Imagine a world where vaccination could be as simple as rubbing a cream behind your ear. Where vaccines are administered without needles with no healthcare worker in sight—just a dab of lotion can trigger a powerful immune response.
According to Michael Fischbach, Associate Professor at Stanford University and a leading voice on microbiology and genetics, that world may not be as far off as you think.
Speaking at Effortless Bay Area 2024, Prof. Fischbach enthralled the audience with his presentation on how he and his team at Stanford discovered a new way to approach vaccination, one that could be more effective and easier to administer than current methods.
His talk tied in with the Effortless themes of simplicity, design and convergence—on the possibility of how healthcare specialists can do more with less.
Missed attending Effortless Bay Area in person? Watch the event here.
The question that sparked an experiment
Prof. Fischbach, who’s the Liu (Liao) Family Professor of Bioengineering at Stanford and holds a PhD from Harvard, specializes in the study of human microbiomes—the complete array of microorganisms that live on and in humans.
His presentation started with how the experiment’s journey began with a deceptively simple question: What is your immune system thinking when it sees the microbial friends that live in your stomach, on your skin, and in your mouth? To most, the immune system’s role is clear—it’s designed to attack harmful invaders like viruses and bacteria. But what happens when it encounters harmless microbes that live on and in our bodies?
We thought the immune system had friendly things in mind when it saw our microbial colonists, Prof. Fischbach admitted. "But that’s not at all what happens." Instead, as Fischbach and his team discovered, the immune system mounts an unexpected and massive immune response, even to these so-called friends.
Certain microbes, when you put them on the skin or in the gut of a mouse, human, or monkey, induce a huge burst of immune cells," he explained. The strange part? "When your immune system responds to one of your microbial friends, apparently nothing happens. You can’t see any signs of inflammation, there’s no swelling, there’s nothing." He says, adding that about 10 days later, there would be a big burst of adaptive immune cells, which would just sit underneath the skin or right underneath the epithelial lining of the gut without doing anything.
Turning skin bacteria into a tumor cure
As the first step in the experiment, a physician scientist in Prof. Fischbach’s lab genetically engineered Staphylococcus epidermidis, a species of bacterium commonly found on human skin, to carry a small piece of a tumor within its genome. Then, she injected these genetically engineered bacteria using cotton swabs into lab mice having tumors on their bodies.
“All she does is take a Q-tip, dip it in a culture of this engineered bacterium, and then very gently rub it on the head of the mouse. That’s it. That’s the entire experiment,” Prof. Fischbach explained. The idea was to trick the immune system of the mice into responding to the bacterium, with the hope that it might then direct that immune response to the tumor itself.
What happened next was astonishing. The tumors didn’t just shrink—they disappeared entirely. “If she applies this engineered bacterium that has a little piece of the tumor on its surface, then about ten days later, the tumor completely goes away,” Prof. Fischbach revealed.
As Prof. Fischbach described it, these results flew in the face of previous research as the immune response triggered by the genetically engineered bacteria was more aggressive than the researchers had expected. “We thought the immune system had friendly things in mind when it saw our microbial colonists, but it doesn’t have that at all,” he said.
A vaccine revolution in a jar of cream?
While responding to a pathogen as in the case of vaccines, our immune systems initially react by releasing 2 things: the T-cells—also known as “killer cells”—and antibodies. Since the previous experiment noted only the release of the killer cells, another scientist in his lab wondered whether the immune system’s response to the engineered skin bacterium might also generate antibodies.
The experiment was simple this time too: she took a cotton swab and swabbed the bacteria onto the head of a mouse. And this time too, the results were unexpected.
Unlike traditional vaccines, which trigger an initial spike in antibodies that eventually tapers off, the antibody levels in the mice just kept rising. “The level of antibody doesn’t go up and down like [with traditional vaccines]. It just goes up and up and up until about six weeks, and then it levels off, and it stays there forever,” Prof. Fischbach explained, adding it appeared as though the mice had now been vaccinated against this bacterium that was put on its surface.
While the original intent for this experiment was about understanding how the immune system responds to the skin bacterium, he noted that the experiments revealed a new and effective approach to vaccine administration, given that the scientists applied the bacterium on the skin of the mice.
“The way we apply this bacterium to the skin of the mice is we whip it into a little bit of cream that we buy from CVS—Cetaphil. Some of you may even use Cetaphil. Imagine taking a little dab of Cetaphil and rubbing it behind your ear, and that’s it—you’re vaccinated,” Prof. Fischbach elaborated.
For children and particularly infants who are in need of multiple vaccinations, this approach could make the entire experience painless, he noted. “No needle, no healthcare worker, no pain, and for those of you who have children, no need to hold a screaming child down to get vaccinated repeatedly.”
Prof. Fischbach concluded in an optimistic note where he elaborated on how this approach could be economically viable, commercially feasible, and medically powerful. Especially for a world which came out of a pandemic not so long ago, the idea of a painless and effortless vaccination carries substantial weight.
We think this could be not just incredibly cheap and easy to distribute but a very powerful way of eliciting a kind of immune response that doesn’t just show up in your bloodstream but also in the membrane inside your nose, in the membrane on the inside of your lungs, which is where you really need immunity against respiratory pathogens like SARS-CoV-2 and flu.
An effortless way to change the world
Prof. Fischbach’s presentation was more than just a discussion of biology and medicine. It was a testament to the central theme of Effortless: Developing solutions that are faster, simpler, and smarter.
His presentation was a reminder that the future of both healthcare and technology is not just about doing more—it’s about simplifying traditionally complex systems to do fewer things, but better.
