updated 5:14 p.m. ET Jan. 28, 2008
Cold and flu

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Under-the-tongue vaccine could help lick the flu
Needles might no longer be needed to protect against the seasonal bug

Lucian Perkins / Washington Post file
The Associated Press
WASHINGTON - Relief may be on the way for all those youngsters
trembling at the thought of another needle jab. One day, the flu
vaccine may simply be placed under the tongue.

Korean researchers say the new vaccine worked in mice, avoiding not
only the painful prick but also the discomfort some people feelfrom
the inhaled vaccine.

The team led by Dr. Mi-Na Kweon of the International VaccineInstitute
in Seoul reported their findings in Monday's online edition of
Proceedings of the National Academy of Sciences.

Better ways of delivering vaccine have long been under study, ranging
from orally to inhaled, but all seem to have drawbacks.

Now, Kweon and colleagues say, two doses of influenza vaccine under
the tongues of mice primed the animals' immune system to fight off
what would otherwise have been a deadly dose of flu.

Next, they are turning their attention to people, to see if under-the-
tongue vaccine also prompts a strong immune response.

Placing a couple of drops of liquid under the tongue gets the vaccine
directly to mucus membranes and prompts a response both in mucus
tissues throughout the body as well as in the immune system itself,
the researchers said.

"These studies provide a basis for further human testing of this
alternative form of needle-free vaccination. Aside from
itsconvenience, sublingual vaccination appears to disseminate immunity
to a broader range of organs than the classical routes of injectingor
ingesting vaccines,'' said Dr. Cecil Czerkinsky, deputy director-
general for laboratory science at the Institute.

"If these findings are replicated in humans, they could pave the way
for the development of a new generation of vaccines that could be used
for mass vaccination against respiratory infections, including the
pandemic avian-human influenza viruses,'' he said in a statement.

Several research efforts applying vaccine to mucus membranes have been
tried, seeking to avoid both the needle sticks that people dislike and
the harsh environment of the digestive systemthat can damage or
destroy a vaccine. Studies of under-the-tongue use of other medicines
have also been done.

Dr. William Schaffner of Vanderbilt University noted that recent flu
studies have involved nasal sprays.

However, he said while he had expected people to be averse to needles,
he was surprised to discover that "many people are averse to people
messing with their nose ... so there are limitations to nasal spray.''

So for researchers looking for another means of doing this, "just a
drop under the tongue at least will protect mice ... that's a very
exciting and promising line of investigation,'' said Schaffner, who
was not part of the research team.

And, he added, "if we were faced with a pandemic, the easier and more
acceptable we can make the distribution of the vaccine, the more
rapidly we can protect a proportion of population.''

Kweon also said that with a nasal spray there might be a chance of a
vaccine affecting the central nervous system, which is not a risk of
the under-the-tongue vaccine.

The under-the-tongue vaccine worked whether it was a live or
inactivated virus, Kweon reported. And, she added, it could also be
flavored to make it more acceptable.

© 2008 The Associated Press. All rights reserved. This material may
not be published, broadcast, rewritten or redistributed.

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