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Ocular Sensitivity to Thimerosal: A Problem With Hepatitis B Vaccine?

Strict interpretation of the package insert for hepatitis B vaccine (Heptavax-B and Recombivax HB) would preclude its administration to anyone with a history of ocular sensitivity to thimerosal, but data to support this are hard to find. Given the large number of vaccinees, many of whom wear contact lenses, reported cases of significant adverse reactions are sparse. No studies have directly addressed the ocular sensitivity issue. For two years, we monitored an immunization program for hospital employees. Ten employees (2.2%) gave a history of ocular sensitivity to thimerosal. Nine were vaccinated, without untoward reactions. This small series does not resolve the safety issue and should not be so interpreted. Likewise, the question of danger remains unanswered. If others administering the vaccine would ask the proper questions, sufficient numbers could be generated and reported that would either support the contraindication, or lead to a change in its present wording.