Aluminum Adjuvants-'Back to the Future'

Aluminum-based adjuvants will continue to be a key component of currently approved and next generation vaccines, including important combination vaccines. The widespread use of aluminum adjuvants is due to their excellent safety profile, which has been established through the use of hundreds of mill...

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Bibliographic Details
Published in:Pharmaceutics 2023-07, Vol.15 (7), p.1884
Main Authors: Laera, Donatello, HogenEsch, Harm, O'Hagan, Derek T
Format: Article
Language:English
Subjects:
adjuvant combinations
Adsorption
Aluminum
aluminum hydroxide
aluminum phosphate
antigen adsorption
Antigens
Independent regulatory commissions
Lymphatic system
Microscopy
multivalent vaccines
Nanoparticles
Potassium
Review
Toll-like receptors
Vaccines
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Summary:Aluminum-based adjuvants will continue to be a key component of currently approved and next generation vaccines, including important combination vaccines. The widespread use of aluminum adjuvants is due to their excellent safety profile, which has been established through the use of hundreds of millions of doses in humans over many years. In addition, they are inexpensive, readily available, and are well known and generally accepted by regulatory agencies. Moreover, they offer a very flexible platform, to which many vaccine components can be adsorbed, enabling the preparation of liquid formulations, which typically have a long shelf life under refrigerated conditions. Nevertheless, despite their extensive use, they are perceived as relatively 'weak' vaccine adjuvants. Hence, there have been many attempts to improve their performance, which typically involves co-delivery of immune potentiators, including Toll-like receptor (TLR) agonists. This approach has allowed for the development of improved aluminum adjuvants for inclusion in licensed vaccines against HPV, HBV, and COVID-19, with others likely to follow. This review summarizes the various aluminum salts that are used in vaccines and highlights how they are prepared. We focus on the analytical challenges that remain to allowing the creation of well-characterized formulations, particularly those involving multiple antigens. In addition, we highlight how aluminum is being used to create the next generation of improved adjuvants through the adsorption and delivery of various TLR agonists.
ISSN:1999-4923
1999-4923
DOI:10.3390/pharmaceutics15071884