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The winter and post-holiday season is when Covid and flu cases usually surge, which means it’s the time of year when people should be taking every measure to protect themselves. Yet, uptake levels of vaccines in the US would tell a different story. As of mid-December, only 20.9 percent of adults in the US had received their Covid vaccine. For the flu shot, it’s 41.7 percent. Both figures represent a significant drop-off compared to the 73 percent of adults who had received at least one dose of their Covid shot back in November 2021, and the 63.7 percent of people who received their flu shots the season before the pandemic.

There are a host of reasons why people don’t get vaccinated, from a lack of trust in science to the assumption they are unneeded to simple forgetfulness. One major reason, though, has nothing to do with politics or the Make America Health Again movement or confidence in one’s natural immune system, but should be familiar to anyone who has tried to get their toddler to sit still for a shot. It’s the fear of needles. One in four adults report having a phobia of needles, and one study found that 16 percent of Americans say they skipped their flu vaccinations to avoid facing this fear.

Beyond scaring some people away, conventional shots also present serious logistical challenges to distributing some vaccines, especially for Covid mRNA vaccines. These have to be transported in super cold storage as they make their way to clinics and hospitals, which can prove particularly difficult for rural communities and lower-income countries that may not have reliable access to specialized refrigeration.

So how do we address these barriers and ensure people get vaccinated? One option: nasal vaccines, which would be sprayed into our noses — no needles required. Beyond sidestepping people’s fear of needles, these vaccines would also make it easier to store and distribute ahead of administering. Scientists have been focusing more on nasal vaccines — like the flu vaccine FluMist that was recently approved for at-home use — as a way to overcome these social and practical challenges to vaccination.

Multiple studies have also shown that nasal vaccines could be more effective at preventing infection and transmission of Covid, which, in turn, can help lower the risk of getting long Covid. By getting vaccinated through our noses, our body generates immunity to the virus right where it enters our bodies. While a nasal vaccine for Covid has yet to be approved for full use in the US, researchers at Washington University in St. Louis developed a Covid nasal vaccine that was employed for emergency use in unvaccinated people and as a booster dose in India two years ago.

“Because of the danger of having this chronic condition afterwards, we really should be caring about Covid still,” says Akiko Iwasaki, head of the Center for Infection and Immunity and professor of Immunology at the Yale School of Medicine, who has worked on developing nasal vaccines. “We should be doing anything we can to prevent infection.”

If nasal vaccines can increase vaccination uptake, they could help make Covid and other respiratory viruses a bit more manageable all around the world. But scientists and researchers must first clear the hurdles that have kept them mostly out of reach to people........

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