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Needle and Pain Free Vaccinations
The development of a needle-free vaccine delivery system has identified Grand Challenges in Global Health (GCGH) initiative as one the major challenges facing global health care today.
Millions of needles and syringes are used each day in health care. The World Health Organization (WHO) estimates that 12 billion injections are given every year. Only about 5% is used to deliver vaccines for immunization and prevention of infectious diseases. Although the vaccine has saved lives in the year, there are some hurdles to overcome. One of them is the use of needles or "sharps" to deliver the vaccine.
According to Myron Levine of the Center for Vaccine Development, University of Maryland School of Medicine and member of the Global Alliance for Vaccines and providing immune (GAVI) "three main themes remain common around the world: first, high immunization coverage of target population in general must be attained for largest public health impact, 2, most current vaccines are given parenterally using a needle and syringe, 3, there is a wide recognition of the need to find ways to administer vaccines without the use of 'sharps' (that is, needles and syringes). "
The disadvantages needle delivery of vaccines include:
(1) Pain and irritation of the vaccination site. A large portion of our population is scared of needles, likely as result of a previous bad experience. The majority of patients and the delivery end of the immunization of very young children under the age of two and needle pricks to the patient population can cause lot of pain and distress. Needles can also cause discomfort at the injection site long after the shot has been applied.
(2) Lack of compliance. Expanded Programme The World Health Organization in immunization (EPI) has recommended six major vaccine for infants in developing countries: diphtheria, pertussis, and tetanus toxoids (DPT), Bacillus Calmette-Guerin (BCG), and attenuated polio and measles. In developed countries like the U.S., more vaccine is required of health authorities. However, for the so-called "herd freedom" to work, a certain% of the population should follow the vaccination schedule.
(3) Safety. Needle vaccine produces hazardous infectious waste that comes with serious health threat for both patients and health care professionals. The unsterilized needles again have facilitated the transmission of blood-borne infections such as HIV and hepatitis.
(4) Speed and efficiency. Recently, the threat of bioterrorism and pandemic flu highlighted the need of fast, easy and safe delivery of the Mass vaccination should need arise. Certainly, immunization with syringes and needles are not designed for these situations.
(5) Cost-efficiency and logistics. Doing away with syringes and needles can make vaccines in less developed countries less expensive and easier. Syringes and needles must be transported and stored for vaccine purposes. Injectible vaccine must be refrigerated during vehicle.
Although needle-free delivery systems exist for many drugs, vaccines present a challenge because they typically consist of large molecules that can not be easily delivered transdermally. Myron Levine summarized in an article reviewing the various methods of administrating needle-free vaccine.
(1) vaccine delivered through the mucosal surface. Although theoretically possible, this form of delivery is not caught on except perhaps in the use of nasal spray.
(2) oral vaccine. Specific vaccine can be given orally in the form of pills. Oral polio vaccine has been around for the moment. Other vaccines can be delivered through This route includes some type of cholera vaccine and the new rotavirus vaccine. However, this delivery route presents some problems for very young children to not be able to swallow and well as the digestive system will not be able to withstand the effects of the vaccine.
(3) nasal vaccines. The nasal vaccine by the respiratory tract is a very popular alternative to flu shot. The nasal spray FluMist ™, made from live, attenuated, cold-adapted vaccines, has been approved by the FDA and is delivered with a single-use device explosion through nostrils.
(4) aerosol vaccine. The method of administration by the respiratory tract were tested for measles vaccine. It is an alternative to nasal spray and can be used in liquid and dry power aerosol for mass vaccination.
(5) percutaneous needle-free jet injection. device It works by propelling liquid through a small lesson of the skin under high pressure. The liquid is then transported to the dermis and underlying tissues and muscles. There are multiple dose injectors available, making this type of delivery of fast and practical for mass immunization. However, it is the absence of a high incidence of local irritation at the vaccination site as well as the possibility of transmission of infectious diseases.
(6) Transcutaneous delivery. It is usually known as the "vaccine patch" and it will be delivered through the skin. The adhesive patch is applied after an initial hydration, directly on the skin. The occlusive patch makes the skin covering the vaccine. The cutaneously applied antigens are then taken up by Langerhans cells found in the top layer (epidermis) the skin that allows the immune-processing cells migrate to the lymph nodes.
In recent years, many biotech companies have invested millions of dollars in development, testing and finalizing various forms of needle-free delivery systems for all types of drugs, not just vaccines. The most promising of the needle-free This system of vaccine once it is Trans Cutaneuous immunization (TCI).
Identified many advantages of TCI. included in cost-effective, safe, fast distribution, easy storage (can be stockpiled!) and easy administration, with potential for self administration.
In 2007, American researchers tested the efficacy of TCI in Clostridium difficile toxoid A in mice, with positive results. The bacteria C. difficile is the leading cause of nosocomial diarrhea, eg infectious diarrhea gets to the hospital setting. Also in 2007, Johns Hopkins University researchers tested the protective spirit of TCI in the heat change-toxin (LT) of enterotoxigenic Escherichia coli (ETEC). The results showed that the patch "mandatory anti-toxin immune responses that did not prevent but mitigated the disease.
Apollo Life Sciences has developed and patented a needle-free drug delivery and in May 2007 it released the results of preliminary studies on needle-free transdermal delivery of tetanus toxoid vaccine in mice. Apollo has developed non-invasive transdermal carrier, which works TransD ™ by delivering "a protein-laden layer of water across the skin and the surrounding skin and sub-layers of skin. It has potential to replace injections for biodrugs based on molecules such as Interferon, growth hormones and anti-TNF (tumor necrosis factor). "
The TCI developed by biotech company Iomai, now owned Austrian company Intercell has recently made the headlines. Drug Delivery Report described how it works: "Administration is a two-step process. First, the skin is prepared by placing the device in patients arm and pulling a tab. The tab draws a mildly caustic substance beyond skin, which makes no pain and almost imperceptible formation and simultaneously leaving an ink mark to indicate where the patch should be applied. The patient then wears a sticky [patch vaccine] for some time. "The innovative design company Ideo helped designed the patch required removal of a very thin layer skin (about one-thousandth of an inch!).
At present, the patch Intercell's vaccine against traveler's diarrhea or the so-called Montezuma's Revenge is showing promise. The disease is a major cause of diarrhea in travelers, with symptoms ranging from stomach cramps to vomiting and diarrhea. Dr. Herbert DuPont of the University of Texas is one of the researchers involved in testing the vaccine. He told Reuters: "I think this is one of the most exciting new developments in travel medicine. Those who can buy it and put it on their own when they take a trip. This is the most convenient form of immunization I have ever seen. "
The vaccine was tested on visitors to travel to Guatemala and Mexico and showed 70% against the spirit of traveler's diarrhea. In other fields of study of 170 travelers as part of Phase II vaccine trial patch, patch the vaccine reduced the risk of developing moderate to severe traveler's diarrhea by 75%. Part III clinical trials are in the process. If approved, this is the first vaccine to prevent traveler's diarrhea. The study results were published in Lancet and finish that "the vaccine patch is safe and feasible, with benefits to the rate and severity of travelers' diarrhea."
The second promising vaccine Intercell patch is targeted against pandemic flu. If successful, the patch will expand the limited vaccine supplies by allowing fewer or more low dose of the vaccine. The program is funded by a United States Department of Health and Human Services contract. "The patch contains a vaccine made from the H5N1 influenza virus. Results of Phase I / II trial showed that a small amount of vaccine triggered a protective immune response in 73% of study participants. Phase II trial is expected to begin in 2009.
Vaccines and immunization technologies have changed a lot in recent years as it tries to meet the health challenges facing both developed and developing countries. The TCI or vaccine patch is a promising tool which will hopefully help solve some the problems facing traditional vaccine delivery system.
About the Author
The article Needle and Pain Free Vaccinations may be found in its entirety with references and links on http://HealthWorldNet.com .
