I was reading the following article and my interest was piqued to do some research. There is a lot to unpack and some questions I can’t answer without more information. I will share what I found and we can keep digging for answers.
The first thing that totally doesn’t make sense as others have said is why she got the vaccines when she came in for treatment for Paroxysmal Nocturnal Hemoglobinuria. The important thing to know about PNH is it is an autoimmune disorder. I will discuss those first. I will give you information about ingredients and such and you can decide what you think.
Why they gave her tetanus from a medical viewpoint is only if she had no proof of ever receiving one. You get it as a child that lasts a lifetime. Adults get Tdap. Here is info from CDC.
Tetanus, Diphtheria, and Pertussis (Tdap) Vaccines
There are two Tdap vaccines used in the United States: Adacel® and Boostrix®. The Food and Drug Administration (FDA) approved both Boostrix® and Adacel® for use during pregnancy.
Each 0.5-mL dose of Adacel® (Sanofi Pasteur) contains 5 Lf tetanus toxoid, 2 Lf diphtheria toxoid, and acellular pertussis antigens (2.5 µg detoxified PT, 5 µg FHA, 3 µg pertactin, 5 µg FIM). Other ingredients per 0.5-mL dose include 1.5 mg aluminum phosphate (0.33 mg aluminum) as the adjuvant, ≤5 µg residual formaldehyde, <50 ng residual glutaraldehyde, and 3.3 mg (0.6% v/v) 2-phenoxyethanol (not as a preservative).
Each 0.5-mL dose of Boostrix® (GlaxoSmithKline) contains 5 Lf of tetanus toxoid, 2.5 Lf of diphtheria toxoid, 8 µg of inactivated PT, 8 µg of FHA, and 2.5 µg of pertactin (69 kiloDalton outer membrane protein). Each 0.5-mL dose contains aluminum hydroxide as adjuvant (not more than 0.39 mg aluminum by assay), 4.5 mg of sodium chloride, ≤100 µg of residual formaldehyde, and ≤100 µg of polysorbate 80 (Tween 80).
Immunogenicity and Vaccine Efficacy
Diphtheria and tetanus
Today, diphtheria and tetanus are at historic low rates in the United States. No one has ever studied the efficacy of tetanus toxoid and diphtheria toxoid in a vaccine trial. However, experts infer efficacy from protective antitoxin levels. A complete vaccine series has a clinical efficacy of virtually 100% for tetanus and 97% for diphtheria. A complete series is 3 doses for people 7 years or older and 4 doses for children younger than 7.
Another interesting thing I found is one of the protein carriers that they use in the diphtheria and tetanus vaccines CRM197. Meningococcal oligosaccharides are conjugated to the protein carriers. The study was using mice and how they were affected by the proteins that are used before and after being given meningitis A injections. Here is the link to that study. We will see meningitis again.
The pneumococcal I don’t understand from a medical standpoint. They used no one that was immunocompromised in any trials of those vaccines. This is for medical personnel of the Pfizer drug. Safety and immunogenicity data on Prevnar 20® are not available for individuals in immunocompromised groups and vaccination should be considered on an individual basis. Based on experience with pneumococcal vaccines, individuals with altered immunocompetence may have reduced immune responses to Prevnar 20®.
There are different meningitis vaccines out there and we don’t know which one she got. I looked at Bexsero since that was a vaccine mentioned in the article. It is for meningitis serogroup B. They state the same thing. Some individuals with altered immunocompetence may have reduced immune responses to BEXSERO. Individuals with certain complement deficiencies and individuals receiving treatment that inhibits terminal complement activation (for example, eculizumab) are at increased risk for invasive disease caused by Neisseria meningitidis serogroup B even if they develop antibodies following vaccination with BEXSERO. Here is the link to the clinical formulation. One of the references they use for the antigen fHbp they don’t specify how they are using it in the vaccine. I found a study that talks about the importance of how to use it for it to be effective in humans. You can view it here. One last antigen they put in the vaccine I will give you the definition of. It is NadA. That stands for Neisseria meningitidis. The bacteria that cause meningitis. You can read all about it here.
Now I will talk about the medications. They all require that prescribers must be enrolled in Risk Evaluation and Mitigation Strategy (REMS) program for each drug; counsel patients about the risks, signs, and symptoms of serious infections caused by encapsulated bacteria; provide patients with the REMS educational materials; ensure patients are vaccinated against encapsulated bacteria; prescribe antibacterial drug prophylaxis if patients’ vaccine status is not up to date and treatment must be started urgently; and provide instructions to always carry the Patient Safety Card during treatment and for 2 weeks following the last dose of each of these drugs.
FABHALTA is indicated for the treatment of adults with paroxysmal nocturnal hemoglobinuria (PNH). Here is the prescribing information.
EMPAVELI® (pegcetacoplan) is indicated for the treatment of adult patients with paroxysmal nocturnal hemoglobinuria (PNH). Here is the prescribing information.
ULTOMIRIS is a prescription medicine used to treat:
adults and children 1 month of age and older with a disease called Paroxysmal Nocturnal Hemoglobinuria (PNH).
Here is the prescribing information.
SOLIRIS is a prescription medicine used to treat adults with a disease called neuromyelitis optica spectrum disorder (NMOSD) who are anti-aquaporin-4 (AQP4) antibody positive. Here is the prescribing information.
All of these drugs in the prescribing information are filled with danger, danger. I don’t know the drugs that Alexis is taking. The biggest danger with all of this is from encapsulated bacteria. I will throw in one other thing. A nice little article about meningitis. You can read it here.
Excellent, thank you! I will add this article as an update add-on to my Lorenze articles. This is what I call crowdsourcing information.