Table 1.
Emulsion adjuvants approved and under development.
| Name | Time of approval | Clinical development stage | Formulation | Mechanism or receptor | Immune profile | Adverse reaction |
|---|---|---|---|---|---|---|
| MF59 | 1997 | Licensed for seasonal and pandemic flu vaccine | Squalene oil, span 85, Polysorbate 80 | Immune cell recruitment and antigen uptake | Antibody, Th1, Th2 | Local reactions and inflammatory arthritis |
| AS03 | 2009 | Licensed for pandemic flu vaccine, phase III for COVID-19 | Squalene oil, α-tocopherol, polysorbate 80 | Immune cell recruitment, antigen uptake | Antibody, Th1, Th2 | Injection-site pain, fatigue, headache, and muscle aches |
| AF03 | 2010 | Licensed for pandemic flu | Squalene oil, span80, eumulgin B1, mannitol | Immune cell recruitment and antigen uptake | Antibody, Th1, Th2 | Fever and erythema |
| CoVaccine HT | 2022 | Phase III for COVID-19 | Squalane oil, polysorbate 80, sucrose fatty acid sulfate esters | Little is known | Antibody, Th1 | Produce pro-inflammatory cytokine, exacerbates immunopathology |
| GLA-SE/SLA-SE | – | Phase I – phase III for tuberculosis, schistosomiasis, leishmaniasis | Squalene oil, poloxamer188 and synthetic phosphatidylcholines | TLR4 | Antibody, Th1 | Increased levels of pro-inflammatory cytokines |
| Sepivac SWE | – | Preclinical, phase I for COVID-19 | Squalene oil, span85 and polysorbate 80 | Immune cell recruitment and antigen uptake | Antibody, Th1, Th2 | Local reactions |
GLA-SE, glucopyranosyl lipid adjuvant-stable emulsion; SE, stable emulsion; SLA-SE, synthetic lipid A stable emulsion; SWE, squalene-in-water emulsion.
‒, not applicable.