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Ocular sensitivity to thimerosal: a problem with hepatitis B vaccine?
1Department of Medicine, Emory University Hospital, Atlanta, GA 30322.
Southern Medical Journal
|May 1, 1990
Summary
Hepatitis B vaccine administration in individuals with ocular sensitivity to thimerosal is debated. A small study found no adverse reactions in nine vaccinated employees, suggesting further investigation is needed.
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.