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Saud B, Adhikari S. Re-evaluating polio vaccination strategies in Nepal: transitioning from OPV to fIPV for sustained immunity. THE LANCET. INFECTIOUS DISEASES 2024:S1473-3099(24)00515-2. [PMID: 39181145 DOI: 10.1016/s1473-3099(24)00515-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/01/2024] [Accepted: 08/06/2024] [Indexed: 08/27/2024]
Affiliation(s)
- Bhuvan Saud
- Department of Medical Laboratory Technology, Janamaitri Foundation Institute of Health Sciences, Lalitpur 44700, Nepal.
| | - Saroj Adhikari
- Government of Nepal, Ministry of Health and Population, Kathmandu, Nepal
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Sutter RW, Eisenhawer M, Molodecky NA, Verma H, Okayasu H. Inactivated Poliovirus Vaccine: Recent Developments and the Tortuous Path to Global Acceptance. Pathogens 2024; 13:224. [PMID: 38535567 PMCID: PMC10974833 DOI: 10.3390/pathogens13030224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 04/21/2024] Open
Abstract
Inactivated poliovirus vaccine (IPV), available since 1955, became the first vaccine to be used to protect against poliomyelitis. While the immunogenicity of IPV to prevent paralytic poliomyelitis continues to be irrefutable, its requirement for strong containment (due to large quantities of live virus used in the manufacturing process), perceived lack of ability to induce intestinal mucosal immunity, high cost and increased complexity to administer compared to oral polio vaccine (OPV), have limited its use in the global efforts to eradicate poliomyelitis. In order to harvest the full potential of IPV, a program of work has been carried out by the Global Polio Eradication Initiative (GPEI) over the past two decades that has focused on: (1) increasing the scientific knowledge base of IPV; (2) translating new insights and evidence into programmatic action; (3) expanding the IPV manufacturing infrastructure for global demand; and (4) continuing to pursue an ambitious research program to develop more immunogenic and safer-to-produce vaccines. While the knowledge base of IPV continues to expand, further research and product development are necessary to ensure that the program priorities are met (e.g., non-infectious production through virus-like particles, non-transmissible vaccine inducing humoral and intestinal mucosal immunity and new methods for house-to-house administration through micro-needle patches and jet injectors), the discussions have largely moved from whether to how to use this vaccine most effectively. In this review, we summarize recent developments on expanding the science base of IPV and provide insight into policy development and the expansion of IPV manufacturing and production, and finally we provide an update on the current priorities.
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Affiliation(s)
| | - Martin Eisenhawer
- Polio Eradication Department, World Health Organization, 1211 Geneva, Switzerland; (M.E.); (H.V.)
| | - Natalia A. Molodecky
- Polio Surge Capacity Support Program, The Task Force for Global Health, Inc., Decatur, GE 30030, USA;
| | - Harish Verma
- Polio Eradication Department, World Health Organization, 1211 Geneva, Switzerland; (M.E.); (H.V.)
| | - Hiromasa Okayasu
- Division of Healthy Environments and Population, Regional Office for the Western Pacific, World Health Organization, Manila 1000, Philippines
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Meyer BK, Nahas D, An M, Danziger A, Smith J, Patel M, Lin SA, Gleason A, Cox K, Capen R, Howe J, Bett A. Evaluation of luciferase and prefusion-stabilized F protein from respiratory syncytial virus mRNA/LNPs in pre-clinical models using jet delivery compared to needle and syringe. Vaccine X 2024; 16:100420. [PMID: 38192619 PMCID: PMC10772402 DOI: 10.1016/j.jvacx.2023.100420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/15/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024] Open
Abstract
Described here is the evaluation of a luciferase (luc) and respiratory syncytial virus (RSV) messenger RNA / lipid nanoparticle (mRNA/LNP) vaccine using a Needle-free Injection System, Tropis®, from PharmaJet® (Golden, Colorado USA). Needle-free jet delivery offers an alternative to needle/syringe. To perform this assessment, compatibility studies with Tropis were first performed with a luc mRNA/LNP and compared to needle/syringe. Although minor changes in particle size and encapsulation efficiency were observed when using Tropis on the benchtop, in vitro luciferase activity remained the same. Next, the luc mRNA/LNP was administered to rats intramuscularly using Tropis or needle/syringe and tracking of the injection and distribution was performed. Lastly, an mRNA encoding a prefusion-stabilized F protein from RSV was delivered intramuscularly using both Tropis and needle/syringe at 1 and 5 mcg mRNA. An equivalent IgG response was observed using both Tropis and needle/syringe. The cell mediated immune (CMI) response was also evaluated, and responses to RSV-F were detected from animals immunized with needle/syringe at all dose levels, and from the animals immunized with Tropis in the 5 and 25 ug groups. These results indicated that delivery of mRNA/LNPs with Tropis is a potential means of administration and an alternative to needle/syringe.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kara Cox
- Merck & Co., Inc., West Point, PA, USA
| | | | - John Howe
- Merck & Co., Inc., West Point, PA, USA
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Biya O, Manu JI, Forbi JC, wa Nganda G, Ikwe H, Sule A, Edukugho A, Shehu A, Aliyu N, Barau ND, Wiesen E, Sutter RW. Notes from the Field: House-to-House Campaign Administration of Inactivated Poliovirus Vaccine - Sokoto State, Nigeria, November 2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:1290-1291. [PMID: 37991997 PMCID: PMC10685385 DOI: 10.15585/mmwr.mm7247a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
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Peng S, Tu HF, Cheng M, Hu MH, Tsai HL, Tsai YC, Koenig C, Brayton C, Wang H, Chang YN, Arend RC, Levinson K, Roden RBS, Wu TC, Hung CF. Immune responses, therapeutic anti-tumor effects, and tolerability upon therapeutic HPV16/18 E6/E7 DNA vaccination via needle-free biojector. mBio 2023; 14:e0212123. [PMID: 37791765 PMCID: PMC10653862 DOI: 10.1128/mbio.02121-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/15/2023] [Indexed: 10/05/2023] Open
Abstract
IMPORTANCE Respectively, HPV16 and HPV18 cause 50% and 20% of cervical cancer cases globally. Viral proteins E6 and E7 are obligate drivers of oncogenic transformation. We recently developed a candidate therapeutic DNA vaccine, pBI-11, that targets HPV16 and HPV18 E6 and E7. Single-site intramuscular delivery of pBI-11 via a needle elicited therapeutic anti-tumor effects in mice and is now being tested in high-risk human papillomavirus+ head and neck cancer patients (NCT05799144). Needle-free biojectors such as the Tropis device show promise due to ease of administration, high patient acceptability, and the possibility of improved delivery. For example, vaccination of patients with the ZyCoV-D DNA vaccine using the Tropis device is effective against COVID19, well tolerated, and licensed. Here we show that split-dose, multi-site administration and intradermal delivery via the Tropis biojector increase the delivery of pBI-11 DNA vaccine, enhance HPV antigen-specific CD8+ T-cell responses, and improve anti-tumor therapeutic effects, suggesting its translational potential to treat HPV16/18 infection and disease.
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Affiliation(s)
- Shiwen Peng
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hsin-Fang Tu
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michelle Cheng
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ming-Hung Hu
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hua-Ling Tsai
- Department of Oncology Biostatistics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ya-Chea Tsai
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chelsea Koenig
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Cory Brayton
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hao Wang
- Department of Oncology Biostatistics, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Rebecca C. Arend
- Department of Obstetrics and Gynecology, O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kimberly Levinson
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Richard B. S. Roden
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA
| | - T. C. Wu
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Oncology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland, USA
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Peletta A, Lemoine C, Courant T, Collin N, Borchard G. Meeting vaccine formulation challenges in an emergency setting: Towards the development of accessible vaccines. Pharmacol Res 2023; 189:106699. [PMID: 36796463 DOI: 10.1016/j.phrs.2023.106699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
Vaccination is considered one of the most successful strategies to prevent infectious diseases. In the event of a pandemic or epidemic, the rapid development and distribution of the vaccine to the population is essential to reduce mortality, morbidity and transmission. As seen during the COVID-19 pandemic, the production and distribution of vaccines has been challenging, in particular for resource-constrained settings, essentially slowing down the process of achieving global coverage. Pricing, storage, transportation and delivery requirements of several vaccines developed in high-income countries resulted in limited access for low-and-middle income countries (LMICs). The capacity to manufacture vaccines locally would greatly improve global vaccine access. In particular, for the development of classical subunit vaccines, the access to vaccine adjuvants is a pre-requisite for more equitable access to vaccines. Vaccine adjuvants are agents required to augment or potentiate, and possibly target the specific immune response to such type of vaccine antigens. Openly accessible or locally produced vaccine adjuvants may allow for faster immunization of the global population. For local research and development of adjuvanted vaccines to expand, knowledge on vaccine formulation is of paramount importance. In this review, we aim to discuss the optimal characteristics of a vaccine developed in an emergency setting by focusing on the importance of vaccine formulation, appropriate use of adjuvants and how this may help overcome barriers for vaccine development and production in LMICs, achieve improved vaccine regimens, delivery and storage requirements.
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Affiliation(s)
- Allegra Peletta
- Section of Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), University of Geneva, Rue Michel-Servet 1, 1221 Geneva, Switzerland.
| | - Céline Lemoine
- Vaccine Formulation Institute, Rue du Champ-Blanchod 4, 1228 Plan-les-Ouates, Switzerland.
| | - Thomas Courant
- Vaccine Formulation Institute, Rue du Champ-Blanchod 4, 1228 Plan-les-Ouates, Switzerland.
| | - Nicolas Collin
- Vaccine Formulation Institute, Rue du Champ-Blanchod 4, 1228 Plan-les-Ouates, Switzerland.
| | - Gerrit Borchard
- Section of Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), University of Geneva, Rue Michel-Servet 1, 1221 Geneva, Switzerland.
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Needle-Free Devices and CpG-Adjuvanted DNA Improve Anti-HIV Antibody Responses of Both DNA and Modified Vaccinia Ankara-Vectored Candidate Vaccines. Vaccines (Basel) 2023; 11:vaccines11020376. [PMID: 36851255 PMCID: PMC9965773 DOI: 10.3390/vaccines11020376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
The combination of mosaic Gag and CAP256 envelope in an HIV vaccine regimen comprising DNA prime and modified vaccinia Ankara (MVA) boost followed by protein boost has previously been shown to generate robust autologous Tier 2 neutralizing antibodies (nAbs) in rabbits. Further refinements of this strategy have been investigated to improve antibody responses. The delivery of both DNA and recombinant MVA vaccines with a needle-free device was compared to delivery by injection, and the effect of formulating the DNA vaccine with adjuvant CpG ODN 1826 was determined. The Pharmajet Stratis® needle-free injection device (PharmaJet, Golden, CO, USA) improved binding antibody responses to the DNA vaccine as well as both binding and neutralizing antibody responses to the MVA vaccines. Formulation of the DNA vaccines with CpG adjuvant further improved the antibody responses. A shortened vaccination regimen of a single DNA inoculation followed by a single MVA inoculation did not elicit Tier 1B nor Tier 2 neutralization responses as produced by the two DNA, followed by two MVA vaccination regimen. This study showed the immunogenicity of HIV DNA and MVA vaccines administered in a DDMM regimen could be improved using the PharmaJet Stratis needle-free injection device and formulation of the DNA vaccines with CpG adjuvant.
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Improved DNA Vaccine Delivery with Needle-Free Injection Systems. Vaccines (Basel) 2023; 11:vaccines11020280. [PMID: 36851159 PMCID: PMC9964240 DOI: 10.3390/vaccines11020280] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
DNA vaccines have inherent advantages compared to other vaccine types, including safety, rapid design and construction, ease and speed to manufacture, and thermostability. However, a major drawback of candidate DNA vaccines delivered by needle and syringe is the poor immunogenicity associated with inefficient cellular uptake of the DNA. This uptake is essential because the target vaccine antigen is produced within cells and then presented to the immune system. Multiple techniques have been employed to boost the immunogenicity and protective efficacy of DNA vaccines, including physical delivery methods, molecular and traditional adjuvants, and genetic sequence enhancements. Needle-free injection systems (NFIS) are an attractive alternative due to the induction of potent immunogenicity, enhanced protective efficacy, and elimination of needles. These advantages led to a milestone achievement in the field with the approval for Restricted Use in Emergency Situation of a DNA vaccine against COVID-19, delivered exclusively with NFIS. In this review, we discuss physical delivery methods for DNA vaccines with an emphasis on commercially available NFIS and their resulting safety, immunogenic effectiveness, and protective efficacy. As is discussed, prophylactic DNA vaccines delivered by NFIS tend to induce non-inferior immunogenicity to electroporation and enhanced responses compared to needle and syringe.
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Abbasi FH, Shaikh AA, Mehraj J, Raza SM, Rasool S, Bullo UF, Mehraj S, Phul ZA, Sahitia S, Zardari AA, Chandio SA. Vaccine Hesitancy and Perceptions of the Community about Polio in High-Risk Areas of Karachi, Sindh, Pakistan. Vaccines (Basel) 2022; 11:vaccines11010070. [PMID: 36679915 PMCID: PMC9866813 DOI: 10.3390/vaccines11010070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
The study aimed to determine the reasons for polio vaccine hesitancy among parents of persistently missed children (PMCs) in the high-risk areas of Karachi, Pakistan. A cross-sectional survey of parents of PMCs was conducted in April 2019 in 34 high-risk union councils of Karachi. PMCs were randomly selected from the polio program database, and further information was collected on a questionnaire by trained staff using face-to-face interviews with parents of PMCs. A total of 325 participants were included in the study. Among refusals, 112 (37.3%) had no trust in vaccine quality, followed by 45 (15.0%) who were afraid of side effects, 42 (14.0%) whose elders did not allow polio vaccination, 39 (13.0%) who refused due to the influence of negative social media videos, and 20 (6.7%) who had no trust in polio teams. We concluded that misconception is still a big challenge, and the program needs to strive for community acceptance. Low levels of trust in vaccines and teams as well as fear of OPV side effects were among the main reason for vaccine hesitancy. The participant communities recommended involving famous medical doctors, religious influencers, and TV or sports stars to enhance knowledge and acceptance of polio vaccination.
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Affiliation(s)
- Fayaz Hussain Abbasi
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
| | - Ahmed Ali Shaikh
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- Bill and Melinda Gates Foundation, Islamabad 44000, Pakistan
| | - Jaishri Mehraj
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- Integral Global Health Inc., Islamabad 44000, Pakistan
- Correspondence: ; Tel.: +92-21-35213035
| | - Syed Musa Raza
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- The United Nations Children’s Fund (UNICEF), Islamabad 44050, Pakistan
| | - Shumaila Rasool
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- National Stop Transmission of Polio (N-STOP) Program, Karachi 75510, Pakistan
| | - Umar Farooq Bullo
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
| | - Sandeep Mehraj
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- National Stop Transmission of Polio (N-STOP) Program, Karachi 75510, Pakistan
| | - Zamir Ali Phul
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- National Stop Transmission of Polio (N-STOP) Program, Karachi 75510, Pakistan
| | - Sundeep Sahitia
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- World Health Organization (WHO), Islamabad 45500, Pakistan
| | - Asif Ali Zardari
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- World Health Organization (WHO), Islamabad 45500, Pakistan
| | - Shoukat Ali Chandio
- Emergency Operations Centre for Polio Eradication and Immunization, Government of Sindh, Karachi 75510, Pakistan
- The United Nations Children’s Fund (UNICEF), Islamabad 44050, Pakistan
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Giersing B, Shah N, Kristensen D, Amorij JP, Kahn AL, Gandrup-Marino K, Jarrahian C, Zehrung D, Menozzi-Arnaud M. Strategies for vaccine-product innovation: Creating an enabling environment for product development to uptake in low- and middle-income countries. Vaccine 2021; 39:7208-7219. [PMID: 34627624 PMCID: PMC8657812 DOI: 10.1016/j.vaccine.2021.07.091] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/30/2021] [Indexed: 11/23/2022]
Abstract
Vaccine-product innovations that address barriers to immunization are urgently needed to achieve equitable vaccine coverage, as articulated in the new Immunization Agenda 2030 and the Gavi 5.0 strategy. In 2020, the Vaccine Innovation Prioritisation Strategy (VIPS) prioritized three innovations, namely microarray patches (MAPs), heat-stable and controlled-temperature chain (CTC) enabled liquid vaccine formulations and barcodes on primary packaging. These innovations were prioritized based on the priority immunization barriers that they may help overcome in resource constrained contexts, as well as by considering their potential impact on health, coverage and equity, safety, economic costs and their technical readiness and commercial feasibility. VIPS is now working to accelerate the development and lay the foundation for future uptake of the three priority vaccine-product innovations, with the long term-goal to ensure equitable vaccine coverage and increased impact of vaccines in low- and middle- income countries. To inform our strategic planning, we analyzed four commercially available vaccine product-innovations and conducted interviews with individuals from 17 immunization organizations, and/or independent immunization experts. The findings are synthesized into an 'innovation conundrum' that describes the challenges encountered in developing vaccine-product innovations and a vaccine-product innovation 'theory of change', which highlights actions that should be undertaken in parallel to product development to incentivize sustainable investment and prepare the pathway for uptake and impact.
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Affiliation(s)
- Birgitte Giersing
- World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland.
| | - Natasha Shah
- World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland
| | | | | | - Anna-Lea Kahn
- World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland
| | | | | | - Darin Zehrung
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Marion Menozzi-Arnaud
- Gavi, the Vaccine Alliance, Global Health Campus, Chemin du Pommier 40, 1218, Grand-Saconnex, Geneva, Switzerland
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Xu J, McKeage JW, Ruddy BP, Nielsen PMF, Taberner AJ. Jet-induced Tissue Disruption for Blood Release. IEEE Trans Biomed Eng 2021; 69:1850-1859. [PMID: 34807816 DOI: 10.1109/tbme.2021.3129606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Needle free jet injection is a drug delivery technique that uses the momentum of the fluid drug to break through the skin. This technique has recently also been applied to blood release, aiming to collect samples from capillaries in the skin without needing a lancet prick. This work provides new information about the wound geometry and tissue disruption caused by shallow jet injection with circular shaped and slot shaped jets. METHODS We use histological analysis to compare the disruption of tissue, including blood vessels, caused by lancet-pricking and jet injection with a circular shaped jet and a lancet-inspired slot shaped jet. RESULTS Intradermal injection into porcine skin using a slot shaped jet disrupted more vascular endothelium in the tissue than a circular shaped jet and did so at a smaller penetration depth with smaller wound volume. Our results suggest that shallow jet injections may have the potential to release more capillary blood than a lancet prick. CONCLUSION These findings demonstrate that a reversible jet injector might be used in diabetes management as a device to release and collect blood samples, in addition to being used to deliver insulin. SIGNIFICANCE Tissue disruption is crucial to consider when using jet injection to deliver drug and release capillary blood.
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