COVID Update: Vaccine Edition

12/22/20

Are you wondering if any of the COVID-19 vaccines are the right choice for you? You may be curious to know if Greenhouse Natural Medicine has an official stance on the vaccine at this time. Unfortunately, we can’t offer a formal medical opinion at the moment; the trials (appropriately per the circumstances) were short and have not been widely reviewed. However, we can summarize the data available to give greater insight; this will help you decide for yourself whether you want to vaccinate.

How many different kinds of vaccines are there?

According to the CDC, there are four vaccines being studied, and two approved for use. The World Health Organization indicate that there are upwards of 50 vaccines in clinical trials. (10) The primary vaccine used is the Pfizer-BioNTech COVID-19 vaccine, approved for emergency use 12/11/20. The other approved vaccine is Moderna’s COVID-19, and the two in trial include AstraZeneca’s COVID-19 vaccine and Janssen’s COVID-19 vaccine. (6) The Moderna COVID-19 vaccine was approved for emergency use as of 12/18/20. (3) Click here to learn more about the Pfizer-BioNTech vaccine. According to the CDC, it does not contain eggs, preservatives, or latex. (5)

The two approved vaccines are created using mRNA. For details about this type of vaccine, click the link here.

Who is eligible for vaccination?

It’s no secret that the US has limited supplies of the COVID-19 vaccine vaccine. For this reason, vaccinations (initially) will be limited to the following according to the CDC: (1)

  • health care workers
  • long term care facility residents

Persons below age 16 are excluded per the ACIP (Advisory Committee on Immunization Practices) for the Pfizer-BioNTech vaccine. (4) For the Moderna COVID-19 vaccine, persons below age 18 are excluded. (17)

Clarification of the above groups:

  • Healthcare personnel are defined as paid and unpaid people serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials.
  • Long-term care facility residents are defined as adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently. (3)

Among these populations, there will be those pregnant and nursing who have concerns about the safety of vaccinating at this time. The CDC makes no formal recommendations, but does indicate little data on the effect of the vaccine during pregnancy and no data on the effects while
breastfeeding. (2) The CDC encourages each individual to decide at their own risk.

Who is next for receiving the vaccine? Well, the vaccine will be released in stages: (12)

  • Phase 1a: health care personal, long term care facility residents
  • Phase 1b: frontline essential workers, persons >/=75 years
  • Phase 1c: persons aged 65-74 years, persons aged 16-64 years with high risk medical conditions, essential workers excluded from phase 1b
  • Phase 2: all others >/= 16 years

It’s estimated that phase 2 will not be available until this summer. (11) For more details on who is eligible during each phase, click here.

How is the COVID vaccine administered?

The Pfizer-BioNTech COVID-19 vaccine consists of 2 doses (30 μg, 0.3 mL each) injected intramuscularly, 3 weeks apart. (4) Vaccination with the Moderna COVID-19 vaccine consists of 2 doses (100 μg, 0.5 mL each) injected intramuscularly 1 month apart. (7)

How much does the COVID-19 vaccine cost?

Patients will not be charged for the vaccine. However, doctors and administrators may charge a fee for the injection. (5)

Are there side effects?

Side effects from the Pfizer-BioNTech COVID-19 vaccine were studied in a large clinical trial. According to this study, generalized side effects are minimal but more likely after the second injection. Around 8.8% of study participants experienced fatigue, headache, muscle pain, or chills as primary symptoms; these were more common in younger patients (<55 yrs). A certain percentage of patients (around 0.6%) experienced serious symptoms during the period of the trial; however a similar percentage occurred in the placebo group (0.5%). More common side effects were localized to the site of injection (such as redness, swelling) and reported as mild to moderate pain. Of these side effects, the typical presentation was 2 days after administration, resolving in one day. (4) Side effects of the Moderna COVID-19 vaccine are higher when compared to the Pfizer-BioNTech COVID-19 vaccine. Around 16% of patients experienced systemic effects. However comparable to the Pfizer-BioNTech COVID-19, the development of more serious symptoms were the same in the testing and placebo groups (1.0%) (7).

How are the vaccines studied?

Prior to the release of the Pfizer-BioNTech COVID-19 vaccine, there was one large, randomized, double-blind, placebo-controlled clinical trial that enrolled >43,000 participants with ages ranging 16–91 years. This study demonstrated that the vaccine was 95% effective in reducing COVID-19 in patients with no prior symptoms. These effects were 92% consistent across age, race, ethnicity, underlying medical conditions, and those with prior infection. (4)

Prior to the release of the Moderna COVID-19 vaccine, there was one large, randomized, double-blind, placebo-controlled clinical trial that enrolled 30,000 participants with ages ranging 18–95 years. This study demonstrated that the vaccine was 94% effective in reducing COVID-19 in patients with no prior symptoms. These effects were 86% consistent across age, race, ethnicity, underlying medical conditions, and those with prior infection. (7)

What do experts say about the available vaccines?

There are many opinions circulating about the safety of the COVID-19 vaccines. One writer for the University of California San Francisco, Ann Brody Guy, consulted multiple medical experts for an educated opinion. Her article can be found here.

To be clear: I would say it’s a personal decision on when to be vaccinated, not whether to be vaccinated.

JOEL ERNST, MD

Professor of medicine; chief, Division of Experimental Medicine

In this article, experts agree that a vaccine is necessary for managing COVID-19. Some feel that 6 month of trials (rather than two months, the time taken for the approved vaccines) is ideal for establishing data on any vaccine. However, for patients with the highest risk of COVID-19 two months may be enough for prevention. Low risk patients, especially those with a possibility of complications, may decide to wait for more data to be present. In addition, these experts conclude it’s unlikely that one vaccine will accomplish all the goals for preventing disease. In conclusion, more data including clinical trials and independent review will be necessary before ascertains are made to the true safety of these medicines. Despite this, vaccination is still the next step in fighting the pandemic. (9)

1. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations.html
2. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html
3. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations-process.html
4. https://www.cdc.gov/mmwr/volumes/69/wr/mm6950e2.htm
5. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations.html
6. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html
7. https://www.cdc.gov/mmwr/volumes/69/wr/mm695152e1.htm
8. https://www.ucsf.edu/magazine/covid-vaccine-safety
9. https://www.ucsf.edu/magazine/covid-vaccine-safety
10. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines
11. https://www.cnn.com/2020/12/22/us/coronavirus-vaccine-general-public-states/index.html
12. https://www.cdc.gov/mmwr/volumes/69/wr/mm695152e2.htm?s_cid=mm695152e2_w#T1_down

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