Needleless Vaccinations

Annie Hoang
Independent Research G/T
May 26, 2017

Advisor: Dr. Paul A. Offit, MD

Instructor: E. Leila Chawkat
 Hoang 1

Abstract

This research project involves discovering how needleless vaccinations can change the way

todays problems are experiencing. The goal is to show that patients should be considerate about how

beneficial a new delivery method could change the community. This has been done by surveying my local

friends and families such as children twelve years old and younger, adolescents, adults, and elderlies.

Upon examination of these responses, it becomes clear that nearly twenty percent of individuals in my

community are facing the conditions of needle phobia. This research highlights the importance of a safe

free environment and a new pain-free and needleless vaccine delivery method.
 Introduction

This research analyses the possible outcomes of a new pain-free and needleless vaccine delivery

method. Vaccination is the treatment with a vaccine that produces immunity against a disease and the

purpose of vaccines is to weaken and kill the viruses in the immune system (Vaccination), which is the

ability for organisms to prevent diseases. Approximately twenty percent of the population has a needle

phobia, fear of needles (Needle Phobia Facts). For those who are suffering from this condition, it has

been reported that at least 20 percent avoid any medical treatment (Fear of Needles: The Fatal

Phobia). In addition parents with children, the age twelve years old and under are most likely to

experience this needle phobia problem. For that reason, children are the main target of this project

because they react to shots compared to adults. For example, they would cry and try a plan to avoid the

procedures (Needle Phobia Facts).

Since prototypes of a needleless vaccine delivery method already exist, it could be easily heard of

in the future progression and be beneficial for all types of common shots, which includes flu, HPV,

hepatitis A/B, pneumococcal and much more. The problem that needs to be solved is that some children

and individuals with needle phobia experience horrific uneasiness when they are given their required

shots. In order to solve this problem, these designs need to grow in their popularity and be approved by

official companies to be capable of vaccine delivery in humans. At the end, the researcher will examine

the likely course of action for needleless medicated injections to inform future patients with major issues

in needle anxiety of the probability of a safe and cost-effective vaccine procedure efficacy and treatment.

Therefore within this research, the thesis is if there were a painless and needleless vaccine delivery then

the less worried and hesitant the children will be.

Glossary:

Immunity: the ability of an organism to resist disease, either through the activities of

specialized blood cells (Immunity)

Immune cells: attack the virus, and kills them all to stop the growth of any possible
 illnesses (Vaccination)
Vaccines: weakens and kills viruses in the immune system, which is the ability for

organisms to prevent diseases (Vaccination)

Needlestick injuries: wounds caused by needles that accidentally puncture the skin

(Needlestick and Sharp Injuries)

Review of Literature

The first main idea is the vaccinations purpose is to stimulate an individuals person immune

system. In the history of the vaccines, an English physician and scientist named Edward Jenner spent fifty

years of hard work contracting a hypodermic syringe that could produce sufficient immunity to the body

harmlessly in the year of 1885 (History of Vaccines). People began to see the benefits of immunizing

large groups; for example, soldiers and children. During World War I, the syringes benefited the soldiers

and children who obtained tetanus, typhus, or diphtheria (History of Vaccines).

The health in the immune system is important to know the function of the immune cells. Their
function is to attack the viruses that are present and kill them to stop any growth of illness

(Vaccination). This makes vaccines an important factor to the process of the elimination of illnesses.

Vaccines have been here for centuries and have a purpose of keeping individuals healthy and alive.

Consequently, vaccination helps in public health measures after the provisions of safe food, water, and

sanitation. For that reason, a painless and needleless vaccine delivery needs to consist of the same

functions as historic syringes; in order to be successful in having healthy children.

The second main idea is the causes of needle phobia and how no one likes receiving shots. The

best definition of needle phobia is an absolute refusal of vaccination because of the fear of needles and for

no other reason (Offit). A person who is afraid of needles would avoid them, which leads to their death

(Spendlove). This is one of the most effective problems in todays society. Patients often keep away from

their fears for their own comfort and eventually die due to the fact that vaccines keep humans alive and in

good health.

Next, approximately twenty percent of the population has a needle phobia, fear of needles

(Needle Phobia Facts). For those who are suffering from this condition, it has been reported that at

least twenty percent avoid any medical treatment (Fear of Needles: The Fatal Phobia). As well as

twenty-three percent of all Americans have shunned vaccinations because of their fear of needles

(Emanuelson). In addition parents with children, the age twelve years old and under, are most likely to

experience this needle phobia problem. Hence, children behave and react differently towards shots than

adults.

However, avoidance is not the only reason that leads to death. It has been noted that 1.3 million

deaths a year take place due to needle contamination injuries (Spendlove). Needle contamination injuries

include when people use, disassemble, or dispose of needles (Needlestick and Sharp Injuries).

Contaminated needles can insert hazardous fluids from the body into and out of the skin from accidental

punctures. Also, sharp injuries allow correspondence between fluids and blood from open cuts.

Nevertheless, the main factors that cause needlestick injuries are equipment design, nature of the
procedure, condition of work, staff experience, recapping, and disposal (Needlestick and Sharp

Injuries). Needlestick and sharp injuries may be prevented by improving the equipment design, creating

disposal systems, or training employees. Also, using a patch rather than a needle could transform disease

prevention around the world (Wakefield). That being the case, the improvement of the needlestick would

be most effective because if there were a painless and needleless vaccine delivery then the less amount of

injury errors would be present.

Another reason for a condition of needle phobia is because the fear of needles is both a learned

and an inherited condition. A fairly small number inherit a fear of needles, but most people acquire needle

phobia around age four to six (Maryan). The condition of fear of needles can be derived genetically from

one parents or ancestors and it can be studied from other patients. Though only a few percentage of

individuals are living in constant fear of shots and it may be developed at a young age. Therefore, a

needleless vaccine delivery would reduce the number of patients who are facing anxiety from the

procedures of shots.

Additionally, nearly ten percent of the population has trypanophobia, the fear of needles and

injections (Needle Phobia Facts). This has prevented patients from going to the doctors, getting routine

blood testing, and following up with their prescribed treatments (Needle Phobia Facts). If individuals

continue to practice these actions, then they would never be able to face their fears and stay in good

health. Thus, if there were a painless and needleless vaccine delivery then the greater amount of patients

will receive their shots efficiently without any preventions.

Notwithstanding, healthcare provider information has been the main reason why patients who tend

to refuse their children getting vaccinated reversed their thoughts on the opportunity. Vaccine programs

start gaining trust by gathering all accurate information and demonstrate care to each person being treated

with medical issues (Vogel). Hesitant patients await medication being informed about their children.

Vogels article discusses vaccine programs and how they should target contributions to vaccine hesitant

individuals to obtain their trust, so patients will start permitting their children to be immune and avoid
diseases. Hesitant parents supposedly rely on negative information about injections and doubt science in

general. Wherefore, if there were a painless and needleless vaccine delivery then the less worried and

hesitant the children will be.

The next third big idea is a safe design of needleless vaccinations. The needle-free benefits are that

it allows vaccine delivery methods eliminate the risk of people being immunized. The risk of needle

contamination is dangerous since it is with blood-borne illnesses like HIV and the cost of purchasing

many thousands of hypodermic needles. Moreover, the benefits of a microneedle are that it is so light and

patients would hardly know an injection has taken place (This won't hurt a bit - honest). The technique

to a needle-free process is that the proteins become enclosed in the nanofibers for the ultimate delivery

into the skin (Kwan). Before injecting needle-free vaccines, scientists have to anticipate a shallow

penetration of the sugar needles by simply dissolving it into the upper layer of the skin, so patients would

feel comfortable (Ross). Nonetheless, this method would then create a safe environment in the medication

field, even though needle-free syringes are expensive than traditional syringes (Cantrell). Cantrells article

discusses how healthcares dual missions of reducing medical error, promoting patients, and worker safety

have fueled searches for more efficient and alternate methods of delivering drugs. For that reason, a

painless and needleless vaccine delivery would be a safe design for

There are many solutions to solve the needle phobia condition. Firstly, Doctor Amy Baxter created

a new solution, Buzzy, to assist children who dreaded needles due to her inspiration from her needle

phobic son (Lynn). Lynns article discusses how approximately ten percent of the population who has a

fear of needles. Needle phobia is a complex set of different conditions that causes people to refrain from

medical needle procedures. Additionally, about half of needle-phobia cases are actually a medical

condition, probably with specific genetic origins, and not a true phobia at all.

However, some individuals have an acute sensitivity to pain in needle procedures. Procedures that

are painless for some individuals may cause intense pain in others. All different kinds of people have a

combination of different types of needle phobia. Professor Amy Baxter, Pediatric Emergency Physician &
CEO, MMJ Labs, created a solution for those who has a needle phobia, mainly towards children. She

invented a device called Buzzy, which provides natural pain relief by confusing a bodys own nerves

and distracting attention away from the poke, thereby dulling and eliminating sharp pain. These are the

possible outcomes of a new pain-free and needleless vaccine delivery method. Again, vaccination is the

treatment with a vaccine that produces immunity against a disease (Vaccination). The purpose of

vaccines is to weaken and kill the viruses in the immune system (Vaccination), which is the ability for

organisms to prevent diseases. In this procedure, this is active immunization where a dose of the

responsible virus or bacteria which has been killed or inactivated. Active immunization is usually long

lasting. It may take some time to fully develop and often needs boosting (Vaccination).

Another professor named Mark Kendall ... was able to create a device that can deliver a minute

dose of dry vaccine right where it is needed (Mark Kendall) and the device is called the Nanopatch. The

Nanopatch uses tiny powder-coated spikes to deliver a small dose of vaccine just under the skin,

immunizing a person in about a minute. The Nanopatch is created through deep reactive ion etching. The

process has been in place for years in the semiconductor industry, keeping the cost of production low.

Kendall and his team have also created an applicator to place the Nanopatch into the skin. The projections

placed on the patch break the outer layer of skin and the vaccines inside the patch release in less than a

minute (Spendlove). Also, the cost is made for less than a dollar and it uses only a fraction of a vaccine

dose delivered by traditional syringe method (which was invented in 1853), at the same time eliminating

the risk of needle injuries (Mark Kendall). The Nanopatch an infused vaccine that is designed to be heat-

stable, so it can be transported without refrigeration and the process does not draw blood, which reduces

the risk of infections. Professor Mark Kendall, an Australian biomedical engineer, was part of a team at

the University of Queensland that advanced the Nanopatch by vaccinating animals. Now his company,

Vaxxas, is on a mission to commercialize the device for human use around the country for those who have

been weakened in their immune system. Mark Kendall plans to run an international trial using the

Nanopatch, starting with the human papillomavirus (HPV) vaccine to protect against cervical cancer.
 Furthermore, Professor Boris Stoeber designed medication that created both drug injections and

pain-free vaccinations, over the past fourteen years (This won't hurt a bit - honest). This injection would

be so light and tiny that patients would not know an injection is taking place (This won't hurt a bit -

honest). Professor Boris Stoeber, an engineering professor at the University of British Columbia, who

has used up his fourteen years to create an ideal design. This design also carries pain-free vaccinations and

medications, which may develop universally and be the new innovation of future days. Professor Mike

Redmond explained how his needleless system works delivering by intramolecular needleless injections

from other liquid medications (Cantrell). The liquid medication is powered at a high speed through a tiny

opening into the patient. The advantages of having a needleless system, besides the absence of the ouch,

are no sharps being wasted, no chance of an accidental needlestick, and much less anxiety and fear

towards the patients. Even though needle-free syringes are priced higher than traditional needles and

syringes, they can be more cost effective in the long run due to the safety factor.

Needleless vaccines would create less of a hazard for parents with children, twelve years old and

under. Although traditional injections may take a few seconds to overcome, a small percentage of patients

may be facing difficulty towards todays vaccine method. Those patients would delay their annual

necessity shots so they would not have to feel any discomfort. With the knowledge that twenty-three

percent of all Americans have shunned vaccinations because of their fear of needles, it becomes difficult

to find a solution to this problem. The researcher has examined the results from individuals of different

age groups. The request for reassurance, especially the decision-making process, determines the approval

of the needleless systems with a focus on pain-free post-vaccination. Therefore within this research, the

thesis is if there were a painless and needleless vaccine delivery then the less worried and hesitant the

children will be.

As of right now, what are the opinions of needleless vaccinations from parents with children who

are twelve years old and younger? Additionally, what are the ultimate opinions if needleless vaccination

would improve health?

Research Methods and Data Collection

The researchers data collection method was a survey/questionnaire. This method was the most

appropriate for the study because it allows a researcher to determine the opinions of a large group of

people to support or refute an idea based on the research topic. The large group of people that was

targeted were adolescents and parents with children who are under the ages of twelve. The survey was

sent out by emailing and sharing the questionnaire link with family and friends. Altogether, the

questionnaire received 125 responses and it took a whole week to gather all the intriguing results.

Moreover, there was specific statistical information that relates to the local population in the community.

The methods were distinguished by which the process was brief, simple, provided a purpose, and

contained concise language.

Results and Data Analysis

 The results that were received were quite surprising since approximately a third of the responders

acknowledged upon the hypothesis, which was, When a new vaccine is introduced, there will be a

change of behavior in hesitant patients. They ended up that way because each age group had different

opinions on what they believe is considered useful or what companies may or may not change in todays

vaccine methods. For example, the majority population in the survey thought present day shots were

neither least nor most painful and were neither satisfied nor dissatisfied. Additionally, the people who

consented to introduce a new vaccine delivery method are the ones who rated the shots as dissatisfying.

Majority of the careless parents replied that they would ...trick them into thinking something, so

then errors are smaller, Shots painful or not; they are supposed to help, so I recommend everyone to

receive their shots, and I would still tell my kids to go and get their shots. Additionally, the results

meant that a small population of individuals have a condition of needle phobia. Approximately 34.4% of

the people answered that needles or the fear of needles have discouraged them from getting vaccine(s) for

themselves or their children. While the other 65.6% responders have not worried about the procedure and

replied with an absolute No.

 Future researchers and humanity generally will think of these results as understandable. Since a

total of 20% of the approximate U.S. population has a severe needle phobia, then it is predictable that a

low percentage of the responders have a significant fear of needles. Therefore, about forty-four

individuals who completed this questionnaire have been noted with a fear of needles or have been

discouraged by the procedures. Additionally, once humanity increases the population of needle phobia

then the Nanopatch or other needleless methods will be widely spread throughout the country. Other

vaccine companies will then decide to create a needleless and pain-free vaccine delivery similar to the

Nanopatch since vaccine companies compete to receive the most satisfaction from patients.

New knowledge that can extrapolate from the results is that some parents are embarrassed to

express their opinions on the vaccine procedures for them or their children. This parent who responded

with that may feel mortified about the judgment they would have received from those who have no

problem with todays shots. Subsequently, it appears to be that some concerned parents are embracing

their viewpoints about traditional injections for themselves and their children. According to these

responses, If there was a painless way of receiving shots, then itll be preferable and Receiving shots is

a pain for myself; especially when my kids need them. They end up crying and I would be glad for a less

painful way to receiving shots; these responses are evidence and show that these parents are worried

about their own children since they feel intolerable to see their kids in discomfort from the short duration

of receiving their required vaccines.

Thus, it can be concluded that the results received were based on vaccine injections concerns from

parents and they have the same opinion on the hypothesis and research question.

Discussion and Conclusion

In conclusion, the goal of this research is that patients should be considerate about how beneficial

a new delivery method could change the world and the behaviors of their children. People should also

spread the word of upcoming needleless procedures to relieve those who have a fear of injections, so the

individuals with those conditions are able to receive their shots comfortably. Vaccination is the treatment
with a vaccine that produces immunity against a disease. The purpose of vaccines is to weaken and kill

the viruses in the immune system (Vaccination), which is the ability for organisms to prevent diseases.

In order to keep hesitant patients and their children in good health, then needle-free vaccine procedures

would have to provide the same functions and medications as in ordinary syringes and allow companies to

be cost-effective and purchase more of the product. This research analyses the possible outcomes of a new

pain-free and needleless vaccine delivery method to reduce the amount of anxiety needle phobias produce

at doctor appointments.

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