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CpG oligodeoxynucleotide + aluminum hydroxide is a **combination vaccine adjuvant** comprising synthetic unmethylated CpG motifs (CpG-ODNs) and aluminum hydroxide (commonly referred to as alum). CpG-ODNs are short, synthetic single-stranded DNA sequences that mimic bacterial DNA, acting as potent **Toll-like receptor 9 (TLR9) agonists**. This combination stimulates the innate immune system by activating antigen-presenting cells (APCs) and B cells, driving a Th1-skewed immune response and promoting the production of neutralizing antibodies and regulatory cytokines[1][2][3][4]. Aluminum hydroxide acts both as a classic depot adjuvant, enhancing antigen retention and presentation, and as a co-adsorbent to CpG-ODNs, optimizing co-delivery and efficacy[1][4]. Used in candidate and investigational vaccines (e.g., SARS-CoV-2, pertussis, malaria), this adjuvant pairing has demonstrated increased immunogenicity versus either adjuvant alone[1][3][4].
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