Building the Science of COVID-19 Vaccinations

An opinion piece written by ACNEM President Dr Mark Donohoe, with approval of the ACNEM Board.

 

I have a problem. It may be a big problem. It may be a minuscule problem. But it is a problem I would like you to help me solve. And, in doing so, make an important contribution to the science and safety of COVID-19 vaccination.

My problem is the number of my patients reporting to me their adverse reactions following COVID-19 vaccination. Twenty-eight in the past month. Those reports are robbing my time and attention from the medical care of my other patients. And they rob it again with the 10+ min of time taken to complete a single adverse reaction report on the TGA’s website.1

Most of my patients suffer chronic and complex illnesses requiring nutritional, environmental and integrative interventions to keep them functional. It’s a fine line separating them from exacerbations caused by insults that most healthy people would breeze through.

The current crop of vaccines available in Australia (AstraZeneca Vaxzevria, Pfizer Cominarty and Moderna Spikevax) are acknowledged to be unusually “reactogenic” (causing local and systemic reactions2), and this plays out in the data from 62,699 COVID-19 adverse reactions recorded by the TGA to date (accessed 13 October 2021).

Do NOT misunderstand me, these vaccines work and work well for most people most of the time. They diminish hospitalisation and death rates considerably following SARS-CoV-2 infection. They seem miracles of technology.

BUT…there is a catch. There are no free lunches in Medicine. We balance the “on average” good versus the “on average” harms, both short and long term, and then use clinical judgement on how to weigh that balance for every individual patient.

As the great epidemiologist, George Davy Smith put it so well decades ago, “Randomized trials have not, however, answered the question of which individuals actually benefit from medical interventions”.3 Nor can they predict which individuals suffer harm. Clinical judgement is critical for this.

So how do we contribute to the science of COVID-19 and especially in the vaccination area? We report what we observe. We help build an evidence base which accurately identifies the harms to weigh against the manifest goods of the vaccines.

ACNEM wants to encourage all its practitioners to report adverse vaccine reactions as they arise in your practice. For me, each report takes between 9 and 16 minutes and you can set up a TGA account in minutes to streamline the process and track your adversely affected patients. Simply go to the TGA Adverse Event Reporting page to help build the science around COVID-19 vaccination.

That said, we need less reactogenic vaccines for our at-risk patients. Vaccines with the same ability to stop hospitalisation and death, but with lower potential for exacerbation of complex inflammatory conditions.

The soon-to-be-released Novavax may be a significant vaccine if the phase 3 trials are to be believed. The same is likely true of the COVAX-19 vaccine developed here in Australia and currently passing through final clinical trials.

The Federal Health Minister has announced that Novavax will be available to Australians in November this year, but with a hint that it may be held back for use as a “booster”. If it proves to be less reactogenic, Novavax needs to be available for the primary course of immunisation, even if only at the discretion of the prescribing doctor.

Our community can learn more about the Novavax vaccine this Friday in a webinar with Novavax by registering here.

In no way is ACNEM endorsing or promoting Novavax or any other vaccine. Our educational remit is to provide access to information for our members and community on both nutritional and environmental medicine, as well as, important updates on the broader field of medicine that will affect all of our practices. With the arrival of new vaccines and COVID-19 therapeutics, we aim to keep high quality information flowing regularly to our practitioners, for them to make the best-informed judgements on behalf of their patients.

1 https://aems.tga.gov.au/privacy/

2 Reactogenicity Following Receipt of mRNA-Based COVID-19 Vaccines. Chapin-Bardales, J et al JAMA April 5, 2021

3 Incommunicable Knowledge? Interpreting and Applying the Results of Clinical Trials and Meta-Analyses. Davey Smith G, Egger, M. J Clin Epidemiol Vol. 51, No. 4, pp. 289–295, 199

 

 

Dr Mark Donohoe, MS BS (Syd) FACNEM FASLM

ACNEM President Dr Mark Donohoe graduated from Sydney University in 1980, opening his medical practice on the Central Coast New South Wales in 1983. The patients of his new practice led him into the fields of Environmental Medicine and Nutritional Medicine. He was awarded fellowships from the Australian Society of Environmental Medicine (ASEM), ACNEM and more recently the Australasian Society of Lifestyle Medicine (ASLM).

Over his 38 years in practice, Mark has specialised in the fields of chronic fatigue syndrome, environmental and occupational toxicology, and sensory sensitivities including multiple chemical sensitivity. Mark works with his wife, Fiona, at Mosman Integrative Medicine in Sydney. While he focuses on causes of illnesses and diseases, Fiona manages the healthcare side of the practice where she and other natural healthcare practitioners provide consultations and classes in yoga, Qi gong, pregnancy yoga, meditation, mindfulness and movement.

Mark and Fiona work together with an underlying philosophy that health in all its forms is the best prevention of disease, and that most disease is best managed by clean air, clean food, clean water and a commitment to a diet and lifestyle that is health enhancing.