China approves world’s first nasal COVID-19 vaccine booster

The inhaled booster is the first approved alternative to an injectable COVID-19 vaccine.

The H1N1 nasal vaccine pictured here, has been available for over a decade. (Photo by Joe Raedle/Getty Images)

Good news for those with trypanophobia, or fear of needles. Regulators in China have approved a COVID-19 vaccine booster nasal spray, providing those virus-fighting antibodies without the jab of a needle.

According to vaccine maker CanSino, one breath of their vaccine mist provides protection against COVID-19. The dose will be used as a booster and is the first approved alternative to injectable COVID-19 vaccines. The inhaled vaccine has the same ingredients as the intramuscular vaccine in China, but uses a nebulizer machine to turn it from a liquid into an easily inhaled aerosol spray.

Data from the World Health Organization (WHO) shows that a single-dose of the CanSino shot is about 92 percent effective at preventing severe disease and about 58 percent effective at preventing COVID-19 entirely. Clinical trials that used the mist as a booster (after a single injected dose of the vaccine) showed that the mist is about as effective as the two-dose vaccine that’s widely used elsewhere in Asia and in other countries.

[Related: Omicron boosters are the future of COVID vaccines in the US.]

CanSino’s formulation contains pieces of COVID-19’s genetic material so the body can recognize the virus, similar to how the vaccines in the United States work. However, this vaccine uses a benign version of the common cold virus to carry information about the virus, instead of introducing the material directly like the Moderna or Pfizer vaccines do. “It’s completely possible to determine efficacy,” said Sandy Douglas, a is chief investigator of an intranasal COVID-19 vaccines being developed by the University of Oxford, in an interview with Nature. “It’s just a bit trickier than testing first-generation intramuscular vaccines in an infection-naive population,” he added.

This nasal vaccine is one of more than 100 nasal (or mucosal) vaccines currently in development around the world, with 20 of them currently in clinical trials. In theory, inhaled vaccines could prime the immune cells in in the nose and mouth and quickly prevent the virus spread. According to CanSino’s press release, this is how their nasal mist works: by stopping the virus in its tracks where it typically enters the body.

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FluMist intranasal vaccine is one of the more common mucosal vaccines that is typically available in pediatricians’ offices during flu season. These inhaled vaccines provide a needle-free alternative for both children and adults. Nasal vaccines have been available for the H1N1 (aka swine flu) strain of influenza for over a decade.

However, some evidence from past flu seasons has shown that the mist doesn’t always achieve the same level of efficacy as a shot. The data is not clear on whether or not that same efficacy gap will exist with new inhaled COVID boosters.