Covid-19 Vaccine: What You Need to Know



The covid-19 vaccine is out and in full swing with at least 1/4th of the population of the United States fully vaccinated and almost 40% of the population receiving at least one dose (at the time of this post April 2021). As a parent of a child with Down syndrome, you may be wondering if should give your child the vaccine, especially given the risk of fatality with a covid-19 infection.


So should you give your child the vaccine?


While this article won't attempt to answer that question, I do hope that it will give you some facts to talk with your health care provider over so that you can make the best decision for your loved one with Down syndrome.


At the time of this post, there are 3 covid-19 vaccines available: Pfizer, Moderna, and Johnson & Johnson. Although the Johnson & Johnson vaccine has been paused due to a link to blood clot formation in 6 women.


At the time of the publication of this blog post, the Johnson &Johnson vaccine has been recommended to be paused to look into the blood clotting associated with the vaccine.




Vaccine Efficacy

While the Johnson & Johnson vaccine only requires one dose, the Pfizer and Moderna vaccines both require two doses for greatest efficacy. According to the CDC, the Pfizer vaccine is about 95% effective at preventing a covid-19 infection while the Moderna vaccine is about 94% effective.


The Johnson & Johnson vaccine was 66% effective against a covid-19 infection.


The Way the Vaccines Work

Both Pfizer and Moderna are mRNA vaccines. mRNA, or messenger ribonucleic acid, is a molecule that gives your cells a set of instructions. These instructions use machinery in your cells, called ribosomes, to tell your cells what types of proteins to make.


With the covid-19 vaccines, synthetic (lab made) mRNA is packaged into lipid (fat) nanoparticles and injected into the body. The lipid packaging allows the mRNA to get into the cells and use the cell's ribosomes to start creating spike protein [1].


These mRNA vaccines differ from traditional vaccines in that they actually use your own body to make the antigen (foreign invader) as opposed to using a weakened or dead version of the virus itself.


Essentially, the mRNA covid-19 vaccines tell your body to make the SARS-Cov-2 spike protein and then your immune system recognizes this as a foreign protein (even though it is made by your own body via the mRNA instructions from the vaccine). Your body then should mount an immune response to the newly made spike protein.


The Johnson & Johnson vaccine works in a slightly different way. This is a viral vector vaccine. This means that the spike protein is cloned into a vector, or a type of viral shell, usually an adenovirus, that can't reproduce. This technology usually produces a strong cellular immune response [2].




Vaccine Ingredients

The covid-19 vaccines have varying ingredients that may or may not be a cause for concern depending on your child's personal immune response.


The Johnson & Johnson vaccine ingredients: recombinant, replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein, citric acid monohydrate, trisodium citrate dihydrate, ethanol, 2-hydroxypropyl-β-cyclodextrin (HBCD), polysorbate-80, sodium chloride [3].


Pfizer: mRNA, lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3- phosphocholine, and cholesterol), potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose [4].


Moderna: messenger ribonucleic acid (mRNA), lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate trihydrate, and sucrose [5].


One of the immediate concerns about vaccine reactions revolves around polyethylene glycol, or PEG. This compound is used in many different cosmetics and medications. A form of PEG, PEG 3350, is even used as a laxative in the over-the-counter medicine Miralax.


While PEG is generally thought to be safe, PEG 3350 has been associated with neurological symptoms like seizure, speech disorders, and behavioral disturbances in children [6]. PEG has also been associated with immediate hypersensitivity reactions, like itching, hives, and even cardiac arrest [7].


Interestingly, patients who are allergic to PEG can be misdiagnosed as having allergies to multiple drugs due to the pharmaceuticals containing the substance.


While allergies to PEG may be rare, they often go unreported due to a lack of general awareness of their existence.


This may be something that you want to discuss with your health care provider.



Emergency Use Authorization

While the CDC states that the covid-19 vaccines are safe and effective, it should be noted that these vaccines are still not approved by the FDA. As of the date of this blog post, there are at least 4000 studies that are either ongoing, recruiting, or authorized on covid-19 including a wide range of vaccine studies.


What this means is that we really don't have any long-term data about the safety or side effects of this vaccine. For example, as of April 2021, there have been 68, 872 adverse events associated with the covid-19 vaccine reported to the Vaccine Adverse Event Reporting System (VAERS).


It is important to state that this is most likely a tiny fraction of the the true adverse events associated with the covid-19 vaccine due to underreporting to VAERS, a serious issue acknowledged by the CDC [8].


It is also important to note that many of the adverse events reported to VAERS associated with the covid-19 vaccine may not necessarily due to the vaccine although this is a possibility. You can learn how to search VAERS for yourself with this easy to watch video from the CDC.


With the increased risk of a covid-19 infection and increased chance of mortality with individuals with Down syndrome, it is wise to speak with your trusted health care about the options, risks, and benefits, available to your child. While clinical trials for the covid-19 vaccine are beginning for children younger than 16 years old, at this time, the vaccine isn't recommended for anyone under 16 years of age.


Whether you choose to vaccinate your child or not, it's always a great idea to keep your child's immune system strong with these healthy tips . Also make sure to sign up for our monthly newsletter all about Down syndrome health!




References

  1. https://pubmed.ncbi.nlm.nih.gov/33798667/

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405756/

  3. https://www.fda.gov/media/146305/download#page=2

  4. https://www.fda.gov/media/144414/download#page=2

  5. https://www.fda.gov/media/144638/download#page=2

  6. https://onlinelibrary.wiley.com/doi/pdf/10.1002/ygh2.336

  7. https://pubmed.ncbi.nlm.nih.gov/33011299/

  8. https://wonder.cdc.gov/controller/datarequest/D8;jsessionid=31E068BF995E98D95B549EA6D016