Health Secretary Robert F. Kennedy Jr. and his allies have made no secret about the next target in their campaign against vaccines: Shots that include trace amounts of aluminum salts, which they claim cause a range of conditions, such as autism, asthma and food allergies.
These assertions have been rigorously studied and discredited, yet federal health agencies are now revisiting the claims. President Donald Trump himself has said he wants “no aluminum in the vaccine.” So it’s worth setting the record straight: There is no credible reason to eliminate this ingredient from vaccines.
A ban on aluminum-containing vaccines would carry enormous consequences. Aluminum salts are used in at least seven widely used vaccines, including those that protect against diphtheria, tetanus and whooping cough; pneumococcal pneumonia; human papillomavirus; and hepatitis A and B. Manufacturers would have to start from scratch, developing and testing entirely new formulations, a process that would take years. In the meantime, children and high-risk adults would be left exposed to preventable infections.
But aluminum is not a rare substance, nor is immunization the only way people are exposed to it. In fact, it is the third-most abundant element on Earth and is found naturally in soil, air and plants. People consume it every day through food and water. Many medications, including antacids and certain types of aspirin, also contain aluminum.
For nearly 100 years, tiny amounts of aluminum salts have been added to vaccines to enhance the body’s immune response, since they help cells recognize the vaccine more effectively. By strengthening that response, the salts allow for smaller quantities of the active ingredient and, in some cases, fewer doses to achieve protection.
To be clear, these are not aluminum metals like those used in construction materials or kitchen foil, but aluminum salts that dissolve and are handled by normal physiological processes. Once in the bloodstream, the salts are filtered by the kidneys and leave the body in urine. The body processes it the same way that it would if it were to come from food or water.
Like many substances, aluminum can be harmful at high levels. Patients with severe kidney failure must be cautious with medications that contain aluminum because their bodies cannot clear it efficiently.
But that scenario bears little resemblance to vaccination. The amount of aluminum in vaccines is extremely small. Federal regulations limit vaccines to 0.85 milligrams of aluminum per dose, and many vaccines contain substantially less. A 2-month-old who receives all their recommended vaccines would receive just 1.1 milligrams of aluminum, according to a new study published in JAMA.
By comparison, infants ingest far more than that just through normal feeding, the study found. Average daily intake is estimated at about 5.3 milligrams from breast milk, roughly 19 milligrams from cow’s milk-based formula and nearly 127 milligrams from soy-based formula.
Exposure rises substantially once solid foods are introduced. Over the first 18 years of life, daily dietary intake can reach up to 438 milligrams. And aluminum exposure is far higher for those who use certain medications. A single antacid tablet can contain as much as 200 milligrams.
As the paper’s senior author and vaccine researcher, Paul A. Offit, told me, “You have much more aluminum in your bloodstream from just living on this planet than you would ever get from vaccines.”
Might even those small amounts of aluminum in vaccines cause harm? That question has been extensively studied. A 23-year analysis of more than 1.2 million Danish children, published last year, examined whether aluminum exposure from childhood vaccines had any link to 50 conditions, including five neurodevelopmental disorders, nine allergic diseases and 36 autoimmune disorders. Researchers found no association with any of them.
Unsurprisingly, Kennedy was not a fan of this study. In a lengthy blog post, he labeled it “deceptive” and urged journal editors to “immediately retract” it.
The journal, the Annals of Internal Medicine, rejected this demand. Its editor in chief emphasized that the analysis represented some of the most rigorous evidence available on the subject and that critics objected simply because the findings do not align with preconceived beliefs.
Bravo to the journal for standing up for science. Whether that will matter is another question. Kennedy is not just another vaccine skeptic; he oversees the agencies that can translate anti-vaccine views into federal policy.
The most extreme outcome would be for the Food and Drug Administration to revoke approval of aluminum-containing vaccines, effectively removing them from the market. Short of that, the Centers for Disease Control and Prevention could stop recommending these vaccines, which is not at all improbable given its recent retreat on long-standing recommendations for six childhood immunizations.
A spokesperson from Health and Human Services declined to say whether such steps are under consideration. But don’t be surprised if the worst-case scenarios come to pass. In this administration, ideology dictates outcomes while science — no matter how sound — is no longer welcome.
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