Does flu vaccine contain aluminium hydroxide adjuvant?

Question

I know that some vaccines contain aluminium hydroxide as an adjuvant.

Do common flu vaccines contain aluminium hydroxide too? If yes, are there flu vaccines without aluminium hydroxide?

Answer 1

When I searched for flu vaccines authorized in Germany, I got a list of 65 vaccines (at least I think so, because the information system is available only in German).

The list is available at: http://www.pharmnet-bund.de/static/de/index.html (but I don't think that there is any sense in linking the actual page with the list, because it expires after a while for some reason). You can go the the part of the website called "Arzneimittel-Informationssystem" and then search from there. Search criteria depends on your language skills in German, but at "Recherche für Fachkreise" (information for professionals) you can search by ATC code, which, for flu vaccines is: J07BB02 and you will get the list of many flu vaccines available or registered in Germany (I'm not sure which of those two).

The catch - most of the information seems to be behind a pay wall. So the best I can do is find the vaccines from that list on the EMeA (European Medicines Agency) website. There are less vaccines listed there, and I have omitted those marked as "withdrawn". I also selected those that seemed to be polyvalent ones, since you are asking for the "common flu" I expect you are inquiring about the seasonal flu vaccine. Again, the final consultation about the sort of vaccine appropriate for this season, your organism and other factors, is to be done with your physician and your pharmacist (i.e. your healthcare team).

That being said, I dug up three vaccines that match the previously discussed criteria:

Optaflu:

A/California/7/2009 (H1N1)pdm09 - like strain used A/Brisbane/10/2010 wild type 15 micrograms HA** A/Texas/50/2012 (H3N2) - derived strain used (NYMC X-223A) 15 micrograms HA** B/Massachusetts/2/2012 15 micrograms HA** per 0.5 ml dose .............................................. *propagated in Madin Darby Canine Kidney (MDCK) cells ** haemagglutin

List of excipients: 1. Sodium chloride, 2. Potassium chloride, 3. Magnesium chloride hexahydrate, 4. Disodium phosphate dihydrate, 5. Potassium dihydrogen phosphate, 6. Water for injections

INTANZA

Influenza virus (inactivated, split) of the followi ng strains*: A/California/7/2009 (H1N1)pdm09-derived strain used (NYMC X-179A)....... 9 micrograms HA** A/Texas/50/2012 (H3N2)-derived strain used (NYMC X- 223A) ...................... 9 micrograms HA** B/Massachusetts/2/2012 ..... 9 micrograms HA** Per 0.1 ml dose *propagated in fertilised hens’ eggs from healthy chicken flocks **haemagglutinin

List of excipients: 1. Sodium chloride 2. Potassium chloride 3. Disodium phosphate dihydrate 4. Potassium dihydrogen phosphate 5. Water for injections

IDflu

List of excipients 1. Sodium chloride 2. Potassium chloride 3. Disodium phosphate dihydrate 4. Potassium dihydrogen phosphate 5. Water for injections

The links for each vaccine are for the Summary of Product Characteristics for each one, where you can find more information on their composition, possible incompatibilities and precautions.

Answer 2

The FluMist vaccine contains (source):

Each pre-filled refrigerated FluMist Quadrivalent sprayer contains a single 0.2 mL dose. Each 0.2 mL dose contains 106.5-7.5 FFU (fluorescent focus units) of live attenuated influenza virus reassortants of each of the four strains: A/Bolivia/559/2013 (H1N1) (an A/California/7/2009 (H1N1)pdm09-like virus), A/Switzerland/9715293/2013 (H3N2), B/Phuket/3073/2013 (B/Yamagata/16/88 lineage), and B/Brisbane/60/2008 (B/Victoria/2/87 lineage). Each 0.2 mL dose also contains 0.188 mg/dose monosodium glutamate, 2.00 mg/dose hydrolyzed porcine gelatin, 2.42 mg/dose arginine, 13.68 mg/dose sucrose, 2.26 mg/dose dibasic potassium phosphate, and 0.96 mg/dose monobasic potassium phosphate. Each dose contains residual amounts of ovalbumin (< 0.24 mcg/dose), and may also contain residual amounts of gentamicin sulfate (< 0.015 mcg/mL), and ethylenediaminetetraacetic acid (EDTA) (< 0.37 mcg/dose). FluMist Quadrivalent contains no preservatives.

So yes, there is at least one flu vaccine, the spray-based live-attenuated vaccine, that does not contain the adjuvant in question.

Answer 3

The flu mist does not contain it. But it does contain MSG according to its package insert:

What are the ingredients in FluMist Quadrivalent?

Active Ingredient: FluMist Quadrivalent contains 4 influenza virus strains that are weakened (A(H1N1), A(H3N2), B Yamagata lineage, and B Victoria lineage). Inactive Ingredients: monosodium glutamate, gelatin, arginine, sucrose, dibasic potassium phosphate, monobasic potassium phosphate, and gentamicin. FluMist Quadrivalent does not contain preservatives.

Source: https://www.fda.gov/media/120689/download