California Urges Stop To 300K Vaccines After Some Fall Ill In San Diego
Speaker 1: 00:00 San Diego joined a nationwide tribute last night to the victims of COVID-19 by illuminating buildings in Belvaux boa park, president Joe Biden, headed the nation's tribute at a ceremony in Washington, DC honoring the more than 400,000 Americans who've lost their lives to the virus. The new administration has put the COVID vaccination program at the top of its priority list, but here in California, the effort hit a glitch this week with news that the state suspended the use of a batch of a dhurna vaccine, several people who received vaccinations from that batch experienced what's being called higher than usual allergic reactions. Joining me is James Paulson, professor and chair of the department of molecular medicine at the Scripps research Institute. And welcome to the program. Speaker 2: 00:49 Thank you very much, Speaker 1: 00:51 10 or so people who got vaccinated at Petco park experience to these allergic reactions. Can you explain just what those reactions were? Speaker 2: 01:01 Well, yes. I mean, uh, allergic reactions in general are pre-existing conditions. So someone has been exposed to, um, some something, you know, beasting peanut allergy, or everyone's familiar with, with allergies in general, Palin, uh, and if you've been exposed and you, and you are allergic you producer producer, um, your immune system produces an antibody that, um, that causes allergies. Then, then they're just sitting there waiting for the next exposure. And, uh, the immune system reacts quite vigorously to produce what's called anaphylaxis, which is, uh, a severe shock to the body. Speaker 1: 01:44 Is that possibly deadly a reaction to a vaccine like that Speaker 2: 01:49 It can be, but it's also very preventable or the medical care. Uh, many people are also familiar with, um, if you are very allergic, like to peanut allergies, especially parents with children that have peanut allergies, they have an epi pen, it's an epinephrin pen. And when the reaction starts a quick administration of that, um, the epi pen generally takes care of it. And, uh, and you know, medical teams, um, who are present at these vaccination sites, by the way, uh, are, are, they're prepared to do that and other things to make sure that these severity actions don't end up in a, in a bad way. Speaker 1: 02:32 Are you aware of what ingredients in the Madrona vaccine could have triggered such a reaction? Speaker 2: 02:40 Well, uh, you know, we could, we could be surprised there could be some things that the nobody's anticipating, but the, the most likely ingredients, uh, that I've seen are polyethylene glycol, which is used in manufacturing processes. And I've also heard mention of polysorbate. Um, polyethylene glycol in particular is used in other medicines, and some people become allergic, uh, become, uh, to the, you know, to these materials that aren't present in, in, in most, uh, common day life. Um, so, uh, it's possible that the pH, the people that, that were, um, impacted and had these severe reactions had previous exposure and as a result, um, uh, you know, experienced the same thing with this particular batch of, of maternal vaccine. Speaker 1: 03:36 How common is it for people to have allergic reactions to vaccines? Speaker 2: 03:41 Oh, it's, it's very rare. So this is a common problem for all vaccines, uh, for anyone that's had an influenza vaccine, you, you, you, you will recall that you get, you have to fill out a questionnaire asking if you have allergies to eggs in particular, because many influenza vaccines are produced in eggs, and there's some carry over of those allergens into the vaccine. So this is not a new problem at all. And, um, and, and it's very rare because the ingredients in the vaccines, uh, produce these allergies very, very uncommonly. So it was, uh, I think surprising and raise the red flag when, when more than one person in a day, uh, or more than one or two in a day experienced some negative reaction. Speaker 1: 04:37 And this is a new kind of vaccine. It's not the egg based flu vaccine that we're used to, is it? Speaker 2: 04:44 Yes, it's not an egg based at all. So it's not the same allergy. It would be a different allergy for components that were carried over in the manufacturing process for this particular, um, or during the vaccine. Speaker 1: 04:57 And why did the state decide to take that entire batch of Madonna out of circulation? Speaker 2: 05:02 Well, I think it was just, uh, an abundance of caution. Uh, the, the term that was used, we've heard that term used a lot these days, but, uh, and, and, and it's for that reason, um, now with Moderna and the FDA, and the CDC are investigating that batch to see if perhaps some of the suspected allergic compounds, uh, were in higher quantity, for example, or if they could detect other things that, that, uh, weren't anticipated to be in that batch or other batches. Um, you know, I, I personally think that learn a lot more by, um, asking the patients what their previous exposures have been. And if there's anything in common, uh, between the patients that would help narrow down what could be the problem with this particular of vaccine, if, if there is a problem we don't know for sure if it was the vaccine, it could have just been a cluster of cases that are extremely rare to have happened that put the finger on that, on that batch of vaccine. But, um, you know, I think it's a combination for you have patient privacy. You can't ask a patient to spend the time and go through their history, but, but, uh, certainly they can be asked if they're willing and a combination of analyzing the, the vaccine and, and talking to the patients, uh, my teachers a lot. Speaker 1: 06:33 And it is common. In fact, it isn't expected for people to have some kind of reaction to this vaccine. Isn't that right? Speaker 2: 06:43 Well, yes. Uh, but, but this is, uh, a very specific type of reaction that is medically and threatening. So many people will expand experienced pain at the site. And as the immune system reacts, um, some more, expect more, more pain or swelling or redness, but this is not an allergic reaction. Um, the allergic reaction is, is mediated by a class of antibodies, uh, called IgE. And, you know, many people don't make many these kinds of antibodies. And some people make lots of them to lots of different things, which means, and what they do is they, they, they go to specialized immune cells called mass cells and basophils, and those antibodies just sit there on, on those cells waiting for an allergen to come along. And when it does it activates that cell to release all kinds of nasty contents that, that, uh, cause in the mild cases, you know, sniffling and headaches and nasal congestion, but in severe cases, anaphylaxis with all organs and, uh, being affected with, uh, uh, you know, very severe consequences. And so this is the thing that we're concerned about, not the type of side effects that most people would experience. Speaker 1: 08:10 And is there any tests that can be done beforehand to find out if people might be allergic to these COVID vaccines? Speaker 2: 08:18 Well, you know, I I've, I've gone recently to, uh, one of the vaccinating, uh, vaccine sites, um, the, the Petco, and in fact that's where the, where the problem was. And, uh, they asked me questions right up front, you know, do you have allergies? Have you ever had anaphylaxis, um, have you ever used an epi pen? So these are sort of very clear direct questions. Um, the, uh, the screening nature, and I had another colleague who went to the same site, uh, and she has very severe allergies to at least 20 different things. So she's a prime candidate to be worried about any allergic material and she was screened and she was, um, she answered, yes, yes, yes. To all of these questions. And they immediately put her in a different line. They have a different line set up for people with allergic, uh, with allergies and the potential to undergo this anaphylaxis. Speaker 2: 09:24 And so, uh, she was greatly relieved cause she really wanted to get the vaccine. She got the vaccine and she had no problem at all. So here's a case of a very severely allergic person that had no problem. And the reason is that she wasn't allergic to what ever the components were in the vaccine. You'd have to have had some pre-exposure and be allergic already when you go to get your vaccination. So I think these screening questions are critical and the more we know about, uh, about the potential allergies for the maternal vaccine, they can make their questions a little bit more specific, um, and, and flag people that might've had exposure that would need to go into that special line. Speaker 1: 10:11 Well, this has really been some very useful information. I want to thank you very much. James Paulson, professor and chair of the department of molecular medicine at the Scripps research Institute. Thanks very much for speaking with us. My pleasure.