Aluminum is the third most abundant element after oxygen and silicon, and it is the most abundant metal making up almost 9 percent of the earth's crust. Aluminum is found in plants, soil, water and air. Most plants have low quantities of aluminum, but a few are known to be aluminum accumulators, including some types of tea plants, grasses and orchids.
Aluminum is used extensively in various ways:
Aluminum is used in vaccines as an adjuvant. An adjuvant is a vaccine component that boosts the immune response to the vaccine. The adjuvant effects of aluminum were discovered in 1926. Aluminum adjuvants are used in vaccines such as hepatitis A, hepatitis B, diphtheria-tetanus-containing vaccines, Haemophilus influenzae type b, and pneumococcal vaccines, but they are not used in the live, viral vaccines, such as measles, mumps, rubella, varicella, or rotavirus.
Vaccines containing adjuvants are tested extensively in clinical trials before being licensed. Aluminum salts are the only materials that can be used as adjuvants in the United States. The quantities of aluminum present in vaccines are low and are regulated by the Center for Biologics Evaluation and Research (CBER).
The aluminum contained in vaccines is similar to that found in a liter (about 1 quart or 32 fluid ounces) of infant formula. While infants receive about 4.4 milligrams of aluminum in the first six months of life from vaccines, they receive more than that in their diet. Breast-fed infants ingest about 7 milligrams, formula-fed infants ingest about 38 milligrams, and infants who are fed soy formula ingest almost 117 milligrams of aluminum during the same period.
|Quantities of Aluminum in Vaccines|
|Pneumococcal vaccine||0.125 mg/dose|
|Diphtheria-tetanus-acellular pertussis (DTaP) vaccine||< 0.17 to < 0.625 mg/dose|
|Haemophilus influenzae type b (Hib) vaccine||0.225 mg/dose|
|Hib/ Hep B vaccine||0.225 mg/dose|
|Hepatitis A vaccine (Hep A)||0.225 to 0.25 mg/dose (pediatrics)
0.45 to 0.5 mg/dose (adults)
|Hepatitis B vaccine (Hep B)||0.225 to 0.5 mg/dose|
|Hep A/ Hep B vaccine||0.45 mg/dose|
|DTaP/inactivated polio/ Hep B vaccine||< 0.85 mg/dose|
|DTaP/inactivated polio/Hib vaccine||0.33 mg/dose|
|Human Papillomavirus (HPV) vaccine||0.225 mg/dose|
|Japanese Encephalitis (JE) vaccine||0.25 mg/dose|
|Quantities of Aluminum in Other Things|
|Breast milk||0.04 milligrams per liter (mg/L)|
|Ponds, lakes, streams||0.1 mg/L|
|Infant formula||0.225 mg/L|
|Soy-based formula||0.46 to 0.93 mg/L|
|Buffered aspirin||10 to 20 mg/tablet|
Given the quantities of aluminum we are exposed to on a daily basis, the quantity of aluminum in vaccines is miniscule. Aluminum-containing vaccines have been used for decades and have been given to over one billion people without problem. In spring 2000, the National Vaccine Program Office (NVPO) reviewed aluminum exposure through vaccines and determined that no changes to vaccine recommendations were needed based on aluminum content. The Global Advisory Committee on Vaccine Safety, part of the World Health Organization (WHO), has also reviewed studies and found no evidence of health risks that would require changes to vaccine policy.
The health effects of aluminum have been studied; however, few have been shown to result from aluminum exposure. Kidney dialysis patients have developed disorders of the brain and bones due to the aluminum content in water following years of dialysis. Both disorders have decreased in occurrence due to improvements to dialysis systems. The bone disease was due to poor absorption of phosphate in the presence of high quantities of aluminum. Children taking large amounts of aluminum-based medications have also been found to suffer this bone disorder.
It has been suggested that some diseases involving the brain, such as Alzheimer's disease, are caused by aluminum accumulation in brain tissues. However, studies have not consistently found increased levels of aluminum leading some to hypothesize that the aluminum accumulation may be the result of tissue damage rather than the cause of disease.
Aluminum is considered to be an essential metal with quantities fluctuating naturally during normal cellular activity. It is found in all tissues and is also believed to play an important role in the development of a healthy fetus. This is supported by several findings:
Agency for Toxic Substances & Disease Registry. (2006). Public Health Statement Aluminum CAS # 7429-90-5.
Cherin, P. and J. Authier. (2001). Macrophagic Myofasciitis. Retrieved May 19, 2008 from Orphanet encyclopedia Web site.
Finn, T. M. and W. Egan. (2008). Vaccine Additives and Manufacturing Residuals in U.S.-Licensed Vaccines. In S. Plotkin, W. Orenstein, and P. Offit (Eds.), Vaccines, Fifth Edition (pp. 73-81). China: Saunders Elsevier.
Ganrot, P. O. (1986). Metabolism & Possible Health Effects of Aluminum. Env. Health Perspect. 65, 363-441.
Mineral Information Institute. Aluminum & Bauxite. Retrieved May 19, 2008, from Mineral Information Institute Web site.
Offit, P.A. and R. K. Jew. (2003). Addressing Parents Concerns: Do Vaccines Contain Harmful Preservatives, Adjuvants, Additives or Residuals? Pediatrics, 112(6), 1394-1401.
Sorenson, J. R. J., Campbell, I. R., et. al. (1974). Aluminum in the Environment and Human Health. Env. Health Perspect. 8, 3-95.
Vogel, F. R. and S. L. Hem. (2008). Immunologic Adjuvants In S. Plotkin, W. Orenstein, and P. Offit (Eds.), Vaccines, Fifth Edition (pp. 59-71). China: Saunders Elsevier.
World Health Organization. (1999). Macrophagic Myofasciitis and Aluminum-Containing Vaccines. Weekly Epidemiological Record.74, 338-340.
World Health Organization. (2002). Aluminum-Containing Vaccines and Macrophagic Myofasciitis. Weekly Epidemiological Record. 77, 392-393.
World Health Organization. (2004). Aluminum-Containing Vaccines and Macrophagic Myofasciitis. Weekly Epidemiological Record.79, 20.
Reviewed by: Paul A. Offit, MD
Date: April 2013
Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.