(C) PLOS One This story was originally published by PLOS One and is unaltered. . . . . . . . . . . Next Generation Covid Vaccine Update: Intranasal & Other Mucosal Vaxes [1] [] Date: 2022-07-31 Mucosal vaccines are aimed at the mucosal membranes in our airways—the wet linings starting inside our noses and mouths. Like the coronavirus itself, they get into our bodies through the mucosal membranes in our airways – the wet linings of our nose, mouth, throat, and lungs. They can be sprays, drops, or tablets. The goal is to set up a first line of defence in those membranes. That’s called mucosal immunity, backed up by systemic immunity – the antibodies and immunity-driving cells circulating in our blood. (Mucosal immunity is often called sterilizing immunity.) Some of these vaccines aim to be the total package, providing mucosal and systemic immunity, while others aim to be boosters only after shots—either an injected version of the same vaccine, or another one. In a recent editorial by Eric Topol and Akiko Iwasaki, they wrote of the pandemic, “The variant-chasing strategy of an Omicron BA.1 specific or multivalent vaccine, which took more than 7 months to develop and validate after BA.1 was found to be spreading in South Africa, is not likely to provide a remedy.” Topol and Iwasaki argued that it wasn’t enough to rely only on intramuscular shots alone—we need tissue-level mucosal immunity: “The only path to achieve this will be via nasal or orally administered vaccines.” Mucosal vaccines also have the advantage of being easier to store, distribute, and use. They’re not easier to develop, though. One manufacturer, Altimmune, stopped work on theirs after phase 1 results came in, and another vaccine worked well in animals when injected, but not intranasally. It’s been 4 months since my first post on mucosal vaccines. I had found 73 that had released preclinical results and/or had started or registered clinical trials, not counting Altimmune’s: there are 87 in this post. There is still only one rolled out—the Razi Cov Pars vaccine in Iran—and there are still only another 4 that have reached phase 3 trials for efficacy. But several vaccines have advanced. You can see lists of all the vaccines below my summary of the news. (For details on how I track Covid vaccine progress, see my background post. Notes on my collection of studies are here. The collection is in a public Zotero library you can dig into here.) First up, there are new clinical trial reports for 3 vaccines, one from the USA (Vaxart) and the others from China: Vaxart’s had previously only had a press release for clinical results of their oral vaccine. They have now published a preprint of the results. Vaxart is planning a human challenge trial, where a small number of people are given the virus to test the efficacy of the vaccine. That would fast-forward final results. Vaxart has commissioned a company to develop a version of Omicron to use in that trial. Beijing Wantai Biological’s influenza viral vector vaccine: new results for their phase 1 and 2 trials were published, and there are preclinical results in mice and ferrets. This is the vaccine with the largest phase 3 trial underway, an international trial of 2 doses for 40,000 people. CanSino’s adenoviral vector vaccine: there are full results now for the phase 1 and 2 trial of an aerosolized booster delivered orally after CoronaVac injection. CanSino also registered another phase 3 trial, this time for an Omicron-adapted aerosolized booster, with a planned starting date of August 1. There’s some news on Razi Cov Pars. That’s a 3-dose protein subunit vaccine with 2 injections plus an intranasal booster. Previously, the only results I could find were in a press release for the first participants in the phase 3 trial. There are now preclinical results for this vaccine. Finally, some news on the Medigen protein subunit vaccine. Medigen is a manufacturer in Taiwan, and their injected Covid vaccine has authorization in Taiwan, Paraguay, and Somaliland. The injected version of this vaccine is to be evaluated by the Australian drug regulator. In early July, preclinical results for an intranasal booster after 2 shots of their vaccine were published. In late July, they released a preprint of the phase 3 trial results for the injected version. Addenda Mucosal vaccines with clinical results (Not included below: the intranasal vax from AltImmune that was discontinued after phase 1 in June 2021.) Other mucosal vaccines – with preclinical results and/or in clinical trial * Indicates a manufacturer that has already rolled out a Covid vaccine in at least one country ~~~~ For details on how I track Covid vaccine progress, see my background post. Notes on my collection of studies are here. The collection is in a public Zotero library you can dig into here. All my Absolutely Maybe Covid-19 vaccine posts All previous Covid-19 posts at Absolutely Maybe My posts at The Atlantic, at WIRED, and debunking posts at my personal website. Disclosures: My interest in Covid-19 vaccine trials is as a person worried about the virus, as my son is immunocompromised: I have no financial or professional interest in the vaccines. I have worked for an institute of the NIH in the past, but not the one working on vaccines (NIAID). More about me. The cartoons are my own (CC BY-NC-ND license). (More cartoons at Statistically Funny.) [END] --- [1] Url: https://absolutelymaybe.plos.org/2022/07/31/next-generation-covid-vaccine-update-intranasal-other-mucosal-vaxes/ Published and (C) by PLOS One Content appears here under this condition or license: Creative Commons - Attribution BY 4.0. via Magical.Fish Gopher News Feeds: gopher://magical.fish/1/feeds/news/plosone/