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Why isn't there more of a push for emergency use of intranasal vaccines? Apparently there are some in the testing phase, but I think if they were given as much

Why isn't there more of a push for emergency use of intranasal vaccines? Apparently there are some in the testing phase, but I think if they were given as much resources as the mRNA vaccines were we might have already had an intranasal vaccine in use by now. The Israelis have one in testing but it still sounds like it's a long ways off from being deployed on a large scale. The other advantage of an intransal vaccine is that we might be able to convince a portion of the vaccine hesitant to get it.

rolph 5y ago
nasal mucosal immunity[IgA] is short term relative to humoral immunity[IgG; IgM]; this however would be a good prophylactic approach, as the nasal vault is a major contributor to transmission mechanisms
- superkuh 5y ago
  Yes, the neutralizing antibodies go away relatively quickly but now you have mucosal resident T cells trained on spike epitopes ready to go right at the start of the infection before things get out of hand.
Animats 5y ago
Here's a good explanation of why.[1] There are several intranasal coronavirus vaccines in test. There's only one approved nasal vaccine now, for anything: FluMist. It's not recommended for people over 50. There have been previous failures. Intranasal vaccines are hard to make work. Think of the current mRNA vaccines as a minimum viable product. The basic formulation was computed days after the virus was sequenced and they made it to market fast. They do the basic job. Serious side effects are rare. They require two doses and later, boosters. They're a pain to store and ship because of cold requirements. They're hard to manufacture because putting fragile messenger RNA into a liquid carrier envelope requires exotic equipment. They have reduced effectiveness for virus variants. Expect later-generation products that solve some of those problems. [1] https://www.pbs.org/newshour/health/scientists-debate-potential-benefits-of-intranasal-covid-19-vaccines https://www.pbs.org/newshour/health/scientists-debate-potent...
- unanswered 5y ago
  This raises an interesting question: is someone who is waiting for an effective intranasal vaccine to get something more like sterilizing immunity, and foregoing the less-effective vaccine meanwhile, anti-vax?
  - Jabbles 5y ago
    Yes. Refusing to get a vaccine now is harmful to yourself and others. The current vaccines are effective. A more effective intranasal vaccine may come, but you should protect yourself and others now.
  - walterbell 5y ago
    If they are healthy and have survived Covid with natural immunity, that overall beats all vaccines. Antibody and T-cell tests tests are available to find out if they have already recovered from an an infection. If they have not been isolating much for the past 18 months, e.g. first responder or other essential worker, they were likely infected and already recovered. If they are not yet infected, are healthy and take precautions to isolate at the first sign of illness, they are a lower transmission risk than a vaccinated person who gets infected but whose symptoms are suppressed by the vaccine, so they don't know they should isolate. CDC recommends that vaccinated people exposed to SARS-CoV-2 should be tested after exposure, and then wear a mask if the test is positive, https://www.webmd.com/lung/news/20210729/cdc-reverses-guidance-testing-fully-vaccinated-people https://www.webmd.com/lung/news/20210729/cdc-reverses-guidan... & https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vac... > Even if they’re not showing symptoms, fully vaccinated people should “get tested 3-5 days after exposure to someone with suspected or confirmed COVID-19 and wear a mask in public indoor settings for 14 days after exposure or until they receive a negative test result,” the agency’s website says ... “Our updated guidance recommends vaccinated people get tested upon exposure regardless of symptoms,” CDC Director Rochelle Walensky, MD, told The New York Times in an email. “Testing is widely available.”
  - contravariant 5y ago
    That only seems like an interesting question if you view anti-vax as some kind of ethical group. If you choose to define it more literally as the people that are against taking any particular vaccine in common use then it's vacuously true.

rolph 5y ago

nasal mucosal immunity[IgA] is short term relative to humoral immunity[IgG; IgM]; this however would be a good prophylactic approach, as the nasal vault is a major contributor to transmission mechanisms

superkuh 5y ago
Yes, the neutralizing antibodies go away relatively quickly but now you have mucosal resident T cells trained on spike epitopes ready to go right at the start of the infection before things get out of hand.

Animats 5y ago

Here's a good explanation of why.[1] There are several intranasal coronavirus vaccines in test. There's only one approved nasal vaccine now, for anything: FluMist. It's not recommended for people over 50. There have been previous failures. Intranasal vaccines are hard to make work. Think of the current mRNA vaccines as a minimum viable product. The basic formulation was computed days after the virus was sequenced and they made it to market fast. They do the basic job. Serious side effects are rare. They require two doses and later, boosters. They're a pain to store and ship because of cold requirements. They're hard to manufacture because putting fragile messenger RNA into a liquid carrier envelope requires exotic equipment. They have reduced effectiveness for virus variants. Expect later-generation products that solve some of those problems. [1] https://www.pbs.org/newshour/health/scientists-debate-potential-benefits-of-intranasal-covid-19-vaccines https://www.pbs.org/newshour/health/scientists-debate-potent...

unanswered 5y ago
This raises an interesting question: is someone who is waiting for an effective intranasal vaccine to get something more like sterilizing immunity, and foregoing the less-effective vaccine meanwhile, anti-vax?
- Jabbles 5y ago
  Yes. Refusing to get a vaccine now is harmful to yourself and others. The current vaccines are effective. A more effective intranasal vaccine may come, but you should protect yourself and others now.
- walterbell 5y ago
  If they are healthy and have survived Covid with natural immunity, that overall beats all vaccines. Antibody and T-cell tests tests are available to find out if they have already recovered from an an infection. If they have not been isolating much for the past 18 months, e.g. first responder or other essential worker, they were likely infected and already recovered. If they are not yet infected, are healthy and take precautions to isolate at the first sign of illness, they are a lower transmission risk than a vaccinated person who gets infected but whose symptoms are suppressed by the vaccine, so they don't know they should isolate. CDC recommends that vaccinated people exposed to SARS-CoV-2 should be tested after exposure, and then wear a mask if the test is positive, https://www.webmd.com/lung/news/20210729/cdc-reverses-guidance-testing-fully-vaccinated-people https://www.webmd.com/lung/news/20210729/cdc-reverses-guidan... & https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vac... > Even if they’re not showing symptoms, fully vaccinated people should “get tested 3-5 days after exposure to someone with suspected or confirmed COVID-19 and wear a mask in public indoor settings for 14 days after exposure or until they receive a negative test result,” the agency’s website says ... “Our updated guidance recommends vaccinated people get tested upon exposure regardless of symptoms,” CDC Director Rochelle Walensky, MD, told The New York Times in an email. “Testing is widely available.”
- contravariant 5y ago
  That only seems like an interesting question if you view anti-vax as some kind of ethical group. If you choose to define it more literally as the people that are against taking any particular vaccine in common use then it's vacuously true.