Big gap between Pfizer, Moderna vaccines for preventing Covid hospitalizations

https://www.post-gazette.com/news/health/2021/09/18/Big-gap-between-Pfizer-Moderna-vaccines-seen-for-preventing-COVID-19-hospitalizations/stories/202109180045

by bryan0 • 5 years ago

126 117 5 years ago

post-gazette.com

DantesKite• 5 years ago

So Moderna provides better long-term protection than Pfizer huh?

It'll be interesting to see whether even more effective vaccines come out in a few years.

version_five2• 5 years ago

Stupid question, could this come down to the volume of the shot? I understand Moderna is ~3x as much as pfizer volume wise, otherwise I thought the method of action is roughly the same.

bryan04• 5 years ago

Not stupid at all. Yes this is the main theory as to why moderna wanes less than pfizer.

https://www.businessinsider.com/pfizer-lower-dose-moderna-co...

Gibbon13• 5 years ago

Other theory is Moderna has 4 weeks between doses vs 3 for Pfizer.

ayngg• 5 years ago

Among other differences, Moderna dosages had ~3x more mRNA compared to Pfizer (100 v 30 micrograms), and their regime had longer periods between dosages. Apparently rationale for Pfizer doses was to minimize side effects because from their initial testing they did not find a significant increase in antibodies with a higher dosage [1].

[1] https://www.nejm.org/doi/full/10.1056/NEJMoa2027906

Robotbeat3• 5 years ago

Indeed. To some extent, we can use pretty basic principles like the Law of Mass Action (https://en.wikipedia.org/wiki/Law_of_mass_action "In chemistry, the law of mass action is the proposition that the rate of the chemical reaction is directly proportional to the product of the activities or concentrations of the reactants.") to inform our priors on this. We should expect the Moderna one to be both somewhat more effective and have somewhat worse side effects simply due to the higher dose and similar action.

userbinator• 5 years ago

The other question is whether Moderna will also last approximately 3x as long as Pfizer, or if it's a far more nonlinear curve.

BuyMyBitcoins• 5 years ago

This question is being asked from a place of ignorance, why aren’t there inactivated virus vaccines for covid yet? Wouldn’t they be more effective?

(Edit: in the US. It seems like only mRNA is available)

Animats• 5 years ago

Several inactivated virus vaccines exist for COVID-19. SinoVac/CoronaVac.[1] Sputnik-V.[2] Janssen.[3] (The Johnson and Johnson vaccine.) None are as effective as the messenger RNA vaccines at preventing symptomatic illness, although they're pretty good at preventing death.

All three are easier to store and transport than the mRNA vaccines, as well as being one-shot vaccines. There's a political problem - they're seen as inferior vaccines for poor people, at least in the US.

[1] https://en.wikipedia.org/wiki/CoronaVac

[2] https://en.wikipedia.org/wiki/Sputnik_V_COVID-19_vaccine

[3] https://en.wikipedia.org/wiki/Janssen_COVID-19_vaccine

fhdch2• 5 years ago

Sputnik V and Johnson and Johnson are not live or attenuated virus but adenovirus vaccines. They infect the host with a harmless virus that make your cell produce spike protein. They are a fairly new tech.

Also Sputnik V is a two dose vaccine, like Astra Zeneca’s

Spooky232• 5 years ago

It’s unfortunate that went that way. There were supply problems with J&J, and by the time that cleared up, states had mostly built out infrastructure to handle the storage and transport limitations of the RNA vaccines.

One shot is a miracle for vulnerable populations — my dad was a very vulnerable person with limited mobility; the county sheriffs went out and vaccinated him and others. The two shot regimens are also difficult for workers in swing /night shift and other scenarios.

redis_mlc• 5 years ago

Sinovac is considered barely effective, even by WHO, who consider it to be 51% effective, vs. 70+% for Western vaccines. (50% is considered to be ineffective.)

Most countries who have an alternative don't use Sinovac.

Japan reported contamination of Moderna, and recalled a million doses:

https://apnews.com/article/business-health-coronavirus-pande...

armchairhacker• 5 years ago

inferior vaccines for poor people

I thought the vaccines in the US were free, why would the inferior ones be for poor people?

deepnotderp• 5 years ago

JNJ is adenovirus iirc

mdp20213• 5 years ago

(You should edit to correct that, Animats)

Infographics are available at the British Society for Immunology website, Types of vaccines for COVID-19 page (April 2021):

https://www.immunology.org/coronavirus/connect-coronavirus-p...

Which lists:

-- Viral vector vaccines (OAZ; Jannsen; CanSino; Gamaleya)

-- Genetic vaccines (Pfizer; Moderna; CureVac; Inovio)

-- Inactivated vaccines (Sinovac; Sinopharm; Bharat; Shifa; CAMS)

-- Attenuated vaccines (Codagenix)

-- Protein vaccines (Novavax; Sanofi)

danzk• 5 years ago

There's plenty, Sinovac and Sinopharm to name a few. They aren't as effective because a dead virus doesn't trigger the same immune response as the live version. The western vaccines replicate an important piece of the live virus which produces a better immune response.

bryan04• 5 years ago

It looks like there have been a few studies with inactivated SARS-CoV-2 vaccines. It looks like they are effective but I’m not sure if they are expected to be more effective than the current mRNA vaccines:

https://www.nejm.org/doi/full/10.1056/NEJMoa2107715

https://jamanetwork.com/journals/jama/fullarticle/2780562

danielvf• 5 years ago

I think Sinovac is this. (https://en.wikipedia.org/wiki/Sinovac_Biotech)

I think in testing in the west it was less effective at the time than others.

Robotbeat3• 5 years ago

(Speculating here.) What I think might be a good idea is to do both. The mRNA vaccines seem extremely effective at what they do, but there might be benefit in giving the immune system experience with other parts of the virus besides the spike as that may make immune escape a lot harder for the virus to pull off.

mikeytown23• 5 years ago

In general a whole cell vaccine is better as the entire virus gets targeted. I believe the mRNA was done the way it was for calendar speed. Hopefully whole cell vaccines will be approved in the near future as odds are they'll be much better at handling variants.

hilbertseries• 5 years ago

How can we talk in generalities about dead virus vaccines vs mRNA when these are the first ever mRNA vaccines approved? And the current attenuated vaccines are certainly not more effective than the mRNA vaccines.

tiahura• 5 years ago

Why would you expect a vaccine to confer significantly longer lasting immunity than an ordinary infection? What evidence do we have that natural immunity lasts any longer than a year?

jdavis703• 5 years ago

If you’re wary of the mRNA platform the Jansen vaccine is on the adenovirus vector platform and is authorized and available in the US.

dehrmann6• 5 years ago

Isn't it mostly the vector that's different? It's still modified to produce the spike protein, so it's not actually a deactivated coronavirus?

sbassi• 5 years ago

I already have 2 doses of Pfizer, can I get Moderna on top of that?

bryan04• 5 years ago

This is a good question. Are you in the US? I think they are only approving the pfizer boosters right now for those 65+. However people are definitely going into CVS or whatever and say they need to get their first moderna shot…

ghaff• 5 years ago

65+ or immunocompromised. And there’s no proof required of the latter.

But as you say presumably one can go someplace that has no record of them and get a “first” shot of something else.

dehrmann6• 5 years ago

Most (if not all) states aren't requiring an ID, so it's pretty easy. I'm getting suspicious of the Santa Clara county vaccination numbers. I wouldn't be shocked if 5% of people got a third dose.

hnyolo0812218• 5 years ago

I'm in the US and in a very vaccine hesitant and anti-vaccination area (they maybe semantically different but are effectively identical in outcome).

onionisafruit• 5 years ago

Most Americans aren’t going to let an FDA recommendation influence what we put in our bodies. Half of us are taking horse dewormers.

fhdch2• 5 years ago

How old are you that you’re even considering this? You’re unlikely to be posting here and belong to the at-risk demographic.

Also, since you believe the vaccines are valuable (otherwise you wouldn’t want a third), how do you deal with the thought that most of the world hasn't had an opportunity to get a first shot?

numbsafari• 5 years ago

If Covid has validated anything, it’s that if you have the money, anything can be done.

dylan6042• 5 years ago

I'm pretty sure we had plenty of evidence this was the case long before covid-19 was a thing. Wealthy people have better lawyers which affords them to do things like get away with murder, not pay taxes, have better medical care, have better housing, have better education, on and on and on.

jefftk• 5 years ago

Eh, you don't need money: nothing's stopping you from going to a CVS and not disclosing your earlier shots.

anonuser123456• 5 years ago

I think you have this wrong.

I know plenty of rich people that got their shots really early. They didn’t do that using money; they used their creativity. They printed up a fake letterhead for a non-existent medical company and just went for it.

That attitude of ‘just go for it’ has a propensity to make people rich as well.

belltaco• 5 years ago

Complicating things Moderna applied for an authorization with studies for a booster with only 50ug(half the original dosage).

hnyolo0812218• 5 years ago

News was just coming out that Moderna faired better against the Delta variant than Pfizer which I had received back in February. I had an upcoming trip so I decided to go get the Moderna. The CVS pharmacist asked if I had received a Moderna shot before, nope, which is the truth. So I got the first Moderna shot about 3 weeks before my trip, and went ahead and got the 2nd round about 4 days ago.

I would much rather that every dose going un-used somehow find it's way into the arm of someone in the world that would take it and get us that much closer to stopping variants and achieving herd immunity, but that's not the world we live in. Instead doses are being thrown away, and enough people with access to the vaccine are instead insisting on dragging this pandemic out. So I'll take every defense available to me, and all the benefits it incurs to those around me, and not apologize for it (yes, I still wear a mask indoors even after 4 rounds.)

Edit: corrected March to February.

avidphantasm• 5 years ago

Did you have any side effects from the Moderna shots? I did the same thing as you (originally got Pfizer, decided to get a Moderna booster based on Delta efficacy; I have a young child who can’t be vaxxed yet). However, I haven’t yet had the 2nd Moderna dose. I am still debating it. So far I have pushed it out to the recommended 42 day maximum interval in the US. The thing that is keeping me on the fence is that the 1st Moderna booster I got hit me like a truck. I had much more severe fatigue and discomfort (i.e., body aches, maybe chest pain) than with the 2nd Pfizer dose (I had no side effects with the 1st Pfizer). I usually feel like crap for a couple of days after flu shots, so none of this is too alarming to me.

senectus12• 5 years ago

wow, so your "bootser" shot was actually 2 shots?

Wasn't expecting that... or was that because of the carefully asked and answered question about previously having had moderna, and not mentioning the previous pfizer?

ehsankia• 5 years ago

In Canada, many people got Pfizer as first dose and Moderna as 2nd. I'm curious to see the data on that. We also got our 2nd dose 2-4month after the first.

adventured• 5 years ago

Angela Merkel did one Astra dose in April and then one Moderna dose in June. It likely works quite fine. I've yet to see any data showing that mixing vaccines produces a particularly greater risk of a bad outcome.

It did make me wonder why Merkel went with Moderna instead of BioNTech. I would assume she could have easily chosen either. Perhaps because Moderna was thought to be more potent by the June timeframe.

carbine2• 5 years ago

This is what I had, and my one frustration is having such little data to suggest how this regime (mixing mRNA vaccines and long interval between doses) will or won’t perform over time.

dehrmann6• 5 years ago

Hopefully someone's testing this, but I'm really curious if J&J would be better as a booster because it works somewhat differently.

ali92hm• 5 years ago

I got the J&J back in early April which was all I could get my hands on back then(no side effects aside from a sore arm). After seeing its efficacy (specially against the delta variant) I went and got a Pfizer shot in early July which hit me like a truck. Since I was already "fully vaccinated" I delayed the second dose of my Pfizer shot till now (~10 weeks) to maximize the induced immunity. I gotta say the second dose of Pfizer only give me mild side effects for half a day.

roenxi• 5 years ago

Is there somewhere that tracks the number of Pfizer/Moderna/Other vaccines administered in the US?

“That’s the beauty of the emergency use authorization,” said Monto, an epidemiologist at University of Michigan. “It can be changed based on changing data.”

It is pushing 2 years. Although this is technical language, really there should be a move away from the word 'emergency' to talk about what is going on. This is now what business as usual looks like for the next 5 years.

justinator• 5 years ago

I think it's an apt description. "Emergency Use" is different than, "FDA Approved"

Spooky232• 5 years ago

It is not pushing two years. The initial vaccination campaigns began last November in limited quantities.

Israel is the leader here, and has better control of reactionary elements of the population. Their data is pretty solid. Personally, I’d focus on the Israeli reports and ignore hot takes from the US government - between the chaos of the previous POTUS and the stresses of the pandemic, I think the US agencies are hurting.

nradov• 5 years ago

The CDC is putting our solid data and reports. They don't seem to be hurting too badly, and shouldn't be ignored.

atlgator• 5 years ago

There is so much money raining down on CDC that contractors can't keep up on procurements.

refurb• 5 years ago

What? Israel is at 62% fully vaccinated which is quite far behind countries like Canada and Singapore.

A big part of that is the Orthodox population who is choosing not to get vaccinated.

Not sure why you think Israel isn’t dealing with the same issues countries like the US are.

williadc• 5 years ago

Is there somewhere that tracks the number of Pfizer/Moderna/Other vaccines administered in the US?

https://www.nytimes.com/interactive/2020/us/covid-19-vaccine... scroll down slightly to see that Pfizer is administered more, but not vastly more than Moderna.

ipaddr3• 5 years ago

This helps with the future lawsuits.

pkaye• 5 years ago

Yes CDC tracks how much of each vaccine was administered. See bottom of below page.

https://covid.cdc.gov/covid-data-tracker/#vaccinations_vacc-...

Moto7451• 5 years ago

Pfizer’s is officially approved.

https://www.fda.gov/news-events/press-announcements/fda-appr...

thatsamonad• 5 years ago

A couple of things I found interesting from the study:

- The eligible participants in the study tended to be over the age of 65 (Moderna median = 66, Pfizer median = 68)

- The Pfizer cohort (738 eligible participants) was almost twice the size of the Moderna cohort (476 eligible participants)

Would these factors have skewed the results at all? To me it seems like the study strongly indicates a difference for those age 65 and over but not necessarily for younger groups.

There is also still evidence of strong protection from hospitalization and death with both vaccines so I don’t think anyone necessarily needs to be regretting the fact that they got a pair of Pfizer shots at this point.

Source study: https://www.cdc.gov/mmwr/volumes/70/wr/mm7038e1.htm#T1_down

kristofferR3• 5 years ago

It's consistent with basically all non-US research too though, this is just one study out of many with consistent results.

The evidence for Moderna providing a larger immune response due to the 3x dosage and longer intervals between doses isn't really in dispute at this point.

dehrmann6• 5 years ago

due to the 3x dosage and longer intervals between doses

Aren't these just hypotheses? They're very plausible, but I wouldn't go as far as saying the mechanism isn't in dispute. It's the outcome that isn't in dispute.

senectus12• 5 years ago

I wonder how they compare to the AZ vaccine.

pandeiro2• 5 years ago

Wonder of the number and frequency of these 'surprises' has anything to do with them being trialed and authorized in 3-6 months rather than the standard 6-10 years.

wmf• 5 years ago

I'd rather have a vaccine that only lasts 6 months than be dead.

pandeiro2• 5 years ago

COVID IFR for your probable age group: 0.05%

nverno2• 5 years ago

77% still quite a bit better than flu vaccines (40-60) but not nearly as good as some like measles (~97). They basically eradicated polio but that was 99-100% after three doses.

smnrchrds3• 5 years ago

77% is the effectiveness against hospitalization. Effectiveness against infection and transmission tends to be lower. To stop the spread, what matters is effectiveness against transmission. And since there are animal reservoirs for COVID, it will not be eradicated.

nverno2• 5 years ago

So is the 77% comparable to the effectiveness of polio vaccine? Or has the meaning changed. If a lot of these vaccines leave people walking around with no symptoms but still infectious it's a miracle they ever eradicate anything. It's starting to make sense why most diseases are still around actually.

Gibbon13• 5 years ago

What always gets me is how pleased guys like you are when you say this stuff.

dehrmann6• 5 years ago

animal reservoirs

Are there? It might have come from another species, but humans might not interact with it all that often. Other animals can clearly get it, but do we know the R0 for covid in, say, cats?

dzhiurgis• 5 years ago

https://archive.is/xlwtx

Big gap between Pfizer, Moderna vaccines for preventing Covid hospitalizations

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