What do you need to know about the Covid-19 Vaccine
I have received my two doses of the Pfizer Vaccine and had no problems. The first dose hurt less than a flu shot and I had no side effects except a soreness at the injection site. I received the second shot 21 days later and had some fatigue and a headache. I wasn’t even sure if that was due to the vaccine because I hadn’t had a lot of sleep the night before. A couple Motrin took care of the headache. A day later I was fine and I have had no other problems. My staff has received their first dose of Moderna with no problems.
A Brief History mRNA Vaccines
Researches have been studying and working with mRNA vaccines for decades. Matter a fact, there is a Philadelphia connection to the development of the mRNA vaccine. Katalin Karikó, a faculty member at the University of Pennsylvania, started work on mRNA technology in the 1990s. Eventually she joined forces with Drew Weissman, an immunologist with a medical degree and Ph.D. from Boston University. Karikó’s research was based on the fact that mRNA tells cells which proteins to make. She knew if you could design your own mRNA, you could hijack that process and create any protein you might desire. This would allow you to create antibodies to vaccinate against infection, enzymes to reverse a rare disease, or growth agents to mend damaged heart tissue. In 2013, BioNTech hired Karikó to be Senior Vice President to help oversee its mRNA work. mRNA vaccines were studied before for flu, Zika, rabies, and cytomegalovirus (CMV). So while the COVID-19 vaccines were developed in record time the research behind the vaccines has been around for decades.
On January 10, 2020, Chinese scientists isolated the COVID-19 virus from patients and posted the virus genetic sequence online. The companies that work with mRNA didn’t need the virus itself to create a vaccine, just a computer that tells scientists what chemicals to put together and in what order. So the researchers at Moderna, BioNTech, and other companies got to work. Eventually, Pfizer partnered with BioNTech to manufacture the vaccine with Moderna not far behind. The U.S. Food and Drug Administration issued the first emergency use authorization (EUA) for the Pfizer vaccine December 11, 2020 and for Moderna on December 18, 2020.
How mRNA Vaccines Work
COVID-19 mRNA vaccines give instructions for our cells to make a harmless piece, called the spike protein. A unique spike protein is found on the surface of the virus that causes COVID-19.
COVID-19 mRNA vaccines are given in the upper arm muscle. Once the instructions (mRNA) are inside the immune cells, the cells use them to make the protein piece. After the protein piece is made, the cell breaks down the instructions (mRNA) and gets rid of them.
Next, the cell displays the protein piece, spike protein, on its surface. Our immune systems recognizes that the protein doesn’t belong there and begins building an immune response and making antibodies, similar to what happens in natural infections.
What is in the Vaccine
Basically the vaccine contains mRNA, lipids, salts and sugar.
— 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 & cholesterol
— potassium chloride
— monobasic potassium phosphate
— sodium chloride
— dibasic sodium phosphate dihydrate
— Lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG],) & Cholesterol
& 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC])
— tromethamine hydrochloride
— acetic acid
— sodium acetate
What are the Side Effects of the Vaccine
Most common side effects are pain at the injection site, fatigue, headache, chills, fever, and joint and muscle pain. In the trials these are all described as temporary.
Neither Moderna's nor Pfizer's clinical trials found that the vaccine caused severe adverse events such as anaphylaxis. While people who are allergic to any of the ingredients in the vaccines were excluded from the trials, people with severe food or drug allergies were not. In Pfizer's trials, anyone who had a severe reaction from any vaccine in the past was excluded.
Dr. Purvi Parikh, allergist and immunologist at New York University, who was not involved in the vaccine's development, stated "True allergic reactions to vaccines are very rare. Statistically, you're more likely to be hit by lightning than have a true anaphylactic reaction to a vaccine."
Since the vaccine roll out the Pfizer vaccine has detected 21 cases of anaphylaxis and less severe non-anaphylaxis allergic reactions after a reported administration of 1,893,360 of Pfizer vaccine first doses. That is only 11.1 cases per million vaccine doses administered. Most (86%) anaphylaxis cases had symptom onset within 30 minutes of vaccination, and most persons with anaphylaxis (81%) had a history of allergies or allergic reactions.
The components of the vaccines: mRNA, lipids and salts and sugar are things that are unlikely allergens. It is believed the rare anaphylactic reactions may be due to polyethylene glycol (PEG), which is found in both vaccines. PEGs are petroleum-based compounds that are widely used in cosmetics as thickeners, solvents, softeners, moisture-carriers and in pharmaceuticals such as laxatives.
What are vaccine sites doing to promote safe administration of the vaccine
1) ensure that necessary supplies are available to manage anaphylaxis, especially sufficient quantities of epinephrine in prefilled syringes or autoinjectors
2) screen potential vaccine recipients to identify persons with contraindications and precautions
3) implement recommended post-vaccination observation periods, either 15 or 30 minutes depending on each patient’s previous history of allergic reactions
4) ensure that health care providers can recognize the signs and symptoms of anaphylaxis early
5) immediately treat suspected anaphylaxis with intramuscular epinephrine
Almost all reactions to the COVID-19 mRNA vaccines are mild and self-limited. Severe reactions are very rare and may relate to an unusual sensitivity to PEGs. The risk of severe illness and death from COVID-19 is much higher than any risk of associated with the vaccine. As of January 12, 2021, the United States had 22,522,749 total cases of COVID-19 and 375,124 deaths. While the vaccines are one step in conquering the COVID-19 virus, we must continue to take precautions including wearing a mask, social distancing and gatherings especially indoors. Always consult with your personal physician about receiving vaccines and follow your local health officials recommendations.
Cheryl Bellaire MD January 13,2021
Click photo above for video of Dr. Bellaire by Brooks
Should I take Hormone Replacement?
The average age of menopause is 52 and symptoms are mostly caused by a decrease in estrogen. Women wonder if they should take hormone replacement or not. If a women chooses to take hormone replacement therapy and has a uterus she must take progesterone in addition to estrogen to prevent uterus cancer. Most women experience menopause as a process of decreased menses and increased symptoms but menopause is different for everyone.
There are risks and benefits of hormones. Hormones can help symptoms such as hot flashes, night sweats, insomnia, vaginal dryness, mood and skin changes. Medical advantages of hormones are they can help prevent osteoporosis and colon cancer. Hormone replacement may increase the risk of breast cancer, blood clots and stroke, especially if you smoke, or are overweight and inactive. So each women needs to discuss with her doctor what her personal risks are based on her history and family history before starting hormone replacement. There are man made hormones, bio-identical and natural phytoestrogens. Hormone replacement therapy can come in the form of pills, creams, vaginal rings and patches.