The Allegheny County Health Department has flu shots for pregnant women that contain only trace amounts of mercury, potentially making them safer for unborn babies than traditional flu vaccines containing larger amounts of the toxin. But you have to know to ask for them -- and sometimes you have to ask twice.

Finding out that they were available at all, though, was no easy task.

	Darrell Sapp, Post-Gazette Claudia Gallegos, of Zacatecas, Mexico, gets a flu shot from Nancy Kapp, a nurse at the Allegheny County Health Department, in Oakland on Friday. Visiting family in the area, Ms. Gallegos is expecting her first child Dec. 29. Click photo for larger image.

After I got pregnant, and especially after I began to feel my daughter kicking inside me, I became much more careful about what I ate, drank and even breathed. Smoky bars were out. So was aspirin, unpasteurized cheese and many kinds of mercury-laden fish, such as mackerel, swordfish and more than one serving a week of tuna.

Babies exposed to high levels of mercury in the womb can have brain damage, learning disabilities and hearing loss. And although an Institute of Medicine panel has said otherwise, some parents and health professionals suspect that mercury might be a cause of autism.

Also, mercury persists and accumulates in the body, so even small amounts can build up and eventually cause harm.

So when I went to get my flu shot recently, and happened to notice that it contained a mercury-based preservative, a red flag immediately went up.

Neither my employer, who had organized the flu clinic at our office, nor the nurses distributing the shots had warned me about the preservative, called thimerosal, even though I am obviously pregnant. My obstetrician -- who had followed the federal government's guidance and recommended that I get a flu shot because I will be in my second and third trimester during flu season, which peaks in March -- hadn't either.

But the mention of mercury in the fine print of my consent form, which I read only because I had a few minutes to kill while waiting my turn for my flu shot, got me asking questions. If I'm not supposed to eat much mercury-containing tuna while I'm pregnant, was it really such a good idea to let the nurses inject me with a vaccine that contained mercury?

		Low-thimerosal flu shots To get a thimerosal-free flu shot for your child or receive a trace-thimerosal flu shot if you're pregnant, visit the Allegheny County Health Department's flu shot clinic at 3441 Forbes Ave., Oakland. While flu shot supplies (including those containing thimerosal) last, the clinic will be open Monday, Tuesday, Thursday and Friday from 9 a.m. to 3 p.m., and on Wednesday from 9 a.m. to 7 p.m. Today's hours are from 8:30 a.m. to 3:30 p.m. Call 412-687-ACHD (2243) for more information.

The nurses told me that if I felt hesitant about getting the thimerosal-containing vaccine, I should wait; I could get a thimerosal-free version from a pediatrician.

So I got my check back, tore it up, and started calling pediatricians in the area, just to be extra-cautious.

Some didn't have the mercury-free version of the flu shot. Neither did my primary care physician, who had ordered only the version containing mercury. The pediatricians who did have the mercury-free vaccine wouldn't give it to me because, one, I wasn't a patient and, two, I wasn't a child. I should call the Allegheny County Health Department, they said.

But the health department was closed in advance of Veterans Day. So I called the childbirth education office at West Penn Hospital, thinking it might have a listing of area physicians who gave mercury-free shots.

They didn't keep that kind of listing, said one of the educators at the office.

And truly, he said, each shot contained such a small amount of mercury that the benefit of being protected from the flu -- as long as the strain in the vaccine was the same as that being passed around this winter -- outweighed any potential risks.

I would probably absorb more mercury by driving past a coal-burning power plant, which gives the toxin off in its exhaust, he said.

Still, I decided to do some reading. A look at the Centers for Disease Control and Prevention's Web site showed that the federal agency recommends that pregnant women get flu shots.

A study of 2,000 pregnant women showed no adverse effects on the fetus from thimerosal, according to the CDC's Web site.

"Because pregnant women are at increased risk for influenza-related complications and because a substantial safety margin has been incorporated into the health guidance values for organic mercury exposure, the benefits of influenza vaccine with reduced or standard thimerosal content outweighs the theoretical risk, if any, of thimerosal," according to the CDC.

News articles, however, showed the government had ordered thimerosal -- which has been used since the 1930s to protect against fungal and bacterial contamination of bulk batches of vaccines -- removed from every other childhood vaccine as a precaution in 1999.

Since then, vaccines such as those for measles, mumps and rubella and hepatitis B have been given in single-use, pre-packaged doses.

Influenza vaccine, however, is given in mass quantities on a seasonal basis, making it easier and cheaper to store in bulk. It was exempted from the ban, although in 2004 California banned thimerosal-containing versions of the vaccine from use in pregnant women and children under 3.

All of which made me worry about getting vaccinated, regardless of what the CDC says. If thimerosal is safe, why did the federal government order it banned from every other childhood vaccine?

But should I skip the thimerosal-containing vaccine and take my chances amid the tide of coughing, sneezing flu victims who were sure to spread germs around in my office, on the bus, in stores and even at the hospital where I will have my baby in late February? Or should I get the vaccine and protect myself and my baby from flu complications such as high fever, oxygen deprivation and pre-term labor, but potentially risk brain damage or other problems from accumulated mercury?

I agonized. I called the county health department's flu clinic, and was told they had only thimerosal-free flu vaccines for children, and no, I couldn't have two of the smaller pediatric doses, pregnant or not.

I called my obstetrician, who sympathized with my concerns, but still supported the CDC's recommendations to get vaccinated. I called the departments of maternal and fetal medicine, obstetrics and infectious disease at the city's major hospitals. None had the mercury-free flu shots, or knew how to get them.

Finally, I bent my rules as a journalist and called Guillermo Cole, public relations officer for the county health department, with whom I had worked on stories for the Post-Gazette in the past. (I don't believe in using professional contacts for personal advantage, but in this case I was feeling especially desperate.)

Did the department have a list of doctors who gave thimerosal-free flu shots? Or any information on how to get one?

The health department, he said, didn't keep a list like that, and he was pretty sure its flu clinic only had pediatric doses, he said, but he would check into it.

If you order thimerosal-free flu vaccines for kids, I asked, why wouldn't you order thimerosal-free flu vaccines for pregnant women and their unborn kids?

"There's just not that much demand for it," he said.

Later that day, he called back. The department, he said, actually had just received several thousand doses of flu vaccine for pregnant women with only trace amounts of thimerosal from the manufacturing process -- not mercury-free, but almost.

And because they were single-use, pre-packaged shots, they didn't need preservative to keep them fungus- and bacteria-free.

They were at the department's warehouse, he said, but would arrive at the flu clinic by Friday, so come then.

Fantastic. He had made my month. So on Friday, I called the department's flu clinic to make sure the low-mercury vaccines had arrived.

No, I was told, the clinic only had mercury-free shots for children. I'm looking for the low-mercury flu shot for pregnant women, I persisted.

Guillermo Cole said they would come in Friday, I said, dropping the name.

The clinician put me on hold and checked. Sorry, she said when she returned, I was right: They arrived at the clinic on Thursday.

So now, I'm about to go get my low-mercury flu shot at the county health department. And I'm not taking "no" for an answer.