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China and India approve nasal COVID vaccines — are they a game changer?

Scientists hope the immunizations, delivered through the nose or mouth, will prevent even mild cases of illness.
  1. Emily Waltz
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A display of the adenovirus type-5 vector-based COVID-19 vaccine sits on a white table

CanSino Biologics’ inhaled vaccine has the same ingredients as the company’s COVID-19 shot that is already available in China.Credit: Chen Yuancai/VCG/Getty

Two needle-free COVID-19 vaccines that are delivered through the nose or mouth have been approved for use in China and India. China’s new vaccine, announced on Sunday, is inhaled through the nose and mouth as an aerosolized mist, and India’s, announced on Tuesday, is administered as drops in the nose.

These mucosal vaccines target thin mucous membranes that line the nose, mouth and lungs. By prompting immune responses where SARS-CoV-2 first enters the body, mucosal vaccines could, in theory, prevent even mild cases of illness and block transmission to other people — something COVID-19 shots have been unable to do. Vaccines that produce sterilizing immunity would be game changing for the pandemic.

“These approvals validate the need for mucosal vaccines,” says Marty Moore, co-founder of Meissa Vaccines in Redwood City, California, which is developing a COVID-19 immunization that is delivered through the nose. “That’s the direction we need to go globally, and the United States needs to catch up.”

The regulatory nods from China and India bring the number of approved COVID-19 mucosal vaccines in the world to four, including one already approved in Iran and another in Russia. More than 100 mucosal vaccines against the disease are in development globally, and about 20 have reached clinical trials in humans, according to Airfinity, a health-analytics company in London. Delivery methods include sprays, drops, aerosols and pills.

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Nature 609, 450 (2022)

doi: https://doi.org/10.1038/d41586-022-02851-0

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