Does the world\’s first vaccine robot even make sense? We ask a nurse

By now, you may have seen the YouTube video. A robot called the Cobi pokes its head out of a box like a cyborg ostrich. Over the course of roughly 30 seconds, it eases its head forward, poking its nose into an arm. This nose is actually a needle-free injector delivering a vaccine to muscle tissue, automatically.

Developed by the Canadian startup Cobionix, the company claims this robot is the world’s first autonomous injector—a vaxbot, if you will.

For now, it’s just a working prototype that could take two years or longer to come to market, and vaccinations are just one of many tasks it could potentially perform, according to cofounder Tim Lasswell, who lent his arm for the video.

The question is not whether this technology is remarkable. The question is, Is Cobi actually designed to replace a healthcare professional—even for a task as seemingly simple as jabbing a vaccine?

“My initial thoughts were, I don’t even trust my Roomba!” Melody Butler, executive director for the nonprofit Nurses Who Vaccinate, says with a laugh. A registered nurse herself, she quickly clarifies that the criticism is not a critique of robotics, but of the automation of robots inside a medical facility.

“We do use a lot of robotics in healthcare. We have the Da Vinci robot surgeons that use amazing technology,” says Butler. “However, there’s a person behind that robot at all times. It’s not automated. You have the clinical skills and experience a person is able to provide.”

Meanwhile, Cobionix is interested in automating patient care, but through long-term software iteration of their hardware platform. “Similar to Tesla, it has all the self-driving autonomous hardware on board, but the cars are not self-driving yet,” says Lasswell. He says the Cobi—which uses AI and 3D vision to see patients—could one day perform ultrasounds, blood draws, and biopsies, swapping out its tools for each job much like a doctor or a nurse. “Our initial robotic platform is probably overkill in terms of what we’d need from hardware and software to give vaccines.”

[Photo: courtesy Cobionix]

In theory. Though as Butler explains, automation in medicine is trickier than mere mechanics. A person provides patient comfort—soft skills that include answering questions and concerns—as well as constant clinical assessment that treatment is going all right.

“Not every person is the same. Maybe the technology will be there, and is better than the human eye at assessing someone’s deltoid muscle.” But for now, she doubts that’s the case.

“You have to remember, with vaccines, the most common adverse reaction is from improper technique,” says Butler. That reaction is known as Shoulder Injury Related to Vaccine Administration (SIRVA), and while rare, it can occur if a shot is given too high in the arm, damaging tissue in a way that causes pain and mobility loss long term. Specifically because of issues like SIRVA, even medical professionals must take an hour-long refresher course if they’ve stopped giving vaccines for more than a year before picking the practice back up, then demonstrate their skills to a manager.

That said, Butler is actually concerned less about the robot’s ability to administer a vaccine than a patient’s own familiarity with the machine to receive that vaccine safely. She points out that patients would need to be educated to receive a vaccination from this robot—which is actually a CDC-recommendation for all vaccines. Perhaps that could be through a chat with a doctor or a video explainer, she muses, but Butler was skeptical that the existing user interface would be enough to ensure that every patient could smoothly receive a vaccine from a robot on the first try. (Keep in mind the importance of reliable, automated care at scale—3 billion people on earth have been vaccinated against COVID-19 alone. If one out of a hundred people encounter a problem, that’s 30 million people.)

[Image: courtesy Cobionix]

“Right now it’s really dependent on the user to allow the robot to administer the vaccine to them,” says Butler. “This would be fine for someone who is trained, and gets regular shots. But I’d be hesitant to use this now for a mass vaccination campaign because each individual would require education [first].”

The challenges of administering vaccines only grows when vaccinating a child. Two-thirds of children are afraid of needles, and at CVS, the pharmacists and technicians who administer vaccines are trained to serve as an emotional support as much as a vaccinator.

“Our teams are engaged with children during the vaccination process, talking with the child, making jokes, and trying to keep them distracted and calm,” says a CVS spokesperson. “Our teams are focused on allowing the child to make choices, such as what Band-Aid they would like and which arm they want to use for the vaccination.”

To be fair, Cobionix is taking many of these issues into consideration when developing its platform. They specifically fitted the Cobi with a needle-free technology because they knew a robot holding a needle would be terrifying. (Have you ever seen a robot do a nasal swab? Shivers.) And while they declined to make any attempt to hide the robot itself—perhaps covering it with some sort of facade to make it look like a vaccine kiosk rather than a vaccine robot—they did approach the industrial design with comfort in mind.

“For this product, we decided to go with the shape of a robotic arm that’s smooth, and [even] cute, [using] rounded joints, and a shiny white appearance,” says cofounder Nima Zamani. “We tried to make it as least-threatening as possible. But over time people will get more accepting of robotic arms.”

However, in the near term, Butler suggests a robot like Cobi doesn’t even need to give vaccines to be incredibly helpful in a healthcare context. Vaccines like Pfizer have to be thawed, mixed, and diluted before administration—a careful preparation practiced by healthcare providers that you might never realize goes into each shot. This behind-the-scenes work is ripe for automation to give time back to staff.

“That’s a technology that could be used right now!” says Butler.