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Immunologic adjuvant

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and presumably induce an immune response. A second mechanism depends on alum killing immune cells at the injection site although researchers aren't sure exactly how alum kills these cells. It has been speculated that the dying cells release DNA which serves as an immune alarm. Some studies found that
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in mineral oil developed in 1930. It is not safe enough for human use. A version without the bacteria, that is only oil in water, is known as Freund's incomplete adjuvant. It helps vaccines release antigens for a longer time. Despite the side effects, its potential benefit has led to a few clinical
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The precise mechanism of aluminium salts remains unclear but some insights have been gained. It was formerly thought that they function as delivery systems by generating depots that trap antigens at the injection site, providing a slow release that continues to stimulate the immune system. However,
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Subsequently, the American National Center for Biotechnology Information published an article discussing the comparative safety of vaccine adjuvants which stated that "the biggest remaining challenge in the adjuvant field is to decipher the potential relationship between adjuvants and rare vaccine
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Due to the variety of mechanisms and links between the innate and adaptive immune response, an adjuvant-enhanced innate immune response results in an enhanced adaptive immune response. Specifically, adjuvants may exert their immune-enhancing effects according to five immune-functional activities.
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In the early days of vaccine manufacture, significant variations in the efficacy of different batches of the same vaccine were correctly assumed to be caused by contamination of the reaction vessels. However, it was soon found that more scrupulous cleaning actually seemed to
364:(IL‑1β), an immune signal that promotes antibody production. Alum adheres to the cell's plasma membrane and rearranges certain lipids there. Spurred into action, the dendritic cells pick up the antigen and speed to lymph nodes, where they stick tightly to a 527:
In order to understand the links between the innate immune response and the adaptive immune response to help substantiate an adjuvant function in enhancing adaptive immune responses to the specific antigen of a vaccine, the following points should be considered:
852:-specific fragments that bind to DQB1*602 in cell culture experiments, leading to the hypothesis that autoimmunity may arise in genetically susceptible individuals, but there is no clinical data to support this hypothesis. The third AS03 ingredient is 401:
is a naturally-occurring organic compound used in human and animal vaccines. Squalene is an oil, made up of carbon and hydrogen atoms, produced by plants and is present in many foods. Squalene is also produced by the human liver as a precursor to
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Discussing the safety of squalene as an adjuvant in 2006, the World Health Organisation stated "follow-up to detect any vaccine-related adverse events will need to be performed." No such followup has been published by the WHO.
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methods, and in 1996 the Vaccine-Associated Feline Sarcoma Task Force was formed to address the problem. However, evidence conflicts on whether types of vaccines, manufacturers or factors have been associated with sarcomas.
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Masoudi S, Ploen D, Kunz K, Hildt E (May 2014). "The adjuvant component α-tocopherol triggers via modulation of Nrf2 the expression and turnover of hypocretin in vitro and its implication to the development of narcolepsy".
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is another squalene-containing adjuvant. In addition, squalene-based O/W emulsions have also been shown to stably incorporate small molecule TLR7/8 adjuvants (e.g. PVP-037) and lead to enhanced adjuvanticity via synergism.
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Second, adjuvants may provide physical protection to antigens which grants the antigen a prolonged delivery. This means the organism will be exposed to the antigen for a longer duration, making the immune system more
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is an oil-in-water emulsion of squalene adjuvant used in some human vaccines. As of 2021, over 22 million doses of one vaccine with squalene, FLUAD, have been administered with no severe adverse effects reported.
55:, meaning to help or aid. "An immunologic adjuvant is defined as any substance that acts to accelerate, prolong, or enhance antigen-specific immune responses when used in combination with specific vaccine 373:. No matter what the mechanism is, alum is not a perfect adjuvant because it does not work with all antigens (e.g. malaria and tuberculosis). However, recent research indicates that alum formulated in a 2313:"T cell proliferation by direct cross-talk between OX40 ligand on human mast cells and OX40 on human T cells: comparison of gene expression profiles between human tonsillar and lung-cultured mast cells" 1370: 959:
These observations suggest that although TLR activation can lead to increases in antibody responses, TLR activation is not required to induce enhanced innate and adaptive responses to antigens.
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Aluminium adjuvants have caused motor neuron death in mice when injected directly onto the spine at the scruff of the neck, and oil–water suspensions have been reported to increase the risk of
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which underlie TLR signaling has been significant in understanding why adjuvants used during vaccinations are so important in augmenting adaptive immune responses to specific
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for commercial vaccines. Aluminium salts are the most commonly-used adjuvants in human vaccines. Their adjuvant activity was described in 1926.
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Kirpensteijn J (October 2006). "Feline injection site-associated sarcoma: Is it a reason to critically evaluate our vaccination policies?".
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844:). Those vaccinated with Pandemrix have almost a twelve-times higher risk of developing the disease. The adjuvant of the vaccine contained 2692:"Risk of narcolepsy in children and young people receiving AS03 adjuvanted pandemic A/H1N1 2009 influenza vaccine: retrospective analysis" 369:
DNA from dying cells causes them to adhere more tightly to helper T cells which ultimately leads to an increased release of antibodies by
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proteins in TLR signaling), they were still able to induce inflammatory responses, increase T cell activation and generate greater
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development, the majority of researchers do not support a causal connection with aluminium. Adjuvants may make vaccines too
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In the lymph nodes, dendritic cells mince the engulfed pathogen and then express the pathogen clippings as antigen on their
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Fourth, they may induce the release of inflammatory cytokines which helps to not only recruit B and T cells at sites of
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as it makes use of the additional time by upregulating the production of B and T cells needed for greater immunological
2836: 4480: 2733:"AS03 adjuvanted AH1N1 vaccine associated with an abrupt increase in the incidence of childhood narcolepsy in Finland" 2606:
Tomljenovic L (2010). "Aluminum and Alzheimer's disease: after a century of controversy, is there a plausible link?".
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As of 2016, several TLR ligands were in clinical development or being tested in animal models as potential adjuvants.
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receptor that is present in a number of cell types of the immune system. The adjuvant CpG 1018 is used in an approved
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relationship between VAS and administration of aluminium adjuvated rabies and FeLV vaccines was established through
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Glenny A, Pope C, Waddington H, Wallace U (1926). "The antigenic value of toxoid precipitated by potassium alum".
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events that ultimately lead to innate immune responses and the development of antigen-specific acquired immunity.
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form rather than microparticles can broaden the utility of alum adjuvants and promote stronger adjuvant effects.
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Leroux-Roels G (August 2010). "Unmet needs in modern vaccinology: adjuvants to improve the immune response".
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or in the form of invasive moieties during times of natural infection – to TLRs mark the key
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Stertman L, Palm AE, Zarnegar B, Carow B, Lunderius Andersson C, Magnusson SE, et al. (December 2023).
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to allow immune cells of both systems to clear the area of pathogens. In addition, mast cells also release
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Immunopharmacology of infectious diseases: vaccine adjuvants and modulators of non-specific resistance
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Finally, adjuvants are believed to increase the innate immune response to antigen by interacting with
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Del Giudice G, Fragapane E, Bugarini R, Hora M, Henriksson T, Palla E, et al. (September 2006).
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Clements CJ, Griffiths E (May 2002). "The global impact of vaccines containing aluminium adjuvants".
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the effectiveness of the vaccines, and some contaminants actually enhanced the immune response.
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of other immune cells of both the innate and adaptive immune responses to the infected area.
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The combination of QS-21, cholesterol and MPL forms the adjuvant AS01 which is used in the
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studies have shown that surgical removal of these depots had no impact on the magnitude of
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adverse reactions, such as narcolepsy, macrophagic myofasciitis or Alzheimer's disease."
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Soni D, Borriello F, Scott DA, Feru F, DeLeon M, Brightman SE, et al. (July 2024).
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to the vaccine more vigorously, and thus providing increased immunity to a particular
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As of 2006, the premise that TLR signaling acts as the key node in antigen-mediated
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Third, adjuvants may help to increase the capacity to cause local reactions at the
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640:. This will ultimately lead to greater T cell activity resulting in a heightened 593:
and represents a physical link between the innate and adaptive immune responses.
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are often used to modify or augment the effects of a vaccine by stimulating the
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can also activate T cells in a similar approach (but do not do so naturally).
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This process carried out by both dendritic cells and macrophages is termed
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that was no more than a day's normal dietary intake. Vitamin E increases
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site (during vaccination), inducing greater release of danger signals by
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possess characteristics of both the innate and adaptive immune responses.
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Small molecules: TLR7/8 agonists (imidazoquinolines, imidazopyrimidines)
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Reports after the first Gulf War linked anthrax vaccine adjuvants to
945: 849: 661: 555:(adaptive immune cells) wait for signals to trigger their activation. 247:. MPL (Monophosphorylated lipid A) is a modified form of a bacterial 244: 1648: 789:
Aluminium salts used in many human vaccines are regarded as safe by
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is a substance that increases or modulates the immune response to a
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used for this purpose, but has been almost completely replaced by
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to effectively increase trafficking to and seal off the site of
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and other European countries after vaccinations to address the
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correlated with the use of AS03-adjuvanted influenza vaccine (
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There are many known adjuvants in widespread use, including
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surface by coupling them to a special receptor known as a
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have observed antigen-mediated inflammatory responses in
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T cells can then recognize these clippings and undergo a
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dinucleotide-containing DNA. Because immune systems have
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vaccine approved in 2017, as well as in the approved
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The 887:in rats already prone to arthritis. 718:is, in part, due to the presence of 701:(PRRs) on or within accessory cells. 690:events leading to a net increase of 547:Dendritic cells then migrate to the 2520:Toussi DN, Massari P (April 2014). 1080:DNA Vaccines: Methods and Protocols 987:United States Department of Defense 444:(MPL), a detoxified version of the 427:is a liposome made up of two plant 4440:Eradication of infectious diseases 4197:Androvax (androstenedione albumin) 2643:"Is the Aluminum Hypothesis dead?" 2145:from the original on 24 April 2019 1373:from the original on 9 August 2021 1363:"Peanut Oil Used in a New Vaccine" 1078:. 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It is used in the approved 388:is a solution of inactivated 3078:10.1016/j.vetmic.2006.04.010 2832:Food and Drug Administration 2758:10.1371/journal.pone.0033536 2659:10.1097/jom.0000000000000063 2136:Food and Drug Administration 989:strongly denied the claims. 791:Food and Drug Administration 459:to enhance immune response. 437:, a Chilean soap bark tree. 150:to recognize these specific 2330:10.4049/jimmunol.173.8.5247 1844:10.1126/science.341.6141.26 714:that are broadly shared by 200:calcium phosphate hydroxide 4529: 3148:Butler D (November 1997). 2281:10.4049/jimmunol.154.2.804 1637:Nature Reviews. Immunology 1470:10.1038/s41573-021-00163-y 1295:10.1016/j.phrs.2015.08.003 1072:Sasaki S, Okuda K (2000). 892:vaccine-associated sarcoma 482:immune stimulating complex 391:Mycobacterium tuberculosis 386:Freund's complete adjuvant 298:Freund's complete adjuvant 122:, components of bacterial 29: 4458: 3274:10.1007/s40264-015-0350-4 2129:"Shingrix package insert" 2008:European Medicines Agency 1410:10.1017/s0022172400024323 1123:Travis K (January 2007). 1092:10.1385/1-59259-688-6:241 813:medication if necessary. 540:through a process called 505:cytosine phosphoguanosine 216:). Adjuvant 65 (based on 3782:Clostridioides difficile 3042:10.2460/javma.229.9.1405 2430:International Immunology 2406:10.1051/medsci/200723167 2002:October 7, 2009, at the 1283:Pharmacological Research 675:releasing cells such as 523:Adaptive immune response 494:Novavax Covid-19 vaccine 406:and is present in human 333:was the first aluminium 224:is used in the adjuvant 4040:Tick-borne encephalitis 3066:Veterinary Microbiology 2937:Journal of Autoimmunity 2892:Neuromolecular Medicine 2620:10.3233/JAD-2010-101494 2539:10.3390/vaccines2020323 1184:10.1126/science.1135299 816:An increased number of 805:, which often leads to 571:cellular transformation 362:Interleukin 1 beta 173:by mimicking a natural 4450:List of vaccine topics 3450:Mathematical modelling 2641:Lidsky TI (May 2014). 1546:10.1126/sciadv.adg3747 1398:The Journal of Hygiene 1215:Majde JA, ed. (1987). 159:innate immune response 130:nucleic acids such as 118:, molecular cages for 51: 4445:Vaccinate Your Family 3896:Japanese encephalitis 3321:immunologic adjuvant 2442:10.1093/intimm/dxh186 2317:Journal of Immunology 2268:Journal of Immunology 1022:Pharmaceutic adjuvant 780:Medical complications 686:but also to increase 503:Several unmethylated 186:Inorganic compounds: 27:Component of vaccines 4328:John Franklin Enders 3245:on November 4, 2012. 2862:dailymed.nlm.nih.gov 2653:(5 Suppl): S73–S79. 2579:(Suppl 3): S18–S23. 1934:10.1128/CVI.00191-06 1884:10.3390/ijms23094707 1790:10.1096/fj.11-184556 1744:(Suppl 3): C25–C36. 1704:10.1155/2016/1459394 1585:(Suppl 3): S24–S33. 885:rheumatoid arthritis 744:natural killer cells 591:antigen presentation 234:Bordetella pertussis 30:For other uses, see 3514:Virus-like particle 3438:Vaccine ingredients 3166:1997Natur.390Q...3B 3111:(5807): 1859–1860. 2749:2012PLoSO...733536N 2481:1997Natur.388..394M 2240:10.1038/nature02238 2231:2004Natur.427..154M 1976:on November 4, 2012 1836:2013Sci...341...26L 1243:. Superbabyonline. 1176:2006Sci...314.1936G 1170:(5807): 1936–1938. 799:Alzheimer's disease 724:toll-like receptors 706:Toll-like receptors 517:Hepatitis B vaccine 448:from the bacterium 343:aluminium phosphate 339:aluminium hydroxide 312:Inorganic adjuvants 240:Mycobacterium bovis 214:preclinical studies 196:aluminium phosphate 192:aluminium hydroxide 140:single-stranded DNA 136:double-stranded RNA 4485:Never to phase III 4284:Hexavalent vaccine 4098:Epstein–Barr virus 3993:Oxford–AstraZeneca 3686:NmVac4-A/C/Y/W-135 3356:2020-05-14 at the 3344:2012-02-27 at the 3318:has a profile for 2905:10.1385/NMM:9:1:83 2017:2013-07-15 at the 1614:J Pathol Bacteriol 881:autoimmune disease 862:Oxford–AstraZeneca 446:lipopolysaccharide 434:Quillaja saponaria 423:The plant extract 116:lipopolysaccharide 4495: 4494: 4407:Vaccines and SIDS 4294: 4293: 4068:Hepatitis A and B 4044:Varicella zoster 3506:Subunit/component 3324: 3268:(11): 1059–1074. 2799:(25): 2980–2988. 2702:(feb26 2): f794. 2475:(6640): 394–397. 2393:MĂ©decine/Sciences 2225:(6970): 154–159. 2170:Nature Immunology 983:Gulf War syndrome 869:COVID-19 vaccines 752:endothelial cells 596:Upon activation, 381:Organic adjuvants 356:Alum can trigger 16:(Redirected from 4520: 4386:MMR autism fraud 4333:Maurice Hilleman 4318:Hilary Koprowski 3631: 3387: 3380: 3373: 3364: 3334:Adjuvant therapy 3322: 3312: 3311: 3296: 3295: 3285: 3253: 3247: 3246: 3241:. Archived from 3234: 3228: 3227: 3225: 3223: 3214:. 30 July 2001. 3202: 3196: 3195: 3177: 3145: 3139: 3138: 3120: 3096: 3090: 3089: 3061: 3055: 3054: 3044: 3035:(9): 1405–1441. 3020: 3014: 3013: 3008:. Archived from 2999: 2982:(6): 2057–2065. 2967: 2961: 2960: 2932: 2926: 2925: 2907: 2883: 2877: 2876: 2874: 2873: 2854: 2848: 2847: 2845: 2844: 2823: 2817: 2816: 2787: 2781: 2780: 2770: 2760: 2728: 2722: 2721: 2711: 2709:10.1136/bmj.f794 2687: 2681: 2680: 2670: 2638: 2632: 2631: 2603: 2597: 2596: 2568: 2562: 2561: 2551: 2541: 2517: 2511: 2510: 2492: 2460: 2454: 2453: 2425: 2419: 2418: 2408: 2384: 2378: 2377: 2349: 2343: 2342: 2332: 2323:(8): 5247–5257. 2308: 2302: 2301: 2283: 2259: 2253: 2252: 2242: 2210: 2204: 2203: 2185: 2161: 2155: 2154: 2152: 2150: 2144: 2133: 2125: 2116: 2115: 2105: 2073: 2064: 2063: 2027: 2021: 1994: 1985: 1984: 1982: 1981: 1972:. Archived from 1962: 1956: 1955: 1945: 1928:(9): 1010–1013. 1913: 1907: 1906: 1896: 1886: 1862: 1856: 1855: 1819: 1813: 1812: 1802: 1792: 1783:(3): 1272–1279. 1768: 1762: 1761: 1733: 1727: 1726: 1716: 1706: 1682: 1671: 1670: 1660: 1628: 1622: 1621: 1609: 1603: 1602: 1574: 1568: 1567: 1557: 1540:(27): eadg3747. 1534:Science Advances 1525: 1516: 1515: 1513: 1512: 1498: 1492: 1491: 1481: 1449: 1432: 1431: 1421: 1389: 1383: 1382: 1380: 1378: 1358: 1352: 1351: 1323: 1317: 1316: 1306: 1274: 1257: 1256: 1254: 1252: 1237: 1231: 1230: 1212: 1206: 1205: 1195: 1155: 1144: 1143: 1141: 1140: 1120: 1114: 1113: 1077: 1069: 1063: 1062: 1060: 1058: 1052: 1045: 1037: 859: 830:pandemic in 2009 811:over-the-counter 720:immune receptors 509:oligonucleotides 292:oligonucleotides 144:unmethylated CpG 110:, which include 54: 21: 4528: 4527: 4523: 4522: 4521: 4519: 4518: 4517: 4498: 4497: 4496: 4491: 4490: 4475:Clinical trials 4454: 4423: 4362: 4338:Stanley Plotkin 4300: 4290: 4202:Cancer vaccines 4185: 4179:Schistosomiasis 4157: 4151:Trypanosomiasis 4124: 4088:Cytomegalovirus 3998:Pfizer–BioNTech 3798: 3622: 3571:Vaccine wastage 3541: 3469: 3421: 3391: 3358:Wayback Machine 3346:Wayback Machine 3339:Animal research 3330: 3329: 3328: 3313: 3309: 3304: 3299: 3255: 3254: 3250: 3236: 3235: 3231: 3221: 3219: 3211:TheGuardian.com 3204: 3203: 3199: 3147: 3146: 3142: 3098: 3097: 3093: 3063: 3062: 3058: 3022: 3021: 3017: 2969: 2968: 2964: 2934: 2933: 2929: 2885: 2884: 2880: 2871: 2869: 2856: 2855: 2851: 2842: 2840: 2825: 2824: 2820: 2789: 2788: 2784: 2730: 2729: 2725: 2689: 2688: 2684: 2640: 2639: 2635: 2605: 2604: 2600: 2570: 2569: 2565: 2519: 2518: 2514: 2462: 2461: 2457: 2427: 2426: 2422: 2386: 2385: 2381: 2351: 2350: 2346: 2310: 2309: 2305: 2261: 2260: 2256: 2212: 2211: 2207: 2163: 2162: 2158: 2148: 2146: 2142: 2131: 2127: 2126: 2119: 2075: 2074: 2067: 2029: 2028: 2024: 2019:Wayback Machine 2004:Wayback Machine 1995: 1988: 1979: 1977: 1964: 1963: 1959: 1915: 1914: 1910: 1864: 1863: 1859: 1830:(6141): 26–27. 1821: 1820: 1816: 1770: 1769: 1765: 1735: 1734: 1730: 1684: 1683: 1674: 1649:10.1038/nri2510 1630: 1629: 1625: 1611: 1610: 1606: 1576: 1575: 1571: 1527: 1526: 1519: 1510: 1508: 1500: 1499: 1495: 1451: 1450: 1435: 1391: 1390: 1386: 1376: 1374: 1360: 1359: 1355: 1325: 1324: 1320: 1276: 1275: 1260: 1250: 1248: 1239: 1238: 1234: 1227: 1214: 1213: 1209: 1157: 1156: 1147: 1138: 1136: 1122: 1121: 1117: 1102: 1071: 1070: 1066: 1056: 1054: 1050: 1043: 1039: 1038: 1034: 1030: 1017:Immunostimulant 1012:Immunomodulator 1003: 979: 954:Ribi's adjuvant 914: 909: 877: 857: 787: 782: 761:The binding of 736:dendritic cells 708: 688:transcriptional 679:and mast cells. 648:throughout the 534:dendritic cells 525: 498:malaria vaccine 468:malaria vaccine 440:Monophosphoryl 383: 358:dendritic cells 319: 317:Aluminium salts 314: 269:Polygala senega 183: 163:dendritic cells 84: 72:aluminium salts 35: 28: 23: 22: 18:Immune adjuvant 15: 12: 11: 5: 4526: 4524: 4516: 4515: 4510: 4500: 4499: 4493: 4492: 4489: 4488: 4487: 4486: 4483: 4472: 4466: 4460: 4459: 4456: 4455: 4453: 4452: 4447: 4442: 4437: 4431: 4429: 4425: 4424: 4422: 4421: 4416: 4409: 4404: 4399: 4394: 4389: 4376: 4370: 4368: 4364: 4363: 4361: 4360: 4355: 4353:Katalin KarikĂł 4350: 4345: 4340: 4335: 4330: 4325: 4320: 4315: 4310: 4304: 4302: 4296: 4295: 4292: 4291: 4289: 4288: 4287: 4286: 4281: 4276: 4271: 4263: 4258: 4253: 4248: 4243: 4242: 4241: 4236: 4235: 4234: 4229: 4219: 4214: 4209: 4199: 4193: 4191: 4187: 4186: 4184: 4183: 4182: 4181: 4176: 4167: 4165: 4159: 4158: 4156: 4155: 4154: 4153: 4145: 4144: 4143: 4132: 4130: 4126: 4125: 4123: 4122: 4121: 4120: 4115: 4110: 4108:Herpes simplex 4105: 4100: 4095: 4090: 4082: 4081: 4080: 4075: 4070: 4062: 4057: 4056: 4055: 4050: 4042: 4037: 4032: 4027: 4026: 4025: 4020: 4015: 4010: 4008:Sinopharm BIBP 4005: 4000: 3995: 3990: 3985: 3980: 3975: 3970: 3965: 3960: 3958:Bharat Biotech 3955: 3945: 3940: 3935: 3930: 3929: 3928: 3923: 3913: 3908: 3903: 3898: 3893: 3892: 3891: 3886: 3876: 3871: 3866: 3861: 3856: 3855: 3854: 3849: 3844: 3829: 3828: 3827: 3817: 3812: 3806: 3804: 3800: 3799: 3797: 3796: 3795: 3794: 3789: 3784: 3776: 3775: 3774: 3769: 3761: 3756: 3755: 3754: 3749: 3739: 3738: 3737: 3727: 3722: 3717: 3716: 3715: 3710: 3700: 3695: 3690: 3689: 3688: 3683: 3673: 3668: 3663: 3658: 3653: 3648: 3643: 3637: 3635: 3628: 3624: 3623: 3621: 3620: 3619: 3618: 3613: 3608: 3603: 3598: 3590: 3589: 3588: 3586:Vaccine injury 3583: 3578: 3573: 3568: 3563: 3558: 3549: 3547: 3546:Administration 3543: 3542: 3540: 3539: 3534: 3529: 3520: 3503: 3502: 3501: 3496: 3488: 3483: 3477: 3475: 3471: 3470: 3468: 3467: 3462: 3457: 3452: 3447: 3446: 3445: 3435: 3429: 3427: 3423: 3422: 3392: 3390: 3389: 3382: 3375: 3367: 3361: 3360: 3351:Vaxjo database 3348: 3336: 3314: 3307: 3306: 3305: 3303: 3302:External links 3300: 3298: 3297: 3248: 3229: 3197: 3140: 3091: 3056: 3015: 3012:on 2003-11-21. 2962: 2927: 2878: 2849: 2818: 2782: 2723: 2682: 2633: 2614:(4): 567–598. 2598: 2563: 2532:(2): 323–353. 2512: 2455: 2420: 2379: 2360:(4): 456–463. 2344: 2303: 2274:(2): 804–813. 2254: 2205: 2176:(6): 579–585. 2156: 2117: 2088:(1): 2189885. 2065: 2038:(6): 807–816. 2022: 1986: 1957: 1908: 1857: 1814: 1763: 1728: 1672: 1643:(4): 287–293. 1623: 1604: 1569: 1517: 1493: 1464:(6): 454–475. 1433: 1404:(2): 251–259. 1384: 1367:New York Times 1353: 1318: 1258: 1232: 1226:978-0845141052 1225: 1207: 1145: 1115: 1101:978-0896035805 1100: 1064: 1031: 1029: 1026: 1025: 1024: 1019: 1014: 1009: 1002: 999: 978: 975: 913: 910: 908: 905: 876: 873: 854:polysorbate 80 786: 783: 781: 778: 707: 704: 703: 702: 695: 680: 677:helper T cells 665: 653: 587: 586: 580: 574: 567: 556: 545: 524: 521: 500:R21/Matrix-M. 382: 379: 327:immunogenicity 318: 315: 313: 310: 309: 308: 305: 296:Combinations: 294: 286: 272: 252: 229: 202: 188:potassium alum 182: 179: 104:evolutionarily 83: 80: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 4525: 4514: 4511: 4509: 4506: 4505: 4503: 4484: 4482: 4479: 4478: 4476: 4473: 4470: 4467: 4465: 4462: 4461: 4457: 4451: 4448: 4446: 4443: 4441: 4438: 4436: 4433: 4432: 4430: 4426: 4420: 4417: 4415: 4414: 4410: 4408: 4405: 4403: 4400: 4398: 4395: 4393: 4390: 4387: 4385: 4380: 4377: 4375: 4372: 4371: 4369: 4365: 4359: 4358:Drew Weissman 4356: 4354: 4351: 4349: 4346: 4344: 4343:H. Fred Clark 4341: 4339: 4336: 4334: 4331: 4329: 4326: 4324: 4321: 4319: 4316: 4314: 4313:Louis Pasteur 4311: 4309: 4308:Edward Jenner 4306: 4305: 4303: 4297: 4285: 4282: 4280: 4279:DTwP-HepB-Hib 4277: 4275: 4274:DTaP-IPV-HepB 4272: 4270: 4267: 4266: 4265:combination: 4264: 4262: 4259: 4257: 4254: 4252: 4249: 4247: 4244: 4240: 4237: 4233: 4230: 4228: 4225: 4224: 4223: 4220: 4218: 4215: 4213: 4210: 4208: 4205: 4204: 4203: 4200: 4198: 4195: 4194: 4192: 4188: 4180: 4177: 4175: 4172: 4171: 4169: 4168: 4166: 4164: 4163:Helminthiasis 4160: 4152: 4149: 4148: 4146: 4142: 4139: 4138: 4137: 4134: 4133: 4131: 4127: 4119: 4116: 4114: 4111: 4109: 4106: 4104: 4101: 4099: 4096: 4094: 4091: 4089: 4086: 4085: 4083: 4079: 4076: 4074: 4071: 4069: 4066: 4065: 4064:combination: 4063: 4061: 4058: 4054: 4051: 4049: 4046: 4045: 4043: 4041: 4038: 4036: 4033: 4031: 4028: 4024: 4021: 4019: 4016: 4014: 4011: 4009: 4006: 4004: 4001: 3999: 3996: 3994: 3991: 3989: 3986: 3984: 3981: 3979: 3976: 3974: 3971: 3969: 3966: 3964: 3961: 3959: 3956: 3954: 3951: 3950: 3949: 3946: 3944: 3941: 3939: 3936: 3934: 3931: 3927: 3924: 3922: 3919: 3918: 3917: 3914: 3912: 3909: 3907: 3904: 3902: 3899: 3897: 3894: 3890: 3887: 3885: 3882: 3881: 3880: 3877: 3875: 3872: 3870: 3867: 3865: 3862: 3860: 3857: 3853: 3850: 3848: 3845: 3842: 3838: 3835: 3834: 3833: 3830: 3826: 3823: 3822: 3821: 3818: 3816: 3813: 3811: 3808: 3807: 3805: 3801: 3793: 3790: 3788: 3785: 3783: 3780: 3779: 3777: 3773: 3770: 3768: 3767:DPT/DTwP/DTaP 3765: 3764: 3763:combination: 3762: 3760: 3757: 3753: 3750: 3748: 3745: 3744: 3743: 3740: 3736: 3733: 3732: 3731: 3728: 3726: 3723: 3721: 3718: 3714: 3711: 3709: 3706: 3705: 3704: 3701: 3699: 3696: 3694: 3691: 3687: 3684: 3682: 3679: 3678: 3677: 3676:Meningococcus 3674: 3672: 3669: 3667: 3666:Leptospirosis 3664: 3662: 3659: 3657: 3654: 3652: 3649: 3647: 3644: 3642: 3639: 3638: 3636: 3632: 3629: 3625: 3617: 3614: 3612: 3609: 3607: 3604: 3602: 3601:Vaccine court 3599: 3597: 3594: 3593: 3591: 3587: 3584: 3582: 3579: 3577: 3574: 3572: 3569: 3567: 3564: 3562: 3559: 3557: 3556:GAVI Alliance 3554: 3553: 3551: 3550: 3548: 3544: 3538: 3535: 3533: 3530: 3528: 3524: 3521: 3519: 3515: 3511: 3507: 3504: 3500: 3497: 3495: 3492: 3491: 3489: 3487: 3484: 3482: 3479: 3478: 3476: 3472: 3466: 3463: 3461: 3458: 3456: 3453: 3451: 3448: 3444: 3441: 3440: 3439: 3436: 3434: 3431: 3430: 3428: 3424: 3419: 3415: 3411: 3407: 3403: 3399: 3395: 3388: 3383: 3381: 3376: 3374: 3369: 3368: 3365: 3359: 3355: 3352: 3349: 3347: 3343: 3340: 3337: 3335: 3332: 3331: 3326: 3325: 3317: 3301: 3293: 3289: 3284: 3279: 3275: 3271: 3267: 3263: 3259: 3252: 3249: 3244: 3240: 3233: 3230: 3217: 3213: 3212: 3207: 3201: 3198: 3193: 3189: 3185: 3181: 3176: 3175:10.1038/36158 3171: 3167: 3163: 3160:(6655): 3–4. 3159: 3155: 3151: 3144: 3141: 3136: 3132: 3128: 3124: 3119: 3114: 3110: 3106: 3102: 3095: 3092: 3087: 3083: 3079: 3075: 3071: 3067: 3060: 3057: 3052: 3048: 3043: 3038: 3034: 3030: 3026: 3019: 3016: 3011: 3007: 3003: 2998: 2993: 2989: 2985: 2981: 2977: 2973: 2966: 2963: 2958: 2954: 2950: 2946: 2942: 2938: 2931: 2928: 2923: 2919: 2915: 2911: 2906: 2901: 2898:(1): 83–100. 2897: 2893: 2889: 2882: 2879: 2867: 2863: 2859: 2853: 2850: 2838: 2834: 2833: 2828: 2822: 2819: 2814: 2810: 2806: 2802: 2798: 2794: 2786: 2783: 2778: 2774: 2769: 2764: 2759: 2754: 2750: 2746: 2742: 2738: 2734: 2727: 2724: 2719: 2715: 2710: 2705: 2701: 2697: 2693: 2686: 2683: 2678: 2674: 2669: 2664: 2660: 2656: 2652: 2648: 2644: 2637: 2634: 2629: 2625: 2621: 2617: 2613: 2609: 2602: 2599: 2594: 2590: 2586: 2582: 2578: 2574: 2567: 2564: 2559: 2555: 2550: 2545: 2540: 2535: 2531: 2527: 2523: 2516: 2513: 2508: 2504: 2500: 2496: 2491: 2490:10.1038/41131 2486: 2482: 2478: 2474: 2470: 2466: 2459: 2456: 2451: 2447: 2443: 2439: 2435: 2431: 2424: 2421: 2416: 2412: 2407: 2402: 2398: 2394: 2390: 2383: 2380: 2375: 2371: 2367: 2363: 2359: 2355: 2348: 2345: 2340: 2336: 2331: 2326: 2322: 2318: 2314: 2307: 2304: 2299: 2295: 2291: 2287: 2282: 2277: 2273: 2269: 2265: 2258: 2255: 2250: 2246: 2241: 2236: 2232: 2228: 2224: 2220: 2216: 2209: 2206: 2201: 2197: 2193: 2189: 2184: 2183:10.1038/ni928 2179: 2175: 2171: 2167: 2160: 2157: 2141: 2137: 2130: 2124: 2122: 2118: 2113: 2109: 2104: 2099: 2095: 2091: 2087: 2083: 2079: 2072: 2070: 2066: 2061: 2057: 2053: 2049: 2045: 2041: 2037: 2033: 2026: 2023: 2020: 2016: 2013: 2009: 2005: 2001: 1998: 1993: 1991: 1987: 1975: 1971: 1967: 1961: 1958: 1953: 1949: 1944: 1939: 1935: 1931: 1927: 1923: 1919: 1912: 1909: 1904: 1900: 1895: 1890: 1885: 1880: 1876: 1872: 1868: 1861: 1858: 1853: 1849: 1845: 1841: 1837: 1833: 1829: 1825: 1818: 1815: 1810: 1806: 1801: 1796: 1791: 1786: 1782: 1778: 1777:FASEB Journal 1774: 1767: 1764: 1759: 1755: 1751: 1747: 1743: 1739: 1732: 1729: 1724: 1720: 1715: 1710: 1705: 1700: 1696: 1692: 1688: 1681: 1679: 1677: 1673: 1668: 1664: 1659: 1654: 1650: 1646: 1642: 1638: 1634: 1627: 1624: 1619: 1615: 1608: 1605: 1600: 1596: 1592: 1588: 1584: 1580: 1573: 1570: 1565: 1561: 1556: 1551: 1547: 1543: 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Index

Immune adjuvant
adjuvant
immunology
vaccine
antigens
aluminium salts
virosomes
immunology
immune system
respond
disease
evolutionarily
pathogen-associated molecular patterns
liposomes
lipopolysaccharide
antigens
cell walls
endocytosed
RNA
double-stranded RNA
single-stranded DNA
unmethylated CpG
evolved
antigenic
moieties
innate immune response
dendritic cells
lymphocytes
macrophages
infection

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