That is the crux of a debate over adjuvants — a class of substances that somewhat mysteriously increase the potency of vaccines. Early studies suggest that adjuvants (pronounced AD-joo-vants) could allow four times as many people to be immunized against the H1N1 pandemic influenza with a given amount of vaccine. So with the world facing possibly severe shortages of vaccine, the World Health Organization and some health experts have been calling for the use of adjuvants to stretch the vaccine supply.
“We have always argued that using adjuvanted vaccine would leave more vaccine for poor people,” said Marie-Paule Kieny, director of the World Health Organization’s initiative for vaccine research.”
Comment from Leslie
Oh…this article gets better and better – calling adjuvants a witches brew of ingredients…also mentioning Gardasil and Cervarix, aluminum and squalene…boil, boil, toil and trouble….hmmm maybe a witches brew to burn the witches….
….“For the longest time, adjuvants were sort of a witch’s brew of substances, empirically designed,” said Bali Pulendran, a professor of pathology at Emory University. “What was once a black box is now being illuminated at the mechanistic level by new advances in immunology.”
The term adjuvant, from a Latin word meaning “to help,” was coined in the 1920s by Gaston Ramon, a veterinarian at the Pasteur Institute in France, who observed that horses given diphtheria toxin had a stronger immune response if they had some inflammation at the injection site. Among his first adjuvants were bread crumbs and tapioca.
Within a few years, scientists discovered that aluminum salts could prompt an immune response. Alum, as this adjuvant is often called, is now used in various vaccines, including those for tetanus and hepatitis B. It is a relatively weak adjuvant. But about 80 years after its discovery, it is still the only one used in vaccines the United States.
That could soon change. An advisory committee to the F.D.A. recently recommended approval of Cervarix, a vaccine against the virus that causes cervical cancer. The vaccine, made by GlaxoSmithKline, uses an adjuvant containing a bacterial lipid. (Gardasil, the Merck cervical cancer vaccine already in use, has an aluminum adjuvant.)
Alum is not used in flu shots because it has little effect. But Novartis and GlaxoSmithKline are selling pandemic flu vaccines containing newer adjuvants they have developed. They are oil-in-water emulsions of squalene, a lipid that is found in the body. Glaxo’s also contains vitamin E.