Skip to main content

Adjuvants for Pandemic Influenza Vaccines

  • Chapter
  • First Online:
Book cover Vaccines for Pandemic Influenza

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 333))

Abstract

The use of adjuvants is being explored as a means of improving vaccine immunogenicity. This is particularly important for the development of vaccines against potential pandemic influenza virus strains. Adjuvants act by prolonging the exposure time of antigen to the immune system, enhancing the delivery of antigen to antigen-presenting cells, or providing immunostimulatory signals that potentiate the immune response. Aluminum salts are the only licensed adjuvant in the United States, but the combination of these salts with inactivated influenza A/H5N1 antigens has had little effect on seroresponses. Several oil-in-water adjuvants, including MF59 and AS03, have significantly enhanced immune responses in healthy adult vaccine recipients to inactivated influenza A/H5N1. Additional studies are needed in vulnerable populations (younger and elderly persons, pregnant women, and immunocompromised patients) to confirm the safety and enhanced immunogenicity of these promising formulations. A number of other adjuvants are under investigation to evaluate their ability to improve the immunogenicity of inactivated vaccines targeting influenza A/H5N1.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aguilar JC, Rodriguez EG. (2007) Vaccine adjuvants, revisited. Vaccine 25:3752–3762

    Article  PubMed  CAS  Google Scholar 

  • Akira S, Uematsu S, Takeuchi O. (2006) Pathogen recognition and innate immunity. Cell 124:783–801

    Article  PubMed  CAS  Google Scholar 

  • Atmar RL, Keitel WA, Patel SM, Katz JM, She D, El Sahly H, Pompey J, Cate TR, Couch RB. (2006) Safety and immunogenicity of nonadjuvanted and MF59-adjuvanted influenza A/H9N2 vaccine preparations. Clin Infect Dis 43:1135–1142

    Article  PubMed  CAS  Google Scholar 

  • Babai I, Barenholz Y, Zakay-Rones Z, Greenbaum E, Samira S, Hayon I, Rochman M, Kedar E. (2001) A novel liposomal influenza vaccine (INFLUSOME-VAC) containing hemagglutinin-neuraminidase and IL-2 or GM-CSF induces protective anti-neuraminidase antibodies cross-reacting with a wide spectrum of influenza A viral strains. Vaccine 20:505–515

    Article  PubMed  CAS  Google Scholar 

  • Baldridge JR, Yorgensen Y, Ward JR, Ulrich JT. (2000) Monophosphoryl lipid A enhances mucosal and systemic immunity to vaccine antigens following intranasal administration. Vaccine 18:2416–2425

    Article  PubMed  CAS  Google Scholar 

  • Baras B, Stittelaar KJ, Simon JH, Thoolen RJ, Mossman SP, Pistoor FH, van Amerongen G, Wettendorff MA, Hanon E, Osterhaus AD. (2008) Cross-protection against lethal H5N1 challenge in ferrets with an adjuvanted pandemic influenza vaccine. PLoS ONE 3:e1401

    Article  PubMed  CAS  Google Scholar 

  • Belshe RB, Gruber WC, Mendelman PM, Mehta HB, Mahmood K, Reisinger K, Treanor J, Zangwill K, Hayden FG, Bernstein DI, Kotloff K, King J, Piedra PA, Block SL, Yan L, Wolff M. (2000) Correlates of immune protection induced by live, attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine. J Infect Dis 181:1133–1137

    Article  PubMed  CAS  Google Scholar 

  • Ben-Yehuda A, Joseph A, Barenholz Y, Zeira E, Even-Chen S, Louria-Hayon I, Babai I, Zakay-Rones Z, Greenbaum E, Galprin I, Glück R, Zurbriggen R, Kedar E. (2003a) Immunogenicity and safety of a novel IL-2-supplemented liposomal influenza vaccine (INFLUSOME-VAC) in nursing-home residents. Vaccine 21:3169–3178

    Article  CAS  Google Scholar 

  • Ben-Yehuda A, Joseph A, Zeira E, Even-Chen S, Louria-Hayon I, Babai I, Zakay-Rones Z, Greenbaum E, Barenholz Y, Kedar E. (2003b) Immunogenicity and safety of a novel liposomal influenza subunit vaccine (INFLUSOME-VAC) in young adults. J Med Virol 69:560–567

    Article  Google Scholar 

  • Bernstein DI, Edwards KM, Dekker CL, Belshe R, Talbot HK, Graham IL, Noah DL, He F, Hill H. (2008) Effects of adjuvants on the safety and immunogenicity of an avian influenza H5N1 vaccine in adults. J Infect Dis 197:667–675

    Article  PubMed  CAS  Google Scholar 

  • Bracci L, Canini I, Venditti M, Spada M, Puzelli S, Donatelli I, Belardelli F, Proietti E. (2006) Type I IFN as a vaccine adjuvant for both systemic and mucosal vaccination against influenza virus. Vaccine 24:S56–S57

    Article  CAS  Google Scholar 

  • Brady RC, Treanor JJ, Atmar RL, Chen WH, Winokur P, Belshe R. (2007) A phase I-II, randomized, controlled, dose-ranging study of the safety, reactogenicity, and immunogenicity of intramuscular inactivated influenza A/H5N1 vaccine given alone or with aluminum hydroxide to healthy elderly adults. In: Options for the Control of Influenza VI, Toronto, Ontario, Canada, 17–23 June 2007 (abstract P739)

    Google Scholar 

  • Bresson JL, Perronne C, Launay O, Gerdil C, Saville M, Wood J, Höschler K, Zambon MC. (2006) Safety and immunogenicity of an inactivated split-virion influenza A/Vietnam/1194/2004 (H5N1) vaccine: phase I randomised trial. Lancet 367:1657–1664

    Article  PubMed  CAS  Google Scholar 

  • Bright R, Pushko P, Smith G, Compans R. (2009) Influenza virus-like particles as pandemic vaccines. In: Compans RW, Orenstein WA. (eds) Vaccines for pandemic influenza. Current topics in microbiology, vol 333. Springer, Heidelberg

    Google Scholar 

  • Christensen D, Korsholm KS, Rosenkrands I, Lindenstrøm T, Andersen P, Agger EM. (2007) Cationic liposomes as vaccine adjuvants. Expert Rev Vaccines 6:785–796

    Article  PubMed  CAS  Google Scholar 

  • Clements ML, O’Donnell S, Levine MM, Chanock RM, Murphy BR. (1983) Dose response of A/Alaska/6/77 (H3N2) cold-adapted reassortant vaccine virus in adult volunteers: role of local antibody in resistance to infection with vaccine virus. Infect Immun 40:1044–1051

    PubMed  CAS  Google Scholar 

  • Connell T. (2007) Cholera toxin, LT-I, LT-IIa and LT-IIb: the critical role of ganglioside binding in immunomodulation by type I and type II heat-labile enterotoxins. Expert Rev Vaccines 6:821–834

    Article  PubMed  CAS  Google Scholar 

  • Coombes AG, Major D, Wood JM, Hockley DJ, Minor PD, Davis SS. (1998) Resorbable lamellar particles of polylactide as adjuvants for influenza virus vaccines. Biomaterials 19:1073–1081

    Article  PubMed  CAS  Google Scholar 

  • Cooper CL, Davis HL, Morris ML, Efler SM, Krieg AM, Li Y, Laframboise C, Al Adhami MJ, Khaliq Y, Seguin I, Cameron DW. (2004) Safety and immunogenicity of CPG 7909 injection as an adjuvant to Fluarix influenza vaccine. Vaccine 22:3136–3143

    Article  PubMed  CAS  Google Scholar 

  • Couch RB, Kasel JA, Six TH, Cate TR, Zahradnik JM. (1984) Immunological reactions and resistance to infection with influenza virus. In: Stuart-Harris C, Potter CW. (eds) The molecular virology and epidemiology of influenza. Academic, New York, pp 119–144

    Google Scholar 

  • Davenport FM, Hennessy AV, Askin FB. (1968) Lack of adjuvant effect of AlPO4 on purified influenza virus hemagglutinins in man. J Immunol 100:1139–1140

    PubMed  CAS  Google Scholar 

  • de Bruijn IA, Nauta J, Gerez L, Palache AM. (2006) The virosomal influenza vaccine Invivac: immunogenicity and tolerability compared to an adjuvanted influenza vaccine (Fluad) in elderly subjects. Vaccine 24:6629–6631

    Article  PubMed  CAS  Google Scholar 

  • Drane D, Gittleson C, Boyle J, Maraskovsky E. (2007) ISCOMATRIX adjuvant for prophylactic and therapeutic vaccines. Expert Rev Vaccines 6:761–772

    Article  PubMed  CAS  Google Scholar 

  • Ehrlich HJ, Müller M, Oh HM, Tambyah PA, Joukhadar C, Montomoli E, Fisher D, Berezuk G, Fritsch S, Löw-Baselli A, Vartian N, Bobrovsky R, Pavlova BG, Pöllabauér EM, Kistner O, Barrett PN; Baxter H5N1 Pandemic Influenza Vaccine Clinical Study Team. (2008) A clinical trial of a whole-virus H5N1 vaccine derived from cell culture. N Engl J Med 358:2573–2584

    Article  PubMed  CAS  Google Scholar 

  • Eisenbarth SC, Colegio OR, O’Connor W, Sutterwala FS, Flavell RA. (2008) Crucial role for the Nalp3 inflammasome in the immunostimulatory properties of aluminium adjuvants. Nature 453:1122–1126

    Article  PubMed  CAS  Google Scholar 

  • Ernst WA, Kim HJ, Tumpey TM, Jansen ADA, Tai W, Cramer DV, Adler-Moore JP, Fujii G. (2006) Protection against H1, H5, H6 and H9 influenza A infection with liposomal matrix 2 epitope vaccines. Vaccine 24:5158–5168

    Article  PubMed  CAS  Google Scholar 

  • European Committee for Proprietary Medicinal Products. (2003) Guideline on dossier structure and content for pandemic influenza vaccine marketing authorization application (CPMP/VEG/4717/03)

    Google Scholar 

  • Food and Drug Administration. (2007) Guidance for industry: clinical data needed to support the licensure of pandemic influenza vaccines. http://www.fda.gov/CbER/gdlns/panfluvac.pdf

  • Frech SA, Kenney RT, Spyr CA, Lazar H, Viret JF, Herzog C, Glück R, Glenn GM. (2005) Improved immune responses to influenza vaccination in the elderly using an immunostimulant patch. Vaccine 23:946–950

    Article  PubMed  CAS  Google Scholar 

  • Garçon N, Chomez P, Van Mechelen M. (2007) GlaxoSmithKline adjuvant systems in vaccines: concepts, achievements and perspectives. Expert Rev Vaccines 6:723–739

    Article  PubMed  Google Scholar 

  • Gerth H-J, Mok-Hsu YCh. (1981) Reactogenicity and serological response to polyvalent aqueous and Al (OH)3 adsorbed Tween-ether split product influenza vaccine in young adults 1979. Infection 9:85–90

    Article  Google Scholar 

  • Guy B. (2007) The perfect mix: recent progress in adjuvant research. Nat Rev Microbiol 5:505–517

    Article  PubMed  Google Scholar 

  • Hehme N, Engelmann H, Kunzel W, Neumeier E, Sanger R. (2002) Pandemic preparedness: lessons learnt from H2N2 and H9N2 candidate vaccines. Med Microbiol Immunol 191:203–208

    Article  PubMed  CAS  Google Scholar 

  • Hem SL, HogenEsch H. (2007) Relationship between physical and chemical properties of aluminum-containing adjuvants and immunoprecipitation. Expert Rev Vaccines 6:685–698

    Article  PubMed  CAS  Google Scholar 

  • Hennessy AV, Davenport FM. (1974) Studies on vaccination of infants against influenza with influenza hemagglutinin. Proc Soc Exp Biol Med 146:200–204

    PubMed  CAS  Google Scholar 

  • Huleatt JW, Nakaar V, Desai P, Huang Y, Hewitt D, Jacobs A, Tang J, McDonald W, Song L, Evans RK, Umlauf S, Tussey L, Powell TJ. (2008) Potent immunogenicity and efficacy of a universal influenza vaccine candidate comprising a recombinant fusion protein linking influenza M2e to the TLR5 ligand flagellin. Vaccine 26:201–214

    Article  PubMed  CAS  Google Scholar 

  • Ichinohe T, Tamura S, Kawaguchi A, Ninomiya A, Imai M, Itamura S, Odagiri T, Tashiro M, Takahashi H, Sawa H, Mitchell WM, Strayer DR, Carter WA, Chiba J, Kurata T, Sata T, Hasegawa H. (2007) Cross-protection against H5N1 influenza virus infection is afforded by intranasal inoculation with seasonal trivalent inactivated influenza vaccine. J Infect Dis 196:1313–1320

    Article  PubMed  CAS  Google Scholar 

  • Keitel WA, Atmar RL. (2009) Vaccines for pandemic influenza: summary of recent clinical trials. In: Compans RW, Orenstein WA. (eds) Vaccines for pandemic influenza. Current topics in microbiology, vol 333. Springer, Heidelberg

    Chapter  Google Scholar 

  • Keitel W, Couch R, Bond N, Adair S, van Nest G, Dekker C. (1993) Pilot evaluation of influenza virus vaccine (IVV) combined with adjuvant. Vaccine 11:909–913

    Article  PubMed  CAS  Google Scholar 

  • Keitel WA, Campbell JD, Treanor JJ, Walter EB, Patel SM, He F, Noah DL, Hill H. (2008a) Safety and immunogenicity of an inactivated influenza A/H5N1 vaccine given with or without aluminum hydroxide to healthy adults: results of a phase I-II randomized clinical trial. J Infect Dis 198:1309-1316

    Article  Google Scholar 

  • Keitel W, Dekker C, Mink C, Campbell J, Edwards K, Patel S. (2008b) A phase I, randomized, double-blind, placebo-controlled dose ranging clinical trial of the safety, reactogenicity and immunogenicity of immunization with inactivated Vero cell culture-derived influenza A/H5N1 vaccine given with or without aluminum hydroxide to healthy young adults. In: 11th Annual Conference on Vaccine Research, Baltimore, MD, 5–7 May 2008 (abstract)

    Google Scholar 

  • Leroux-Roels I, Bernhard R, Gérard P, Dramé M, Hanon E, Leroux-Roels G. (2008) Broad clade 2 cross-reactive immunity induced by an adjuvanted clade 1 rH5N1 pandemic influenza vaccine. PLoS ONE 3:e1401

    Article  Google Scholar 

  • Leroux-Roels I, Borkowski A, Vanwolleghem T, Dramé M, Clement F, Hons E, Devaster JM, Leroux-Roels G. (2007) Antigen sparing and cross-reactive immunity with an adjuvanted rH5N1 prototype pandemic influenza vaccine: a randomised controlled trial. Lancet 370:580–589

    Article  PubMed  CAS  Google Scholar 

  • Levie K, Leroux-Roels I, Hoppenbrouwers K, Kervyn AD, Vandermeulen C, Forgus S, Leroux-Roels G, Pichon S, Kusters I. (2008) An adjuvanted, low-dose, pandemic influenza A (H5N1) vaccine candidate is safe, immunogenic, and induces cross-reactive immune responses in healthy adults. J Infect Dis 198:642–649

    Article  PubMed  Google Scholar 

  • Lin J, Zhang J, Dong X, Fang H, Chen J, Su N, Gao Q, Zhang Z, Liu Y, Wang Z, Yang M, Sun R, Li C, Lin S, Ji M, Liu Y, Wang X, Wood J, Feng Z, Wang Y, Yin W. (2006) Safety and immunogenicity of an inactivated adjuvanted whole-virion influenza A (H5N1) vaccine: a phase I randomised controlled trial. Lancet 368:991–997

    Article  PubMed  CAS  Google Scholar 

  • Marciani DJ, Reynolds RC, Pathak AK, Finley-Woodman K, May RD. (2003) Fractionation, structural studies, and immunological characterization of the semi-synthetic Quillaja saponins derivative GPI-0100. Vaccine 21:3961–3971

    Article  PubMed  CAS  Google Scholar 

  • Matassov D, Cupo A, Galarza JM. (2007) A novel intranasal virus-like particle (VLP) vaccine designed to protect against the pandemic 1918 influenza A virus (H1N1). Viral Immunol 20:441–452

    Article  PubMed  CAS  Google Scholar 

  • Mbawuike I, Zang Y, Couch RB. (2007) Humoral and cell-mediated immune responses of humans to inactivated influenza vaccine with or without QS21 adjuvant. Vaccine 25:3263–3269

    Article  PubMed  CAS  Google Scholar 

  • Moldoveanu Z, Love-Homan L, Huang WQ, Krieg AM. (1998) CpG DNA, a novel immune enhancer for systemic and mucosal immunization with influenza virus. Vaccine 16:1216–1224

    Article  PubMed  CAS  Google Scholar 

  • Morein B, Sundquist B, Höglund S, Dalsgaard K, Osterhaus A. (1984) Iscom, a novel structure for antigenic presentation of membrane proteins from enveloped viruses. Nature. 308:457–460

    Article  PubMed  CAS  Google Scholar 

  • Moser C, Amacker M, Kammer AR, Rasi S, Westerfeld N, Zurbriggen R. (2007) Influenza virosomes as a combined vaccine carrier and adjuvant system for prophylactic and therapeutic immunizations. Expert Rev Vaccines 6:711–721

    Article  PubMed  CAS  Google Scholar 

  • Murasko DM, Bernstein ED, Gardner EM, Gross P, Munk G, Dran S, Abrutyn E. (2002) Role of humoral and cell-mediated immunity in protection from influenza disease after immunization of healthy elderly. Exp Gerontol 37:427–439

    Article  PubMed  CAS  Google Scholar 

  • Mutsch M, Zhou W, Rhodes P, Bopp M, Chen RT, Linder T, Spyr C, Steffen R. (2004) Use of the inactivated intranasal influenza vaccine and the risk of Bell’s palsy in Switzerland. N Engl J Med 350:896–903

    Article  PubMed  CAS  Google Scholar 

  • Nicholson KG, Tyrrell DA, Harrison P, Potter CW, Jennings R, Clark A. (1979) Clinical studies of monovalent inactivated whole virus and subunit A/USSR/77 (H1N1) vaccine: serological responses and clinical reactions. J Biol Stand 7:123–136

    Article  PubMed  CAS  Google Scholar 

  • Nicholson KG, Colegate AE, Podda A, Stephenson I, Wood J, Ypma E, Zambon MC. (2001) Safety and antigenicity of non-adjuvanted and MF59-adjuvanted influenza A/Duck/Singapore/97 (H5N3) vaccine: a randomised trial of two potential vaccines against H5N1 influenza. Lancet 357:1937–1943

    Article  PubMed  CAS  Google Scholar 

  • O’Hagan DT. (2007) MF59 is a safe and potent adjuvant that enhances protection against influenza virus infection. Expert Rev Vaccines 6:699–710

    Article  PubMed  Google Scholar 

  • O’Hagan DT, Valiante NM. (2003) Recent advances in the discovery and delivery of vaccine adjuvants. Nat Rev Drug Discov 2:727–735

    Article  PubMed  CAS  Google Scholar 

  • Potter CW. (1982) Inactivated influenza virus vaccine. In: Beare AS (ed) Basic and applied influenza research. CRC, Boca Raton, FL, pp 119–158

    Google Scholar 

  • Powers DC. (1997) Summary of a clinical trial with liposome-adjuvanted influenza A virus vaccine in elderly adults. Mech Ageing Dev 93:179–188

    Article  PubMed  CAS  Google Scholar 

  • Pressler K, Peukert M, Schenk D, Borgono M. (1982) Comparison of the antigenicity and tolerance of an influenza aluminium oxide adsorbate vaccine with an aqueous vaccine. Pharmatherapeutica 3:195–200

    PubMed  CAS  Google Scholar 

  • Pushko P, Tumpey TM, Van Hoeven N, Belser JA, Robinson R, Nathan M, Smith G, Wright DC, Bright RA. (2007) Evaluation of influenza virus-like particles and Novasome adjuvant as candidate vaccine for avian influenza. Vaccine 25:4283–4290

    Article  PubMed  CAS  Google Scholar 

  • Ramon G. (1926) Procedes pour accroitre la production des antitoxins. Ann Inst Paseur (Paris) 29:31–40

    Google Scholar 

  • Rimmelzwaan GF, Baars M, van Beek R, van Amerongen G, Lövgren-Bengtsson K, Claas EC, Osterhaus AD. (1997) Induction of protective immunity against influenza virus in a macaque model: comparison of conventional and iscom vaccines. J Gen Virol 78:757–765

    PubMed  CAS  Google Scholar 

  • Ruat C, Caillet C, Bidaut A, Simon J, Osterhaus AD. (2008) Vaccination of macaques with adjuvanted formalin-inactivated influenza A virus (H5N1) vaccines: protection against H5N1 challenge without disease enhancement. J Virol 82:2565–2569

    Article  PubMed  CAS  Google Scholar 

  • Sambhara S, Kurichh A, Miranda R, Tumpey T, Rowe T, Renshaw M, Arpino R, Tamane A, Kandil A, James O, Underdown B, Klein M, Katz J, Burt D. (2001) Heterosubtypic immunity against human influenza A viruses, including recently emerged avian H5 and H9 viruses, induced by FLU-ISCOM vaccine in mice requires both cytotoxic T-lymphocyte and macrophage function. Cell Immunol 211:143–153

    Article  PubMed  CAS  Google Scholar 

  • Schultze V, D’Agosto V, Wack A, Novicki W, Zorn J, Hennig R. (2008) Safety of MF59™ adjuvant. Vaccine 26:3209–3222

    Article  PubMed  CAS  Google Scholar 

  • Singh M, Chakrapani A, O’Hagan D. (2007) Nanoparticles and microparticles as vaccine-delivery systems. Expert Rev Vaccines 6:797–808

    Article  PubMed  CAS  Google Scholar 

  • Somani J, Lonial S, Rosenthal H, Resnick S, Kakhniashvili I, Waller EK. (2002) A randomized, placebo-controlled trial of subcutaneous administration of GM-CSF as a vaccine adjuvant: effect on cellular and humoral immune responses. Vaccine 21:221-230

    Article  PubMed  CAS  Google Scholar 

  • Stephenson I, Nicholson KG, Colegate A, Podda A, Wood J, Ypma E, Zambon M. (2003) Boosting immunity to influenza H5N1 with MF59-adjuvanted H5N3 A/Duck/Singapore/97 vaccine in a primed human population. Vaccine 21:1687–1693

    Article  PubMed  CAS  Google Scholar 

  • Stephenson I, Zambon MC, Rudin A, Colegate A, Podda A, Bugarini R, Del Giudice G, Minutello A, Bonnington S, Holmgren J, Mills KH, Nicholson KG. (2006) Phase I evaluation of intranasal trivalent inactivated influenza vaccine with nontoxigenic Escherichia coli enterotoxin and novel biovector as mucosal adjuvants, using adult volunteers. J Virol 80:4962–4970

    Article  PubMed  CAS  Google Scholar 

  • Takeda K, Akira S. (2003) Toll receptors and pathogen resistance. Cell Microbiol 5:143-153

    Article  PubMed  CAS  Google Scholar 

  • Takeda K, Akira S. (2005) Toll-like receptors in innate immunity. Int Immunol 17:1–14

    Article  PubMed  CAS  Google Scholar 

  • Treanor JJ, Campbell James D, Zangwill KM, Rowe T, Wolff M. (2006) Safety and immunogenicity of an inactivated subvirion influenza A (H5N1) vaccine. N Engl J Med 54:1343–1351

    Article  Google Scholar 

  • Vajo Z, Kosa L, Visontay I, Jankovics M, Jankovics I. (2007) Inactivated whole virus influenza A (H5N1) vaccine. Emerg Infect Dis 13:807–808

    PubMed  Google Scholar 

  • Vogel FR, Hem SL. (2008) Immunologic adjuvants. In: Plotkin SA, Orenstein WA, Offit PA (eds) Vaccines, 5th edn. Saunders, Philadelphia, PA, pp 59–71

    Google Scholar 

  • Wack A, Baudner BC, Hilbert AK, Manini I, Nuti S, Tavarini S, Scheffczik H, Ugozzoli M, Singh M, Kazzaz J, Montomoli E, Del Giudice G, Rappuoli R, O’Hagan DT. (2008) Combination adjuvants for the induction of potent, long-lasting antibody and T-cell responses to influenza vaccine in mice. Vaccine 26:552–561

    Article  PubMed  CAS  Google Scholar 

  • Wyde PR, Guzman E, Gilbert BE, Couch RB. (2001) Immunogenicity and protection in mice given inactivated influenza vaccine, MPL, QS-21 or QS-7. In: Osterhaus ADME, Cox N, Hampson AW. (eds) Options for the control of influenza IV. Excerpta Medica, New York, pp 999–1005

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert L. Atmar .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Atmar, R.L., Keitel, W.A. (2009). Adjuvants for Pandemic Influenza Vaccines. In: Compans, R., Orenstein, W. (eds) Vaccines for Pandemic Influenza. Current Topics in Microbiology and Immunology, vol 333. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-92165-3_16

Download citation

Publish with us

Policies and ethics