COVID-19 vaccine choices – which one should you get?

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There are now three COVID-19 vaccine choices that have been given clearance under Emergency Use Authorization (EUA) in the USA. The one question I keep getting from friends and strangers is – which of the COVID-19 vaccines should they get?

The three vaccines which have the EUA in the USA, from Pfizer, Moderna, and Johnson & Johnson (JNJ), are very safe and very effective, so my simple answer to the question is succinct – get whichever vaccine is available to you. It probably does not matter in the long run which will be better than the other, they all prevent SARS-CoV-2, the virus that causes COVID-19.

All three of the vaccines, plus additional COVID-19 vaccines from AstraZeneca and Novavax (neither of which have submitted EUAs to the FDA as of this date), will be available in the developed world, that is, the European Union, USA, Japan, Canada, Australia, and New Zealand. Each country will have slightly different combinations of these vaccines available, but this discussion should be germane to anyone asking about which to get.

COVID-19 vaccine choices

COVID-19 vaccine choices – technology

The Pfizer and Moderna vaccines are mRNA vaccines that use an mRNA fragment to induce our cells to produce the S-subunit protein (or S-protein or spike) of the SARS-CoV-2 virus. This induces an immune response to the virus.

The JNJ and AstraZeneca vaccines use a recombined adenovirus vector “that carries” the genes for the S-subunit to the cell which will reproduce the protein, then inducing the immune response.

Both adenovirus-based and mRNA vaccines have been investigated for several decades. Despite the myth that these vaccines are some strange new technology that came out of nowhere and have never been tested, nothing could be further from the truth.

Effectiveness

I think this is one area where people are making choices between the COVID-19 vaccines, that one may be better than the other. The Pfizer and Moderna mRNA vaccines have shown about 95% effectiveness in preventing COVID-19 in clinical trials during the summer through autumn of 2020.

On the other hand, the JNJ COVID-19 vaccine has shown somewhat less effectiveness, as low as 50% in some groups. I have read numerous comments that among the choices for a COVID-19 vaccine, they will avoid the JNJ version.

However, the JNJ vaccine showed 100% effectiveness against death and 86% effectiveness against the most severe forms of the disease. Although it may appear at the surface that the vaccine is less effective than the mRNA vaccines from Moderna and Pfizer, the JNJ COVID-19 vaccine is within the statistical range of them. It should not be dismissed as a viable vaccine.

Furthermore, it is difficult to compare one clinical trial to another to determine whether one vaccine is more effective than another. The Moderna and Pfizer COVID-19 vaccines were in clinical trials during the earliest part of the pandemic, whereas the JNJ vaccine underwent clinical trials during the later part of the pandemic where there were more virulent variants of the disease out in the world.

The AstraZeneca vaccine has shown about the same effectiveness as the JNJ vaccine, around 70%, but there may have been a clinical trial design issue that may have had an impact on their calculated effectiveness. Furthermore, like with the JNJ vaccine, it is important to not derive too much by comparing one vaccine clinical trial to another.

Safety

Among COVID-19 vaccine choices, they all appear to be extremely safe. The mRNA vaccines seem to have more minor injection site events compared to the adenovirus vaccines, but again, it’s not appropriate to compare one clinical trial to another.

Despite some of the myths regarding the vaccines killing people, there is no link between the vaccines and real and mythical deaths. During clinical trials, no serious adverse events were linked to the vaccine, and the rates of them were no different than in the placebo group or in the general, unvaccinated population.

However, there is one caveat. There appear to be extremely rare, but serious, allergic reactions to the mRNA vaccines. Apparently, some people may be allergic to one component of the lipid nanoparticles that are used to deliver the mRNA to the cells. Individuals who have a history of serious allergies, especially to polyethylene glycol, should avoid the vaccine or be observed for a while after receiving it.

Other than that one important issue, the safety differences between the COVID-19 vaccines should not have a material impact on your choices between one or the other.

Which is the best of your COVID-19 vaccine choices?

From the aspect of technology, effectiveness, and safety, there are only minor differences – they all work and they are all very safe.

Among the COVID-19 vaccine choices, go for the one that you can get as early as you can. When I qualify (at this rate, I may get mine in 2025, I’m so far down the list), I’ll ask which one I get out of intellectual curiosity, nothing else. Of course, maybe I’ll ask for Big Pharma Shill Bucks™ for telling the world which one I’m getting!



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The Original Skeptical Raptor
Chief Executive Officer at SkepticalRaptor
Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!