Every few years the U.S. Centers for Disease Control (CDC) publishes a new edition of its "Pink Book," Epidemiology and Prevention of Vaccine-Preventable Diseases. In its Appendix B is a table (pp. B7-B10) entitled Vaccine Excipient & Media Summary: Excipients Included in U.S. Vaccines, by Vaccine. It lists all the "inactive" ingredients in each vaccine listed on the manufacturer's package insert.The CDC has published an updated version of the table with package-insert information as of January, 2017, which is the data presented in this table. Its header states:
|
In addition to weakened or killed disease antigens (viruses or bacteria), vaccines contain very small amounts of other ingredients – excipients or media.
Some excipients are added to a vaccine for a specific purpose. These include:
Preservatives, to prevent contamination. For example, thimerosal.
Adjuvants, to help stimulate a stronger immune response. For example, aluminum salts.
Stabilizers, to keep the vaccine potent during transportation and storage. For example, sugars or gelatin.
Others are residual trace amounts of materials that were used during the manufacturing process and removed. These include:
Cell culture materials, used to grow the vaccine antigens. For example, egg protein, various culture media.
Inactivating ingredients, used to kill viruses or inactivate toxins. For example, formaldehyde.
Antibiotics, used to prevent contamination by bacteria. For example, neomycin.
The following table lists all components, other than antigens, shown in the manufacturers' package insert (PI) for each vaccine. Each of these PIs, which can be found on the FDA's website (see below) contains a description of that vaccine's manufacturing process, including the amount and purpose of each substance. In most PIs, this information is found in Section 11: "Description."
|
|
However, while the by-vaccine organization of that table makes it useful for checking the contents of vaccines, it is not useful for seeing the range of vaccines that contain any one of these ingredients. A note at the foot of the published table points to a vaccines-by-excipient table in a book [Grabenstein JD. ImmunoFacts: Vaccines and Immunologic Drugs – 2013 (38th revision). St Louis, MO: Wolters Kluwer Health, 2012], but not to an online source. This table is designed to fill that need. A few notes about its construction:
- Excipient names – Except for a very few instances (e.g., "formalin" changed to "formaldehyde," correcting misspellings, shuffling words for better sorting), the text is literally as it was in the original table. As a result, there are many cases of seemingly almost-duplicate listings for many of the components. But given that this adaptation was not based on deep knowledge of the vaccines themselves, it was considered safest to not lump these "duplicates" together, but only shuffle the words to allow them to sort adjacent to each other.
- Dates – Package-insert dates were not provided in the updated table, so those in the 2015 table are provided here for reference, but the data is current as of the January 2017 inserts.
- Categories – In order to facilitate grouping certain ingredients into potentially useful categories, those ingredients were duplicated and prefixed with headers -- medium, bovine, canine, monkey, porcine -- and thus will be found in two places in the table.
- Growth Media – Many of the vaccine content listing include references to growth media. In two cases:
| DMEM | Dulbecco's Modified Eagle Medium | |
| M199 | Medium 199 | |
the contents of the medium were spelled out in the Excipient Table and could be listed separately here, identified as such by (DMEM) and (M199). However, there were many other non-itemized media. Until these can be broken out, they have all been grouped here under the general category "Media."
- Abbreviations – To make the table more readable, excipient names have sometimes been shortened, with the remainder in footnotes; vaccines have been abbreviated with links to the full names in the vaccine list below it.
Other "Ingredients" – This table does not include inadvertent contaminants introduced in the manufacturing or storage process, such as the metal debris and biological contamination documented in a recent study. And it should be noted that manufacturers and distributers, since 1986, are not liable for damage from any materials contained in vaccines.
|
| 3-O-desacyl-4' Monophosphoryl lipid A |
HPV.C |
| 2-phenoxyethanol |
DTap.D |
DTap+.Pn |
Polio |
Tdap.A |
| acetone |
Aden |
| alcohol |
Aden |
Men.Ma |
Men.Mo |
| alpha-tocopheryl hydrogen succinate |
Inf.Fa |
| aluminum hydroxide |
Anth |
DTap.I |
DTap+.K |
DTap+.Pd |
HepA.H |
HepAB.T |
HepB.E |
HPV.C |
| aluminum hydroxide (cont) |
JapEnc |
MenB.B |
Tdap.B |
| aluminum hydroxyphosphate sulfate |
Hib.P |
| aluminum hydroxyphosphate sulfate, amorph |
HepA.V |
HepB.R |
Hib+.C |
HPV.G |
HPV.G9 |
| aluminum phosphate |
DTap.D |
DTap+.Pd |
DTap+.Pn |
HepAB.T |
Td.M |
Td.T |
Tdap.A |
| aluminum potassium sulfate |
DT |
Td.D |
| amino acid supplement |
HepA.H |
| amino acids |
Anth |
HepAB.T |
HepB.R |
Hib+.C |
HPV.C |
HPV.G |
HPV.G9 |
Inf.Fb |
| amino acids (cont) |
Men.Mv |
Rot.R |
Typh.O |
| amino acids (M199) |
DTap+.Pn |
MMR |
Polio |
| amino acids solution (DMEM) |
Aden |
Rot.R |
| ammonium phosphate |
Td.M |
| ammonium sulfate |
DT |
DTap.D |
DTap+.Pn |
Hib.A |
Men.Ma |
Td.D |
Td.T |
Tdap.A |
| amphotericin B |
Rab.A |
| anhydrous lactose |
Aden |
| arginine |
Inf+.Fm |
| ascorbic acid |
Typh.O |
| asparagine |
BCG |
| bacterial protein |
HPV.C |
| baculovirus and cellular DNA |
Inf.Fb |
| baculovirus and host cell proteins |
Inf.Fb |
| barium |
Inf.Ag |
| benzethonium chloride |
Anth |
| beta-propiolactone |
Inf.Af |
Inf.Fc |
Inf.Fv |
Rab.A |
Rab.I |
| bovine: bovine albumin |
HepA.V |
| bovine: bovine extract |
DT |
| bovine: bovine muscle tissue (US sourced) |
Td.D |
| bovine: bovine serum |
DTap+.K |
Rab.A |
| bovine: bovine serum albumin |
DTap+.Pn |
JapEnc |
| bovine: calf serum |
DTap+.Pd |
MMRV |
Varic.R |
Zost.F |
Zost.R |
| bovine: calf serum protein |
Polio |
| bovine: CMRL medium 1969 [1] |
DTap+.Pn |
| bovine: Fenton medium [2] |
DTap.I |
DTap+.K |
DTap+.Pd |
Tdap.B |
| bovine: fetal bovine serum |
Aden |
Rot.T |
Varic.F |
| bovine: fetal bovine serum (M199) |
DTap+.Pn |
MMR |
Polio |
| bovine: Latham medium [3] |
Tdap.B |
| bovine: Latham medium [3], mod |
DTap.I |
DTap+.K |
DTap+.Pd |
Td.M |
| bovine: polygeline (processed bovine gelatin) |
Rab.A |
| calcium carbonate |
Rot.R |
| calcium chloride |
Inf.Af |
| calcium chloride (DMEM) |
Aden |
Rot.R |
| canine: MDCK cell protein |
Inf.Fc |
| canine: MDCK cell DNA |
Inf.Fc |
| carbohydrates |
HPV.G |
HPV.G9 |
| casamino acids |
Pneu.13 |
| casein |
Typh.O |
| castor oil |
Aden |
| cell culture media |
Rot.T |
| cellulose acetate phthalate |
Aden |
| cetyltrimethylammonium bromide |
Inf.Ag |
Inf.Fc |
| chick embryo cell culture |
MMR |
MMRV |
| chicken protein |
Rab.A |
| chlortetracycline |
Rab.A |
| citric acid |
BCG |
| D-fructose |
Aden |
| D-glucose (DMEM) |
Aden |
Rot.R |
| D-mannose |
Aden |
| deoxycholate |
MenB.B |
| detergent |
Hib.P |
Hib+.C |
Men.Ma |
Men.Mo |
| dextran |
Rot.R |
| dextrose |
Aden |
HepB.R |
Hib+.C |
Typh.O |
| dimethyl 1-beta-cyclodextrin |
DTap.D |
| dimethyl-beta-cyclodextrin |
Tdap.A |
| disodium phosphate |
Typh.I |
| E. coli |
MenB.B |
MenB.T |
| EDTA |
Inf+.Fm |
Varic.F |
| EDTA, sodium |
Rab.A |
| egg proteins |
Inf.Af |
Inf.Ag |
Inf.Fl |
Inf.Fv |
Inf.Fz |
Inf+.Fm |
Rab.A |
YelFev |
| enzymes |
Hib.P |
Hib+.C |
| ethanol |
Hib.P |
Hib+.C |
| FD&C Yellow #6 aluminum lake dye |
Aden |
| ferric (III) nitrate (DMEM) |
Aden |
Rot.R |
| formaldehyde |
Anth |
DT |
DTap.D |
DTap.I |
DTap+.K |
DTap+.Pd |
DTap+.Pn |
HepA.H |
| formaldehyde (cont) |
HepA.V |
HepAB.T |
HepB.R |
Hib.A |
Hib.H |
Hib+.C |
Hib+.M |
Inf.Ag |
| formaldehyde (cont) |
Inf.Fa |
Inf.Fl |
Inf.Fz |
JapEnc |
Men.Ma |
Men.Mv |
Polio |
Td.D |
| formaldehyde (cont) |
Td.M |
Td.T |
Tdap.A |
Tdap.B |
Typh.I |
| galactose |
Typh.O |
| gelatin |
Typh.O |
YelFev |
| gelatin: (standard trivalent formulation only) |
Inf.Fz |
| gelatin: hydrolyzed gelatin |
MMR |
MMRV |
Varic.F |
Varic.R |
| gelatin: hydrolyzed porcine gelatin |
Inf+.Fm |
Zost.F |
Zost.R |
| gelatin: polygeline (processed bovine gelatin) |
Rab.A |
| gentamicin sulfate |
Inf.Fa |
Inf+.Fm |
| glutamate |
Varic.F |
Varic.R |
| glutamate (M199) |
DTap+.Pn |
MMR |
Polio |
| glutaraldehyde |
DTap.D |
DTap.I |
DTap+.K |
DTap+.Pd |
DTap+.Pn |
Tdap.A |
Tdap.B |
| glycerin |
BCG |
SPX |
| guinea pig cell cultures, embryonic |
Varic.F |
Varic.R |
| hemin chloride |
Hib+.C |
| HEPES |
SPX |
| hexadecyltrimethylammonium bromide |
Typh.I |
| histidine |
MenB.B |
MenB.T |
| human albumin |
MMRV |
Rab.I |
| human diploid cell cultures (WI-38) |
Varic.F |
Varic.R |
| human diploid fibroblast cell cultures (WI-38) |
Aden |
| human diploid lung fibroblasts (WI-38) |
MMR |
MMRV |
| human embryonic lung cultures |
Varic.F |
Varic.R |
| human serum albumin |
Aden |
Rab.A |
SPX |
| hydrocortisone |
Inf.Fa |
| inorganic salts and sugars |
Anth |
| insect cell protein |
HPV.C |
| iron ammonium citrate |
BCG |
| kanamycin |
Inf.Ag |
MenB.B |
| L-cystine (DMEM) |
Aden |
Rot.R |
| L-glutamine (DMEM) |
Aden |
Rot.R |
| L-histidine |
HPV.G |
HPV.G9 |
| L-tyrosine (DMEM) |
Aden |
Rot.R |
| lactalbumin hydrolysate |
DTap+.K |
DTap+.Pd |
| lactose |
BCG |
Hib.H |
Men.Mo |
Typh.O |
| lipids |
HPV.C |
Inf.Fb |
| magnesium stearate |
Aden |
Typh.O |
| magnesium sulfate |
BCG |
| magnesium sulfate (DMEM) |
Aden |
Rot.R |
| mannitol |
SPX |
| Media |
| medium: CMRL 1969 (suppl. w/ calf serum) |
DTap+.Pn |
| medium: complex fermentation |
Hib.P |
| medium: CY medium |
Men.Mv |
| medium: Eagle MEM (DMEM) mod |
Polio |
| medium: Fenton medium[2] |
DTap.I |
DTap+.K |
DTap+.Pd |
Tdap.B |
| medium: fermentation growth media |
MenB.T |
| medium: Franz complete medium |
Men.Mv |
| medium: Latham medium [3] |
Tdap.B |
| medium: Latham medium [3], mod |
DTap.I |
DTap+.K |
DTap+.Pd |
| medium: Minimum Essential Medium |
MMR |
| medium: Mueller Hinton agar |
Men.Ma |
| medium: Mueller Hinton casein agar |
Men.Mo |
| medium: Mueller-Miller |
Td.D |
| medium: Mueller-Miller [5] |
DTap+.Pn |
Tdap.A |
| medium: Mueller-Miller [5], mod |
DTap.D |
Td.T |
| medium: Mueller-Miller medium, mod |
DT |
Hib.A |
Men.Ma |
| medium: Mueller's growth medium |
DTap+.Pn |
| medium: Mueller's growth medium, mod |
DTap.D |
Tdap.A |
| medium: Mueller's media [4], mod |
Td.M |
| medium: semi-synthetic |
Hib.H |
Hib+.M |
Typh.I |
| medium: Stainer-Scholte medium |
DTap.D |
Tdap.A |
| medium: Stainer-Scholte medium [6] |
DTap+.Pn |
| medium: Stainer-Scholte medium, liquid |
Tdap.B |
| medium: Stainer-Scholte medium, liquid, mod |
DTap.I |
DTap+.K |
DTap+.Pd |
| medium: synthetic |
Hib+.M |
| medium: Watson Scherp media |
Men.Ma |
Men.Mo |
| |
| micro crystalline cellulose |
Aden |
HepB.R |
| mineral salts |
Hib+.C |
HPV.C |
HPV.G |
HPV.G9 |
Inf.Fb |
| monkey kidney cells |
Polio |
| monkey: Vero (monkey kidney) cells |
DTap+.K |
DTap+.Pd |
JapEnc |
| monosodium glutamate |
Aden |
Inf+.Fm |
| monosodium L-glutamate |
MMRV |
Varic.F |
Varic.R |
Zost.F |
Zost.R |
| monosodium phosphate |
Typh.I |
| MRC-5 (human diploid) cells |
DTap+.Pn |
HepA.V |
HepAB.T |
MMRV |
Rab.I |
| MRC-5 (human diploid) cells [7] |
Varic.F |
Varic.R |
Zost.F |
Zost.R |
| MRC-5 (human diploid) cellular proteins |
HepA.H |
| neomycin |
DTap+.Pn |
HepA.V |
Inf.Fv |
MMR |
MMRV |
Polio |
Rab.A |
SPX |
| neomycin (cont) |
Varic.F |
Varic.R |
Zost.F |
Zost.R |
| neomycin sulfate |
DTap+.K |
DTap+.Pd |
HepA.H |
HepAB.T |
Inf.Af |
Inf.Ag |
Rab.I |
| nicotinamide adenine dinucleotide |
Hib+.C |
| nonylphenol ethoxylate |
Inf.Fv |
| ovalbumin |
Inf.Fa |
| peptone |
DT |
Td.D |
| phenol |
Hib.P |
Hib+.C |
Pneu.23 |
SPX |
Typh.I |
| phenol red (DMEM) |
Aden |
Rot.R |
| phenol red indicator |
Rab.I |
| phosphate |
MMR |
Varic.F |
Varic.R |
| phosphate buffer |
HepAB.T |
HepB.R |
Inf.Fa |
Inf.Fc |
Inf.Fl |
Inf.Fv |
| phosphate buffers |
HepB.E |
Inf.Fz |
Men.Ma |
| plasdone C |
Aden |
| polacrilin potassium |
Aden |
| polydimethylsiloxane |
Typh.I |
| polymyxin |
Inf.Fv |
| polymyxin B |
DTap+.K |
DTap+.Pd |
Inf.Af |
Polio |
SPX |
| polymyxin B sulfate |
DTap+.Pn |
| polysorbate 20 |
HepA.H |
HepAB.T |
Inf.Fb |
| polysorbate 80 |
DTap.I |
DTap+.K |
DTap+.Pd |
DTap+.Pn |
HPV.G |
HPV.G9 |
Inf.Ag |
Inf.Fc |
| polysorbate 80 (cont) |
MenB.T |
Pneu.13 |
Rot.T |
| polysorbate 80 (Tween 80) |
Inf.Fa |
Tdap.B |
| porcine circovirus type 1 [8] |
Rot.R |
| porcine circoviruses type 1 and 2 DNA [9] |
Rot.T |
| porcine: hydrolyzed porcine gelatin |
Inf+.Fm |
Zost.F |
Zost.R |
| potassium aluminum sulfate |
HepB.R |
Hib+.C |
| potassium chloride |
Inf.Af |
MMRV |
Varic.F |
Varic.R |
Zost.F |
Zost.R |
| potassium chloride (DMEM) |
Aden |
Rot.R |
| potassium glutamate |
Rab.A |
| potassium phosphate |
Aden |
BCG |
| potassium phosphate, dibasic |
Inf+.Fm |
MMRV |
| potassium phosphate, monobasic |
Inf.Af |
Inf+.Fm |
MMRV |
Varic.F |
Varic.R |
Zost.F |
Zost.R |
| protamine sulfate |
JapEnc |
| recombinant human albumin |
MMR |
| sodium bicarbonate |
Aden |
MMRV |
| sodium borate |
HepA.V |
Hib+.C |
HPV.G |
HPV.G9 |
| sodium citrate |
Rot.T |
| sodium deoxycholate |
Inf.Fa |
Inf.Fl |
| sodium dihydrogen phosphate dihydrate |
HepB.E |
HPV.C |
| sodium hydrogenocarbonate (DMEM) |
Aden |
Rot.R |
| sodium hydroxide |
Rot.T |
| sodium metabisulphite |
JapEnc |
| sodium phosphate (DMEM) |
Aden |
Rot.R |
| sodium phosphate, dibasic |
Inf.Af |
Inf.Fb |
MMRV |
Varic.F |
Varic.R |
Zost.F |
Zost.R |
| sodium phosphate, monobasic |
Inf.Af |
Inf.Fb |
Varic.F |
Varic.R |
| sodium phosphate, monobasic monohydrate |
Rot.T |
| sodium pyruvate (DMEM) |
Aden |
Rot.R |
| sodium taurodeoxycholate |
Inf.Af |
| sorbitol |
MMR |
MMRV |
Rot.R |
YelFev |
| soy peptone |
HepB.R |
Hib+.C |
| soy peptone broth |
Pneu.13 |
| streptomycin |
Polio |
| succinate buffer |
Pneu.13 |
| sucrose |
Aden |
DTap+.Pn |
Hib.A |
Hib+.M |
Inf.Af |
Inf.Fa |
Inf.Fz |
Inf+.Fm |
| sucrose (cont) |
JapEnc |
MenB.B |
MMRV |
Rot.R |
Rot.T |
Typh.O |
Varic.F |
Varic.R |
| sucrose (cont) |
Zost.F |
Zost.R |
| sucrose (M199) |
DTap+.Pn |
MMR |
Polio |
| thimerosal |
Inf.Fl |
Td.D |
| thimerosol (multi-dose vial only) |
Inf.Af |
Inf.Fz |
Men.Mo |
| thimerosal (multi-dose vial) [10] |
Inf.Fv |
| thimerosal (trace) |
DT |
Td.M |
| tris (trometamol)-HCl |
Hib+.M |
| Triton X-100 |
Inf.Fb |
| Triton X-100 (octoxynol-10) |
Inf.Fa |
| Triton X-100 (octylphenol ethoxylate) |
Inf.Fz |
| urea |
Varic.R |
Zost.R |
| viral protein |
HPV.C |
| vitamin solution, concentrated (DMEM) |
Aden |
Rot.R |
| vitamins |
Anth |
HPV.C |
HPV.G |
HPV.G9 |
Inf.Fb |
| vitamins (M199) |
DTap+.Pn |
MMR |
Polio |
| xAnthan |
Rot.R |
| yeast |
Pneu.13 |
| yeast [11] |
Hib+.C |
| yeast extract |
Men.Mv |
Typh.O |
| yeast protein |
DTap+.Pd |
HepAB.T |
HepB.E |
HepB.R |
HPV.G |
HPV.G9 |
| Aden | Adenovirus – March 2011 |
| Anth | Anthrax (Biothrax) – May 2012 |
| BCG | BCG (Tice) – February 2009 |
| DT | DT (Sanofi) – December 2005 |
| DTap.D | DTaP (Daptacel) – October 2013 |
| DTap.I | DTaP (Infanrix) – November 2013 |
| DTap+.K | DTaP-IPV (Kinrix) – November 2013 |
| DTap+.Pd | DTaP-HepB-IPV (Pediarix) – November 2013 |
| DTap+.Pn | DTaP-IPV/Hib (Pentacel) – October 2013 |
| Hib.A | Hib (ActHIB) – January 2014 |
| Hib.H | Hib (Hiberix) – March 2012 |
| Hib.P | Hib (PedvaxHIB) – December 2010 |
| Hib+.C | Hib/Hep B (Comvax) – December 2010 |
| Hib+.M | Hib/Mening. CY (MenHibrix) – 2012 |
| HepA.H | Hep A (Havrix) – December 2013 |
| HepA.V | Hep A (Vaqta) – February 2014 |
| HepB.E | Hep B (Engerix-B) – December 2013 |
| HepB.R | Hep B (Recombivax) – May 2014 |
| HepAB.T | Hep A/Hep B (Twinrix) – August 2012 |
| HPV.C | Human Papillomavirus (HPV) (Cerverix) – November 2013 |
| HPV.G | Human Papillomavirus (HPV) (Gardasil) – June 2014 |
| HPV.G9 | Human Papillomavirus (HPV) (Gardasil 9) – December 2014 |
| Inf.Af | Influenza (Afluria) – December 2013 |
| Inf.Ag | Influenza (Agriflu) – 2013 |
| Inf.Fa | Influenza (Fluarix) Trivalent and Quadrivalent – June 2014 |
| Inf.Fb | Influenza (Flublok) – March 2014 |
| Inf.Fc | Influenza (Flucelvax) – March 2014 |
| Inf.Fv | Influenza (Fluvirin) – February 2014 |
| Inf.Fl | Influenza (Flulaval) Trivalent and Quadrivalent – February 2013 |
| Inf.Fz | Influenza (Fluzone: Standard (Trivalent and Quadrivalent), High-Dose, & Intradermal) – 2014 |
| Inf+.Fm | Influenza (FluMist) Quadrivalent – July 2013 |
| JapEnc | Japanese Encephalitis (Ixiaro) – May 2013 |
| Men.Ma | Meningococcal (MCV4Menactra) – April 2013 |
| Men.Mv | Meningococcal (MCV4Menveo) – August 2013 |
| Men.Mo | Meningococcal (MPSV4Menomune) – April 2013 |
| MenB.B | Meningococcal (MenB – Bexsero) – 2015 |
| MenB.T | Meningococcal (MenB – Trumenba) – October 2015 |
| MMR | MMR (MMR-II) – June 2014 |
| MMRV | MMRV (ProQuad) – March 2014 |
| Pneu.13 | Pneumococcal (PCV13 – Prevnar 13) – January 2014 |
| Pneu.23 | Pneumococcal (PPSV-23 – Pneumovax) – May 2014 |
| Polio | Polio (IPV – Ipol) – May 2013 |
| Rab.I | Rabies (Imovax) – April 2013 |
| Rab.A | Rabies (RabAvert) – March 2012 |
| Rot.T | Rotavirus (RotaTeq) – June 2013 |
| Rot.R | Rotavirus (Rotarix) – May 2014 |
| SPx | Smallpox (Vaccinia – ACAM2000) – September 2009 |
| Td.D | Td (Decavac) – March 2011 |
| Td.T | Td (Tenivac) – April 2013 |
| Td.M | Td (Mass Biologics) – February 2011 |
| Tdap.A | Tdap (Adacel) – March 2014 |
| Tdap.B | Tdap (Boostrix) – February 2013 |
| Typh.I | Typhoid (inactivated – Typhim Vi) – March 2014 |
| Typh.O | Typhoid (oral – Ty21a) – September 2013 |
| Varic.F | Varicella (Varivax) Frozen – March 2014 |
| Varic.R | Varicella (Varivax) Refrigerator Stable – March 2014 |
| YelFev | Yellow Fever (YF-Vax) – May 2013 |
| Zost.F | Zoster (Shingles – Zostavax) Frozen – February 2014 |
| Zost.R | Zoster (Shingles – Zostavax) Refrigerator Stable – February 2014
|