COVID-19 Diary – Day 272

Pfizer Vaccine Approved for Emergency Use!

Today, December 9th, 2020, after 272 days of actively working to battle COVID-19 in BC, Canada has approved the Pfizer/BioNtech vaccine Tozinameran for emergency use. It is a huge milestone achievement for our province and our country, and to celebrate we have added an additional vial of vaccine to our Vaccine Watch banner.

The official government of Canada website has a lot of information available about the vaccine, and some of the most important details are as follows:

  • The vaccine is for people aged 16 and over. It is not approved for use on children under 16.
  • The vaccine requires 2 injections, 21 days apart, and it can not give you COVID-19 (because it does not contain the virus itself).
  • You should not take the vaccine if you have any COVID-19 like symptoms.
  • You should not take the vaccine if you have a known history of allergy with any of the vaccine ingredients (see below).
  • You should speak to your healthcare professional before receiving the vaccine if any of the following apply to you: You have had an allergic reaction to a previous vaccination, you are immunocompromised, you have a bleeding problem, bruise easily or use a blood-thinning medication, you are pregnant, think you may be pregnant or plan to become pregnant, or if you are currently breastfeeding.
  • Let your healthcare professional know about any medication you are currently taking, including vitamins, minerals, or natural supplements.
  • If you miss your second dose, contact your healthcare professional book a new appointment
  • Common side effects (1 in 10) include: pain at injection site, tiredness, headache, muscle pain, chills, joint pain, and fever.
  • Uncommon side effects (1 in 100) include: enlarged lymph nodes.
  • If you experience any signs of allergic reaction, dial 9-1-1 or seek treatment immediately. Signs of allergic reaction include: hives (bumps on the skin that are often very itchy), swelling of the face, tongue or throat, or difficulty breathing.
  • Any unexpected side effects should be reported to your healthcare professional

Ingredients List of Tozinameran:

  • ALC-0315 = ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate)
  • ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide
  • 1,2-Distearoyl-sn-glycero-3-phosphocholine
  • Cholesterol
  • Dibasic sodium phosphate dihydrate
  • Monobasic potassium phosphate
  • Potassium chloride
  • Sodium chloride
  • Sucrose
  • Water for injection

Canada’s official information page on the vaccine can be found here.

BC’s Vaccine Rollout Plan

Today Premier Horgan, Minister Dix, Dr. Bonnie Henry, and Dr. Ross Brown held a live briefing to discuss BC’s plan to rollout Pfizer’s vaccine Tozinameran over the coming weeks, months, and year.

Vaccinations in BC are expected to begin at the end of next week. Initially, there will be a little under 4000 doses of the vaccine available, split evenly between the Vancouver Coastal and Fraser Health Authorities. These regions were chosen based on many factors including logistical support, the amount of population at risk, and the current threat of local spread of the virus. The first doses will be given to health care workers, with special focus on people working in ICU and COVID wards, and people working in long term health facilities.

Later in December and into January additional locations will be set up across the province for distributing the vaccine, bringing the number of locations up from 2, to between 7 and 9, and located in all health authority regions. At this time the vaccine will become available to people over 80, indigenous communities, and residents in long-term care facilities. However, there may be difficulty transporting the vaccine to long-term health care facilities (due to the vaccine requiring extremely low temperatures), and the logistics are still being worked out.

By late March or early April, there will be up to 30 vaccine distribution centres set up with the refrigeration units required to store the Tozinameran vaccine, and approximately 400,000 people (~8% of BC’s population) will have been vaccinated. At this point, all frontline workers will now be able to receive the vaccine, including any remaining working in health care, police and fire responders, and essential service providers. The age restriction will also continue to drop.

It is expected that by the Summer anyone who wants to be vaccinated will be able to receive the vaccine. This is based on expectations of additional vaccines being approved for use and continued and increased shipments from Pfizer.

Dr. Bonnie Henry also had the following comments about the vaccine, partly in her prepared speech, and partly as responses to media questions:

  • The vaccine will not be available for children under 16
  • The vaccine will not be available for people currently pregnant
  • The vaccine will not be available for immunocompromised people (this may change with future study data)
  • Other vaccines are expected to become available that the above restrictions will not apply to
  • Independent polls have shown as many as 86% of BC’s population are interested in getting the vaccine
  • The first shipment of ~4000 doses will be given out to ~4000 individuals, who will each receive their second dose from a future shipment. This is to ensure as many people as possible are protected as quickly as possible
  • The location of the vaccine is not being made public currently, as threats have been made targeting it

Premier Horgan also confirmed to the public when asked by the press, that he and his leadership team were not interested in “jumping the line” to get the vaccine before those determined to need it sooner, but were willing to take it early if the people of BC needed reassurance to the safety of the vaccine.

Addressing the Allergy Advisory for Tozinameran

What a whirlwind this vaccine has been! Yesterday the UK began their first vaccinations, today Canada approves the vaccine, BC shares its vaccine rollout plans, and we learn that 2 people in the UK had severe allergic reactions to the vaccine. The UK’s National Health Service immediately cautioned anyone with allergies (from vaccines, medicine, or even food!) to not get the vaccine at this time. This of course led to a lot of questions from concerned individuals and a lot of confusion. To make matters worse, with all the new information coming out in such a short period of time, it became very difficult to find any actual answers to any of these questions. And to that end, we hope we can help!

The two people in the UK who had allergic reactions were both employees of the UK’s National Health Service. Both of them had a previously known history of having serious reactions to medical treatments, and regularly carried emergency adrenaline shots (epi-pens) with them as a precaution. The negative response they had is called an anaphylactoid reaction. It usually involves a skin rash, breathlessness and sometimes a drop in blood pressure. This is not the same as anaphylaxis which can be fatal. Both of the people involved recovered quickly, and are now fine.

The UK National Health Service reacted to this news in a way that Mayo Clinic virologist Gregory Poland described as “overdoing it“, with specific regard to the comments made about food allergies. The UK National Health Service has already walked back their comments about food allergies, and now only recommend not taking the vaccine if you have a history of severe reactions to medical treatments or other vaccines.

To be clear: If you have a peanut allergy, you can still safely get vaccinated.

So far neither Health Canada nor BC Public Health has specifically advised against getting the vaccine even if you have a history of severe reactions with medical treatments or other vaccines, but they do recommend speaking to your health care professional to help you determine the best course of action. This lines up well with additional comments from Gregory Poland on how he feels the situation should be handled: “I would have said, ‘If you’ve had anaphylactic-level reactions to vaccines, we want to know about that so we take extra care,’” he said. “That doesn’t mean I wouldn’t immunize you. But I would do it in a more controlled setting.”

Imperial College London’s Paul Turner, an expert in allergy and immunology who has been advising the MHRA on their revised guidance for the vaccine had this to say: “As we’ve had more information through, the initial concern that maybe it affects everyone with allergies is not true. The ingredients like PEG which we think might be responsible for the reactions are not related to things that can cause food allergy. Likewise, people with a known allergy to just one medicine should not be at risk.”

To summarize, if you have a history of severe reactions to medicine or vaccines you should speak to your health care provider before getting the vaccine, and additional precautions may be recommended. Either way, the vaccine should be safe for everyone over 16 who isn’t pregnant or immunocompromised.

That’s all for now, stay safe everyone!

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