Good news for everyone, but especially people afraid of needles: New York biotech company Codagenix is developing a COVID-19 vaccine designed to be delivered via a nasal spray.
Before Codagenix's coronavirus nasal spray vaccine has any hope of reaching the public, the company will need to clear a hurdle not in front of any of the other vaccine candidates: prove it's safe to spray weakened, but live, coronavirus up people's noses.
A Live-Attenuated Vaccine for COVID-19
The idea of purposefully coming into contact with a virus, particularly one as dangerous as the novel coronavirus, might sound like a counterintuitive way to prevent infection, but it's not that radical.
The point of a vaccine is to prepare the immune system to fight a particular virus by giving it an early introduction to the pathogen.
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Most of the COVID-19 vaccine candidates do this by introducing the body to part of the virus — the University of Oxford's vaccine, for example, includes a bit of the genetic material from the coronavirus's spike protein.
The coronavirus nasal spray vaccine Codagenix is developing would introduce the body to the entire coronavirus — but only after weakening it to the point it can no longer cause an active infection.
Vaccines made from these hamstrung pathogens are called "live-attenuated vaccines." They're already used to protect against chickenpox and measles, and the vaccine that eradicated smallpox also falls under this category. A version of the flu vaccine is also offered as a nasal spray made from live-attenuated influenza.
The idea is that exposing the immune system to the entire virus — and not just a part of it — the vaccine could produce longer lasting and more robust protection.
Codagenix's Coronavirus Nasal Spray Vaccine
For its coronavirus nasal spray vaccine, Codagenix engineered a coronavirus strain that contains 240 genetic mutations.
These mutations should make the virus up to 1,000 less efficient at replicating itself when in a human, Codagenix founder J. Robert Coleman told MIT Technology Review, giving a vaccinated person's immune system plenty of time to squash the virus before it can cause harm.
People with compromised immune systems, however, might not be able to clear Codagenix's genetically engineered coronavirus, meaning this vaccine wouldn't be able to help protect everyone from COVID-19.
Still, the unique delivery method could allow the coronavirus nasal spray vaccine to play a major role in combating the virus.
A vaccine delivered via a shot travels through the bloodstream to reach the entire body, producing what's called "systemic immunity."
But it's possible for a virus to infect a person's nasal passages before immunity is established in the cells lining the nose. Even if the virus doesn't spread anywhere else in the body and the person doesn't get sick, it's still possible the virus could spread to others, just from normal coughing and sneezing.
"You add a level of immunity that you don't get with an intramuscular vaccine."
We don't know whether this is possible or likely with the coronavirus — clinical trials to evaluate the effectiveness of other COVID-19 vaccines are already underway.
But a vaccine that targets the place where the infection is likely to start could stop any of that from happening.
"You still get systemic immunity if you deliver it via the intranasal route, so that doesn't go away, and you add a level of immunity that you don't get with an intramuscular vaccine," Frances Lund, an immunologist who is developing another coronavirus nasal spray vaccine, told NPR in August. "And that immunity is local."
The Path Forward
Aside from possibly being faster and more effective, Codagenix's vaccine would require a smaller dosage than other types of vaccines, making it easier to manufacture in large numbers. As Coleman told BioSpace, it would take just six weeks to produce "hundreds of millions of doses."
It would also be easier to administer, as it wouldn't require a sterile needle or healthcare provider, he added.
Major vaccine maker the Serum Institute of India is already manufacturing Codagenix's vaccine, but the path to deployment is still long — the company plans to launch a Phase 1 human trial in 2020, but thus far, it's only tested the vaccine on animals.
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