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San Francisco Marin Medical Society Blog

SFDPH Health Alert: Temporary Exemption to Flu Vaccine Thimerosal Law for Young Children

California law [H&S Code 124172] holds that vaccines containing more than a trace amount of the preservative thimerosal cannot be administered to knowingly pregnant women or to children younger than age three years, but that under conditions of short supply, an exemption to this law may be granted.

Currently, there is a temporary shortage of Fluzone® Quadrivalent 0.25 ml prefilled syringe (Sanofi-Pasteur), the only influenza vaccine that is both FDA-approved for children age 6 – 35 months and below the state limit for thimerosal content. 

Due to the insufficient supply of this vaccine, and the dangers posed by the seasonal influenza epidemic, a temporary exemption to the thimerosal law has been granted by the Secretary of the California Health and Human Services Agency, for 2015-16 seasonal influenza vaccine administered to children younger than 3 years old. The exemption extends from October 9, 2015 – December 31, 2015, to be used as needed based on vaccine availability.

This temporary exemption will help protect young children at high-risk for severe influenza complications and is similar to exemptions issued in 2006, 2009, and 2013. In accordance with the intent of the law, during this exemption period physicians should prioritize any remaining supplies of thimerosal-free vaccine to young children when feasible. As with other routine vaccines, providers should continue to provide patients and parents or guardians with the specific Vaccine Information Statement (VIS) that lists risks and benefits before immunization.

Influenza vaccine that may be given to children age 6 – 35 months during the exemption:

  • Fluzone® Quadrivalent Multi-Dose Vial (Sanofi-Pasteur); licensed for age > 6 months
  • Fluzone® Trivalent Multi-Dose Vial (Sanofi-Pasteur); licensed for age > 6 months

Also, FluMist® Quadrivalent (Medimmune) contains no thimerosal and is licensed for healthy persons aged 2 – 49 years, and so may be given to children 24 – 35 months, with or without the exemption.

Information about the exemption is described at

For questions, contact the SFDPH Communicable Disease Prevention Unit at (415) 554-2955 or

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