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A Sublingual Flu Vaccine?

Summary and Comment |
February 13, 2008

A Sublingual Flu Vaccine?

  1. Richard T. Ellison III, MD

Both formalin-inactivated and live influenza virus, administered sublingually, appeared protective in a mouse model.

  1. Richard T. Ellison III, MD

Who wants to get a shot? Detailed epidemiologic analyses are not needed to determine that fear of injections is a limiting factor in vaccine acceptance and that use of alternative delivery systems could greatly improve immunization rates. A multinational team of researchers recently used a mouse model to investigate the immunogenicity of sublingually administered influenza virus.

Mice were immunized sublingually twice, 2 weeks apart, with formalin-inactivated influenza virus (A/PR/8; H1N1) either alone or together with a mucosal adjuvant. Both preparations, compared with a saline control vaccine, induced significant levels of systemic IgG and mucosal secretory IgA (SIgA); the preparation with adjuvant was also associated with increases in interferon-γ–producing CD4 and CD8 cells. Both inactivated preparations provided protection against a lethal intranasal challenge with A/PR/8 virus 2 weeks after the final immunization (80% survival with formalin-inactivated virus alone; 100% survival with inactivated virus plus adjuvant). Sublingual administration of a single dose of live A/PR/8 virus induced IgG and SIgA responses and protected the mice against a lethal challenge 3 days later with A/PR/8 virus. Sublingual administration of live A/Chile (H1N1) or A/Philippines (H3N2) virus induced protection against a lethal challenge 4 weeks later with A/PR/8 virus.

Comment

Much work is needed before a trial of sublingual influenza vaccines can be conducted in humans. However, such vaccines should improve patient acceptance and, because they stimulate both systemic and mucosal immunity, might be more effective than the traditional intramuscular preparations.

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