Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data

The research paper that generated 22 counts a fraud and money laundering charges against the leader of the research project who embezzled more than $1,000,000 from CDC and his university.…

Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data

Kreesten M. Madsen, MD; Marlene B. Lauritsen, MD; Carsten B. Pedersen, Msc; Poul Thorsen, MD, PhD; Anne-Marie Plesner, MD, PhD; Peter H. Andersen, MD; Preben B. Mortensen, MD, DMSc

Reprint requests to (K.M.M.) Danish Epidemiology Science Centre, Department of Epidemiology and Social Medicine, University of Aarhus, 8000 Aarhus, Denmark. E-mail: kmm@dadlnet.dk

Pediatrics (2003) 112 (3): 604–606.

AAP: Data were analyzed from the Danish Psychiatric Central Research Register recording all psychiatric admissions since 1971, and all outpatient contacts in psychiatric departments in Denmark since 1995. There was no trend toward an increase in the incidence of autism during the period when thimerosal was used in Denmark through 1990. From 1991-2000, the incidence increased and continued to rise after thimerosal was removed from vaccines. There also were increases among children born after thimerosal was no longer used. Data do not support a correlation between thimerosal-containing vaccines and the incidence of autism.
https://doi.org/10.1542/peds.112.3.604

Objective. It has been suggested that thimerosal, a mercury-containing preservative in vaccines, is a risk factor for the development of autism. We examined whether discontinuing the use of thimerosal-containing vaccines in Denmark led to a decrease in the incidence of autism.

Design. Analysis of data from the Danish Psychiatric Central Research Register recording all psychiatric admissions since 1971, and all outpatient contacts in psychiatric departments in Denmark since 1995.

Patients. All children between 2 and 10 years old who were diagnosed with autism during the period from 1971–2000.

Outcome Measures. Annual and age-specific incidence for first day of first recorded admission with a diagnosis of autism in children between 2 and 10 years old.

Results. A total of 956 children with a male-to-female ratio of 3.5:1 had been diagnosed with autism during the period from 1971–2000. There was no trend toward an increase in the incidence of autism during that period when thimerosal was used in Denmark, up through 1990. From 1991 until 2000 the incidence increased and continued to rise after the removal of thimerosal from vaccines, including increases among children born after the discontinuation of thimerosal.

Conclusions. The discontinuation of thimerosal-containing vaccines in Denmark in 1992 was followed by an increase in the incidence of autism. Our ecological data do not support a correlation between thimerosal-containing vaccines and the incidence of autism.

“The activities of the Danish Epidemiology Science Centre and the National Centre for Register-Based Research are funded by a grant from the Danish National Research Foundation. This study was supported by the Stanley Medical Research Institute.” [Two of the seven authors were employees of Denmark’s largest vaccine manufacturer, Statens Serum Institute]

Ginger Taylor, 2005 (before the financial corruption was exposed in 2010)

The findings in the Denmark study have come under serious criticism. When the data of study was reviewed, it was found that the sampling presented fatal flaws.

The low incidence of autism during the use of thimerosal can be attributed to the fact that the database that was used only tracked inpatient cases of autism at the time. At the point in time where thimerosal was removed, the database was expanded to include cases that were diagnosed at a large clinic outside of Copenhagen where 20% of the countries autistic patents were diagnosed. At the point in time where thimerosal was no longer used, but the cases of autism seem to have skyrocketed, the database had expanded further to include all cases of autism, inpatient and outpatient, in the country.

The sample size of the study was only 956 children. That is the number of people that their disability database had on record as being diagnosed with autism in Denmark between 1971 and 2000. 956 people in 29 years. That is 33 people a year in the entire country. [Hyperbole warning] I have that many autistic kids in my kitchen right now!

The study is further compromised by the fact that several of the coauthors were employed by the Statens Serums Institut, the countries sole vaccine manufacturer who would presumably be held liable if it was indeed found that the use of thimerosal in vaccines contributed to autism.

[Update: Kristjan has pointed out here that the Danish health care system and liability laws are different from ours and no such legal liability exists for the Statens Serums Institut. I still wonder what might motivate these researchers to stand buy this study and not protest its poor use. More on that in the comments here, here and here.]

Further, even if the study were reliable, applying it to the U.S. population as the IOM has done presents problems. Children in Denmark were administered less than half the amount of thimerosal of US children, and it was administered later and over a longer period of time.

Finally, American children, like my sons, are subject to an autism rate at least 10 times that of Denmark, so this study should not be applied to determine their risk of autism from thimerosal exposure.


Master Manipulator: The Explosive True Story of Fraud, Embezzlement, and Government Betrayal at the CDC

The explosive true story of fraud, embezzlement, and government betrayal. An insider’s view of what takes place behind the closed doors of agencies and drug companies, and the people tasked to protect the health of American children.

In 2000, the US Centers for Disease Control (CDC) carried out a secret mission to bury, skew, and manipulate data in six vaccine safety studies, in a coordinated effort to control the message that “vaccines do not cause autism.” They did so via secret meetings and backtesting health-care data. The CDC invested tens of millions of dollars in a foreign health-care data analytics startup run by Danish scientist Poul Thorsen, a move to ensure that no link ever surfaced. But fate had other ideas. The agency soon learned it couldn’t control Thorsen. In 2011, the US Justice Department indicted him for the theft of more than $1 million of CDC grant money.

Master Manipulator exposes the CDC’s hidden agenda for the cover-up. Influenced by Big Pharma money, future high-paying jobs, and political lobbyists, CDC executives charted a course different than what the findings of earlier vaccine safety studies revealed. The CDC needed an outsider to “flatten” the results of the data, while building an exit strategy: a fall guy in case the secret plan was exposed. Thorsen fit the bill nicely, conducting studies overseas. But the CDC’s plan backfired, as Thorsen took the money to the bank and the power went to his head. It would take years for his fraud scheme—funneling CDC grant money to a Danish university and then back to a CDC bank account he controlled—to play out.

Now available for the first time in paperback, Master Manipulator is a true story of fraud and betrayal. It’s a cautionary tale of the dangers of blind trust in the government and the health-care industry.


Updated 11:41 AM EDT, Tue September 16, 2025

By Patrick Layton

For more than two decades, the pharmaceutical industry and its defenders in government have leaned heavily on a handful of studies to dismiss the link between vaccines and autism. At the center of that body of work stands recently-arrested federal fugitive Poul Thorsen, a Danish scientist whose research is still repeatedly cited in courtrooms, media reports, and even last week in a government hearing as evidence that vaccines are “safe.”

But Thorsen’s story reveals a disturbing truth: one of the most prominent figures used to silence vaccine concerns is himself a disgraced fugitive accused of defrauding U.S. taxpayers and falsifying documents.

The CDC Connection

From approximately 2004 to 2010, Thorsen was deeply involved in CDC-funded studies exploring autism, cerebral palsy, genetic disorders, and fetal alcohol syndrome. While working as a visiting scientist at the CDC’s Division of Birth Defects and Developmental Disabilities, he helped secure multimillion-dollar grants funneled through Danish institutions such as Aarhus University and Odense University Hospital.

These studies—particularly those examining a possible link between vaccines and autism—became cornerstones of the pro-vaccine argument. When parents raised alarms about adverse reactions, when congressional hearings grew heated, and when lawsuits against vaccine manufacturers mounted, officials frequently pointed to Thorsen’s work in Denmark to declare the science “settled.”

The Fraud

According to U.S. authorities, during this very period, Thorsen was engaged in an elaborate scheme to steal CDC grant money for personal gain. By submitting fraudulent invoices on CDC letterhead and directing payments into his own bank account, he allegedly siphoned off more than $1 million.

The invoices gave the appearance that the CDC itself was requesting funds from Danish institutions, but the money was funneled directly to Thorsen. The charges read like a playbook of corruption: abuse of position, falsified documents, and brazen theft from a public health agency entrusted with safeguarding American children. Not once, not twice… but 22 counts.

The Significance

Thorsen’s alleged criminal behavior should raise serious questions about the credibility of the research he conducted and the system that continues to rely on it. How can studies produced under the shadow of financial fraud still serve as the bedrock of government claims about vaccine safety?

Even beyond Thorsen’s personal misconduct, his scandal illustrates a deeper issue: the public is asked to place blind trust in scientists and institutions whose incentives and oversight are deeply compromised. If the very researchers tasked with disproving harm from vaccines are also defrauding taxpayers, how can parents have confidence in the conclusions?


CRITIQUES OF THE STUDY

The Same Danish Database – Critics stated the obvious: This study was little more than a second version of the Danish section included in the Stehr-Green paper, which was published one week earlier. The main flaw in that study, of course, was the major change in the Danish registry – from including inpatient only cases, to including both inpatient and outpatient cases.

Repeating the Swedish Mistake in Denmark – In order to address the issue of adding outpatient cases in 1995, Madsen et al. went back and looked at inpatient cases only. Among this small minority of cases, they reported “the same trend with an increase in the incidence rates from 1990 until the end of the study period.” The authors failed to provide these data in their study. And the sampling was essentially identical to the Swedish analysis, in which the IOM committee (in addition to the authors) conceded that the apparent increase in autism incidence could be due to “changes in diagnostic criteria and increasing awareness of autism and related disorders.”

Weakness of Ecological Studies – This was another ecological analysis which, as the Director of the CDC, Dr. Julie Gerberding, wrote to Congress: the contributions of such studies toward establishing causality are “limited.”

A Very Low Autism Rate – Even if autism rates were shown to actually be increasing in Denmark, they were remarkably low both before and after thimerosal was removed. According to the Madsen study, Denmark’s prevalence rate was a tiny 1-per-10,000 – one of the lowest rates ever reported – before thimerosal’s removal. By 1999 (with the addition of outpatient cases) the rate “rose” to 4-6 per 10,000 – still very low – comparable to US rates before thimerosal exposures in that country tripled, around 1990. The rate was also at least ten times lower than the estimated 2000 US rate, 60-per-10,000.

Undisclosed Conflicts of Interest – SafeMinds and others criticized the inherent conflicts of interest among some of the study authors. Two of them worked for the Statens Serum Institut, a Danish manufacturer of thimerosal containing vaccines. According to its mission statement, “Statens Serum Institut is a public enterprise operating as a market-oriented production and service enterprise. In 2002, more than 80% of SSI profits came from vaccines.” Still, this conflict was not disclosed by Pediatrics.


WHAT AN INTERNATIONAL TEAM OF SCIENTISTS SAID

In 2005, Joachim Mutter of the Institute for Environmental Medicine and Hospital Epidemiology, in Freiburg, Germany and colleagues in the UK and US published a paper in Neuroendocrinology Letters that included a serious indictment of the study. It echoed many of the same points made by SafeMinds and others, namely:[51]

● Autism counts were based on hospitalized, inpatient records in the first cohort and then changed in the middle of the study period (1995) to include outpatient records. Therefore, the purported increases after 1994 may be explained by the additional recruitment of an existing autism population that did not require hospitalization.

● After 1992, the register added in patients from a large Copenhagen clinic, which accounted for 20% of the caseload in Denmark. The patients from this clinic were excluded prior to 1992.

● The diagnostic category changed after 1993 from “psychosis proto-infantilis” of ICD-8 (code 299) to “childhood autism” of ICD-10. Another paper using the same inpatient register reports that the psychosis proto-infantilis category includes inpatient cases that do not fulfill the criteria for autism.

● Many of the children were between 7–9 years old, and most were over 4 years old, when recorded. But the onset of autism must occur, by definition in the diagnostic criteria, before three years of age. The most widely used approach to assessing autism trends is to use year of birth as the “incidence time” and to assess trends in autism rates based on birth year of the study population rather than time at diagnosis or some other measure of incidence. 

● Another recent study performed by Madsen et al. reported Danish autism rates of 6 per 10,000 for children born in the 1990s.[52] These Danish rates are very low in the 1990s compared to the United States.  Madsen et al. also report inpatient rates for the pre-1993 “psychosis proto-infantilis” at well below 1 per 10,000. This low rate would contradict the single published survey of autism rates from Denmark, which indicated an autism rate of over 4 per 10,000 as far back as the 1950s.

● Additional confounders were present in the U.S. with high prevalence of autism that were not present in Denmark: Between 1970–92, the only childhood vaccine given in Denmark until 5 months of age was the monovalent pertussis vaccine. In the United

States, children were exposed to multiple doses of diphtheria, pertussis, tetanus, polio, hepatitis B and haemophilus influenza B (Hib) vaccines before five months of age in the 1990s.


WHAT THE MEDIA SAID:

The mainstream media portrayed the Madsen study as definitive. The New York Times declared: “Study Casts Doubt on Theory of Vaccines’ Link to Autism” and quoted the CDC’s Dr. Robert Davis as saying the evidence was “clear-cut: If you remove cars from highways, you’ll see a marked decrease in auto-related deaths. If thimerosal was a strong driver of autism rates, and you remove it from vaccines, you should have seen some sort of decline — and they didn’t.”[53] 

The Times also quoted Dr. William Schaffner, Chairman of Preventive Medicine at Vanderbilt University in Nashville, as claiming that the study added to “the whole mosaic of studies that have addressed this. Each is imperfect, but they all add up to this theme: thimerosal is not the culprit.”

The paper included a SafeMinds statement asserting that the researchers “artificially boosted the number of cases by adding outpatients and those at a large Copenhagen clinic to earlier inpatient figures.” It also reported that two authors worked for a Danish vaccine maker, “suggesting a conflict of interest.”


WHAT THE AUTHORS SAID:

Outpatients “May Exaggerate Incidence” – The authors conceded that, “because many patients with autism in former years have been treated as outpatients this may exaggerate the incidence rates simply because a number of patients attending the child psychiatric treatment system before 1995 were recorded for the first time, and thereby counted as new cases in the incidence rates.”

Greater Awareness, New Diagnostics Can Boost Numbers – The reported increase in autism in Denmark “may be attributable to more attention being drawn to the syndrome of autism and to a change in the diagnostic criteria from the ICD-8 to the ICD-10 in 1994.”

Exposure Levels Were Lower Than US – Echoing criticism that the Danish data are not comparable to other countries, such as the US where mercury exposures were greater, the authors wrote: “Our data cannot, of course, exclude the possibility that thimerosal at doses larger than used in Denmark may lead to neurodevelopmental damage.”

WHAT THE IOM REVIEW SAID: 

Limited Contribution – Adding additional outpatient cases into the Danish register was noted as a potential problem. “A reanalysis was conducted, limiting itself to inpatient data only, and the authors found similar trends in autism rates, although the data were not shown,” the IOM wrote. “However, despite the reanalysis the authors stated that autism incidence after 1995 may have been exaggerated due to the change in including outpatient cases into the Danish Psychiatric Central Register. This limits the study’s contribution to causality.

SUMMARY: This study is perhaps the least informative of all the thimerosal studies. The shifting definition of cases and limitation, at any point, of only autism cases that were admitted to hospitals make this analysis thoroughly unreliable from the outset. 


putchildrenfirst.org

It’s Rotten in Denmark

“Mercury is hazardous to humans. Its use in medicinal products is undesirable, unnecessary and should be minimized or eliminated entirely. Manufacturers of vaccines and thimerosal, (an ethlymercury compound used in vaccines), have never conducted adequate testing on the safety of thimerosal. The FDA has never required manufacturers to conduct adequate safety testing on thimerosal and ethlymercury compounds…Thimerosal used as a preservative in vaccines is likely related to the autism epidemic. This epidemic in all probability may have been prevented or curtailed had the FDA not been asleep at the switch regarding injected thimerosal and the sharp rise of infant exposure to this known neurotoxin. Our public health agencies’ failure to act is indicative of institutional malfeasance for self-protection and misplaced protectionism of the pharmaceutical industry” – Mercury In Medicine: Taking Unnecessary Risks, Committee On Government Reform, U.S. House of Representatives, May 21, 2003
The Mercury In Medicine report, from Chairman Burton’s Committee on Government Reform, was released in May 2003, and provided a scathing indictment of the Federal Health bureaucracy and their inexplicable complacency regarding mercury and vaccines. Despite the entire report being publicly available in the Congressional Record, it has gotten little publicity.
While the Mercury In Medicine report was certainly not welcome by CDC, they knew that by the Fall of 2003 the pendulum would swing back towards exonerating Thimerosal with the near simultaneous release of four separate studies between September and November in four separate medical journals that would provide the basis for “proof” that vaccines and autism are unrelated as cited by the IOM six months later in their 2004 report. Three of those studies, in Pediatrics, The Journal of the American Medical Association, and The American Journal of Preventative Medicine, would be based on the Danish data, and one study, also in Pediatrics, would be the data finally released by CDC of their analysis of the VSD.
For practicing Doctors, medical journals are their primary source of information from the outside world. For pediatricians, tasked with administering the lengthy U.S. Immunization Schedule, Pediatrics, the Journal of the American Academy of Pediatrics, is their trusted source of information. We believe few pediatricians are remotely aware of the conflicts, limitations, and manipulation that the published studies were subjected to, and that few realize many of the published authors were CDC employees or SSI employees, a Danish vaccine manufacturer. Because Pediatrics is the trusted source of information for Doctors, and because the two Pediatrics studies are most often cited regarding “proof”, we will focus our time analyzing these two.
In September 2003, Pediatrics published Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data. Thimerosal was removed from Danish vaccines in 1992, and the study showed that not only did autism rates not go down after its removal, they actually went up. The study’s lead other, Kristeen Madsen, had been one of the Danish researchers Dr. Diane Simpson reached out to early on in her world travel of 2001. This study was highly flawed for the following reasons (read SafeMinds’ critique here):

  1. CDC and SSI employees were the primary study authors of studies that would exonerate their own policies (CDC) and products (SSI).
  2. Conflicts of the study authors were never cited in any of the studies published.
  3. CDC knew about the limitations of the Danish data, but moved towards publication any way, with a senior official actually lobbying Pediatrics for publication.
  4. CDC manipulated evidence of a correlation between Thimerosal and autism from their own VSD data, despite the overwhelming evidence of “Generation Zero” and the data presented at Simpsonwood.
  5. We have never proven, using American data, that Thimerosal didn’t cause the autism epidemic, yet “proof” is often cited of exactly that.
    Where is the Evidence?
  6. Email from Simpson to Madsen: “It would mean a great deal to us”
    June 12-13, 2001
    Communication between Dr. Diane Simpson, Deputy Director of the National Immunization Program for CDC, and Kreesten Madsen, a Danish scientist.
    This email is important for a number of reasons. Firstly, it is the first communication between CDC and the Danish Dr. Madsen, who would later co-author the Pediatrics study in September 2003 exonerating Thimerosal. It shows that CDC is looking anywhere to try and find data and that the heads of the National Immunizations Program, like Dr. Simpson, are leading the charge.
    Dr. Simpson: “Our primary question is: did the rates increase dramatically from the late 1980’s into the 1990s as they did here in the United States. A quick answer to that question would mean a great deal to us here!!!”
    Secondly, Dr. Madsen highlights an issue that would be manipulated to form the basis for the 2003 Pediatrics study: outpatient clinics, where the majority of Danish children are diagnosed with autism, were not included in the Danish registry until 1995. This administrative change forms the basis for the studies put forth by CDC regarding the “proof” in Denmark that Thimerosal does not cause autism.
    Dr. Madsen: “To the best of my knowledge – no, the rates did not increase dramatically in the late 1980’s…”
    Dr. Simpson: “Did they increase after 1993??”
    Dr. Madsen: “Yes, but not very dramatically and there could be more reasons for that…and furthermore our outpatient clinics were registered in our surveillance from 1995.”
    Source: FOIA filing by parents.
  7. Email from Verstraeten to Chen: “Not worth doing”
    June 26, 2001
    Communication between Dr. Thomas Verstraeten, head of internal analysis of CDC Vaccine Safety Data and Dr. Robert Chen, Director of Vaccine Safety, CDC.
    This email is important for two reasons:

“The maximum exposure [in Britain] is indeed relatively low…my estimate is that you need at least >50 [mcg of mercury] by 3 months or >100 by 6 months to see an effect if there is one which you barely make…I hate to say this, but given these concerns, it may not be worth doing this after all. On the other hand, maybe the grant can be given to Harald in Sweden…”
Source: FOIA filing by parents.

  1. Letter From Cordero to Pediatrics
    December 10, 2002
    Dr. Cordero, Director of the CDC’s National Center on Birth Defects and Developmental Disabilities, to Pediatrics in support of publication of the Danish study exonerating Thimerosal.
    Dr. Cordero, who had been privy to the Generation Zero data and was present at the Simpsonwood meeting, encouraged Pediatrics to publish the Danish study, despite its fatal flaws, and noted “its findings provide one strong piece of evidence that thimerosal is not causally linked to autism.”
    Source: FOIA filing by parents.
  2. Criticisms of Danish Studies
    2002-2003
    Soon after their publication, many helpful criticisms of the Danish studies were released, including:
    SafeMinds analysis of the network of Danish researchers and the CDC available here
    SafeMinds analysis of the Pediatrics study available here
    SafeMinds analysis of the Journal of American Medical Association study available here
  3. Criticisms of CDC’s Study in Pediatrics
    2002-2003
    Soon after their publication, many helpful criticisms of the CDC’s Study in Pediatrics were released including:
    SafeMinds detailed analysis of the manipulation of data by the CDC available here
    SafeMinds analysis of “Generation Zero” VSD data available here
    Dr. Mark Geier’s letter to Pediatrics available here