Research On Longer Needles For COVID-19 Vaccinations And Community Pharmacies Tracking Circulating Viruses

Thursday, 29 August 2024

Research investigates greater use of community pharmacies to boost infectious diseases surveillance and vaccination effectiveness.

Te Niwha-funded research projects are harnessing the national coverage and expertise of community pharmacies as these health professionals play an ever-increasing role in the frontline fight to keep communities safe from infectious diseases.

The Medical Research Institute of New Zealand (MRINZ) is leading two Te Niwha-funded research projects that involve community pharmacists. These projects, conducted through its nationwide Pharmacy Research Network (PRN), engage with participants through their local community pharmacies.

The first project, in collaboration with the Crown Research Institute of Environmental Science and Research Limited (ESR), assesses the feasibility of enhancing existing national surveillance systems in general practices and hospitals by incorporating pharmacy-based monitoring to track circulating viruses. The second project is a randomized controlled trial investigating whether the immune response and side effects from COVID-19 vaccination vary depending on whether the vaccine is administered into the deltoid muscle or subcutaneous tissue.

Kyley Kerse, MRINZ’s Head Pharmacist, co-leads the Community Pharmacy-based Surveillance Feasibility Study alongside Alex Semprini, MRINZ Deputy Director. This research project investigates the potential and optimal processes for pharmacies nationwide to collect nasopharyngeal swabs, enhancing the existing surveillance of circulating respiratory viruses conducted by general practices.

Ms. Kerse says as patients regularly visit pharmacies to manage cold and flu symptoms, there is an opportunity to gather surveillance data of circulating viruses in those patients who are not ill enough to require GP or hospital level assessment.

“By implementing a pharmacy arm to the existing Influenza-like-illness (ILI) surveillance community based-programme in general practice, we broaden the population demographics participating in surveillance practices. This increases the opportunities for early detection and reaction to circulating respiratory viruses in the community. Data from the existing GP-based ILI programme contributes to specific strain selection in the seasonal influenza vaccine; data from this research project could add to that pool of knowledge.”

MRINZ research fellow Dr Gabby Shortt leads a second Te Niwha-funded research project involving community pharmacy and the PRN. This project uses a randomised controlled trial – a ‘gold standard’ research method – to study whether delivering COVID-19 vaccines into the subcutaneous tissue versus into muscle produces an equally effective immune response and whether it influences the severity of adverse reactions.

Dr Shortt says COVID-19 vaccines are currently registered for injection into the muscle, with the deltoid muscle in the arm being the recommended site.

“Research already conducted by the MRINZ found the standard 25mm needle length typically used in COVID-19 vaccination is insufficient to reach the deltoid muscle in a large proportion of adults with obesity. Obesity can also increase the risk of severe illness from COVID-19.”

Dr Shortt and her team are investigating the impact of vaccination with a 38mm needle versus vaccination with a 13mm needle in a randomised control trial to provide robust evidence to guide the choice of needle length by those administering vaccinations.

With pharmacists providing a large proportion of COVID-19 vaccines, the use of the PRN gives access to a wide population, she says.

Dr Lucia Schweitzer, Te Niwha Pou Rangahau Research Engagement Manager, says the community pharmacy-related research projects are good examples of the robust and cutting-edge science done by Te Niwha-funded researchers in service of the community. The randomised control trial of vaccination needle length, for example, is a ‘gold standard level’ study that will provide both evidence for front line health professionals to use as well as ensuring better outcomes for people being vaccinated.

In addition to the pharmacy-related research projects, the MRINZ is also funded to conduct a Te Niwha research project to develop new treatments for seasonal influenza and other serious respiratory diseases through an existing international network involving patients hospitalised with severe disease.

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