Leading vaccine maker, Bharat Biotech International Limited (BBIL) on November 28 announced that the world's first intranasal vaccine for COVID-19, iNCOVACC (BBV154), has received approval from the Central Drugs Standard Control Organisation (CDSCO) under Restricted Use in Emergency Situation for ages 18 and above, in India, for heterologous booster doses.

iNCOVACC is a recombinant replication deficient adenovirus vectored vaccine with a pre-fusion stabilised SARS-CoV-2 spike protein. This vaccine candidate was evaluated in phases I, II, and III clinical trials with successful results, the Hyderabad company said.

iNCOVACC has been specifically formulated to allow intranasal delivery through nasal drops. The nasal delivery system has been designed and developed to be cost-effective in low- and middle-income countries.

Bharat Biotech said that launch dates, pricing, and availability will be announced in due course of time.

iNCOVACC is stable at 2-8 degrees Celsius for easy storage and distribution. Bharat Biotech has established large manufacturing capabilities at multiple sites across India, including Gujarat, Karnataka, Maharashtra, and Telangana, with operations pan India.

iNCOVACC was developed in partnership with Washington University, St. Louis, which had designed and developed the recombinant adenoviral vectored construct and evaluated it in preclinical studies for efficacy.

Product development related to preclinical safety evaluation, large-scale manufacturing scale-up, formulation, and delivery device development, including human clinical trials, were conducted by Bharat Biotech.

"iNCOVACC, is an intranasal vaccine for the primary 2-dose schedule, and heterologous booster dose. This is a great achievement for us and the global scientific community to enable nasal administration of COVID vaccines. Despite the lack of demand for COVID vaccines, we continued product development in intranasal vaccines to ensure that we are well-prepared with platform technologies for future infectious diseases," said Dr. Krishna Ella, Chairman and Managing Director, Bharat Biotech.

"iNCOVACC has been designed for efficient distribution and easy and pain-free administration. We have also initiated the development of variant-specific vaccines for COVID for future preparedness," he added.

Clinical trials were conducted to evaluate iNCOVACC as a primary dose schedule, and as a heterologous booster dose for subjects who have previously received two doses of the two commonly administered COVID vaccines in India.

Dr. Rajesh S. Gokhale, Secretary, DBT, and Chairperson, BIRAC, lauded the efforts of the scientific community.

"DBT is fostering biotech enterprises & innovation ecosystem and strategically strengthening the Indian bioeconomy. DBT, along with BIRAC, is dedicated to the development of effective and safe COVID-19 vaccines under Mission COVID Suraksha. The DCGI's approval of Bharat Biotech's intranasal vaccine iNCOVACC (BBV154) to be used as a heterologous booster dose against currently available COVID-19 vaccines is a moment of great pride for our country. This move will further strengthen our collective fight against the pandemic and broaden vaccine coverage," he said

"We are excited by the expansion of the EUA for iNCOVACC as a booster, which enables this intranasal vaccine to be used by many more people, and hopefully curtail transmission," said Michael S. Diamond, MD, PhD, of Washington University in St. Louis, who co-developed the nasal vaccine technology with Washington University colleague David Curiel, MD, PhD.

"This approval will increase the options for people to get vaccinated and protected against the SARS-CoV-2 virus during the ongoing pandemic."

Washington University licensed the vaccine technology to Bharat Biotech in 2020 for further development.

iNCOVACC was evaluated to determine its impact on safety. The reactogenic events and adverse events that were documented during the trial were highly comparable to published data from other COVID-19 vaccines. Product development data will be submitted to peer-reviewed journals and will be made available in the public domain.

Bharat Biotech said that iNCOVACC has the double benefit of enabling faster development of variant-specific vaccines and easy nasal delivery that enables mass immunisation to protect from emerging variants of concern. It promises to become an important tool in mass vaccinations during pandemics and endemics.