Currently, Covid vaccine. But in the future, these vaccines may be available as inhalers or even tablets.
In the white, spacious laboratory at Medicon Village, one of the largest science parks in southern Sweden, chemist Ingemo Andersson is holding a thin plastic inhaler about half the size of a matchbox.
Her team hopes this tiny product can play a big role in the global fight against the coronavirus by allowing people to take powdered versions of future vaccines at home.
“It’s simple and very inexpensive to make,” says Johan Waborg, CEO of the firm that usually makes inhalers for asthma patients.
“You just take off the little plastic overlay, and then the inhaler with the vaccine is activated, and you just put it in your mouth, take a deep breath and exhale.”
Iconovo has partnered with Stockholm-based immunology research company ISR, which has developed a dry powder vaccine against Covid-19.
It uses manufactured Covid-19 virus proteins (unlike Pfizer, Moderna and Astra Zeneca, which use RNA or DNA encoding these proteins) and can withstand temperatures up to 40C.
This is quite different from the storage conditions required for existing publicly available coronavirus vaccines approved by the World Health Organization (WHO), which are all in liquid form.
They must be stored in sturdy glass vials at temperatures as low as -70C and then transferred to a refrigerator, otherwise they lose their effectiveness – the so-called “cold chain.”
“The tipping point is that you can very easily distribute [powdered] vaccine without the cold chain, and it can be administered without the involvement of medical professionals,” says ISR founder Ola Winquist, professor of immunology at Karolinska Institute, one of Sweden’s leading medical universities.
The company is currently testing its vaccines on beta (South Africa) and alpha (U.K.) variants of Covid-19.
The company believes this could be particularly helpful in accelerating vaccine introduction in Africa, where there are currently no domestic vaccine manufacturers, and the warm climate and limited electricity supply have led to serious problems in storing and delivering Covid-19 vaccines before they expire.
There is still some way to go before trials show the full potential of the air-dry ISR vaccine, including whether it can provide the same level of protection as the current list of WHO-approved vaccines.
So far, it has only been tested in mice, although ISR and Iconovo have raised enough money to begin human studies within the next two months.
But the medical community is already optimistic: If powder vaccines like this prove successful, they could revolutionize the global response to the coronavirus pandemic, as well as make it easier to store and distribute vaccines for other diseases.
“It would really open up opportunities for hard-to-reach areas and probably save us from having to carry cool boxes on bicycles and camels,” says Stefan Swartling Peterson, head of global health at Unicef from 2016 to 2020 and now professor of global health transformation at Karolinska.
He compares the potential impact to that of freeze-dried products, which have proven to be “a great way to go to all sorts of fun places not accessible to electricity,” whether for use by medical personnel or just adventurers.
While companies around the world are exploring powder vaccines, Swartling Peterson points to another startup with “promising technology” just a 10-minute walk from Ikonovo.
Ziccum is testing technology designed to air-dry existing or future liquid vaccines in a way that doesn’t limit their effectiveness.
This could make it easier to set up so-called “fill-and-complete” plants in developing countries, allowing them to complete the final stages of vaccine production on their own premises.
Vaccine powder is mixed with a sterile aqueous solution just before immunization and then administered using vials and needles.
But the technology “opens up possibilities for various other types of administration,” from nasal sprays to tablets, says CEO Göran Konradsson.
“There’s a lot of research and development that needs to be done. But in principle, yes.”
A greener alternative
Janssen, which makes the single-dose Covid vaccine approved for use in the U.K. by the drug regulator last month, is already working on a pilot project to analyze Ziccum’s air-drying capabilities.
The pharmaceutical giant has not said whether it is related to coronavirus or other infectious diseases, but a company spokesman said the research is part of a deep focus on “exploring new technologies that could potentially facilitate distribution, administration and compliance” of future vaccines.
Powder technology could also help those afraid of needles and offer a “greener” alternative to liquid vaccines by reducing the electricity needed to power refrigerators and freezers commonly used to store vials of vaccines.
And it could help global vaccine coverage.
“No one is safe until everyone is safe,” Mr. Conradsson says. “You never know what’s going to happen if there’s still a coronavirus circulating somewhere in part of the world.”
“We have to be able to deliver vaccines to populations in all conditions to fight epidemics and pandemics around the world,” agrees Ingrid Kromann, a spokeswoman for the Coalition for Epidemic Preparedness Innovation (Cepi), a global nonprofit organization working to accelerate vaccine development.
She is cautious, saying that powder-based vaccines are still in the early stages of development, and “there is still a lot of work to be done,” such as streamlining and expanding the manufacturing process.
“But if successful, it could help improve access to vaccines, reduce waste and lower the cost of vaccination programs.”