Aluminium and you

Aluminium (aluminum if you’re from North America) is the most abundant metal in the earth’s crust and the third most abundant element of the planet.[1,37] Compounds containing aluminium are also widespread. Humans – neonates, babies, infants, children, adults – are exposed to chemical compounds containing aluminium in many ways.[2] During the first 400 days of life, we are also exposed to small aluminium in the form of a component of vaccines.

The #prodisease cults would have us believe that using aluminium is a population health-threatening conspiracy that is kept hidden by medicine and science the world over. But that simply isn’t true. Come with me dear reader, down a path of metallic enlightenment to find out some facts about aluminium and you.

Aluminium is everywhere. But you need not be foiled.
Image by Pezibear from Pixabay

Aluminium isn’t just everywhere in a geological sense though, it’s in nearly all the things we consume and use. Some products that contain aluminium include [9,15]:

  • antacids (aluminium hydroxide e.g 400,000 micrograms per dose)
  • baby formula
  • fruits
  • vegetables
  • astringents
  • buffered aspirin (aluminium hydroxide)
  • food additives
  • beer & wine
  • honey
  • antiperspirants
  • nappy rash paste (aluminium chlorohydrate )
  • cosmetics
  • flour
  • confectionary
  • cakes, biscuits
  • cereals
  • nuts
  • dairy products
  • baking powder
  • colouring agents
  • anticaking agents

We can attach amounts to some of these items:

  • 7,000 micrograms (millionth of a gram) from breast milk during the first 6 months of life [9]
  • 38,000 micrograms from formula during the first 6 months of life [9]
  • 117,000 micrograms from soy formula during the first 6 months of life [9]
  • 15,000 micrograms per slice of bread [7]
  • 50,000 micrograms per slice of processed cheese [7]
  • 1,900 to 11,000 micrograms ingested per day, per adult [2,9,12,14]
  • 125,000 to 1,200,000 micrograms per vaccine dose [9]
  • 0.005 to 8 micrograms per cubic meter of air breathed [10]
  • <100 micrograms of drinking water per litre [10]

Aluminium is usually just passing through

For the majority of us, the aluminium that gets into our bodies does so through ingestion and it is just passing through. It mostly leaves the body in the urine and the faeces. However, we also absorb aluminium via the intestine.[6]

Easy in, easy out for most of the aluminium we come into contact with.
Source: fdcomite, flickr

In those with kidney disease, aluminium in the blood doesn’t get as rapidly excreted and so this group needs to be aware of their intake of aluminium and other things.

Studies have looked at aluminium in humans and animals

In 2007, researchers spelled out some important points. In humans, more than 95% of aluminium is removed by the kidneys into the urine and another 2% leaves us via bile entering the gut from the gall bladder.[6]

Overall, levels of aluminium in tissues increase with age.[6] Normal aluminium levels in the blood plasma sit around 1 to 2 micrograms per litre. Bone harbours 60% of total body aluminium burden. The lung holds 25%, muscle 10%, liver 3% and the brain 1%.[6]

Brain tissue does hold onto aluminium but it retains the least amount among the tissues looked at.

In animals, 0.001 to 0.01% of aluminium injected into the blood (not how vaccines are delivered), entered each gram of brain tissue, and about 100-times more entered the bone.[6]

This all highlights that every body compartment has aluminium in it, all the time and that this aluminium probably goes everywhere.

In 2011 [7], researchers updated a previous study [8] that looked at infant diet and aluminium levels. They noted that a bit less than one per cent of the aluminium we ingest in food gets absorbed into the blood of an infant and only 1% of whole body aluminium is present in the brain.

The authors also noted that some of the aluminium from vaccines is likely to be excreted right away, while the remainder will be retained in the muscle.[7] This is really important because the anti-vaccination message wants us to believe that all of this aluminium will be instantly released and travel straight to the brain. Not only is that misleading, but it is also clear that we have aluminium in our blood from daily dietary and environmental exposures that start from birth and perhaps even earlier.

A report from 2018 looked at blood and hair levels of aluminium in 9 to 13-month-old children who did not have kidney disease.[4] Blood and hair aluminium levels varied among the 85 children but that variation was not related to their vaccination history. There were no links between blood levels and infant development nor between hair levels and infant language or cognitive development.

Bauxite.
Source: flickr, Laurent

It’s got a lot to do with the dose

Aluminium is no different from anything we put in our body in this respect. Drink enough water and you could die.[3] The dose of the item is really important. The route of exposure to it, the length of exposure to it, your age, body mass, organ function and the chemical itself are all important as well.[7]

Only excessive concentrations of aluminium – far more than we see introduced through vaccination or normal diet – result in signs of any toxic effect. This is what we actually know today.

Aluminium helps us respond better to vaccines

Aluminium can persist at the site of a muscle injection for a year or more being ingested by specialised cells called into the injection site.[22,25] These cells keep training the immune system to recognise the vaccine target and be ready to respond in case of an actual infection.[6,9]

In this role, aluminium is known as an adjuvant. An adjuvant lets us use less of the viral or bacterial pieces in the vaccine while still getting our body to produce the long-lasting immune response we want, using what’s left. Aluminium adjuvants – and there are a few types that act a bit differently – help trigger a better immune response. This effect was discovered in 1926.[13]

Decades of monitored aluminium adjuvant use

Aluminium adjuvants have performed safely for decades. They do have known side effects because an adjuvant, like any drug or medicine, is never absolutely safe.[19]

Sometimes they may be linked with the appearance of a little hard bump or nodule under the skin at the injection site (a granuloma).[6,27,28,32]

Macrophagic myofasciitis (MMF) is an inflammatory focus of macrophages which contain aluminium salts.[24] MMF usually affects adults and has been very rarely reported in association with aluminium adjuvants and has mostly been reported from France.[23,35,38] The World Health Organisation’s Global Advisory Committee on Vaccine Safety reported that the persistence of aluminium-containing macrophages at the site of a previous vaccination was not associated with specific clinical symptoms or disease.[33,34] Better MMF studies are awaited.[26]

Yes, there have been studies comparing injections with and without aluminium

Perhaps new research will one day show different levels are good or bad, but for now, we work off the values shown to be safe and at or below the “minimum risk level” – a level above which a chemical dose is known to be unsafe.[7] We know that the levels of aluminium our children get from vaccination don’t cross that level.[7]

Another hardcore #prodisease trope is the one stating there has never been a study which directly compares aluminium-containing vaccines to a placebo that does not contain aluminium. This is incorrect.

You’ll never move the cult.
From the #vaccinesworkblog.[16]

A study without a placebo can be unethical.[20] If you withhold a vaccine which you know to this point has been safe and is likely to work based on all the studies done so far – you are knowingly condemning the people in one arm of the study – that which gets the placebo – to a greater risk of harm. You may be withholding the standard of care.

Having said that, these studies can be found.[20; see the list in [16], and find others using these search terms].

This one is quite clever.[17] The female population (mostly 16 to 26 years of age) had been previously vaccinated with the quadrivalent human papilloma (HPV) vaccine. One third were then given a placebo (just saline) and the other two-thirds given the newer 9-valent aluminium-adjuvanted formulation. There was a bit more pain, swelling, redness at the injection site and bruising among the vaccine group compared to those who received a saline placebo. The same was seen for headache, fever and dizziness. These are all ‘adverse events’ but they were overwhelmingly mild or moderate in severity. Out of 608 vaccinated, there were three severe adverse events in the vaccinated group and three in the placebo group.

Another study, also of an aluminium-adjuvanted HPV vaccine, enrolled 9 to 15-year-old boys and girls.[18] It administered the quadrivalent HPV vaccine to two thirds and a non-aluminium placebo to the other third. Children were followed up for 18 months. More people who got the vaccine reported injection site pain, swelling and redness for up to 5 days after injection compared to those who got the placebo. Headache and fever occurred only slightly more often in the group receiving the vaccine. There were five serious adverse events reported in the vaccine group over the 18 months of follow up, but none were deemed associated with the vaccine.

Safety is an ongoing concern

Vaccines, like other medicines, are watched after they’ve been released.[29] A couple of recent studies looked at the HPV vaccine a decade later.[30,31] They found these aluminium-adjuvanted vaccines to be effective and safe. The same can be said for the other vaccines that have been in use for even longer.

Current AusVaxSafety surveillance data for an HPV vaccine, NCIRS, Australia.

But also consider this: After so much time and so many other infections, life events and exposures to chemicals in our food, water and the air we breathe, it is very hard to know for sure what may have caused some newly appeared health concern. And I think it is this that scares people. People want to blame things so they feel they have control again.

It’s good to know that experts don’t just do their study and walk away. Post-licensure surveillance for safety issues is out there.

Wrapping this up

Yes, the injection site can be a bit painful and there can be some headaches after vaccination using aluminium adjuvants. This is the price we pay for an immune response that protects us from a known bad thing; inflammatory illness due to infection. Some arm pain is a good thing – it tells you your body is reacting and that’s what vaccination, and immunisation, is all about.

Much more rarely it can be a bit worse than that. But serious adverse events have not been associated with aluminium containing vaccines.

We probably will have new research studies in the future that will teach us more and more about vaccines and adjuvant. I look forward to reading them and learning new things. This is how we gain knowledge. Step by step. It’s why we need to keep funding and explaining science and not just sexy new science but science that revisits what we think we already know, delving a bit deeper or more sideways. Still, even new research into aluminium versus non-aluminium vaccines may not reveal anything we don’t already know.

References

  1. Chapter 7. pp216-267. Aluminium, Indium and Gallium, Thallium. Chemistry of the Elements. Vol 2. Editors Greenwood N. N., Earnshaw A. 1997. https://doi.org/10.1016/C2009-0-30414-6
  2. Public Health Statement for Aluminum
    https://www.atsdr.cdc.gov/phs/phs.asp?id=1076&tid=34
  3. Strange but True: Drinking Too Much Water Can Kill
    https://www.scientificamerican.com/article/strange-but-true-drinking-too-much-water-can-kill/
  4. Blood and Hair Aluminum Levels, Vaccine History, and Early Infant Development: A Cross-Sectional Study
    https://www.ncbi.nlm.nih.gov/pubmed/28919482
  5. Effect of Routine Vaccination on Aluminum and Essential Element Levels in Preterm Infants
    https://jamanetwork.com/journals/jamapediatrics/fullarticle/1712578
  6. HUMAN HEALTH RISK ASSESSMENT FOR ALUMINIUM, ALUMINIUM OXIDE, AND ALUMINIUM HYDROXIDE
    https://www.ncbi.nlm.nih.gov/pubmed/18085482
  7. Updated aluminum pharmacokinetics following infant exposures through diet and vaccination
    https://www.ncbi.nlm.nih.gov/pubmed/22001122
  8. Aluminum toxicokinetics regarding infant diet and vaccinations
    https://www.ncbi.nlm.nih.gov/pubmed/12184359
  9. Vaccine Ingredients – Aluminum
    https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-ingredients/aluminum
  10. Public Health Statement for Aluminum
    https://www.atsdr.cdc.gov/phs/phs.asp?id=1076&tid=34
  11. Vaccine ingredients
    http://vk.ovg.ox.ac.uk/vaccine-ingredients#aluminium
  12. Aluminium Toxicokinetics: An UpdatedMiniReview
    https://www.ncbi.nlm.nih.gov/pubmed/11322172
  13. Aluminium salts in vaccines: US perspective.
    https://www.ncbi.nlm.nih.gov/pubmed/12184360
  14. Aluminium in drinking-water | Background document for development of WHO Guidelines for Drinking-water Quality
    https://www.who.int/water_sanitation_health/water-quality/guidelines/chemicals/aluminium.pdf?ua=1
  15. 24th Australian Total Diet Study
    http://www.foodstandards.gov.au/publications/Documents/1778-FSANZ_AustDietStudy-web.pdf
  16. There are no vaccine studies with saline placebo? | #vaccinesworkblog
    https://vaccinesworkblog.wordpress.com/2018/08/06/there-are-no-vaccine-studies-with-saline-placebo/
  17. Safety and immunogenicity of a 9-valent HPV vaccine in females 12–26 years of age who previously received the quadrivalent HPV vaccine
    https://www.ncbi.nlm.nih.gov/pubmed/26411885
  18. Safety and persistent immunogenicity of a quadrivalent human papillomavirus types 6, 11, 16, 18 L1 virus-like particle vaccine in preadolescents and adolescents: a randomized controlled trial.
    https://www.ncbi.nlm.nih.gov/pubmed/17484215
  19. Vaccine Design | The Subunit and Adjuvant Approach. Pharmaceutical Biotechnology Vol 6. Edited by Powell and Newman.
    https://www.springer.com/gp/book/9781461518235
  20. Placebo use in vaccine trials: Recommendations of a WHO expert panel
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157320/
  21. Immunogenicity and safety of an investigational tetravalent recombinant subunit vaccine for dengue: results of a Phase I randomized clinical trial in flavivirus-Naïve adults
    https://www.ncbi.nlm.nih.gov/pubmed/30427741
  22. Insight into the cellular fate and toxicity of aluminium adjuvants used in clinically approved human vaccinations
    https://www.ncbi.nlm.nih.gov/pubmed/27515230
  23. Comparative safety of vaccine adjuvants: a summary of current evidence and future needs
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615573/pdf/nihms729273.pdf
  24. Questions and Answers about macrophagic myofasciitis (MMF)
    https://www.who.int/vaccine_safety/committee/topics/aluminium/questions/en/
  25. [Vaccine adjuvants and macrophagic myofasciitis]
    https://www.ncbi.nlm.nih.gov/pubmed/15653065
  26. Vaccine components and constituents: responding to consumer concerns
    https://www.mja.com.au/journal/2006/184/4/vaccine-components-and-constituents-responding-consumer-concerns
  27. Injection-Site Granuloma due to Aluminum
    https://www.ncbi.nlm.nih.gov/pubmed/6207779
  28. Vaccination granulomas and aluminium allergy: course and prognostic factors
    https://www.ncbi.nlm.nih.gov/pubmed/1395591
  29. Vaccine adverse events surveillance in Australia
    http://www.ncirs.org.au/health-professionals/vaccine-safety
  30. Ten-year immune persistence and safety of the HPV-16/18 AS04-adjuvanted vaccine in females vaccinated at 15– 55 years of age
    https://www.ncbi.nlm.nih.gov/pubmed/28984053
  31. Sustained efficacy, immunogenicity, and safety of the HPV-16/18 AS04-adjuvanted vaccine
    https://www.ncbi.nlm.nih.gov/pubmed/25424918
  32. Questions about vaccination | Australian Department of Health
    https://beta.health.gov.au/resources/publications/questions-about-vaccination
  33. Statement from the Global Advisory Committee on Vaccine Safety on aluminium-containing vaccines
    https://www.who.int/vaccine_safety/committee/topics/aluminium/statement_112002/en/
  34. Weekly epidemiological record No.3 2004, 79, 13-24
    https://afro.who.int/sites/default/files/2017-06/wer7903.pdf
  35. Macrophagic myofasciitis and vaccination: consequence or coincidence?
    https://www.ncbi.nlm.nih.gov/pubmed/24923906
  36. Occurrence, exposure, effects, recommended intake and possible dietary use of selected trace compounds (aluminium, bismuth, cobalt, gold, lithium, nickel, silver)
    https://www.ncbi.nlm.nih.gov/pubmed/25045935
  37. Vaccine components and constituents: responding to consumer concerns
    https://www.mja.com.au/journal/2006/184/4/vaccine-components-and-constituents-responding-consumer-concern