Natural vanilla flavoring is extracted from vanilla beans, the fruit pods of tropical vines that are part of the orchid family. Surprisingly, both the flower and the ripe bean lack the characteristic vanilla aroma that most of us are so fond of. The flavor of vanilla extract is created by the curing (that takes up to 6 months) and processing of the beans.
Pure vanilla extract contains a defined level of natural vanilla and a minimum of 35% alcohol, by FDA standards.
Imitation vanilla extracts are made with synthetic vanilla, called vanillin, a manufactured flavor that replicates the natural vanilla flavoring agent. More economical than pure vanilla extract, it contains about 35% alcohol.
You might also find vanilla flavoring at your grocery store. It contains less alcohol and less natural and/or artificial vanillin than imitation vanilla extract.
Alcohol-free vanilla flavor is available in many health food stores. This flavoring typically contains glycerin instead of alcohol as the main liquid component.
Regarding your concerns about medication interacting with alcohol, I suggest you talk to your doctor. Extracts typically are used in very small amounts and most of the alcohol evaporates during the cooking process. Some medications, however, may be affected in an adverse way by even such a small amount of alcohol.
A helpful reader, Roxanne Stedman of Thorofare, New Jersey, wrote that she uses vanilla powder instead, which she buys on-line.
Our Test Kitchen checked out a few Web sites and found the Nielsen-Massey Vanilla Powder that Roxanne suggested. They tried it in a cookie recipe and noted there was virtually no difference in flavor between the vanilla powder and regular vanilla extract.