Refl ection and Reaction
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Aluminium-adsorbed vaccines
In 2004, I commented in The Lancet Infectious Diseases
that it was too early to conclude that aluminium adjuvants
were safe for all to use.1 This opinion has been
strengthened by recent research highlighting delayed
hypersensitivity to aluminium in children who have
received aluminium-adsorbed vaccines.2,3 Contact allergy
to aluminium has been known for some time,4 although
delayed hypersensitivity to aluminium is a recently
recognised phenomenon of unknown aetiology. The
observation that the body retains a “memory” of previous
exposure to aluminium (as an adjuvant) is intriguing and
may support research that reported the development of
anti-aluminium monoclonal antibodies.5 Delayed
hypersensitivity to aluminium raises a number of issues
relating to the biological availability of this environmental
toxin, perhaps not least of which, and pertinent to this
moment in time, is the plan to improve the
immunogenicity of (bird) fl u vaccine by using aluminiumbased
adjuvants.6 It is my opinion that substantially
increased use of aluminium-adsorbed vaccines should be
put on hold until research has demonstrated their safety,
if not to all then to most individuals.
Christopher Exley
CE is Reader in Bioinorganic Chemistry, Birchall Centre for
Inorganic Chemistry and Materials Science, Keele University, UK.
Correspondence to: Dr Christoper Exley, Birchall Centre for
Inorganic Chemistry and Materials Science, Keele University,
Staff ordshire, ST5 5BG, UK.
[email protected]
1 Exley C. Aluminium-containing DTP vaccines. Lancet Infect Dis 2004; 4: 324.
2 Bergfors E, Trollfors B, Inerot A. Unexpectedly high incidence of persistent
itching nodules and delayed hypersensitivity to aluminium in children after
the use of adsorbed vaccines from a single manufacturer. Vaccine 2003; 22:
64–69.
3 Bergfors E, Björkelund C, Trollfors B. Nineteen cases of persistent pruritic
nodules and contact allergy to aluminium after injection of commonly
used aluminium-adsorbed vaccines. Eur J Pediatr 2005; 164: 691–97.
4 Bohler-Sommeregger K, Lindemayr H. Contact sensitivity to aluminium.
Contact Dermatitis 1986; 15: 278–81.
5 Levy R, Shohat L, Solomon B. Specifi city of an anti-aluminium monoclonal
antibody toward free and protein-bound aluminium. J Inorg Biochem 1998;
69: 159–63.
6 Wadman M. Race is on for fl u vaccine. Nature 2005; 438: 23.
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