Ocular sensitivity to thimerosal: a problem with hepatitis B vaccine?

Area of Science:

• Immunology
• Vaccinology
• Ophthalmology

Background:

• Hepatitis B vaccines (Heptavax-B, Recombivax HB) package inserts suggest contraindication for those with ocular sensitivity to thimerosal.
• Limited data exist regarding adverse ocular reactions to thimerosal in vaccine recipients, despite widespread use and contact lens wear.

Purpose of the Study:

• To investigate the incidence of adverse ocular reactions in hospital employees receiving hepatitis B vaccine who reported a history of ocular sensitivity to thimerosal.

Main Methods:

• A two-year prospective monitoring of an immunization program for hospital employees.
• Inquiry into history of ocular sensitivity to thimerosal among vaccine recipients.
• Documentation of any adverse reactions post-vaccination.

Main Results:

• Ten employees (2.2%) reported a history of ocular sensitivity to thimerosal.
• Nine of these employees were vaccinated with hepatitis B vaccine.
• No significant adverse ocular reactions were observed in the vaccinated individuals.

Conclusions:

• This small series suggests that hepatitis B vaccination may be safe for individuals with a history of ocular thimerosal sensitivity, but does not definitively resolve safety concerns.
• Further studies with larger cohorts are required to confirm these findings and inform package insert recommendations.
• Encouraging proper questioning during vaccination could generate more data to support or refute the current contraindication.