Every parent knows the guilty feelings of their child’s first vaccine. Sure, you’re preventing severe illnesses. But the tears shed in the doctor’s office leave you with a heavy heart. Kids fear hypodermic needles more than any other age group. It’s called trypanophobia. Over 60% of kids are afraid of needles: painless microneedles are the solution.
Updating the Hypodermic Needle
Needles hurt. Injections require specially trained people. There is biohazardous waste to dispose of. And the cold chain needed to keep vaccines viable is expensive. The 100-year-old hypodermic model needs a critical modern update.
Here are some painful hypodermic needle research findings:
Young people are more likely to fear needles, and kids top the list. A Canadian study of over 1000 kids found that “63% of children reported a fear of needles.” Even worse, “both parents and vaccinators admit they are non-compliant with childhood immunization schedules in an effort to reduce pain and distress.”
Another review found that “up to 50% of adolescents and up to 30% of young adults” are needle phobic. The long-term effects of needle fear mean that over 15% of adults avoid influenza vaccination.
Although percentages decrease with age, the US Center for Disease Control (CDC) says, “It has been estimated that up to 25% of adults have a fear of needles, with most needle fears developing during childhood.” It adds that “If not addressed, these fears can have long-term effects such as preprocedural anxiety and avoidance of needed health care throughout a person’s lifetime.”
Trypanophobia is one of the main reasons people refuse to get vaccinated. During the COVID-19 pandemic, an Oxford University study of over 15,000 adults found over ¼ feared injections and 22% “were more likely to report COVID-19 vaccine hesitancy.”
A global survey of 2098 adults found:
“63.2% reported experiencing needle phobia, and rated the intensity of their fear as 5.7 [out of 10].”
“Needle fear was associated with widespread avoidance behavior. Most of the subjects with needle fear reported avoiding blood draws, and over one-third reported avoiding blood donations and vaccinations.”
“Needle fear is a common barrier to initiating or adhering to medical treatments and vaccine hesitancy.”
94% of participants said non-invasive alternatives are the top solution to reducing needle fear among participants.
Microneedles are small patches with tiny clusters of hair-sized needles applied to the skin like a bandage. The tips painlessly pierce the outer layer of the skin, delivering vaccines and other medicines into the body.
Kids, adolescents and adults who fear needles will applaud the introduction of painless microneedles. Doctor’s appointments will become a positive experience, eliminating the fear and stress needles create.
Reducing Injection Costs and Improving Outcomes
Another challenge associated with the hypodermic model is its costly reliance on the cold chain to manufacture, package, ship, store, and track vaccines and other drugs at low temperatures. Microneedles are thermostable, meaning they can be shipped and stored at room temperature.
The pharmaceutical cold chain was valued at $17.2 Billion in 2020. It is forecast to reach $21.3B by 2024. This represents a massive price tag, compounded by “an estimated 20% to 40% of biopharmaceutical products damaged before reaching the end user.”
Microneedles have many related benefits. They can:
be shipped and stored at room temperature, reducing cold chain costs
eliminate bio-hazardous waste of used needles
reduce the need for medically skilled personnel and associated costs
prevent thousands of needlestick injuries
provide an equitable method for the global distribution of essential medical products
result in better patient compliance and enhanced health outcomes
Painless microneedles are the solution. The scientific community recognizes their efficacy in delivering medicines and other ingredients across the skin barrier. These advantages will transform how we provide vaccines and other drugs, offering clear benefits to our children and others who experience needle phobia.
How Big is the Global Microneedle Market?
The global microneedle market is big and growing fast. Grandview Research estimates that the global microneedle drug delivery systems market size was USD 5.38 billion in 2022. It’s forecast to hit USD 9.46 billion in 2030.
Both the U.S. FDA and Health Canada support the development of microneedle technology. This results in increased investment and innovation in the market. Established companies and multiple startups are competing to market commercially available medical microneedles.
Microneedles for Kids
Microneedles will have the most significant impact on kids. Painless vaccination means no more tears or fears at the doctor’s office. However, adult and infant skin differ in important ways (see diagram below), requiring unique formulations and compositions.
Infant skin:
is thinner at the outer and inner layers (stratum corneum and epidermis)
loses water faster
has less natural moisturizing factor
contains fewer melanin pigments
has smaller corneocytes (dead or dying skin cells)
Microneedle patches for children, therefore, require unique formulations and compositions.
Source: Eltean
Transdermal drug delivery can be translated from adults to the pediatric population with different dosage forms. The benefits of this non-invasive, painless route ensure its acceptance. The prospect of pediatric vaccine delivery marks a significant shift in the status quo, sure to be popular with kids and parents.
The biocompatibility of microneedle materials for pediatric populations is especially important because of this age group's immature and rapidly evolving skin barrier function.
Pediatricians Support Microneedles
Pediatricians agree that using microneedles “was expected to cause considerably reduced anxiety and distress for the children themselves (87.5%), the parents (88.5%) and even to the healthcare providers who are required for handling and administration (71.7%).”
Compared to conventional drug delivery systems, pediatricians highlight painless drug delivery while pointing to the additional advantages of microneedle patches. They provide controlled delivery of therapeutics, avoid first-pass effects, and decrease needle-stick injuries and transmission of blood-borne infectious diseases.
One survey of pediatricians found the top application for microneedles in pediatric populations could be anti-emetics: drugs prescribed to help with nausea and vomiting that are side effects from other medications. This was followed closely by analgesics (common over-the-counter pain relief drugs), vaccines, and antibiotics.
Source: Semantic Scholar
Clinical Trials in Pediatric Populations
Clinical trials in pediatric populations are limited. The US National Institute of Health (NIH) website lists an Emory University trial clinical trial among pediatric populations that “evaluated the safety, reactogenicity, and acceptability of placement of a placebo microneedle patch to the skin of children.” Thirty-three children aged six weeks to 24 months were evaluated with positive results.
Another trial conducted by Universiti Kebangsaan Malaysia Medical Centre for a “Microneedle Patch for Topical Anesthesia Enhancement in Paediatric Thalassemia Patients”, found microneedles effectively reduced pain for kids needing blood transfusions.
(Thalassemia is a blood disease where the body doesn’t make enough hemoglobin, a protein that helps carry oxygen through the body.)
Even more promising, in March 2023, Micron Biomedical completed Mumps/Rubella vaccine trials delivered via microneedle patch to infants (9 to 10 months), toddlers (15 to 18 months) and adults (18 to 40 years) in The Gambia. Reuters recently reported the trial “showed that Micron’s device delivered the measles-rubella vaccine, produced by the Serum Institute of India, to adults, babies and toddlers as safely and effectively as syringes, and produced a similar immune response.”
These results demonstrate painless microneedles are the solution for delivering vaccines and other medicines.
The Future of Microneedles: Painless Progress in Health Care
Looking at the future of health care, microneedles will redefine how we approach vaccinations and drug delivery. In a world where fear of needles spans across age groups, microneedles hold the promise of converting a once-dreaded medical experience into a painless and anxiety-free process.
Overcoming needle phobia, particularly prevalent among kids and adolescents, will shift health care for the most vulnerable populations. Pediatricians support the adoption of microneedles, anticipating reduced anxiety for children, parents, and healthcare providers.
Size matters. As the name implies, microneedles are small and easy to ship without expensive temperature limitations, improving global access to critical vaccines.
As research and clinical trials continue, support for microneedles in regulatory bodies grows. Nonetheless, there is an increased urgency to complete more clinical trials and achieve regulatory approval of microneedles for vaccines and other medicines. Until this becomes a reality, we are stuck with hypodermic needles.
Imagine doctor's appointments that are associated with positive experiences devoid of the stress and fear traditionally linked to needles. Microneedles pave the way for a more patient-centric approach to health care, ensuring better compliance and improved health outcomes. The transition from hypodermic needles to microneedles is not just a technological shift; it's a paradigm shift in how we perceive and receive medical care.
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