No pain no gain? Adjuvant effects of alum and monophosphoryl lipid A in pertussis and HPV vaccines

Curr Opin Immunol. 2017 Aug;47:17-25. doi: 10.1016/j.coi.2017.06.009. Epub 2017 Jul 17.

Abstract

Development of non-infectious subunit vaccines is hampered by a slow pipeline of new adjuvants to replace or enhance alum in part because expectations of safety are high. Transient vaccine side effects are not clinical priorities because they cause no lasting harm and vaccine development has appropriately been focused on avoidance of serious adverse events. As a result, surprisingly little is known about the extent to which side effects caused by a vaccine's reactogencicity are predictive of successful immunization outcomes. Recent clinical studies of pertussis and human papillomavirus vaccines adjuvanted with alum or the TLR4 agonist monophosphoryl lipid A can be used to advance understanding of the relationship between vaccine side effects and immunization outcomes.

Publication types

  • Review

MeSH terms

  • Adjuvants, Immunologic / administration & dosage*
  • Adjuvants, Immunologic / adverse effects
  • Alum Compounds / administration & dosage*
  • Alum Compounds / adverse effects
  • Antibodies, Viral / metabolism*
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / adverse effects
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / immunology*
  • Drug-Related Side Effects and Adverse Reactions / prevention & control*
  • Humans
  • Lipid A / administration & dosage
  • Lipid A / analogs & derivatives*
  • Lipid A / pharmacology
  • Pain / etiology
  • Pain / prevention & control*
  • Papillomavirus Infections / immunology*
  • Papillomavirus Infections / prevention & control
  • Papillomavirus Vaccines / adverse effects
  • Papillomavirus Vaccines / immunology*
  • Toll-Like Receptor 4 / agonists
  • Treatment Outcome
  • Vaccination
  • Whooping Cough / immunology*
  • Whooping Cough / prevention & control

Substances

  • Adjuvants, Immunologic
  • Alum Compounds
  • Antibodies, Viral
  • Diphtheria-Tetanus-acellular Pertussis Vaccines
  • Lipid A
  • Papillomavirus Vaccines
  • Toll-Like Receptor 4
  • aluminum sulfate
  • monophosphoryl lipid A