Microneedle patches for vaccination in developing countries
Graphical abstract
Section snippets
Barriers to vaccination in developing countries
According to 2014 WHO estimates, 1.5 million children die each year from vaccine-preventable diseases for which there are vaccines recommended by the WHO and 29% of deaths among children 1–59 months old are vaccine preventable [1]. For example, measles vaccine is 97% effective after two doses [2], yet, as of 2010, more than 100,000 children under the age of five died each year from measles, most of whom were unvaccinated children [3].
Vaccines are currently administered in developing countries
Overview of microneedles for vaccination
Microneedle patches (MNPs) have been proposed to improve vaccination in developing countries and are the subject of increasing research in academia and industry (Fig. 1). Microneedles are less than 1 mm long and deliver vaccines to the skin's epidermis and dermis, as compared to conventional injection into deeper tissues in the muscle or subcutaneous space by hypodermic needle and syringe. In a MNP, an array of microneedles is attached to a backing such that it can be applied to the skin by hand
Directions for future research and development
MNPs have great potential to improve vaccination in developing countries, but more work needs to be done to realize this potential. Overall, translation of preclinical studies into clinical trials of MNP vaccination is strongly needed, as is commercial manufacturing that can mass produce MNPs at suitable cost. Additional considerations follow.
- ▪
Increased vaccine effectiveness has been shown for a number of vaccines in animal models, but has not yet been established in human subjects, and the
Conclusions
Many lives could be saved by improved vaccination in developing countries. MNPs offer advantages that could improve vaccination through increased vaccine effectiveness, reduced need for trained healthcare providers, simplified supply chain, reduced risk of sharps, reduced vaccine wastage, no need for vaccine reconstitution and reduced cost of vaccine/vaccination. With continued development, especially translation into clinical trials and advanced manufacturing, MNPs have great potential to
Acknowledgments
The authors would like to thank Darin Zehrung for a critical reading of the manuscript and providing insight and references concerning the barriers to vaccination in developing countries, and Kimberly Haight and Daniel Pardo for their help in gathering information for this review. This work was supported in part by a grant to Mark Prausnitz from the National Institutes of Health (Grant Number - U01EB012495) and an ORISE fellowship to Jaya Arya funded by the Centers for Disease Control and
References (118)
Why children are not vaccinated: a review of the grey literature
Int. Heart
(2012)Efficacy of a monovalent human-bovine (116E) rotavirus vaccine in Indian infants: a randomised, double-blind, placebo-controlled trial
Lancet
(2014)Revolutionary vaccine technology breaks the cold chain
Lancet Infect. Dis.
(2004)One size does not fit all: the impact of primary vaccine container size on vaccine distribution and delivery
Vaccine
(2015)- et al.
Technologies that make administration of vaccines safer
Vaccine
(2004) - et al.
Microneedles for drug and vaccine delivery
Adv. Drug Deliv. Rev.
(2012) - et al.
Intradermal delivery for vaccine dose sparing: overview of current issues
Vaccine
(2013) - et al.
Microneedle technologies for (trans)dermal drug and vaccine delivery
J. Control. Release
(2012) Coated microneedle arrays for transcutaneous delivery of live virus vaccines
J. Control. Release
(2012)Microneedle-mediated transdermal bacteriophage delivery
Eur. J. Pharm. Sci.
(2012)
Bacillus Calmette-Guérin vaccination using a microneedle patch
Vaccine
Vaccine efficacy of transcutaneous immunization with amyloid β using a dissolving microneedle array in a mouse model of Alzheimer's disease
J. Neuroimmunol.
Pocketed microneedles for rapid delivery of a liquid-state botulinum toxin A formulation into human skin
J. Control. Release
Transcutaneous immunization using a dissolving microneedle array protects against tetanus, diphtheria, malaria, and influenza
J. Control. Release
Microneedle arrays for the transcutaneous immunization of diphtheria and influenza in BALB/c mice
J. Control. Release
Formulation and coating of microneedles with inactivated influenza virus to improve vaccine stability and immunogenicity
J. Control. Release
Intradermal influenza vaccine for older adults: a randomized controlled multicenter phase III study
Vaccine
Stability of whole inactivated influenza virus vaccine during coating onto metal microneedles
J. Control. Release
Stability of influenza vaccine coated onto microneedles
Biomaterials
Nanopatch targeted delivery of both antigen and adjuvant to skin synergistically drives enhanced antibody responses
J. Control. Release
Stability kinetics of influenza vaccine coated onto microneedles during drying and storage
Pharm. Res.
Cross-protection by co-immunization with influenza hemagglutinin DNA and inactivated virus vaccine using coated microneedles
J. Control. Release
Influenza subunit vaccine coated microneedle patches elicit comparable immune responses to intramuscular injection in guinea pigs
Vaccine
Dissolvable microneedle patches for the delivery of cell-culture-derived influenza vaccine antigens
J. Pharm. Sci.
Clinical evaluation of a novel microneedle device for intradermal delivery of an influenza vaccine: are all delivery methods the same?
Vaccine
Influenza virus-like particles coated onto microneedles can elicit stimulatory effects on Langerhans cells in human skin
Vaccine
Intradermal and virosomal influenza vaccines for preventing influenza hospitalization in the elderly during the 2011–2012 influenza season: a comparative effectiveness study using the Valencia health care information system
Vaccine
Dose sparing enabled by skin immunization with influenza virus-like particle vaccine using microneedles
J. Control. Release
Improved protection against avian influenza H5N1 virus by a single vaccination with virus-like particles in skin using microneedles
Antivir. Res.
Microneedle mediated intradermal delivery of adjuvanted recombinant HIV-1 CN54gp140 effectively primes mucosal boost inoculations
J. Control. Release
Improved DNA vaccination by skin-targeted delivery using dry-coated densely-packed microprojection arrays
J. Control. Release
DNA vaccine delivery by densely-packed and short microprojection arrays to skin protects against vaginal HSV-2 challenge
Vaccine
Safety and efficacy of novel dermal and epidermal microneedle delivery systems for rabies vaccination in healthy adults
Vaccine
A microneedle patch containing measles vaccine is immunogenic in non-human primates
Vaccine
Inactivated polio vaccination using a microneedle patch is immunogenic in the rhesus macaque
Vaccine
Measles vaccination using a microneedle patch
Vaccine
Global Immunization Data July 2014
Measles Vaccination
GBD Database
Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries
Bull. World Health Organ.
The future of routine immunization in the developing world: challenges and opportunities
Glo. Health: Sci. Pract.
Evaluation of house-to-house versus fixed-site oral poliovirus vaccine delivery strategies in a mass immunization campaign in Egypt
Bull. World Health Organ.
Drivers of routine immunization coverage improvement in Africa: findings from district-level case studies
Health Policy Plan.
New strategies for the elimination of polio from India
Science
Effectiveness of measles vaccination and vitamin A treatment
Int. J. Epidemiol.
Effect of human rotavirus vaccine on severe diarrhea in African infants
N. Engl. J. Med.
Safety and efficacy of a pentavalent human–bovine (WC3) reassortant rotavirus vaccine
N. Engl. J. Med.
Polio eradication. Efficacy of inactivated poliovirus vaccine in India
Science (New York, N.Y.)
Smallpox and its eradication
Polio Eradication & Endgame Strategic Plan 2013–2018
Cited by (149)
Hypericin emulsomes combined with hollow microneedles as a non-invasive photodynamic platform for rheumatoid arthritis treatment
2024, International Journal of PharmaceuticsFourth dose of microneedle array patch of SARS-CoV-2 S1 protein subunit vaccine elicits robust long-lasting humoral responses in mice
2024, International ImmunopharmacologyPromising role of microneedles in therapeutic and biomedical applications
2024, Journal of Drug Delivery Science and TechnologyRecent advances in the preparation of microneedle patches for interstitial fluid extraction and analysis
2023, Microchemical JournalBiomaterial-based delivery platforms for transdermal immunotherapy
2023, Biomedicine and Pharmacotherapy