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Microbes & Immunity

PERSPECTIVE ARTICLE
Benefit of noninvasive vagus nerve stimulation

in vaccine optimization for young children

Claire-Marie Rangon * and Peter Staats 2,3
1
1 One Clinic, Child Neurology, Montmorency, France
2 National Spine and Pain Centers, United States of America
3 Division of Pain Medicine, Johns Hopkins University, Baltimore, United States of America

Abstract
Whether it is mandatory to vaccinate young children against SARS-CoV-2 and
respiratory syncytial virus (RSV) is still an ongoing topic of debate. Indeed, vaccine
acceptance for young children is either too low (in the case of COVID-19) or, in some
cases, unattainable (with the demand far exceeding the capacity of production in
the case of RSV vaccines in some countries). In addition, while vaccines do confer
immunity, they can be complicated by inflammatory reactions to the vaccine itself.
This inflammatory response is controlled by the nervous system, specifically the
vagus nerve. Vagal tone optimization in and of itself confers some level of protection
against viral infections such as SARS-CoV-2 or RSV, but the degree of protection
has not been adequately evaluated. Even though additional studies are needed to
validate a strategy of vagal optimization as an alternative to or co-treatment with
vaccines, studies of noninvasive vagus nerve stimulation should be supported by
public health agencies as an adjunctive tool providing young children with safe, ready-
to-use immunization and protection from vaccine reactions. This recommendation is
*Corresponding author:
Claire-Marie Rangon based on scientific, epidemiological, ethical, and economic considerations.
(dr.clairemarierangon@one.fr)
Citation: Rangon C, Staats P. Keywords: Vagus nerve; Noninvasive stimulation; Vaccine; COVID-19; Bronchiolitis;
Benefit of noninvasive vagus nerve Children
stimulation in vaccine optimization
for young children. Microbes &
Immunity. 2024;1(1):2598.
doi: 10.36922/mi.2598
Received: December 31, 2023 1. Introduction
Accepted: February 27, 2024 The cholinergic anti-inflammatory pathway is a well-known neuro-immunomodulatory
pathway, in which acetylcholine (ACh), released by the interaction of vagal nerve with
Published Online: March 19, 2024
specific nicotinic receptors (α7nAChR), prevents the synthesis and release of pro-
Copyright: © 2024 Author(s). inflammatory cytokines. Afferent vagal signals, mediated by pathogen-associated
1
This is an Open-Access article
distributed under the terms of the molecular patterns and damage-associated molecular patterns including cytokines, are
Creative Commons Attribution conveyed to the nucleus tractus solitarius in the brainstem. This, automatically activates
License, permitting distribution, efferent motor cholinergic neurons from the dorsal motor nucleus of the vagus (DMV)
and reproduction in any medium,
2
provided the original work is to prevent hyperinflammation, creating a negative feedback loop. Thus, targeting this
properly cited. cholinergic anti-inflammatory pathway has been well described as a strategy to treat
Publisher’s Note: AccScience sepsis, as well as a way to mitigate cytokine reactions in disparate diseases, ranging from
Publishing remains neutral with COVID-19 to rheumatologic diseases.
regard to jurisdictional claims in
published maps and institutional Electrical stimulation of the vagus nerve has shown efficiency to decrease the
affiliations. inflammatory response in both preclinical studies and clinical trials. Different
3

Volume 1 Issue 1 (2024) 51 doi: 10.36922/mi.2598