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Will a Shot Be the Only Way to Get a COVID-19 Vaccine?

doctor explaining instructions to child patient

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Key Takeaways

  • A shot is currently the only way to get a COVID-19 vaccine.
  • Oral and nasal vaccines are in testing phases and could be available publicly by 2022.
  • Providing comfort and support to your child can help get them through a shot.

As the world watches the rollout of the first phase of the COVID-19 vaccines, many parents may be wondering: Is there another way for my child to be protected, without having to receive an injection?

According to the Milken Institute COVID-19 Treatment and Vaccine Tracker, there are over 260 vaccines currently in development. Oral and intranasal vaccines are currently in trial phases for use in the U.S., but with injectable vaccination being the most familiar to vaccine developers, this technology is leading the way. Currently, the CDC recommends COVID-19 vaccination for anyone ages 12 and older.

Injectable Vaccine 

Front-runner injectable COVID-19 vaccines, such as the Pfizer-BioNTech and Moderna vaccines currently being distributed, have led the way because the technology is so well understood by vaccine manufacturers. The urgency of this vaccine means that familiar technologies are the fastest way to produce results.

Zhengrong Cui, PhD

Injectable vaccines are relatively more straightforward to develop.

— Zhengrong Cui, PhD

“There has been a persistent interest in developing more vaccines that are given by a mucosal route," says Zhengrong Cui, PhD, professor of molecular pharmaceutics and drug delivery at the University of Texas. "However, injectable vaccines are relatively more straightforward to develop.”

The injectable route also ensures that the vaccine is secured in the body to take effect. The sneezing and vomiting responses of the body may risk the ejection of mucosal vaccines.

On the downside, injectable vaccines have less thermostability (the ability to maintain efficacy at different temperatures), needles pose a risk for injury to health care workers, and injections cause pain. This pain and fear of needles alone may prevent some members of the public from opting for vaccination.

Additionally, this technology only offers systemic immunity, meaning that an immune response is only mounted once the virus enters the bloodstream. Although systemic immunity is needed, the oral and nasal routes claim to offer systemic immunity in addition to mucosal immunity.

Mucosal Vaccine

Mucosal vaccines combine both oral and intranasal vaccines under this umbrella term. The reason is that both vaccines work on inducing a mucosal immune response as well as a systemic immune response.

A mucosal immune response means that when the virus enters the nasal cavity or mouth, the immune cells of the mucosa (the lining of the nose and mouth) will mount a defense locally.

Sarah Browne, MD, infectious diseases specialist and senior director of vaccine development at Altimmune, explains that even after an injectable vaccine, people can still carry the virus in their noses. “Many people do not realize that they may need to wear masks after vaccination," she says. "While they may be protected against disease, they may still carry [the] virus in their nose.”

However, she says, “a vaccine given intranasally could sterilize the nose and block transmission to others. This will help kids go back to school and lower [the] risk of the infection spreading between school friends, teachers, or bringing the virus home to older, more vulnerable household members."

Intranasal Vaccine

Browne is currently working on an intranasal COVID-19 vaccine. The company is aiming to advance the vaccine to Phase 3 clinical trials in 2021, with a hopeful rollout of the vaccine in 2022.

Sarah Browne, MD

The vaccine is delivered as a small spray of liquid delivered as a mist into each nostril and is taken up by immune cells that are present in the nasal mucosa.

— Sarah Browne, MD

Although the vaccine is still undergoing clinical trials, Browne is optimistic that a single dose of intranasal COVID-19 vaccine could provide a minimum of 12 months of immunity.

Oral Vaccine

Stabilitech is one company currently trialing an oral COVID-19 vaccine. Similar to intranasal vaccines, the company claims that this route of administration offers mucosal immunity and systemic immunity, thermostability, and wider acceptance in the community.

For the adult population, the idea of taking a capsule versus getting a needle may indeed be more appealing. But it should be pointed out that this may not be suitable for adults with pre-existing concerns involving gut problems or absorption issues. Additionally, for most children, swallowing a capsule is not only impractical, but poses a choking risk for younger children.

How to Help Children Through the Vaccine

In 2021, injectable vaccines are likely to be the only available option for COVID-19 vaccines. Although 2022 may see the availability of an intranasal vaccine, many parents understand that even a spray of fluid in the nose can be distressing for many children.

Vanessa Anderson, a specialist child health nurse, provides tips for parents and caregivers to help their children through any vaccination.

  • Be honest with your child. Tell them it will sting a little, but it is quick.
  • Talk about why vaccination is important a few days prior to the appointment. This is especially useful with older children who can see what effect COVID-19 is having around us. Remember to explain it in terms your child will understand, depending on their age.
  • Allow your child to bring a special toy or blanket with them for comfort, and be available for cuddles and reassurance.
  • Be available to hold your child on your lap to allow the provider to give the injection (or nasal vaccine) safely.
  • Consider doing something fun afterward as a treat, something your child can look forward to. 
  • See a doctor or nurse that you are familiar with, or that is trained in working with kids, if possible.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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  1. Wang J, Peng Y, Xu H, Cui Z, Williams RO. The COVID-19 Vaccine race: Challenges and opportunities in vaccine formulation. AAPS PharmSciTech. 2020;21(6):1-12. doi:10.1208/s12249-020-01744-7