Dr Charles Shepherd, Hon. Medical Adviser, ME Association
There has been really good news in recent days about Covid-19 vaccine development.
To have produced a growing number of what appear to be very safe and effective vaccines for a completely new viral infection in less than a year is a remarkable and unprecedented scientific achievement.
Finding a safe and effective vaccine for Covid-19 infection is also likely to be the most effective measure we have in bringing this pandemic to an end.
The Astra Zeneca/Oxford University Vaccine
All the indications are that the Astra Zeneca/Oxford University vaccine, which has been developed with government funding, is safe and effective.
The overall results so far indicate that it will prevent infection in around 70% of people who receive it. And even in those who do not gain full protection, it reduces the severity of the infection and hospital admissions.
However, if the first dose is halved, which may act to prime the body's immune system, and this is followed by a second full dose, the efficacy rises to around 90%.
As with any vaccine, a number of minor and short-term side effects – sore arm, headache, fatigue, feeling feverish etc. – are being reported.
However, we don’t yet have any information about possible serious side effects, or how the vaccine might affect people with immune system dysfunction.
What we do know is that – as with any clinical trial involving vaccines – a large number of volunteers who have received the vaccine have been followed up to monitor for adverse effects.
With the Astra Zeneca/Oxford vaccine this has involved around 25,000 people in the UK and Brazil. The UK medicines regulator, the MHRA, will examine all this data before approval for use is given.
The Astra Zeneca/Oxford vaccine, which is based on a genetically modified common cold virus, requires two doses, which are administered a month apart. It is fairly cheap vaccine to make – about £3 per dose compared to £15 for the Pfizer/BioNtech vaccine and £25 for the Moderna vaccine.
And it does not have the logistical problems relating to storage and distribution that the other two front runners from Pfizer/BioNtech and Moderna have. So, it can be kept in a fridge in a GP surgery and does not need to be stored at minus 80 degrees centigrade like the others.
Consequently, the Astra Zeneca/Oxford vaccine is likely to be the vaccine of choice for use with most people here in the UK and the government has secured 100 million doses for UK use.
Covid-19 Vaccines and ME/CFS
We know that all vaccines can occasionally trigger ME/CFS or exacerbate existing symptoms. As with the information previously provided for this year’s flu vaccine, I will be preparing more comprehensive guidance relating to the use of all the Covid-19 vaccines that are likely to become available here in the UK in people with ME/CFS. But it's too early to do so at the moment.
There are a number of other Covid-19 vaccines still being developed and assessed. They are being made using different methods of vaccine production – i.e. they are not all the same. Which means that we are likely to be facing a situation where different vaccines are going to be more appropriate for different groups of people, possibly including those with allergies to drug additives and who have evidence of immune system dysfunction/activation – as occurs with ME/CFS.
The Covid-19 Inoculation Programme
At the moment it looks as though the Pfizer/BioNtech (messenger RNA) vaccine could be the one that will be used to vaccinate key workers, care home residents etc. starting in December.
After that will come people with high risk medical conditions (e.g. respiratory disease, diabetes, immunodeficiency diseases) and the elderly in descending order down to the age of 60, or possibly 50.
Providing all goes to plan, the government is aiming to start mass vaccination early in the New Year and to hopefully have a significant proportion of the population vaccinated by Easter 2021.
I don't think people with ME/CFS are going to be in line for vaccination until February or March next year – unless they belong to one of the above groups that are already being given high priority.
The bottom line here is that if a Covid-19 vaccine has a good safety profile (recognising that all vaccines have side effects, sometimes serious ones as well) and is effective, then this is a form of protection that people with ME/CFS must consider having.
Taking the small risk of having an adverse reaction to a new vaccine in order to obtain possibly around 90% protection from a life-threatening virus is something that we are all now going to have to think about over the coming few weeks as more information is forthcoming about the government’s plans…
More Information
ME Association Leaflets:
- Free Leaflet on the 2020 – 2021 Flu & Pneumonia Vaccine for people with ME/CFS
- General information on vaccines as possible trigger factors for ME/CFS
- Free Leaflets on Covid-19, the restrictions, infection, Post-Covid Fatigue Syndromes & Management
- ME/CFS Disability Classification & Illness Severity Definitions
- ME/CFS Prognosis, Permanency, & Quality of Life
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