Question Number: 247
PDR Number: SQ22-000617
Date Submitted: 21/11/2022
Department or Body: Department of Health
Question 169 Carcinogenicity studies are generally not required under international (ICH) protocols for pharmaceuticals that are administered to patients infrequently (e.g. a few doses per year) or for vaccines or biological medicines. Question 170 Nonclinical studies with the COVID-19 vaccines in laboratory animal species do not indicate potential for causing blood coagulation. Nonclinical toxicology studies were conducted with a single dose or repeated doses of the COVID-19 vaccine in its final clinical formulation as administered to patients. Vaccine doses in the nonclinical studies were very high, up to 200-times the human dose (vaccine dose per kg body weight). These studies did not show any effects of the vaccines on platelets and coagulation parameters (i.e., platelet count/volume/distribution width, prothrombin time, activated partial thromboplastin time) or development of blood clots. The Therapeutic Goods Administration (TGA) continues to monitor national and international data on the risk of blood clots with COVID-19 vaccination. The TGA has not identified a causal link between mRNA vaccines and the formation of blood clots Question 249 mRNA in the Pfizer COVID-19 vaccine is capped at the 5 end using a trinucleotide cap 1 analogue ((m2 7,3?-O)Gppp(m2?-O)ApG) (available at: https://pubmed.ncbi.nlm.nih.gov/32998157/). The SARS-CoV-2 genome, like all other hCoVs, such as SARS-CoV and MERS-CoV, has a m7G-cap structure, m7GpppA1, on the 5? end (available at: https://pubmed.ncbi.nlm.nih.gov/34281608/). 5? capping of mRNA is important in mRNA stability and efficient translation to protein. The slight difference between the 5 capping of the vaccine mRNA and viral genome capping has no impact on the structure and properties of spike protein synthesised from the mRNA. Question 250 Lipid nanoparticles (LNPs) used in COVID-19 vaccines and other pharmaceutical products (e.g. ONPATTRO, a short interfering RNA drug product approved in the USA and EU) are present in a range of sizes depending on the product and the size of the mRNA for example. The biological effect of LNPs of different sizes may differ, but efficacy and safety of the approved COVID-19 mRNA vaccines with LNPs in the specified size range have been demonstrated in nonclinical studies, clinical trials and clinical use. The dose for COVID vaccines is based on antigen and LNP weight and contains a consistent amount of mRNA and LNPs. Question 251 The single-stranded mRNA in COMIRNATY encodes the spike protein of SARS-CoV-2. The reason the theoretical length of the vaccine is larger than the COVID virus is that the sequence of the mRNA was optimized with changes, which does not form a part of the spike protein, to enhance stability and translation efficiency of the vaccine.