Abstract

The advent of mass vaccination has saved millions of human lives and revolutionized the quality of life. Vaccination is currently one of the most cost effective ways of managing healthcare costs in both emerging and developed countries. Despite the long vaccine history and success, design and development of efficacious and safe vaccines has been tradi-tionally semi-empirical. This is mainly due to our limited understanding of vaccination mechanism and its influencing factors. The most important factor is arguably the type and concentration of vaccine adjuvants. Until recently, however, only one type of adjuvant – aluminum salts, had been widely used within licensed human vaccines in the US, even though a variety of novel adjuvants have been evaluated in the past few decades. This review summarizes the key adju-vants that have been evaluated in recent years with an intention to facilitate more efficient development of vaccine products to combat human diseases.

Highlights

  • The advent of mass vaccination significantly reduced the morbidity or mortality of newborns and adults alike from various infectious diseases, which are otherwise unavoidable as a vast majority of the global population concentrate in cities with close contacts with one another

  • Until recent approval of AS04 adjuvant in a product licensed by GSK, only one type of adjuvant-aluminum salts, had been widely used within licensed human vaccines in the US, even though a variety of novel adjuvants have been evaluated in the past few decades

  • The efficacy and safety of aluminum salts have been well established through the long history of use, a minimum quantity is recommended for use in a vaccine, as we continue to gather new evidence for their potential side effect

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Summary

Introduction

The advent of mass vaccination significantly reduced the morbidity or mortality of newborns and adults alike from various infectious diseases, which are otherwise unavoidable as a vast majority of the global population concentrate in cities with close contacts with one another. It is estimated that universal influenza vaccination alone saves 250,000 - 500,000 annual deaths worldwide [1]. The gradual decrease both bvin morbidity and mortality has increased the life expectancy and quality of life as well. They have been proven to be very effective in preventing or controlling the occurrence and spreading of numerous deadly diseases through improvement of the host’s innate and adaptive immune systems. This review summarizes the key adjuvants that have been evaluated in recent years that affect the vaccine immunogenicity/efficacy with an intention to facilitate more efficient development of vaccine products to combat human diseases

Major Players in an Immune Response
Most Commonly Used Adjuvant Aluminum Salts
Adjuvantation Mechanisms
Antigen Adsorption to Aluminum Salts
Degree and Strength of Adsorption vs Immunogenicity
Storage and Process Stability of Aluminum
Stability of Antigen with Aluminum Salts
Oligonucleotides
Emulsions
Iscomatrix
Polymeric Solutions or Particulates
Saponins and QS21
Carrier Proteins
Toxins
4.12. Cytokines
4.12.2. Granulocyte-Macrophage Colony Stimulating
4.14. RNA-Like Compounds
4.15. Surfactant-Like Compounds
4.16. Bacteria and Other Related Components
Adjuvant Combinations
Findings
Summary
Full Text
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