What's in the Pfizer Covid Vaccine?

What's in the Pfizer Covid Vaccine?

One of the most common comments thrown around about the vaccine is, "Do you know what's in the vaccine?"

And most people would have to say they don't know, honestly. They haven't looked that deeply into it.

So let's take a look!

First, why am I somewhat qualified to write this post?

  • I originally trained as an electronics engineer, so I have a significant level of training in math and physics.
  • My core subjects at high school were bio, physics, chemistry, maths and stats.
  • I've spent 20 of the last 28 years I've been working in the life insurance and financial services field
  • And I have been a life insurance adviser for over 9 of those years.
  • Which has also had me exposed to medical conditions and treatments for underwriting and claims for most of that 20 odd years as well.

TL;DR I'm a maths and science geek with a strong medical background to boot.

First, let's talk statistics about the vaccine so far.

  • The US has experienced a 1 in 492 chance of someone unvaccinated dying from Covid
  • The US also sees a 1 in 86,500 chance with the vaccinated dying of Covid.
  • To date, and that is 173,000,000 people vaccinated. One hundred seventy million more than we have in New Zealand...

So there is a clear advantage for people to have the vaccine from that perspective.

So what are the risks so far from the vaccine?

  • I do not include the anecdotal noise from social media. That hasn't been well verified. It also contains a significant number of the same case being repeated multiple times. It's not correct to count one adverse reaction 500 plus times.
  • Looking at the New Zealand experience specifically, we have an excellent reporting system which MedSafe is publishing the data from 
  • From report #27, we have 15,596 reports of adverse reactions to the vaccine, with 14,994 considered non-serious and 602 that were serious. This is from 3,857,146 doses administered.
  • From that, we have 54 deaths reported after the vaccine was administered.
    • 26 have been ruled unlikely to have any correlation,
    • 9 that were inconclusive with the information available,
    • 1 considered being related,
    • and 18 cases are still being investigated.
  • The ages of the people impacted who died were 
    • 8 in the 30 to 59 age range,
    • 23 in the 60 to 79 age range,
    • and 23 in the 80+ age group.

So what's the risk?

  • I'm not going to quantify the non-serious adverse reaction, as most of these are reactions we would expect with a vaccine. And the data to draw reasonable risk indicators is not included in the published data.
  • You have a 1 in 6,407 risk of having a serious adverse reaction.
  • You have a 1 in 71,428 risk that the vaccine may cause or precipitate dying. That includes the 26 unlikely cases where the vaccine may not have caused the death but may have been enough to tip over the underlying conditions that did cause the death.
  • Of the remaining 28 deaths, inconclusive and under investigation, your risk of dying drops to 1 in 137,755
  • And if we excluded the inconclusive deaths, it becomes 1 in 203,000.

So a significant lack of risk compared to the virus' and even lower risk of dying if you had the vaccine and still developed Covid.

Let's put that into context.

  • The New Zealand population at 31 March 2019 was put at 4,965,300 people
  • ACC received 2,034,306 claims in the year ending Feb 2019. Of those claims:
    • 592,227 were relating to sport and recreation.
    • 1,163,588 were related to the home and community, with 500,862 falls.
    • 38,010 were road-related
    • 240,481 were work-related.

190318 ACC Updated 0053856 bubble chart

So the risk of you having an accident and needing medical treatment is 1 in 2.4, so pretty high!

  • The risk of you having a sporting or recreational injury is 1 in 8.4
  • The risk of you having a road-related injury is 1 in 130
  • The risk of having an injury at home or in the community that isn't work-related, 1 in 4.3
  • The chance of having a work-related injury, which also applies to office workers, is 1 in 21.
  • The chance of having a fall and hurting yourself is 1 in 10.

Ok, that may sound benign, and most accidents result in some treatment, but people mostly recover and carry on.
But too, some can be pretty serious.

  • Going to the gym and being injured is a 1 in 93 risk
  • Snowsports is a 1 in 292 risk.
  • Playing rugby is a 1 in 89 risk of being injured.
  • Working in construction has a 1 in 134 risk of being injured
  • And working retail is a 1 in 331 risk of having an injury.

Just riding a bike or motorbike has risks too.

  • Recreational cycling and mountain biking, 1 in 146 risk of being injured.
  • Road cycling injuries are 1 in 1,241, so better than dying from Covid in the US if unvaccinated. The only one I have mentioned so far.
  • And interestingly, riding or being a passenger on a motorbike has about the same risk as road cycling at 1,241, which is interesting; most people would consider riding a motorbike riskier than riding a bicycle.

So yes, the perspective on risk and the actual vaccine risk is being blown way out of proportion.

And before you say, but we're talking deaths and serious issues with the vaccine. Yes, and many of these ACC injuries are as serious as the reported adverse reactions too.

Also, some perspective.

  • ACC deals with an average of 5,573 new injuries every single day.
  • And are managing an additional 2,331,540 active injuries, some new, some older than the numbers used above.

But what about deaths?

  • In 2019 34,260 people died in New Zealand.
  • 80% of deaths were over the age of 65, and 1.6% were under the age of 20.
  • An old stat was about 4% of deaths are from accidental causes rather than sickness and diseases. I don't have providence for that, so let's go looking deeper.
  • In 2018, the 2019 data wasn't available, we had 2,220 deaths that were not considered medical deaths or were from external causes.
  • This was from 33,316 reported deaths for 2018.
  • So the accident death risk is 6.663% for all deaths in 2018.

So when we break that down:

  • of the 2,034,306 accident claims to Feb 2019 (yes, a couple of months of fudge here, not significant), we have 2,220 deaths from external causes, which ACC would also be responsible for.

So that breaks down to:

  • You have a 1 in 2.4 chance of having an accident and a 1 in 15 chance that death in any given year is accidental.
  • This means that you have a 1 in 36 chance that having an accident could result in death, but that's not the risk, as we know that the risk isn't that high. Welcome to the logical facility that can befall those that play with numbers ;)
    • The real risk is you have a 1 in 2.4 chance of having an accident. However, of the 2,034,306 accidents per year, only some result in death, which is a 1 in 916 chance of having had an accident; you die from your injuries.
    • To step that back to you right now, there is a 1 in 2,199 chance of you having an accident and dying.

So the risk of the vaccine causing you harm is presently around three times lower than the risk of you having an accident and dying.

Hopefully, you got through that!

So what's in the vaccine?

From the Pfizer clinicians page for the vaccine we have this:

  • COMIRNATY (COVID-19 Vaccine, mRNA) is a sterile suspension for injection for intramuscular use.
  • COMIRNATY is supplied as a frozen suspension in multiple-dose vials; each vial must be diluted with 1.8 mL of sterile 0.9% Sodium Chloride Injection, USP prior to use to form the vaccine.
  • Each dose of COMIRNATY contains 30 mcg of a nucleoside-modified messenger RNA (mRNA) encoding the viral spike (S) glycoprotein of SARS-CoV-2.
  • Each 0.3 mL dose of the COMIRNATY also includes the following ingredients:
    • lipids (0.43 mg ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate),
    • 0.05 mg 2-(polyethylene glycol 2000)-N,N-ditetradecylacetamide,
    • 0.09 mg 1,2-distearoyl-sn-glycero-3-phosphocholine,
    • and 0.2 mg cholesterol),
    • 0.01 mg potassium chloride,
    • 0.01 mg monobasic potassium phosphate,
    • 0.36 mg sodium chloride,
    • 0.07 mg dibasic sodium phosphate dihydrate,
    • and 6 mg sucrose.
    • The diluent (0.9% Sodium Chloride Injection, USP) contributes an additional 2.16 mg sodium chloride per dose.
  • COMIRNATY does not contain preservative.
  • The vial stoppers are not made with natural rubber latex.

So let's unpack that on a what it is and what is listed basis:

  • Fat, or fatty acid, is used to surround and protect the spike protein of the vaccine with the other fats listed - lipids (0.43 mg ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate),
  • Another fatty acid, but this one does have a history of causing allergic reactions in some people - 0.05 mg 2-(polyethylene glycol 2000)-N,N-ditetradecylacetamide,
  • Another fatty acid - 0.09 mg 1,2-distearoyl-sn-glycero-3-phosphocholine,
  • And one we have all heard of - and 0.2 mg cholesterol),
  • This is a form of salt and is used to manage the pH of the vaccine. Potassium Chloride is a metal halide composed of potassium and chloride. Potassium maintains intracellular tonicity and is required for nerve conduction, cardiac, skeletal and smooth muscle contraction, energy production, the synthesis of nucleic acids, maintenance of blood pressure, and normal renal function. This agent has potential antihypertensive effects and, when taken as a nutritional supplement, may prevent hypokalemia.- 0.01 mg potassium chloride,
  • Another salt, the monopotassium salt, KH2PO4; used as a buffering agent in pharmaceutical preparations and, alone or in combination with other phosphate compounds, as an electrolyte replenisher and urinary acidifier and for prevention of kidney stones. - 0.01 mg monobasic potassium phosphate,
  • Table salt, the stuff your chips taste like crap without. Also able to be used as a fire retardant - 0.36 mg sodium chloride,
  • A food stabiliser, Sodium Phosphate Dibasic is an odourless, colourless, sand-like solid or white powder. It is used to make starch, as an emulsifier in foods, and in the production of enamels, ceramics and detergents. - 0.07 mg dibasic sodium phosphate dihydrate,
  • Sugar - and 6 mg sucrose.
  • And more salt and water - The diluent (0.9% Sodium Chloride Injection, USP) contributes an additional 2.16 mg sodium chloride per dose.

So in basic terms, the vaccine is spike protein, fat, sugar, and salt.

Except for the polyethylene glycol, the rest is as benign as you get. The majority of the vaccine is things we have in our daily food sources.

Frankly, most of the reaction would appear to be salt-based, as in you rub salt in a wound, it bloody hurts!

Polyethylene glycol

From this article  the following is said about this compound.

  • Polyethylene glycols (PEGs) or macrogols are hydrophilic polymers found in everyday products such as foods, cosmetics, and medications.
  • We present 5 cases of confirmed PEG allergy, which to our knowledge, is the largest case series to date. Four of the 5 cases developed anaphylaxis to medications containing PEGs, with 1 near-fatal case resulting in cardiac arrest.
  • Skin tests were undertaken to the index medications and to PEGs of different molecular weights.
  • Three were confirmed with positive skin prick test result to PEG, 1 confirmed with a positive intradermal test result, and 1 confirmed after positive oral challenge. 
  • Two patients developed anaphylaxis following intradermal test to PEG and 1 a systemic allergic reaction (without hypotension or respiratory distress) following PEG skin prick tests. Before diagnosis, all 5 patients were mislabeled as allergic to multiple medications, and their clinical management had become increasingly challenging.
  • An algorithm is proposed to safely investigate suspected PEG allergy, with guidance on PEG molecular weights and skin test dilutions to minimise the risk of systemic allergic reaction. Investigation carries considerable risk without knowledge and informed planning, so should only be conducted in a specialist drug allergy centre.

So there is a clear reaction to this compound that people do need to be aware of. This also suggests that those with existing medication allergies should also talk to their doctor about possible PEG allergies.

Very long story short, there is nothing to fear with the vaccine that isn't far scarier with the virus.

If you are unfortunate enough to react to the spike protein. In that case, you are better to have that reaction from the vaccine rather than the virus and to have to fight off Covid while having that reaction.

Better information should leave you better informed to make a better decision.

I'm vaccinated, and I think you should be too, but I also respect your right to choose as we all should.

Jon-Paul Hale

Written by : Jon-Paul Hale

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