Right in the Nose

Getting that jab—more accurately, a succession of them—has been the main weapon against serious COVID-19 complications since late 2020, but if a University of Maryland researcher succeeds, all those needles could give way to a few quick sniffs.

Xiaoping Zhu, a professor of veterinary medicine, has developed an inhalable coronavirus vaccine that goes directly to work in the parts of the body—like the nose and sinuses—where even those fully up to date with shots can be vulnerable.

“They’re wonderful vaccines that protect people from hospitalization and death, but don’t prevent transmission,” Zhu said. “The nasal vaccine produces an antibody that stays in the upper respiratory tract to stop transmission, which the intramuscular vaccine does not.”

Nasal vaccines were approved this September in both China and India, raising hopes for a more effective way to attack the virus that has killed about 6.5 million people worldwide. The new Chinese vaccine is inhaled as a mist, while the Indian one is administered in drops in the nose.

In a White House summit in June, Dr. Anthony Fauci, chief medical adviser to President Joe Biden and director of the National Institute for Allergy and Infectious Diseases, said nasal vaccines promise “not only to protect against disease, but to protect against acquisition and by acquisition, transmission. And that’s really the holy grail.”

Unlike the Chinese and Indian COVID vaccines, Zhu’s does not rely on live or attenuated virus—making it safe for children and the immunocompromised—but instead uses a patented, engineered protein based on the body’s own mechanism for transporting substances like vaccines across cellular barriers.

Another advantage over current vaccines is that it is stable at room temperature, raising the possibility of mailing vaccines to people’s homes as a primary vaccination or booster to help tamp down outbreaks.

Zhu and colleagues had been developing the method to fight flu, but quickly began adapting it to COVID even before a pandemic was declared. They’ve since conducted two rounds of animal trials, recording high levels of effectiveness. Now, a company Zhu helped found, Transmucosis, is preparing to begin human clinical trials even as Zhu and colleagues work on an improved second-generation vaccine.

It’s time for society to think again about which vaccines to prioritize—and perhaps follow our noses, Zhu suggested.

“We regularly see news stories that COVID is bouncing back again,” he said. “I think this has to do with needing an approach that can stop transmission.”