Dear Provider Letter: Thimerosal Waiver

January 12, 2013

Dear Health Care Provider:

This letter is to inform you that the Commissioner of Health, pursuant to Public Health Law (PHL) 2112(4) hereby authorizes the use of influenza vaccines containing more than the mercury levels described in PHL § 2112 (2) and (3), due to insufficient amounts of vaccine containing the mercury levels described in said sections. This authorization shall continue until such time as I determine the influenza outbreak has ended.

New York State is currently experiencing high levels of influenza disease throughout the State. The State's influenza activity level has been at "widespread", the highest category, for the past seven weeks. Indicators of influenza activity including hospitalizations for confirmed influenza, emergency department visits for influenza-like-illness (ILI), sentinel provider reports of the proportion of patients with ILI, and laboratory reporting of positive influenza results are elevated in most areas of the State, greatly exceeding normal levels for this time of year. There have also been two pediatric deaths due to influenza disease to date.

Young children and pregnant women are documented to be at greater risk of severe disease outcomes from influenza in general. Therefore, vaccine availability for children and pregnant women is extremely important. The Department of Health (DOH) has received numerous calls from private medical providers, county health departments and members of the public about difficulty in obtaining seasonal influenza vaccine.

Vaccine supply available for purchase by providers is very limited at this time. The Department has received many calls from providers asking where to refer their patients for vaccination. In this circumstance, every effort must be made to eliminate barriers to influenza vaccination of children and pregnant women. Providers may still have supplies of these multi-dose vials of influenza vaccines containing thimerosal, which are licensed for use in young children and pregnant women. Such providers should not have to turn away children or pregnant women seeking vaccination because they do not have thimerosal-free vaccine. Though a limited amount of thimerosal-free vaccine may still be available for purchase from some distributors, the Centers for Disease Control and Prevention indicates that even such limited supplies will not be available much longer and many medical providers and local health departments are unable to purchase additional thimerosal-free vaccine for their patients.

For these reasons, I have determined that there will be insufficient supplies of influenza vaccines that contain the mercury levels set forth in PHL §2112 (2) and (3), and the authorization for the use of vaccine containing more than the mercury levels set forth in said sections is necessary to protect the public health.


Nirav R. Shah, M.D., M.P.H.
Commissioner of Health