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Health officials in the United States are reviewing whether to remove aluminium from some common vaccines, as part of the Trump administration’s escalating attacks on vaccines.

The Department of Health and Human Services has reduced some vaccine access. The agency scaled back COVID-19 vaccine recommendations, approved COVID-19 vaccines for fewer people and aimed to remove the preservative thimerosal from US vaccines. Experts told PolitiFact scientific research did not support its removal.

During a September 22 news conference, in which US President Donald Trump told people not to take Tylenol during pregnancy, he also mentioned another objective. “We want no aluminium in the vaccine,” he said. The administration was already in the process of removing aluminium from vaccines, he added.

About two weeks later, on October 8, the US Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices, or ACIP, announced a new working group focused on the childhood vaccine schedule. Its discussion topics include vaccine ingredient safety and aluminium adjuvants.

Robert Malone, an ACIP member who has opposed COVID-19 vaccines, told Axios he expected the ACIP would determine there was “a lot of evidence” of “issues” with aluminium in vaccines. The committee would likely vote to re-categorise vaccines containing aluminium adjuvants so that people would have to discuss with their doctor before getting them, Malone told Axios.

That could have far-reaching ramifications. Here’s what to know about aluminium in vaccines.

A: Small amounts of aluminium are sometimes included in vaccines as adjuvants, or substances that boost the body’s immune response to the vaccine to ensure protection from infection.

That boost means people can get fewer vaccine doses in smaller quantities.

Q: When used, how much aluminium is in a vaccine?

A: Vaccines with aluminium adjuvants usually contain less than 1mg aluminium per dose, according to the Children’s Hospital of Philadelphia.

That is a pretty abstract number. To help make it more concrete: a milligram is one-thousandth (1/1,000th) of 1g. One gram is about the weight of a raisin or a stick of gum. Imagine cutting one of those items into 1,000 equal pieces. One of the pieces would be about 1mg.

Here is another way to think about it.

People come in contact with and consume aluminium all of the time. It is one of the most abundant metal elements in the Earth’s crust, according to the US Geological Survey. It is naturally occurring in soil, air and water. Food is the main way people are exposed to aluminium. The average adult eats 7mg to 9mg of aluminium per day, according to the CDC.

A baby in its first six months might receive a total of about 4.4mg of aluminium from recommended vaccines. In the same period of time, a breastfed infant would ingest about 7mg of aluminium from breastmilk, and a formula-fed baby would ingest about 38mg from formula.

Q: How long have vaccines contained aluminium?

A: Aluminium adjuvants have been used in vaccines for more than 70 years, the CDC said.

“Aluminium is one of our oldest adjuvants; it’s been used in vaccines since the 1920s,” said Dr Peter Hotez, a Baylor College of Medicine professor and codirector of Texas Children’s Hospital Center for Vaccine Development.

Q: How do we know it’s safe to include small amounts of aluminium in vaccines?

A: Every vaccine’s safety and efficacy are tested in animal studies and human clinical trials before the US Food and Drug Administration (FDA) licenses it for public use. Every vaccine containing adjuvants has been tested, and health agencies continuously monitor their safety, the CDC said.

Over several decades of use, vaccines with aluminium adjuvants have been proven safe, the FDA said.

Vaccines containing aluminium have been “given to billions of people worldwide now”, said Dr Kawsar Talaat, a professor at Johns Hopkins Bloomberg School of Public Health.

A growing body of research has also found that aluminium adjuvants do not cause aluminium toxicity or other adverse outcomes.

Q: Do aluminium adjuvants have any risks?

A: Rarely, some people have allergic reactions to aluminium in the same way they might have allergic reactions to other substances, Talaat said.

In 2022, researchers published a retrospective, observational study on more than 325,000 children that found an association between vaccine-related aluminium exposure and persistent asthma. Association is not the same as causation, meaning the study did not prove a link between aluminium in vaccines and asthma.

Experts from the CDC and the American Academy of Pediatrics encouraged more research on the subject because the backwards-looking observational study did not prove causation and also had limitations, including that it excluded many children who developed asthma before they turned two years old.

A 2025 study found no increased risk of asthma associated with childhood exposure to aluminium-absorbed vaccines.

Q: Which vaccines contain aluminium adjuvants?

A: At least 25 vaccines approved for use in the US have aluminium adjuvants, the CDC says. That includes vaccines that protect against HPV, hepatitis A and B and diphtheria, tetanus, and acellular pertussis (whooping cough).

Q: Which vaccines do not contain aluminium adjuvants?

The CDC’s list of vaccines without adjuvants includes vaccines against COVID-19, Ebola, meningococcal, polio and rabies. Additionally, most seasonal flu shots and the vaccine against measles, mumps and rubella do not contain aluminium adjuvants.

Q: Can we remove aluminium from vaccines?

A: Not quickly. If it could be done at all, it would take years to develop, test and license new, aluminium-free vaccines. Many of the vaccines with aluminium adjuvants do not have aluminium-free formulas.

“A vaccine is licensed based on all of its ingredients and the exact manufacturing process,” Talaat said. “If you were to take an ingredient out of a vaccine, you would have to start all over with the clinical trials and the manufacturing, and it is highly possible that some of these vaccines wouldn’t work without the aluminium in there.”

Although other adjuvants exist, they are newer and often more scarce than aluminium, which is abundant.

An immediate ban on aluminium in vaccines would drastically reduce people’s ability to protect themselves and others against numerous diseases.

“I think we’d see outbreaks of vaccine-preventable diseases,” Talaat said.

Q: Why do people think aluminium in vaccines is causing autism?

A: A 2011 study said vaccines with aluminium adjuvants “may be a significant” contributing factor to the rising number of autism diagnoses in kids, Nature reported.

A year later, a World Health Organization vaccine safety committee called the 2011 study “seriously flawed”. The 2011 study and another by the same authors compared vaccines’ aluminium content and autism rates in several countries, the WHO group said, but that cannot be used to establish a causal relationship.

“We studied aluminium, and have no link between aluminium and autism,” Talaat said.

In recent months, a new baseline idea has taken hold in European and United States debates on Ukraine: “Article 5‑like” guarantees. In March, Italy’s Prime Minister Giorgia Meloni was the first to suggest a mechanism inspired by Article 5 of the NATO Charter, which provides for collective action in the event of an attack on a member. US President Donald Trump’s team then promoted a US “Article 5‑type” guarantee outside NATO in August. In September, French President Emmanuel Macron capped this shift by gathering 26 European partners in Paris to pledge a post-war “reassurance force”.

These proposals may sound reassuring, but they should not. In a world where we face nightly drone raids, blurred lines at sea, and constant pressure on critical infrastructure, replicating NATO’s words without NATO’s machinery would leave Ukraine exposed and Europe no safer.

Russia’s activity inside NATO territory has moved from rare to routine. On September 10, two dozen Russian-made drones crossed into Polish airspace during a wider strike on Ukraine, NATO jets shot down those that posed a threat, and Poland activated Article 4 of the NATO Charter, which allows for consultations in the event of a threat.

In the following weeks, Denmark temporarily shut&nbsp, down several airports after repeated drone sightings. Days later, French sailors boarded a tanker suspected of being part of a Russia-linked “shadow fleet” and of taking part in the drone disruptions.

Germany also reported coordinated drone flights over a refinery, a shipyard, a university hospital, and the Kiel Canal. Meanwhile, across the Baltic Sea, months of damage to undersea cables and energy links have deepened concern.

Each of these episodes is serious. Yet, none of them clearly crossed the legal threshold that would have triggered collective defence under Article 5.

That is the core problem with “NATO‑style” guarantees. Article 5 is powerful because it establishes that an attack on one is an attack on all, but it still needs a political process that begins with consultations and leaves each ally free to decide how to respond. It was written for visible aggression: Columns of troops on a border, ships firing across a line, fighter jets attacking territory.

Today’s reality is different. Drones launched from outside Ukrainian territory, one-night incursions over allied infrastructure, or cable cuts by vessels are meant to sit just under formal thresholds. A copy of Article 5 outside NATO’s integrated command, without&nbsp, a&nbsp, standing allied presence or pre-agreed rules for Ukraine, would be even slower and weaker than the original.

When mulling a security mechanism for Kyiv, allies need to recognise that it is no longer a security consumer, it is a security contributor. After Poland’s incident, allies began asking for Ukrainian counter-drone know-how. Ukrainian specialists have deployed to Denmark to share tactics for fusing sensors, jamming, and using low‑cost interceptors.

NATO leaders now say openly that Europe must learn how to defeat cheap drones without firing missiles that cost hundreds of thousands of euros. This is a notable shift: Ukraine is not just receiving protection, it is helping to build it.

Ukraine’s allies also need to remember what happened in 1994. Under the Budapest Memorandum, Kyiv gave up the world’s third‑largest nuclear arsenal in exchange for political “security assurances” from several countries, including Russia and the US. Those assurances were not legally binding.

In 2014, Russia seized Crimea and fuelled war in Donbas while denying its troops were there, using soldiers without insignia to keep the situation ambiguous. Even if Ukraine had been in NATO then, that ambiguity would have raised doubts about whether Article 5 applied. In 2022, Russia invaded openly.

Clearly, non-enforceable promises and debates over thresholds do not stop a determined aggressor. This is why we need guarantees that trigger action automatically, not statements that can be argued over in the moment.

What would work is a package that is tougher than Article 5 on the issues that matter against a sub‑threshold attacker: Time, automaticity, presence, intelligence, and production.

First, there needs to be automatic triggers. A legally ratified “if‑then” mechanism should activate within hours when clear markers are met: State‑origin drones or missiles entering Ukrainian airspace from outside, mass drone incursions into border regions, destructive cyberattacks or sabotage against defined critical infrastructure. The initial package would include both military steps and heavy sanctions. Consultations would adjust the response, not decide whether there will be one.

Second, there needs to be a joint aerial and maritime shield that treats Ukrainian skies and nearby seas as one operating picture. Allies need to keep persistent airborne radar and maritime patrol coverage, fuse sensors from low to high altitude, delegate rules for downing drones along agreed corridors, combine electronic warfare, directed‑energy and radio‑frequency tools, and low‑cost interceptors with classic surface‑to‑air missiles. The test is economic: Europe must make Russian drone raids expensive for Moscow, not for itself.

Third, there must be visible presence and ready logistics. &nbsp, Before a ceasefire is concluded, allies need to build forward logistics: ammunition, spare parts, and maintenance hubs in Poland and Romania with a standing air bridge into Ukraine. Following an agreed ceasefire, they can rotate multinational detachments, &nbsp, air defence crews, maritime patrol teams, and engineers&nbsp, through Ukrainian ports and airfields. The aim would be not to establish permanent bases, but to ensure any renewed attack instantly draws in several capitals.

Fourth, there needs to be an intelligence compact. Allies need to move from ad hoc sharing to an institutional arrangement with Ukraine that integrates satellite, signals, open‑source, and battlefield sensors into common, near‑real‑time products. Fast attribution is central: The right to defend yourself relies on what you can prove, and deterrence relies on an adversary knowing you can prove it quickly.

Fifth, there needs to be a production deal. Multi‑year funding should anchor co‑production in Ukraine of drones, air‑defence components, and artillery rounds, alongside European and US plants making the high‑end systems Ukraine and Europe still lack. Allies should commit to buy Ukrainian systems at scale and tie guarantees to contracted output, not to communiques. Empty magazines make empty promises.

These measures would not copy the letter of Article 5. They would meet a different threat with tools that can counter it. Europe’s recent experience, in Poland’s skies, at German shipyards, at Danish airports, and in the Baltic Sea shows how an adversary can apply steady pressure without triggering classic definitions of “armed attack”.

If Ukraine receives only “NATO‑style” language, it will inherit those same gaps outside the alliance. If instead Ukraine and its partners lock in automatic responses, a shared air picture, visible presence, real‑time intelligence, and an industrial base that keeps pace, they will build something stronger: A guarantee that works in the world as it is, not the world at it was.

At Hong Kong’s International Airport, a cargo plane skidded off the runway and into the water. The accident at the world’s busiest cargo airport claimed the lives of two airport security personnel. What we are aware of about the crash is listed below.