Aluminic macrophagic myofasciitis is associated with fatigue and cognitive dysfunction. Animal studies indicate the ability of adjuvant particles to migrate slowly and bioaccumulate in other organs, stronglt implicating a need for longer safety studies.

PMID: 

Morphologie. 2016 Jun ;100(329):85-94. Epub 2016 Apr 6. PMID: 26948677

Abstract Title: 

Aluminum adjuvants of vaccines injected into the muscle: Normal fate, pathology and associated disease.

Abstract: 

Aluminum oxyhydroxide (Alhydrogel(®)) is a nano-crystalline compound forming aggregates that has been introduced in vaccine for its immunologic adjuvant effect in 1926. It is the most commonly used adjuvant in human and veterinary vaccines but mechanisms by which it stimulates immune responses remain ill-defined. Although generallywell tolerated on the short term, it has been suspected to occasionally cause delayed neurologic problems in susceptible individuals. In particular, the long-term persistence of aluminic granuloma also termed macrophagic myofasciitis is associated with chronic arthromyalgias and fatigue and cognitive dysfunction. Safety concerns largely depend on the long biopersistence time inherent to this adjuvant, which may be related to its quick withdrawal from the interstitial fluid by avid cellular uptake; and the capacity of adjuvant particles to migrate and slowly accumulate in lymphoid organs and the brain, a phenomenon documented in animal models and resulting from MCP1/CCL2-dependant translocation of adjuvant-loaded monocyte-lineage cells (Trojan horse phenomenon). These novel insights strongly suggest that serious re-evaluation of long-term aluminum adjuvant phamacokinetics and safety should be carried out.

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