{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:22:29Z","timestamp":1762867349274,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2018,1,12]],"date-time":"2018-01-12T00:00:00Z","timestamp":1515715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The National Center for Education Statistics reported that between 1990\u20132005 the number of children receiving special education services (SES) rose significantly, and then, from 2004\u20132012, 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\u20138 years of age (born: 1994\u20132007) from the combined 2001\u20132014 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.<\/jats:p>","DOI":"10.3390\/ijerph15010123","type":"journal-article","created":{"date-parts":[[2018,1,15]],"date-time":"2018-01-15T04:01:55Z","timestamp":1515988915000},"page":"123","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["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"],"prefix":"10.3390","volume":"15","author":[{"given":"David","family":"Geier","sequence":"first","affiliation":[{"name":"Institute of Chronic Illnesses, Inc., Silver Spring, MD 20905, USA"},{"name":"CoMeD, Inc., Silver Spring, MD 20905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Kern","sequence":"additional","affiliation":[{"name":"Institute of Chronic Illnesses, Inc., Silver Spring, MD 20905, USA"},{"name":"CoMeD, Inc., Silver Spring, MD 20905, USA"},{"name":"Council for Nutritional and Environmental Medicine (CONEM), US Autism Research Group, Allen, TX 75013, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin","family":"Homme","sequence":"additional","affiliation":[{"name":"International Academy of Oral Medicine and Toxicology, Champions Gate, FL 33896, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Geier","sequence":"additional","affiliation":[{"name":"Institute of Chronic Illnesses, Inc., Silver Spring, MD 20905, USA"},{"name":"CoMeD, Inc., Silver Spring, MD 20905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,1,12]]},"reference":[{"key":"ref_1","unstructured":"National Center for Education Statistics (2016, October 01). 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