Adjuvants in licensed human vaccines
| Type | First licensed | Description | Adjuvant | Vaccine examples |
|---|---|---|---|---|
| Alum (aluminium salts) | 1920 | Suspension of phosphate and hydroxide salts. Adsorption of antigens forms depot effect. Activates NALP3 inflammasome | Aluminium phosphate | Diphtheria, pertussis, tetanus (e.g., Adacel) [92]Pneumococcus (e.g., Synflorix) [93]Neisseria meningitidis (e.g., Trumenba®) [94] |
| Aluminium hydroxide | Anthrax (BioThrax®) [95]Hepatitis B (Engerix B) [96]Hepatitis A (e.g., Havrix®) [97]Japanese encephalitis (Ixiaro®) [98]Neisseria menigitis (e.g., Menjugate®) [97]Pneumococcus (e.g., Prevenar) [99] | |||
| Aluminium phosphate and aluminium hydroxide | Diphtheria, pertussis, tetanus (e.g., Boostrix®) [100] | |||
| Aluminium phosphate and amorphous aluminium hydroxyphosphate sulfate | Diphtheria, pertussis, tetanus (e.g., Vaxelis®) [101] | |||
| Amorphous aluminium hydroxyphosphate sulfate | Human papilloma virus (e.g., Gardasil®) [102]Hepatitis B (e.g., Recombivax) [103] | |||
| Oil-in-water emulsion | 1997 | Stabilized squalene oil in water emulsion induces inflammatory cytokines and forms antigen depot | MF59AS03 | Influenza (e.g., Fluad®, Pandemrix®) [104] |
| Immune potentiator | 2022 | Alum + TLR7/8 agonist | Alhydroxyquim | COVID-19 (Covaxin®) [105] |
| 2004 | Synthetic TLR4 ligand adsorbed to aluminum hydroxide | RC-529 | Hepatitis B [106] | |
| 2013 | Naturally derived TLR4 ligand adsorbed onto L-tyrosine | Monophosphoryl lipid A (MPL) | Pollen allergy (Pollinex®) [107] | |
| 2012 | TLR9 agonist CpG oligonucleotide | ISS1018 | Hepatitis B (Heplisav®) [66] | |
| 2022 | Increased cellular and humoral immunity | Alum-CpG1018 | COVID-19 (CorbeVax®) [108] | |
| Combined adjuvants | 2017 | Liposome co-delivering MPL and QS21 | AS01B | Shingles (Shingrix®) [109]Malaria (Mosquirix®) [110] |
| 2005 | MPL adsorbed on aluminium phosphate | AS04 | Human papilloma virus (e.g., Cervarix™) [111]Hepatitis B (Fendrix®) [112] | |
| 2021 | Delta inulin with synthetic CpG oligonucleotide | Advax-CpG55.2™ | COVID-19 (Spikogen®) [42] | |
| Saponin complex | 2021 | Saponin mixed with cholesterol | Matrix-M | COVID-19 (Nuvaxovid™) [113] |
TLR: Toll-like receptor
The viewpoint and content of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
AA: Writing—original draft. NP: Conceptualisation, Supervision, Writing—review & editing.
AA and NP are affiliated with Vaxine Pty Ltd which hold proprietary interests over Advax-CpG adjuvant.
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Development of Advax-CpG55.2 adjuvant was supported by funding from National Institute of Allergy and Infectious Diseases of the National Institutes of Health [HHS-N272201400053C, HHSN272201800044C]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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