Research into non-injectable Covid vaccines brings hope for needle-phobics

The sight of a needle piercing skin is enough to chill a quarter of adult Britons and trigger up to 4% into fainting. But hope is on the horizon for needle-phobics as researchers are working on a range of non-injectable Covid vaccine formulations, including nasal sprays and tablets.

Almost every vaccine in use today comes with a needle, and the approved Covid-19 vaccines are no exception. Once jabbed, the body’s immune system usually mounts a response, but scientists in the UK and beyond are hoping to harness the immune arsenal of the mucous membranes that line the nose, mouth, lungs and digestive tract, regions typically colonised by respiratory viruses including Covid-19, in part to allay the fears of needle-phobics.

To understand the role this anxiety may be playing in vaccine hesitancy in the UK, Daniel Freeman, a professor of clinical psychology at the University of Oxford, and colleagues recruited more than 15,000 adults – representative of age, gender, ethnicity, income and region of the UK population – in a study and found that a quarter of the group screened positive for a potential injection phobia.

Notably, this subset of people were twice as likely to report that they would put off getting vaccinated or indeed never get the jab. Out of the total number of those fearful of needles, 10% were found to be strongly Covid vaccine-hesitant.

Probably about 3% aan 4% of the UK’s total adult population were needle-phobic (have an intense fear of medical procedures involving injections), hy het gesê. And the fear of needles was more prevalent in younger adults, hy het bygevoeg. “So, potentially, needle phobia explains more of the hesitancy in younger people.”

“The fear of needles is the one type of anxiety where actually you can faint and that sort of fear and sometimes the embarrassment about fainting is a powerful driver that people want to avoid.”

This avoidance, among other reasons, has spawned efforts to develop Covid-19 vaccines in the form of inhaled vapours, tablets, oral drops or intranasal sprays.

Dr Stephen Griffin, a virologist at Leeds University, said he was constantly asked by UK healthcare staff when there would be non-injectable formulations of Covid vaccines – not just for patients, “but because there are so many needle-phobic staff”.

Non-injectable vaccines could be gamechangers for many other reasons. Room-temperature formulations could be a boon for countries that don’t have the logistical resources to handle the ultra-cold requirements of existing Covid vaccines. Van deurslaggewende belang, targeting mucosal tissues has the potential to produce “sterilising immunity”, or the complete elimination of infection in the body, thereby theoretically thwarting transmission. Current intramuscular vaccines, though dramatically effective in preventing serious illness and death, cannot stop transmission altogether.

But there have been hiccups in the quest for non-injectable vaccines – for instance, an existing nasal spray flu vaccine has been shown to outperform flu shots in young children, but its performance is muted in adults. And in June, the US biotech company Altimmune abandoned its intranasal Covid vaccine project, saying that it generated weaker than expected immune responses in an early trial.

At the moment, there are many researchers in the early stages of develop a non-injectable Covid vaccine. 'N Oxford/AstraZeneca aerosolised formulation is in development, and the Chinese biotech company CanSino Biologics recently kicked off the development of its inhaled vaccine. Others looking at nasal sprays include a team at Lancaster University, which is expected to report data from animal trials imminently, as well as the US-based Cadogenix and India’s Bharat Biotech. Drugmakers are also looking at oral alternatives, such as the San Francisco-based Vaxart, which has completed an early human study on its tablet.

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