Wednesday, April 13, 2011

Intranasal vaccines- Up Your Nose, Up and Coming?

Nasal spray vaccines are recently new and have been promoted as alternatives to intramuscular vaccines, especially for Influenza.



In this recent news article, investigators reported a more robust antibody response in laboratory animals when intranasal vaccines for S.pneumoniae, Influenza or Yersinia pestis (plague) were combined with interleukins. I have no reason to doubt the immunogenicity of this process.


My experience with intranasal influenza vaccine, as an Associate Hospital Epidemiolgist, at a major academic medical center, has left me less than enthusiastic.


We aggressively promote influenza vaccination, short of mandatory vaccination. Despite aggressive efforts, flu vaccine clinics, emails, alerts, reminders etc, we have difficulty vaccinating all healthcare workers. Many people cite fear of needles and injection site reactions as barriers to vaccination. So when we offered intranasal influenza vaccine, I was optimistic.


I was wrong. 


Intranasal vaccination was not widely accepted and intramuscular injection was preferred. Overall vaccination compliance did not significantly change. 


For healthcare workers, regardless of the influenza vaccine delivery method, reminders, vaccination campaigns, free vaccines, vaccination clinics and other incentives, there remains a recalcitrant fraction of non-vaccinated individuals.