Today's Family Medicine News Highlights

June 28, 2017

Globe and Mail
Quebec to overhaul province’s generic pharmaceutical purchasing system 
Ottawa to fund mentorship network to support Indigenous health researchers and provide learning opportunities
Federal health minister appoints Dr. Theresa Tam as head of PHAC

CTV News
Canadian researchers develop fibre-optic probe that can detect stray cancer cells, reducing risk of recurrence 

CBC News
PHAC investigates salmonella outbreak linked to frozen breaded chicken products 

Toronto Star
Health Canada allows users at supervised injection sites in BC to use substances orally and nasally

PR Newswire
AAFP launches program to help family physicians educate patients on vaccination to increase vaccination rates

The Northwester
Main Street Medical Clinic in Springdale, NL launches access to opioid treatment program for rural areas and Indigenous communities

Medical Post
Here comes the dissolvable microneedle patch for flu vaccination
Novel device found to be safe and preferred in first-in-human trial


Delivering the influenza vaccine via a dissolvable microneedle patch has been found to be safe and preferred over conventional injection in a phase I trial.

The study, published in the Lancet, is the first randomized trial to test a self-administered, dissolvable microneedle patch vaccine in humans. Results showed that the microneedle patch could be safely self-administered by participants, and was stable for one year at 40 degrees Celsius, potentially reducing delivery and storage costs. Analysis of the patches also found that the microneedles successfully dissolved, thereby eliminating safety risks associated with used hypodermic needles.

The study, led by Emory University and the Georgia Institute of Technology in Atlanta, where the patch was developed, further indicated that the microneedle patch leads to a robust immune response similar to conventional intramuscular injection, but larger trials are needed to further investigate the immune mechanism behind the response and confirm the findings.

Vaccination by microneedle patch could improve vaccination coverage because the patch could be stored and distributed without refrigeration and may be safely self-administered by patients without the need for trained health professionals.

The trial involved 100 people age 18 to 49 who had chosen not to receive the available influenza vaccine for that season. Participants were randomly assigned to one of four groups: they received either a vaccine microneedle patch, vaccine injection or placebo microneedle patch administered by a health professional, or a self-applied vaccine microneedle patch. Participants received a single dose of inactivated influenza vaccine.

The vaccine injection was given in the arm, and the microneedle patch was applied for 20 minutes on the wrist. Participants who self-applied the patch were given instructions via a brief audiovisual presentation. The study was primarily designed to assess safety and acceptability, but also investigated immunogenicity.

At six months, no serious side-effects linked to the vaccine were reported and there were no cases of influenza in any of the groups. Minor reactions to the vaccine were mild and transient. Pain and tenderness were most commonly reported in the injection group, and redness, itching and tenderness in the vaccine microneedle patch groups.

Immediately after receiving the vaccine, participants reported high acceptability, with scores of 4.5 to 4.8 (out of 5) in the three microneedle patch groups, similar to the injection group (4.4). At 28 days post vaccination, 70% of participants who had received the microneedle patch vaccine (33 of 47) said they preferred it to the injection.

“Dissolvable microneedle patches could potentially simplify the delivery of influenza vaccines,” said Dr. Nadine Rouphael, an associate professor of medicine at Emory University and lead author of the study, in a news release. “We found that the vaccine was stable outside the cold chain, meaning that it could potentially be stored on a pharmacy shelf. The patch could also be safely applied by participants themselves, meaning we could envisage vaccination at home, in the work place, or even via mail distribution. These advantages could reduce the cost of the flu vaccine and potentially increase coverage. Our findings now need confirming in larger trials.”

At 28 days post vaccination, the microneedle patch generated a robust immune response, with antibody levels in the microneedle patch groups similar to the injection groups. These outcomes require further research to confirm the findings.

Study co-author Dr. Mark Prausnitz (PhD), director of the Center for Drug Design, Development and Delivery at the Georgia Institute of Technology, added: “The microneedle patch was reliably used by study participants because we incorporated an audible and tactile feedback mechanism to tell participants when sufficient force is applied. After vaccination, examination of used microneedle patches showed that the microneedles had dissolved in the skin, suggesting that used patches could be discarded as non-sharps waste, potentially further increasing the safety and reducing the cost of vaccine delivery.”

The trial was funded by the U.S. National Institutes of Health.

“Microneedle patches have the potential to become ideal candidates for vaccination programs, not only in poorly resourced settings, but also for individuals who currently prefer not to get vaccinated, potentially even being an attractive vaccine for the pediatric population, provided late-stage clinical development confirms vaccine efficacy,” a related editorial noted.

La Presse
Tentative majeure au Québec pour diminuer le prix des médicaments génériques 
Une sonde conçue à Montréal pour faire la lumière sur la présence de cancer dans une cellule 

Le Journal de Montréal
Fermeture estivale de 83 lits au CUSM pour boucler le budget

Ici Radio-Canada
Formation offerte aux infirmières sur l’aide aux couples vivant un avortement spontané
Le rappel de farine toujours en vigueur malgré la fin de l’éclosion d’E. coli 
Consommation de drogues sous forme inhalée autorisée dans certains centres supervisés


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