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 the Maryland-based biotech startup, Altimmune, is trying to develop – a COVID-19 vaccine that is injected into your nose, not stuck in your arm.
“Administering vaccines in sight of the first exposure is an advantage, “said Dr. Buddy Creech, who directs the vaccine research program at Vanderbilt University and has worked with Altimmune.” Normally, you don’t get COVID-19 from the deltoid muscle in your arm, it gets to your nose, eyes and throat. Therefore, it makes sense to consider at least one vaccine that can generate some immunity in the orifices of the mucosa. “
The three COVID-19 vaccines authorized in the United States, of course, are all injections. Although they seem to contain the broadcast, they are unlikely to stop everything together. An intranasal vaccine, however, could create an extra line of defense, as it would cause the immune system to produce antibodies that block the infection locally in the mucous membranes of the nose and throat. This would prevent transmission, interrupting viral spread through these orifices.
Altimmune launched a test with 180 people of its intranasal vaccine, called AdCOVID, last month to test how safe the vaccine is, what side effects it has and what levels of antibodies and T cells it produces. Participants range from 18 to 55 years old. The company expects to have the data in the second quarter of this year.
Altimmune’s COVID-19 candidate vaccine, AdCOVID, was designed to be sprayed into the nostrils.
Courtesy of Altimmune
Scot Roberts, Altimmune’s chief scientific officer, told Insider that the best scenario would be an adult launch later this year or early 2022.
Other intranasal candidate vaccines are also being tested in China, India and the United Kingdom.
A nasal spray can prevent the spread of viruses through the nose and throat
An Altimmune employee examines a vial of COVID-19 intranasal vaccine.
Courtesy of Altimmune
AdCOVID would not be the first vaccine that does not require a needle. The polio vaccine was first swallowed as a pill, and the CDC approved several nasal spray flu vaccines.
Vaccines injected into the arm muscle, however, are more common. They stimulate the immune system to start producing T cells that resemble the pathogen if it comes back, and antibodies that fight the virus throughout the body – what is known as systemic immunity.
But these antibodies do not always flow to the mucus-covered surfaces of the nose and throat (where a respiratory virus likes to spread) in numbers large enough to prevent the virus from replicating there.
A nasal spray, however, can stimulate your immune system to create antibodies known as immunoglobulin A locally in your mucous orifices, according to Dr. Paul Goepfert, director of the Alabama vaccine research clinic.
“It is possible that this vaccine is much more efficient in reducing the spread of the coronavirus,” Goepfert told Insider.
In fact, Altimmune found in a recent animal study that its intranasal vaccine COVID-19 stimulated both systemic and mucosal immunity. Two other animal studies found that an intranasal spray prevented infections while almost completely blocking transmission of the coronavirus.
Nasal sprays can serve as drivers for coronavirus variants.
A frontline healthcare professional receives the Modern COVID-19 vaccination at the Park County Health Department clinic on January 5, 2021 in Livingston, Montana.
William Campbell photo / Getty Images
The proliferation of coronavirus variants has raised concerns that existing vaccines will need to be boosted with booster doses. Pfizer and Moderna are testing new versions of their shots to combat these variants, but distributing them could be another huge undertaking.
The main advantage of Altimmune spray is that it does not require refrigeration and can be kept at room temperature for months.
“If we need revaccination or to increase immunity in the presence of a variant, this approach makes perfect sense,” said Roberts.
According to Daniel Oran and Eric Topol, two researchers at COVID-19 at the Scripps Research Translational Institute in California, intranasal vaccines can help in this process, as people can self-administer them.
“Simply sending someone a nasal spray is much more convenient than providing an injection in person,” they wrote in Scientific American on Monday. The pair also pointed out that exchanging a needle for a spray may encourage more people to get vaccinated.
Altimmune hopes to test its spray on children this year
Chris Diaz receives a nasal spray vaccine for the H1N1 flu at Broadmoor Elementary school in Miami, Florida, on October 19, 2009.
Joe Raedle / Getty Images
Altimmune plans to test its intranasal vaccine on children and is talking to the Food and Drug Administration about how to formulate these pediatric tests. The company hopes to launch a test among children while the drug is still being tested in adults.
None of the COVID-19 vaccines authorized in the United States can be administered to children under the age of 16, as the companies did not include children in their first tests.
“Children are not so sick, but they can certainly spread the virus. So this idea of mucosal immunity that blocks transmission is really a perfect fit for the pediatric population,” said Roberts. “Clearly, the FDA recognizes the need. We cannot leave 70 million Americans aside, unvaccinated.”
Goepfert said that developing a nasal spray vaccine for children would be a victory: it would block their transmission capacity and make it easier to vaccinate them.
“Not having to bore someone is particularly attractive to pediatricians,” he said.
