The SARS-CoV-2 vaccine is finally here.

Vaccines generally instruct the immune system what a pathogen looks like. Like a Most Wanted poster to display throughout the body. If the pathogen does enter the body, the immune system will act quickly to prevent the perpetrator from wreaking havoc and causing acute illness.

There is a great deal of mythos surrounding vaccines and vaccine safety. First, it’s important to remember that since the invention of the vaccine for cow pox by Jenner in 1796, technological advancements have allowed for myriad strategies to develop immunity. As such, each vaccine is unique. So it is moot to compare the flu shot to the HPV vaccine to the new SARS-CoV-2 vaccine.

For example, vaccines may be designed as attenuated viral vaccines, like the BCG vaccine. This means that upon inoculation, the virus mutates or weakens when it enters the body. There are also recombinant viral-vectored vaccines, like the new Ebola vaccine, that are bioengineered to produce weakened viral proteins that the immune system can recognize and attack without causing the full illness. For vaccines like the flu shot or polio vaccine, these are chemically or physically inactive to allow for immune reaction without full disease. There are even more clever examples…

The Pfizer and Moderna SARS-CoV-2 vaccine is the first of its kind to be approved for use.  The vaccine is like no other because it is a messenger RNA virus (mRNA).

How mRNA Vaccines Work

For a virus to perpetuate, it must use its genetic material (DNA or RNA) to produce machinery in the form of proteins to take over cells of the host and replicate. Viruses do so by generating messenger RNA (mRNA) from their DNA or RNA, which is the instruction book for making proteins to help with viral replication.

Researchers were able to determine the key part of that instruction manual for SARS-CoV-2 that could be disrupted to ensure the whole replication process fails. That key step in the process is mRNA’s instruction to make spike protein—S protein.  These are one of the spikey aspects seen on cartoon visuals of the virus. The S protein allows the SARS-CoV-2 virus to enter the host cells and replicate. If the S protein can be stopped, so too can the viral infection.

So upon vaccination with the Pfizer and Moderna vaccine, the mRNA instructions for SARS-CoV-2 spike protein are introduced into the body. To ensure the mRNA can enter our cells, the vaccine is encapsulated in a fatty envelope. The cell machinery takes those instructions and makes the S protein.  The immune cells recognize the S protein as foreign and destroy it as it is made. In the process, the memory of the immune cells creates the Wanted Posters for the S protein. Any future contact with the SARS-CoV-2 virus will not result in COVID-19 infection because the immune system will be alerted and stop the spike protein in its tracks.  Granted, the vaccine must be given with the addition of a booster. Time will tell if a booster will be required every so many years to ensure lifelong immunity.

Vaccination and MCAS

Those with mast cell activation syndrome should exercise great caution in taking the new vaccine. In general, those who have a history of severe allergies are more likely to experience an allergic reaction to the SARS-CoV-2 vaccine. Your healthcare provider will likely screen for this medical history and may advise against vaccination completely depending on your clinical history. Make your healthcare provider aware of your mast cell activation condition or any general allergies. If you’ve ever experienced an anaphylactic reaction, the vaccine is not recommended for you.

General Vaccine Response for those with ME/CFS

It is generally unclear how those with ME/CFS react to vaccination. There are case reports in the literature of individuals who received a vaccine and then developed ME/CFS. This is a condition called autoimmune/inflammatory syndrome induced by adjuvants. This isn’t of too much interest at the moment. No, the main concern is if the new SARS-CoV-2 vaccine will worsen symptoms in ME/CFS patients.

In general, many ME/CFS clinicians do not advise ME/CFS patients receive flu shots or other elective vaccines as it may worsen symptoms. Vaccines trigger an immune response—inflammation—and extra inflammation can exacerbate symptoms. There have been a few studies looking at the flu vaccine in particular—none of which have shown definitely that the flu shot worsens ME/CFS symptoms. Some surveys have been conducted asking patients how they have responded to flu shots. The majority respond that the jab does not worsen symptoms.

More information on this at ME-pedia.

And don’t forget, the flu shot is a very different vaccine than the new SARS-CoV-2 vaccine. The flu vaccine also contains different adjuvants, such as albumin, which may be allergenic to those sensitive to eggs.

The main component of the new SARS-CoV-2 vaccine is the mRNA encapsulated in a fatty lipid bilayer. Some propose that the allergic reactions seen early on may be due to a reaction to this lipid component. Regular readers of this site will know that lipid bilayers are commonly utilized to enhance supplement delivery (liposomal formulations). Those sensitive to such supplements, MAY be more likely to have an allergic response to the new vaccine. That’s a big maybe. Lipid encapsulation processes also vary.

In 2019, a group of ME/CFS clinicians made a collaborated statement on the vaccine issue in ME/CFS in their publication ME/CFS: A Primer for Clinical Practitioners. They stated that the decision to vaccinate should balance the health hazards of becoming ill against the possibility of symptoms worsening due to immunization. They also recommended avoidance of all but essential immunizations--particularly with live vaccines--out of concern for post-vaccination relapse.

Given the current global pandemic that faces all of us, my opinion is that the risk of contracting COVID-19 is far greater than the risk associated with vaccination in those with ME/CFS. Unfortunately, we do not have a vast pile of long-term data. Nonetheless, the benefit of vaccination outweighs the risks here. One must also consider the altruistic decision inherent in getting the SARS-CoV-2 vaccine as it will ensure herd immunity for the world, in time. Vaccine and booster administration of 75-85% of the global population will be necessary to produce herd immunity so that the world can put this global pandemic behind us.

What to Expect After Vaccination

Do not get the jab and head out the door. After receiving the vaccine, do not leave your healthcare provider’s facility for at least 30 minutes. This ensures that any adverse reaction to the vaccine can be promptly addressed. In very rare cases, an anaphylactic reaction can occur, requiring emergency administration of epinephrine. Less severe allergic reactions may require treatment with a basic antihistamine.  Don’t be in a hurry and don’t let the overworked, exhausted healthcare workers push you out the door. Allow the staff to monitor you to ensure that there is no reaction and know what to look for even after you arrive home. Contact your doctor if you experience side effects later on. Physicians are required to report any adverse effects directly to the manufacturer.

A non-allergic reaction to the vaccine is also possible, and common. Many will experience an inflammatory reaction locally around the injection site. Others may experience fever, headache, chills, and aches, but these symptoms should subside in time.

It is important to remember that those who receive the vaccine will continue to require masks. It is still unknown whether vaccinated individuals can or cannot transmit the virus to others. Wear your mask and wash your hands frequently.

I am looking forward to my turn to vaccinate. I also hope you consider all composed here, speak with your doctor, and decide to vaccinate. Remember, there is virtually no medical treatment that is free of side effects. The modern vaccine is exceedingly safe and side effects are exceptionally rare.  Don’t fall for vaccine disinformation that you will contract the virus with vaccination or that the mRNA can alter your genome. The vaccine does not contain microchips, aluminum, or other metal. These are nonsense claims based on fear. And if you read this far, you should understand exactly how the SARS-CoV-2 vaccine will function to protect you from a highly contagious, dangerous viral infection that has killed over 1.6 million.