This was an unbalanced and incomplete account of a new "microneedle" technology for delivering flu shots. We have to wade 300 words into a 500-word piece to learn that the research was primarily conducted in mice, and there’s never even any discussion of what kind of study was actually performed. Almost the entire story is given over to cataloging the benefits of this supposedly painless, more convenient approach to vaccination, with no discussion of limitations and challenges. Had the story sought the perspective of an independent expert, it might have at least mentioned some of the big hurdles this technology will have to clear before it can be used in people, as the competing piece from the Houston Chronicle did.
Children aren’t the only ones traumatized by a fear of needles–this worry can also cause many adults to avoid contact with medical professionals and dentists. Although the toll this problem takes is unknown, it certainly can increase the likelihood of potentially preventable conditions such as the flu leading to more serious health problems.
There is no discussion of costs, which is obviously a huge concern when we’re talking about a vaccine that is recommended for nearly the entire population. Although the cost of the patch is unknown at the present time, the press release from Georgia Tech notes that the hope is that the microneedle patch will cost about the same as the existing needle and syringe approach. Costs deserve at least a nod or a passing comment.
The discussion of benefits in this story is out of balance considering the early stage of development for this technology. The story references some human tests of microneedles that apparently show they are "painless" for "nearly everyone." But what kind of studies were these and how many people were involved in them? Did they use adults or did they include children who are more likely to be traumatized by needle pain? The story unfortunately doesn’t say. There are similar problems with the discussion of the mouse study.
The overarching problem is that the story cites a litany of benefits — reduced pain, greater convenience, better compliance with flu shot recommendations — based on zero evidence that the microneedle patch actually works as a vaccine delivery vehicle in humans. It’s fine to speculate about benefits, but there must be some acknowledgment of where on the spectrum this speculation sits between wishful thinking and reality.
Because this was a mouse study and the potential for harm with this technology appears small, we’ll call it not applicable even though harms were not specifically addressed. But we could have dinged the story for this because ANY new drug delivery system has the potential to produce side effects and untoward events.
The story tells us that microneedles have been tested in mice and that they "delivered a correct dose of the flu vaccine," but that’s about the extent of the evaluation. There’s no discussion of the experiment’s design or how it was determined that the microneedles delivered the correct dose. And there’s not even a hint of caution regarding whether the results are likely to be applicable in humans. As the competing story from the Houston Chronicle pointed out, the differences in immune system function between the mouse and human make it unlikely that a mouse benefit will translate directly into a human benefit.
The only expert source quoted in this story was involved with the research. Including an independent perspective might have injected some much-needed caution into this story (and it would have been painless…)
The story fails to mention that the seasonal flu vaccine is available as a nasal spray that is approved for people ages 2-50. While this doesn’t completely solve the problem of needle pain preventing people from getting the flu vaccine, it certainly does make it less of an issue for a large portion of the population. The story also didn’t mention topical creams that can be used to anesthetize the site of the needle stick.
The enticing lead reads, "One day your annual flu shot could come in the mail."
But when is that day?
Only deep in the story do we learn that most of the work has been done in mice, that "The researchers are now seeking funds to begin tests in people and, if all goes well, the patch could be in use in five years." That’s too little, too late, and a prediction that is not based on anything but hope. A news organization that wants to use the crystal ball for predicting outcomes of yet-undone human trials and then of the FDA approval process should probably have its crystal-ball-gazing license checked.
The story mentions that patches are used to deliver nicotine and other medications, but it could have noted that there are a number of other approaches being explored to deliver painless injections, including so-called jet injectors that propel the drug or other injectable material through the skin. In addition, a team of Japanese researchers is also reportedly working on microneedle technology similar to that described in this story. It would have been interesting to hear how these other approaches differ from the technology discussed in the article.
A close one, but since the story did mention some similar technology and didn’t portray the approach as excessively novel, we’ll give it a satisfactory.
The story quotes from an interview with one of the researchers, so we can be certain it didn’t rely entirely on a press release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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