COVID Vaccinations: your questions answered!
This week, the FDA announced exciting news: children, ages 12 and up, can now receive the COVID vaccine. There is a lot of information about the vaccines out there, so here is the Cliff Notes version. Still coming: a blog on pregnancy, breastfeeding and the COVID vaccine.
There are three vaccines that are being offered: the Pfizer vaccine, the Moderna vaccine and the Johnson & Johnson Janssen (J&J) vaccines. The Pfizer and the Moderna vaccine are similar in that they were constructed using the same technological principles and are two shot series. The J&J vaccine is in its own class, and is given as a single shot.
How do the vaccines work?
Both the Pfizer and the Moderna vaccines use mRNA technology. mRNA vaccines deliver the instructions for making a specific protein – in this case a “spike” protein to the COVID virus. A spike protein is the part of the virus that breaks into and infects our cells. Our immune system then responds to these proteins by producing antibodies: cells that block the “spike” proteins from ever entering our cells. These antibodies then protect us from future virus exposures. This is a great explanation from PBS that can be found on Youtube:
https://www.youtube.com/watch?v=WOvvyqJ-vwo
The J&J vaccine works by taking a harmless, inactivated virus (in this case an adenovirus, ie, the common cold) which has been engineered to carry the genetic code for the COVID spike protein. Once the adenovirus enters an immune cell, it triggers our cells to create the COVID spike protein. These cells then trigger our immune reaction, similarly to the Pfizer and Moderna vaccines:
https://www.youtube.com/watch?v=VnJkPL-jlFI
None of the vaccines interact with our DNA. None of the vaccines carry any “live” virus, which is why they can not make us sick. mRNA technology has been used since the 1990s. The J&J technology has been around since the 1970s.
How effective are the vaccines?
It is hard to compare how effective the vaccines are against each other, because they were tested against different vaccine variants. The Pfizer and Moderna vaccines were tested at the same time and in similar populations and were found to be 93% and 94% effective respectively at preventing COVID infection – these vaccines were not tested against the new, emerging virus variants. The J&J vaccine was tested against the emerging COVID virus variants and found to be 66% effective at preventing the disease two weeks after being given. It is unclear, however, how long the effectiveness will last, ie, will we need yearly booster shots, like with the flu vaccines? That being said, all of the vaccines have PREVENTED SEVERE DISEASE AND DEATH in fully immunized individuals!!!!!!!!
What are vaccine side effects?
All three vaccines can cause an “anaphylactic” reaction in certain individuals. Anaphylaxis is an allergic reaction in which people can go into shock and have difficulty breathing, typically within 15 minutes of getting triggered. This reaction is 100% treatable with epinephrine. People with a history of anaphylaxis or severe allergies are at highest risk for getting anaphylaxis from a vaccine. About 3-5 out of each million people getting the vaccine have had this reaction. All people getting a vaccine are observed for 15 minutes specifically to monitor for anaphylaxis.
All of the vaccines can cause varying degrees or arm soreness, achiness, low grade fevers and fatigues. This is indication that the vaccine is working by triggering your immune response! Younger people have tended to have more of these side effects than older folks. The second vaccine, if getting either the Pfizer or the Moderna vaccine, tends to generate more side effects.
The J&J vaccine can cause blood clots. 15 women, out of 8 million+ individuals receiving the vaccine, have developed blood clots in the 6-13 days following the vaccine. One woman has died. It is unclear why this is occurring and is being actively studied. The FDA briefly paused J&J delivery due to this finding, but ultimately found the risk so low that they re-approved its use.
Can children get vaccinated?
Vaccines are typically studied in adults over 18 who can give their own permission to enter studies. Only when the vaccines have been proven safe in adults can studies on children begin.
The Pfizer vaccine was approved by the FDA for all individuals 12 and up, beginning on May 10, 2021. The vaccine is being studied in children 2 and up, and hopefully will be approved in this population by fall 2021.
The Moderna vaccine is currently approved for ages 18 and up. Studies are underway both in children 12 and up, and children 6 months – 11. If these studies go well, then Moderna will likely be approved in children 12 and up mid-summer and 6 months and up by late fall.
Where can I or my child be vaccinated?
Vaccine storage, in addition to supply and state regulations, determine where the different vaccines can be obtained. The Pfizer vaccine must be stored in special deep freezers. Thus, large health organizations are typically the only places able to offer this vaccine. The Moderna vaccine can be stored in regular vaccine freezers and can be available at any place that routinely gives immunizations. The J&J vaccine is stored at room temperature and can be given anywhere.
Here is a link to Maine immunization sites:
https://www.maine.gov/covid19/vaccines/vaccination-sites
Does Personalized Pediatrics of Maine offer COVID vaccinations?
Personalized Pediatrics of Maine does offer all routine childhood vaccines, but currently is unable to offer any of the COVID vaccines. However, I will be offering the Moderna vaccine once it has been FDA approved in children AND available through state distribution.
Here are links to more vaccine resources:
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html
https://services.aap.org/en/news-room/news-releases/aap/2021/american-academy-of-pediatrics-guidance-the-covid-19-vaccine-is-safe-effective-and-should-be-given-to-all-who-are-eligible/
