A measles vaccine painlessly delivered via sticker shows promising early results
npr.org
npr.org
At first glance I was thinking that this is a solution in search of a problem since SC/IM injections can be taught to a layperson quite quickly, but the lack of cold storage requirements is hugely significant. In their study protocol[0] they estimate a 60% reduction in the cost of delivery!
This would also eliminate the risk of needle-stick injuries which is a nice bonus, particularly in nations with high rates of blood-borne diseases.
In case anyone else was looking for the ethics statement, it's not mentioned in the article but per the protocol this study was funded by the Bill & Melinda Gates Foundation and conducted in collaboration with the London School of Hygiene and Tropical Medicine under the purview of the joint Gambian and LSHTM ethics board.
Even then being painless is a big advantage. Also you can stick a patch to hundreds of children in a matter of minutes, which would be much slower with the conventional method.
Perhaps I'm a bit too jaded but I'm always skeptical of [new drug delivery technology for old medicine] as being a cash-grab since this is almost certainly more expensive than injections.
It's more that I'm pleasantly surprised this will greatly simplify the supply-chain and hopefully offset the added unit cost in a non-insignificant way, in addition to making delivery of care easier and the other benefits you mention.
Painless is nice but a subcutaneous injection isn't really that painful so I'm skeptical payers will see the value-proposition for that benefit in isolation if the vaccine costs substantially more per dose. As an example we've had intranasal flu vaccinations for a while now but my hospital still gives me the injection every year, presumably as it's cheaper.
Painless is nice but a subcutaneous injection isn't really that
painful so I'm skeptical payers will see the value-proposition
for that benefit in isolation
As for pain, I suppose that for some folks their fear of needles has more to do with the expected vs actual pain (or perhaps nothing to do with pain at all). No needles and thus one fewer excuse to avoid vaccination is a huge win IMO.
As an example we've had intranasal flu vaccinations
As for pain, I suppose that for some folks their fear of needles has more to do with the expected vs actual pain (or perhaps nothing to do with pain at all). No needles and thus one fewer excuse to avoid vaccination is a huge win IMO.
The fact this drug is cheaper and better is really impressive.
A quick look reveals that it's an attenuated ("live") virus vaccine (the common injected vaccines aren't) and carries a higher risk of side effects and lower efficacy.
In any case the ACIP (and UpToDate) makes no preference for live attenuated vs recombinant/inactivated in adults > 18 or children > 2 (with some exceptions in kids).
You are right though that there is a recommendation for healthcare workers to get an inactivated vaccine so that would explain my circumstances. Thanks, I learned something new today (actually two things, I had no idea we could use code blocks on HN).
So you were offered both as an covered options?
I would be skeptical of how much you just have people "tough it out" in these economies
in order to vaccinate more people. The fact this drug is cheaper and better is really
impressive.
So you were offered both as an covered options?
I can't think of another time I've been offered the nasal spray. Megacorp had Kaiser nurses on site annually, and they only offered the injection. I'm with (ick) Kaiser now and they were making some noise about covering COVID and flu vaccinations at CVS and Walgreens. If the nasal spray is offered there then presumably it would be covered by insurance.
However…
https://www.cdc.gov/flu/prevent/nasalspray.htm
After the 2009 pandemic, several U.S. studies among 2 through 17-year-olds found that
the nasal spray vaccine was as effective against influenza B viruses and influenza A(H3N2)
viruses as inactivated influenza vaccines but was less effective than inactivated flu
vaccines against the 2009 pandemic H1N1 viruses. These data led ACIP and CDC to recommend
against use of the nasal spray vaccine for the 2016-17 and 2017-18 seasons.
Since the 2017-2018 season, the manufacturer of nasal spray vaccine has used new influenza
A(H1N1) vaccine virus ingredients in production. Because of limited use, there have been
no effectiveness estimates in the United States since LAIV was recommended again in the
2018-2019 influenza season. Data from other countries have demonstrated protection from
LAIV to be similar to that of standard-dose, egg-based inactivated flu vaccine in children.
Painfulness aside, after you have kids and experienced needing two adults to pin down a writhing, screaming two year old to get vaccine injections, you might appreciate a sticker.
That quickly changed once I needed more extensive work done on adult teeth.
I think if the actual vaccine was a pill or spray, things would have turned out very differently.
It's not a public health failure. It's a failure (or rather a "success") of organized groups to convince people not to get vaccinated.
What mechanism could public health orgs possibly have to convince, for example, Hasidic Jews in New York to get their children vaccinated?
Arresting the parents would work
At the time, only a single dose was included in the vaccination schedule, and immunity may fade with time.
It lists conflict, infrastructure, and vaccine hesitancy as the major reasons.
We did a good job of eradicating smallpox which is viral, and diptheria and whooping cough are almost gone (they'll probably never totally go, bacterial diseases are like that), polio isn't really a thing. If you look at a graveyard from the beginning of the 20th century when they started recording such things on gravestones (and maybe a ways back into the 19th) you'll see a lot of children died very young - pretty much all of that was diptheria.
And that brings me round to the last point - we're lucky because pretty much no-one dies or has life-changing aftereffects from measles. Diptheria killed just about everyone that caught it. Polio killed just about everyone that got it, or left them with crippling nerve damage. There are people alive today with disabilities caused by polio, and they were the lucky ones.
So, while it was pretty horrible watching my beautiful little baby boy get stabbed in the legs, two at a time, to get it done quickly - but you don't get over the instinct to defend your child from someone hurting them easily - I'm glad he will never have any of a laundry list of preventable diseases, even the ones that just give you some itchy spots and a few days off school.
That's simply not true.
Polio is asymptomatic or a mild flu-like illness for the vast majority of people infected (still a major public health disaster).
This is well known and, sadly, conclusively demonstrated during the Cutter Incident, where live virus was accidentally injected, due to a manufacturing defect.
> The mistake produced 120,000 doses of polio vaccine that contained live polio virus. Of children who received the vaccine, 40,000 developed abortive poliomyelitis (a form of the disease that does not involve the central nervous system), 56 developed paralytic poliomyelitis—and of these, five children died from polio.
Okay, yes, you're right. What I posted was an oversimplification.
It's true that the vast majority of people who suffered significant complications of polio became very ill, and it was far far more common than measles complications.
Lives will be saved. Bravo, Micron Biomed
My initial thought was that this, if popularized, will create even more conspiracy theories among anti-vaxers who will stop letting their kids have stickers. Actually it was common when I grew up, and now with my own kids, for doctors’ offices to give kids stickers for being a good patient or just generally bring a smile to a sick kid’s face.
It's easier to be convinced that something is bad if you already have negative associations with it.
I let my kids get the nasal spray flu vaccine if it’s available only because it has a 20 year track record, this will be great for their kids if it works out (they, meaning my kids, got the MMR shot). Lots of parents are willing to use tried and true medicine but are more hesitant for brand new treatments regardless of what trials say. This isn’t a javascript framework.