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Immunologic adjuvant

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and presumably induce an immune response. A second mechanism depends on alum killing immune cells at the injection site although researchers aren't sure exactly how alum kills these cells. It has been speculated that the dying cells release DNA which serves as an immune alarm. Some studies found that
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in mineral oil developed in 1930. It is not safe enough for human use. A version without the bacteria, that is only oil in water, is known as Freund's incomplete adjuvant. It helps vaccines release antigens for a longer time. Despite the side effects, its potential benefit has led to a few clinical
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The precise mechanism of aluminium salts remains unclear but some insights have been gained. It was formerly thought that they function as delivery systems by generating depots that trap antigens at the injection site, providing a slow release that continues to stimulate the immune system. However,
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Subsequently, the American National Center for Biotechnology Information published an article discussing the comparative safety of vaccine adjuvants which stated that "the biggest remaining challenge in the adjuvant field is to decipher the potential relationship between adjuvants and rare vaccine
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Due to the variety of mechanisms and links between the innate and adaptive immune response, an adjuvant-enhanced innate immune response results in an enhanced adaptive immune response. Specifically, adjuvants may exert their immune-enhancing effects according to five immune-functional activities.
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In the early days of vaccine manufacture, significant variations in the efficacy of different batches of the same vaccine were correctly assumed to be caused by contamination of the reaction vessels. However, it was soon found that more scrupulous cleaning actually seemed to
353:(IL‑1β), an immune signal that promotes antibody production. Alum adheres to the cell's plasma membrane and rearranges certain lipids there. Spurred into action, the dendritic cells pick up the antigen and speed to lymph nodes, where they stick tightly to a 516:
In order to understand the links between the innate immune response and the adaptive immune response to help substantiate an adjuvant function in enhancing adaptive immune responses to the specific antigen of a vaccine, the following points should be considered:
841:-specific fragments that bind to DQB1*602 in cell culture experiments, leading to the hypothesis that autoimmunity may arise in genetically susceptible individuals, but there is no clinical data to support this hypothesis. The third AS03 ingredient is 390:
is a naturally-occurring organic compound used in human and animal vaccines. Squalene is an oil, made up of carbon and hydrogen atoms, produced by plants and is present in many foods. Squalene is also produced by the human liver as a precursor to
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Discussing the safety of squalene as an adjuvant in 2006, the World Health Organisation stated "follow-up to detect any vaccine-related adverse events will need to be performed." No such followup has been published by the WHO.
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methods, and in 1996 the Vaccine-Associated Feline Sarcoma Task Force was formed to address the problem. However, evidence conflicts on whether types of vaccines, manufacturers or factors have been associated with sarcomas.
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Masoudi S, Ploen D, Kunz K, Hildt E (May 2014). "The adjuvant component α-tocopherol triggers via modulation of Nrf2 the expression and turnover of hypocretin in vitro and its implication to the development of narcolepsy".
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is another squalene-containing adjuvant. In addition, squalene-based O/W emulsions have also been shown to stably incorporate small molecule TLR7/8 adjuvants (e.g. PVP-037) and lead to enhanced adjuvanticity via synergism.
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Second, adjuvants may provide physical protection to antigens which grants the antigen a prolonged delivery. This means the organism will be exposed to the antigen for a longer duration, making the immune system more
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is an oil-in-water emulsion of squalene adjuvant used in some human vaccines. As of 2021, over 22 million doses of one vaccine with squalene, FLUAD, have been administered with no severe adverse effects reported.
44:, meaning to help or aid. "An immunologic adjuvant is defined as any substance that acts to accelerate, prolong, or enhance antigen-specific immune responses when used in combination with specific vaccine 362:. No matter what the mechanism is, alum is not a perfect adjuvant because it does not work with all antigens (e.g. malaria and tuberculosis). However, recent research indicates that alum formulated in a 2302:"T cell proliferation by direct cross-talk between OX40 ligand on human mast cells and OX40 on human T cells: comparison of gene expression profiles between human tonsillar and lung-cultured mast cells" 1359: 948:
These observations suggest that although TLR activation can lead to increases in antibody responses, TLR activation is not required to induce enhanced innate and adaptive responses to antigens.
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Aluminium adjuvants have caused motor neuron death in mice when injected directly onto the spine at the scruff of the neck, and oil–water suspensions have been reported to increase the risk of
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which underlie TLR signaling has been significant in understanding why adjuvants used during vaccinations are so important in augmenting adaptive immune responses to specific
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for commercial vaccines. Aluminium salts are the most commonly-used adjuvants in human vaccines. Their adjuvant activity was described in 1926.
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Kirpensteijn J (October 2006). "Feline injection site-associated sarcoma: Is it a reason to critically evaluate our vaccination policies?".
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Satoh M, Kuroda Y, Yoshida H, Behney KM, Mizutani A, Akaogi J, et al. (August 2003). "Induction of lupus autoantibodies by adjuvants".
3589: 3584: 833:). Those vaccinated with Pandemrix have almost a twelve-times higher risk of developing the disease. The adjuvant of the vaccine contained 2681:"Risk of narcolepsy in children and young people receiving AS03 adjuvanted pandemic A/H1N1 2009 influenza vaccine: retrospective analysis" 358:
DNA from dying cells causes them to adhere more tightly to helper T cells which ultimately leads to an increased release of antibodies by
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proteins in TLR signaling), they were still able to induce inflammatory responses, increase T cell activation and generate greater
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development, the majority of researchers do not support a causal connection with aluminium. Adjuvants may make vaccines too
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In the lymph nodes, dendritic cells mince the engulfed pathogen and then express the pathogen clippings as antigen on their
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Fourth, they may induce the release of inflammatory cytokines which helps to not only recruit B and T cells at sites of
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as it makes use of the additional time by upregulating the production of B and T cells needed for greater immunological
4433: 3740: 3373: 2825: 1213: 1088: 2722:"AS03 adjuvanted AH1N1 vaccine associated with an abrupt increase in the incidence of childhood narcolepsy in Finland" 2595:
Tomljenovic L (2010). "Aluminum and Alzheimer's disease: after a century of controversy, is there a plausible link?".
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As of 2016, several TLR ligands were in clinical development or being tested in animal models as potential adjuvants.
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receptor that is present in a number of cell types of the immune system. The adjuvant CpG 1018 is used in an approved
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relationship between VAS and administration of aluminium adjuvated rabies and FeLV vaccines was established through
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Glenny A, Pope C, Waddington H, Wallace U (1926). "The antigenic value of toxoid precipitated by potassium alum".
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events that ultimately lead to innate immune responses and the development of antigen-specific acquired immunity.
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form rather than microparticles can broaden the utility of alum adjuvants and promote stronger adjuvant effects.
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Leroux-Roels G (August 2010). "Unmet needs in modern vaccinology: adjuvants to improve the immune response".
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or in the form of invasive moieties during times of natural infection – to TLRs mark the key
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Stertman L, Palm AE, Zarnegar B, Carow B, Lunderius Andersson C, Magnusson SE, et al. (December 2023).
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to allow immune cells of both systems to clear the area of pathogens. In addition, mast cells also release
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Immunopharmacology of infectious diseases: vaccine adjuvants and modulators of non-specific resistance
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Finally, adjuvants are believed to increase the innate immune response to antigen by interacting with
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the effectiveness of the vaccines, and some contaminants actually enhanced the immune response.
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of other immune cells of both the innate and adaptive immune responses to the infected area.
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The combination of QS-21, cholesterol and MPL forms the adjuvant AS01 which is used in the
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studies have shown that surgical removal of these depots had no impact on the magnitude of
286: 222: 2454:"A human homologue of the Drosophila Toll protein signals activation of adaptive immunity" 782:. Although there are studies suggesting the role of aluminium, especially injected highly 8: 4506: 4244: 4210: 4096: 3919: 3862: 3857: 3803: 3634: 3502: 3474: 3426: 3247:"Comparative Safety of Vaccine Adjuvants: A Summary of Current Evidence and Future Needs" 2961:"The endogenous adjuvant squalene can induce a chronic T-cell-mediated arthritis in rats" 986:
adverse reactions, such as narcolepsy, macrophagic myofasciitis or Alzheimer's disease."
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to the vaccine more vigorously, and thus providing increased immunity to a particular
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As of 2006, the premise that TLR signaling acts as the key node in antigen-mediated
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Third, adjuvants may help to increase the capacity to cause local reactions at the
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and represents a physical link between the innate and adaptive immune responses.
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are often used to modify or augment the effects of a vaccine by stimulating the
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can also activate T cells in a similar approach (but do not do so naturally).
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This process carried out by both dendritic cells and macrophages is termed
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that was no more than a day's normal dietary intake. Vitamin E increases
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site (during vaccination), inducing greater release of danger signals by
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possess characteristics of both the innate and adaptive immune responses.
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Small molecules: TLR7/8 agonists (imidazoquinolines, imidazopyrimidines)
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Reports after the first Gulf War linked anthrax vaccine adjuvants to
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Aluminium salts used in many human vaccines are regarded as safe by
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is a substance that increases or modulates the immune response to a
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used for this purpose, but has been almost completely replaced by
3951: 3390: 1440: 930: 883:(VAS) occurs at a rate of 1–10 per 10,000 injections. In 1993, a 751: 626: 590: 541: 430: 417: 359: 252: 244: 237: 136: 108: 88: 45: 35: 3339: 3226:
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to effectively increase trafficking to and seal off the site of
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and other European countries after vaccinations to address the
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correlated with the use of AS03-adjuvanted influenza vaccine (
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There are many known adjuvants in widespread use, including
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surface by coupling them to a special receptor known as a
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have observed antigen-mediated inflammatory responses in
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T cells can then recognize these clippings and undergo a
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dinucleotide-containing DNA. Because immune systems have
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The 876:in rats already prone to arthritis. 707:is, in part, due to the presence of 690:(PRRs) on or within accessory cells. 679:events leading to a net increase of 536:Dendritic cells then migrate to the 369: 2509:Toussi DN, Massari P (April 2014). 1069:DNA Vaccines: Methods and Protocols 976:United States Department of Defense 433:(MPL), a detoxified version of the 416:is a liposome made up of two plant 13: 4434:Eradication of infectious diseases 4191:Androvax (androstenedione albumin) 2632:"Is the Aluminum Hypothesis dead?" 2134:from the original on 24 April 2019 1362:from the original on 9 August 2021 1352:"Peanut Oil Used in a New Vaccine" 1067:. In Lowrie DB, Whalen RG (eds.). 909:responses has been in question as 562:resulting in their own activation. 349:and other immune cells to secrete 305: 14: 4518: 4024:Respiratory syncytial virus (RSV) 3290: 2965:The American Journal of Pathology 2001:European Medicines Agency website 1236:from the original on 28 June 2021 1042:from the original on 14 June 2018 1035:. 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Drug Discovery 1350:Jones SV (19 September 1964). 1343: 1308: 1222: 1197: 1105: 1054: 1022: 895: 444:, interacts with the receptor 1: 3776:Group B streptococcal disease 3595:Vaccines for Children Program 3245:Petrovsky N (November 2015). 2977:10.1016/S0002-9440(10)65077-8 2938:10.1016/S0896-8411(03)00083-0 2794:10.1016/j.vaccine.2014.03.085 2574:10.1016/S0264-410X(02)00166-4 2355:10.1016/S0952-7915(00)00120-5 2343:Current Opinion in Immunology 2083:10.1080/21645515.2023.2189885 2033:10.1517/17425247.2016.1151871 1739:10.1016/j.vaccine.2010.07.021 1580:10.1016/s0264-410x(02)00168-8 1329:10.1016/j.vaccine.2012.10.095 1016: 921:found that in the absence of 872:in mice. Squalene has caused 849:80 is also found in both the 688:pattern recognition receptors 605:which result in the positive 481:. It is used in the approved 377:is a solution of inactivated 3067:10.1016/j.vetmic.2006.04.010 2821:Food and Drug Administration 2747:10.1371/journal.pone.0033536 2648:10.1097/jom.0000000000000063 2125:Food and Drug Administration 978:strongly denied the claims. 780:Food and Drug Administration 448:to enhance immune response. 426:, a Chilean soap bark tree. 139:to recognize these specific 7: 2319:10.4049/jimmunol.173.8.5247 1833:10.1126/science.341.6141.26 989: 703:that are broadly shared by 189:calcium phosphate hydroxide 70: 10: 4523: 3137:Butler D (November 1997). 2270:10.4049/jimmunol.154.2.804 1626:Nature Reviews. Immunology 1459:10.1038/s41573-021-00163-y 1284:10.1016/j.phrs.2015.08.003 1061:Sasaki S, Okuda K (2000). 881:vaccine-associated sarcoma 863: 471:immune stimulating complex 380:Mycobacterium tuberculosis 375:Freund's complete adjuvant 287:Freund's complete adjuvant 111:, components of bacterial 18: 4452: 4421: 4360: 4292: 4183: 4155: 4122: 3791: 3622: 3615: 3534: 3462: 3414: 3263:10.1007/s40264-015-0350-4 2118:"Shingrix package insert" 1997:European Medicines Agency 1399:10.1017/s0022172400024323 1112:Travis K (January 2007). 1081:10.1385/1-59259-688-6:241 965: 802:medication if necessary. 773: 529:through a process called 494:cytosine phosphoguanosine 205:). Adjuvant 65 (based on 3771:Clostridioides difficile 3031:10.2460/javma.229.9.1405 2419:International Immunology 2395:10.1051/medsci/200723167 1991:October 7, 2009, at the 1272:Pharmacological Research 664:releasing cells such as 512:Adaptive immune response 483:Novavax Covid-19 vaccine 395:and is present in human 322:was the first aluminium 213:is used in the adjuvant 169: 4034:Tick-borne encephalitis 3055:Veterinary Microbiology 2926:Journal of Autoimmunity 2881:Neuromolecular Medicine 2609:10.3233/JAD-2010-101494 2528:10.3390/vaccines2020323 1173:10.1126/science.1135299 805:An increased number of 794:, which often leads to 560:cellular transformation 351:Interleukin 1 beta 162:by mimicking a natural 4444:List of vaccine topics 3439:Mathematical modelling 2630:Lidsky TI (May 2014). 1535:10.1126/sciadv.adg3747 1387:The Journal of Hygiene 1204:Majde JA, ed. (1987). 148:innate immune response 119:nucleic acids such as 107:, molecular cages for 40: 4439:Vaccinate Your Family 3890:Japanese encephalitis 3310:immunologic adjuvant 2431:10.1093/intimm/dxh186 2306:Journal of Immunology 2257:Journal of Immunology 1011:Pharmaceutic adjuvant 769:Medical complications 675:but also to increase 492:Several unmethylated 175:Inorganic compounds: 16:Component of vaccines 4322:John Franklin Enders 3234:on November 4, 2012. 2851:dailymed.nlm.nih.gov 2642:(5 Suppl): S73–S79. 2568:(Suppl 3): S18–S23. 1923:10.1128/CVI.00191-06 1873:10.3390/ijms23094707 1779:10.1096/fj.11-184556 1733:(Suppl 3): C25–C36. 1693:10.1155/2016/1459394 1574:(Suppl 3): S24–S33. 874:rheumatoid arthritis 733:natural killer cells 580:antigen presentation 223:Bordetella pertussis 19:For other uses, see 3503:Virus-like particle 3427:Vaccine ingredients 3155:1997Natur.390Q...3B 3100:(5807): 1859–1860. 2738:2012PLoSO...733536N 2470:1997Natur.388..394M 2229:10.1038/nature02238 2220:2004Natur.427..154M 1965:on November 4, 2012 1825:2013Sci...341...26L 1232:. Superbabyonline. 1165:2006Sci...314.1936G 1159:(5807): 1936–1938. 788:Alzheimer's disease 713:toll-like receptors 695:Toll-like receptors 506:Hepatitis B vaccine 437:from the bacterium 332:aluminium phosphate 328:aluminium hydroxide 301:Inorganic adjuvants 229:Mycobacterium bovis 203:preclinical studies 185:aluminium phosphate 181:aluminium hydroxide 129:single-stranded DNA 125:double-stranded RNA 4479:Never to phase III 4278:Hexavalent vaccine 4092:Epstein–Barr virus 3987:Oxford–AstraZeneca 3675:NmVac4-A/C/Y/W-135 3345:2020-05-14 at the 3333:2012-02-27 at the 3307:has a profile for 2894:10.1385/NMM:9:1:83 2006:2013-07-15 at the 1603:J Pathol Bacteriol 870:autoimmune disease 851:Oxford–AstraZeneca 435:lipopolysaccharide 423:Quillaja saponaria 412:The plant extract 105:lipopolysaccharide 4489: 4488: 4401:Vaccines and SIDS 4288: 4287: 4062:Hepatitis A and B 4038:Varicella zoster 3495:Subunit/component 3313: 3257:(11): 1059–1074. 2788:(25): 2980–2988. 2691:(feb26 2): f794. 2464:(6640): 394–397. 2382:MĂ©decine/Sciences 2214:(6970): 154–159. 2159:Nature Immunology 972:Gulf War syndrome 858:COVID-19 vaccines 741:endothelial cells 585:Upon activation, 370:Organic adjuvants 345:Alum can trigger 4514: 4380:MMR autism fraud 4327:Maurice Hilleman 4312:Hilary Koprowski 3620: 3619: 3376: 3369: 3362: 3353: 3352: 3323:Adjuvant therapy 3311: 3301: 3300: 3285: 3284: 3274: 3242: 3236: 3235: 3230:. Archived from 3223: 3217: 3216: 3214: 3212: 3203:. 30 July 2001. 3191: 3185: 3184: 3166: 3134: 3128: 3127: 3109: 3085: 3079: 3078: 3050: 3044: 3043: 3033: 3024:(9): 1405–1441. 3009: 3003: 3002: 2997:. Archived from 2988: 2971:(6): 2057–2065. 2956: 2950: 2949: 2921: 2915: 2914: 2896: 2872: 2866: 2865: 2863: 2862: 2843: 2837: 2836: 2834: 2833: 2812: 2806: 2805: 2776: 2770: 2769: 2759: 2749: 2717: 2711: 2710: 2700: 2698:10.1136/bmj.f794 2676: 2670: 2669: 2659: 2627: 2621: 2620: 2592: 2586: 2585: 2557: 2551: 2550: 2540: 2530: 2506: 2500: 2499: 2481: 2449: 2443: 2442: 2414: 2408: 2407: 2397: 2373: 2367: 2366: 2338: 2332: 2331: 2321: 2312:(8): 5247–5257. 2297: 2291: 2290: 2272: 2248: 2242: 2241: 2231: 2199: 2193: 2192: 2174: 2150: 2144: 2143: 2141: 2139: 2133: 2122: 2114: 2105: 2104: 2094: 2062: 2053: 2052: 2016: 2010: 1983: 1974: 1973: 1971: 1970: 1961:. Archived from 1951: 1945: 1944: 1934: 1917:(9): 1010–1013. 1902: 1896: 1895: 1885: 1875: 1851: 1845: 1844: 1808: 1802: 1801: 1791: 1781: 1772:(3): 1272–1279. 1757: 1751: 1750: 1722: 1716: 1715: 1705: 1695: 1671: 1660: 1659: 1649: 1617: 1611: 1610: 1598: 1592: 1591: 1563: 1557: 1556: 1546: 1529:(27): eadg3747. 1523:Science Advances 1514: 1505: 1504: 1502: 1501: 1487: 1481: 1480: 1470: 1438: 1421: 1420: 1410: 1378: 1372: 1371: 1369: 1367: 1347: 1341: 1340: 1312: 1306: 1305: 1295: 1263: 1246: 1245: 1243: 1241: 1226: 1220: 1219: 1201: 1195: 1194: 1184: 1144: 1133: 1132: 1130: 1129: 1109: 1103: 1102: 1066: 1058: 1052: 1051: 1049: 1047: 1041: 1034: 1026: 848: 819:pandemic in 2009 800:over-the-counter 709:immune receptors 498:oligonucleotides 281:oligonucleotides 133:unmethylated CpG 99:, which include 43: 4522: 4521: 4517: 4516: 4515: 4513: 4512: 4511: 4492: 4491: 4490: 4485: 4484: 4469:Clinical trials 4448: 4417: 4356: 4332:Stanley Plotkin 4294: 4284: 4196:Cancer vaccines 4179: 4173:Schistosomiasis 4151: 4145:Trypanosomiasis 4118: 4082:Cytomegalovirus 3992:Pfizer–BioNTech 3787: 3611: 3560:Vaccine wastage 3530: 3458: 3410: 3380: 3347:Wayback Machine 3335:Wayback Machine 3328:Animal research 3319: 3318: 3317: 3302: 3298: 3293: 3288: 3243: 3239: 3224: 3220: 3210: 3208: 3200:TheGuardian.com 3193: 3192: 3188: 3135: 3131: 3086: 3082: 3051: 3047: 3010: 3006: 2957: 2953: 2922: 2918: 2873: 2869: 2860: 2858: 2845: 2844: 2840: 2831: 2829: 2814: 2813: 2809: 2777: 2773: 2718: 2714: 2677: 2673: 2628: 2624: 2593: 2589: 2558: 2554: 2507: 2503: 2450: 2446: 2415: 2411: 2374: 2370: 2339: 2335: 2298: 2294: 2249: 2245: 2200: 2196: 2151: 2147: 2137: 2135: 2131: 2120: 2116: 2115: 2108: 2063: 2056: 2017: 2013: 2008:Wayback Machine 1993:Wayback Machine 1984: 1977: 1968: 1966: 1953: 1952: 1948: 1903: 1899: 1852: 1848: 1819:(6141): 26–27. 1809: 1805: 1758: 1754: 1723: 1719: 1672: 1663: 1638:10.1038/nri2510 1618: 1614: 1599: 1595: 1564: 1560: 1515: 1508: 1499: 1497: 1489: 1488: 1484: 1439: 1424: 1379: 1375: 1365: 1363: 1348: 1344: 1313: 1309: 1264: 1249: 1239: 1237: 1228: 1227: 1223: 1216: 1202: 1198: 1145: 1136: 1127: 1125: 1110: 1106: 1091: 1059: 1055: 1045: 1043: 1039: 1032: 1028: 1027: 1023: 1019: 1006:Immunostimulant 1001:Immunomodulator 992: 968: 943:Ribi's adjuvant 903: 898: 866: 846: 776: 771: 750:The binding of 725:dendritic cells 697: 677:transcriptional 668:and mast cells. 637:throughout the 523:dendritic cells 514: 487:malaria vaccine 457:malaria vaccine 429:Monophosphoryl 372: 347:dendritic cells 308: 306:Aluminium salts 303: 258:Polygala senega 172: 152:dendritic cells 73: 61:aluminium salts 24: 17: 12: 11: 5: 4520: 4510: 4509: 4504: 4487: 4486: 4483: 4482: 4481: 4480: 4477: 4466: 4460: 4454: 4453: 4450: 4449: 4447: 4446: 4441: 4436: 4431: 4425: 4423: 4419: 4418: 4416: 4415: 4410: 4403: 4398: 4393: 4388: 4383: 4370: 4364: 4362: 4358: 4357: 4355: 4354: 4349: 4347:Katalin KarikĂł 4344: 4339: 4334: 4329: 4324: 4319: 4314: 4309: 4304: 4298: 4296: 4290: 4289: 4286: 4285: 4283: 4282: 4281: 4280: 4275: 4270: 4265: 4257: 4252: 4247: 4242: 4237: 4236: 4235: 4230: 4229: 4228: 4223: 4213: 4208: 4203: 4193: 4187: 4185: 4181: 4180: 4178: 4177: 4176: 4175: 4170: 4161: 4159: 4153: 4152: 4150: 4149: 4148: 4147: 4139: 4138: 4137: 4126: 4124: 4120: 4119: 4117: 4116: 4115: 4114: 4109: 4104: 4102:Herpes simplex 4099: 4094: 4089: 4084: 4076: 4075: 4074: 4069: 4064: 4056: 4051: 4050: 4049: 4044: 4036: 4031: 4026: 4021: 4020: 4019: 4014: 4009: 4004: 4002:Sinopharm BIBP 3999: 3994: 3989: 3984: 3979: 3974: 3969: 3964: 3959: 3954: 3952:Bharat Biotech 3949: 3939: 3934: 3929: 3924: 3923: 3922: 3917: 3907: 3902: 3897: 3892: 3887: 3886: 3885: 3880: 3870: 3865: 3860: 3855: 3850: 3849: 3848: 3843: 3838: 3833: 3818: 3817: 3816: 3806: 3801: 3795: 3793: 3789: 3788: 3786: 3785: 3784: 3783: 3778: 3773: 3765: 3764: 3763: 3758: 3750: 3745: 3744: 3743: 3738: 3728: 3727: 3726: 3716: 3711: 3706: 3705: 3704: 3699: 3689: 3684: 3679: 3678: 3677: 3672: 3662: 3657: 3652: 3647: 3642: 3637: 3632: 3626: 3624: 3617: 3613: 3612: 3610: 3609: 3608: 3607: 3602: 3597: 3592: 3587: 3579: 3578: 3577: 3575:Vaccine injury 3572: 3567: 3562: 3557: 3552: 3547: 3538: 3536: 3535:Administration 3532: 3531: 3529: 3528: 3523: 3518: 3509: 3492: 3491: 3490: 3485: 3477: 3472: 3466: 3464: 3460: 3459: 3457: 3456: 3451: 3446: 3441: 3436: 3435: 3434: 3424: 3418: 3416: 3412: 3411: 3379: 3378: 3371: 3364: 3356: 3350: 3349: 3340:Vaxjo database 3337: 3325: 3303: 3296: 3295: 3294: 3292: 3291:External links 3289: 3287: 3286: 3237: 3218: 3186: 3129: 3080: 3045: 3004: 3001:on 2003-11-21. 2951: 2916: 2867: 2838: 2807: 2771: 2712: 2671: 2622: 2603:(4): 567–598. 2587: 2552: 2521:(2): 323–353. 2501: 2444: 2409: 2368: 2349:(4): 456–463. 2333: 2292: 2263:(2): 804–813. 2243: 2194: 2165:(6): 579–585. 2145: 2106: 2077:(1): 2189885. 2054: 2027:(6): 807–816. 2011: 1975: 1946: 1897: 1846: 1803: 1752: 1717: 1661: 1632:(4): 287–293. 1612: 1593: 1558: 1506: 1482: 1453:(6): 454–475. 1422: 1393:(2): 251–259. 1373: 1356:New York Times 1342: 1307: 1247: 1221: 1215:978-0845141052 1214: 1196: 1134: 1104: 1090:978-0896035805 1089: 1053: 1020: 1018: 1015: 1014: 1013: 1008: 1003: 998: 991: 988: 967: 964: 902: 899: 897: 894: 865: 862: 843:polysorbate 80 775: 772: 770: 767: 696: 693: 692: 691: 684: 669: 666:helper T cells 654: 642: 576: 575: 569: 563: 556: 545: 534: 513: 510: 489:R21/Matrix-M. 371: 368: 316:immunogenicity 307: 304: 302: 299: 298: 297: 294: 285:Combinations: 283: 275: 261: 241: 218: 191: 177:potassium alum 171: 168: 93:evolutionarily 72: 69: 15: 9: 6: 4: 3: 2: 4519: 4508: 4505: 4503: 4500: 4499: 4497: 4478: 4476: 4473: 4472: 4470: 4467: 4464: 4461: 4459: 4456: 4455: 4451: 4445: 4442: 4440: 4437: 4435: 4432: 4430: 4427: 4426: 4424: 4420: 4414: 4411: 4409: 4408: 4404: 4402: 4399: 4397: 4394: 4392: 4389: 4387: 4384: 4381: 4379: 4374: 4371: 4369: 4366: 4365: 4363: 4359: 4353: 4352:Drew Weissman 4350: 4348: 4345: 4343: 4340: 4338: 4337:H. Fred Clark 4335: 4333: 4330: 4328: 4325: 4323: 4320: 4318: 4315: 4313: 4310: 4308: 4307:Louis Pasteur 4305: 4303: 4302:Edward Jenner 4300: 4299: 4297: 4291: 4279: 4276: 4274: 4273:DTwP-HepB-Hib 4271: 4269: 4268:DTaP-IPV-HepB 4266: 4264: 4261: 4260: 4259:combination: 4258: 4256: 4253: 4251: 4248: 4246: 4243: 4241: 4238: 4234: 4231: 4227: 4224: 4222: 4219: 4218: 4217: 4214: 4212: 4209: 4207: 4204: 4202: 4199: 4198: 4197: 4194: 4192: 4189: 4188: 4186: 4182: 4174: 4171: 4169: 4166: 4165: 4163: 4162: 4160: 4158: 4157:Helminthiasis 4154: 4146: 4143: 4142: 4140: 4136: 4133: 4132: 4131: 4128: 4127: 4125: 4121: 4113: 4110: 4108: 4105: 4103: 4100: 4098: 4095: 4093: 4090: 4088: 4085: 4083: 4080: 4079: 4077: 4073: 4070: 4068: 4065: 4063: 4060: 4059: 4058:combination: 4057: 4055: 4052: 4048: 4045: 4043: 4040: 4039: 4037: 4035: 4032: 4030: 4027: 4025: 4022: 4018: 4015: 4013: 4010: 4008: 4005: 4003: 4000: 3998: 3995: 3993: 3990: 3988: 3985: 3983: 3980: 3978: 3975: 3973: 3970: 3968: 3965: 3963: 3960: 3958: 3955: 3953: 3950: 3948: 3945: 3944: 3943: 3940: 3938: 3935: 3933: 3930: 3928: 3925: 3921: 3918: 3916: 3913: 3912: 3911: 3908: 3906: 3903: 3901: 3898: 3896: 3893: 3891: 3888: 3884: 3881: 3879: 3876: 3875: 3874: 3871: 3869: 3866: 3864: 3861: 3859: 3856: 3854: 3851: 3847: 3844: 3842: 3839: 3837: 3834: 3831: 3827: 3824: 3823: 3822: 3819: 3815: 3812: 3811: 3810: 3807: 3805: 3802: 3800: 3797: 3796: 3794: 3790: 3782: 3779: 3777: 3774: 3772: 3769: 3768: 3766: 3762: 3759: 3757: 3756:DPT/DTwP/DTaP 3754: 3753: 3752:combination: 3751: 3749: 3746: 3742: 3739: 3737: 3734: 3733: 3732: 3729: 3725: 3722: 3721: 3720: 3717: 3715: 3712: 3710: 3707: 3703: 3700: 3698: 3695: 3694: 3693: 3690: 3688: 3685: 3683: 3680: 3676: 3673: 3671: 3668: 3667: 3666: 3665:Meningococcus 3663: 3661: 3658: 3656: 3655:Leptospirosis 3653: 3651: 3648: 3646: 3643: 3641: 3638: 3636: 3633: 3631: 3628: 3627: 3625: 3621: 3618: 3614: 3606: 3603: 3601: 3598: 3596: 3593: 3591: 3590:Vaccine court 3588: 3586: 3583: 3582: 3580: 3576: 3573: 3571: 3568: 3566: 3563: 3561: 3558: 3556: 3553: 3551: 3548: 3546: 3545:GAVI Alliance 3543: 3542: 3540: 3539: 3537: 3533: 3527: 3524: 3522: 3519: 3517: 3513: 3510: 3508: 3504: 3500: 3496: 3493: 3489: 3486: 3484: 3481: 3480: 3478: 3476: 3473: 3471: 3468: 3467: 3465: 3461: 3455: 3452: 3450: 3447: 3445: 3442: 3440: 3437: 3433: 3430: 3429: 3428: 3425: 3423: 3420: 3419: 3417: 3413: 3408: 3404: 3400: 3396: 3392: 3388: 3384: 3377: 3372: 3370: 3365: 3363: 3358: 3357: 3354: 3348: 3344: 3341: 3338: 3336: 3332: 3329: 3326: 3324: 3321: 3320: 3315: 3314: 3306: 3282: 3278: 3273: 3268: 3264: 3260: 3256: 3252: 3248: 3241: 3233: 3229: 3222: 3206: 3202: 3201: 3196: 3190: 3182: 3178: 3174: 3170: 3165: 3164:10.1038/36158 3160: 3156: 3152: 3149:(6655): 3–4. 3148: 3144: 3140: 3133: 3125: 3121: 3117: 3113: 3108: 3103: 3099: 3095: 3091: 3084: 3076: 3072: 3068: 3064: 3060: 3056: 3049: 3041: 3037: 3032: 3027: 3023: 3019: 3015: 3008: 3000: 2996: 2992: 2987: 2982: 2978: 2974: 2970: 2966: 2962: 2955: 2947: 2943: 2939: 2935: 2931: 2927: 2920: 2912: 2908: 2904: 2900: 2895: 2890: 2887:(1): 83–100. 2886: 2882: 2878: 2871: 2856: 2852: 2848: 2842: 2827: 2823: 2822: 2817: 2811: 2803: 2799: 2795: 2791: 2787: 2783: 2775: 2767: 2763: 2758: 2753: 2748: 2743: 2739: 2735: 2731: 2727: 2723: 2716: 2708: 2704: 2699: 2694: 2690: 2686: 2682: 2675: 2667: 2663: 2658: 2653: 2649: 2645: 2641: 2637: 2633: 2626: 2618: 2614: 2610: 2606: 2602: 2598: 2591: 2583: 2579: 2575: 2571: 2567: 2563: 2556: 2548: 2544: 2539: 2534: 2529: 2524: 2520: 2516: 2512: 2505: 2497: 2493: 2489: 2485: 2480: 2479:10.1038/41131 2475: 2471: 2467: 2463: 2459: 2455: 2448: 2440: 2436: 2432: 2428: 2424: 2420: 2413: 2405: 2401: 2396: 2391: 2387: 2383: 2379: 2372: 2364: 2360: 2356: 2352: 2348: 2344: 2337: 2329: 2325: 2320: 2315: 2311: 2307: 2303: 2296: 2288: 2284: 2280: 2276: 2271: 2266: 2262: 2258: 2254: 2247: 2239: 2235: 2230: 2225: 2221: 2217: 2213: 2209: 2205: 2198: 2190: 2186: 2182: 2178: 2173: 2172:10.1038/ni928 2168: 2164: 2160: 2156: 2149: 2130: 2126: 2119: 2113: 2111: 2102: 2098: 2093: 2088: 2084: 2080: 2076: 2072: 2068: 2061: 2059: 2050: 2046: 2042: 2038: 2034: 2030: 2026: 2022: 2015: 2009: 2005: 2002: 1998: 1994: 1990: 1987: 1982: 1980: 1964: 1960: 1956: 1950: 1942: 1938: 1933: 1928: 1924: 1920: 1916: 1912: 1908: 1901: 1893: 1889: 1884: 1879: 1874: 1869: 1865: 1861: 1857: 1850: 1842: 1838: 1834: 1830: 1826: 1822: 1818: 1814: 1807: 1799: 1795: 1790: 1785: 1780: 1775: 1771: 1767: 1766:FASEB Journal 1763: 1756: 1748: 1744: 1740: 1736: 1732: 1728: 1721: 1713: 1709: 1704: 1699: 1694: 1689: 1685: 1681: 1677: 1670: 1668: 1666: 1657: 1653: 1648: 1643: 1639: 1635: 1631: 1627: 1623: 1616: 1608: 1604: 1597: 1589: 1585: 1581: 1577: 1573: 1569: 1562: 1554: 1550: 1545: 1540: 1536: 1532: 1528: 1524: 1520: 1513: 1511: 1496: 1492: 1486: 1478: 1474: 1469: 1464: 1460: 1456: 1452: 1448: 1444: 1437: 1435: 1433: 1431: 1429: 1427: 1418: 1414: 1409: 1404: 1400: 1396: 1392: 1388: 1384: 1377: 1361: 1357: 1353: 1346: 1338: 1334: 1330: 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Index

adjuvant
immunology
vaccine
antigens
aluminium salts
virosomes
immunology
immune system
respond
disease
evolutionarily
pathogen-associated molecular patterns
liposomes
lipopolysaccharide
antigens
cell walls
endocytosed
RNA
double-stranded RNA
single-stranded DNA
unmethylated CpG
evolved
antigenic
moieties
innate immune response
dendritic cells
lymphocytes
macrophages
infection
potassium alum

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