A Cross-Sectional Study of the Association between Infant Hepatitis B Vaccine Exposure in Boys and the Risk of Adverse Effects as Measured by Receipt of Special Education Services.

David Geier,Janet Kern,Mark Geier,Kristin Homme

doi:10.3390/ijerph15010123

Abstract

The National Center for Education Statistics reported that between 1990–2005 the number of children receiving special education services (SES) rose significantly, and then, from 2004–2012, the number declined significantly. This coincided with the introduction of Thimerosal-containing hepatitis B vaccine in 1991, and the subsequent introduction of Thimerosal-reduced hepatitis B vaccine in the early 2000s. This study examined the potential relationship between infant exposure to mercury from three doses of Thimerosal-containing hepatitis B vaccine and the risk of boys being adversely affected (as measured by receipt of SES). This cross-sectional study examined 1192 boys (weighted n = 24,537,123) 7–8 years of age (born: 1994–2007) from the combined 2001–2014 National Health and Nutritional Examination Survey (NHANES). Survey logistic regression modeling revealed that an exposed population receiving three doses of infant Thimerosal-containing hepatitis B vaccine (weighted n = 11,186,579), in comparison to an unexposed population (weighted n = 704,254), were at an increased risk of receipt of SES. This association was robust (crude odds ratio = 10.143, p = 0.0232), even when considering covariates, such as race and socioeconomic status (adjusted odds ratio = 9.234, p = 0.0259). Survey frequency modeling revealed that receipt of SES for the population that was exposed to three doses of Thimerosal-containing hepatitis B vaccine in infancy (12.91%) was significantly higher than the unexposed population (1.44%) (prevalence ratio = 8.96, p = 0.006, prevalence attributable rate = 0.1147). Despite the limitation of this cross-sectional study not being able to ascribe a direct cause-and-effect relationship between exposure and outcome, it is estimated that an additional 1.2 million boys received SES with excess education costs of about United States (US) $180 billion associated with exposure to Thimerosal-containing hepatitis B vaccine. By contrast, exposure to Thimerosal-reduced hepatitis B vaccine was not associated with an increased risk of receiving SES. Therefore, routine childhood vaccination is important to reduce the morbidity and mortality of infectious diseases, but every effort should be made to eliminate Thimerosal from all vaccines.

Highlights

In 1975, the Individuals with Disabilities Education Act (IDEA) mandated that a child who has a disability adversely impacting academic performance and who is in need of special education and related services should receive a free and appropriate public school education
An overall population of 1192 boys born from 1994–2007 between the ages of 7 and 8 years old, with non-missing values for the demographic, immunization, and special education status variables that were examined in this study was created by combining data from the 2001–2014 National Health and Nutritional Examination Survey (NHANES)
The overall exposed group receiving three doses of infant hepatitis B vaccine (n = 1115, weighted n = 22,994,525) was similar to the overall unexposed group receiving no doses of hepatitis B vaccine (n = 77, weighted n = 1,542,598) for age, birth year, race, and socioeconomic status

Summary

Introduction

In 1975, the Individuals with Disabilities Education Act (IDEA) mandated that a child who has a disability adversely impacting academic performance and who is in need of special education and related services should receive a free and appropriate public school education. Special education services include different disability categories or types. Most special education services cover a specific learning disability and/or speech/language impairment. The bulk of the remainder covers other health impairments, including autism, intellectual disability, developmental delay, and emotional disturbance. The remaining small percentage includes multiple disabilities, hearing impairment, and orthopedic impairment. Data collection activities under IDEA began in 1976 and as such, data on the numbers of children and youth receiving special education services over the years is publicly available

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