirus RotaTeq (Merck and Co., Inc.) Free Approved February 3,
2006, never contained thimerosal
Rotarix (GlaxoSmithKline Biologicals) Free Approved April 3, 2008,
never contained thimerosal

** Thimerosal is approximately 50% mercury (Hg) by weight. A 0.01%
solution (1 part per 10,000) of thimerosal contains 50 µg of Hg per 1 mL
dose or 25 µg of Hg per 0.5 mL dose.
*** The term "trace" has been taken in this context to mean 1 microgram
of mercury per dose or less.
^1 HibTiITER was also manufactured in thimerosal-preservative containing
multidose vials but these were no longer available after 2002.
^2 Children 6 months old to less than 3 years of age receive a half-dose
of vaccine, i.e., 0.25 mL; children 3 years of age and older receive 0.5 mL.
^3 A trace thimerosal containing formulation of Fluzone was approved on
9/14/02 and has been replaced with the formulation without thimerosal.

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Table 2: Preservatives Used in U.S. Licensed Vaccines

Preservative Vaccine Examples (Tradename; Manufacturer)
Thimerosal TT (one)
Influenza multi-dose presentations (several)
Phenol Typhoid Vi Polysaccharide (Typhim Vi; Sanofi Pasteur, SA)
Pneumococcal Polysaccharide (Pneumovax 23; Merck & Co, Inc)
Benzethonium chloride (Phemerol) Anthrax (Biothrax; Emergent BioDefense
Operations Lansing Inc.)
2-phenoxyethanol IPV (IPOL; Sanofi Pasteur, SA)

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Table 3: Thimerosal and Expanded List of Vaccines - /(updated 3/14/2008)/
Thimerosal Content in Currently Manufactured U.S. Licensed Vaccines

Vaccine Trade Name Manufacturer Thimerosal Concentration^1 Mercury
Anthrax Anthrax vaccine Emergent BioDefense Operations Lansing Inc. 0 0
DTaP Tripedia^2 Sanofi Pasteur, Inc ≤ 0.00012% ≤ 0.3 µg/0.5 mL dose
Infanrix GlaxoSmithKline Biologicals 0 0
Daptacel Sanofi Pasteur, Ltd 0 0
DTaP-HepB-IPV Pediarix GlaxoSmithKline Biologicals 0 0
DT No Trade Name Sanofi Pasteur, Inc < 0.00012% (single dose) < 0.3
µg/0.5mL dose
Sanofi Pasteur, Ltd^3 0.01% 25 µg/0.5 mL dose
Td No Trade Name MassBiologics ≤ 0.00012% ≤ 0.3 µg mercury/0.5 ml dose
Decavac Sanofi Pasteur, Inc ≤ 0.00012% ≤ 0.3 µg mercury/0.5 ml dose
No Trade Name Sanofi Pasteur, Ltd 0 0
Tdap Adacel Sanofi Pasteur, Ltd 0 0
Boostrix GlaxoSmithKline Biologicals 0 0
TT No Trade Name Sanofi Pasteur, Inc 0.01% 25 µg/0.5 mL dose
Hib ActHIB/OmniHIB^4 Sanofi Pasteur, SA 0 0
HibTITER Wyeth Pharmaceuticals, Inc. 0 0
PedvaxHIB liquid Merck & Co, Inc 0 0
Hib/HepB COMVAX^5 Merck & Co, Inc 0 0
Hepatitis B

Engerix-B
Pediatric/adolescent

Adult

GlaxoSmithKline Biologicals

0

0



0

0

Recombivax HB

Pediatric/adolescent

Adult (adolescent)

Dialysis

Merck & Co, Inc

0

0

0



0

0

0

Hepatitis A Havrix GlaxoSmithKline Biologicals 0 0
Vaqta Merck & Co, Inc 0 0
HepA/HepB Twinrix GlaxoSmithKline Biologicals < 0.0002% < 1 µg/1mL dose
IPV IPOL Sanofi Pasteur, SA 0 0
Poliovax Sanofi Pasteur, Ltd 0 0
Influenza Afluria CSL Limited 0 (single dose)
0.01% (multidose) 0/0.5 mL (single dose)
24.5 µg/0.5 mL (multidose)
Fluzone^6 Sanofi Pasteur, Inc 0.01% 25 µg/0.5 mL dose
Fluvirin Novartis Vaccines and Diagnostics Ltd 0.01% 25 µg/0.5 ml dose
Fluzone (no thimerosal) Sanofi Pasteur, Inc 0 0
Fluvirin (Preservative Free) Novartis Vaccines and Diagnostics Ltd <
0.0004% < 1 µg/0.5 mL dose
Fluarix GlaxoSmithKline Biologicals < 0.0004% < 1 µg/0.5 ml dose
FluLaval ID Biomedical Corporation of Quebec 0.01% 25 µg/0.5 ml dose
Influenza, live FluMist MedImmune Vaccines, Inc 0 0
Japanese Encephalitis^7 JE-VAX Research Foundation for Microbial
Diseases of Osaka University 0.007% 35 µg/1.0mL dose
17.5 µg/0.5 mL dose
MMR MMR-II Merck & Co, Inc 0 0
Meningococcal Menomune A, C, AC and A/C/Y/W-135 Sanofi Pasteur, Inc
0.01% (multidose)
0 (single dose) 25 µg/0.5 dose
0
Menactra A, C, Y and W-135 Sanofi Pasteur, Inc 0 0
Pneumococcal Prevnar (Pneumo Conjugate) Wyeth Pharmaceuticals Inc 0 0
Pneumovax 23 Merck & Co, Inc 0 0
Rabies IMOVAX Sanofi Pasteur, SA 0 0
Rabavert Novartis Vaccines and Diagnostics 0 0
Smallpox (Vaccinia), Live ACAM2000 Acambis, Inc. 0 0
Typhoid Fever Typhim Vi Sanofi Pasteur, SA 0 0
Vivotif Berna Biotech, Ltd 0 0
Varicella Varivax Merck & Co, Inc 0 0
Yellow Fever Y-F-Vax Sanofi Pasteur, Inc 0 0
Table Footnotes

1. Thimerosal is approximately 50% mercury (Hg) by weight. A 0.01%
solution (1 part per 10,000) of thimerosal contains 50 µg of Hg
per 1 ml dose or 25 µg of Hg per 0.5 ml dose.
2. Sanofi Pasteur's Tripedia may be used to reconstitute ActHib to
form TriHIBit. TriHIBit is indicated for use in children 15 to 18
months of age.
3. This vaccine is not marketed in the US.
4. OmniHIB is manufactured by Sanofi Pasteur but distributed by
GlaxoSmithKline.
5. COMVAX is not licensed for use under 6 weeks of age because of
decreased response to the Hib component.
6. Children under 3 years of age receive a half-dose of vaccine,
i.e., 0.25 mL (12.5 µg mercury/dose.)
7. JE-VAX is distributed by Aventis Pasteur. Children 1 to 3 years of
age receive a half-dose of vaccine, i.e., 0.5 mL (17.5 µg
mercury/dose).

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*References*

1. Agency for Toxic Substances and Disease Registry. Toxicological
profile for mercury. Atlanta, GA: Agency for Toxic Substances and
Disease Registry;1999.
2. Axton JMH. Six cases of poisoning after a parenteral organic
mercurial compound (merthiolate). /Postgrad Med J/ 1972;48:417-421.
3. Bakir F, Damlugi SF, Amin-Zaki L, Murtadha M, Khalidi A, Al-Rawi
NY, Tikriti S, Dhahir HI, Clarkson TW, Smith JC, Doherty RA.
Methylmercury poisoning in Iraq. /Science/ 1973;181:230-241.
4. Ball LK, Ball R, Pratt RD. An assessment of thimerosal use in
childhood vaccines. /Pediatrics/ 2001;1147-1154.
5. Bernard S, Enayati A, Redwood L, Roger H, and Binstock T. /Med.
Hypotheses/ 2001, 56: 462-471.
6. Bernier RH, Frank JA, Nolan TF. Abscesses complicating DTP
vaccination. /Am J Dis Child/ 1981;135:826-828.
7. Blair AMJN, Clark B, Clarke, AJ, Wood, P. Tissue Concentrations of
Mercury after Chronic Dosing of Squirrel Monkeys with Thimerosal.
/Toxicology/ 1975;3:171-1766.
8. Centers for Disease Control and Prevention. Notice to Readers:
Thimerosal in Vaccines: A Joint Statement of the American Academy
of Pediatrics and the Public Health Service. /Morb Mort Wkly Rep/
1999;48:563-565.
9. Cox NH, Forsyth A. Thimerosal allergy and vaccination reactions.
/Contact Dermatitis/ 1988;18:229-233.
10. Davidson PW, Myers GJ, Cox C, Axtell C, Shamlaye C, Sloan-Reeves
J, Cernichiari E, Needham L, Choi A, Wang Y, Berlin M, Clarkson
TW. Effects of prenatal and postnatal methylmercury exposure from
fish consumption on neurodevelopment: Outcomes at 66 months of age
in the Seychelles child development study. /JAMA/ 1998;280:701-707.
11. Fagan DG, Pritchard JS, Clarkson TW, Greenwood MR. Organ mercury
levels in infants with omphaloceles treated with organic mercurial
antiseptic. /Arch Dis Child/ 1977;52:962-964.
12. Federal Register, January 19, 1979;44;3990.
13. Federal Register. November 19, 1999;64:63323-63324.
14. Goncalo M, Figueiredo A, Goncalo S. Hypersensitivity to
thimerosal: the sensitivity moiety. /Contact Dermatitis/
1996;34:201-203.
15. Grabenstein JD. Immunologic necessities: diluents, adjuvants, and
excipients. /Hosp Pharm/ 1996; 31:1387-1401.
16. Grandjean P, Weihe P, White RF et al. Cognitive deficit in 7 year
old children with prenatal exposure to methylmercury.
/Neurotoxicol Teratol/ 1997;6:417-428.
17. Harada M. Minamata disease: Methylmercury poisoning in Japan
caused by environmental pollution. /Crit Rev Toxicol/ 1995;25:1-24.
18. IOM (Institute of Medicine). Thimerosal-containing vaccines and
neurodevelopmental disorders. Washington DC: National Academy
Press; 2001.
19. Lowell HJ, Burgess S, Shenoy S, Peters M, Howard TK. Mercury
poisoning associated with hepatitis B immunoglobulin. /Lancet/
1996:347:480.
20. Magos L, Brown AW, Sparrow S, Bailey E, Snowden RT, Skipp WR. The
comparative toxicology of ethyl- and methylmercury. /Arch Toxicol/
1985,57:260-267.
21. Mahaffey KR, Rice G, et al. /An Assessment of Exposure to Mercury
in the United States: Mercury Study Report to Congress/.
Washington, DC: U.S. Environmental Protections Agency; 1997.
Document EPA-452/R097-006.
22. Mahaffey KR. Methylmercury: A new look at the risks. /Public
Health Rep/ 1999;114:397-413
23. Matheson DS, Clarkson TW, Gelfand EW. Mercury toxicity (acrodynia)
induced by long-term injection of gammaglobulin. /J Pediatr/ 1980:
97:153-155Moller H. All these positive tests to thimerosal.
/Contact Dermatitis/ 1994; 31:209-213.
24. Pfab R, Muckter H, Roider G, Zilker T. Clinical Course of Severe
Poisoning with Thiomersal. /Clin Toxicol/ 1996;34:453-460.
25. Powell HM, Jamieson WA. Merthiolate as a Germicide. /Am J Hyg/
1931;13:296-310.
26. Rohyans J, Walson PD, Wood GA, MacDonald WA. Mercury toxicity
following merthiolate ear irrigations. /J Pediatr/ 1994;104:311-313.
27. Simon PA, Chen RT, Elliot JA, Schwartz B. Outbreak of pyogenic
abscesses after diphtheria and tetanus toxoids and pertussis
vaccine. /Pediatr Infect Dis J/ 1993;12:368-371.
28. U.S. Pharmacopeia 24, Rockville, MD: U.S. Pharmacopeial
Convention; 2001.
29. Wilson GS. The Hazards of Immunization. New York, NY: The Athlone
Press; 1967:75-84.
30. World Health Organization. Trace elements and human nutrition and
health. Geneva: World Health Organization;1996:209.

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*Bibliography*

*Studies on Safety and Effectiveness of Thimerosal:*

1. Batts AH, Narriott C, Martin GP, et al. The effect of some
preservatives used in nasal preparations on mucociliary clearance.
/Journal of Pharmacy and Pharmacology/ 1989; 41:156-159.
2. Batty I, Harris E, Gasson A. Preservatives and biological
reagents. /Developments in Biological Standardization/
1974;24:131-142.
3. Beyer-Boon ME, Arntz PW, Kirk RS. A comparison of thimerosal and
50% alcohol as preservatives in urinary cytology. /Journal of
Clinical Pathology/ 1979;32:168-170.
4. Gasset AR, Itoi M, Ishii Y, Ramer RM. Teratogenicities of
ophthalmic drugs. II. Teratogenicites and tissue accumulation of
thimerosal. /Archives of Ophthalmology/ 1975;93:52-55.
5. Goldman KN, Centifanta Y, Kaufman HF, et al. Prevention of surface
bacterial contamination of donor corneas. /Archives of
Ophthalmology/ 1978;96:2277-2280.
6. Keeven J, Wrobel S, Portoles M, et al. Evaluating the preservative
effectiveness of RGP lens care solutions. /Contact Lens
Association of Ophthalmologists Journal/ 1995;21:238-241.
7. Naito R, Itoh T, Hasegawa E, et al. Bronopol as a substitute for
thimerosal. /Developments in Biological Standardization/
1974;24:39-48.
8. Wozniak-Parnowska W, Krowczynski L. New approach to preserving eye
drops. /Pharmacy International/ 1981;2(4):91-94.

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^1
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#rf1>
FDA's guideline is based in part on a maximum tolerable daily intake
of 30 µg/day of methylmercury from the diet; for purposes of comparison
this would translate to approximately 0.43 micrograms/kg/day for a 70 kg
adult. The FDA recommends that pregnant women, women of childbearing age
who may become pregnant, nursing mothers and young children do not
consume certain kinds of fish that may contain high levels of
methylmercury (i.e., shark, swordfish, king mackerel, and tilefish); see
http://www.cfsan.fda.gov/~lrd/tphgfish.html

^2
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#rf2>
The WHO guideline is expressed as 3.3 µg/kg/week and has been
converted to a daily dose for purposes of comparison.

Table of Contents
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#toc>

-

Related Information

* Mercury in Plasma-Derived Products
<http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/BloodSafety/ucm095529.htm>^2

* Thimerosal in Vaccines Questions and Answers
<http://www.fda.gov/BiologicsBloodVaccines/Vaccines/QuestionsaboutVaccines/ucm070430.htm>^3

-
-

Related Links

* Institute of Medicine (IOM) - Immunization Safety Review: Vaccines
and Autism
<http://www.iom.edu/Reports/2004/Immunization-Safety-Review-Vaccines-and-Autism.aspx>^4
^5
* National Institutes of Health, National Institute of Allergy and
Infectious Diseases
<http://www3.niaid.nih.gov/about/organization/dmid/>^6
* National Academies Press
<http://www.nap.edu/catalog.php?record_id=9899>^7 ^8

-

Contact Us

*

Consumer Affairs Branch (CBER)

* (800) 835-4709
* (301) 827-1800
* ocod@fda.hhs.gov <mailto:ocod@fda.hhs.gov>

Division of Communication and Consumer Affairs

Office of Communication, Outreach and Development

Food and Drug Administration

1401 Rockville Pike

Suite 200N/HFM-47

Rockville, MD 20852-1448

-
http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/UCM096228#t3

PROTECT YOURSELF AND YOUR FAMILY
Consumer Guide to Mercury in Fish

The list below shows the amount of various types of fish that a woman
who is pregnant or planning to become pregnant can safely eat, according
to the Environmental Protection Agency. People with small children who
want to use the list as a guide should reduce portion sizes. Adult men,
and women who are not planning to become pregnant, are less at risk from
mercury exposure but may wish to refer to the list for low-mercury choices.

Protecting yourself -- and the fish: Certain fish, even some that are
low in mercury, make poor choices for other reasons, most often because
they have been fished so extensively that their numbers are perilously
low. These fish are marked with an asterisk (read more below
<http://www.nrdc.org/health/effects/mercury/guide.asp#note1>).

This list applies to fish caught and sold commercially. For information
about fish you catch yourself, check for advisories
<http://www.nrdc.org/health/effects/mercury/sources.asp> in your state.

LEAST MERCURY
Enjoy these fish:
Anchovies
Butterfish
Catfish
Clam
Crab (Domestic)
Crawfish/Crayfish
Croaker (Atlantic)
Flounder***
Haddock (Atlantic)***
Hake
Herring
Mackerel (N. Atlantic, Chub)
Mullet
Oyster
Perch (Ocean)
Plaice
Pollock
Salmon (Canned)****
Salmon (Fresh)****
Sardine
Scallop***
Shad (American)
Shrimp***
Sole (Pacific)
Squid (Calamari)
Tilapia
Trout (Freshwater)
Whitefish
Whiting

MODERATE MERCURY
Eat six servings or less per month:
Bass (Striped, Black)
Carp
Cod (Alaskan)***
Croaker (White Pacific)
Halibut (Atlantic)***
Halibut (Pacific)
Jacksmelt
(Silverside)
Lobster
Mahi Mahi
Monkfish***
Perch (Freshwater)
Sablefish
Skate***
Snapper***
Tuna (Canned
chunk light)
Tuna (Skipjack)***
Weakfish (Sea Trout)

HIGH MERCURY
Eat three servings or less per month:
Bluefish
Grouper***
Mackerel (Spanish, Gulf)
Sea Bass (Chilean)***
Tuna (Canned Albacore)
Tuna (Yellowfin)***

HIGHEST MERCURY
Avoid eating:
Mackerel (King)
Marlin***
Orange Roughy***
Shark***
Swordfish***
Tilefish***
Tuna
(Bigeye, Ahi)***

** Fish in Trouble! *These fish are perilously low in numbers or are
caught using environmentally destructive methods. To learn more, see the
Monterey Bay Aquarium <http://www.mbayaq.org/cr/seafoodwatch.asp> and
the Blue Ocean Institute <http://www.blueoceaninstitute.org/>, both of
which provide guides to fish to enjoy or avoid on the basis of
environmental factors.

*** Farmed Salmon* may contain PCB's, chemicals with serious long-term
health effects.

*Sources for NRDC's guide:* The data for this guide to mercury in fish
comes from two federal agencies: the Food and Drug Administration, which
tests fish for mercury, and the Environmental Protection Agency, which
determines mercury levels that it considers safe for women of
childbearing age.

*About the mercury-level categories: * The categories on the list (least
mercury to highest mercury) are determined according to the following
mercury levels in the flesh of tested fish.

* Least mercury: Less than 0.09 parts per million
* Moderate mercury: From 0.09 to 0.29 parts per million
* High mercury: From 0.3 to 0.49 parts per million
* Highest mercury: More than .5 parts per million

Intro <http://www.nrdc.org/health/effects/mercury/index.asp> | Effects
<http://www.nrdc.org/health/effects/mercury/effects.asp> | Sources
<http://www.nrdc.org/health/effects/mercury/sources.asp> | Protect
Yourself <http://www.nrdc.org/health/effects/mercury/protect.asp> | For
Medical Professionals
<http://www.nrdc.org/health/effects/mercury/medical.asp>

*Related NRDC Webpages:*
Mercury Pollution: An End in Sight?
<http://www.nrdc.org/international/ftoxic.asp> Work begins on a global
treaty to solve the world's mercury pollution problem.
Sustainable Seafood Guide
<http://www.nrdc.org/oceans/seafoodguide/page4.asp>

*Related Websites:*
Zero Mercury Campaign
<http://www.zeromercury.org/UNEP_developments/index.html>

http://www.nrdc.org/health/effects/mercury/guide.asp

Thimerosal Content in Some US Licensed Vaccines

This table was updated October 11, 2011

Vaccine



Brand Name



Manufacturer



* Thimerosal Concentration^1
<http://www.vaccinesafety.edu/thi-table.htm#1.#1.> *



Mercury
mcg/0.5 ml

Anthrax



BioThrax <http://www.fda.gov/cber/label/biopava0131022LB.pdf>



BioPort Corp



0



0

DTaP



Daptacel <http://www.vaccineshoppe.com/US_PDF/DAPTACEL_4757_12-03.pdf>



sanofi pasteur



0



0

Infanrix <http://us.gsk.com/products/assets/us_infanrix.pdf>



GlaxoSmithKline



0



0

Tripedia <http://www.vaccineshoppe.com/US_PDF/Tripedia_4620_4.04.pdf>



sanofi pasteur



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>

DTaP+HepB+IPV



Pediarix <http://us.gsk.com/products/assets/us_pediarix.pdf>



GlaxoSmithKline



0



0

DTaP+Hib



Tr <HTTP://www.vaccineshoppe.com/US_PDF/ActHIB_5122_08.03.06.pdf>iHIBit
<http://www.vaccineshoppe.com/US_PDF/597_05_4043_4058.pdf> (ActHIB+Tripedia)



sanofi pasteur



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>

DTaP+IPV



Kinrix <http://us.gsk.com/products/assets/us_kinrix.pdf>



GlaxoSmithKline



0



0

DTaP+IPV+Hib



Pentacel
<https://www.vaccineshoppe.com/image.cfm?doc_id=11169&image_type=product_pdf>



sanofi pasteur



* 0*



0

DT



Diphtheria & Tetanus Toxoids Adsorbed USP
<https://www.vaccineshoppe.com/image.cfm?doc_id=5972&image_type=product_pdf>



sanofi pasteur



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>

Td



Decavac
<http://www.vaccineshoppe.com/US_PDF/DECAVAC_5082.5083_07.05%20syr_vl.pdf>



sanofi pasteur



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>

Tetanus and Diphtheria Toxoids Adsorbed
<http://www.vaccineshoppe.com/US_PDF/271-83_4152_4153.pdf>



Mass Biolocial Labs



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>



* <http://www.vaccinesafety.edu/thi-table.htm#*#*>

Tdap



Adacel <HTTP://www.vaccineshoppe.com/US_PDF/ADACEL%20_2022396%20_6.06.pdf>



sanofi pasteur



0



0

Boostrix <http://us.gsk.com/products/assets/us_boostrix.pdf>



GlaxoSmithKline



0



0

Tetanus Toxoid



Generic
<https://www.vaccineshoppe.com/image.cfm?doc_id=5976&image_type=product_pdf>



sanofi pasteur



.01%



25

Hib



ActHIB <HTTP://www.vaccineshoppe.com/US_PDF/ActHIB_5122_08.03.06.pdf>



sanofi pasteur



*



*

Hiberix <http://us.gsk.com/products/assets/us_hiberix.pdf>



GlaxoSmithKline



0



0

PedvaxHIB
<http://www.merck.com/product/usa/pi_circulars/p/pedvax_hib/pedvax_pi.pdf>



Merck



0



0

Hib+HepB



Comvax
<http://www.merck.com/product/usa/pi_circulars/c/comvax/comvax_pi.pdf>



Merck



0



0

Hepatitis A



Havrix <http://us.gsk.com/products/assets/us_havrix.pdf>



GlaxoSmithKline



0



0

Vaqta <http://www.merck.com/product/usa/pi_circulars/v/vaqta/vaqta_pi.pdf>



Merck



0



0

Hepatitis B



Engerix-B <http://us.gsk.com/products/assets/us_engerixb.pdf>



GlaxoSmithKline



0



0

Recombivax HB
<http://www.merck.com/product/usa/pi_circulars/r/recombivax_hb/recombivax_pi.pdf>



Merck



0



0

Hep A+B



Twinrix <http://us.gsk.com/products/assets/us_twinrix.pdf>



GlaxoSmithKline



0



0

HPV



Cervarix
<http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf>



GlaxoSmithKline



0



0

Gardasil
<http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf>



Merck



0



0

Influenza 2011/12 Formula



Afluria
<http://www.merck.com/product/usa/pi_circulars/a/afluria/afluria_pi.pdf>



single dose



CSL Limited



0



0

multi-dose



.01%



24.5

Agriflu
<https://www.novartisvaccinesdirect.com/PDF/AgriFlu-PI-2010-2011_approved.pdf>



Novartis



* 0*



* 0*

Fluarix <http://us.gsk.com/products/assets/us_fluarix.pdf>



GlaxoSmithKline



* 0*



* 0*

FluLaval <http://us.gsk.com/products/assets/us_flulaval.pdf>



GlaxoSmithKline



.01%



25

FluMist <http://www.medimmune.com/pdf/products/flumist_pi.pdf>



MedImmune



0



0

Fluvirin <http://www.fda.gov/cber/label/inflchi072106LB2.pdf>



prefilled syringe



Novartis




≤1

multi-dose



.01%



25

Fluzone <HTTP://www.vaccineshoppe.com/US_PDF/Fluzone_2006.2007_7.06.pdf>



all single dose



sanofi pasteur



0



0

multi-dose



.01%



25

Japanese Encephalitis



Ixiaro commercial <http://us.gsk.com/products/assets/us_hiberix.pdf> |
military
<http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM142569.pdf>



Intercell Bio



0



0

JE-Vax
<https://www.vaccineshoppe.com/image.cfm?doc_id=5987&image_type=product_pdf>



sanofi pasteur



0.007%



Meningococcal



Menactra <HTTP://www.vaccineshoppe.com/US_PDF/Menactra_5447_09.06.pdf>



sanofi pasteur



0



0

Menomune-A/C/Y/W-135
<https://www.vaccineshoppe.com/image.cfm?doc_id=10447&image_type=product_pdf>



single dose



sanofi pasteur



0



0

multi-dose



.01%



25

Menveo
<https://www.novartisvaccinesdirect.com/PDF/Menveo_Full_Promotional_PI.pdf>



Novartis



0



0

MMR



M-M-R II
<http://www.merck.com/product/usa/pi_circulars/m/mmr_ii/mmr_ii_pi.pdf>



Merck



0



0

MMR+Varicella



ProQuad
<http://www.merck.com/product/usa/pi_circulars/p/proquad/proquad_pi.pdf>



Merck



0



0

Polio



IPOL
<https://www.vaccineshoppe.com/image.cfm?doc_id=5984&image_type=product_pdf>



sanofi pasteur



0



0

Pneumococcal



Pneumovax 23
<http://www.merck.com/product/usa/pi_circulars/p/pneumovax_23/pneumovax_pi.pdf>



Merck



0



0

Prevnar <http://www.wyeth.com/content/ShowLabeling.asp?id=134>



Wyeth-Ayerst



0



0

Prevnar 13
<http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM201669.pdf>



Wyeth-Ayerst



0



0

Rabies



Imovax <http://www.vaccineshoppe.com/US_PDF/LE4733_Imovax_IM_VS.pdf>



sanofi pasteur



0



0

RabAvert
<http://www.novartisvaccines.com/downloads/diseases-products/us-pl-rabavert.pdf>



Chiron



0



0

Rotavirus



Rotarix <http://us.gsk.com/products/assets/us_rotarix.pdf>



GlaxoSmithKline



0



0

RotaTeq
<http://www.merck.com/product/usa/pi_circulars/r/rotateq/rotateq_pi.pdf>



Merck



0



0

Typhoid Fever



Typhim Vi
<http://www.vaccineshoppe.com/US_PDF/TyphimVi_4928_4929%20_03.05.pdf>



sanofi pasteur



0



0

Vivotif <http://www.bernaproducts.com/PDFs/Vivotif2006PI.pdf>



Berna Biotch



0



0

Varicella Zoster



Varivax <http://www.merckvaccines.com/vaccines/vari/pi_vari.pdf>



Merck



0



0

Zostavax
<http://www.merck.com/product/usa/pi_circulars/z/zostavax/zostavax_pi.pdf>
<http://www.merckvaccines.com/vaccines/vari/pi_vari.pdf>



Merck



0



0

Yellow Fever



YF-VAX <HTTP://www.vaccineshoppe.com/US_PDF/YF-VAX_5055_5056_8.05.pdf>



sanofi pasteur



0



0

1./ A concentration of 1:10,000 is equivalent to a 0.01% concentration
and contains 25 mcg of Hg per 0.5 mL.. Thimerosal is approximately 50%
Hg by weight./
* This product should be considered equivalent to thimerosal-free
products. This vaccine may contain trace amounts (<0.3 mcg) of mercury
left after post-production thimerosal removal; these amounts have no
biological effect. JAMA 1999;282(18) and JAMA 2000;283(16).

<http://www.vaccinesafety.edu/thi-table.htm#Top>

http://www.vaccinesafety.edu/thi-table.htm

Saya Rangkum dari BIO Farma seperti ini :

VAKSIN PABRIK PEMBUAT KOMPOSISI DETAIL
Vaksin Hepatitis B Rekombinan BIO FARMA Setiap 1 ml vaksin mengandung
HBsAg 20 mcg yang teradsorbsi pada Aluminium hidroksida 0,5 mg.
Setiap 0,5 ml vaksin mengandung HBsAg 10 mcg yang teradsorbsi pada
Aluminium hidroksida 0,25 mg.
Seluruh formulasi mengandung Thimerosal 0,01 w/v% sebagai pengawet.
http://www.biofarma.co.id/index.php/detil/items/vaksin-hepatitis-b-rekombinan.html

Vaksin Polio 10 Dosis BIO FARMA Tiap dosis ( 2 tetes = 0,1 ml )
mengandung virus polio tidak kurang dari :
tipe 1 : 106,0 CCID50
tipe 2 : 105,0 CCID50
tipe 3 : 105,5 CCID50
http://www.biofarma.co.id/index.php/detil/items/vaksin-polio-10-dosis.html
Vaksin Polio Bivalen Tipe 1 & 3 BIO FARMA Vaksin polio oral tipe 1 & 3
(bOPV) adalah vaksin bivalen yang mengandung virus Polio tipe 1 & 3 yang
dilemahkan (strain Sabin) yang dibuat pada jaringan ginjal kera. Tiap
dosis (2 tetes = 0,1 ml) mengandung tidak kurang dari 106.0 CCID50 tipe
1 dan 105.8 CCID50 tipe 3. Sukrosa digunakan sebagai penstabil. bOPV
mengandung residu Eritromisin tidak lebih dari 2 mcg dan Kanamisin tidak
lebih dari 10 mcg.
http://www.biofarma.co.id/index.php/detil/items/vaksin-polio-bivalen-tipe-1-3.html

Vaksin FluBio BIO FARMA Tiap dosis vaksin (0,5 ml) mengandung strain :

A / H1N1 15 μg HA

A / H3N2 15 μg HA

B / 15 μg HA

Thimerosal 4 μg
http://www.biofarma.co.id/index.php/detil/items/vaksin-flubio.html
Vaksin Polio 20 Dosis BIO FARMA Tiap dosis (2 tetes = 0,1 ml)
mengandung virus polio tidak kurang dari :
tipe 1 : 106,0 CCID50
tipe 2 : 105,0 CCID50
tipe 3 : 105,8 CCID50
http://www.biofarma.co.id/index.php/detil/items/vaksin-polio-20-dosis.html
Vaksin Hepatitis B Rekombinan Uniject BIO FARMA Setiap 1 ml vaksin
mengandung HBsAg 20 mcg yang teradsorpsi pada Aluminium hidroksida 0,5 mg.
Setiap 0,5 ml vaksin mengandung HBsAg 10 mcg yang teradsorbsi pada
Aluminium hidroksida 0,25 mg.
Seluruh formulasi mengandung Thimerosal 0,01w/v% sebagai pengawet.
http://www.biofarma.co.id/index.php/detil/items/vaksin-hepatitis-b-rekombinan-uniject.html

vaksin campak BIO FARMA Tiap dosis vaksin yang sudah dilarutkan
mengandung :
Virus Campak ³ 1.000 CCID50
Kanamycin sulfat £ 100 mcg
Erithromycin £ 30 mcg
http://www.biofarma.co.id/index.php/detil/items/vaksin-campak.html
Vaksin Polio Monovalent Tipe 1 (mOPV1) BIO FARMA Setiap dosis (2 tetes
= 0,1 ml) mengandung :

Zat berkhasiat : Virus Polio tipe 1 tidak kurang dari 106,0 CCID50

Zat tambahan : Eritromisin tidak lebih dari 2 mcg

Kanamisin tidak lebih dari 10 mcg

Sukrosa 35 % v/v (sebagai zat penstabil)
http://www.biofarma.co.id/index.php/detil/items/vaksin-polio-monovalent-tipe-1-40mopv141.html

Vaksin TT Uniject BIO FARMA Tiap ml mengandung :
Toksoid tetanus yang dimurnikan 20 Lf.
Aluminium fosfat 3 mg
Thimerosal 0,1 mg
http://www.biofarma.co.id/index.php/detil/items/vaksin-tt-uniject.html
Vaksin DT BIO FARMA Tiap ml mengandung : Toksoid difteri yang
dimurnikan 40 Lf.
Toksoid tetanus yang dimurnikan 15 Lf.
Aluminium fosfat 3 mg
Thimerosal 0,1 mg
http://www.biofarma.co.id/index.php/detil/items/vaksin-jerap-dt.html
Vaksin BCG BIO FARMA Vaksin ini adalah vaksin bentuk beku kering yang
mengandung Mycobacterium bovis hidup yang sudah dilemahkan (Bacillus
Calmette Guerin = BCG) dari strain Paris No. 1173-P2.
http://www.biofarma.co.id/index.php/detil/items/vaksin-bcg.html
Vaksin TT BIO FARMA Tiap ml mengandung :
Toksoid tetanus yang dimurnikan 20 Lf.
Aluminium fosfat 3 mg
Thimerosal 0,1 mg
http://www.biofarma.co.id/index.php/detil/items/vaksin-tt.html
Vaksin DTP BIO FARMA Tiap ml mengandung :
Toksoid difteri yang dimurnikan 40 Lf
Toksoid tetanus yang dimurnikan 15 Lf
B, pertussis yang diinaktivasi 24 OU
Aluminium fosfat 3 mg
Thimerosal 0,1 mg
http://www.biofarma.co.id/index.php/detil/items/vaksin-dtp.html
Vaksin BioTT BIO FARMA Tiap dosis (0,5 ml) mengandung :
Toksoid tetanus yang dimurnikan 10 Lf
Aluminium fosfat (sebagai adsorban) 1,5 mg
Thimerosal (sebagai preservatif) 0,05 mg
http://www.biofarma.co.id/index.php/detil/items/vaksin-biott.html
Vaksin DTP â€" HB BIO FARMA Setiap dosis (0.5 ml) mengandung Zat aktif :
Toksoid difteri murni : .............................20 Lf
Toksoid Tetanus murni : ............................. 7,5 Lf
B Pertussis Inaktif : .............................12 OU
HBsAg : .............................10 mcg
Zat tambahan :
aluminium fosfat : .............................1,5 mg
Natrium klorida : .............................4,5 mg
Thimerosal : .............................0,05 mg
http://www.biofarma.co.id/index.php/detil/items/vaksin-dtp-hb.html
Serum Anti Diptheri BIO FARMA Tiap ml mengandung :
Antitoksin difteri 2.000 IU
Fenol 0,25 % v/v
http://www.biofarma.co.id/index.php/detil/items/serum-anti-diptheri.html
Tuberkulin PPD RT 23 (2 TU) BIO FARMA Tiap dosis (0.1 ml) mengandung :

Tuberkulin PPD RT 23………………………………....................

0,04 μg

Chinosol…………………………………….......…….......................

100 μg

Tween 80………………………………………………......................

50 μg
http://www.biofarma.co.id/index.php/detil/items/tuberkulin-ppd-rt-23-402-tu41.html

Serum Anti Bisa Ular BIO FARMA Tiap ml dapat menetralisasi
10 - 15 LD50 bisa ular tanah (Ankystrodon rhodostoma)
25 - 50 LD50 bisa ular belang (Bungarus fasciatus)
25 - 50 LD50 bisa ular kobra (Naja sputatrix)
Dan mengandung fenol 0,25% v/v
http://www.biofarma.co.id/index.php/detil/items/serum-anti-bisa-ular.html
Serum Anti Tetanus BIO FARMA Untuk pencegahan tiap ml mengandung :
Antitoksin tetanus 1.500 IU
Fenol 0,25 % v/v
Untuk pengobatan tiap ml mengandung :
Antitoksin tetanus 5.000 IU
Fenol 0,25 % v/v
http://www.biofarma.co.id/index.php/detil/items/serum-anti-tetanus.html






--
"Knowing is not enough, We must apply. Willing is not enough, We must
do."--Goethe

[Non-text portions of this message have been removed]

2a.

Re: (Sharing) Cerita Pesat Aceh 2

Posted by: "sari_paprika@yahoo.com" sari_paprika@yahoo.com

Wed Dec 21, 2011 10:46 pm (PST)



Great job!
^_^
♥
Powered by Telkomsel BlackBerry®

-----Original Message-----
From: niea_152@yahoo.com
Sender: sehat@yahoogroups.com
Date: Wed, 21 Dec 2011 16:35:00
To: sehat@yahoogroups.com<sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: [sehat] (Sharing) Cerita Pesat Aceh 2

Dear all,

Di ultahnya milis, nyempetin share cerita dari Pesat Aceh 2. Sekalian nyolek medan :)

*PRA PESAT

Dimulai dr dapat jadwal yg fixed setelah ketunda 8bln dr jadwal awal di februari lalu (aq ajuin jadwal dari sebelum lahiran ragha) mulai grasak grusuk ama medan.
Sounding2 di socmed nyari temen utk jd panitia baru selain ranti dan aku, yg daftarin diri cuma 1org. Yuni/ninin pengen jd sukarelawan utk pesat aceh meski belum berkeluarga.

Mulai prepared yg kecil2. Alamat email pesat aceh lama ga bs diakses. Ranti siapin email baru, buat akun twitter pesat aceh, keluar dr beberapa BBG biar hape ga tereak. Begitu medan sounding di milis,baru inget untuk sounding jg.
Besoknya ngekor medan, dan k'ratu edit lalu brotkes via BBM. Mulai satu hari satu org yg daftar. Waktu jalan terus,tp jumlah yg daftar bikin deg2an.
Kali ini ga buka pendaftaran di tempat2 tertentu,via email dan sms doank.
Sponsor?? Sama sekali ga dapat..hehehe..

1minggu menjelang hari H, bunda usul undang kader posyandu. Kebetulan suami kerja di kecamatan,putusin untuk undang bides dan kader posyandu di kecamatan suamiku kerja. Kali ini undang 10 bides dan 10 kader posyandu.
(Mudah2an taon dpn kalo dapat jadwal lagi bisa undang lbh banyak..amin)
Komunikasi ama ranti yg tinggal di lhokseumawe jalan terus,via wattsap,sms,telpon. Kopian materi dikirim dari sana :D
Ama medan tiap hari colek2an..panas dingin terus ya mak..

Begitu pesat aceh punya logo,temen yg kerja di salah satu bank baru ngeh. Nanya apa bisa jadi sponsor, padahal dari kapan tau udh aq tanyain :( tp berhubung udh mau dekat acara,mereka akhirnya ga bisa.

Ninin mulai print brosur,dan nitip di beberapa sekolah,tempat2 umum.
Sampe hari H kita dapat 50peserta.
Jujur sedikit kecewa,pengennya lebih banyak, biar yg dapat pencerahan lebih banyak. Tapi tetap disyukuri yaa..

Yg bikin deg2an lagi,H-3 suami dapat surat resmi dari ibu camat,aku ditunjuk jd manajer kecamatan kegiatan HUT DW di tanggal 18 itu jg karna ketua. DW kecamatannya aku. Duuuhhh...beraniin diri cerita ke bunda (maap ya bun bikin kesel :D), akhirnya ngobrol ke temen2 di kantor suami, mereka ga masalah aq ga datang. jadi aku bisa full di pesat.

Pas jemput dr.anto pun sempet panik. Tadinya mau jemput ama suami dan 2R ikut krna baru jemput mereka di rumah kakakku,eh razan ngantuk ga mau ikut ke bandara.sementara ga mungkin ditinggal di rumah.akhirnya udh jam 3.30 sore itu kabari ninin ikut jemput dr.anto. 2R di rumah ama bapaknya.
Alhasil nyampe bandara pesawat udh landing, dan dr.anto udh duduk maniss nungguin...maaaaapp ya dr.anto.

Oiya,di jalan menuju hotel,sempetin singgah makan tahu goreng. Kata dr.anto makanan sehat, seger lagi..:)

Turunin dr.anto di hotel, kami langsung ke aula,berberes dan janjian ama peserta bazar utk cek tempat. Menjelang magrib,nganter ninin dan pulang.
Abis magrib langsung jalan lagi. Jemput ninin,lalu dr.anto pergi ngopi. Tadinya mau ngajak makan bistik ayam GS,tp pilihan enak duduk di kedai kopi.
Sempet muter2 liat kota juga

Yang bikin deg2an lagi malam minggu itu hujan lebat sampe paginya. Kekhawatiran ada 2: peserta ga semua datang atau acara molor.

*PESAT

Bener!! Ada 11 peserta ga datang, dan jadwal molor 45menit :(
Malah ada peserta yg baru datang di topik terakhir.

Pagi jam 6.30 suami udh ke venue,siapin infocus dan pernak perniknya,sekalian kasi baju panitia ama OB kantor yg diminta sstand by dr hari sabtu. (Bajunya kekecilan semua hehehe)
Jam 8.20 jemput dr.anto sendiri,karna ninin stand by utk peserta yg registrasi ulang. Dr.anto mutusin acara mulai jam 9. Sambil nunggu peserta yg masih berdatangan.

Ada sedikit insiden,10menit mau mulai baru inget microphone lupa disiapin ama suamiku. Minta tolong OB beli baterai mic lagi ujan deres,pake acara motor ninin ngadat. Untung ga jauh tokonya. Takut juga pada tutup karna hari minggu dan ujan pula.

Masuk ke materi MPASI, tadinya mau aku yg bawain,dr.anto blg gpp bliau yg bawain aja, aq selingin doorprize aja.
Padahal malemnya udh bergadang siapin materi lho dok :D

sementara temen2 yg ikut bazar mulai ga sabar,udh jam 12 acara belum menunjukkan tanda2 usai. Yaiyalah, materi padat, dan ga ada peserta yg curi2 cuci mata di bazar. Semua betah di dalam nyimak. Oiya,ada 2 peserta bapak2nya juga. Yg satu malah ikut maju jawab quiz.

Ga tau sukses tidaknya, cuma sedikit kecewa dengan jumlah peserta aja. Tapi terbayar dengan antusiaSnya peserta. Kami terpaksa hanya membuka 4x sesi bertanya karna waktu. Dan dr.anto masih di kelilingi ibu2 abis acara selesai..

*POST PESAT

sampe sekarang ada yg sms minta dibuat lg dan dr.anto tampil lagi :D

Buat bbg sehat aceh. Untuk rangkul alumni pesat. Biar tetap kumpul dan apdet informassi. Mulai bulan depan buat kopdar yg bahas 1 topik (nyontek JPC yak)

Masih banyak yg ga ngeh juga pesat itu apa.meski bolak balik aq kasi link di fb/twitter, jelassin langsung. Pas acara udh kelar baru ngeh dan nyesel maksimal..ckckck..
Jd curcol di twitter,untung di kuatin ama teh dinny,mb ria,dan banyak lg (maap ga ketulis)

Salah satu alumni yg juga member milis mau buat pesat di kantor suami. Mudah2an bisa terealisasi ya..amin

Sudah ada panitia utk pesat aceh 3. Ini inisiatif sendiri bun. Mudah2an dapat jadwal utk 2012..amin

Tinggal kirim laporan pelaksanaan ke mb nia dan bunda..

Support ranti untuk pesat company. Ayo maak..

*UCAPAN TERIMA KASIH

Alhamdulillah member milis asal aceh yg tinggal di lampung bantuin panitia. Amat sangat membantu kebutuhan kami. Langsung bisa di manfaatkan.. (Makasih banyak kak..jd tempat curhat jg pdhl lagi banyak kerja ya kak..maapkeun)

Alhamdulillah dapat bantuan lagi dr temen milis juga, mamanya 2R..tadinya mau beli tas utk materi kit,krna budget ga cukup di cancel. Eh malah di kasih..(˘̩̩̩⌣˘̩̩̩)..thx ya da

Alhamdulillah bisa buat barengan ama medan,dibantuin sangad sama panitia medan..*peluk kenceng satu2 panitia medan*

Terima kasih untuk mba nia yg udh kita "rewelin" minta jadwal.
Terima kasih untuk bunda yg ssupport kita dari jauh.
Terima kasih utk temen2 bbg dan miliss yg udh semangatin kita secara japri,di grup,fb,twitter. Means a lot.
Terima kasih utk dr.anto yg udh mau hadir ditengah segala kekurangan kami..(Mudah2an bisa kerja di aceh or medan..uhuyy)
Terima kasih utk ranti n ninin, yg udh rela capek.cuma dapat tengkiu lagi xixixi..
Terima kasih utk peserta yg udh betah duduk 4jam,mohon maaf atas segala kekurangan panitia.mudah2an ilmunya bermanfaat dan bisa di bagi kpd yg lain (Yg udh join milis,muncul ya)
Terima kasih utk temen2 yg mengisi bazar,mudah2an lancar usahanya abiss ikut bazar.
Terima kasih utk camat baiturrahman, yg bolehin kami pakai aulanya dan segala fasilitasnya..

Mudah2an ketemu lagi di Pesat Aceh 3
(Colek dr.endah :D )

Maap kepanjangan sharingnya. Nunggu medan sharing juga.

Salam


-nia-ibunya Razan Ragha®
@nieafardina

[Non-text portions of this message have been removed]

2b.

Re: (Sharing) Cerita Pesat Aceh 2

Posted by: "Ida Rifai" riffatriffan@gmail.com   farida_indriyani

Wed Dec 21, 2011 10:54 pm (PST)



Huebaaaattt deeh mak 2R iniihhh *toss 2R-nya hehehe*

Smoga bola salju makin bergulir...

Ida
Mama 2R

2c.

Re: (Sharing) Cerita Pesat Aceh 2

Posted by: "Hoesana.Doee" nana.sehat@gmail.com   hoesana_doee

Wed Dec 21, 2011 10:54 pm (PST)



Mak nia,

Baca sharingnya bikin aku tidak bisa berkata kata...
selain mengacungkan jempol dan peluk erat...
Semoga bola salju terus mengelinding tiada henti..

Pada tanggal 22/12/11, alifah davida <alifah.davida@gmail.com> menulis:
> Luarrr biasaaa...
> Semoga niatnya untuk mengadakan PESAT lagi di 2012 terlaksana
> yaaa....Aamiiin.
>
>
> regards,
>
> --Alifah--
>
>
> [Non-text portions of this message have been removed]
>
>
>
> ------------------------------------
>
> Milis SEHAT mengucapkan terimakasih kepada:
> - Asuransi AIA atas partisipasinya sebagai sponsor PESAT Bali 2011
> - PT LG Electronics Indonesia atas partisipasinya sebagai Sponsor Tunggal
> FAMILY FUN DAY MILIS SEHAT 2011.
>
> Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland,
> dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami,
> PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
>
> "Milis SEHAT didukung oleh : CBN Net Internet Access &Website.
> =================================================================
> Milis Sehat thanks to:
> - AIA Insurance as sponsor for PESAT Bali 2011
> - PT LG Electronics Indonesia as exclusive partner of FAMILY FUN DAY MILIS
> SEHAT 2011.
>
> Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk.
> who have consistently sponsored our program, PESAT (Program Edukasi
> Kesehatan Anak Untuk Orang Tua)."
> "SEHAT mailing list is supported by CBN Net for Internet Access &Website.
>
> Kunjungi kami di (Visit us at):
> Official Web : http://milissehat.web.id/
> FB : http://www.facebook.com/pages/Milissehat/131922690207238
> Twitter : @milissehat <http://twitter.com/milissehat/>
> ==================================================================
> Donasi (donation):
> Rekening Yayasan Orang Tua Peduli
> Bank Mandiri
> Cabang Kemang Raya Jakarta
> Account Number: 126.000.4634514
> ==================================================================Yahoo!
> Groups Links
>
>
>
>

--
Dikirim dari perangkat seluler saya

Nana-makphine
"get everychilh happy"

2d.

Re: (Sharing) Cerita Pesat Aceh 2

Posted by: "niea_152@yahoo.com" niea_152@yahoo.com   niea_152

Wed Dec 21, 2011 11:20 pm (PST)



Sepertinya yahoogroups ngulah lagi ya.
Ini postingan td malam, ada yg udh masuk ada yg belum..

Anyway buat mb alif,mb monik yg udh direpotin ama merchandise, buat ida sekali lg, buat mb citra, mb atun, mb aina makasih ya..*kecup*


-nia-ibunya Razan Ragha®
@nieafardina
2e.

Re: (Sharing) Cerita Pesat Aceh 2

Posted by: "VIE" home_vie@yahoo.com   home_vie

Thu Dec 22, 2011 12:09 am (PST)



Makcik yang satu ini emang top markotop deh *hug



-sol-
•BR•
K's Mom


Sent from my KiMChiBerry®
powered by Sinyal Kuat INDOSAT
3a.

OOT: diphtheria outbreak di Indonesia

Posted by: "Ratna Sari" ratnasari00@gmail.com

Wed Dec 21, 2011 11:03 pm (PST)



Berhubung ga punya Twitter, jd kesini aja.

1. Angka difteri di Jatim mencapai 600 kasus (data terakhir). Data per 31
Oktober adlh 484 kasus.
2. Tiap menemukan 1 kasus difteri saja, segera laporkan ke Dinas Kesehatan
setempat utk segera ditindaklanjuti sblm jd wabah. Kasus ini akan
dikonfirmasi dg pemeriksaan mikrobiologi.
3. Banyak kejadian di lapangan, awalnya pasien datang ke dokter (umum) &
dianggap sbg sore throat biasa, kmudian krn keluhan tdk membaik, baru
ketahuan difteri.
4. Dari kasus yg ada di Indonesia: 50% tidak diimunisasi DPT sama sekali,
50% sisanya tidak diimunisasi DPT secara lengkap.

Berikut data yg disampaikan oleh pembicara dr Kemenkes pd case report siang
ini mengenai diphtheria outbreak.

Lessons learned:
1. Inilah akibat dari banyaknya orangtua yg tidak memberikan imunisasi pd
anak2nya.
2. Imunisasi secara lengkap yaa.. Di bawah 1 tahun 3x suntik, umur 18 bulan
diulang, trus 5 thn, trus 10-12 thn.
3. Pentingnya orangtua belajar common problems seperti sore throat, kapan
curiga virus/bakteri, kapan curiga strep throat atau difteri, n imunisasi
tentunya.

Maaf jika kurang berkenan.

Apin

[Non-text portions of this message have been removed]

3b.

Re: OOT: diphtheria outbreak di Indonesia

Posted by: "tristanathan" tristanathan.amadeo@gmail.com   trinovi

Wed Dec 21, 2011 11:06 pm (PST)



sediiiihh banget bacanya dok..
mudah2an semakin banyak ortu yg tergerak untuk melindungi anak mereka ya dok

-ria-

2011/12/22 Ratna Sari <ratnasari00@gmail.com>

> **
>
>

[Non-text portions of this message have been removed]

3c.

Re: OOT: diphtheria outbreak di Indonesia

Posted by: "arianyhy@gmail.com" arianyhy@gmail.com   ariany_hy

Wed Dec 21, 2011 11:22 pm (PST)



Maaf ga potek..
Di twitter, .. Salah satu penganut "ASI dan tahnik saja sebagai pengganti vaksin " , dengan yakinnya berkata bahwa : "100% kasus di jatim adalah anak2 yg divaksin. Anak yg tidak divaksin sehat luar biasa."

Geregetaaannnn.... :( dari mana dia yakin dapat data itu... Padahal data dibawah sudah jelas

"Dari kasus yg ada di Indonesia: 50% tidak diimunisasi DPT sama sekali,
50% sisanya tidak diimunisasi DPT secara lengkap"


Terima kasih dokter apin..

Regards,
Ariany
Sent from my AXIS Worry Free BlackBerry® smartphone

-----Original Message-----
From: Ratna Sari <ratnasari00@gmail.com>
Sender: sehat@yahoogroups.com
Date: Thu, 22 Dec 2011 14:03:15
To: sehat@yahoogroups.com<sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: [sehat] OOT: diphtheria outbreak di Indonesia

Berhubung ga punya Twitter, jd kesini aja.

1. Angka difteri di Jatim mencapai 600 kasus (data terakhir). Data per 31
Oktober adlh 484 kasus.
2. Tiap menemukan 1 kasus difteri saja, segera laporkan ke Dinas Kesehatan
setempat utk segera ditindaklanjuti sblm jd wabah. Kasus ini akan
dikonfirmasi dg pemeriksaan mikrobiologi.
3. Banyak kejadian di lapangan, awalnya pasien datang ke dokter (umum) &
dianggap sbg sore throat biasa, kmudian krn keluhan tdk membaik, baru
ketahuan difteri.
4. Dari kasus yg ada di Indonesia: 50% tidak diimunisasi DPT sama sekali,
50% sisanya tidak diimunisasi DPT secara lengkap.

Berikut data yg disampaikan oleh pembicara dr Kemenkes pd case report siang
ini mengenai diphtheria outbreak.

Lessons learned:
1. Inilah akibat dari banyaknya orangtua yg tidak memberikan imunisasi pd
anak2nya.
2. Imunisasi secara lengkap yaa.. Di bawah 1 tahun 3x suntik, umur 18 bulan
diulang, trus 5 thn, trus 10-12 thn.
3. Pentingnya orangtua belajar common problems seperti sore throat, kapan
curiga virus/bakteri, kapan curiga strep throat atau difteri, n imunisasi
tentunya.

Maaf jika kurang berkenan.

Apin


[Non-text portions of this message have been removed]



[Non-text portions of this message have been removed]

4a.

Re: Epilepsi

Posted by: "Endah" endahgunawan@ymail.com

Wed Dec 21, 2011 11:04 pm (PST)



Gak menular Bu. Kan udah baca :-)

Endah

5.

Re: OOT: Diphtheria outbreak di Indonesia

Posted by: "F.B.Monika" f_monika_b@yahoo.com   f_monika_b

Wed Dec 21, 2011 11:14 pm (PST)



TFS dr Apin..Saya bantu sebarkan via twitter..supaya g SOL tmbhn referensi :

http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-dtap.pdf

F.B.Monika

6a.

Re: baca ttg konstipasi dan Hirschsprung's Disease jadi khawatir..

Posted by: "gita Nasution" gitamuu@yahoo.com   gitamuu

Wed Dec 21, 2011 11:26 pm (PST)



mba Hilda..hahaha...malah elmonya yg suka dia suapin mkn sm minum..smbil niruin aku dgn versi lebaynya dia..hihihihi...
aku coba boneka elmonya yg nasehatin dia..hihihi..makasih mba sarannya... :)

gita

[Non-text portions of this message have been removed]

7a.

Re: re : Ask-Urgent: IUFD di 28 minggu, what to do?

Posted by: "nisriin usman" nisriinusman@gmail.com

Wed Dec 21, 2011 11:34 pm (PST)



Turut berduka. Maaf hanya ingin menyampaikan rasa duka senger cerita
saudara mba intan dan, mba nia dan mom's yang mebgalami pengalamn ygvsama

Maaf menuh menuhin inbox cuma dihati terasa perih. Dnger ceritanya mg tabh
dan diberikan kekeuatan

Maaf ga banyak bantu

Diba

Mama ibrahim n nisriin
(ga tega sama anak suka ngomel hiks)

[Non-text portions of this message have been removed]

8a.

Re: (Oot) tas lapis aluminium. u/ bekal.

Posted by: "pria ardhana" priaardhana@yahoo.co.uk   priaardhana

Thu Dec 22, 2011 12:02 am (PST)



TK udah masuk siang, bahkan sampai jam 13..??

________________________________
From: Sisilia <sisil.mahadaya@gmail.com>
To: sehat@yahoogroups.com
Sent: Monday, 6 June 2011, 8:38
Subject: Re: [sehat] (Oot) tas lapis aluminium. u/ bekal.


 
Mbak,

Sharing aaah,
anak sy, kemarin masuk tk pas 4 thn... Saat masuk pagi jam 7-9.45, bekal sy bwkan untuk snack: mashed potato, makaroni saus daging, oatmeal keju ... Snack tpo sedikit berat. Wkt masuk siang jam 10.15-13, sy bawakan yg agak lebih berat, asumsinya dia makan siang di sekolah. Kalau ga habis, sampai rmh dia habiskan sambil sy temani makan siang.
Biasanya nasi, lauk sayur lengkap atau one dish meal jg kadang kayak mie goreng isi sayur/ayam

Nah, sy nggak kepikiran malah pakai kemasan/tas khusus. Krn sy dr awal bilang bhw dia hras bw tas sendiri (sy jalan kaki 5-7 menit ke sekolah). Jd makanan dan minuman semua masuk ke tas. Paling sy ilih kotak makan yg lebarnya pas masuk tasnya dengan posisi normal menghadapo ke atas, bukan miring, supaya nggak berantakan kalau sy pas bikin bentuk lucu2 di kotak makannya.

Kalau bawa sayur biasanya di kotak terpisah yg gak akan tumpah, tp bs ditumpuk di tasnya. Jd anak sy cuma bw 1 tas ke sekolah, dan pulang pergi bs membawa sendiri tasnya.

Soal tas alumunium biasanya unt membuat makanan tahan hangaty/dingin kalo ga salah ya... 2 jam sih kata teman sy msh cukup hangat. Cuma kalau sy nggak perlu hangat makanannya, jd nggak pakai tas itu.

Oiya, bekal sekolah nggak perlu banyak2... Secukupnya aja, supaya anak bangga saat bisa menghabiskan bekalnya. Nanti di rumah bs diajak makan kan...

Itu aja sharing sy...

Maaf kalau nggak berguna dan gak menjawab:D

Sisil
@sisilmahadaya


[Non-text portions of this message have been removed]

8b.

Re: (Oot) tas lapis aluminium. u/ bekal.

Posted by: "VIE" home_vie@yahoo.com   home_vie

Thu Dec 22, 2011 12:17 am (PST)



Mungkin maksudnya mba sisil itu jam masuknya beda kali ya. Bukan dr jam 7-13. -sol-


#anyway trit uda lama nih




•BR•
K's Mom


Sent from my KiMChiBerry®
powered by Sinyal Kuat INDOSAT
9.1.

Daftar Sementara Pemesanan Buku_VERSI 5

Posted by: "/ghozansehat" ghozansehat@yahoo.com.sg   ghozansehat

Thu Dec 22, 2011 12:13 am (PST)



dear sp's

untuk pemesanan berikutnya bisa lanngsung menghubungi
Ibu Dyah Prima : dyahprima@gmail.com

beliau selanjutnya yg akan membantu kita untuk mendatanya.

terima kasih

NO NAMA EMAIL Q&A BAYIKU

1 Anggi anggi.mariana@xxxxxxx 2 2
2 Dipa dipa.consultant@xxxxxxx 2
3 Lia holia.wati@xxxxxxx 1 1
4 Mi yun bongmiyun@xxxxxxx 5 5
5 Nur Rahadiani diansoemawinata@xxxxxxx 5 5
6 Ninik sdlarasati@xxxxxxx 5
7 Dini mamanya_nabila@xxxxxxxxxxx 3
8 Nataria tari_romzi@xxxxxxx 3 3
9 Rini greeny_love@xxxxxxx 3
10 Rika rika_elfira@xxxxxxx 10 10
11 Ferry ftj@xxxxxxxx 10 10
12 Mila Novita mila.novita.911@xxxxxxx 1 1
13 Anind anind3x@xxxxxxx 4
14 Vemy vemytrisnawaty@xxxxxxx 2 1
15 amm amm_mee@xxxxxxx 1 1
16 Endrawati Endrawati.Saleh@xxxxxxxxxxxxx 10 10
17 Nancy nankrist@xxxxxxx 100 100
18 Windy wrdolphin@xxxxxxx 3
19 Hanny thena_bunda@xxxxxxx 2 2
20 Herlina lina_maniezok@xxxxxxx 2 2
21 Hilda hilda.iriany@xxxxxxx 50
22 Vivien vivienandriyani@xxxxxxx 2 2
23 Wuri wurihandayani.nugroho@xxxxxxx 3
24 Caeshi caishie.sabrina@xxxxxxx 1
25 Siska siskafadlika@xxxxxxx 100 100
26 Ami amianakbinus@xxxxxxx 6 6
27 Viyenti tviyenti@xxxxxxx 5 5
28 Sarie nj_sarie@xxxxxxx 2 2
29 MeiDalia meidalia.maliki@xxxxxxx 2 2
30 Pipin yosephine@xxxxxxx 3
31 Ary arsantika@xxxxxxx 1
32 Dian madedian@xxxxxxx 2 2
33 Mayang ms_marchainy@xxxxxxx 3 3
34 Ryan ryanherdian@xxxxxxx 1 1
35 Santi santi.mufi@xxxxxxx 2
36 Agus S agus.susanto17@xxxxxxx 1 1
37 Imelda imeldamarliana@xxxxxxx 1
38 Akmal akmal.arsenio@xxxxxxx 1 1
39 Cheril cheril.mycat@xxxxxxx 1 1
40 Nurasiah Nurasiah@xxxxxxxxxxxxx 1
41 Dyah S ds_ri2n@xxxxxxx 3 3
42 Fitriana fitrieyds@xxxxxxx 2 2
43 Maria mariasehat@xxxxxxx 1
44 Senri s_irnes@xxxxxxx 2
45 Ariska r3nnee@xxxxxxx 2 1
46 Rieza rieza.numan@xxxxxxx 5 1
47 Prita meprita_84@xxxxxxx 1 1
48 Lina dwi.erlinae@xxxxxxx 5 5
49 Jully cr_ibunyakmt@xxxxxxx 1 1
50 Dita anindita85@xxxxxxx 5 3
51 Esther esihombing@xxxxxxx 2 2
52 Nadhia nonni_na@xxxxxxx 10
53 Sesy sesy83@xxxxxxx 2
54 Yulianti julieaminingsih@xxxxxxx 2 2
55 Elin elin_s05@xxxxxxx 5 1
56 Chici chici.ernest@xxxxxxx 5 5
57 Rusmina rosshy77@xxxxxxx 5
58 Meydi si.kacamata@xxxxxxx 5 1
59 Aina aina.anwar@xxxxxxx 3 1
60 Iin wening2007@xxxxxxx 1
61 Amalia leamiranti@xxxxxxx 1 1
62 Marcia msahusilawane@xxxxxxx 5 5
63 Mira handayani imelnyamira@xxxxxxx 1 1
64 Rezka lopelope_funky@xxxxxxx 1 1
65 Ika luc14_ika@xxxxxxx 3 1
66 Yanie fab_fabiana@xxxxxxx 1 1
67 Tika tika_ktk@xxxxxxx 4 4
68 Annie annie_vega05@xxxxxxx 2 2
69 Ery ery_ayukusumawati@xxxxxxx 1 1
70 Ulfa ulfa.danu@xxxxxxx 1
71 Devy d3v1_vie@xxxxxxx 1
72 Santy asamisunt@xxxxxxx 4 4
73 Vie home_vie@xxxxxxx 2 3
74 Amanda amandatikamayang@xxxxxxx 1 1
75 Sany sany@xxxxxxxxxxx 2
76 Lely hapsari_lely@xxxxxxx 5 2
77 Syifa snuufysyifa@xxxxxxx 2 2
78 Ina ina@xxxxxxxxxxxx 1 1
79 Alno alnolaselena_jtk03@xxxxxxx 3
80 Selvi nmselvi@xxxxxxx 1
81 Natalia the_sign08@xxxxxxx 1 1
82 Diana Irawati dna_ira@xxxxxxx 3
83 Dinny umialiyah_dzatil@xxxxxxx 3 3
84 Fitri santi.mufi@xxxxxxx 2 2
85 Diana bachtiar diana.bachtiar@xxxxxxx 2
86 Lisvi lisvi_na@xxxxxxx 2 1
87 Rita opletjadul@xxxxxxx 1
88 Dini dini_jusidira@xxxxxxx 1 1
89 Rahmi rahmiandarini@xxxxxxx 2
90 Carolyna gilbygaile@xxxxxxx 2
91 Endang ina5712@xxxxxxx 1
92 Hanna hanna.yuliwanty@xxxxxxx 1 1
93 Marcella Marcella.KASIH@xxxxxxxxxxxx 10 10
94 Qiqie deswita.nashwa@xxxxxxx 1
95 Diana Wijaya diana_oei_81@xxxxxxx 10 10
96 Novie tarmasis@xxxxxxx 1
97 Kristiyanti kristiyanti_ed@xxxxxxx 15
98 Yuni jtriekowati@xxxxxxx 3
99 Evi septiani eviseptiani@xxxxxxx 2
100 Wulan wulan.wuls@xxxxxxx 10 10
101 Evi Kusuma evi_y_kusuma@xxxxxxx 2
102 Sibarani joice_celine@xxxxxxx 2
103 Amanda Kania amandaunique@xxxxxxx 3 1
104 Tera Mayang teramayang@xxxxxxx 3 5
105 Susilowati susilowati.4r@xxxxxxx 3
106 Ppei jaqueen.king@xxxxxxx 2 2
107 Rosianna a_rosianna@xxxxxxx 2 2
108 Rani kirana ranipkirana@xxxxxxx 1 1
109 Devie leonisa waitybear@xxxxxxx 2 2
110 Meirina meirina23@xxxxxxx 3 3
111 Lilis lilis_pinky@xxxxxxx 5 2
112 Indah indah.anggita@xxxxxxx 10
113 Oktaviani caplixs_vi@xxxxxxx 5 3
114 Yosy Natalya yosy_nana@xxxxxxx 2 2
115 Ocha rzanziwar@xxxxxxx 1 1
116 Yuliafitri yuliafitri.utami@xxxxxxx 1 1
117 Dhani baretaramadhani@xxxxxxx 2 1
118 Yani febrianti yani.febriyanti@xxxxxxx 1 1
119 Nida f4_r14_m451@xxxxxxx 2 2
120 Agustina agustinav3@xxxxxxx 4
121 Rika ykusumatuti@xxxxxxx 1
122 Nisa a_neesa@xxxxxxx 3
123 Djati indiradewie@xxxxxxx 1
124 Novitasari novitasari.dian@xxxxxxx 1
125 Anna Sholihah anna.ns@xxxxxxx 1
126 Ayoe ay_ayoe@xxxxxxx 1 1
127 Anin nien_as@xxxxxxx 2 2
128 Meta metahanindita@xxxxxxx 1
129 Tuti Nurmala tututi_nurmala@xxxxxxx 2 1
130 Anche anche.simatupang@xxxxxxx 1 1
131 Nanda goofypinkku83@xxxxxxx 3 3
132 Stevy stevy_e@xxxxxxx 2
133 Nia Mara nia.mara@xxxxxxx 1
134 Retno retno.purwandari@xxxxxxx 1
135 Ratih rciptaningdyas@xxxxxxx 2
136 Andini andiniokto@xxxxxxx 1 2
137 Maria saragih maria_saragih@xxxxxxx 1 1
138 Herni niew2@xxxxxxx 1
139 Catherine cath_susantio@xxxxxxx 1 1
140 Yunita yunita.sukata@xxxxxxx 5 1
141 Rini rini140885@xxxxxxx 1
142 Sherry sherry_saptaulan@xxxxxxx 1 1
143 Lia Teguh liateguh@xxxxxxx 2
144 Nita nyun_figaro@xxxxxxx 2 2
145 Mira mira.amelia.maharani@xxxxxxx 1
146 Nunu nunumedia@xxxxxxx 1
147 Lina lina.twin09@xxxxxxx 1
148 Ira mons_club@xxxxxxx 2
149 Deasy drahmayanty@xxxxxxx 1
150 Asriani asriani_hari@xxxxxxx 10
151 Aisyah raisyakoe@xxxxxxx 1 1
152 Khonic khonic_ds@xxxxxxx 1 1
153 Ambar ambar.wardhani@xxxxxxx 1 1
154 Regia just.regia@xxxxxxx 4 4
155 Ajeng ajenghc@xxxxxxx 5 1
156 Prita nicoll nicoll.prita@xxxxxxx 2 2
157 Dewi agustina dewi_agustina@xxxxxx 1 2
158 Andrys andryserawan@xxxxxxx 2 2
159 Wulandari wulan.ndeari@xxxxxxx 2 1
160 Andriana andheew@xxxxxxx 1 1
161 Gilda fgilda@xxxxxxx 1
162 Iffah hehefafa@xxxxxxx 1 1
163 Marliyana nu.marliy@xxxxxxx 1
164 Lia Julianti lee_niez@xxxxxxx 10
165 Nanin nanin.salam@xxxxxxx 1
166 Yeptirani sehat.syari@xxxxxxx 5 1
167 Dian Nov dinovianthi@xxxxxxx 2 2
168 Mei meiree26@xxxxxxx 3
169 Detha dethadelta@xxxxxxx 1 1
170 Nuning narsyas_mine@xxxxxxx 1
171 Ade Novita ade.novita.juliano@xxxxxxx 5 5
172 Primianti primianti_m@xxxxxxx 2
173 Rikades rikades@xxxxxxx 1
174 Adriani d.adriani@xxxxxxx 1 1
175 Ninies niskalala@xxxxxxx 1 1
176 Anggina anggina_diksita@xxxxxxx 1 1
177 Mamameyva mamameyva@xxxxxxx 2 1
178 Mira amelia mira.amelia.maharani@xxxxxxx 1
179 Candra Rudy shen2403@xxxxxxx 20 10
180 Angga rahadian ansira_ramadhan@xxxxxxx 2 2
181 Vera verasinambela@xxxxxxx 1 1
182 Gusni gusni_ayu@xxxxxxx 5
183 Diah Utari deeach83@xxxxxxx 1 1
184 Leny kurnia leny1804@xxxxxxx 2
185 Yunita yunita.angg@xxxxxxx 6 4
186 Risma bunda_fazil@xxxxxxx 5
187 Shinta Novita shintano.1912@xxxxxxx 1
188 Nada nada.arini@xxxxxxx 1 1
189 dr. Endah endahgunawan@xxxxxxx 10 10
190 Fanie tifani.adilla@xxxxxxxx 1 1
191 Cholifah cholifah_umi@xxxxxxx 2 2
192 Helen helen.gunawan@xxxxxxx 1
193 Hernita meetha_munaf@xxxxxxx 2
194 Nisaa Dwityarahma icha_belle@xxxxxxx 1 1
195 Ribka allyka.abelle@xxxxxxx 2 2
196 Ratna Wulan srwulan@xxxxxxx 5
197 Denella denella.hadibroto@xxxxxxxx 5 1
198 Erika heidy_jo@xxxxxxx 1 1
199 Anindhita inidhita@xxxxxxx 1 1
200 Istiwahyuni istiwahyuni@xxxxxxx 1 1
201 Intan intanariestya@xxxxxxx 10 10
202 Mira Savitri mira_v3@xxxxxxx 1
203 Antie bundakau@xxxxxxx 2 1
204 Ira nonejulz@xxxxxxx 10 10
205 Sitti sitti_aeni@xxxxxxx 2 1
206 Ardhana priaardhana@xxxxxxx 1 1
207 Rahma dewi r4hmadewi@xxxxxxx 2 2
208 Melly eng7047@xxxxxxxxx 2 1
209 Rustina Yuli yuli@xxxxxxxxxx 1 1
210 Renky renky@xxxxxxxxxxx 2 2
211 Elisabeth Elisabeth.Subagyo@xxxxxx 5 5
212 Anandhi pussycat_dora@xxxxxxx 2 1
213 Rizaini lituhayu@xxxxxxx 5 5
214 Linda Meilani nda_meilani@xxxxxxx 2 2
215 Indri handriani indrihandriani@xxxxxxx 1
216 Yasmine Tobing yasmine.nauli@xxxxxxx 1 1
217 Chulaifah c_fikriyah@xxxxxxx 2
218 Rina Palmira rpalmira@xxxxxxx 3 3
219 Lestari maya maya.lestari@xxxxxxxxxx 1 1
220 Fance Indah d3f4r0@xxxxxxx 2
221 Hesti Natalia natalia_hesti@xxxxxxx 5 5
222 Erlyn amien e2osalyn@xxxxxxx 2 2
223 Yoyoh Komariah yoyoh@xxxxxxx 5
224 Okky okky.riani@xxxxxxx 2 2
225 Atika ibu.jauza@xxxxxxx 5
226 Pamelia hidupsehat.pam@xxxxxxx 2
227 Budiasih Dyah chic_callista@xxxxxxx 5 5
228 Tiwi kalbu8381@xxxxxxx 1 2
229 Esti Nurhayati esti.nurhayati@xxxxxxx 1 1
230 Eka Pujaastuti ekapujaastuti@xxxxxxx 2 2
231 Anastasia anastasia.sabon@xxxxxxx 1
232 Yenny yennyko@xxxxxxx 1 1
233 Suzan coechen_rsb@xxxxxxx 15 5
234 Sophia staceyelizabeth11@xxxxxxx 2 2
235 Nilam Sari nilamku@xxxxxxx 2 2
236 Retti retti.syafriani@xxxxxxx 1
237 Antie bundakau@xxxxxxx 1 1
238 Asriani asriani_hari@xxxxxxx 10
239 Dianti dianti@xxxxxxx 5 2
240 Oktavera oktavera02ub@xxxxxxx 1 1
241 Eddith sisca.eddith@xxxxxxx 1 1
242 Lydia Amrina l_amrina@xxxxxxx 2
243 Ana Agustina fariandani@xxxxxxx 1 1
244 Prinka prinkablue@xxxxxxx 1
245 Yuanita tinggal_ketik_nita@xxxxxxx 2 2
246 Desy melia_desiana@xxxxxxx 4 1
247 Indrii indrii.putri@xxxxxxx 2 2
248 Desty farlina desty_farlina@xxxxxxx 4 5
249 Ummi farikhah farikhahlilmuttaqin@xxxxxxx 1 1
250 Tina Dariyan tina.dariyan@xxxxxxx 1 1
251 Sari Alamanda sari.alamanda@xxxxxxx 1
252 Viona vjlollipop@xxxxxxx 1
253 Julia bund4.khansa@xxxxxxx 1 1
TOTAL 891 633

10a.

Re: Met Ultah Sewindu Milis Sehat

Posted by: "romzy@cbn.net.id" romzy@cbn.net.id   romzy

Thu Dec 22, 2011 12:19 am (PST)



Yang hebat ya Dr Wati, she is inspiring us

----- Original Message -----
From: "/ghz" <ghozan10032005@gmail.com>
To: <sehat@yahoogroups.com>
Cc: <romzy@cbn.net.id>
Sent: Thursday, December 22, 2011 9:52 AM
Subject: Re: Met Ultah Sewindu Milis Sehat

> On 12/22/2011 9:38 AM, romzy@cbn.net.id wrote:
>> Dr Wati, dear Moderator, member millis
>> Iya, itu tahun anak saya kedua lahir, pada saat itu saya dikirimi email
>> terus menerus ntk dibaca dari Dr Wati, yg sdh sejak 2001 saya kenal (anak
>> pertama)
>> Saya kagum, kok ada yah Dr. yg rajin mendidik pasiennya
>> Ngobrol2, lalu saya tawarkan ntk membentuk millis, krn akan sangat
>> mempermudah Dr. Wati dlm berkomunikasi dng pasiennya
>>
>> Nah itulah tgl 19 Des 2003 saya membuka akun Sehat, terus saya email Dr.
>> Wati sambil mengirimkan linknya, 21 Des 2003 saya menerima posting
>> pertama
>>
>> Alhamdulillah berkat para mod yg org tua cerdas, inisiasi Dr Wati
>> disambut baik hingga hari ini
>>
>> Selamat yah ntk semua Mod. Anggota, dan para dokter serta Dr wati
>> Semoga menjadi amalan yg manfaat sepanjang masa
>>
>> Thx GHZ for remind me
>> Wass
>> Romzy
>>
> wow.....
> luar biasaaaaaaaa
>
> jadi anak kedua sekarang dah 10tahun yah pak...
> jangan2 anak yg pertama dah mau mantu pak...:)
>
> terima kasih juga pak romzy
> semoga bapak sekeluarga sehat selalu dan dimudahkan dalam setiap gerak
> langkahnya.amiiin
>
> quote:
> Semoga menjadi amalan yg manfaat sepanjang masa
>
> saya ikut mengamini pak.
>
> wassalam
> ghz

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