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Pediatric Dosing
of Aluminum in
Vaccines:
Comparisons
of Schedules
James Lyons-Weiler, PhD
The Institute for Pure and Applied Knowledge
Collaborators: R. Richardson, G. McFarland, E.
Lajoie & P. Thomas
1/5/2020
at the
University of California Los Angeles
Blinded peer-review
2018
2020
CDC
Vaccine
Friendly
Plan
Why Reduce Aluminum?
• Aluminum is found in amyloid, the protein/non-protein aggregates in
Alzheimer’s brain
• Aluminum hydroxide is used to routinely and reliably induce
autoimmune conditions in animals (mice & rats)
Disruption of erythropoesis and RBC function
• Osteomalacia in bone
• Cholestasis in liver
• Aluminum inhibits defensive mechanisms connected with white
blood cells and macrophages
• https://www.ncbi.nlm.nih.gov/pubmed/16146022
Genetic risk animal models
Clark’s Rule
•FDA Adult Limit 850
mcg per dose
•FDA Pediatric Limit:
????????????
Mitkus et al. – The FDA’s Paper on Aluminum
• Used a model by Priest et al .which is based on human clearance of citrated aluminum
forms (form in vaccines are not citrated)
• Data for the models in two studies were from 1 and 6 males (adults)
• Mitkus adjusted the model using data from creatine in infants
• MRL was derived from ATSDR oral limits
• ATSDR had picked 1 study and misrepresented the findings of Golub et al. [Next Slide]
• In P/K, the focus tends to be on plasma/serum clearance
• Mitkus assumes excretion via the kidney is similar to creatine (aluminum damages
animal tissue) [Incorrect]
• Our concern is the accumulation (body burden) originally realized in the first Priest et al.
study [because aluminum has known toxic effects in human tissue]
Provenance of
PTWI
Limit ERROR
found by
Lyons-Weiler
& Ricketson
(2018)
Disagreement Between Two Committees
JEFCA
Joint FAO/WHO Expert Committee on Food Additives
• 1989. Provisional Tolerable Weekly
Intake (PTWI) established at 1 mg/kg
all dietary sources and additives.
Mean highest daily intake US children
0.5 mg Al/kg per day1
• 2011. Previous PTWI of 1 mg Al/kg
withdrawn. Revised PTWI to 2 mg/kg
(adults)2
ATSDR
Agency for Toxic Substances Disease Registry
• 2008 (CAS ID #: 7429-90-5)3
• Daily dietary intake of Al 2 mg/kg-day
in adults
• Minimal Risk Level (MRL) 1 mg/kg-day
(adults) same as No Observed Adverse
Effect Level (NOAEL)
1Evaluation of certain food additives and contaminants [Thirty-third report of the Joint FAO/WHO Expert Committee on Food Additives). WHO Technical Report Series, No. 776, 1989
2 Evaluation of certain food additives and contaminants (Seventy fourth report of the Joint FAO/WHO Expert Committee on Food Additives) WHO Technical Report Series, JECFA/74/SC, 2011
3Agency for Toxic Substances and Disease Registry (ATSDR) CAS ID #: 7429-90-5
How did 1 mg Al/kg week become 1 mg/kg –day
and 850 mcg per dose regardless of body weight
• 1981-CFR amended to include 1250 mg/dose
• 1996-2007 PTWI estimated at 1 mg/kg/week; 0.5 mg/kg-day US child > 2 years of age (WHO Evaluation and
Certain Food Additives and Contaminants. Section 4.1 Aluminum, 1996-2007)
• 1996 Committee on Nutrition Aluminum Neurotoxicity in Infants and Children (J Pediatrics),
1 mg/kg-day (in error as to PTWI- “provisional tolerable intake”)
• 2001 0.85 mg "selected empirically from data because it enhance the antigenicity and effectiveness of the
vaccine" (Baylor et al 2001)
• 2001-2008 ATSDR set MRL/NOAEL to 1 mg/kg-day from all sources based on Golub 26 mg/kg-day NOAEL
(ATSDR references Baylor et al (2001),
• 2001 MRL/NOAEL 2 mg/kg-day in adult humans from dietary sources (Golub et al 2001 (62 mg/kg-day, Keith
et al)
• 2011 MRL=1 mg/kg bw/day (ATSDR, 2008), Mitkus (2011)
• 2017: CFR is 850 mg/DOSE.
Mitkus’ Three-Compartment Model
Flarend Rabbit Study (N=6)
• Injected radioactive
ALPO4 and ALOH3 into
rabbits
• Only 5.6% of the ALOH3
had been cleared from
the body after 28 days
(22 days fors ALPO4)
Flarend found low clearance rate from blood
• “The aluminum concentration [in blood] produced by AH [Al
hydroxide] adjuvant at 1 hour was similar to the concentrations found
from 2 to 28 days.”
Clearly something is different between rabbits
and humans?
Movsas Infant Study (N=15)
Found aluminum serum levels rose 1% immediately after vaccination.
“We were reassured to find no significant postvaccine rise in serum
aluminum level after vaccination of preterm infants with vaccines
containing a total of 1200 μg of aluminum.“ (JAMA Pediatrics, Letter)
?
Our Question
• If 850-1150 mcg is a regulated level per dose in human adults (FDA),
since FDA has never published a pediatric dose limit (PDL) for
humans, what might a scaled human dose limit look like?
• We considered bodyweight and allometric scaling (Clark’s Rule)
• We adapted Priest’s model as a liberal model of excretion.
Priest model
Clearance of single doses in a few individuals
Recommendations
• Perform per body-weight dose escalation studies in
mice using injected forms of aluminum in infant mice
• Re-evaluate the use of aluminum in vaccines
altogether
• Encourage awareness of the differences between
vaccine risk awareness, which can lead to
improvements in vaccines, and “Anti-vaccination”
positions
Next Steps
IPAK VAXXED VS.
UNVAXXED STUDY
ANALYSIS OF HEALTH
OUTCOMES IN >3300
CHILDREN BORN
INTO DR. PAUL’S
PRACTICE
681 UNVACCINATED,
2647 VARIABLY
VACCINATED (VFP)
IRB APPROVED PHASE 1 IS
COMPLETE, UNDER
REVIEW
RESULTS INCLUDE
HEALTH OUTCOMES
RISK FROM ACV’S CF.
ALL VACCINES (%
LIABILITY)
UCLA - Pediatric Dosing of Aluminum in Vaccines - Comparison of Three Schedules
UCLA - Pediatric Dosing of Aluminum in Vaccines - Comparison of Three Schedules

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UCLA - Pediatric Dosing of Aluminum in Vaccines - Comparison of Three Schedules

  • 1. Pediatric Dosing of Aluminum in Vaccines: Comparisons of Schedules James Lyons-Weiler, PhD The Institute for Pure and Applied Knowledge Collaborators: R. Richardson, G. McFarland, E. Lajoie & P. Thomas 1/5/2020 at the University of California Los Angeles
  • 3. CDC
  • 5. Why Reduce Aluminum? • Aluminum is found in amyloid, the protein/non-protein aggregates in Alzheimer’s brain • Aluminum hydroxide is used to routinely and reliably induce autoimmune conditions in animals (mice & rats) Disruption of erythropoesis and RBC function • Osteomalacia in bone • Cholestasis in liver • Aluminum inhibits defensive mechanisms connected with white blood cells and macrophages • https://www.ncbi.nlm.nih.gov/pubmed/16146022
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  • 11. Clark’s Rule •FDA Adult Limit 850 mcg per dose •FDA Pediatric Limit: ????????????
  • 12. Mitkus et al. – The FDA’s Paper on Aluminum • Used a model by Priest et al .which is based on human clearance of citrated aluminum forms (form in vaccines are not citrated) • Data for the models in two studies were from 1 and 6 males (adults) • Mitkus adjusted the model using data from creatine in infants • MRL was derived from ATSDR oral limits • ATSDR had picked 1 study and misrepresented the findings of Golub et al. [Next Slide] • In P/K, the focus tends to be on plasma/serum clearance • Mitkus assumes excretion via the kidney is similar to creatine (aluminum damages animal tissue) [Incorrect] • Our concern is the accumulation (body burden) originally realized in the first Priest et al. study [because aluminum has known toxic effects in human tissue]
  • 13. Provenance of PTWI Limit ERROR found by Lyons-Weiler & Ricketson (2018)
  • 14. Disagreement Between Two Committees JEFCA Joint FAO/WHO Expert Committee on Food Additives • 1989. Provisional Tolerable Weekly Intake (PTWI) established at 1 mg/kg all dietary sources and additives. Mean highest daily intake US children 0.5 mg Al/kg per day1 • 2011. Previous PTWI of 1 mg Al/kg withdrawn. Revised PTWI to 2 mg/kg (adults)2 ATSDR Agency for Toxic Substances Disease Registry • 2008 (CAS ID #: 7429-90-5)3 • Daily dietary intake of Al 2 mg/kg-day in adults • Minimal Risk Level (MRL) 1 mg/kg-day (adults) same as No Observed Adverse Effect Level (NOAEL) 1Evaluation of certain food additives and contaminants [Thirty-third report of the Joint FAO/WHO Expert Committee on Food Additives). WHO Technical Report Series, No. 776, 1989 2 Evaluation of certain food additives and contaminants (Seventy fourth report of the Joint FAO/WHO Expert Committee on Food Additives) WHO Technical Report Series, JECFA/74/SC, 2011 3Agency for Toxic Substances and Disease Registry (ATSDR) CAS ID #: 7429-90-5
  • 15. How did 1 mg Al/kg week become 1 mg/kg –day and 850 mcg per dose regardless of body weight • 1981-CFR amended to include 1250 mg/dose • 1996-2007 PTWI estimated at 1 mg/kg/week; 0.5 mg/kg-day US child > 2 years of age (WHO Evaluation and Certain Food Additives and Contaminants. Section 4.1 Aluminum, 1996-2007) • 1996 Committee on Nutrition Aluminum Neurotoxicity in Infants and Children (J Pediatrics), 1 mg/kg-day (in error as to PTWI- “provisional tolerable intake”) • 2001 0.85 mg "selected empirically from data because it enhance the antigenicity and effectiveness of the vaccine" (Baylor et al 2001) • 2001-2008 ATSDR set MRL/NOAEL to 1 mg/kg-day from all sources based on Golub 26 mg/kg-day NOAEL (ATSDR references Baylor et al (2001), • 2001 MRL/NOAEL 2 mg/kg-day in adult humans from dietary sources (Golub et al 2001 (62 mg/kg-day, Keith et al) • 2011 MRL=1 mg/kg bw/day (ATSDR, 2008), Mitkus (2011) • 2017: CFR is 850 mg/DOSE.
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  • 19. Flarend Rabbit Study (N=6) • Injected radioactive ALPO4 and ALOH3 into rabbits • Only 5.6% of the ALOH3 had been cleared from the body after 28 days (22 days fors ALPO4)
  • 20. Flarend found low clearance rate from blood • “The aluminum concentration [in blood] produced by AH [Al hydroxide] adjuvant at 1 hour was similar to the concentrations found from 2 to 28 days.” Clearly something is different between rabbits and humans?
  • 21. Movsas Infant Study (N=15) Found aluminum serum levels rose 1% immediately after vaccination. “We were reassured to find no significant postvaccine rise in serum aluminum level after vaccination of preterm infants with vaccines containing a total of 1200 μg of aluminum.“ (JAMA Pediatrics, Letter) ?
  • 22. Our Question • If 850-1150 mcg is a regulated level per dose in human adults (FDA), since FDA has never published a pediatric dose limit (PDL) for humans, what might a scaled human dose limit look like? • We considered bodyweight and allometric scaling (Clark’s Rule) • We adapted Priest’s model as a liberal model of excretion.
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  • 26. Priest model Clearance of single doses in a few individuals
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  • 35. Recommendations • Perform per body-weight dose escalation studies in mice using injected forms of aluminum in infant mice • Re-evaluate the use of aluminum in vaccines altogether • Encourage awareness of the differences between vaccine risk awareness, which can lead to improvements in vaccines, and “Anti-vaccination” positions
  • 36. Next Steps IPAK VAXXED VS. UNVAXXED STUDY ANALYSIS OF HEALTH OUTCOMES IN >3300 CHILDREN BORN INTO DR. PAUL’S PRACTICE 681 UNVACCINATED, 2647 VARIABLY VACCINATED (VFP) IRB APPROVED PHASE 1 IS COMPLETE, UNDER REVIEW RESULTS INCLUDE HEALTH OUTCOMES RISK FROM ACV’S CF. ALL VACCINES (% LIABILITY)