With 13 COVID-19 vaccines in use around the world, pharmaceutical companies are exploring second-generation technology that could change how doses are administered and distributed.

These vaccines could be taken orally as a capsule that could be swallowed, as a tablet that dissolves under the tongue or as a nasal spray. Such formulations would not require refrigeration, nor would they need healthcare workers to administer them.

The efforts are in early stages with no guarantee of success. Research and development costs are steep, and only a small number of companies — none with a vaccine currently authorized for use — are exploring these alternate methods. The work may seem like a gamble but could play a critical role in ending the pandemic.

“It is encouraging to see manufacturers pursue easier to administer formulas of the vaccine,” said Esther Krofah, executive director of the Milken Institute’s FasterCures. “We need to have a global focus, and not just a domestic focus.”

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