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Aluminum hydroxide (Alum) is used as an adjuvant to enhance immunogenicity, while excipients such as phosphate buffers and sodium chloride help maintain isotonicity

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However, in addition to the effects described above there are well-documented increases in alveolar oxidative stress 53,58,73-77 and decreased antioxidant levels, 54,55,59,78,79 impairment of surfactant protein D (SP-D) structure and function, 80-82 reduced secretion of antimicrobial peptides, 83-85 impaired transport of IgA into alveolar space, 86 changes to the metabolic profile, 87-89 and alterations in the pulmonary microbiota

Kshirsagar AD, Mohite R, Aggrawal AS, Suralkar UR