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What’s really in a COVID-19 vaccine?



Potassium? Phosphate? Sodium?

The ingredient list in a vaccine looks a little more complicated than a packet-mix birthday cake, so it can be a little intimidating at first. But don’t fear, we’ve got all the information you need to make a safe and informed choice.

From polio to whooping cough, tuberculosis and tetanus, we’ve had vaccinations for all sorts of things for a long time. Over 100 years, in fact.

They might all look a little different, but they’re all more alike than they are dissimilar.

In fact, many ingredients found in vaccines are also commonly found in your pantry and many are just used to make the vaccine last longer in storage. Other parts of the vaccine are things already inside you, like water and salt.

The main ingredient in all vaccines is plain and simple water.

There are two main vaccines Queenslanders will be receiving this year for COVID-19. These are made by Pfizer and AstraZeneca.

Pfizer

The Pfizer vaccine is the first to be available across Queensland. This is because it was the first to be approved by the Therapeutic Goods Administration (TGA), and the first to be made available to the Australian Government. It is a little harder to transport, store and deliver, so it will only be made available through six Pfizer ‘hubs’ across Queensland Health with the Commonwealth Department of Health providing a Pfizer vaccine roll-out to other specific high risk members of the community (e.g. Aged Care facilities).

Pfizer stocks are limited worldwide and is in very high demand having been used to start vaccination programs in the UK and Europe.

So what does the content of the vaccine look like?

mRNA (messenger ribonucleic acid)

What is mRNA? This is the active ingredient. The only active ingredient, actually. This is where the genetic material for the virus is stored. The mRNA will assist in teaching your own body how to develop an immune response to the COVID19 virus. But rest assured, it’s not a live part of the virus. It’s more like a set of instructions.

COVID-19 mRNA vaccines contain genetic material that gives instructions for your cells to make a piece of protein, the same 'spike protein' that is found on the surface of the virus that causes COVID-19. Your immune system recognises this protein does not belong there and begins to produce antibodies, training your body to respond if you get the real virus.

The cell breaks down and your body gets rid of the mRNA soon after it has used the instructions to train your immune system. It does not affect or interact with your DNA in any way. mRNA never enters the nucleus of the cell, which is where our DNA (genetic material) is kept.

mRNA vaccines are new, but not unknown. Researchers have been studying and working with mRNA vaccines for decades.

mRNA vaccines have been studied and tested before for flu, Zika, rabies, and cytomegalovirus (CMV). mRNA has also been used in cancer research to trigger the immune system to target specific cancer cells.

Lipids

What’s a lipid? Think of fats, oils and waxes. Lipids don’t dissolve in water, but they help other things move around. We use lipids in almost every part of our bodies functions every day. In the Pfizer vaccine, lipids are used to help the mRNA move into cells.

What does a lipid look like on an ingredient list?

  • ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate)

  • 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide

  • distearoylphosphatidylcholine

  • cholesterol

Salts

We know what salts are – we use sodium chloride (kitchen salt) for cooking! These salts are in vaccines to help balance out any acidity in the solution so it is more stable for storage and ultimately compatible with the body tissue we inject it into.

What does salt look like on an ingredient list?

  • potassium chloride

  • monobasic potassium phosphate

  • sodium chloride

  • dibasic sodium phosphate dihydrate

Sugar

Simple sugar. The same one you put in your coffee in the morning (or don’t). Sugar is used in vaccines to stop the molecules from losing their shape during the intense freezing process.

What does sugar look like on an ingredient list?

  • sucrose

And there you have it, a whole vaccine.

AstraZeneca

AstraZeneca has also been approved by the TGA, and is now available in Australia. Not only that, but Australia will be producing its own supply of the AstraZeneca vaccine.

Because AstraZeneca is easier to store, move and share, its availability will allow for a much broader distribution of vaccine, and more locations will come online, including more hospitals, GPs and pharmacies.

Most Australians will be receiving the AstraZeneca vaccine.

So what does the content of the vaccine look like?

Modified virus (adenovirus)

This is the vaccine active ingredient. Adenoviruses are a group of common viruses that can cause a variety of illnesses (e.g. Bronchitis, conjunctivitis). Most people will have been exposed to some kind of adenovirus in their lifetime. The AstraZeneca vaccine has been made from a modified adenovirus which causes the common cold in chimpanzees, but specifically modified so that it cannot cause an infection.

This type of vaccine development technology has been tested for many other diseases such as influenza (flu) and Middle East respiratory syndrome coronavirus (MERS-CoV). It sounds a little scary, but it’s anything but new.

Emulsifiers

Some vaccines contain both oil and water-based ingredients, and we all know the two do not easily go together. Vaccine developers will add emulsifiers to help the oil and water-based ingredients stay together, like adding lemon to a mayonnaise recipe!

What does an emulsifier look like on an ingredient list?

  • polysorbate 80

Preservatives

Since vaccines go into the body, it’s pretty important to keep them clear of any contamination.

Some vaccines come in multi-dose vials, so there is an increased risk of introducing contamination, like bacteria, each time a needle enters the vial. Tiny amounts of anti-microbial ingredients are added to the vials to protect the vaccine and you, as a result, making the vaccines safer to use.

What does a preservative look like on an ingredient list?

  • disodium edetate dihydrate

  • ethanol (at less than 0.005% - remember that a regular beer is 1000 times stronger than that at around 5%)

Amino Acids

What is an Amino Acid? Amino acids are often referred to as the building blocks of proteins, playing a critical role in many of your body functions. We use amino acids in every part of our bodies' functions every day – from building proteins to synthesising neurotransmitters. In the AstraZeneca vaccine, amino acids are used to help the active part of the vaccine work more effectively.

What does an amino look like on an ingredient list?

  • L-histidine

  • L-histidine hydrochloride monohydrate

Sugar

Simple sugar. The same one you put in your coffee in the morning (or don’t). Sugar is used in vaccines to stop the molecules from losing their shape during the production process.

What does a sugar look like on an ingredient list?

  • sucrose

Salt

We know what salts are – we use sodium chloride (kitchen salt) for cooking! These salts are in vaccines to help balance out any acidity in the solution so it is more stable for storage and ultimately compatible with the body tissue we inject it into.

What does a salt look like on an ingredient list?

  • sodium chloride

  • magnesium chloride hexahydrate

And that’s it!

What about allergies?

For those worried about their allergies, the Pfizer and AstraZeneca vaccines do not contain human or animal products, or common allergens such as latex, milk, lactose, gluten, egg, maize/corn, or peanuts.

Allergic reactions to vaccines or their ingredients are very rare, but they do happen. In the US, a report from the Centres for Disease Control and Prevention (CDC) suggested that severe allergic reaction (anaphylaxis) was very rare at 11.1 instances per million doses of vaccine, and that more than 80 per cent of those cases occurred in people with a history of allergic reactions.

You must not get a COVID-19 vaccine if you have had any of the following:

  • Anaphylaxis (a severe allergic reaction) to a previous dose of the same COVID-19 vaccine

  • Anaphylaxis after exposure to any ingredient of the COVID-19 vaccine.

If you have ever had a severe allergic reaction or anaphylaxis to anything else, including after receiving a vaccine, you can still get the vaccine, but you must tell the immunisation provider beforehand.

Vaccines are usually delivered in a healthcare setting by trained professionals who have the right medications and equipment on hand and know what to do if there is an issue.

If you are asked to wait around for 30 minutes after your vaccination, don’t be alarmed. This is a standard procedure, depending on your medical history.





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