The population needs to be prepared for the side effects of the vaccine

ScienceThe COVID-19 report is supported by the Pulitzer Center and the Heising-Simons Foundation

This summer, computer biologist Luke Hutchison volunteered to try the Moderna COVID-19 vaccine. But after the second injection, his arm swelled to “goose egg size,” Hutchison says. You may not be sure you received the vaccine and not a placebo, but within a few hours, the healthy and 43-year-old Hutchison had bone and muscle pain and a fever of 38.9 ° C. “I started shaking. I had cold and hot attacks, he says. “I sat by the phone all night thinking,‘ Shall I call 911? “

Hutchison’s symptoms disappeared after 12 hours. But he says, “No one has prepared you for this seriousness.”

According to him, the public needs to be better prepared than it was because some people are intense when they have to face temporary side effects called reactogenicity caused by vaccination with Moderna. Some health experts agree.

“Someone needs to address the elephant: What about the reactogenicity of the vaccine? While this… won’t cause long-term problems … how will this perception turn to the public once they get it? asks Deborah Fuller, a vaccinologist at the University of Washington (Seattle) whose laboratory is developing second-generation RNA vaccines against COVID-19. There is concern that side effects may fuel vaccine hesitation. – I feel like it’s smoothed out.

These concerns arise after a week of good news about coronavirus vaccines: Moderna and Pfizer, along with BioNTech, have announced that their messenger RNA (mRNA) vaccines have achieved 95% efficacy in clinical trials on tens of thousands of people. The companies added that the investigations did not reveal any serious safety concerns.

Both vaccines consist of a piece of genetic code that controls the production of coronavirus spike protein, called a tiny fat bubble called a lipid nanoparticle. Some researchers suspect that the reaction of the immune system to that carrier causes short-term side effects.

These transient reactions should not deter people from vaccinating themselves against a pandemic virus that infects at least one in 200 patients, says Florian Krammer, a vaccinologist at Icahn School of Medicine in Mount Sinai who attended the Pfizer trial. . Aching arms, fever, and fatigue are “unpleasant but not dangerous,” he says. I’m not worried [reactogenicity] at all. “

Most people will avoid the “serious” side effects that are defined to prevent daily activity. Less than 2% of Pfizer and Moderna vaccine recipients developed severe fever at 39-40 ° C. But if companies win official approvals, they want to vaccinate 35 million people worldwide by the end of December. If 2% of them experienced a severe fever, it would be 700,000 people.

Other temporary side effects are likely to affect even more people. An independent panel conducting an interim analysis of a large study of Moderna found that among the serious side effects, 9.7% of participants had fatigue, 8.9% had muscle pain, 5.2% had joint pain, and 4.5% had headache. volt. In the Pfizer / BioNTech vaccine trial, the numbers were lower: Serious side effects included fatigue (3.8%) and headache (2%).

But this rate of severe reactions is higher than people could get used to. “This is more reactogenic than is usually the case with most flu vaccines, even high-dose ones,” says Arnold Monto, an epidemiologist at the University of Michigan School of Public Health.

So cutting-edge public health workers “will need a story to come before [stories like Hutchison’s]- it provides an answer to the way people try to make this story about vaccine injuries.

Transparency is key, Hausman emphasizes. Instead of minimizing the chance of a fever, for example, vaccination administrators can warn people that they may experience a fever that may feel severe but be temporary. “It would be a significant way to people if they felt like they were telling them the truth.” Adds Drew Weissman, an immunologist at the University of Pennsylvania whose research has contributed to both vaccines: “Companies just have to warn people,“ That’s what you have to expect. Grab the Tylenol and suck it in for a day.

Hausman also sees a need to support people who have serious reactions. For example, people may need a “hotline in which a nurse works … to find out if she needs to go to the hospital or not. Will your medical expenses be covered, if so? These are important issues. “

Both Moderna and Pfizer / BioNTech vaccines require two doses, separated by weeks. Reactogenicity is typically higher after a second dose, Weissman says. Side effects mean that the vaccine works well. … [It] it means you had such a good immune response to the first dose and now you can see the effect of that, ”he says.

“We believe that lipid nanoparticles cause reactogenicity because lipid nanoparticles that lack mRNA do the same in animals,” Weissman says. “We see the production of inflammatory mediators that cause pain, [redness], swelling, fever, flu symptoms, etc. “

Hutchison hopes there are better vaccinations on the way. Still, he says, “Given COVID’s ability to kill people or incapacitate people, everyone has to bite the bullet and expect a rough night. … Bring plenty of naproxen.