Understanding the Pfizer/BioNTech COVID-19 Vaccine

Staff of the Nathaniel Centre

 
How does the immune system and immunity work?

When viruses, bacteria, or fungi enter our body, our immune system responds by producing proteins called antibodies to protect us from them. For every different germ we are
exposed to, our immune system produces a specific protein – an antibody – to protect us from it. However, it takes time for our immune system to produce these antibodies the first time we are exposed to a new germ and, whilst this process is happening, we are susceptible to becoming ill. However, once our immune system has produced an antibody, it remembers how to make it and it remembers the specific germ the antibody is for. This means that if the virus, bacteria or fungi ever enters our body again, our immune system will recognise it and quickly produce the specific antibody needed to tackle it.1, 2

 

What are vaccines and how do they work?

Vaccines contain either weakened or inactive parts of an antigen that, when injected or ingested into our body, stimulate our immune system to produce antibodies against the antigen. These ‘antigen parts’ do not cause disease in themselves.
Rather, they mimic infection and, in doing so, provide our immune system with enough information for it to create the antibodies needed to prevent disease if we are ever exposed to the antigen in the future.3, 4
As vaccines are about protecting the health of individuals and communities, they ideally need to be able to do several things:

(i)    prevent us from becoming infected with a disease;
(ii)    prevent serious illness if we do become infected with a disease;
(iii)    reduce the mortality rate caused by a disease;
(iv)    in a pandemic, ease the strain on healthcare workers and healthcare systems by reducing the number of people becoming severely ill from a disease;
(v)    in a pandemic, reduce the ‘knock on’ mortality rate from other illnesses due to the overloading of the healthcare system because of a disease;
(vi)    prevent symptomatic and asymptomatic transmission of a disease from those who have it to those who do not have it;
(vii)    provide ongoing immunity for the future.

I have heard that the Pfizer/BioNTech vaccine is a ‘new kind’ of vaccine because it is an ‘mRNA vaccine’. What is an mRNA vaccine and how does it work?

‘mRNA’ stands for ‘messenger ribonucleic acid’. mRNA is a molecule that occurs naturally in the body. It is involved in protein synthesis – the process via which our body produces all the different proteins we need to live, including antibodies. An mRNA vaccine, such as the Pfizer/BioNTech COVID-19 vaccine, harnesses this process. The vaccine contains an mRNA molecule that carries the specific instructions for how to make the SARS-CoV-2 ‘spike’ protein – the non-disease-causing prickly projection on the surface of the COVID-19 virus that is characteristic of it and unique to it. Once injected into the body, the mRNA molecule is taken up into our cells where it instructs them to make this spike protein. When our cells have finished making this spike protein, our body recognises it as a foreign antigen (a germ), with our immune system responding by creating an antibody against it. This means that if we are ever infected with the COVID-19 virus in the future, our body will recognise the virus and produce antibodies to protect us from it. Once the mRNA in the vaccine has fulfilled its function, naturally occurring enzymes in the body degrade the mRNA and our body disposes of the debris. Although the Pfizer/BioNTech is one of the first mRNA vaccines of its kind to be broadly tested and used, scientists have been working on mRNA vaccines for a long time, so the technology itself is not new.5, 6

Does the mRNA in the Pfizer/BioNTech vaccine affect DNA?

No, the mRNA in the vaccine does not affect DNA for two reasons:
(i)    mRNA cannot enter the nucleus of our cells, the place where our DNA (genetic material) is housed;
(ii)    the cell breaks down and destroys the mRNA soon after it is finished using the instructions.7

Are vaccines safe? Is the Pfizer/BioNTech vaccine safe?

As with all medicines and medical treatments, vaccines are not 100% completely risk-free.8 However, evidence from decades of research and monitoring indicates that, on the whole, vaccinating against a given disease is much safer than not vaccinating, and that the vast majority of people can safely be given vaccines.9 In terms of the Pfizer/BioNTech vaccine, the clinical tests carried out indicate that, to date, it has a safety record comparable with other non-COVID-19 vaccines that have been in use for decades.10, 11, 12 For example, as of mid- January 2021, no severe adverse reactions have been reported up to 21 days following the administration of 121,000 doses of the Pfizer/BioNTech vaccine in the USA.13, 14 Since this date, this reassuring trend has continued and, as of 6th April 2021, over 100 million doses of the Pfizer vaccine have been safely administered worldwide.15 Overall, the data collected indicates that most adverse reactions to the vaccine are minor – akin to what some experience when taking the flu vaccine.16, 17 Whilst the possibility of developing a more serious reaction to the vaccine cannot be absolutely excluded, serious reactions, if they occur, are likely to be extremely rare.18 Based on this data and on the global health trends that have emerged during the pandemic, it can be concluded that the risk of developing a serious, and even fatal, illness from COVID-19 is far greater than the risk of experiencing an adverse reaction to the vaccine.19

How efficient is the Pfizer/BioNTech vaccine?

According to data so far, the Pfizer/BioNTech vaccine has an efficiency rate of between 90-100% after two doses.20, 21
Moderate protection has been observed after one dose. 22, 23 The ability of the vaccine to prevent disease transmission is unclear at this point in time.24 However, with fewer symptomatic people producing and spreading large quantities of virus as a result of being vaccinated, it is expected that the spread of the virus will be reduced. 25

There is limited evidence about how effective the vaccine is against new strains of COVID-19, such as the variants first identified in the UK and South Africa.26 Early data suggests that the vaccine has a similar efficacy against the UK variant, and is slightly less effective against the South African one.27
Nevertheless, even with these variations in efficacy, the vaccine still offers substantial protection.28 Importantly, the nature of the mRNA production process is such that, if needed, the vaccine can, in the future, be adjusted relatively quickly to keep up with changes in the COVID-19 virus in order to maintain
its effectiveness.29 It is not yet clear how long immunity lasts following vaccination as not enough time has passed between people being vaccinated and being able to assess the longevity of the immune response.30, 31 It is, therefore, also not known whether booster vaccinations will be needed to maintain immunity.32, 33

Can I still develop immunity without taking the vaccine?

Data suggests that vaccination is capable of stimulating a stronger immune response than the response elicited from having had disease itself.34 Immunity gained through
vaccination reduces the risks of serious short-term and long- term illness from infection with COVID-19.35 Immunity gained through vaccination also contributes towards protecting those in the community who are vulnerable and are unable to be vaccinated for health reasons (see ‘herd immunity’ question below).36

It usually takes years to produce new vaccines. How was this vaccine produced so quickly?

Have safety checks been compromised in the production of it?

No, safety checks have not been compromised in the production of the Pfizer/BioNTech vaccine. The reason that vaccines usually take so long to develop is because pharmaceutical companies must invest billions of dollars
upfront to produce them. Because of this, drug manufacturers have traditionally moved very slowly from one phase of vaccine development to the next so as to minimise their financial risk and financial loss. However, given the urgency of the COVID-19 pandemic, these financial barriers were removed through a process of collective global funding and advance ‘insurance payments’ designed to protect the pharmaceutical companies from these risks and potential losses. In addition, pharmaceutical companies have historically tended to work in competitive isolation from each other, with little if any collaboration or sharing of information. Again, because of the seriousness of the COVID-19 pandemic, various pharmaceutical companies decided to work together – something that, until now, was unheard of on such a large scale.37, 38
In addition to speeding the vaccine development process up by sharing the financial risk and sharing knowledge between different organisations, the process has also been accelerated by:
(i)    building off what was already known about pandemics and epidemics from, for example, SARS in 2002, Swine flu in 2009, MERS-CoV in 2012, Avian flu in 2013, Ebola in 2014, and Zika in 2015;
(ii)    stream-lining the process involved in approving the COVID-19 vaccines by reviewing this data as it was
produced, rather than saving it up to review in one go at the end of the development process;
(iii)    cutting out unnecessary red-tape and bureaucracy.39
Commentators working in the fields of microbiology and immunology have noted that, “the COVID-19 vaccines are a remarkable example of the incredible things we can do with international effort, funding, and a common goal for good. This achievement is something to be celebrated and the question around why the vaccines were created so quickly when others take years should be flipped. We should be asking: why isn’t there similar funding and government support for other preventable diseases to have vaccines developed?”40

Has anyone died from having the vaccine?

No, not as far as anyone knows. Some deaths have occurred during the trials that were set up to test the vaccine but, when these were investigated, no direct links between the vaccine and the deaths were found. Instead, it was found that the people who died did so for unrelated reasons, such as from pre-existing illnesses.41, 42, 43

Has anyone caught COVID-19 from having the Pfizer/BioNTech vaccine?

No. It is not possible to catch COVID-19 from the vaccine because the vaccine does not contain any live virus – it is an inert, lifeless vaccine.44

Is it possible to be infected with COVID-19 after being vaccinated?

Yes. To date, a very small number of people have been infected with COVID-19 after being vaccinated.45 When this happens, it is called a ‘breakthrough case’. This is a recognised phenomenon in epidemiology. The chances of this happening are very low when considered from an individual perspective but, when tens of millions of people are being vaccinated against a disease in a pandemic, it is to be expected that some breakthrough infections will occur.46 Several factors can contribute towards breakthrough cases, such as:
(i)    incorrect vaccine storage;
(ii)    incorrect vaccine administration;
(iii)    a vaccine being administered to someone who only develops a weak immune response to it because of other biological or medical factors.47
However, although it is still possible to catch COVID-19 after having been vaccinated, research shows that the Pfizer/ BioNTech vaccine is 100% effective in preventing deaths from the virus.48

What is herd immunity and how does it work?

Not everyone is able to be vaccinated against COVID-19. For example, some people with a compromised immune system may not be able to have the vaccine. But, these people will still have a great deal of protection from COVID-19 if they live in a community where most people have been vaccinated. This is so because when the majority of people in a community are vaccinated, the pathogen has a harder time circulating; most people it encounters are immune to it. In this situation, the people who have been vaccinated effectively form a protective shield around those who cannot be vaccinated. This protective shield is called ‘herd immunity’.49, 50, 51 Herd immunity is an example of how individual health and community health
are woven together and are not separable. Although herd immunity is not 100% effective for those who cannot be directly vaccinated, it does provide substantial protection to them; the more people who are vaccinated in a community, the higher the degree of this protection for those who are vulnerable.52, 53

I have heard that there is a historical link between abortion and the vaccine. Is this true? What is the relationship between the Pfizer/ BioNTech vaccine and human foetal cells/ tissue?
Yes, there is a very distant, historical link between abortion and the Pfizer/BioNTech vaccine. 54 Some of the COVID-19 vaccines that have been developed rely on human cell lines (started with cells that originally came from an electively aborted foetus)
for their production.55 While the Pfizer/BioNTech vaccine does not require the use of such cell lines for its production, it has been tested using an ethically compromised human cell line, HEK293.56 In the case of the development of the Pfizer/ BioNTech vaccine, the HEK293 cells used in the testing phase trace their ancestry back to a foetus legally aborted in the Netherlands in the 1970s for reasons unrelated to medical research. The cells used for testing are not the original cells
taken from the foetus itself but are descendants of those cells. These descendent cells are referred to in biomedical research as ‘immortal cell lines’ because they are artificially maintained in a state of continual replication under laboratory conditions. No new foetal tissue is needed to maintain the cell line.
Therefore, the cell line in question, HEK293, does not require further abortions for its continued existence.57 This fulfills an
 
important moral criterion for establishing moral justification in situations where a well-intentioned action has unavoidable negative consequences; the chosen action (being vaccinated) will not lead to further immoral outcomes (additional abortions).58

Is there any religious reason to reject the vaccine?

No. Given the danger posed by COVID-19, being vaccinated can be accurately described as an act of solidarity that upholds our duty to the common good and that protects those who are most vulnerable amongst us.59 Being vaccinated does not imply moral endorsement of the vaccine production process or complicity with abortion.60 The Vatican’s Congregation for the Doctrine
of the Faith has stated that “all vaccinations recognised as clinically safe can be used in good conscience”.61

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