I don’t like needles. When I give blood, I stare at the ceiling and hold my breath. That one scene in Dead Space 2 makes me crawl the walls.
I’m not alone here: a Gallup poll notes that fear of needles is the sixth most common phobia, after staples like “heights” and “spiders”. So, when I found out about a new technology that could eliminate the needles from vaccines, I was thrilled.
How Vaccines Work
Antibodies are special proteins which stick to a specific molecule on the surface of foreign cells, crippling them. The antibodies are produced by B-cells, each of which is tuned to a specific, randomly selected target molecule. Each B-cell is covered in receptors that bind to its target molecule, and can produce antibodies that attack the same molecule.
When a disease invades your body, it eventually binds to the B-cell that fits it, informing that cell that it is useful. The chosen B-cell begins to multiply, and produce its special antibody to fight the infection. Long-lived remnants of these B-cells (“memory cells”) survive in the body long after the initial infection. This is how you become immune to disease.
Vaccines are designed to be a shortcut: they infect you with a harmless substance which has the same molecular signature as the real disease. As a result, when you get the real infection, your body already has the infrastructure to deal with it. This works really well. It is estimated that 2.5 million lives are saved by vaccinations every year.
The History of Vaccines
The first vaccine ever made was created in the late 1700s, and targeted at smallpox, a disease that we have now driven extinct. Doctors made cuts on people’s arms or chests, and rubbed pus into the wound to infect them with cowpox, a disease similar to but less dangerous than smallpox. After a brief illness, the person who received the vaccine would have B-cells ready to fight smallpox if they got it in the future.
Since then, we’ve developed vaccines for a huge number of diseases, reducing the incidence of infectious disease by orders of magnitude. These vaccines usually take the form of injections of dead or synthetic virus particles in saline with some preservatives.
These vaccines have been hugely successful, but they have many downsides. First, there’s the issue of transportation. Vaccines need to be refrigerated, which makes it challenging to carry them to where they’re needed most. If the “cold chain” breaks down at any point, the vaccines are useless.
Vaccines can also be expensive. The HPV vaccine is potent at preventing many kinds of cancer, but costs about $500 — out of the question for most of the developing world.
Finally, the issue of needle-phobia is real. Many adults avoid or delay vaccination boosters and new vaccines (like the flu shot), because they are uncomfortable with injections. The form factor of the vaccine (a scary needle and mysterious fluid) contributes to the psychology behind the anti-vaccination movement, making it easier to convince the public that there’s something sinister or dangerous about them.
Luckily, there’s a new technology on the horizon that could help solve these problems, through the power of nanotechnology.
How Does Nanotechnology Work?
The vaccine of the future is based on a technology called “nano-needles”. Several independent researchers are developing this approach as we speak.
Professor Mark Kendall at the University of Queensland, Australia, has created a company (Vaxxas) to develop his pioneering invention into a commercial reality. A different project is being developed by Mark Prausnitz at Georgia Tech University, also with an eye on commercialization.
The patch resembles a small Band-Aid. However, under a microscope, its structure becomes clear. The patch has thousands of tiny, painless silicon spikes. Manufacturers create these spikes using microchip etching technology, which makes them cheap to mass produce — unlike some other forms of medical nanotechnology.
Each spike is coated with dry vaccine material, similar to what’s used in existing powder vaccines. Because the spikes are so tiny, they don’t fully penetrate the skin, but deposit the vaccine into the middle-layer of the skin, where the immune system has its strongest defenses.
This makes sense: the immune system works better if it stops an infection from getting a foothold in the first place, rather than trying to fight it once it’s already in the blood and muscle. Because of this, you can use far less vaccine-material. About 100 times less, in fact, which could drastically cut the cost of vaccines.
There are other benefits: The vaccines are dry matter – not a liquid. As such, they don’t need to be refrigerated, making them easier to ship around the world. They’re also easier to apply and dispose of than traditional vaccines: you don’t need a nurse, and it eliminates the contamination risks with needles. There’s no visible puncture, and no pain, which means no needle phobia.
The Challenges of Commercialization
There are major challenges associated with this technology, but not insurmountable ones. Developing dry versions of existing vaccines is one, and so is navigating the FDA safety hurdles. Vaxxas has undertaken early trials in Papua, New Guinea, and raised twenty five million dollars to fund clinical trials. Their competition, the Georgia Tech team, is looking to start human trials for a measles vaccine as early as 2017.
Millions of dollars is going into R&D and testing between where the technology is now, and a needle-free future. However, the potential is so enormous that it’s difficult to imagine that it won’t happen.
What do you think? Are you afraid of needles? Live in a country without reliable access to vaccines? Just wish they were cheaper? Let us know in the comments.