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Vaccines contain more than just the “Wanted” photos, called antigens, that help your immune system identify pathogens (see the preceding section). Other ingredients are needed to make sure the vaccine works as it should:

 Some of these “Wanted” photos don’t create much of an immune response. The immune system needs to be alerted to the fact that this “Wanted” photo is important to remember. Vaccines may include an alert, which acts like a red blinking light, saying “pay attention here.” This ingredient may even be directly attached to the “Wanted” photo. Such alerts when added to the vaccine mix are called adjuvants. A common adjuvant includes aluminum, also found in drinking water, antacids, and antiperspirants. We discuss the ingredients that go into vaccines more in Chapter 7.

 Vaccines also may contain stabilizers, much like some of our food does. These include sugars and gelatin (also found in Jell-O) that keep the vaccine ingredients well mixed, so they don’t separate or deteriorate.

 Vaccines can sometimes include preservatives to keep mold or bacteria from growing in the vaccine, much like we would have in a bottle of jam at home. Just as many foods are advertised as preservative-free, many vaccines are too. Preservatives are particularly used in multi-use vaccine bottles, especially for the flu, as these are kept open longer to vaccinate multiple people. In some cases, this can include thimerosal, which contains mercury, but it’s a type of mercury that doesn’t have the same worrisome risk as the mercury found in fish. Children’s vaccines do not include mercury, except in rare cases with multi-use flu vaccine vials and some specific brands of tetanus shots for adolescents.

 Vaccines may also include trace amounts of chemicals used in their production. These substances are removed, but sometimes a very small amount remains. In order to include a whole virus or bacteria but make sure it’s dead and won’t make copies of itself, formaldehyde is used. The amount used in a vaccine is much, much less than we naturally have in our bodies.

 Sometimes antibiotics, usually not the sorts we are allergic to, are used to keep bacteria from growing during production. These antibiotics are removed at the end, so at most only a tiny amount remains. Eggs are used to grow some viruses used to make vaccines, and so egg proteins, in very tiny amounts, may be present in some specific vaccines.