6 ms·

A measles vaccine painlessly delivered via sticker shows promising early results

125 points by _Microft 3y ago

jesusofnazarath 3y ago
[dead]
haldujai 3y ago
> Many vaccines require careful cold storage, which can be difficult or even impossible in some parts of the world. The adhesive patch does not need to be refrigerated. 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. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472726/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472726/
- selcuka 3y ago
  > 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 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.
  - haldujai 3y ago
    My understanding of developing health systems (who stand to benefit the most from this) is regrettably limited but colleagues who participate in global health initiatives tell me that material costs are the biggest barrier rather than local labour which is relatively cheap in these economies. 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.
    - inferiorhuman 3y ago
      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 I'd expect that folks funding vaccination programs in underdeveloped countries won't look at any one cost or benefit in isolation. Well, I hope so anyways. Dropping the cold storage requirement is potentially huge IMO. 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 This was offered to me by my GP once and I wasn't a fan. It left me feeling worse than any flu shot I can remember. 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. It's not recommended for children and comes with more contraindications than the injectable vaccines which goes a long way to explaining why it's not more commonly available.
      - haldujai 3y ago
        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. True but in their protocol they mention the government of Gambia paid $1.3m (and that even the modest $80,000 on this trial was significant for them) for 802,000 patients of injectable MMR putting the cost at 1.67/person. Depending how much more expensive the transdermal version may have been (US/Can reformulations are usually significantly more expensive) 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. 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. I mean the evidence isn't really compelling for healthy adults 18-49 and kids for efficacy to begin with so I'm not sure we can make that statement with confidence. 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?
  - sacnoradhq 3y ago
    It seems like a huge win for mass vaccination drives. Maybe an alcohol swab and press on a sticker. It's much less traumatic for kids too. Seems like major UX advance for preventative healthcare.
- SoftTalker 3y ago
  [flagged]
  - bheadmaster 3y ago
    Too late, I've already wrote 5 Facebook posts, shared an image macro, assembled a gorilla warfare group, destroyed HAARP and sent assassins to torch the vaccine fields.
about3fitty 3y ago
This has the potential to “peel off” some portion of anti-vax moderates; maybe some who are looking for a way to save face as they re-enter the pro-vax fold. Lives will be saved. Bravo, Micron Biomed
- crooked-v 3y ago
  On the other hand, there will probably be a significant number who double down using some chain of nonsense connected to 'vaccines have chips in them' because of the larger size of the applicator.
  - ineedasername 3y ago
    And anti-sticker movements lest their children be secretly vaccinated against the parents wishes. Schools will stop giving out stickers to grade schoolers, or anti-vaxers will push schools to require opt-in sticker permission slips without which their child cannot be given stickers.
- ineedasername 3y ago
  Why would anti-vaxers be any less skeptical of this? From their standpoint it’s an even newer and less tested method. 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.
  - kadoban 3y ago
    There's an argument to be had that some antivax sentiment has roots in just not liking shots. They creep people out, and they hurt. It's easier to be convinced that something is bad if you already have negative associations with it.
  - jerkstate 3y ago
    Informed consent means it’s unethical to give this vaccine without parental permission anyways.. one would hope that the medical profession continues to be trustworthy in this way. 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.
martythemaniak 3y ago
I wondered a lot during Covid how much of the vaccine hesitancy was due to people's squeamishness about needles and how much that was consciously or unconsciously rationalized with the familiar takings points. I think if the actual vaccine was a pill or spray, things would have turned out very differently.
- SoftTalker 3y ago
  I disagree. Everything surrounding COVID became ideology. People refused masks, you think they would accept a spray vaccine?
  - tempcovidvax 3y ago
    Sample size 1, but I avoided getting a vaccine for over a year, and I only got it when extensive measures were taken to combat my anxiety about the needle. For sure, I would have been in line to get it day 1 if it had been a nasal spray or other method.
  - hgsgm 3y ago
    We can't turn back the clock, but if w never had Wakefield, and never had needles, am maybe antivax would never have achieved critical mass.
- PeterStuer 3y ago
  I think reservations were not at all about the needle (except perhaps for the strange guidance about not aspirating to check for potential blood vessel puncture without explanation).
- deleted 3y ago
  [deleted]
- culopatin 3y ago
  Mine was 90/30 needles/side effects (fever, pain, etc)
- Tagbert 3y ago
  My husband, who is not a fan of needles, complained that in television coverage of covid vaccinations, the news coverage always showed closeup images of dripping needles while telling people to get vaccinated. He felt that would turn off people like him who try to avoid needles.
photochemsyn 3y ago
I'm really kind of surprised that measles hasn't been eradicated. There's not a non-human biologica reservoir is there? Apparently there isn't. So could have been eradicated, should have been eradicated - just another public health failure.
- russdill 3y ago
  Yes, it can be eradicated, but it's very contagious and stays airborne for a long time. You'd need very high rates of vaccination across all of humanity. Probably the reason this approach is being tried.
- smt88 3y ago
  > just another public health failure 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?
  - nisegami 3y ago
    >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
    - smt88 3y ago
      You can't do that in the US, and no public health org makes those decisions anyway.
  - oldgradstudent 3y ago
    The largest group of people with no immunity to measles may be middle aged people who got vaccinated as children. At the time, only a single dose was included in the vaccination schedule, and immunity may fade with time.
- eesmith 3y ago
zabeltech 3y ago
Oh wow, this opens up a whole new set of pandemic control options like smear or droplet vaccination. Simply apply the vaccine onto surfaces or into air conditioner in public transportation for example.
- friendlyHornet 3y ago
  Wouldn't that be hazardous for people who can't get due vaccinated due to medical conditions?
- jimlongton 3y ago
  Never going to happen. Aside from the ethical objections, that would be a great way to injure or kill already immunocompromised people.

125 points by _Microft 3y ago

[dead]

> Many vaccines require careful cold storage, which can be difficult or even impossible in some parts of the world. The adhesive patch does not need to be refrigerated. 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. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472726/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9472726/

selcuka 3y ago
> 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 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.
- haldujai 3y ago
  My understanding of developing health systems (who stand to benefit the most from this) is regrettably limited but colleagues who participate in global health initiatives tell me that material costs are the biggest barrier rather than local labour which is relatively cheap in these economies. 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.
  - inferiorhuman 3y ago
    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 I'd expect that folks funding vaccination programs in underdeveloped countries won't look at any one cost or benefit in isolation. Well, I hope so anyways. Dropping the cold storage requirement is potentially huge IMO. 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 This was offered to me by my GP once and I wasn't a fan. It left me feeling worse than any flu shot I can remember. 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. It's not recommended for children and comes with more contraindications than the injectable vaccines which goes a long way to explaining why it's not more commonly available.
    - haldujai 3y ago
      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. True but in their protocol they mention the government of Gambia paid $1.3m (and that even the modest $80,000 on this trial was significant for them) for 802,000 patients of injectable MMR putting the cost at 1.67/person. Depending how much more expensive the transdermal version may have been (US/Can reformulations are usually significantly more expensive) 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. 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. I mean the evidence isn't really compelling for healthy adults 18-49 and kids for efficacy to begin with so I'm not sure we can make that statement with confidence. 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?
- sacnoradhq 3y ago
  It seems like a huge win for mass vaccination drives. Maybe an alcohol swab and press on a sticker. It's much less traumatic for kids too. Seems like major UX advance for preventative healthcare.
SoftTalker 3y ago
[flagged]
- bheadmaster 3y ago
  Too late, I've already wrote 5 Facebook posts, shared an image macro, assembled a gorilla warfare group, destroyed HAARP and sent assassins to torch the vaccine fields.

about3fitty 3y ago

This has the potential to “peel off” some portion of anti-vax moderates; maybe some who are looking for a way to save face as they re-enter the pro-vax fold. Lives will be saved. Bravo, Micron Biomed

crooked-v 3y ago
On the other hand, there will probably be a significant number who double down using some chain of nonsense connected to 'vaccines have chips in them' because of the larger size of the applicator.
- ineedasername 3y ago
  And anti-sticker movements lest their children be secretly vaccinated against the parents wishes. Schools will stop giving out stickers to grade schoolers, or anti-vaxers will push schools to require opt-in sticker permission slips without which their child cannot be given stickers.
ineedasername 3y ago
Why would anti-vaxers be any less skeptical of this? From their standpoint it’s an even newer and less tested method. 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.
- kadoban 3y ago
  There's an argument to be had that some antivax sentiment has roots in just not liking shots. They creep people out, and they hurt. It's easier to be convinced that something is bad if you already have negative associations with it.
- jerkstate 3y ago
  Informed consent means it’s unethical to give this vaccine without parental permission anyways.. one would hope that the medical profession continues to be trustworthy in this way. 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.

martythemaniak 3y ago

I wondered a lot during Covid how much of the vaccine hesitancy was due to people's squeamishness about needles and how much that was consciously or unconsciously rationalized with the familiar takings points. I think if the actual vaccine was a pill or spray, things would have turned out very differently.

SoftTalker 3y ago
I disagree. Everything surrounding COVID became ideology. People refused masks, you think they would accept a spray vaccine?
- tempcovidvax 3y ago
  Sample size 1, but I avoided getting a vaccine for over a year, and I only got it when extensive measures were taken to combat my anxiety about the needle. For sure, I would have been in line to get it day 1 if it had been a nasal spray or other method.
- hgsgm 3y ago
  We can't turn back the clock, but if w never had Wakefield, and never had needles, am maybe antivax would never have achieved critical mass.
PeterStuer 3y ago
I think reservations were not at all about the needle (except perhaps for the strange guidance about not aspirating to check for potential blood vessel puncture without explanation).
deleted 3y ago
[deleted]
culopatin 3y ago
Mine was 90/30 needles/side effects (fever, pain, etc)
Tagbert 3y ago
My husband, who is not a fan of needles, complained that in television coverage of covid vaccinations, the news coverage always showed closeup images of dripping needles while telling people to get vaccinated. He felt that would turn off people like him who try to avoid needles.

photochemsyn 3y ago

I'm really kind of surprised that measles hasn't been eradicated. There's not a non-human biologica reservoir is there? Apparently there isn't. So could have been eradicated, should have been eradicated - just another public health failure.

russdill 3y ago
Yes, it can be eradicated, but it's very contagious and stays airborne for a long time. You'd need very high rates of vaccination across all of humanity. Probably the reason this approach is being tried.
smt88 3y ago
> just another public health failure 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?
- nisegami 3y ago
  >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
  - smt88 3y ago
    You can't do that in the US, and no public health org makes those decisions anyway.
- oldgradstudent 3y ago
  The largest group of people with no immunity to measles may be middle aged people who got vaccinated as children. At the time, only a single dose was included in the vaccination schedule, and immunity may fade with time.
eesmith 3y ago

zabeltech 3y ago

Oh wow, this opens up a whole new set of pandemic control options like smear or droplet vaccination. Simply apply the vaccine onto surfaces or into air conditioner in public transportation for example.

friendlyHornet 3y ago
Wouldn't that be hazardous for people who can't get due vaccinated due to medical conditions?
jimlongton 3y ago
Never going to happen. Aside from the ethical objections, that would be a great way to injure or kill already immunocompromised people.