Covid: Oxford nasal vaccine hopes hit after poor trial results | Coronavirus

Hoping to distribute the Oxford/AstraZeneca Covid vaccine as one nasal spray has been dealt a blow after researchers said it performed poorly in its first clinical trial.

The underwhelming results have prompted researchers to abandon plans to develop the spray in its current form, with hopes now resting on different formulations of the vaccine and more complex delivery devices, such as nebulizers that can deliver drugs deep into the lungs.

“The nasal spray did not work as well in this study as we had hoped,” said Dr. Sandy Douglas, lead researcher on the trial at Oxford’s Jenner Institute. “Delivery of vaccines to the nose and lungs remains a promising approach, but this study suggests that there are likely to be challenges in making nasal sprays a reliable option.”

Scientists have been eager to develop nasal Covid vaccines since the earliest days of the pandemic because they are easier to administer than injections and have the potential to reduce transmission by blocking the virus from entering the body. While existing vaccines are extremely good at preventing severe disease, they are far less effective at slowing the spread of the virus.

The AstraZeneca-funded phase 1 trial tested the effectiveness of the Oxford vaccine when delivered through a simple device that squirts drops into the nose. The trial involved 30 people who had not previously been vaccinated against Covid and 12 more who received the spray as a booster.

While the trial did not raise safety concerns, the researchers found that the spray produced “weak and inconsistent” immune responses, which, according to their report in eBioMedicinewere “insufficient to warrant further development of the current formulation/device combination”.

The researchers measured levels of both mucosal and systemic antibodies against Covid, found in the airways and bloodstream respectively. There was little evidence of mucosal antibodies after one nasal spray. After two doses, a handful of participants had mucosal antibodies, but the levels were only “rarely and modestly” above those seen after Covid infection.

Only a fraction of trial volunteers had detectable systemic antibodies to Covid a month after one or two doses of the spray, and the levels were typically lower than those seen after two jabs of the same vaccine.

The results are particularly disappointing given China and India’s recent approval of two new nasal Covid vaccines. China’s Covid booster, developed by CanSino Biologics in Tianjin, is administered through a nebulizer that turns the liquid vaccine into a mist. India’s vaccine, developed by Bharat Biotech in Hyderabad, is a two-shot primary vaccination delivered via nasal drops.

A possible problem with the Oxford spray is that the majority of the droplets may end up being swallowed and destroyed in the stomach instead of priming the immune system in the nose, throat and lungs. To circumvent this, the vaccine could be given at a higher concentration or reformulated so that more of the liquid sticks to the lining of the airways.

Prof Gordon Dougan, an expert in vaccinology, infection and genomics at the University of Cambridge, said that while the results were not promising, the data were “very useful” for the field because nasal spray vaccines were so technically challenging. “We need better science to understand how to induce immunity through nasal and oral delivery,” he said. “It is still not well understood.

“Nasal vaccines provide the opportunity to induce local immunity, potentially limiting transmission, which will be critical to prevent the emergence of vaccine-escape variants.”

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