Pfizer/BioNTech Covid Vaccine – Questions and Answers

Pfizer/BioNTech Covid Vaccine – Questions and Answers

1. How did they make the vaccine so quickly?

A misconception is that work on the vaccine began when the pandemic started; scientists had already begun research for coronavirus vaccines during previous outbreaks caused by related coronaviruses such as SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome). That earlier research provided a head start for rapid development of vaccines to protect against infection with the novel coronavirus SARS-CoV2, the virus that causes COVID-19.

Making a vaccine is expensive and funding is a common issue, but as the pandemic increased with worldwide spread so did the resources made available to research teams.

The different stages of the vaccine development process have also overlapped; such that manufacturing was already underway whilst the clinical trials were still ongoing, further speeding up the process.

2. What is in the mRNA Covid-19 vaccine?

Pfizer BioNTech COVID-19 vaccine is a nucleoside-modified messenger RNA vaccine (mRNA) vaccine. mRNA vaccines use the pathogen’s genetic code as the vaccine; this then exploits the host cells to translate the code and then make the target spike protein. The protein then acts as an intracellular antigen to stimulate the immune response. The mRNA is then normally degraded within a few days.

Pfizer BioNTech COVID-19 vaccine has been generated entirely in the laboratory, outside of living cells, formulated in lipid nanoparticles. The vaccine contains the following ingredients:

  • mRNA (messenger ribonucleic acid = a single-stranded RNA molecule that is complementary to one of the DNA strands of a gene).
  • Lipids / fats
    ALC-0315 = (4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), – ALC-0159 = 2[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, – 1,2-Distearoyl-sn-glycero-3-phosphocholine, 5 – cholesterol,
  • Salts
    – potassium chloride, – potassium dihydrogen phosphate, – sodium chloride, – disodium hydrogen phosphate dihydrate,
  • Sugar
    – sucrose

The vaccine contains less than 1 mmol (39 mg) of potassium per dose, i.e. it is considered essentially ‘potassium-free’. It also contains less than 1 mmol sodium (23 mg) per dose, so is considered essentially ‘sodium-free’.

3. I heard that the COVID-19 vaccines contain microchips, is this true?

No, the COVID-19 vaccines do not contain microchips.

4. Will receiving the mRNA vaccine alter my DNA?

mRNA stands for messenger ribonucleic acid and can be described as ‘instructions for how to make a protein or even just a piece of a protein’. The mRNA from a COVID-19 vaccine never enters the nucleus of the cell, which houses our DNA and therefore cannot alter or modify a person’s genetic makeup (DNA). Instead, COVID-19 vaccines that use mRNA work with the body’s natural defences to safely develop protection (immunity) to disease.

5. Is it safer to contract COVID-19 naturally as opposed to getting vaccinated?

No, it is not safer to contract COVID-19 naturally. Around 80% of people who contract COVID-19 have a mild infection; however there is no guarantee that you will be amongst this group. If you are someone who suffers severe symptoms, there is a greater risk of complications due to progressive infection and even death. Emerging evidence suggests that those who have previously recovered from COVID-19, including those who had mild symptoms, may suffer from what is termed long-covid. People with long-covid suffer prolonged symptoms after recovery, including malaise or fatigue, muscle or joint pain, headaches, altered taste/ smell etc. which can persist for months. More seriously, recent studies indicate that young, low risk patients who continue to have ongoing symptoms of covid-19 have signs of damage to multiple organs for months after the initial infection.

6. Will getting the vaccine give me COVID-19?

No, the Pfizer/BioNTech COVID-19 vaccine does not have any viable virus particles so cannot cause the disease.

7. I have had Covid-19; do I still need the vaccine?

Currently, data suggests that immunity to mild COVID-19 infections wanes over time; and protective serum antibodies that were generated as a result of contracting the infection cannot be detected after a few months. This could mean that you are no longer protected, and therefore will not be immune to COVID-19 after this period. In a small number of cases, COVID-19 re-infection has occurred in recovered patients.

Getting the vaccine will help prolong immunity to COVID-19 and provide a better defence against potential long term consequences of natural infection (Long-Covid). Vaccination is therefore recommended for anyone who has recovered from COVID-19 (12 weeks from recovery date in 12 – 15 year olds; 4 weeks from recovery date in those who are older).

8. What are the recommended interval times between vaccines?

Timings between vaccines vary according to age and following natural infection. Recommendations are as follows:

  • For those above 16 years of age – 8 weeks between 1st and 2nd vaccine then a minimum of 12 weeks until booster
  • For 12-15 year olds – 12 weeks between 1st and 2nd vaccine
  • After contracting COVID-19 – vaccination should be deferred for 4 weeks post infection. 

9. I have a strong immune system, and I don’t usually catch a colds, should I  worry about catching COVID-19?

Some of us are healthy and may not be prone to seasonal coughs and colds. This does not make you immune to catching any viral infections, including COVID-19. Moreover, COVID-19, unlike other coronaviruses that cause coughs and colds, can also cause long-term health concerns, even in those who suffer seemingly mild symptoms. It also has a higher death rate.  Vaccination is deemed a key component to navigating the pandemic –  consider taking the offer of a vaccine when presented with one and encourage those close to you, especially the elderly who have a higher risk of death from COVID-19 to do the same.

10. What is the duration of immunity obtained after the vaccine?

It is too early to know the exact length of COVID-19 immunity, from either vaccination or natural infection. Initial studies indicate a low risk of subsequent infection for at least 6 months.

Both vaccination and natural infection provide protection that is seen to wane over time (read more here).

Immunity provided by the Pfizer/BioNTech COVID-19 vaccine appears to reach full effect seven days after the second dose.

Booster doses of the vaccine will be required to maintain immunity, though the timings for the administration of this have yet to be established (i.e. will this be annual vaccination similar to that for the ‘flu?). WHO highlights that these decisions must ultimately be made according to the local community and based on rigorous evidence (read more here).

11. How many does of this Covid-19 vaccine will I need?

You will need two doses of the Pfizer/BioNTech COVID-19 vaccine; the two injections should be given eight weeks apart. Booster doses will be offered as required (e.g. the 3rd dose offered approximately 6 months after the 2nd dose).

12. What are the potential side effects of getting vaccinated?

Most medicines have some side effects; it is important to weigh risks and benefits.

The Pfizer vaccine cuts hospitalisation cases from COVID-19 by more than 80%, but can have common side-effects including pain at the injection site, tiredness, headache, muscle pain, chills, joint pain, and fever. These symptoms affect more than one in 10 people. Some reports from the FDA suggest that more people experienced these side effects after receiving the second dose of the vaccine, as opposed to the first.

It is important, however, to remember that these side effects are all signs that the immune system is responding and working and can be managed at home with paracetamol, fluids and adequate rest.

“Not many of us think twice about driving somewhere, but the risk of a car accident is a lot higher than serious effects of a vaccine…
The danger is people falsely assume health problems that happen by coincidence are caused by the vaccine. But the truth is that people get sick all the time. Every five minutes in the UK one person has a heart attack and one person has a stroke.”
Dr Penny Ward, KCL Faculty of Pharmaceutical Medicine.

13. What is the advice for those who suffer from allergies?

Information regarding allergies is continuously being updated based upon data from on-going vaccination programs. Guidance now states that anyone who has had an unexplained anaphylaxis (severe allergic reaction leading to hospitalisation) or is allergic to multiple drugs should not get this vaccine. They should discuss vaccination with their GP.

The vaccine is suitable for those who are allergic to:

  • a single drug (e.g. penicillin, or ibuprofen)
  • dust or pollen
  • eggs
  • preservatives
  • latex
  • shellfish

In Gibraltar we have a pre-screening survey for everyone before COVID-19 vaccination. This helps determine suitability for the COVID-19 vaccine.

14. What is the advice for pregnant or breastfeeding women?

The Joint Committee on Vaccination and Immunisation (JCVI) in the UK has now advised that pregnant women can be offered the COVID-19 vaccine. This change to the guidance comes after data from the United States shows that 90,000 pregnant women have been vaccinated with mRNA vaccines (such as the Pfizer vaccine we are using in Gibraltar) without any specific safety concerns being raised.

Women who are considering pregnancy, those who are already pregnant and those who have given birth and who may be breastfeeding are now all eligible for the vaccine should they wish to receive it.

Pregnant women may wish to discuss this further by approaching their GP or Obstetrician.

15. Can I transmit COVID-19 after vaccination?

Anyone who has an active COVID-19 infection can transmit it. Preliminary studies of those who have been vaccinated show reduced rates of asymptomatic infection and low viral loads in the nose after swabbing. Unfortunately, this does not mean the risk has been removed entirely. Following public health advice about COVID-19 best measures remains important (washing hands, maintaining mask use, ventilating indoor spaces and physical distancing etc.).

16. Who will get the vaccine first?

The vaccination program will progress in stages, beginning with the most vulnerable:

PriorityRisk group
1Residents in ERS and their carers
2All those 80 years of age and over
3All those 70 years of age and over and front-line health and social care workers
4Clinically extremely vulnerable individuals
5All those 65 years of age and over
6All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7All those 50 – 65 years of age
8All those 12 – 50 years of age, resident in Gibraltar
9All those who are cross frontier workers who are entitled to free healthcare in Gibraltar

People will be vaccinated twice and full immunity is considered seven days after the second dose.

17. What about vaccinating children?

Guidance for the immunisation of children will be updated alongside on-going studies surrounding COVID-19 infection.

Children and young people have a low risk of suffering the severe health harms following  COVID-19 infection, thus they have previously been considered a lower priority. However, we do know that children can carry the virus and pass this onto household and social contacts. This becomes of greater concern if close contacts are elderly or vulnerable.

To try reduce the amount of virus circulating in our community, and following safety advice/ recommendations from the JCVI, vaccinations are currently offered to those above 12 years of age.

18. How do mRNA vaccines work and how are they different to previously used vaccines?

The messenger ribonucleic acid (mRNA) COVID-19 vaccine contains the genetic sequence (mRNA) for the spike protein which is found on the surface of the SARS-CoV-2 virus. The mRNA is wrapped in a lipid envelope (referred to as a nanoparticle) to enable it to be transported into the cells in the body. Lipids provide a well-established delivery system into cells both in normal cell function and during a viral infection.

When injected, the mRNA is taken up by the host’s cells which in turn produce the spike proteins. The spike proteins are then displayed on the surface of the cell. This stimulates the immune system to produce antibodies (proteins that recognise and bind the spike protein) and activate immune memory cells which remain ready for any future exposure to the COVID-19 virus.

As there is no whole or live virus involved, the mRNA vaccine cannot cause disease. The mRNA naturally degrades after a few days.

19. How effective is the vaccine?

The phase 3 human trials of the Pfizer BioNTech COVID-19 vaccine demonstrated a vaccine efficacy of 95%, with consistent efficacy across age, gender, and ethnicity. The observed efficacy in adults over 65 years of age was 94%. (Read more here)

As with any vaccine, there will be a few that fall in the percentage that are not fully protected following vaccination. For those with a weakened immune system, or who are taking chronic treatment that suppresses or prevents immune responses, around 40% are seen to mount an undetectable immune response; making a further 3rd dose advisable.

20. Do I need the vaccine to travel?

At present the International Air Transport Association (IATA) have not indicated whether vaccination will be a necessary requirement for all journeys abroad, it will be down to individual countries to determine their own requirements for tourists/ residents.

In order to allow safe travel between countries it is likely that some form of COVID-19 consideration will be required; being COVID-19 negative (providing a negative test result), vaccinated and/or demonstrating a recent natural COVID-19 infection (providing some form of immunity).

21. What percentage of the population needs to be vaccinated to have herd immunity against Covid-19?

The percentage of people who need to have protection in order to achieve herd immunity varies by disease. Read more on herd immunity HERE.

At present, the percentage of people that would need to get vaccinated to achieve herd immunity to COVID-19 is unknown.

22. Do I need to wear a mask when receiving the vaccine?

Yes. It is recommended that during the pandemic people wear a mask/face covering that covers their nose and mouth when in contact with others outside your household, including in healthcare facilities, and when receiving any vaccine, including a COVID-19 vaccine. (Note: Anyone who has trouble breathing, or is unable to remove a mask without assistance, should not wear a mask).

It is important to note that COVID-19 information is based on the most recently available data and as such responses may be updated as new data emerges and advice may therefore change over time.