Reading, Writing, and Reflecting

Recently, I’ve visited with family and friends who’ve had to take their children for routine vaccinations, tests for allergies, and other medical procedures.  In most cases, these tests or vaccinations are applied with hypodermic needles and syringes.  It’s still heart breaking to hear that even infants have to deal with needles for shots, in one instance, I was told of a 4 month old baby that had to have 36 routine shots.

I’ve always wondered, shouldn’t there have been real advances to hypodermic  needle technology just like in so many other medical fields?  To understand this question better, I looked at the history of the hypodermic needle, comparisons to other medical advances, and recent advances in needle technologies.

History

According to MedhelpNet.com (as documented in About.com), Charles Gabriel Pravaz (1791-1853), a French surgeon, and Alexander Wood (1817-1884), a Scottish physician, independently invented the hypodermic syringe around 1853.

Dr. Alexander Wood's syringe

Also documented in About.com, per the “The History of Medical Science”, Edward Jenner performed the first vaccination. In the eighteenth century, Jenner, an English doctor, began to study smallpox and used the syringe to test his theories.

So, from what I can tell, the syringe of today looks similar to the syringe of the 1800’s.  While there have certainly been advances over the years with needles such as disposable syringes, mass production of syringes, pronged vaccination needles and plastic syringes, to me, none of them have been ground breaking changes to the basic delivery method originally developed.

Comparison to other Medical Advances

To better assess the hypodermic needle’s rate of comparative innovation over a similar time frame, I looked at the top medical advances over the years.  In 2007, the British Medical Journal (now BMJ) conducted a survey of the top medical advances since 1840, the year the journal was formed (a similar year as the invention of the hypodermic syringe).  The results of the survey is documented here in a Fox News article.  The top vote getters in the survey:

1. Sanitation— Importance of clean drinking water and disposable waste in the late 1800’s recognized.
2. Antibiotics- Penicillin discovered in 1928.   Variety of new antibiotics continue to become available.
3. Anesthesia- Used for first time in 1846, has become a mainstay of surgeries today.
4. Vaccines– As mentioned, first vaccination developed for smallpox and more vaccinations have been developed over the years (but the delivery methods haven’t changed much)
5. Discovery of DNA structure- Discovery of the molecule that carries genetic information

Just a sample of the top medical advances during the last 150 years (for some more recent advances; here’s Time Magazine’s list of the top ten advances of 2008).  While it may be unfair to expect advances in a delivery method like a syringe to be comparable to the top advances in all of medicine or public health, I certainly doubt that there were any votes for the continued improvement in the hypodermic needle.

Recent Advances in Hypodermic Needle Technology

The good news is that in even in the last two months, there have been publication of recent articles that discuss technologies that promise to make injections much more pain-free.   Key advances include:

Micro-needles–   Today, the most likely replacement of the traditional hypodermic needle will involve micro-needles.  The drug is encapsulated within a grid or array of very small micro-needles, which are then inserted into the skin to release the drug with much less pain than ever before.

Polymer Microneedle

Ceramic Hybrid Needles– Uses polymerized ceramic materials to create hollow, very fine micro-needles that patients won’t  feel piercing their skin when delivered.

Novel Needle based on Oil industry Concepts–  New needle involves a hollow S-shaped needle containing a filament that acts as a guide wire.  This device in essence, reduces the chance that the needle penetrates too far under their skin reducing medical complications and pain.    This innovation could reach clinics in 3-5 years.

E-Mosquito–  A skin patch that consists of four micro-needles that are electronically controlled to penetrate the skin deep enough to hit a capillary, but not deep enough to hit a nerve, limiting the amount of pain.

Microjet System– Microjets combine high velocity (more than 100 meters per second) with very small jet diameters (between 50 and 100 micrometers), delivering only 2 to 15 nanoliters of liquid drug at a time.

Five-in-One Vaccine– If the advances in needles doesn’t actually materialize, maybe infants can at least have less injections to get the same amount of vaccinations.  One of Time Magazines top medical advances in 2008, the development of Pentacel is the first vaccine to immunize against five diseases at once — diphtheria, tetanus, pertussis, polio and haemophilus influenzae type B.

While none of these advances appear likely to gain mass penetration anytime soon, advances are being made.   I can actually foresee the reliance of the large, painful needles diminishing and being able to tell parents of small children that hopefully soon, future rounds of shots for their kids will be much less painful.