iNCOVACC® – World’s New Nasal COVID-19 Vaccine from India

Overview

India has rolled out the world’s first needleless intranasal vaccine against COVID-19. The nasal COVID-19 vaccine, called iNCOVACC®, is to be administered as a primary or a booster dose for adults. Developed by Bharat Biotech in partnership with US-based Washington University, the nasal vaccine is a recombinant adenoviral vector vaccine. Made available only for adults (18+ age group) and approved by the Drugs Control General of India as a heterologous booster dose, the new iNCOVACC vaccine can potentially revolutionise the battle against COVID-19 infection.

The new nasal vaccine will now be only administered as a booster dose to those who have already taken two doses of the vaccine. The new intranasal vaccine will soon be available at private hospitals/health centres and is now available on the CoWin platform. 

Read on to understand how the newly developed intranasal COVID-19 dose can boost India’s efforts in the battle against COVID -19.

What is a nasal COVID-19 vaccine? 

As it is commonly seen, the most common route for any vaccine dose is subcutaneous (between the skin and muscles). To date, all the approved COVID-19 vaccines were subcutaneous, often administered into the upper area of the arm. In the case of nasal delivery, the vaccine or the nasal spray is administered through the nose and does not need needles. 

As the virus that causes COVID-19 infection enters our body through the mucosa (the moist tissues that line the nose, lungs and digestive tract), scientists developed the intranasal vaccine since it makes sense to act against this virus at the entry points.

The intranasal vaccine is given as drops in the nose to stop the virus in the mucosal region by triggering an immune response in the cells and molecules present there. 

How does the intranasal vaccine work for COVID-19? 

To understand how nasal vaccines work, let’s first explore how the current vaccines, such as Covishield or Covaxin, work. 

These shots prompt an immune response to activate immune cells like T cells that destroy infected cells, and B cells that produce antibodies which neutralize pathogens by binding with them, as a result stopping them from entering the healthy cells. These antibodies and cells circulate through our bloodstream and prevent further infection. However, these cells are not present in the entry point – the mucosal region – to provide quick protection. By the time these antibodies and cells reach the entry points of the virus, the individual is already infected as the virus spreads quickly.

That’s why intranasal vaccines are said to be more effective. India’s new nasal vaccine, iNCOVACC is touted to  have the ability to end the cycle of transmission, stop infection and stop lung damage, including other adverse effects as the dose is administered through the nose, where the virus first enters our body. 

Apart from T cells and B cells, the intranasal vaccines can activate another set of immune cells that hang around mucosal tissues. The B cells present in the mucosal tissues, make another type of antibody, known as IgA, which plays a significant role in destroying airway pathogens. In addition, the nearby T cells can memorize the pathogens they have encountered and will continue to scout the region where they were encountered initially.

What are the advantages of the iNCOVACC nasal vaccine?

As per the experts, India’s new iNCOVACC nasal vaccine may prove to be a game-changer in the battle against COVID -19. According to Bharat Biotech, some of the main features and benefits of the nasal coronavirus vaccine include:

1. It can reduce costs by eliminating the need for needles and syringes thus overcoming the potential difficulties with mass vaccination.
2. It is painless and eliminates needle-associated risks (infections & injuries) 
3. Individuals scared of needles can take this vaccine without any fear 
4. Taking this vaccine is super easy with just a drop into the nose. It can be administered by any medical practitioner or nurse, thus reducing the dependence on trained healthcare personnel.
5. It is cost-effective and so low- and middle-income people can easily get it.
6. The new nasal vaccine is easy to store and transport as it can be stored safely in a refrigerator and does not need expensive equipment to carry
7. Potential to block both the infection and the transmission of COVID-19.

What are the side effects of the iNCOVACC vaccine?

Side effects of the iNCOVACC nasal vaccine are those that are seen in any vaccine, which may include:

• Fever
• Headache
• Running nose
• Sneezing

Although extremely rare, a severe allergic reaction may occur after getting a dose of iNCOVACC. However, as per the Bharat Biotech factsheet, no such events were reported in the clinical trial with this nasal vaccine.

Conclusion

India’s first COVID-19 nasal vaccine, iNCOVACC, is available in India and will be used as a booster dose for adults (18+ age group) for now. The vaccine, developed by Bharat Biotech, will be available at government and private hospitals. People can book the precautionary dose at CoWin App. The nasal vaccine can revolutionise the battle against the virus and prove to be a big boost to the vaccination programme in India as it removes needle-associated risks and can even cut into vaccine hesitancy.

Frequently Asked Questions (FAQs)

How many doses of iNCOVACC must  be taken?

The iNCOVACC® vaccine is administered through the nose, as a two-dose series, four weeks apart. The vaccination course includes two separate doses of 0.5 mL of eight drops with four drops for each nostril.

Recently, the Government of India has approved it as a heterologous booster dose and is recommended to be administered or taken as the first booster dose only.

Who can receive the nasal vaccine?

As of now, the iNCOVACC is recommended as one of the options for precautionary doses for adults (aged 18 years and above) in India. Those vaccinated with two doses of either Covishield or Covaxin, and in some cases, the Sputnik V can opt for this nasal vaccine as a precautionary dose.

Who cannot receive iNCOVACC nasal vaccine?

The following people cannot receive the iNCOVACC vaccine:

1. People who have had a severe allergic reaction to any ingredients of the vaccine
2. Those who have had a severe allergic reaction after a previous dose of the vaccine
3. People currently having an acute infection or fever

What should you mention before taking your vaccination?

You must inform your vaccinator about all of your medical conditions, including:

1. Your regular medicines for any illness, for how long and for which condition
2. Your allergies (if any)
3. If you are pregnant
4. If you have a fever
5. If you are on a blood thinner or have a coagulation/bleeding disorder 
6. If you are immunocompromised or are on medications that affect your immune system

CAN iNCOVACC nasal vaccine be self-administered? 

While it is easy to administer, it will be only available through the CoWin platform in designated private and government institutions that are on the CoWin platform. Therefore, you have to go to the designated location to get the dose. In addition, nasal vaccines have to be stored at temperatures between 2 to 8 degrees Celsius. In addition, it should be used once opened and out of the refrigerator within 6 hours.