COVID Vaccine Update | Family Doctor in Port Hope

Health Canada has now authorized two COVID-19 vaccines, one made by Pfizer/BionTech and one by Moderna. We’re getting a lot of questions, and I thought an update with the answers to some of these might help!

When will I be able to book an appointment for the vaccine?

Fair question, but I don’t know.

Currently, we know the vaccine won’t be coming to Northumberland until February, and then the government has released recommendations for how to prioritize who gets it. Residents of nursing and retirement home, as well as the staff that work in these facilities are high priority due to the risks of outbreak. Front-line health care workers are up there too.

It’s not yet clear how family doctors will be involved in the rollout, though we’re certainly advocating that we know best how to vaccinate our patients quickly and safely! Please keep checking my website – I’ll update it as soon as we know more.

It feels like the approval on these was rushed. Are we sure they’re safe?

Absolutely the review and approval process was quick. But all that means, in this case, is that the reviewers barely slept, and didn’t do anything else for the many days it took to review all of the data. No steps were skipped in the process of approving these – they went through the exact same approval process as every other vaccine, it’s just that we put way more resources into speeding up the review process.

This is new vaccine technology, and that makes me nervous.

I can understand that. What’s interesting to me, is that this technology isn’t totally new – mRNA vaccines have been around for awhile, in cancer treatments, but they weren’t great at that, so we weren’t prioritizing the science around them. Now that we realize how amazing they are for this virus (94% efficacious! Wow!), we’re pretty darn excited about the technology, though.

All vaccines work by showing your immune system some component of the “bad guy”; in this case, the coronavirus spike protein, so that your immune cells recognize it if it enters your body. Essentially, these vaccines use your own body’s machinery to make the protein, rather than introducing it another way, which is pretty nifty, when you think about it.

We don’t have the machinery in us to store this mRNA long-term, so once it’s been used, both the mRNA and the protein get broken down, and you go about your business without any issues.

What are the side effects of these vaccines?

These vaccines are especially reactogenic, which is actually a good thing, as the side effects are just your immune system kicking in. It’s one of the signs that a vaccine is really effective!

If I’ve given you Shingrix in the part, I’ve no doubt warned you that you may feel a little punky the next day, like you’re coming down with something. Possibly a low-grade fever, kind of tired, maybe some chills, pretty commonly a sore arm. This one is similar (but seemingly, not as bad as Shingrix). The ick feeling can be worse after the booster, but then you’ll go back to normal.

Just like the flu shot, you can’t get the disease from the vaccine!

These haven’t been around very long – what do we know about the more serious reactions they can cause?

Just like any new vaccine, these are well-studied in trials to determine general safety and efficacy. But even the big trials they do (Pfizer was 30,000 ppl!), aren’t big enough to see the 1-in-a-million reactions. What’s nifty, though, is that because this is a world-wide effort at the moment, over 12 million doses have been given, and we can confidently say that the only severe reactions have been the few severe cases of anaphylactic allergy.

Why are do these vaccines require such specific storage (like a -80 degree freezer)?

It turns out that getting the mRNA (which normally hangs out inside a cell only) into your arm muscle cells is actually the most technically challenging part of this new vaccine method. The little mRNA molecules are in teensy fat droplets (essentially, looking like tiny little cells that only have mRNA in them), so they can get into your cells when they get into your arm. These fat droplets are finicky, and break apart really easily if at all warm – hence the super-freezer requirements.

I have a history of a severe allergic reaction. Does that mean I shouldn’t get the vaccine?

In the UK, they had a few severe allergic reactions in the early days, and recommended anyone with a history of severe allergic reaction to anything hold off on this vaccine for now. In both Canada and the US, the recommendation is specifically if you have a severe allergy to polyethylene glycol that you avoid it, as this is the only allergenic component of the vaccine. Polyeythelene glycol is in a lot of things, including laxatives (including my fave, Restoralax), and moisturizers. Chances are, you would know if you were allergic to it.

Am I someone who shouldn’t get the vaccine?

There are some groups that haven’t yet been studied in terms of the vaccine effects – people who are immunocompromised/suppressed, pregnant/breastfeeding, and children.

Immunosuppressed/immunocompromised – the risk of the vaccine here is that your immune system isn’t hearty enough to mount a good response to the vaccine. But obviously the bigger risk is that it’s not hearty enough to mount a good response to COVID. Getting the vaccine may produce a weaker response than in other people, but that will hopefully protect you from severe disease, if you’re exposed to COVID-19. Safe for you to get it.
Pregnant – we’re just generally super-cautious with pregnant women, so none have been included in the trials. This should be a case-by-case assessment, so please book an appointment with me to discuss.
Breastfeeding – we have more data now, and know that the vaccine doesn’t show up in breastmilk. Safe for you to get it.
Children – again, not included in trials so far. They’re working on it. If your child is at increased risk of exposure, or severe disease (due to other health conditions), then this is worth a conversation, so please book an appointment with me to discuss.