title: Opportunities and challenges in delivering influenza vaccine by microneedle patch.
abstract: BACKGROUND
  Simple and efficacious delivery methods for influenza vaccines are needed to improve health outcomes and manage possible pandemics both in the United States and globally. One approach to meeting these needs is the microneedle patch (MNP), a small array of micron-scale needles that is applied to the skin like a bandage.
  
  
  METHODS
  To inform additional technical developments and the eventual introduction of MNPs for influenza vaccination, we interviewed key opinion leaders in the United States for insights into the opportunities and challenges associated with this technology, particularly its potential for self-administration.
  
  
  RESULTS
  All interviewees expressed high support for administration of influenza vaccine in MNPs by health care providers and for self-administration in groups supervised by a provider. Self-administration via prescription and over-the-counter purchase of MNPs received lower levels of support. Interviewees also highlighted priorities that should be considered in the ongoing development of an influenza vaccine MNP, such as confirming efficacy and ensuring safety for self-administration. For patient and health care provider acceptability, important attributes are ease of use, short wear times, and an easily accessible application site.
  
  
  CONCLUSIONS
  Stakeholders agreed that using MNPs can help increase coverage, facilitate easy and safe delivery, reduce the cost of vaccination, and decrease the global morbidity and mortality associated with influenza. Another opportunity for this delivery method is the potential for self-administration. The prospect of reduced provider training requirements, increased thermostability, and high patient and provider acceptability makes it an attractive option for use in remote and low-resource settings worldwide. However, in addition to the technological challenges associated with producing the patch, developers must be mindful of cost considerations and key product attributes or requirements, such as usability, wear time, and proper disposal, that can affect how the product will be received in the marketplace.
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Jacoby
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Jarrahian
authors.affiliation: HF Hull & Associates, 1200 Riverside Dr., Reno, NV 89503, USA.
authors.forename: Harry F
authors.initials: HF
authors.lastname: Hull
authors.affiliation: PATH, PO Box 900922, Seattle, WA 98109, USA. Electronic address: dzehrung@path.org.
authors.forename: Darin
authors.initials: D
authors.lastname: Zehrung
mesh_terms: D016503:Drug Delivery Systems / Q000379:methods*; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D007271:Injections, Intradermal / Q000009:adverse effects / Q000379:methods; D007407:Interviews as Topic; D012646:Self Administration; D014481:United States
chemical_list: D007252:Influenza Vaccines
keywords: Immunization safety; Influenza; Microneedle; Public health; Vaccine delivery; Vaccines