Skin vaccination (delivery of vaccine to the upper layers of the skin) has the potential to improve the safety and effectiveness of current vaccine strategies, according to a special issue of the journal Vaccine. The supplement, co-edited by Darin Zehrung, portfolio leader of Vaccine and Pharmaceutical Delivery Technologies at PATH, explores recent advances in product development and related topics such as cost, access, and potential health impact.
Aimed at the broad global immunization community, the issue is a single source for the latest information on skin vaccination. In addition to an editorial by Zehrung and fellow co-editor Marcel B. M. Teunissen of the University of Amsterdam, it provides insights and research findings from a variety of academics and public health specialists, including PATH technical experts Jennifer Foster, Courtney Jarrahian, Mercy Mvundura, and Eugene Saxon.
The supplement was published as a lead-up to the third international Skin Vaccination Summit, which was held September 2—4 in Lausanne, Switzerland.
Innovative needle-free skin vaccination technologies as well as dissolvable microneedle patches (MNPs) hold promise for reducing or eliminating the needlestick injuries and sharps waste associated with conventional needle-based injections. Additional advantages of these and other technologies in development include more efficient packaging, fewer training requirements, and potential storage outside the cold chain–which are especially important for remote outreach and the large-scale immunization campaigns common to low- and middle-income countries. For some vaccines, skin vaccination may also help lower the amount of antigen necessary to confer immunity, increasing the number of doses that can be produced from a given amount of vaccine.
The new Vaccine supplement includes five articles authored by PATH experts in collaboration with research partners. Together, the articles, summarized below, highlight our leadership and contributions in the rapidly developing field of skin vaccination:
- "Cutaneous vaccination — Protective immunization is just a skin-deep step away."
For some vaccines, research has demonstrated that skin vaccination is equally effective as, or superior to, conventional intramuscular or subcutaneous needle and syringe-based delivery methods. In this editorial, supplement co-editors Zehrung and Teunissen review the history of skin vaccination and its potential transformative impact on immunization.
- "Opportunities and challenges in delivering influenza vaccine by microneedle patch."
Alternative delivery methods for influenza vaccines could improve health outcomes and help public health personnel to better manage pandemics in the United States and globally. This article explores how MNPs in development might meet future needs, particularly if they are developed for self-administration.
- "Clinical performance and safety of adapters for intradermal delivery with conventional and autodisable syringes."
One factor that may be limiting the use of needle and syringe-based intradermal (ID) delivery is concern about the ease and reliability of the Mantoux technique required to achieve it. This article details a clinical trial comparing the safety, simplicity, and reliability of ID injections using two different ID adapter injection-delivery aids: a prototype autodisable ID adapter (for autodisable syringes) and a marketed side-merge adapter.
- "A randomized clinical trial in adults and newborns in South Africa to compare the safety and immunogenicity of bacille Calmette-Guérin vaccine administration via a disposable-syringe jet injector to conventional technique with needle and syringe."
Intradermal bacille Calmette-Guérin (BCG) vaccination by disposable-syringe jet injectors offers a promising needle-free alternative to the Mantoux method. This article details a clinical trial comparing the safety and immunogenicity of administering BCG vaccine using disposable-syringe jet injectors as well as needle and syringe-based techniques.
- "An economic model assessing the value of microneedle patch delivery of the seasonal influenza vaccine."
In preclinical studies, MNPs hold promise for improving the acceptability and efficacy of influenza vaccines. This article examines the potential economic and epidemiologic impacts of introducing MNPs (including self-administered MNPs) within different vaccination settings in the current influenza vaccine market in the United States.
Read the full special issue of Vaccine on the publisher's website.