วัคซีนโควิด - ฉีด หรือ พ่น ดม?

==COVID-19 Vaccines: Intramuscular (injection) or Intranasal (nasal spray)?==

Image credit istockphoto.com

 

Many Intramuscular (injection) COVID-19 vaccines have been approved and deployed ‘en mass’ around the world. The results as we can read from reports (in newspaper and journals) and government campaigns showing moderate success in prevention or containment of the pandemic disease. Alternatives are now deemed necessary and being sought vigorously in medical labs in several countries. One notable option is the ‘nasal vaccine’. But 

https://theconversation.com/nasal-covid-19-vaccines-help-the-body-prepare-for-infection-right-where-it-starts-in-your-nose-and-throat-183790 27 May 2022 — As of late May 2022, there are no approved COVID-19 intranasal vaccines for human use. There are currently seven in clinical trials, and three - manufactured by Beijing Wantai Biological Pharmacy, Bharat Biotech, and Codagenix and Serum Institute of India – are in phase-3 human trials.

NIAID Mouse Study Shows Benefits of COVID-19 Nasal Vaccine vs. Intramuscular
https://www.niaid.nih.gov/news-events/mva-nasal-study 10 June 2022 — A new comparison study in PNAS from NIAID intramural scientists clearly shows that for SARS-CoV-2, nasal vaccination – particularly in two doses..

• SARS-CoV-2 initially establishes infection in the nose and throat before spreading to the lungs. Within six hours of delivery, nasal vaccine works in all the key areas..remains active for 3 days. ..(compare to) the into-muscle vaccines (which) remain in place, generate a slow immune response only to the lung region and blood.
• Broad protection: The nasal vaccine quickly generated a variety of protective immune responses, including antibodies A and G. The muscular vaccine only generated type G antibodies, and mainly in the lungs.
• Rapid protection: Nasal vaccination either prevented or accelerated SARS-CoV-2 elimination in nasal passages and lungs as early as two days after exposure to the virus. (By comparison) Muscular vaccination was less effective, preventing death and clearing virus from the respiratory tract, but over several days and not protecting nasal passages

What the media say:

NBC News: Nasal vaccines may stop Covid infections. Will we get them? ..5 days ago — Nasal vaccines hold promise at stopping Covid because they build up immunity in the nose, where the virus first enters the body.  

Operation Nasal Vaccine —Lightning speed to counter COVID-19 https://www.science.org/doi/10.1126/sciimmunol.add9947 

Nasal sprays will be essential to tackle Covid-19 variants, study says https://www.theweek.in/news/health/2022/07/23/nasal-sprays-will-be-essential-to-tackle-covid-19-variants--stud.html 

โควิด-19 : สำรวจเทคโนโลยีผลิตวัคซีนเม็ดและผงต้านไวรัสโคโรนาที่กำลังพัฒนาในปัจจุบัน https://www.bbc.com/thai/international-57983748 28 กรกฎาคม 2021 

ยาพ่นจมูกฆ่า"โควิด" วางขายแล้วได้ผล 99% - [YouTube] . ( Nitric Oxide Nasal Spray ) ฆ่าเชื้อไวรัสโควิด-19 ในทางเดินหายใจส่วนบน ..

What about medical research?

The toxicology of inhaled nitric oxide  https://pubmed.ncbi.nlm.nih.gov/11134540/  Jan 2001 ..Abstract: Inhaled nitric oxide is a targeted pulmonary vasodilator that improves clinical outcomes for newborn patients with persistent pulmonary hypertension of the newborn, and may be effective in treating some premature patients with acute respiratory distress syndrome or lung disease of prematurity. Nitric oxide is now recognized as playing an important role in the regulation of diverse physiological processes. However, the pharmacological properties of inhaled nitric oxide are not easy to separate from its toxicological effects. For example, the intended effect of inhaled nitric oxide, vasodilation in the lung, is mediated, in part, by increased cellular cyclic GMP (cGMP). However, increased cGMP can also interfere with normal cellular proliferation. Nitric oxide has also been shown to cause DNA strand breaks and/or base alterations that are potentially mutagenic. Inhaled nitric oxide can rapidly react with oxygen in the lung to form nitrogen dioxide, which is a potent pulmonary irritant. Nitric oxide also reacts with superoxide anion to form peroxynitrite, a cytotoxic oxidant that can interfere with surfactant functioning. The overall effect of inhaled nitric oxide in potentiating or attenuating inflammation and oxidative damage in diseased lung is dependent on the dose administered. Furthermore, despite rapid inactivation by circulating hemoglobin, inhaled nitric oxide exerts effects outside the lung, including blocking platelet aggregation, causing methemoglobinemia, and possibly inducing extrapulmonary vasodilation. The toxicology of inhaled nitric oxide is not completely understood and must be considered in the design of protocols for its safe and effective clinical use.

Inhaled Nitric Oxide
A Selective Pulmonary Vasodilator: Current Uses and Therapeutic Potential 
https://www.ahajournals.org/doi/10.1161/01.cir.0000134595.80170.62  2004
Inhalation of low levels of NO appears to be safe. The major clinical toxicity is due to the formation of NO2 and methemoglobinemia...During the past 14 years, inhaled NO has been used to treat pulmonary hypertension and hypoxemia in tens of thousands of pediatric and adult patients worldwide. For many, it is lifesaving..

Inhaled high dose nitric oxide is a safe and effective respiratory treatment in spontaneous breathing hospitalized patients with COVID-19 pneumonia 2021 https://pubmed.ncbi.nlm.nih.gov/34400339/  -- Results: Twenty-nine COVID-19 patients received a total of 217 intermittent inhaled NO treatments for 30 min at 160 ppm between March and June 2020. Breathing NO acutely decreased the respiratory rate of tachypneic patients and improved oxygenation in hypoxemic patients. The maximum level of nitrogen dioxide delivered was 1.5 ppm. The maximum level of methemoglobin (MetHb) during the treatments was 4.7%. MetHb decreased in all patients 5 min after discontinuing NO administration. No adverse events during treatment, such as hypoxemia, hypotension, or acute kidney injury during hospitalization occurred. In our NO treated patients, one patient of 29 underwent intubation and mechanical ventilation, and none died. The median hospital length of stay was 6 days [interquartile range 4-8]. No discharged patients required hospital readmission nor developed COVID-19 related long-term sequelae within 28 days of follow-up.

Conclusions: In spontaneous breathing patients with COVID-19, the administration of inhaled NO at 160 ppm for 30 min twice daily promptly improved the respiratory rate of tachypneic patients and systemic oxygenation of hypoxemic patients. No adverse events were observed. None of the subjects was readmitted or had long-term COVID-19 sequelae. 

[This blog aims to bring an alternative to COVID-19 control to more prominent public position, but  leaving  issues for the ‘experts’ and medical authorities to resolve. We can see many advantages of nasal vaccines and nitric oxide treatments for young children and older aged population.

⚠️WARNING:⚠️ Readers should not experiment with any nasal remedy without medical doctor's supervision. ]

[25 Jul 2565 added Use of chlorhexidine to eradicate oropharyngeal SARS‐CoV‐2 in COVID‐19 patients Y. Hanna Huang, BA 1 and Jong T. Huang, MD corresponding author https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251493/ 

Note.  Chlorhexidine gluconate 0.12% is a germicidal mouthwash used at dentists, see Wikipedia for other information. 

น้ำยาบ้วนปากไม่สามารถป้องกันการติดเชื้อโควิด-19 ได้ - อนามัยมีเดีย
https://multimedia.anamai.moph.go.th 15 July 2021

การกลั้วคอ ขจัดไวรัส COVID-19 จริงหรือ ? (ใช้น้ำประปาประมาณ 20 ซีซี กลั้วคอนานอย่างน้อย 15 วินาที อย่างน้อย 3 ครั้งต่อวัน) สรุป : ไม่จริง https://chulalongkornhospital.go.th/kcmh/line/การกลั้วคอ-ขจัดไวรัส-covid-19-จร/ 24 กรกฎาคม 2563

มหิดล พัฒนา "น้ำยาบ้วนปาก" ยับยั้งการแพร่โควิดได้ผล 99% https://news.thaipbs.or.th/content/307437 30 สิงหาคม 2564]
 [Added link to  

วัคซีนโควิด - BA.1 หรือ BA.5 https://www.gotoknow.org/posts/704603 ]

[Updated 8/10/2565: Mouthwashes may suppress SARS-CoV-2 https://www.sciencedaily.com/releases/2022/10/221006092334.htm  ..Commercially available mouthwashes contain a number of antibiotic and antiviral components that act against microorganisms in the mouth. One of these, cetylpyridinium chloride (CPC), has been shown to reduce the viral load of SARS-CoV-2 in the mouth, primarily by disrupting the lipid membrane surrounding the virus. While there are other chemicals with similar effects, CPC has the advantage of being tasteless and odorless…]