Friends, family members, and contacts often ask for my recommendations on getting vaccines, particularly the type of vaccine they should get. With the proprietary vaccines licensed in recent years, which vaccine to take becomes confusing. Based on my experience in vaccines and adjuvants, including my involvement in developing some of these vaccines, I am providing my recommendations based on the decision of the vaccines that I or my family would take. The disclaimer is that I have not been paid for this decision and have worked directly (employee) or indirectly (consultant) with most vaccine manufacturers and the CBER FDA, reviewing the approval of some of these vaccines. I am not disclosing any confidential information. The decision is based on my understanding of the scientific data. I encourage anybody using this recommendation to do their due diligence in deciding which vaccine to take. This is a personal decision but is often taken by the pharmacy, depending on availability.

Pneumococcal Vaccines: Prevnar 20 or Capvaxive. My personal choice is Capvaxive because it covers 21 serotypes, in contrast to 20 by Prevnar, and does not use an adjuvant. I have nothing against Prevnar; in fact, my wife and I recently took Prevnar 20 because the pharmacy, CVS, did not carry Capvaxive. One serotype does not make much difference, and the aluminum adjuvant is not really an adjuvant; it is just for formulation. You can take a look at my recent presentation on aluminum adjuvants for this statement.

RSV Vaccine – ABRYSVO, My decision is not to recommend Arexvy is the use of a potent adjuvant containing MPL in Arexvy, for which I have personal experience of “interstitial Lung Disease” due to the same adjuvant in Shingrix. This adjuvant elicits antibodies to Lipopolysaccharide (LPS), which can cross-react with human tissue, causing auto-immune reactions. I have reservations about mRNA vaccines due to their shorter track record of not recommending mRESVIA. Personally, I decided not to take the RSV vaccine for some time due to recent cases of Guillain-Barré Syndrome (GBS).

COVID Vaccine—Comirnaty, only 2 doses for primary immunization. I don’t believe that yearly booster doses are required. You may refer to my brief presentation at the FDA’s Vaccine Advisory Committee on booster doses for the COVID-19 vaccine. My decision for Comirnaty is its lower dose (30 µg) compared to Spikevax (100 µg). I believe the dose of this vaccine could be even lower to 10 µg. My wife and I took the initial 2 doses of this vaccine.

Shingles Vaccines—ZOSTAVAX, I don’t recommend the “Shingrix vaccine” due to its strong adjuvant (See above for RSV vaccine). My wife and I took one dose of this vaccine in 2018 and regretted it. It caused my wife “interstitial lung disease.”

Influenza Vaccines – Not recommended. My wife and I never took this vaccine. Please see my recent post. Annual vaccination causes damage to the immune system of several generations. I know it is mandatory for healthcare workers, and they are forced to take this vaccine. My daughter, a cardiologist, and one of my friends had to take it. Then my recommendation was “FLUCELVAX”, though it has a problem with the use of flu virus isolated in eggs, which changes the protective antigen on virus.

Human Papilloma Virus Vaccine – Gardasil, Cervarix has problems with the MPL-based adjuvant. Please see the above. Further, I am not convinced with the data for vaccines made with baculo virus technology for Cervarix and Flublok.

Meningococcal Vaccines – Any conjugate vaccines can be taken.

Typhoid Vaccine – Vi conjugate vaccine

Rotavirus vaccine – Any vaccine can be taken.

Hepatitis A Vaccine – Any vaccine can be taken

Cholera Vaccine – No recommendation, as I don’t have much experience with the vaccines approved recently.

Most childhood vaccines (tetanus, diphtheria, pertussis, Hib-conjugate, polio, hepatitis B, measles, mumps, rubella, chicken pox) are generic, and any product can be taken. For pertussis, my preference is the acellular pertussis vaccine, which is not available in many countries. For my own family, I gave the acellular pertussis vaccine in 1984 in India, which I brought from Japan during my trip and meeting with Dr. Satos. This vaccine was only licensed in Japan at that time.

Finally, I cannot emphasize enough that required vaccines must be taken. There are some rare serious side effects that are considered risks in life. There is a risk in everything we do in life, even crossing a road. Vaccines not only protect individuals but also provide herd immunity when used correctly (See below benefits of vaccines).

Except for safe water, vaccines have been the most effective public health intervention in reducing mortality and morbidity due to many infectious diseases. One of the deadliest diseases in the history of mankind, smallpox and its causative agent, the smallpox virus, has been eradicated from the planet by universal vaccination with the smallpox vaccine. Polio has been eliminated from the Western Hemisphere through effective vaccination campaigns. While measles was eliminated, imported cases still pose a threat to unvaccinated individuals and those who are immunocompromised.

Vaccines have also controlled many other diseases with high morbidity and mortality, including tetanus, diphtheria, pertussis, typhoid, mumps, rubella, chicken pox, shingles, yellow fever, diseases caused by hepatitis B, hepatitis A, human papillomavirus, Pneumococci, Meningococci, and Haemophilus influenzae type b, etc. Vaccines benefit people of all ages, protecting the health of the elderly and vulnerable from infectious diseases and preventing infection-related cancers. They also reduce the risk of transmitting disease to others in the community, providing herd immunity.