The occurrence of sterile abscesses in a small proportion of people given Adju-Fluax has led the manufacturer (MSD) to withdraw the preparation for the present. Some of the abscesses may have been due to faulty injection technique. As the manufacturer’s instructions say, the vaccine must be injected deeply into muscle; more superficial injection is likely to cause a sterile abscess. But this is probably not the whole story. It is possible that small amounts of impurities in the aqueous component of the vaccine may be concerned. Inflammatory and other effects of such impurities would be trivial in an aqueous vaccine, but might be boosted by the adjuvant. New and extremely sensitive methods for detecting impurities have been developed, and the next step will be to prepare some more highly purified vaccine.
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