Sunday, December 20, 2020

Active And Inactive Ingredients In Vaccines

Active And Inactive Ingredients In Vaccines

A vaccine against a particular virus will contain a small amount of the pathogen or a part of it. When we receive the vaccine, the viral interloper triggers our immune system to launch a series of events that leave us protected against the pathogen in the future.

The WHO estimate that vaccinations prevent between 2 and 3 million deaths every year across the globe. Severe side effects are very rare, making vaccines one of the safest healthcare interventions in the history of modern medicine.

The ingredients in common vaccines reveals a long list of other components, the roles of which might not seem so clear. What is the purpose of gelatin, thimerosal, and Polysorbate 80? And why do some vaccines contain aluminum? Let us look at the active and inactive ingredients that make their way into vaccines and reveal what their role is in protecting us from infectious diseases.

Do vaccines contain human cell material?

Some vaccines are made from viruses or pathogenic molecules that are expanded in human, animal, or yeast cells.

There are two human cell lines that pharmaceutical companies use. These are called WI-38 and MRC-5. Both of these cell lines were established from cells taken from the lungs of aborted fetuses.

But for some people, the fact that cells from aborted fetuses are used in this way presents a moral problem.

Other viruses are grown in animal cells before being incorporated into vaccines. Animal cells used for this purpose include kidney cells from African green monkeys (Vero cells) and chick embryo cells.

Some recombinant vaccines may contain small trace amounts of yeast proteins or yeast DNA.

Our immune system and active ingredients

The active ingredient in a vaccine is usually made from the viral or bacterial pathogen itself. There are two different approaches to this, with the pathogen being either alive or inactivated.

Vaccines that incorporate living bacteria or viruses are called live attenuated vaccines. The pathogen is weakened to prevent it from causing the disease, but it is still able to elicit a strong immune response. Live attenuated vaccines work very well, but they are not suitable for everyone. If a person is immunocompromised, they may contract the very disease from which the vaccine should be protecting them. Many vaccines, therefore, use an inactivated version of the active ingredients, which can take the form of whole bacteria or viruses that have been killed.

However, most vaccines are actually acellular, which means that they do not contain the whole pathogenic organism. Instead, they are made from parts of the pathogen, such as proteins or sugar molecules. Our bodies recognize these molecules as foreign and mount an immune response.

Examples of acellular vaccines are:

Toxoid vaccines that contain inactivated toxins from pathogenic bacteria.

Conjugate vaccines made from a combination of pathogen-specific sugar molecules and toxoid proteins, as the sugars themselves do not cause sufficiently strong immune responses.

Recombinant vaccines made by using bacteria or yeast cells to make many copies of specific molecules from the pathogen.

Aside from the active ingredient, vaccines contain many other things. The technical term for these is excipients.

Excipients include preservatives and stabilizers, traces of things that were used to produce the vaccine, and adjuvants. Adjuvants make vaccines stronger.

Although many vaccines contain active ingredients that are strong enough to kick our immune system into gear, some need a little bit of extra help to be effective.

Adjuvants are compounds that elicit a strong immune response, improving how well a vaccine works.

Examples of adjuvants include:

Metals, Oils, Biological molecules, such as components isolated from bacteria and synthetic DNA

Aluminum, in the form of aluminum salt, features in a variety of vaccines, including several routine childhood vaccines. Scientists believe that this adjuvant increases the production of antibodies.

Aluminum is a naturally occurring metal that has many uses aside from its adjuvant properties. Cans, foil, and some window frames contain aluminum.

Aluminum salts are also used in the food industry as additives.

As an adjuvant, aluminum has a long history going back to the 1930s. Despite its widespread use, some scientists believe that the metal can cause damage to the nervous system and promote autoimmunity.

The Food and Drug Administration (FDA) published a study in 2011 in the journal Vaccine, which concluded that “episodic exposures to vaccines that contain aluminum adjuvant continue to be extremely low risk to infants and that the benefits of using vaccines containing aluminum adjuvant outweigh any theoretical concerns.”

Another example of an adjuvant is squalene, a naturally occurring oil.

The Fluad vaccine, a flu vaccine licensed for adults aged 65 years and older, contains an adjuvant called MF59, which is an oil-in-water emulsion containing squalene. The squalene used in MF59 is purified from shark liver oil.

In 2000, a research team pointed to a link between squalene and Gulf War Syndrome, prompting fears about the safety of this adjuvant.

Preservatives, Stabilizers, and Emulsifiers

The number of excipients in any particular vaccine varies and is highly dependent on both the manufacturing process and the vaccine’s intended use.

Thimerosal is a preservative primarily used in vaccines that come in multidose vials. Thimerosal kills bacteria and fungi that may contaminate a vaccine.

It is an organic compound containing about 50% mercury, prompting some people to be concerned about exposure to this heavy metal.

Gelatin is a stabilizer used in some vaccines to protect the active ingredient. It is usually sourced from pigs and highly processed. Other stabilizers include the sweetener sorbitol and the sugar molecules sucrose and lactose.

Polysorbate 80 is an emulsifier used in the food industry in ice creams, gelatin desserts, barbecue sauce, and pickled products. In vaccines, it helps other components remain soluble.

Some people have voiced concerns over the safety of polysorbate 80 after research showed potential links to reproductive problems in female rats and premature ovarian failure in girls receiving the quadrivalent human papillomavirus vaccine.

Remnants of the vaccine production process

Vaccine manufacturers need sufficient quantities of bacteria and viruses to make the required doses.

Bacteria or viruses are often grown in large numbers before undergoing purification and then attenuation or inactivation during the production process.

Although most of the materials used during this expansion phase will be present in trace amounts or not at all in the final product, they may feature on the list of ingredients.

Antibiotics are used in the production of vaccines against some viruses to prevent bacterial contamination. The most commonly used antibiotics are neomycin, streptomycin, polymyxin B, gentamicin, and kanamycin.

Acidity regulators, such as succinic acid and disodium adipate, help keep the pH at the correct level during the expansion process.

Bovine serum is a component in some growth media formulations.

Ovalbumin is a protein in the whites of chicken eggs. The viral particles used in some flu and rabies vaccines are grown on chicken eggs, making it possible that small traces of ovalbumin will appear in the final product.

Glutaraldehyde and formaldehyde are chemicals used to inactivate toxins from viruses and bacteria in some vaccines. These chemicals are toxic in large quantities.

Excipients in pharmaceuticals

While some people may be surprised to see excipients in vaccines, these compounds actually feature heavily in all medicines.

Sugars and flavoring in syrups mask the potentially unpleasant taste of the formulation, while colors help people avoid mistaking one drug for another. 

Some excipients improve how well a drug can penetrate the skin or determine where in the gastrointestinal tract its breakdown occurs.

As with vaccines, their purpose is to ensure that drugs are safe and effective.

Friday, December 11, 2020

The top 10 biggest pharma companies in the world in 2020

The top 10 biggest pharma companies in the world in 2020: In 2019, the global pharmaceutical industry continued to grow making an estimated $1.3 trillion. The US FDA approved 48 new drugs and biologics in 2019. The FDA approved an impressive number of generics with a huge 1,171 approvals, breaking its previous record of 971 in 2018.


American multinational, Amgen. With its “biology-first approach”, Amgen produces innovative medicines and delivers them to 100 countries and regions worldwide.

French multinational pharmaceutical giant, Sanofi. Sanofi provides healthcare solutions to 170 countries worldwide and has three core focuses: speciality care, vaccines and general medicines. Sanofi’s pharmaceutical segment grew by 4% on a year-on-year basis, with recently launched Eczema treatment Dupixent, which is set for further growth as Sanofi plans to extend its reach to another 89 countries.

Founded 133 years ago, Bristol-Myers Squibb is a leading global pharmaceutical company that specialises in medicinal advancements in four key areas: oncology, haematology, immunology and cardiovascular disease.

Headquartered in Osaka, Japanese multinational Takeda is the largest pharmaceutical company in Asia. Takeda focuses its efforts in four core areas: oncology, rare diseases, neuroscience, and gastroenterology.

AbbVie was created in 2013, when the company separated from Abbott. Employing 47,000 experts, AbbVie tends to drive its R&D efforts towards difficult-to-cure diseases and successfully acquired Allergan in May 2019. 

Swiss multinational pharmaceutical company Novartis has developed, manufactured and marketed breakthrough medicines for over 250 years. Now with presence in 155 countries across the world, Novartis focuses on innovative medicines as well as generics and biosimilars. Key brands Cosentyx, Entresto and Zolgensma.

American pharmaceutical company Merck was founded in 1891. With 71,000 employees worldwide, the company is well known for its contributions to diabetes and cancer care. Key growth drivers included Keytruda, Gardasi and Varivax.

With headquarters based in New Jersey, Johnson & Johnson develops and produces pharmaceuticals, medical devices and consumer health goods. Key brands Strelara, Darzalex and Imbruvica.

Pfizer takes second place in 2020. Pfizer specialises in the development of medicines and vaccines across a wide range of disciplines including immunology, oncology, cardiology and neurology. The company employees over 88,000 people and delivers its healthcare solutions to over 150 countries across the world. Pfizer has dealt with some costly patent expirations including Viagra and Lyrica. Key performers in medicine included Irbrance, Eliquis, Lyrica and Xeljanz. In 2019, Pfizer took bold steps to position the company for sustained growth with the plan to combine Upjohn and Mylan’s strengths, resources and access.

Roche has taken the top spot in 2020, surpassing Pfizer as the biggest pharmaceutical company in the world. With a workforce of over 90,000 and headquarters based in Basel Switzerland, Roche is at the forefront of oncology, immunology, infectious diseases, ophthalmology and neuroscience. In 2019, sales of Roche’s pharma segment rose by a healthy 16% to $53bn. Roche’s best-selling drugs included multiple sclerosis medicine Ocrevus, haemophilia medicine Hemlibra and cancer medicines Tecentriq and Perjeta. Looking to the future, Roche will continue to focus on prescription medicines.

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