COVID-19 intranasal vaccine spray could curb spread, researchers say

It’s an intuitive idea: wouldn’t it be better to administer a COVID-19 vaccine where it first invades the body?

That’s what Maryland-based biotech startup Altimmune is trying to develop – a COVID-19 vaccine that’s injected into your nose, not your arm.

“Providing vaccines at the sight of the first exposure is a benefit, “Dr. Buddy Creech, who leads the Vanderbilt University Vaccine Research Program and has worked with Altimmune, told Insider.” Typically, you don’t get COVID-19 in the deltoid muscle. of your arm, you put it in your nose, eyes and throat. It is therefore logical that we would at least want to consider a vaccine that can generate some immunity in the mucosal openings. “

The three COVID-19 vaccines licensed in the United States, of course, are all vaccines. Although they appear to be slowing down the transmission, they are unlikely to stop it all together. An intranasal vaccine, however, could create an additional line of defense, as it causes the immune system to produce antibodies that block the infection locally in the lining of your nose and throat. This would prevent transmission by stopping viral excretion from these openings.

Altimmune last month launched a 180-person trial of its intranasal vaccine, called AdCOVID, to test the vaccine’s safety, the side effects it causes, and the levels of antibodies and T cells it produces. Participants are between 18 and 55 years old. The company expects to have data in the second quarter of this year.

Scot Roberts, chief scientist at Altimmune, told Insider the best-case scenario would be a deployment to adults at the end of this year or early 2022.

Other intranasal vaccine candidates are also being tested in China, India and the UK.

Nasal spray could prevent viral shedding from nose and throat

Courtesy of Altimmune

AdCOVID would not be the first vaccine not to require a needle. The polio vaccine was first swallowed in pill form, and the CDC has approved several nasal spray influenza vaccines.

However, vaccines injected into the muscle of the arm are the most common. These cause your immune system to start making T cells that remember the pathogen if it returns, and antibodies that fight the virus all over your body – this is called systemic immunity.

But these antibodies don’t always get into the mucous surfaces of the nose and throat (where a respiratory virus likes to hang out) in large enough numbers to prevent the virus from replicating in those places.

A nasal spray, however, can trick your immune system to create antibodies called immunoglobulin A locally in your mucous openings, according to Dr. Paul Goepfert, director of the Alabama Vaccine Research Clinic.

“It is possible that this is a much more effective vaccine in reducing the spread of the coronavirus,” Goepfert told Insider.

Indeed, Altimmune found in a recent animal study that its intranasal COVID-19 vaccine caused both systemic immunity and mucosal immunity. Two other animal studies have shown that an intranasal spray prevented infections while almost completely blocking the transmission of the coronavirus.

Nasal sprays could serve as boosters to target coronavirus variants

A proliferation of coronavirus variants has raised concerns that existing vaccines will need to be bolstered via booster shots. Pfizer and Moderna are each testing new versions of their plans to combat such variants, but distributing them could be another huge undertaking.

A key benefit of Altimmune spray is that it does not require refrigeration and can be stored at room temperature for months.

“Whether we need revaccinations or boost immunity in the presence of a variant, this approach makes perfect sense,” said Roberts.

According to Daniel Oran and Eric Topol, two COVID-19 researchers at the Scripps Research Translational Institute in California, intranasal vaccines could help in this process because people may be able to self-administer.

“Just sending someone a nasal spray is much more convenient than arranging an injection in person,” they wrote in Scientific American on Monday. The duo also pointed out that replacing a needle with a spray could encourage more people to get the shot in the first place.

Altimmune hopes to test its spray in children this year

Altimmune plans to test its intranasal vaccine in children and is speaking with the Food and Drug Administration on how to formulate these pediatric trials. The company hopes to start a trial in children while the drug is still being tested in adults.

None of the COVID-19 vaccines licensed in the United States can be given to children under the age of 16 because the companies did not include children in their first trials.

“Children don’t get that sick, but they can certainly spread the virus. So this idea of ​​mucosal immunity that blocks transmission is really perfect for the pediatric population, ”said Roberts. “Clearly the FDA recognizes the need. We cannot leave 70 million Americans out unvaccinated.”

Goepfert said developing a nasal spray vaccine for children would be a win-win: it would reduce their transmission capacity and make it easier for them to be vaccinated.

“Not having to tape someone is especially appealing to pediatricians,” he said.