Faster than the speed of light, the warp speed COVID-19 vaccines are here at last….

There are currently two vaccines authorized for emergency use in the US population: Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 Vaccine. Emergency use is NOT an FDA approval. Currently, there are no COVID-19 vaccines that are approved by the FDA.

Now that employers are beginning to recommend these vaccines to employees, it’s important and vital that you know what is in these vaccines, what are the possible side effects of these vaccines (this will be another post), and how to report a vaccine reaction.

What Is Messenger RNA?

The new COVID-19 vaccines use a technology called messenger RNA that no other vaccine currently on the market uses. While the technology is not itself new, there are no, and never has been, any licensed mRNA vaccines in the US. So, it’s new to us.

Traditional vaccines either use live attenuated viral vaccines, or inactivated vaccines, or recombinant vaccines or toxoid vaccines–each of these examples functions similarly in that it contains a piece or protein of the antigen (from the virus, or bacteria or toxin), either combined with an adjuvant like aluminum, unless it is a weakened live virus where an adjuvant is not needed, and it causes some cell damage to alert your immune system, to which your immune cells then mount a response and make antigen specific antibodies.

mRNA is different.

It uses your cells to make the antigen (spike protein) of SARS-CoV-2

Messenger RNA vaccines have strands of genetic material called mRNA encapsulated inside a lipid shell. That coating protects the mRNA from enzymes in the body that would otherwise break it down. This coating enables the mRNA to enter the dendritic cells and macrophages in the lymph node near the vaccination site.

The lipid coating contains PEG, which is thought to be one of the ingredients responsible for the severe allergic reactions.

mRNA is described as instructions for the cell on how to make a piece of the “spike protein” unique to SARS-CoV-2. The cells then make the “spike protein” and displays this on the cell’s surface, which then signals the immune system to begin producing antibodies and activating T-cells to fight off what it thinks is an infection.

However, as with all vaccines, there are many ingredients that can have non-specific effects that are outside of the singular goal of the vaccine. Because everyone’s genetic make-up is unique, everyone will respond differently to the vaccine, including people who had prior exposure to SARS-CoV-2 (these people may develop Antibody-Dependent Enhancement, or ADE).

What Are the Ingredients of the COVID Vaccines?

Pfizer-BioNTech COVID-19 Vaccine Ingredients:

• mRNA (Nucleoside-modified mRNA encoding the viral spike (S) glycoprotein of SARS-CoV-2)
• lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate) 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3- phosphocholine, and cholesterol)
• potassium chloride
• monobasic potassium phosphate
• sodium chloride
• dibasic sodium phosphate dihydrate
• sucrose

Moderna COVID-19 Vaccine Ingredients:

• mRNA (Nucleoside-modified mRNA encoding the viral spike (S) glycoprotein of SARS-CoV-2)
• lipids (SM-102:  heptadecan-9-yl 8-((2-hydroxyethyl) (6-oxo-6-(undecyloxy) hexyl) amino) octanoate, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC])
• tromethamine
• tromethamine hydrochloride
• acetic acid
• sodium acetate
• sucrose

* Neither vaccine contain eggs, gelatin, latex, or preservatives (which means it must be discarded if not used once thawed)

Severe Allergy Warning For COVID-19 Vaccines

An increased rate of allergic reactions have been observed for both COVID-19 vaccines. Anaphylactic reactions have been observed at a rate of 1 in 40,000 doses which is much higher than expected. Anaphylaxis is a potentially life-threatening allergic reaction to a sensitized protein.

Because both Pfizer’s and Moderna’s COVID-19 vaccine contains polyethylene glycol (PEG), which is a primary ingredient in osmotic laxatives (such as Miralax) or oral bowel preparations for colonoscopy procedures, an inactive ingredient or excipient in many medications, and is used in a process called pegylation to improve the therapeutic activity of some medications (including certain chemotherapeutics), warning is recommended for those with possible allergy toward PEG, or sensitization from past use. Additionally, cross-reactive hypersensitivity between PEG and polysorbates (included as an excipient in some vaccines and other therapeutic agents) can occur. 

Polysorbates are a common ingredient in many vaccines, as well as many health, beauty, and pharmaceutical products.

How to Report a Vaccine Reaction:

Every vaccine reaction should be reported to ensure proper vaccine safety surveillance. Simply go to  VAERS.hhs.gov/reportevent.html to report any adverse event. There is no time limit. You can report a reaction that occurred years ago, and most doctors keep medical records for 8 years if you need to check dates and vaccine lot numbers.

SOURCES:

1. https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
2. https://www.cdc.gov/vaccines/covid-19/hcp/mrna-vaccine-basics.html