Vaccine Q&A
Updated 1/26/21
*see below for additional sourcing info
Two very effective mRNA vaccines against COVID-19 (caused by the coronavirus SARS-CoV-2) from Pfizer/BioNTech or Moderna are now available and authorized for emergency use by the U.S. Food and Drug Administration (FDA). The Moderna vaccine is approved for those 18 and over, while the Pfizer vaccine is approved for those 16 and over. They both require two shots - 21 days apart for Pfizer and 28 days apart for Moderna.
Key Points:
Both vaccines approved for emergency use in the United States are mRNA vaccines
mRNA vaccines use genetic instructions that trigger your body to produce an immune response
These types of vaccines have been studied for decades and are quicker to produce than traditional vaccines
Approved COVID-19 vaccines for emergency use have passed clinical trials and current data shows they are safe and effective
While we wait for enough people to get vaccinated, everyone should continue to wear a mask and keep their distance
You can't get COVID or spread it from the vaccine
It's critical to get the 2nd shot!
Be prepared for side effects, especially after the 2nd shot
The vaccine takes about 10-14 days to ‘work’ after the 2nd shot
The vaccines do not contain heavy metals
The mRNA in the vaccines does not interfere with your DNA
mRNA vaccines do not cause infertility
How do these vaccines work?
Watch this quick, basic overview. Or watch this video for specifics about mRNA vaccines from University of Washington.
‘Many existing vaccines (such as the measles or flu vaccine) use an inactive or weakened form of the virus. The inactive virus can’t make you sick, but it still triggers your body’s immune response. The approved COVID-19 vaccines, however, are a new generation of vaccine called messenger RNA (mRNA) vaccines. Instead of using the virus itself, these vaccines use genetic instructions called mRNA that cause your cells to produce a protein from the virus. In the case of COVID-19, this protein is the spike protein from SARS-CoV-2. This single protein is harmless, but when your immune system detects this protein, it makes antibodies that can attack and neutralize the real virus.’
How new is mRNA vaccination technology?
Not very new. “A lot of people think that with SARS-CoV-2, we invented RNA vaccines right there,” Fuller says. “In reality, RNA vaccines have been in development for over 30 years and were 95% of the way to becoming the next level of vaccines. The pandemic just accelerated things.” - Dr. Deborah Fuller, a vaccinologist and microbiology professor at the University of Washington School of Medicine
Read more here on the rich history of mRNA vaccines and their potential to address other health issues like cancer, Zika, and rabies.
Why mRNA vaccines finished first for COVID-19?
mRNA vaccines are quick to produce. Once researchers learned the genetic sequence of SARS-CoV-2 back in January, they were able to have vaccine candidates ready for testing in a matter of days. Traditional vaccines, on the other hand, take months to prepare for testing.
Were expected safety protocols followed for the mRNA clinical trials?
Although fast to produce — allowing the COVID-19 vaccines to pass clinical trials at a record-setting pace — no safety evaluation steps were skipped in clinical trials or evaluation. The mRNA vaccines approved for COVID-19 are safe and effective within the timespan studied, which, of course, we all wish was longer. Safety studies generally look at long term data, and in this case, it’s just not available. In light of the current pandemic & the risks associated with infection (chronic illness or death), we are forced to move forward with the vaccine based on the safety data we have.
Why Must People Who've Been Vaccinated Keep Wearing Masks and Social Distancing?
Until experts know more about the protection provided by the COVID-19 vaccines, it is important that even those who have been vaccinated continue to follow the CDC's recommendations for protecting themselves and others. While the vaccines can protect the person who was vaccinated (although there is a very small risk that even vaccinated people can become infected), it is unknown if these people can still carry the virus and infect those who have not yet been vaccinated, including those who can't be vaccinated. Furthermore, experts don't yet know what percentage of the population needs to get vaccinated to achieve herd immunity to COVID-19, as this percentage varies by disease (CDC, Frequently Asked Questions about Vaccination 2020).
Can I get COVID or spread it from the vaccine?
The mRNA vaccines don't contain virus. They instruct your body to make a protein found on the virus that triggers an immune reaction, creating immunity to the virus. The mRNA never enters the cell's nucleus, so it never interacts with or becomes part of your DNA. It also doesn't stick around inside the body — it's broken down once the protein is made.
Do I need to get the second shot?
At best, you only get about 52% protection from the first shot but 94% to 95% after the second. Come back about 21 days later for Pfizer and 28 days later for Moderna second doses (it's okay to get it up to 4 days early, and you should still get your second shot if you miss the recommended date, although you'll have less protection during that time). If you get a first shot, use v-safe to set a reminder on a smartphone for when to get second shot, as well as to reports side effects.
Should I Expect Side Effects After the Vaccine?
Injection site pain (typical for any vaccine) and flu-like symptoms are the most common side effects for both the Pfizer and Moderna vaccines. These side effects are typically short-lived and not severe. More are reported after the 2nd shot.
How Long before I’m protected after the Vaccine?
Don't assume you're protected from COVID-19 immediately after receiving the second shot, and certainly not during the 21 to 28 days between the first and second shot.
Do the vaccines contain heavy metals like Mercury and Aluminum?
No. There are no heavy metal in any of the mRNA vaccines. For more details read this Complete vaccine ingredient list and explanation .
Can mRNA could get into the nucleus and interfere with cellular DNA?
No, the vaccines cannot change your DNA. Read more here “What’s really reassuring about these mRNA vaccines, the mRNA never even goes into the nucleus, the part of the cell contains all of your own DNA and instructions.”
Can mRNA vaccines cause infertility?
‘The COVID-19 mRNA vaccines now have been in tens of thousands of people and infertility has not been a problem for men or women.
Twenty-three women became pregnant after participating in Pfizer's mRNA vaccine clinical trial. Pfizer reported one poor pregnancy outcome in someone in the control/placebo group – meaning they had not received the vaccine.
There is a rumor that antibodies against the spike protein will also target a protein in the placenta of pregnant mothers, syncytin-1. There is no data suggesting that these antibodies will affect syncytin-1, as they are different proteins.’
From NYT 1/26/21:
‘Our team compared the coronavirus’s spike protein to placental syncytin-1, and we found no notable similarity between their amino acid sequences. We analyzed serum from women with Covid-19 and did not detect any reaction between patients’ antibodies and the syncytin-1 protein. There is also no evidence or reports so far of infertility among women who have recovered from Covid-19, despite the millions who have been infected. To the contrary, women have conceived after coronavirus infection and vaccination.’
What if I am immune compromised, or if I have an underlying condition? Is the vaccine still safe for me?
Safety studies generally look at long term data, and in this case, it’s just not available. In light of the current pandemic & the risks associated with infection (chronic illness or death), we are forced to move forward with the vaccine based on the safety data we have.
According to recommendations made by the Advisory Committee on Immunization Practices (ACIP), people with some, but not all, underlying medical conditions may still receive the mRNA COVID-19 vaccines (CDC, Interim Clinical Considerations 2020). If you are a member of Consumer Labs, they have more detailed information on this topic available. Below is a list of underlying medical conditions and the current recommendations regarding the safety of the mRNA COVID-19 vaccines in people with these conditions:
Current or prior history of SARS-CoV-2 infection
Previous passive antibody therapy
What if I have history of allergic reactions? (From Consumer Labs)
‘The ACIP recommends the following contraindications and precautions for people with a history of allergic reactions:
No contraindications or precautions: People with food allergies, pet allergies, allergies to medicines taken by mouth, environmental allergies, or latex allergies may receive the COVID-19 vaccines. People with a history of anaphylaxis due to any of these causes should be monitored for 30 minutes after vaccination. People with a history of allergic reactions but not anaphylaxis should be observed for 15 minutes after vaccination.
Contraindications: Those who have a severe allergic reaction (anaphylaxis) to the first dose of the COVID-19 vaccine or those with a known severe allergic reaction to any ingredient in the vaccine should not receive a second dose.
Those who have an immediate allergic reaction (of any severity) to the first dose of the COVID-19 vaccine should not receive the second dose unless an allergist-immunologist has determined that the second dose would be safe.
Those who have an immediate allergic reaction (of any severity) to any ingredient in the mRNA COVID-19 vaccines should not be vaccinated unless an allergist-immunologist has determined that the vaccine would be safe in that individual. To find out more about the ingredients in these vaccines, see our table above.
Although it is still unclear which of the vaccine components have caused the reported severe allergic reactions in people who were vaccinated, some experts have speculated that PEG may be the cause (de Vrieze, Science 2020). PEG is included in both the Pfizer and Moderna vaccines.
Keep in mind that PEG is already an ingredient in numerous other medicines, including certain laxatives (e.g., MiraLAX) and bowel preparations for colonoscopies, as well as certain injectable contraceptives (e.g., Depo-Provera), steroids (e.g., injectable methylprednisolone), and some chemotherapy drugs (e.g., Doxil). The PEG in many of these medicines is higher molecular weight (i.e., a bigger molecule) compared to the PEG in the vaccines, and there is some evidence that the risk of sensitization is higher with higher molecular weight PEG (Castells, N Engl J Med 2020).
Due to potential cross-reactive hypersensitivity, people with known immediate allergic reactions (of any severity) to PEG-like molecules such as polysorbates should also not receive the vaccines unless an allergist-immunologist has approved the vaccination. ‘
Can Pain Relievers / Fever Reducers Be Taken to Lessen Side Effects? (from Consumer Labs)
If possible, avoid taking pain relievers / fever reducers such as aspirin, acetaminophen or ibuprofen before getting the vaccine, since research has found that acetaminophen and ibuprofen can reduce antibody response to several other vaccines (Herve, NPJ Vaccines 2019). However, people who are taking aspirin, acetaminophen or similar medicines for other conditions may continue to do so as directed by one's doctor.
Can Antihistamines Be Taken To Reduce the Risk of Anaphylaxis? (from Consumer Labs)
The CDC, as well as allergy-immunology experts, advise against taking antihistamines (e.g., Benadryl) prior to receiving a vaccine, even among people with a possible allergic reaction to the first dose of COVID-19, as antihistamines do not prevent anaphylaxis and might mask skin symptoms, delaying the diagnosis and treatment of anaphylaxis (Banerji, J Allergy Clin Immunol Pract 2020; CDC, Interim Clinical Considerations 2020).
How Does FDA Authorization Differ from FDA Approval? (from Consumer Labs)
‘The Pfizer and Moderna COVID-19 vaccines have emergency use authorization (EUA) from the FDA, which is different from FDA approval. An authorized product has been tested in adequate and well-controlled trials according to rigorous standards set forth by the FDA and the potential benefits of the product outweigh the known and potential risks. However authorized products do not undergo the complete safety evaluation required for approval (which requires a much longer period of evaluation — sometimes years).
Although the long-term safety of these vaccines is still unknown, the FDA and CDC will continue to monitor their safety, in part, through the Vaccine Adverse Event Reporting System (VAERS). This is a national vaccine surveillance program used to detect vaccine-related safety concerns by collecting reports of side effects from healthcare providers and vaccine manufacturers (who are required by law to report certain adverse events), as well as from patients and parent of patients who received the vaccine. The FDA also expects that manufacturers of the authorized COVID-19 vaccines will continue obtaining safety and efficacy data from ongoing clinical trials and that they will pursue approval (FDA, EUA for Vaccines Explained 2020). If an authorized medical product shows evidence of serious safety issues after being authorized, the FDA can revoke the authorization.’
+ Additional Credit:
I used many online resources to put this together and did my best to link whenever possible.
I relied heavily on info from Consumer Labs and the CDC. I attempted to give credit each time and apologize if I missed a line. This was a doozy of an endeavor.
Thanks to my pal and colleague Wendy Ellis, ND, for generously sharing her newsletter with me.
I also really loved this interview with Heather Zwickey, PhD: https://www.naturalmedicinejournal.com/journal/2021-01/what-practitioners-need-know-about-covid-19-vaccine
