Coronavirus disease 2019 (COVID-19) is a highly contagious viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that has emerged as the most consequential global health emergency.^[1] The World Health Organisation (WHO) is committed to maintaining the momentum for expanding access to COVID-19 vaccinations and supporting countries in accelerating vaccine distribution to save lives and prevent individuals from becoming critically ill. The Indian government has announced strict precautionary measures in response to the virus’s widespread distribution worldwide and has encouraged individuals to receive the full course of vaccinations, including the booster dose.

Recently, the Central Drugs Standard Control Organisation (CDSCO) has approved world’s first intranasal vaccine (BBV154) for COVID-19 developed by India for restricted use in emergency situations for patients aged ≥18 years, for heterologous booster doses.

BBV154 is a recombinant replication-deficient adenovirus vectored vaccine with a pre-fusion stabilised spike protein. It has been designed specifically to facilitate intranasal delivery via nasal drops. The nasal delivery system has been formulated and developed to be cost-effective in low- and middle-income countries.^[2]

Benefits of intranasal vaccine:

• An intranasal vaccine induces a broad immune response by neutralising immunoglobulin G (IgG), mucosal IgA, and T cell responses.
• The prevention of COVID-19 infection and transmission depends on immune responses at the infection site (in the nasal mucosa).
• Due to the well-organised immune systems of the nasal mucosa, the nasal route provides excellent potential for vaccination.
• It is non-invasive and needle-free. There are no risks of needle-associated injuries and infections.
• It is easy to administer and does not require trained healthcare workers.
• It has high compliance.
• It is able to meet global demand.
• This vaccine is stable at 2-8°C for easy storage and distribution.
• This vaccine facilitates the rapid development of variant-specific vaccines and simple nasal delivery that allows mass immunisation to protect against emerging variants of concern.

This vaccine has produced positive results in clinical trials. Therefore, it has the potential to be a crucial tool in mass vaccinations during pandemics and endemics.