What Doctors Want You to Know About Choosing a COVID Vaccine in 2024

What Doctors Want You to Know About Choosing a COVID Vaccine in 2024

The new COVID-19 vaccine rolled out across the country last month, giving people access to the most recent versions of the Moderna, Pfizer, and Novavax shots. But, given that you have options, which COVID vaccine is better at protecting you from the Coronavirus?

It’s important to state this up front: There is no vaccine that’s considered the best out of all of them. Instead, there are a few factors to consider with each to help you to make the best decision for yourself.

Meet the experts: William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine; David Diemert, M.D., professor of medicine in the George Washington University School of Medicine & Health Sciences; Donald Dumford III, M.D., an infectious disease specialist at Cleveland Clinic Akron General.

With that in mind, here’s what infectious disease doctors want you to know about the COVID vaccines, plus how to decide which is best for you.

What COVID vaccines are available now?

You probably have some idea of your options when it comes to COVID vaccines, but it never hurts to recap. These are the three vaccines that are currently updated and available for use in the U.S.:

  • Moderna’s Spikevax mRNA vaccine

  • Pfizer-BioNTech’s Comirnaty vaccine

  • Novavax’s NVX-CoV2705 vaccine

Which COVID vaccine is better?

It’s hard to say that one is better than the other. “Antibody studies have shown that the mRNA vaccines tend to produce a more robust immune response,” Donald Dumford III, M.D., an infectious disease specialist at Cleveland Clinic Akron General, says. “However, when we look at efficacy in clinical trials, the mRNA vaccines and protein-based vaccines perform similarly in how many cases of COVID they prevent and hospitalizations/deaths they prevent.”

All three vaccines have similar safety and protection against severe disease, says David Diemert, M.D., professor of medicine in the George Washington University School of Medicine & Health Sciences. “However, some people may prefer getting the Novavax vaccine, as it uses a technology that has been used for several other licensed vaccines for many decades—hepatitis B vaccine, HPV vaccine.”

The Centers for Disease Control and Prevention (CDC) currently recommends that everyone aged 6 months and up get the Moderna or Pfizer COVID-19 vaccines. The Novavax vaccine is authorized by the U.S. Food and Drug Administration (FDA) for use in people aged 12 and older.

How do the vaccines work?

It’s first important to understand how viruses work, says Dr. Dumford. “Viruses cause disease in the body by attaching to and invading a cell, and then using the cell’s own mechanisms to make more virus copies,” he says. “Once the virus has made a bunch of new copies of itself, it kills the cell by bursting out of that cell.”

Pfizer and Moderna

Both are mRNA vaccines, and these work a little differently. They encourage your body to make the spike protein, Dr. Dumford says. The spike protein is what the virus uses to latch onto your cells and infect you. “So, a small piece of genetic material that is the blueprint for the spike protein is injected to the muscle,” he explains. “It then causes your cells to make just the spike protein of the COVID-19 virus and then your body responds by making anti-spike protein antibodies.”

Novovax

“A lot of vaccines will inject a protein directly into your muscle to make your body produce antibodies,” Dr. Dumford says. “This is how the Novavax vaccine works.”

With the Novavax vaccine, “just the spike protein from the COVID-19 virus is injected into the muscle and then the body makes antibodies against that spike protein,” he says. As a result, when your body is later exposed to COVID-19, you have already built a defense against it because your body recognizes the spike protein, Dr. Dumford explains.

How effective are the Pfizer and Moderna COVID vaccines?

There hasn’t been recent data on the effectiveness of these vaccines since they’ve been updated. However, data from clinical trials when the vaccines were first released showed that the Pfizer vaccine was 95% effective at preventing COVID-19, while the Moderna vaccine was 94.1% effective.

Data since then has shown that the vaccines are effective at preventing severe illness and hospitalization, although they won’t necessarily prevent everyone from getting COVID-19, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine.

How effective is the Novavax COVID vaccine?

Studies conducted on the original Novavax vaccine found that it was 90% effective at preventing people from developing the virus and 100% effective at protecting people from severe disease.

It’s important to point out that the Novavax COVID vaccine targets the JN.1 variant of the virus, which is less common now than the KP.2 version targeted by the mRNA versions of the vaccine. However, Novavax says that its updated vaccine can protect against multiple strains of the virus.

Is Novavax better than mRNA?

No, the Novavax vaccine isn’t better than the mRNA COVID vaccines—it’s just different.

“If someone is worried about myocarditis, for example a younger male, they may opt for the Novavax vaccine as it appears to have a lower risk of this rare side effect of the mRNA vaccines,” Dr. Diemert says.

If you have concerns or are unsure of which vaccine to get, Dr. Dumford suggests contacting your primary care physician for guidance. “There are some people that have apprehensions about the mRNA platform as it is looked at as a ‘new’ technology, so I would recommend the Novavax for those people,” he says. “But keep in mind that, while commercially available mRNA vaccines are new, scientists have been studying this technology for the past several decades.”

Overall, Dr. Schaffner recommends getting whatever vaccine is available to you. “Many private providers will have purchased one, which is what one usually does with any kind of vaccine,” he says. “But some pharmacies may have several.”

“Just take the one that’s available to you, because a vaccine delayed is often a vaccine never received,” Dr. Schaffner says.

Which COVID vaccine is safest?

All of the COVID vaccines are considered safe, says Dr. Diemert. “For any vaccine, there will always be the extremely rare risk of allergic reactions, but the three vaccines have similar levels of risk when it comes to this,” he says.

But Dr. Diemert points out that there is a risk of heart muscle inflammation (myocarditis) for the two mRNA vaccines, especially in younger men. “While there have been some rare reports of myocarditis associated with the Novavax vaccine, these were all from outside the U.S. and the FDA has not stated that there is a suspected link between the Novavax vaccine and myocarditis,” he says.

The Novavax vaccine also tends to produce less localized side effects in your arm, as well as “fewer senses of feeling puny the next day,” Dr. Schaffner says. Dr. Dumford agrees. “Mild to moderate side effects such as fever, fatigue, headache, and muscle aches seem to be more common in the mRNA vaccines,” he says.

But Dr. Dumford stresses that “the vaccines are all considered very safe.”

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