新冠免疫纵横谈， 读者问答续一

Part1:

Thank u. There are ppl who are allergic to PEG and refuse to get vaccinated. Here’s what I told them: mRNA vaccines are simpler with few ingredients.  Most of the ingredients we already have in our body. The pfizer mRNA vaccines have the smallest amount of ingredients.  You can look them up.  The only active ingredient is the mRNA and sucrose and fat. 

Polyethylene glycol (PEG) is needed in the vaccine to stablilize the mRNA vaccine molecule in your body so it will not dissolve prior to the 72 hours needed to teach your body how to manufacture antibodies to the virus.  PEG is what is in antifreeze.  It is also in all kinds of self care items like medications, face creams, baby wipes and in medications like laxatives. 

You may be able to find out if you are allergic to PEG with allergy testing.  A skin test for PEG allergy is available.    

If you’re allergic to PEG you should not get an mRNA vaccine.  

Polysorbate is the ingredient in the J&J/Janssen vaccine that you should consider getting.  Consider asking your allergist to stratify risk of a vaccine reaction and make a recommendation for the best vaccine in your case.  

Many people after watching a couple of YouTube clips started to bring up epigenetics left and right.  

Here’s my response: — mRNA is not gene therapy. mRNA is short lived and CANNOT integrate into DNA. It gets into cells makes the vaccine antigen which is then recognized by the immune system. Then it degrades. The only long lived change that I know of may be in the Immune cells themselves as they will remember what the spike protein looks like. 

Well, the epigenetics of millions of billions x more covid virus continuing to replicate and affect the entire body in the situation of individual natural infection and treatments required to fight that off I’d say are *infinitely* higher than the effect of what would be relatively few copies of spike protein made from relatively few mRNA molecules where the mRNA genetic material and localized cells that took up the vaccine mRNA are destroyed within a few days. 

With the delta variant, new upcoming variants, waning immunity, persistent global under vaccination, and the fact this disease is going to be endemic into the unforeseeable future, covid is coming for anyone who doesn’t additionally protect themselves with any vaccine.  

Epigenetics are  DNA, non-sequence modifications that altered gene expression.  mRNA is made when you need proteins. mRNA is transcribed from DNA in the nucleus and transported to the cytoplasm.  DNA is not transcribed from mRNA, the mRNA does not re-enter the nucleus to interact with the DNA, and it lives in the cytoplasm where ribosomes can read it as instructions and make the proteins. 

Even if there were evidence RNA did something like this, viruses use the same system, SARSCoV2 dumps RNA into our cells to be replicated for new viruses. So, why would the mRNA from vaccine affect DNA more than SARSCoV2, which is dumping a lot more RNA into your cells?

Vaccine mRNA does not change our DNA. It can’t. Even people who want to change their DNA to cure genetic diseases cannot, and we have no good gene therapy today. That’s how well protected our DNA is from medical intervention. The only thing that guarantees zero long term health effect is death now. If you are sitting in a plane already in the air and one engine has already fallen off. Do you grab the parachute in front of you or wait for long term data on the parachute knowing that the plane is going to crash soon?

…. there's a lot we don't know. forget the vaccine. there's a lot we don't know about life. The food we eat, the air we breathe, the water we drink. And we don't worry about epigenetic changes from all those things. Not because there isn't the possibility of badness, but because there isn't an a priori reason to think that these things confer worse outcomes than the alternative (eg not eating this food, not drinking this water). what is the alternative to the vax? Covid. With its own unknowns. All you can do is look at the parts you do know. And there, the vaccine beats covid on every front. 

Epigenetic effects of food additives, plastics around us, staring at a computer for hours everyday, isolation during the pandemic,……. all human actions contain risk - benefit analysis. All we know is how this virus is affecting us as humanity now. Antivaxxers worrying “no animal experiments and we human are the guinea pigs for mRNA vaccines” will not change what I do know —- Covid is lethal for way too many people, with excessive morbidity for others. That is why I decided to be ok with being a part of “the experiment”. Life is an experiment. As I know there are adverse effects of eating preserved food, drinking or eating out of plastic containers, using computers, I can always try to mitigate poor epigenetic changes with better ones. This is why it is also important to live as healthily as we can right now. Sleep well, eat the rainbow (colorful fruit and veggies), drink water, limit junk. We do want to have our systems be a strong as possible since we inevitably encounter this virus. We know the vaccine reduces death very significantly, as well as morbidity. The rest we have to work out as we go along. 

Close to 100% of people will get covid, likely more than once. This is not a benign illness in many cases. There are definitely epigenetic effects of viruses. 

I have read that historical viral infections have and continue to change the human genome or at least how our body reads our DNS sequences, which is the definition of epigenetics. Likely some or much of the junk or filler DNA that we all have is actually remnants of ancestral virus infections. As we live, we accumulate more of these and more mutations. I’m sure as well, more epigenetic changes. I doubt that mRNA vaccines will be any worse that what we are currently using in terms of other vaccines and certainly getting COVID19 infection has a large range of immediate and likely long term health effects. I would not mess around, vaccine is the best medical science can offer to combat Covid at this time. 

With the delta variant now more than ever the choice is between unknowns with vaccine vs unknowns with virus. It’s going to be really hard to avoid with the delta variant. I would rather take my chances with with the vaccine, especially after a year and a half of watching what the virus can unpredictability do. And after millions of shots have been safely given. 

 岑瀑啸医生在1992年于中山医科大学六年制医学系全英班毕业后赴美，1995到1998年在当时附属于纽约大学的Lenox Hill Hospital任内科住院医生，1998年至2001年，在费城的天普大学医院（Temple University Hospital）任心血管专科住院医师兼内科带教导师（Clinical Instructor），2001年起至今，在佛罗里达的奥兰多AdventHealth医院（原名Florida Hospital）任心血管/心移植专科医生。