HM’s point may be that since the molecular mechanism of at least some adjuvants is incompletely understood we shouldn’t be using them.
However, there are situations in medicine where effective therapies have been used safely for a long time without such mechanisms being elucidated.
A case in point is salicylic acid, which was used to combat pain and fever for at least hundreds of years before the development of aspirin in the 19th century, followed by aspirin’s use for the same thing for many decades before we got a good handle on just how aspirin worked.
I don’t see the reasoning behind dumping adjuvants which have been found safe and effective and help eliminate suffering and death from preventable infectious disease.
I never wrote that the applications of adjuvants ought to be dumped. I meant purely that their use ought to be limited until a better understanding of the mechanism is needed before approval for the general consumption.
That said, it was also the same reason that artificial hearts were not used, in the beginning. Could it have saved more lives had they implanted them as soon as the concept was viable? Probably, and probably more lives could have been saved, but it was delayed to work out the complexities with the issue.
I don’t see how an analogy between vaccine adjuvants and artificial hearts works. We are far from the “beginning” as far as adjuvant use goes. Further refinements are in fact being tested before approval, as previously noted.
I’m under the impression that there’s actually a lot in the medical field where we don’t quite understand how it works, but we’ve studied it and it has shown to be more beneficial than harmful so we use it.
The next question I ask is, are we almost at the point where a argument about vaccines are pointless? If memory serves, I think there’s some sort of M2e vaccine that blocks the ion channel protein?
Nope, I don’t think we’re remotely close to that point.
There’s a “universal” M2E type of influenza vaccine in early testing stages, but even if that works out in human trials it’s not clear that adjuvants would not be needed. From a recently published paper about a study of such a vaccine in mice:
“Our results showed that M2e-MAP vaccine induced strong M2e-specific IgG antibody responses following 3-dose immunization of mice with M2e-MAP in the presence of Freunds’ or aluminium (alum) adjuvant.” (bolding added).
And there remain other vaccines that employ adjuvants to boost immunity to infectious disease organisms.
Freund’s adjuvant is an example of a mixture that can cause a lot of immunologic response, more than what is wanted or beneficial. It is not approved for use in humans, and only used in certain animal experiments.
My understanding of alum is that it causes cell damage, to invoke a immune response, to boost the immunity? But can the doses be lowered to not overstimulate?
This site discusses aluminum-containing adjuvants, the vaccines they are used in (including DTP, pneumoccal and some Hib vaccines) and their lengthy record of safety.
“Tissue damage”, which Hadrian’s Wall seems concerned about, has not been shown to be a practical matter of concern in connection with use of these adjuvants in the last 75 years. The tissue damage, disability and death associated with the diseases prevented by these vaccines are a matter of record.
Hadrian’s Wall has raised the issue of whether adjuvants should be allowed at all in vaccines, stated (s)he is “just interested in people’s opinions” that “the other side” should be brought out and made a fundamentally flawed comparison of adjuvants to thalidomide. This kind of focus on adjuvants is a staple of antivax ideology, and it would be appreciated if HW would just come out and acknowledge where (s)he stands on the subject of adjuvants and vaccines in general.
At this point I don’t see any kind of coherent case having been made for either banning the current adjuvants that go into a variety of safe, effective vaccines, or for shying away from novel adjuvants that may make it possible for us to develop new and better vaccines.
“Simplicity” in this case means lots of people go unvaccinated because the supply of vaccine material doesn’t go as far. If we had an additive that made each gallon of gasoline provide 30% more energy, would you also eschew that in the name of simplicity?
The purpose of an adjuvant in a vaccine depends on the vaccine itself. Sometimes, they are necessary to evoke any immune response at all. Without the adjuvant, the vaccine may as well be made of water.
However, those vaccines are rare. The most common reason for the addition of adjuvants to vaccines is that they lower the required antigen concentration needed to achieve host immunity. This is important for a manufacturer, as it essentially dictates how much vaccine you can make, how quickly you can make it, and how much it costs. If the H1N1 vaccine had made use of adjuvants, we would not have seen the early shortages we had during the early stages of the epidemic.
To throw some numbers into the equation, assume that you need 100 antigenic particles to achieve adequate host immunity. Your manufacturing process can produce 1,000,000 antigenic particles in a month. From those numbers, you can make 10,000 vaccination doses per month. Now throw some adjuvant in there, and suddenly you can achieve immunity with 10 antigenic particles. Suddenly, you can manufacture 100,000 vaccine doses. That right there is the difference between achieving rapid herd immunity and having an epidemic on your hands.
You might argue that all you need to do is make more vaccine, but you can’t magically do that in a short time period. Over the long term, sure you can do it through the acquisition of additional capital. But that lag time in vaccine production can cost lives.