New Zealand / Covid 19

Call for alternative to mRNA vaccines after healthcare worker's anaphylactic reaction

23:19 pm on 2 September 2021

As the team of five million flood into vaccine centres each day to get their shots, a small group are unable to get the Pfizer mRNA vaccine.

Photo: AFP

They are not conspiracy theorists, or anti-vaxxers. They just need an alternative to Pfizer due to an ingredient in the mRNA vaccine that allows it to be stored at very low temperatures without freezing.

Emma, an immunocompromised frontline healthcare worker, is among those who cannot get mRNA vaccines, like Pfizer and Moderna.

She said she was particularly worried about the Delta variant of Covid-19 and her potential for exposure at work.

But her first dose of the Pfizer vaccine sent her to hospital, and getting another was potentially life-threatening.

"I had the dose, within five minutes broke out in hives. I went home after a half hour or so, but as soon as I got home my throat started swelling and I had to go to hospital," she said.

"I had at least two EpiPens and high doses of steroids and antihistamines - enough to knock people out. I then had to stay overnight in hospital."

As a result of the anaphylactic reaction, she had been told by an immunologist not to get a second dose - leaving her vulnerable to the virus.

Studies showed between about two to 11 cases of anaphylaxis per one million doses of mRNA vaccine administered.

Unfortunately for Emma, she was one of them.

"As part of my role I'm waltzing in and out of a waiting room collecting young people to go and meet with them all day, everyday. And what Delta has shown is you can just be in vaguely the same space - so you can just be next door to someone and the door is open, and you can catch it, right? So that's a little bit scary."

Alternatives were available, like the Johnson & Johnson and AstraZeneca vaccines, and they had even been approved for use in New Zealand.

But the government had so far committed to a Pfizer first and Pfizer only strategy.

Emma wondered where that left her.

"If they really care about the people of Aotearoa and getting them vaccinated, and really protecting us against Covid-19, they really, really need to prioritise getting these alternative vaccine brands," she said, of the government.

Malaghan Institute director Professor Graham le Gros said cases like Emma's demonstrated why the governmen should not have all its eggs in one basket.

"As far as I understand it, the government has pre-purchased both the AstraZeneca and Johnson & Johnson, Medsafe has given their approval and there's no reason why they shouldn't be bringing it across - either for the emergency or for these cases where it may actually help some people who've got a specialised response to the Pfizer."

Vaccinologist Helen Petousis-Harris, a member of the government's Covid-19 immunisation implementation advisory group, said though reactions like Emma's were incredibly rare other options were being looked at.

"The only people who really can't receive the [mRNA] vaccine are people who have already had an anaphylactic reaction to a dose or have had an anaphylactic reaction to something in the vaccine itself. So a very, very small group," she said.

"We are in fact anticipating delivery of an alternative vaccine, so it is very likely that this will be a suitable vaccine option for these few people."

Dr Petousis-Harris was referring to the Johnson & Johnson vaccine, or Janssen as it was also known, which got Medsafe approval in early July.

The Covid-19 Response Minister Chris Hipkins at the time said Cabinet would decide in August on its use.

But that had now changed to September.

"Cabinet has so far approved the use of the Pfizer vaccine in New Zealand for those aged 12 years and over and will be considering the use of Janssen in September," he said in a statement to RNZ.

"The Ministry of Health is currently working on plans to be able to distribute the Janssen vaccine, where it is needed, once it has been approved. At his point, Janssen is indicating we can expect deliveries in the fourth quarter of the year.

"The number of doses of vaccine required in New Zealand as an alternative to the mRNA are understood to be small in scale.

"My message to [Emma] is to say thank you for getting your first dose. The government is committed to making vaccines available to everyone in New Zealand by the end of the year."