Immune and Hematological Responses to the Third Dose of an mRNA COVID-19 Vaccine An Interview with Dr. Yasar Yousafzai, MD, PhD

World View, Local Health Environment and Experiences Shape Health Professionals Questions and Perspectives on Covid-19 Vaccine Implementation, Efficacy and Health Risks… Open Dialogue is Encouraged.


View and Listen to Interview Here: 42:28 min:sec

Yasar Mehmood Yousafzai, MD, PhD
Hematologist/Pathologist
Institute of Pathology and Diagnostic Medicine
Khyber Medical University, Peshawar, Pakistan
yasar.yousafzai@kmu.edu.pk

“Immune and hematologicak responses to the third dose of an mRNA COVID-19 vaccine: a six-month longitudinal study. Front Cell Infect Microbiol. 2025 Jul 10;15:1615227. “

Kirk’s Comment…

I decided to put my commentary at the top of this summary and outline of my interview with Dr. Yasar Yousafzai, MD, PhD, from Pakistan regarding the study he and his colleagues did on a third dose of a Covid-19 vaccine in young adults, this one being the Pfizer mRNA vaccine,
because I had some biases when I first looked at this paper. I have a very negative view of the mRNA Covid-19 vaccine so I was looking for anything that could be possibly negative about the vaccine in this study. Truthfully this study did not show any real “negative” sequelae from the single mRNA vaccine given (Pfizer) in this healthy young population. Only some transient and expected elevations in some inflammatory markers were observed. The real importance of doing this interview for me wasn’t any unique finding of the study. It was realizing that we all have different world views and experiences when looking at Covid 19 vaccine information. The benefit for me was opening my mind up of how an extremely well trained health professional (M.D., PhD) halfway around the world (13 hours ahead of my PST time zone) viewed Covid vaccine use during the pandemic from a different perspective than where I was coming from. And by doing this interview in an open-minded fashion I may have exposed an open and honest physician researcher to look at the Covid 19 mRNA vaccine differently.

Dr. Yousafzai told me he still sees cases of polio. He feels that vaccines are critical for his patient population which comes from his country of Pakistan and neighboring Afghanistan. Vaccines are seen has agents that can save needless death and suffering. Yet he was open to my comment of “What if these populations who are poor had excellent sanitation, pure water and basic whole food nutrition. Would there be a need for such vaccinations? Would there be these polio cases?” (Encourage reading Vaccines: Mythology, Ideology, and Reality, by Peter McCullough, MD and John Leake) He was open to the fact that the spike protein is something he needed to look at in a more in-depth fashion as a potential pathogenic agent that might cause thrombotic/vascular events, accelerated cancer and other side effects even though in this study there wasn’t any findings that were truly remarkable.

In closing I think I made a positive connection with a professional colleague half-way around the world that is open to seeing some of the evidence and sources on vaccine harm not only from the Covid vaccination viewpoint but other vaccines as well without confrontation, but with cooperation and openness. That is why I am so thankful for this interview to have taken place!

Enjoy. I hope you get something from this interview and summary to help your decision making on your own and/or your patient’s health.

P.S. ?? Since China (Chinese Communist Party-CCP) appears not to have used an mRNA Covid 19 vaccine on their people (they used either inactivated Covid 19 virus (Sinovac) or innocuous vector borne delivery of DNA (CanSino) you have to ask the question why? Did they (CCP) know something about the Covid-19 mRNA vaccine technology (Moderna, Pfizer) that they didn’t want their people to be exposed to in mass?? (See Below)

Databases Chronicling Covid Vaccine Adverse Events…

Open VAERS (Vaccine Adverse Events Reporting System) Red Boxes
1) Click on US for U.S. Statistics versus world-wide.
2) All Deaths Reported to VAERS by Year (scroll down page)
3) VAERS Covid Vaccine Reports of Deaths by Days to Onset All-Ages (scrol0 down page)

World Council for Health Covid-19 Vaccine Pharmacovigilance Report

1. Data from Pharmacovigilance Databases about Covid-19 Vaccines and Other Commonly Administered Vaccines and Interventions

This report collates adverse event data on COVID-19 vaccines from the following pharmacovigilance databases:

The World Health Organization (WHO) – VigiAccess

The U.S. Center for Disease Control (CDC) – Vaccine Adverse Events Reporting System (VAERS)

EudraVigilance – European Database of Suspected Adverse Drug Reaction Reports

Medicines & Healthcare products Regulatory Agency – UK Yellow Card Reporting Site

The Covid-19 vaccine adverse event data gathered on each pharmacovigilance database is compared with the adverse event data of similar pharmacological products (other common vaccines) on the same databases when possible.

Detailed Summary of Interview…

In this Staying Healthy Today interview, Kirk Hamilton, PA speaks with Yasar Mehmood Yousafzai, MD, PhD—Professor of Hematology and Director at Khyber Medical University—about his 2025 study published in Frontiers in Cellular and Infection Microbiology titled “Immune and hematologic responses to the third dose of an mRNA COVID-19 vaccine: a six-month longitudinal study.” Dr. Yousafzai explains that his team conducted a prospective study of 68 healthy young adults (ages 20–30) who received a third (Pfizer mRNA) COVID-19 vaccine dose (the first two vaccines prior to this study were were Sinovac and CanSino vaccines), intentionally selecting a uniform, low-comorbidity population to isolate biologic effects without confounding disease variables. The researchers evaluated short-term inflammatory and coagulation markers within 48 hours post-vaccination—including C-reactive protein (CRP), interferon levels, prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer—and found a subtle but consistent transient increase in inflammatory markers along with mild, temporary alterations in coagulation parameters across participants. These changes normalized over time and were not associated with clinical thrombotic events, suggesting a short-lived inflammatory and hematologic response expected after immunization. At six months follow-up there was focused antibody persistence (IgG and IgA against SARS-CoV-2 antigens), demonstrating sustained humoral immune response, though these assays were not spike-protein–specific quantitative tests. Dr. Yousafzai hypothesized that while these physiologic shifts were mild and self-limited in healthy individuals, rare exaggerated responses in susceptible persons (due to genetic predisposition, comorbidities, or immune variability) might help explain infrequent severe adverse events reported in broader populations. The discussion also explored evolving perspectives on COVID-19 severity, natural immunity, vaccine risk-benefit balance over time, and public health ethics, with Dr. Yousafzai noting that as population-level natural immunity increased and disease severity declined, the justification for ongoing broad vaccination campaigns became less compelling outside high-risk groups.

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NOTE: The first two doses of Covid Vaccines used in subjects prior to this study were a combination of either the Sinovac and CanSino vaccines… This study did not use three consecutive mRNA doses of vaccine. Only the last one was an mRNA vaccine from Pfizer.

How The Sinovac Vaccine Works…

The Sinovac vaccine uses an inactivated form of the COVID-19 virus, instead of the mRNA technology that Pfizer and Moderna use. Developed by the Chinese biopharmaceutical company Sinovac Biotech, this vaccine has been approved for use and widely used in countries like China, Indonesia and other South American countries.

How The CanSino Vaccine Works…

  • Viral vector platform (adenovirus-based):
    The vaccine uses a modified (non-replicating) adenovirus type 5 (Ad5) as a vector to carry the DNA — a harmless cold-like virus altered so it cannot reproduce or cause disease. The CanSino vaccine, formally known as Convidicea, is produced by CanSino Biologics Inc. often referred to as CanSinoBIO. Founded in 2009 in Tianjin, China, this biotechnology company specializes in developing and manufacturing vaccines, including mRNA and adenovirus-based platforms.

  • It delivers DNA instructions:
    Inside this vector is DNA that encodes the spike (S) protein of SARS-CoV-2, the part of the virus your immune system learns to recognize.

  • Inside your cells:
    Once injected, the adenovirus enters your cells and delivers the spike gene to the cell’s nucleus. There the DNA is transcribed into mRNA, which is then used by the cell’s machinery to make the spike protein (translation). This is similar in concept to how mRNA vaccines lead to spike protein production, but the delivery method is different.

  • Immune response:
    The cell displays the spike protein on its surface, and your immune system sees it as foreign and builds protective responses (antibodies and T-cells) against it.

Key difference vs. mRNA vaccines

  • mRNA vaccines (like Pfizer-BioNTech [the 3rd dose in this study] and Moderna) contain synthetic mRNA that directly instructs cells to make the spike protein.

  • CanSino’s vaccine uses a viral vector delivering DNA that must first be converted to mRNA within the cell — it does not contain or deliver mRNA itself in the same way.

Summary In Short…

– The CanSino vaccine delivers instructions for a piece of the coronavirus (the spike protein) using a harmless virus carrier.
– Your cells make that spike protein.
– Your immune system learns to fight it without you ever being infected with actual COVID-19.

This is similar in concept to the adenovirus-based vaccines from other manufacturers (like Johnson & Johnson’s), but uses a specific Ad5 vector.

Study Vaccine mRNA Third Dose…

The vaccine used for the third dose was the Pfizer/BioTech mRNA vaccine (Batch/Lot No#36310BA, ex. date 08/2022)

mRNA vaccines work by delivering synthetic mRNA into cells, instructing them to produce the spike protein.

The immune system recognizes this protein as foreign, triggering the production of spike protein antibodies. These antibodies remain in the body to fight the actual virus if exposed later, providing immunity without causing infection.

Key Aspects of How mRNA Vaccines Function:

  • Instructional Mechanism: Instead of using weakened virus components, these vaccines provide genetic instructions (mRNA) for cells to create a specific, foreign protein (spike protein).

  • Immune System Activation: The immune system detects the foreign protein and mounts an immune response, producing antibodies to the spike protein which theoretically reduces infection, transmission and severity of illness.

Study Outline, Clinical Pearls and Action Plan

Immune & Hematologic Responses to a Third mRNA COVID-19 Vaccine Dose:
Six-Month Longitudinal Study in Healthy Young Adults

Study Snapshot…

Design: Prospective longitudinal cohort
Participants: 68 healthy adults (ages 20–30)
Intervention: Third-dose mRNA COVID-19 vaccine (Pfizer)
Focus:

  • Short-term inflammatory and coagulation responses (48-hour window)

  • Six-month antibody persistence

Purpose:
To identify measurable subclinical biologic changes that may help explain rare adverse events observed in large-scale vaccination programs.

Key Findings

1️. Acute Inflammatory Response (Within 48 Hours)

  • Mild CRP elevation

  • Increased interferon signaling

  • Uniform but subtle inflammatory activation across cohort

  • No persistent inflammatory elevation

Interpretation:
Expected innate immune activation following antigen exposure; transient and self-limited.

2️. Coagulation Parameters

  • Mild prolongation of PT and aPTT

  • Slight D-dimer elevation

  • No observed clinical thrombotic events

  • Parameters normalized after acute phase

Interpretation:
Temporary disturbance of coagulation cascade without overt thrombosis in healthy young individuals.

3️. Six-Month Immune Response

  • Sustained IgG and IgA antibodies

  • Demonstrated persistence of humoral immunity

  • No chronic inflammatory signature

Clinical Pearls…

1. Vaccination Produces Measurable Systemic Effects

Even in asymptomatic individuals, laboratory shifts in inflammatory and coagulation markers can occur.

2. Transient Coagulation Changes Do Not Equal Clinical Thrombosis

Lab abnormalities in the acute window normalized and did not translate into events in this cohort.

3. Risk Is Likely Susceptibility-Dependent

Rare severe events may represent amplified responses in individuals with:

  • Endothelial dysfunction

  • Hypercoagulable states

  • Autoimmune predisposition

  • Genetic susceptibility

4. Age & Comorbidity Matter

Findings apply to young, healthy adults — not directly generalizable to:

  • Elderly patients

  • Oncology populations

  • Autoimmune patients

  • Patients with cardiovascular disease

5. Risk–Benefit Is Time-Sensitive

As viral virulence declines and natural immunity rises, the public health and individual risk–benefit balance shifts.

6. Inflammation Is Part of Mechanism

Short-lived inflammation is expected and likely necessary for immune priming.

Clinical Action Plan

1️. Pre-Vaccination Risk Stratification

Evaluate:

  • History of myocarditis/pericarditis

  • Prior thromboembolic events

  • Known thrombophilia

  • Active malignancy

  • Autoimmune disease

  • Chronic inflammatory disorders

  • Immunocompromised state

2️. Patient Counseling

Discuss:

  • Individual risk of severe COVID-19

  • Prior infection and natural immunity

  • Occupational exposure risk

  • Local epidemiology

  • Known short-term immune responses

  • Rare but documented adverse events

Encourage shared decision-making.

3️. Post-Vaccination Monitoring

Routine laboratory monitoring not recommended for low-risk individuals.

Consider labs if symptoms develop:

  • CRP

  • PT/aPTT

  • D-dimer

  • Troponin (if cardiac symptoms)

  • ECG / echocardiogram if clinically indicated

Red flag symptoms:

  • Chest pain

  • Dyspnea

  • Severe headache

  • Unilateral limb swelling

  • Neurologic deficits

4️. Special Populations

Elderly / High-Risk

  • Potential benefit greater?

  • Individualized assessment required

Oncology / Autoimmune

  • Consider baseline inflammatory burden

  • Assess timing relative to immunotherapy or chemotherapy

Prior Vaccine Reaction

  • Would not recommend further vaccination

Limitations of the Study…

  • Small sample size (n=68)

  • Narrow age range

  • No control (unvaccinated) arm

  • No spike-specific quantitative antibody assay

  • No mechanistic endothelial or mitochondrial markers evaluated

Practical Clinical Takeaway…

In this study healthy young adults:

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Kirk Hamilton PA-C
Health Associates Medical Group
3301 Alta Arden, Suite 3
Sacramento, CA 95825
(916) 489-4400 (w)
krhammer@surewest.net
StayingHealthyToday.Substack.com
www.StayingHealthyToday.com
www.HealthyLivingforBusypeople.com
www.KwikerMedical.com

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