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Would you rather receive a COVID vaccine via needle or nasal spray? Scientists are working to make nasal COVID vaccines a reality.

A nasal vaccine for COVID may be on the horizon

When we think about COVID vaccines, most of us picture a pointy needle — and some of us might even faint. But what if getting vaccinated was as easy as inhaling a nasal spray?

The World Health Organization (WHO) estimates that more than 16 billion injections are given annually around the world. That number is set to grow this year — the global vaccination campaign against COVID could require an additional 5.6 billion.

Scientists are currently working on alternatives to meet the high demand, including nasal vaccines.

When a vaccine is given via the nose, the host produces a mucosal immune response at the site of infection.

In Mexico, scientists are working on a nasal vaccine called Patria — meaning "homeland" in Spanish — and hope to get clinical trials started soon.

Peter Palese, chairman of the Department of Microbiology at the Ichan School of Medicine at Mount Sinai Hospital in the United States, developed the key ingredient being used in the nasal vaccine with his research team.

Speaking on DW's Covid-19 Special TV program, Palese said one of the major advantages of the nasal vaccine is its ability to be stored in a normal fridge at 2-4 degrees Celsius, rather than the ultra-low temperatures required for the Pfizer and Moderna vaccines.

Because the vaccine is grown in chicken eggs — the same technology used for many flu vaccines all over the world — the cost of development is also cheaper.

"It is much, much cheaper to produce this vaccine as compared to the mRNA vaccines by Pfizer and Moderna," Palese told DW.

Phase one and two trials are currently being facilitated in parallel due to the urgency of the pandemic. People from five countries are involved in the trials and initial data is expected by July.

"It works beautifully in animals, we have fantastic, compelling studies in hamsters and mice, but obviously mice and hamsters are not humans," said Palese.

Scientists at Washington University in St. Louis are also working on a nasal COVID vaccine.

A research team, led by viral immunologist Michael Diamond and oncologist David Curial, found that mice that received a single dose of the vaccine through the nose were fully protected from SARS-CoV-2. But mice that received the same vaccine via injection were only partially protected.

To make the vaccine, the researchers inserted the SARS-CoV-2 spike protein inside an adenovirus, which causes the common cold. But they altered the adenovirus so it was unable to cause the illness. This allows the body to develop an immune defense to the spike protein.

"It's also important that a single dose produced such a robust immune response," said Curial in a press release. "Vaccines that require two doses for full protection are less effective because some people, for various reasons, never receive the second dose," he added.

Since the vaccine contains no live virus, it would also be a good option for people whose immune systems are compromised by illnesses such as cancer, HIV and diabetes, the scientists said.

The idea might sound novel, but needle-free vaccines have been around for decades.

The first to have  a major impact was the oral polio vaccine, which is still used in low-income countries. The vaccine contains a weakened version of the poliovirus and works by infecting the gastrointestinal tract and provoking an immune response in the host.

There are also oral vaccines for typhoid fever, cholera and rotavirus, as well as a nasal vaccine for influenza. These also contain weakened forms of the pathogen that causes the disease.

Medical staff who want to vaccinate the inhabitants of the mountainous regions of southeastern Turkey must be physically fit. Ensuring vaccinations in the mountain villages is particularly important, Dr. Zeynep Eralp told DW. "People often live close together, and an infection could spread quickly," she said. Also, people don't like going to hospitals, so "we have to go to them."

Many elderly people can't make the journey to a vaccination center. In the Maira Valley in the western Italian Alps, close to the border with France, doctors go from house to house to give residents older than 80 their COVID-19 shot. A blessing from the roadside Madonna is a bonus.

Carrying a single vial containing several doses of vaccine, this nurse is en route to Eagle, a town on the Yukon River in the US state of Alaska with fewer than 100 inhabitants. Indigenous people are prioritized in many immunization programs. Depending on where they live, the nearest health clinic can be far away.

Anselmo Tunubala washes his hands before vaccinating an elderly lady. Every day, the 49-year-old is out and about in the mountains of southwestern Colombia, telling people in the local language about the importance of a vaccination. He is a member of the Misak, many of whom are skeptical about vaccination because they tend to rely on traditional medicine and the guidance of religious leaders.

The men and women in the above photo walked up to four hours to get their coronavirus shot in the remote village of Nueva Colonia in central Mexico. They belong to the indigenous Wixarika people, perhaps better known under the name Huichol.

For her shot, Olga Pimentel simply pulled up her boat next to that of the vaccination team. The community of Nossa Senhora do Livramento on the Rio Negro in Brazil can only be reached by river. "Beautiful! It hardly hurt," the 72-year-old laughed and shouted, "Viva o SUS!" — "long live Brazil's public health service!"

For a long time, right-wing populist President Jair Bolsonaro campaigned against COVID-19 vaccinations in Brazil. But in the meantime, the campaign has taken off. Indigenous people and quilombolas, descendants of African slaves, were among the first to be vaccinated. Raimunda Nonata, 70, lives in a community without power so she got her shot by candlelight.

After their vaccination, an elderly woman and her daughter paddle away from the island of Bwama, the largest in Lake Bunyonyi in Uganda. The government in the central African country is trying to supply remote areas with the vaccine.

Another journey over the water — but his time, no boat. On the way to the village of Jari in Zimbabwe, this vaccination team had to navigate a flooded road. According to the African Union's health agency, Africa CDC, fewer than 1% of the population in Zimbabwe has been fully vaccinated to date. Medical staff came first.

Japan may have huge, sprawling cities, but many people also live in small, isolated villages with only a few hundred inhabitants — like here, in Kitaaiki. Residents who can't make it to the next city are happy to welcome the doctor and a vaccine at home.

Indonesia launched its vaccination campaign in January. From Banda Aceh, the medical team traveled via boat to remote islands. The vaccines in the cooler are so valuable that the team was accompanied by security personnel.

India has been hardest hit by the pandemic in recent weeks. In mid-March, medical personnel made their way to the village of Bahakajari on the Brahmaputra River, where a group of women registered for their COVID-19 shot. None wore face masks or kept a safe distance.

Austria's vaccine mandate for adults passed easily with only far-right politicians protesting. Meanwhile, Germany reported another record high in daily infection rates. DW has the latest.  

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