Day: October 29, 2024

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Dr. Casey

Spooked by Needles? The Future of Needle-Free Vaccines Could Be a Treat!

Given we are in the Halloween season, I thought it would be fitting to talk about an aspect of vaccines that some people find “scary” but might not be in the near future. One of the most common reasons I hear why people are hesitant to get vaccines is because they are afraid of needles. That might sound childish to some, and I know people who have the attitude that getting a shot is not a big deal, that people with this fear need to “get over it.” But it is a very real thing. Did you know there is even a name for it? Trypanophobia is an intense fear of needles, and in severe cases, people with this fear can put themselves at great risk by not getting vaccines or even medical treatment when needed. To be very clear, I am not talking about a dislike of needles. I think most people dislike needles, especially being poked with them. Rather, here I am describing a true, irrational fear of needles that causes anxiety, panic attacks, even fainting, and other consequences. However, for those who have a genuine fear of needles and those who simply don’t like them, there could be good news in the pretty near future…

Another way to vaccinate

Vaccines for several diseases are currently undergoing testing — that can be delivered through a person’s nose! So far, early trials in the United States have had very promising results. For example, trials of two of these nasal spray vaccines have initiated multiple immune system responses against the virus that causes COVID. Results like these have researchers optimistic that there could be an approved COVID vaccine nasal spray available by even 2027! Some other countries, like China and India, are already using approved COVID nasal vaccines because they prioritized developing these types of vaccines during the pandemic. In the U.S. and many other wealthy countries, we chose to remain with our tried-and-true methods of arm injections. Many of the most recent efforts in nasal vaccines in the U.S. have focused on COVID-causing viruses, but nasal vaccines could also be effective against the flu, respiratory syncytial virus (RSV), and others.

Yes, a handful of nasal vaccines have already been developed in the U.S., but they have had a variety of issues. Maybe the most well-known of these is FluMist (a flu vaccine), but it never became a leading option because its effectiveness was widely debated. What is different about the ones being developed now? They use new technology that can produce stronger immune responses and is safer than the medicines used previously.

Could these vaccines be even better than traditional methods?

It is very possible. Researchers say it is possible that vaccines delivered through nasal spray or possibly inhaling through the mouth can offer stronger (and quicker) protection against respiratory viruses than our long-standing way of injecting into the arm. Why is that? When introduced to the body through inhaling (through nose or mouth), these vaccines stimulate part of the immune system that has adapted specifically for fast, comprehensive protection from airborne germs. This could help an infection from really setting in by fighting it off quickly and completely. While an injected vaccine is good at keeping a disease from spreading, it doesn’t stop the initial infection. A nasal spray, however, is much more effective at this because sprays are targeted where many viruses first enter the body — the nose and nasal tissue (called mucosa, which is a thick, multi-layered tissue that produces mucus, full of immune cells, to fight infections). So mucosal immunity gets your immune system ready to fight off infection, where it starts and offers three different types of protection, while shots provide two types.

Additionally, attacking the invading virus in the nose may prevent it from spreading to other people because it would lower the amount of virus the infected person inhales. Another positive consideration is that, by the spray limiting how far into the body the infection progresses, it is possible that it could prevent long COVID, the chronic, sometimes debilitating condition that so many individuals have faced in the aftermath of infection with COVID. Another pros of these vaccines? They should be less expensive and more convenient to transport to poor areas than the injections we use now (which require rigid, specific temperature regulations, etc.).

Regardless of how it is delivered (through a shot or a spray), developing any new vaccine is extremely complicated and challenging. Researchers have to find that perfect balance where they elicit an immune response intense enough to protect the body from future infections but not too strong so that it harms the individual. There is a delicate balance of individuals’ immune systems, exposures, various cell stimulations, and a host of other factors that will go into fine-tuning these sprays before they can be thoroughly tested and approved by the U.S. Food and Drug Administration. If you are interested in the nuts and bolts and very nitty-gritty details of immunology, I will include a couple of resources below where you can explore more thorough explanations of T cells and spike proteins and all of that good stuff related to this topic, and you can find plenty out there — it is a hot topic!

But for now, I hope some people might be a little less “spooked” knowing that the future of vaccination may be one free of needles…

Other Questions?

I am always interested to hear from you, to answer your questions and even have just interesting conversation! I love the engagement from readers, and all of you are fantastic. Also, feel free to send in topic suggestions if there is anything related to vaccines or similar that you’d like me to take a deeper dive into. I would love to hear what you are interested in reading more about!

Be Well; Be Kind,

Dr. Casey

Want to Learn More?

For a fairly brief discussion about the potential future of COVID-19 nasal vaccines, here is a pretty concise overview: https://abcnews.go.com/Health/clinical-trial-begins-generation-nasal-covid-19-vaccine/story?id=111605093

The National Institutes of Health (NIH) began trials of a nasal COVID-19 vaccine back in July of this year. This link will take you to a press release from when those trials first started and gives some information about the trials themselves: https://www.nih.gov/news-events/news-releases/nih-sponsored-trial-nasal-covid-19-vaccine-opens

This is a lengthier article from Scientific American, but contains a lot of detailed information and is great for anyone who wants to read about the in-depth mechanisms related to immunology and other technical details (particularly later in the article): https://www.scientificamerican.com/article/new-nasal-vaccines-offer-stronger-protection-from-covid-flu-and-more-no-needle-needed/

You can find another article (and briefer, if you are looking for more of a quick read) that discusses the potential greater effectiveness that nasal vaccine may have in stopping COVID-19 transmission compared to traditional injections by individuals from the Washington University School of Medicine here: https://scitechdaily.com/better-than-traditional-shots-new-nasal-vaccine-halts-covid-19-transmission/

If you are interested in learning more about what I described quite briefly, above regarding nasal immunity, etc., this article is fantastic. It is all about the immune cells of the nose, specifically, and how their effectiveness could be a great advantage to protecting us: https://www.nature.com/articles/d41586-024-02503-5

Bird Flu 101: What Parents Need to Know to Keep Kids Safe

The United States has seen an increase in cases of H5 bird flu, also known as avian influenza. This disease has gained attention due to its spread across wild birds, poultry, dairy cattle, and even a small number of human cases in the U.S. While there are currently no recorded cases in the state of Tennessee, it’s important for families to stay informed about the situation, particularly regarding the safety of children.

What is H5 Bird Flu?

H5 bird flu is a type of influenza that affects birds but can occasionally spread to other animals, including dairy cattle and humans. Since early 2024, the U.S. has seen several outbreaks in poultry flocks, widespread infections in wild birds, and a growing number of cases in dairy herds across several states. There hasn’t been human-to-human transmission of the H5 flu, but the virus has affected workers in the dairy and poultry industries because of their direct exposure to infected animals.

As of October 2024, there have been 27 reported human cases of H5 bird flu in the U.S., with 16 of those cases confirmed to be the H5N1 strain, which can potentially cause severe illness in humans. Thankfully, none of these cases have been in Tennessee, but the situation could turn if people aren’t cautious.

How Can It Affect Children?

While children have not been confirmed as infected so far, they are at a higher risk due to their developing immune systems. The chances of getting infected increase if a child spends time on farms, lives near areas with wild bird populations or comes into contact with poultry or dairy cattle.

Parents should monitor their children’s interactions with wild birds, domestic animals, and potentially contaminated surfaces, especially if they visit rural areas or farms. The CDC advises avoiding direct contact with birds and animals that may be infected and practicing proper hygiene, such as handwashing, after being outdoors.

If your child does come into contact with an infected animal, some common symptoms will appear:

● Fever

● Cough

● Sore throat

● Muscle aches

● Shortness of breath

In severe cases, bird flu can lead to complications such as acute respiratory distress syndrome, organ failure, or even death. Parents should seek medical help if their child shows any symptoms, particularly after possible exposure to birds.

Vaccines Part in Protecting Children

While no routine vaccine for bird flu is available to the general public, specific vaccines have been developed for strains like H5N1, which are used in outbreak situations or for high-risk populations. Vaccination is essential for bird flu and preventing the spread of other diseases during outbreaks.

Researchers are continuously developing new vaccines that could provide broader protection against bird flu viruses. Parents can help strengthen their children’s immune systems by getting the seasonal flu vaccine. This precautionary measure will reduce the risk of seasonal flu and potential complications if they are exposed to other viruses like bird flu.

Why is All This Important to Know?

It is important for parents to read and understand the current situation, as it will provide essential knowledge to protect their children from potential exposure to H5 bird flu. While the current public health risk is low, simple preventive measures — such as avoiding contact with wild birds, handling food safely, and practicing good hygiene — can reduce the chances of infection.

Parents can also help protect their children by staying aware of how the virus spreads, especially if they live in rural areas, visit farms, or are near wildlife.

Should We Be Worried?

For now, the risk to the general public, including children, remains low. Continuous surveillance data shows no unusual flu activity, and there has been no evidence of person-to-person spread of H5N1. In Tennessee’s agricultural community, managing animal health is crucial. Tennessee is not only one of the top beef-producing states; its agricultural production represented 4.4 percent of the total state GDP in 2022. Families need to do what they can to ensure this disease doesn’t spread on their farms and through their family groups.

Sources:

CDC: H5 Bird Flu: Current Situation

U.S. Food and Drug Administration: Updates on Highly Pathogenic Avian Influenza (HPAI)

U.S. Department of Agriculture: Avian Disease

University of Arkansas System Division of Agriculture: Economic Impact of Agriculture

Rising Whooping Cough Cases in the U.S.: Essential Tips for Tennesseans to Stay Protected

We are in the midst of the respiratory virus season, and health officials are already sounding the alarm about the number of whooping cough cases across the United States. New data from the Centers for Disease Control and Prevention (CDC) reveals an explosion in cases, up fivefold compared to last year. As of October 12, 2024, have been 18,506 cases reported nationwide, a significant jump from the 3,382 cases reported by this time last year. Like many other states, Tennessee is seeing its share of cases rise, with some reports indicating that the state currently has around 200 cases compared to around 60 last year. This rise in cases concerns children, as the infection can spread quickly from one to many. That’s why it’s important to understand this infection and how to prevent it.

What is Whooping Cough?

Whooping cough, known medically as pertussis, is a highly contagious respiratory infection that starts with symptoms similar to a mild cold, such as a runny nose, low-grade fever, and mild cough. The bacteria release toxins, which damage the cilia and cause airways to swell. Once contracted, symptoms may worsen after a week or two, often leading to intense, uncontrollable coughing fits. These fits can be so forceful that they may lead to vomiting or even fractured ribs, making breathing difficult and often resulting in the distinct “whooping” sound that follows each coughing spasm.

How it spreads

Whooping cough spreads through respiratory droplets. Tiny droplets containing the bacteria become airborne when someone with the infection coughs, sneezes, or talks. If people breathe in these droplets, they can become infected. It’s especially contagious in the early stages, often before severe symptoms develop, making it easy for the infection to spread unnoticed.

Why is Whooping Cough So Dangerous?

For adults, a whooping cough infection is usually less serious. While it can be unpleasant and frustrating, it typically doesn’t result in significant health risks. However, infants under one year old are at the highest risk of complications if they catch this infection. Their immune systems are not fully developed, and if they haven’t received all recommended vaccines, they’re more likely to develop serious complications like pneumonia or encephalopathy (a brain disorder). Some infants don’t develop the typical cough and instead experience severe breathing difficulties, which is why early diagnosis is essential for their health.

Why Are Cases Rising?

Over the past few years, we’ve seen fewer cases of pertussis, or whooping cough, likely due to the COVID-19 pandemic and the measures taken to limit transmission. Currently, the U.S. is beginning to see a return to pre-pandemic patterns, with typically over 10,000 cases reported each year. Because this infection spreads through airborne bacteria, crowded places such as schools, daycare centers, and hospitals can be hotspots for transmission.

The infection is known to spread without symptoms, especially in adults and adolescents, who may unknowingly infect younger, more vulnerable family members. Older siblings, parents, and caregivers are often a source of infection for children who have not yet been fully vaccinated.

How to Protect Your Family

Vaccination is the best way to prevent this infection from spreading to you and your children. The CDC recommends that:

● Infants and children receive the DTaP vaccine, which covers diphtheria, tetanus, and pertussis, in doses beginning at two months.

● Adolescents and adults get the Tdap booster, particularly if they are around young children or work in environments where the infection can spread easily.

If you have any questions about the vaccine, it is best to set up an appointment with your healthcare provider so they can provide you with the most up-to-date information.

Key Takeaways for Tennesseans

Tennessee, like many other states, is experiencing this significant rise. If this infection spreads even further, it can result in school closures and strain the state’s healthcare system. All families need to take proactive steps to ensure vaccinations are current and they recognize the symptoms of this infection. If someone in your household develops a runny nose, cough, or fever, consult a healthcare provider to determine whether testing or treatment is needed.

Tennessee is just beginning its respiratory virus season, making now the best time to promote awareness and prevention. Stay informed, keep your vaccinations up-to-date, and help prevent whooping cough from impacting Tennessee’s communities more.

Sources:

CDC: Whooping Cough (Pertussis)

CDC: Weekly Cases of Notifiable Disease

Mayo Clinic: Whooping Cough

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