Vaccines save millions of lives each year, but the powerful ingredients to make them can be one in a million. One of these ingredients is the adjuvant, a “power-up” additive that boosts the body’s immune response to the vaccine as a whole. Like putting salt into a recipe, each type of adjuvant can be added to a range of vaccines to enhance them.

The AS01 adjuvant is often used to increase the efficacy of the shingles, RSV, and malaria vaccines. However, the AS01 adjuvant typically hails from the Chilean soapbark tree, which is increasingly difficult to extract and process.

As a solution, scientists at Walter Reed Army Institute of Research (WRAIR) formulated a new adjuvant called ALFQ — the Army Liposome Formulation with QS21 — that meets or exceeds the potency of AS01. Like AS01, ALFQ uses liposomes, or fatty-layered spherical molecules, to protect the vaccine from degrading early in the body.

ALFQ differs from AS01 in the size and composition of its liposomes, giving it greater flexibility across a wide range of vaccines. This gives ALFQ a “plug and play” versatility that can be paired with vaccines targeting malaria, HIV, Campylobacter, and SARS-CoV-2. A collaboration with the Henry M. Jackson Foundation for the Advancement of Military Medicine has led to a next-generation coronavirus vaccine that could offer broader protection against a range of SARS-CoV-2 variants. WRAIR also partnered with the U.S. Agency for International Development, resulting in two completed Phase 1 trials and one Phase Ib trial for two malaria vaccines.

Over the past nine years, ALFQ has become a rising star in medicine, with more than 100 technology transfer agreements, a partnership with the U.S. Agency for International Development, and a lucrative, partially exclusive license with Pfizer. Now, vaccines incorporating ALFQ have successfully completed six clinical trials, which show that the adjuvant is safe and well-tolerated in humans.

Moving forward, five more clinical trials on ALFQ are scheduled to take place. The Defense Health Agency Research and Development, Medical Research and Development Command Technology Transfer team successfully promoted ALFQ to secure multiple collaborations and licensees.

While ALFQ has not yet been approved by the FDA, the adjuvant has already injected a good dose of impact. Thanks to ALFQ, WRAIR is continuing to invest in basic research and clinical development of ALFQ.