As I’ve discussed, I disagree with almost every objection to vaccinations, unless it’s a very specific medical condition. However, the pain of the injection is one thing that makes both children, and frankly, many adults, shutter at the sight, and even thought, of a vaccination. The retail chain, Target, had an online poll that said that 23% of people wouldn’t get the flu shot because they were afraid of needles. Maybe a part of the anti-vaccination movement results from parents seeing their children scream when getting shots.
There are ways to make the needles hurt less, usually by using a smaller needle. Unfortunately, a smaller needle makes the flow rate slower, and requires pushing at a higher pressure, causing less control over the injection. This itself could cause more pain in the patient. If we only had those injectors that Bones used on Star Trek.
Things may be changing. A Korean research team, lead by Jack Yoh of Seoul National University, has reported the development of a laser-based transdermal (across the skin, usually into the muscle or skin) injection system for drug delivery. The devices uses a laser, according to a Medical News Today, “to drive a tiny, precise stream of liquid drug with just the right amount of force. It uses multiple pulses of laser beam at lower energy, thereby delivering a significantly higher dose than a previous version.”
In the past, other techniques have been designed to make injections painless, but for ease-of-use, control, precision, and cost, the hypodermic syringe and needle (invented in the 1840’s, though syringe like devices have been used since Roman times) has never been replaced. Other devices have attempted to use a laser to “drill” transdermally, but still required a piston-based system to drive the drug through the skin, which didn’t allow control over precision over the dose and depth of injection.
According to Medical News Today, the research team has tested the device on guinea pig skin and has showed the laser injection drives the drug up to several millimeters under the skin, without damaging surrounding tissue, which reduces pain and adverse events. The speed and thinness of the jet should be enough to make the procedure nearly painless according to the research team. For a few types of vaccinations, where the the injection can be aimed at the epidermal layer just under the surface of the skin, where there are no nerve endings, the injection could be virtually pain free.
The research team is still working on making low cost replaceable injectors for clinical use, and of course, there will be a long time course to receive FDA and regulatory approval, get it into the market and then gain acceptance by healthcare workers. A standard syringe and needle costs anywhere from $0.10 to $0.50 each (depending on the type and quality). And these are completely disposable.
How would the laser syringe be used? Would the laser portion be reusable? If it is reusable, how would the hospital maintain infection control, since reusing medical instruments is a major concern? And since a number of vaccines are sold as a “pre-filled syringe”, that is, the syringe and vaccine are ready-to-use right out of the package, the new laser syringe would have to replace that system directly with the vaccine manufactures, a long design, manufacturing, and regulatory process, that may take a decade or more.
I think there are a lot of questions that need to be answered about this product before we see it. But after 150 years, the hypodermic syringe needs to be replaced. It’s time has passed, and I think this idea is one of the best I’ve seen for mass vaccinations.
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