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Two vials of a COVID vaccine

For many, the fact that scientists were able to produce vaccines for COVID-19 in record time is cause for celebration, bringing the end of the pandemic into view at last. For others, there’s some hesitation about taking a vaccine that was produced so quickly.

We asked three functional-medicine physicians who take an integrative, food-first approach to health to share their thoughts on the new Moderna and Pfizer vaccines for COVID:

  • Susan Blum, MD, founder of the Blum Center for Health
  • Frank Lipman, MD, founder of the Eleven Eleven Wellness Center
  • Gregory Plotnikoff, MD, founder of Minnesota Personalized Medicine

Here’s what they had to say. 

How do the new vaccines work?

The primary goal of any vaccine is to teach your immune system how to recognize an unfamiliar bug. This primes your immune system to defend you against it should you ever be exposed.

Up until now, there have been two main types of vaccines. The first is an active, or attenuated, vaccine, with a live dose of the pathogen that has been weakened so it won’t cause the disease in humans but tricks your immune system into action. Examples of live vaccines include those for mumps, measles, and tuberculosis.

The second is an inactivated vaccine made from dead versions of the virus or bacteria. Inactive viruses are not as powerful at stimulating your immune system, so multiple boosters are required over time. Examples include the rabies, polio, and hepatitis A vaccines.

The first two COVID vaccines, produced by Pfizer and Moderna, train the immune system using a revolutionary new mRNA platform, which spurs the immune system to create its own (tolerable) version of the COVID viral protein and mount a defense against it.

“I’m excited about the new type of vaccines that use messenger RNA (mRNA) and no adjuvants like aluminum or preservatives with mercury,” says Blum. “It promises to be a cleaner vaccine and easier to adjust quickly if the virus mutates.”

The vaccines were produced in such a short time — are they safe?

Blum notes that the mRNA vaccines are new but the platform “has been in the research pipeline for a while.” She’s referring to the fact that scientists have been working on the mRNA platform for 30 years, many with a focus on coronaviruses since the SARS and MERS epidemics; both of these are also coronaviruses.

The salient thing about the mRNA platform is that it can be readily adapted to a variety of infectious agents because scientists only need a virus’s genetic sequence to create a new vaccine. (Typically a culture of deactivated viral particles is the base for a vaccine, and those can take years to develop.) The preexistence of the mRNA platform allowed scientists to start designing a vaccine the moment they had the COVID-19 genetic information.

Asked if he thinks the current vaccination protocol for COVID is safe and if he is recommending it to patients, Lipman says, “I am recommending it to my patients, and I am planning to get vaccinated.”

Lipman is considered a pioneer in the field of integrative medicine, and he uses lifestyle medicine before drugs whenever possible, for himself and in his practice. “To be clear, I don’t ever get the flu vaccine, and have never been a major proponent of it,” he says. “Not because I think it is that harmful but because it is not that efficacious.”

What are the short- and long-term risks to taking the COVID vaccines?

“From what I have read so far, I don’t have short-term concerns,” says Blum. “Also, many millions of people have received their first doses and all appears to be going well. This month [February 2021] we should start seeing data for people getting their second doses.”

At the moment, the main short-term risk appears to be allergic reactions, including the risk of anaphylactic shock — which, in the case of the Pfizer vaccine, has so far occurred about 11 times per million doses. Such reactions tend to occur within 30 minutes after the shot and can usually be quickly resolved with a shot of epinephrine. The vast majority of these reactions (81 percent) have occurred in people with a propensity for allergies.

There’s also the reactogenic effect, in which some people will experience symptoms such as soreness at the site of injection, as well as fever, headache, and chills — especially after the second (booster) injection. While these are positive signs that the immune system is activated, and they normally abate within a day or two, Plotnikoff is watching this data carefully to see if it shows any trends.

“I’m concerned about less severe reactions such as symptoms that require missing work or precipitate visits to emergency rooms,” he says. Plotnikoff works primarily with patients who have stubborn chronic conditions and allergies; he is planning to get a COVID vaccine himself.

He does caution against making safety judgments based on the early recipients in the elderly population, who tend to have a range of existing health challenges, because they “are at much greater statistical risk for adverse events that could be completely unrelated to the vaccine.”

As for long-term risks, we simply have to wait to find out if there are any. “We don’t know what we don’t know about long-term because the messenger RNA vaccine is totally new as a type of vaccine. We call this ‘unknown unknowns,’” Blum says.

Yet she feels confident that our bodies can process the vaccine. “Based on the science of how the vaccines work, I believe it has the potential to be very safe long term, because the mRNA gets destroyed by the cell pretty quickly and doesn’t linger around.”

What about additives like PEG?

It’s unclear which aspect of the current vaccines is provoking allergic responses, but some experts, including Plotnikoff, have concerns about the presence of polyethylene glycol, or PEG, in the Moderna and Pfizer vaccines. “The leading culprit at this time is PEG,” he says.

PEG is a lipid-stabilizer that’s commonly used in injectable medicines; in the vaccines it suspends and protects the mRNA molecules. Plotnikoff notes that it’s found in many drugs that have occasionally triggered anaphylaxis, and that some immunologists and allergists believe it might cause problems for people who have high levels of PEG antibodies in their blood.

Blum doesn’t like PEG either, and is also concerned that it can trigger allergic or inflammatory reactions in some people who are sensitive. However, she says, “Most people have been exposed to PEG already through everyday life from common products like Miralax and a host of other products, including toothpaste and shampoo, where it acts as a thickener. What’s different here is that the PEG goes directly into the bloodstream from the vaccine and might trigger a stronger reaction.”

Again, she trusts that most of our bodies can eventually process it. “I am not thrilled with the PEG in the vaccine, because I think of it like a possible toxin, but I trust that my body will detox it and get rid of it after the vaccine clears through my body in a few days.”

(For those people who have genetic issues that make detoxification more difficult, it may be worthwhile to take extra steps to support the body’s natural detox process following the shots. Find suggestions here.)

Should people with autoimmune conditions take special caution?

In her clinic, Blum works with many patients who have chronic autoimmune issues, and her book Healing Arthritis takes a food-first approach to treating autoimmune arthritis and related conditions. She readily acknowledges that for people whose immune systems have a tendency to go rogue, a vaccine can be a daunting prospect. But given the overall risks of a COVID environment, she still recommends getting vaccinated when you’re not in an active flare-state.

“For people with autoimmunity, it’s a tough choice,” she says. “Those with autoimmunity are naturally worried that the vaccine might trigger symptoms for them. This hasn’t been shown to be an issue so far, but it’s only been a few months. A more cautious stance would be to wait a little longer for more data. But even in a few months we don’t have long-term data; that will take years.”

“I’m very concerned about people with autoimmunity getting COVID,” Blum adds. “We know that viruses can linger in the body and cause autoimmunity, and it’s possible that people with autoimmunity already have a defect in their ability to fight viruses. “But eventually, I think vaccination will be the right decision versus trying to avoid getting COVID by staying home indefinitely. There will come a time when each person will have seen enough information on the vaccine to feel they are ready.”

What can I do to prepare for getting vaccinated?

Experts recommend you get yourself in the best possible shape to receive the vaccine. As a reminder, if you have autoimmune issues, ensure that you’re not in an active flare-state. Beyond that, keep your focus on building a healthy baseline.

“Before you get vaccinated, please do focus on all resilience factors in your power,” says Plotnikoff. “These include good sleep, good nutrition, and good exercise. Ensure excellent levels of vitamin D, vitamin A, vitamin C, zinc, and selenium.”

You may also want to set aside some time to rest after your appointments in case your immune response makes you feel crummy. Note that this response is more common after the second shot.

If you’re still feeling hesitant, putting the risks in a larger context might also help.

“I understand hesitancy and mistrust of the medical establishment and Big Pharma,” says Lipman. “I too in many ways feel the same, but this goes way beyond personal health. The efficacy is pretty high, and we have a major pandemic and public health crisis that needs to be addressed. So, in my opinion, the benefits far outweigh the possible adverse effects.”

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